Olle Rudolphi

Patient with acute B-cell leukemia of burkitt's type (L3) and marker chromosomes including an (8;14) translocation

A 20-year-old man with acute B-cell leukemia of Burkitts type (L3) presenting unusual début symptoms with jaw involvement is reported. The leukemic cells revealed chromosomal abnormalities including four marker chromosomes [1q+, 6q-, t(8;14)].

Cobalaminopenia in a postindustrial society: minimal incidence, age distribution, and differences by sex

Abstract The aim of this study was to obtain a conservative estimate of the current incidence of low serum cobalamin levels (cobalaminopenia) in a modern, postindustrial region in Sweden. All serum cobalamin determinations made during 1993 in one health care area (Umea) with 131,393 inhabitants were analyzed. These analyses were all performed in a single laboratory; data were available for 6451 serum samples from 5225 patients. Serum cobalamin levels

Controversies around vitamin B12 in Sweden. : Attitudes and values behind clinical decision-making in primary health care 1996

Over a five-year period, 1991-1995, the vitamin B12 market in Sweden increased three-fold, from approximatelyy 2 million U.S. dollars to approximately 6 million U.S. dollars. Most prescriptions, ap ...

Controversies Around Vitamin B12 in Sweden.

Over a five-year period, 1991-1995, the vitamin B12 market in Sweden increased three-fold, from approximately 2 million U.S. dollars to approximately 6 million U.S. dollars. Most prescriptions, approximately 60%, originated from primary health care. The attitudes, values and knowledge of the family physicians/general practitioners were elucidated by a questionnaire study with visuo-analogue opinion scales, evaluating 24 basic statements on problems associated with the management of vitamin B12 deficiency. The questionnaire was sent to a representative sample of 506 family physicians/general practitioners. Response rate was 74%. Dropout analysis supported the view that responders provided a representative sample of Swedish FP/GPs. Analysis of the answers was compatible with the hypothesis that the mentioned increase in Swedish B12 market reflected increased awareness in primary health care about the biochemical, pathophysiological and social problems associated with vitamin B12 deficiency.

Ig-Gene and T-Cell Receptor Gene Rearrangements in a Secondary, Mono-Histiocytic Malignancy

In 1984, a 21-year-old male was diagnosed with an acute lymphoblastic leukemia of pre-B cell type. Treatment with chemotherapy, including alkylating agents and prophylactic radiotherapy to the central nervous system, induced a complete remission. In June 1990, a biopsy from a supraclavicular node revealed a malignancy of mono-histiocytic type with erythrophagocytosis. Soon thereafter bone marrow involvement was found. No remission was achieved and the patient died in December 1990. DNA from bone marrow and lymph node obtained 1990 showed clonal rearrangements of both the immunoglobulin heavy-chain gene and the T-cell receptor gamma chain gene. This unusual case illustrates a typical secondary malignancy proven to be separate from the primary neoplasm judged by morphological appearance, immunophenotype and cytogenetic constitution. Coexistent clonal rearrangements of immunoglobulin and T-cell receptor genes have been reported in acute non-lymphoblastic leukemias and notably in cases expressing TdT, interpreted as a predominant lymphoid commitment of the tumor cells. In the present case, however, the malignant cells had a differentiated phenotype and showed erythrophagocytosis, indicating a more mature mono-histiocytic cell type. However, also CD3 expression was found by immunohistochemistry of frozen sections which might indicate a biphenotypic malignancy.

Myelodysplastic syndromes : a population-based study on transformation and survival

A retrospective analysis was done on 113 patients (median age 73 years) with myelodysplastic syndromes (MDS), consecutively diagnosed at our center during a 10-year period. Patients with refractory anemia (RA) and refractory anemia with ringed sideroblasts (RARS) had significantly longer survival than patients with refractory anemia with excess blasts (RAEB), chronic myelomonocytic leukemia (CMML) or refractory anemia with excess blasts in transformation (RAEB-T). Thirty-seven patients (33%) subsequently developed acute myelogenous leukemia (AML). The percentages of AML transformation for the subgroups were: RA: 26%, RARS: 14%, RAEB: 38%, CMML: 25% and RAEB-T: 69%. A total of 9 patients received high-dose chemotherapy, 7 of them already at the time of MDS diagnosis. Six of the RAEB-T patients entered complete and two partial remission. The median age in the group of RAEB-T patients was significantly lower (62 years) than in the other MDS subgroups. It seems that high-dose chemotherapy, at least in RAEB-T, may induce complete remission and improve survival time.

Gamma Globulin in Urinary Protein in Chronic Pyelonephritis

The concentration of gamma globulin in the urinary protein was on average higher in patients with chronic pyelonephritis than in non-infectious urinary-tract disorders. This confirmed observations by Tidstrom (1961). In the present study 44 patients with chronic pyelonephritis had a mean gamma globulin percentage of 15 ± 6 in the urinary protein. The figure reported by Tidstrom was 19 ± 6. A low concentration of gamma globulin in the urinary protein, however, does not preclude pyelonephritis.A gamma globulin concentration of 15 per cent or more in protein from concentrated night urine with a protein content of at least 0.1 per thousand is an indication of infection. Such readings were found in 55 per cent of patients with chronic pyelonephritis, but in only 10 to 15 per cent of patients with nephrosclerosis, glomerulonephritis, benign proteinuria, hydronephrosis or systemic lupus erythematosus. The test does not help to distinguish between chronic pyelonephritis and urinary-tract infection without verifie...