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  • 1.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    McKenna, Laurence
    The role of cognition in tinnitus2006In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 126, p. 39-43Article in journal (Refereed)
    Abstract [en]

    Conclusions: The role of cognition in tinnitus is difficult to ignore. First, tinnitus is likely to disrupt cognitive functioning, and there are some indications that tinnitus patients have impaired capacity to perform certain cognitive tasks. Second, evidence is emerging that tinnitus patients show cognitive bias in the way they handle information. Such information processing style suggests either depressive functioning, or anxious vigilance, or both. Finally, self-report measures of tinnitus distress all require conscious recollection of how tinnitus is perceived and the consequences of tinnitus. Such reports necessitate cognitive capacity. Objectives: To review the literature on the interface between cognitive function and tinnitus with special regard to the role of different levels of information processing. Materials and methods: A selective systematic literature search was conducted using the search engines of Medline and Psychological Abstracts, and by hand search of conference proceedings. Results: There are yet relatively few published studies on cognitive functioning in tinnitus patients. Most research has been conducted by a few separate research groups. However, the available studies clearly implicate an important role of cognitive processes at different levels from basic cognitive function to more conscious appraisal of the consequences of tinnitus. Finally, a tentative model of the road from tinnitus generation to annoyance via cognitive function is suggested.

  • 2.
    Aschan, Gunnar
    et al.
    Linköping University. Departments of Otolaryngology and Clinical Pharmacology, Regional and University Hospital, Linköping University, Linköping, Sweden.
    Bunnfors, Irja
    Linköping University. Departments of Otolaryngology and Clinical Pharmacology, Regional and University Hospital, Linköping University, Linköping, Sweden.
    Hydén, Dag
    Linköping University. Departments of Otolaryngology and Clinical Pharmacology, Regional and University Hospital, Linköping University, Linköping, Sweden.
    Larsby, Birgitta
    Linköping University. Departments of Otolaryngology and Clinical Pharmacology, Regional and University Hospital, Linköping University, Linköping, Sweden.
    Ödkvist, Lars
    Linköping University. Departments of Otolaryngology and Clinical Pharmacology, Regional and University Hospital, Linköping University, Linköping, Sweden.
    Tham, Richard
    Linköping University. Departments of Otolaryngology and Clinical Pharmacology, Regional and University Hospital, Linköping University, Linköping, Sweden.
    Xylene exposure. Electronystagmografic and gaschromatografic studies in rabbit1977In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 84, no 1-6, p. 370-376Article in journal (Refereed)
    Abstract [en]

    Complaints of vertigo from people who are exposed to industrial solvents have focused interest on their toxic effect on the nervous system. In order to evaluate the influence of an organic solvent, xylene, on the mammalian vestibular system, a series of rabbit experiments were performed. To achieve a constant concentration, the xylene was infused as a lipid emulsion. Blood concentrations were estimated by gas chromatography. Elec-tronystagmography in darkness revealed that at blood xylene concentrations of 30 ppm all rabbits had a positional nystagmus. The beat direction was the opposite of positional alcohol nystagmus. Another difference between the alcohol and the xylene reaction was that rotatory nystagmus responses were exaggerated. The relations between the present findings and the reactions and blood concentrations in people exposed to industrial solvents are discussed.

  • 3.
    Ask, Per
    et al.
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Tibbling, Lita
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    A simple device measuring differences in level in the oesophagus1978In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 85, no 3-4, p. 296-297Article in journal (Other academic)
    Abstract [en]

    A device for measuring the difference in level between the pressure transducer and a point of measurment is described. It can be used in oesophageal manometry with waterfilled catheters to measure and compensate for superimposed hydrostatic pressure. The practical application of the method is illustrated.

