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Articles by L Johansson
Total Records ( 5 ) for L Johansson
  L Johansson and C. Schmidt

The aim of the present study was to investigate, if increased levels of apoB/apoA-I ratios are associated with future peripheral arterial disease as measured by ankle-brachial index. Increased apoB/apoA-I levels are defined as 0.9, which has been suggested for men, and as 0.63, which has observed to be associated with plaques in the femoral artery. The study was performed in a cohort of initially clinically healthy 58-year-old men living in the city of Göteborg, Sweden.

The group with an apoB/apoA-I ratio ≥0.9 had a significantly increased risk of having PAD during 8.9 years of follow-up than the group below that level (OR: 2.15 CI: 1.21 to 3.82, p < 0.01). When applying the lower apoB/apoA-I cut off, results showed that the group with a level >0.63 had more than a three-fold risk of future PAD compared to the group ≤0.63 (OR: 3.28 CI: 1.14 to 9.40, p < 0.05).

  M Lind , K Boman , L Johansson , T. K Nilsson , A. K Ohlin , L. S Birgander and J. H. Jansson

Background  The major adverse effect of warfarin treatment is hemorrhage. Several risk factors for bleeding complications are also risk factors for thromboembolic events, making the clinical decision to initiate or withhold anticoagulant treatment difficult. Specific markers that solely identify patients at high risk of bleeding would have great clinical impact. This study aimed to test if thrombomodulin (TM) concentrations were associated with bleeding complications, cardiovascular events, or mortality in long-term anticoagulant-treated patients.

Methods  In a longitudinal cohort study we followed up 719 patients receiving warfarin treatment for a mean duration of 4.2 years. All bleeding complications causing hospitalization were registered and classified. Soluble TM antigen (sTM) concentration in plasma was measured with an enzyme-linked immunosorbent assay method.

Results  During the follow-up time, 113 clinically relevant bleeding events and 73 major bleeding events occurred. Increased concentration of sTM was associated with both clinically relevant bleeding and major bleeding events after adjustment for age. In the multivariable models, hazard ratios for the highest tertiles compared with the lowest were 2.29 (95% confidence interval, 1.35-3.89) and 2.33 (95% confidence interval, 1.21-4.48), respectively. No association between sTM concentration and nonfatal ischemic cardiovascular events or all-cause mortality was found.

Conclusions  Increased levels of sTM are associated with bleeding complications during warfarin treatment but not with cardiovascular events or all-cause mortality. Soluble TM antigen concentration has potential as a new specific marker to identify patients at high risk of bleeding during warfarin treatment.

  L Johansson , X Guo , M Waern , S Ostling , D Gustafson , C Bengtsson and I. Skoog

The number of people with dementia has increased dramatically with global ageing. Nevertheless, the pathogeneses of these diseases are not sufficiently understood. The present study aims to analyse the relationship between psychological stress in midlife and the development of dementia in late-life. A representative sample of females (n = 1462) aged 38–60 years were examined in 1968–69 and re-examined in 1974–75, 1980–81, 1992–93 and 2000–03. Psychological stress was rated according to a standardized question in 1968, 1974 and 1980. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders criteria based on information from neuropsychiatric examinations, informant interviews, hospital records and registry data. During the 35-year follow-up, 161 females developed dementia (105 Alzheimer’s disease, 40 vascular dementia and 16 other dementias). We found that the risk of dementia (hazard ratios, 95% confidence intervals) was increased in females reporting frequent/constant stress in 1968 (1.60, 1.10–2.34), in 1974 (1.65, 1.12–2.41) and in 1980 (1.60, 1.01–2.52). Frequent/constant stress reported in 1968 and 1974 was associated with Alzheimer’s disease. Reporting stress at one, two or three examinations was related to a sequentially higher dementia risk. Compared to females reporting no stress, hazard ratios (95% confidence intervals) for incident dementia were 1.10 (0.71–1.71) for females reporting frequent/constant stress at one examination, 1.73 (1.01–2.95) for those reporting stress at two examinations and 2.51 (1.33–4.77) at three examinations. To conclude, we found an association between psychological stress in middle-aged women and development of dementia, especially Alzheimer’s disease. More studies are needed to confirm our findings and to study potential neurobiological mechanisms of these associations.

  J Boson , L Johansson , H Rameback and G. Agren

Semi-empirical methods are often used for efficiency calibrations of in situ gamma-ray spectrometry measurements with high-purity germanium detectors. The intrinsic detector efficiency is experimentally determined for different photon energies and angles of incidence, and a suitable expression for the efficiency is fitted to empirical data. In this work, the combined standard uncertainty of such an efficiency function for two detectors was assessed. The uncertainties in individual efficiency measurements were found to be about 1.9 and 3.1% (with a coverage factor k = 1, i.e. with a confidence interval of about 68%) for the two detectors. The main contributions to these uncertainties were found to originate from uncertainties in source-to-detector distance, source activity and full-energy peak count rate. The standard uncertainties of the fitted functions were found to be somewhat higher than the uncertainty of individual data points, i.e. 5.2 and 8.1% (k = 1). With the introduction of a new expression for the detector efficiency, these uncertainties were reduced to 3.7 and 4.2%, i.e. with up to a factor of two. Note that this work only addresses the uncertainty in the determination of intrinsic detector efficiency.

  I Haggstrom , L Johansson , A Larsson , N Ostlund , J Sorensen and M. Karlsson

Positron emission tomography (PET) is increasingly used for delineation of tumour tissue in, for example, radiotherapy treatment planning. The most common method used is to outline volumes with a certain per cent uptake over background in a static image. However, PET data can also be collected dynamically and analysed by kinetic models, which potentially represent the underlying biology better. In the present study, a three-parameter kinetic model was used for voxel-wise evaluation of 11C-acetate data of head/neck tumours. These parameters which represent the tumour blood volume, the uptake rate and the clearance rate of the tissue were derived for each voxel using a linear regression method and used for segmentation of active tumour tissue. This feasibility study shows that it is possible to segment images based on derived model parameters. There is, however, room for improvements concerning the PET data acquisition, noise reduction and the kinetic modelling. In conclusion, this early study indicates a strong potential of the method even though no ‘true’ tumour volume was available for validation.

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