  • 4.
    Benson, Mikael
    et al.
    Pediatric Allergy Research Group, Queen Silvia Children's Hospital, Göteborg, Sweden.
    Steenhoff Hov, D. A.
    PubGene, Oslo, Norway.
    Clancy, T.
    PubGene, Oslo, Norway.
    Hovig, E.
    Norwegian Radium Hospital, Oslo, Norway.
    Rudemo, M.
    Chalmers University of Technology, Göteborg, Sweden.
    Cardell, L. O.
    Malmö University Hospital, Sweden.
    Connectivity can be used to identify key genes in DNA microarray data: a study based on gene expression in nasal polyps before and after treatment with glucocorticoids.2007In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 127, no 10, p. 1074-1079Article in journal (Refereed)
    Abstract [en]

    CONCLUSIONS: The presented analysis of nasal polyposis using connectivity based on the PubGene literature co-citation network demonstrates that this tool can be used to identify key genes in DNA microarray studies of human polygenic diseases.

    OBJECTIVES: DNA microarray studies of complex diseases may reveal differential expression of hundreds of genes. According to network theory and studies of yeast cells, genes that are connected with several other genes appear to have key regulatory roles. This study aimed to examine if this principle can be translated to DNA microarray studies of human disease, using nasal polyposis as a base for the analysis.

    MATERIALS AND METHODS: The connectivity of differentially expressed genes from a previously described microarray study of nasal polyposis before and after treatment with glucocorticoids was determined. This was done using the literature co-citation network PubGene.

    RESULTS: In all, 166 genes were differentially expressed; 39 of these were previously defined as inflammatory and considered important for nasal polyposis. The connectivity of all differentially expressed genes was analysed using the PubGene literature co-citation network. Seventy-four of the 166 genes were connected to other genes. By contrast, the average number of connected genes among 100 sets of 166 randomly chosen genes was 31.5. A small number of the differentially expressed genes were highly connected, while most genes had few or no connections. This indicated a scale-free network. The most connected gene was interleukin-8, an inflammatory gene of known importance for nasal polyposis. Twenty-eight of the 74 connected genes were inflammatory (38%), compared with 11 of the 92 unconnected genes (12%), p < 0.0001. Since most evidence suggests that nasal polyps are inflammatory in their nature, this supports the hypothesis that connected genes have more disease relevance than unconnected genes.

  • 5.
    Benson, Mikael
    et al.
    Malmö University Hospital, Sweden.
    Uddman, Rolf
    Malmö University Hospital, Sweden.
    Cardell, Lars Olaf
    Malmö University Hospital, Sweden.
    Epithelial cells in nasal fluids from patients with allergic rhinitis: how do they relate to epidermal growth factor, eosinophils and eosinophil cationic protein?2002In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 122, no 2, p. 202-205Article in journal (Refereed)
    Abstract [en]

    The nasal epithelium protects the underlying tissue from damage. Epithelial cell growth is controlled by epidermal growth factor (EGF) and is possibly affected by toxic proteins, e.g. eosinophil cationic protein (ECP). The aims of this study were to examine nasal fluid epithelial cell counts and their relations to EGF, eosinophils and ECP in 23 patients with seasonal allergic rhinitis and 20 healthy controls. Nasal fluid epithelial cell counts were lower in patients than in controls. EGF levels did not differ between patients and controls, and correlated with epithelial cell counts in controls but not in patients. Eosinophils and ECP were higher in patients than in controls, but did not correlate with epithelial cell counts. The role of growth factors, such as EGF, in regulating epithelial cells merits further study.

  • 6. Borg, Erik
    et al.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Neovius, L.
    Monitoring the environment: Sound localization equipment for deaf-blind people1999In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 2, no 119, p. 146-149Article in journal (Refereed)
  • 7.
    Browaldh, Nanna
    et al.
    Karolinska University Hospital.
    Friberg, Danielle
    Karolinska University Hospital.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Neurophysiology UHL.
    Nerfeldt, Pia
    Karolinska University Hospital.
    15-year efficacy of uvulopalatopharyngoplasty based on objective and subjective data2011In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 131, no 12, p. 1303-1310Article in journal (Refereed)
    Abstract [en]

    Conclusions: This follow-up showed a stable and significant decrease in median oxygen desaturation index 4% (ODI(4)) values over the years. Approximately two-thirds of the patients fulfilled the success criteria (ODI4 reduction of 50% and andlt;20) after 15 years. A majority had improved/cured excessive daytime sleepiness (EDS) and were satisfied. No increased mortality rate was seen. Objectives: To evaluate sleep apnoea recordings and symptoms in patients with obstructive sleep apnoea syndrome 15 years after uvulopalatopharyngoplasty (UPPP) compared to baseline and previous follow-ups. Methods: This was a non-randomized, prospective intervention study on 50 patients who underwent UPPP during 1985-88. Their initial median age was 49 years (range 38-71) and ODI4 was 26.5 (4-82). Results: In all, 13 patients had died; 26 patients underwent sleep apnoea recordings. Median ODI4 had decreased from 26.5 (range 4-82) to 8.5 (0-60), p andlt; 0.01, a mean reduction of 52%; 65% of patients achieved the success criteria. One-third was objectively categorized as non-snorers. Median body mass index was unchanged. The questionnaires were answered by 32 of 37 patients; 88% reported improved or cured EDS and 78% were satisfied. Pharyngeal disturbances ratings were low. The standardized mortality rate did not differ from the general Swedish population.

  • 8.
    Browaldh, Nanna
    et al.
    Karolinska University Hospital.
    Friberg, Danielle
    Karolinska University Hospital.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
    Nerfeldt, Pia
    Karolinska University Hospital.
    Correction: 15-year efficacy of uvulopalatopharyngoplasty based on objective and subjective data (vol 1303–1310, pg 1303, 2011, DOI: 10.3109/00016489.2011.616912)2012In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 132, no 5, p. 570-570Article in journal (Refereed)
    Abstract [en]

    n/a

  • 9. Bunne, M
    et al.
    Falk, B
    Magnusson, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Hellström, S.
    Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Eustachian tube function varies over time in children with secretory otitis media.2000In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 120, p. 716-723Article in journal (Refereed)
  • 10.
    Edfeldt, Lennart
    et al.
    University of Uppsala Hospital, Sweden .
    Stromback, Karin
    University of Uppsala Hospital, Sweden .
    Grendin, Joakim
    Umeå University Hospital, Sweden .
    Bunne, Marie
    Oslo University Hospital, Norway .
    Harder, Henrik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Peebo, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Eeg-Olofsson, Mans
    Sahlgrens University Hospital, Sweden .
    Petersson, Carl-Magnus
    Skåne University Hospital, Sweden .
    Konradsson, Konrad
    University of Uppsala Hospital, Sweden .
    Evaluation of cost-utility in middle ear implantation in the Nordic School: a multicenter study in Sweden and Norway2014In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, no 1, p. 19-25Article in journal (Refereed)
    Abstract [en]

    Conclusion: Hearing restoration using an active middle ear implant (AMEI) is a highly cost-effective treatment for a selected group of patients with no other possibilities for auditory rehabilitation. Objectives: To evaluate the cost-utility of using an AMEI for hearing rehabilitation. Methods: This was a prospective, multicenter, single-subject repeated study in six tertiary referral centers. Twenty-four patients with sensorineural (SNHL), conductive (CHL), and mixed hearing loss (MHL) were implanted with the AMEI Vibrant Soundbridge (R) (VSB) for medical reasons. All patients were previously rehabilitated with conventional hearing aids. Multiple validated quality of life patient questionnaires, Health Utilities Index (HUI 2 and 3), and Glasgow Hearing Aid Benefit Profile (GHABP) were used to determine the utility gain and quality adjusted life years (QALY). Directly related treatment costs for the implantation were calculated and related to utility gain and QALY. Results: The cost/QALY for patients with SNHL was estimated at (sic)7260/QALY, and for patients with C/MHL at (sic)12 503/QALY.

  • 11.
    Farnebo, Lovisa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Laurell, Göran
    Uppsala University, Sweden.
    Makitie, Antti
    University of Helsinki, Finland; Helsinki University Hospital, Finland; Karolinska Institute, Sweden.
    A Nordic survey on the management of head and neck CUP2016In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, no 11, p. 1159-1163Article in journal (Refereed)
    Abstract [en]

    Conclusion: The management of Head and Neck Cancer of Unknown Primary (HNCUP) patients varies both between centres within and also between the Nordic countries. This study contributes to a continuing discussion of how to improve the accuracy of diagnosis and quality of treatment of HNCUP patients.Objectives: The initiative for this study was based on the lack of common guidelines for diagnostic procedures and for treatment of HNCUP patients in the Nordic countries constituting a region having a rather homogeneous population.Method: A structured questionnaire was sent to all university hospitals in the five Nordic countries.Results: Four of the five Nordic countries use either national guidelines or specific protocols when handling HNCUP. The main diagnostic tools are PET-CT, fine needle aspiration, endoscopic evaluation with biopsies, and most often bilateral tonsillectomy. At 21 of 22 university hospitals the treatment decision is made at a multidisciplinary conference. Three of seven Swedish centres use only radiotherapy or chemoradiotherapy to treat N+ HNCUP patients. Robotic surgery for biopsy of the tongue base is beginning to become an alternative to targeted biopsies in Sweden and Finland. Narrow Band Imaging is used only in Finland.

  • 12.
    Fransson, Mattias
    et al.
    Malmö University Hospital, Sweden.
    Benson, Mikael
    Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Wennergren, Göran
    Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Cardell, Lars-Olaf
    Malmö University Hospital, Sweden.
    A role for neutrophils in intermittent allergic rhinitis2004In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 124, no 5, p. 616-620Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: In patients with intermittent allergic rhinitis, allergen challenge may induce both early- and late-phase responses. The aim of this study was to examine the correlation between inflammatory cells in the nasal lavage fluid and clinical parameters following pollen challenge.

    MATERIAL AND METHODS: Nasal lavage fluids were obtained from 29 patients with intermittent allergic rhinitis before and 1 and 6 h after allergen provocation, representing the control, early and late phases, respectively. Symptom and rhinoscopic scores were registered on the same occasions. Inflammatory cells were determined in the nasal fluid.

    RESULTS: The early phase was characterized by increased symptom scores, rhinoscopic signs of oedema and secretion and neutrophilia. In the late phase, symptom scores had diminished, but the signs of ongoing secretion remained. Both the total nasal symptom score and the secretion score correlated with the number of neutrophils in lavage fluids at 1 h. The eosinophil count did not increase during the early or late phases.

    CONCLUSION: A single allergen provocation induces an early-phase response dominated by neutrophils, with secretion being the only clinical sign remaining during the late phase. The increase in neutrophil numbers correlated with the registration of secretory symptoms. The presented data indicate a role for neutrophils in intermittent allergic rhinitis and their relation with secretory parameters makes it intriguing to speculate that neutrophils may function as promoters of nasal secretion.

  • 13.
    Franzen, Thomas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Norrköping.
    Tibbling, Lita Ingrid
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Hagg, Mary Karin
    Hudiksvall Hosp, Sweden.
    Oral neuromuscular training relieves hernia-related dysphagia and GERD symptoms as effectively in obese as in non-obese patients2018In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 138, no 11, p. 1004-1008Article in journal (Refereed)
    Abstract [en]

    Background: Many physicians insist patients lose weight before their hiatal hernia (HH) condition and related symptoms including intermittent esophageal dysphagia (IED) and gastroesophageal reflux disease (GERD) can be treated, but it is not proven that body mass index (BMI) has an impact on exercise-based treatment of HH-related symptoms. Aims/Objectives: To investigate whether BMI has significance on IQoro (R) neuromuscular training (IQNT) effectiveness in treating HH-related symptoms. Material and Methods: Eighty-six patients with sliding HH and enduring IED and GERD symptoms, despite proton pump inhibitor medication, were consecutively referred for 6 months IQNT comprising 11/2 minutes daily. They were grouped by BMI which was recorded before and after IQNT, as were their symptoms of IED, reflux, heartburn, chest pain, globus sensation, non-productive cough, hoarseness, and misdirected swallowing. They were also assessed on food swallowing ability, water swallowing capacity and lip force both before and after treatment. Results: After IQNT, all BMI groups showed significant improvement (p amp;lt; .001) of all assessments and symptoms; and heartburn, cough and misdirected swallowing were significantly more reduced in the severely obese. Conclusions and significance: IQNT can treat HH-related IED and GERD symptoms as successfully in moderately or severely obese patients as in those with normal bodyweight.

  • 14.
    Fridberger, Anders
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Ulfendahl, M.
    Karolinska Institute, Stockholm, Sweden.
    Acute mechanical overstimulation of isolated outer hair cells causes changes in intracellular calcium levels without shape changes1996In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 116, no 1, p. 17-24Article in journal (Refereed)
    Abstract [en]

    Impaired auditory function following acoustic overstimulation, or noise, is mainly reported to be accompanied by cellular changes such as damage to the sensory hair bundles, but changes in the cell bodies of the outer hair cells have also been described. To investigate more closely the immediate cellular responses to overstimulation, isolated guinea pig outer hair cells were subjected to a 200 Hz oscillating water jet producing intense mechanical stimulation. The water jet was aimed at the cell body of the isolated outer hair cell. Cell shape changes were studied using video microscopy, and intracellular calcium concentration changes were monitored by means of the fluorescent calcium indicator Fluo-3. Cells exposed to a high-intensity stimulus showed surprisingly small light-microscopical alterations. The cytoplasmic calcium concentration increased in most cells, although some cells appeared very resistant to the mechanical stress. No correlation could be found be tween the calcium concentration changes and the cell length. The changes in calcium concentration reported here are suggested to be involved in the long-term pathogenesis of noise-induced hair cell damage.

  • 15.
    Fridberger, Anders
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    van Maarseveen, J.
    Rijksuniversiteit Groningen, The Netherlands.
    Ulfendahl, M.
    Karolinska Institutet, Stockholm, Sweden.
    An in vitro model for acoustic overstimulation1998In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 118, no 3, p. 352-361Article in journal (Refereed)
    Abstract [en]

    Although many studies have been performed on the effects of acoustic overstimulation on the inner ear, our knowledge about the cellular processes underlying reduced hearing sensitivity and auditory cell death is still limited. In order to further our understanding of cellular processes occurring in conjunction with acoustic trauma, we designed an in vitro model to study the effects of overstimulation directly on sensory hair cells isolated from the low-frequency part of the guinea pig cochlea. The isolated outer hair cells were subjected to pressure jets delivered by a glass micropipette positioned close to the cell, in order to mimic the pressure changes occurring in the intact inner ear during sound stimulation. A second micropipette coupled to a piezoresistive pressure transducer was used as a probe measuring the pressure at precise locations at and around the cell. In a previous study, we found that such stimulation gave rise to increases in the intracellular calcium concentration. The present study characterizes the stimulus, describes the computer-controlled setup used for calibration, and gives examples of different modes of overstimulation at the cellular level. The peak pressure that could be generated using the pressure jet was around 325 Pa, or 144 dB (re 20 microPa) at 140 Hz. The pressure jet elicited large mechanical vibrations of the cell bodies of isolated cells. The vibration mode of the cells often changed over time, implying that the stimulation caused changes of the cellular stiffness. However, most cells appeared quite resistant to the high intensity mechanical stimulation.

  • 16.
    Fridberger, Anders
    et al.
    Karolinska Institutet / Karolinska University Hospital, Stockholm, Sweden.
    Von Tiedemann, Miriam
    Karolinska Institutet, Stockholm.
    Flock, Åke
    Karolinska Institutet, Stockholm.
    Flock, Britta
    Karolinska Institutet, Stockholm.
    Öfverstedt, Lars-Göran
    Karolinska Institutet, Stockholm.
    Skoglund, Ulf
    Karolinska Institutet, Stockholm.
    Three-dimensional structure of outer hair cell pillars2009In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 129, no 9, p. 940-945Article in journal (Refereed)
    Abstract [en]

    Conclusions. Electron tomography was used to generate three-dimensional reconstructions of the pillars that connect the cell membrane with the cytoskeleton of the outer hair cell. Results are consistent with the hypothesis that pillars are important for mechanically linking the membrane with the cytoskeleton.

    Objective: To make a qualitative assessment of the morphology of the sub-membrane pillars of cochlear outer hair cells.

    Materials and methods. Guinea pig cochleae were fixed and prepared for electron microscopy using protocols described previously. Sections were imaged on an electron microscope equipped with a goniometer. The specimens were tilted through a range of 120°, and an image was acquired at each tilt angle. Filtered back-projection was used to generate three-dimensional reconstructions.

    Results. Twelve individual pillars were successfully reconstructed. Pillars often connect to the cell membrane through a thin segment, and to the cytoskeleton through a forking structure that may form a central cavity.

  • 17. Hafström, Anna
    et al.
    Fransson, Per-Anders
    Karlberg, Mikael
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Magnusson, Måns
    Visual influence on postural control, with and without visual motion feedback2002In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 122, p. 392-397Article in journal (Refereed)
  • 18.
    Hagg, Mary
    et al.
    Hudiksvall Hospital, Sweden; Uppsala University, Sweden.
    Tibbling, Lita
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Linköping University, Department of Clinical and Experimental Medicine.
    Effect of IQoro (R) training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke2016In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, no 7, p. 742-748Article in journal (Refereed)
    Abstract [en]

    Conclusion All patients with dysphagia after stroke have impaired postural control. IQoro (R) screen (IQS) training gives a significant and lasting improvement of postural control running parallel with significant improvement of oropharyngeal motor dysfunction (OPMD). Objectives The present investigation aimed at studying the frequency of impaired postural control in patients with stroke-related dysphagia and if IQS training has any effect on impaired postural control in parallel with effect on OPMD. Method A prospective clinical study was carried out with 26 adult patients with stroke-related dysphagia. The training effect was compared between patients consecutively investigated at two different time periods, the first period with 15 patients included in the study more than half a year after stroke, the second period with 11 patients included within 1 month after stroke. Postural control tests and different oropharyngeal motor tests were performed before and after 3 months of oropharyngeal sensorimotor training with an IQS, and at a late follow-up (median 59 weeks after end of training). Result All patients had impaired postural control at baseline. Significant improvement in postural control and OPMD was observed after the completion of IQS training in both intervention groups. The improvements were still present at the late follow-up.

  • 19.
    Hydén, Dag
    et al.
    Linköping University. Department of Otolaryngology, Linköping University, Sweden.
    Larsby, Birgitta
    Linköping University. Department of Otolaryngology, Linköping University, Sweden.
    Velocity dependence of the vestibulo-ocular reflex over a broad frequency range1991In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 111, no s481, p. 293-294Article in journal (Refereed)
  • 20.
    Hydén, Dag
    et al.
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden).
    Larsby, Birgitta
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden).
    Schwartz, D. W. F.
    University of Toronto, Ontario, Canada.
    Ödkvist, Lars
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden).
    Quantification of slow compensatory eye movements in patients with bilateral vestibular loss: A Study with a Broad Frequency-band Rotatory Test1983In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 96, no 3-4, p. 199-206Article in journal (Refereed)
  • 21.
    Hydén, Dag
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Åkerlind, Britt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Clinical Microbiology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Peebo, Markus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Inner ear and facial nerve complications of acute otitis media with focus on bacteriology and virology2006In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 126, no 5, p. 460-466Article in journal (Refereed)
    Abstract [en]

    Conclusion. Among 20 patients with inner ear complications and/or peripheral facial palsy secondary to acute otitis media (AOM) a proven or probable bacteriological cause was found in 13 (65%). In seven patients (35%), a proven or probable viral cause was found. Only two of the patients (10%), with a proven bacterial AOM and a clinical picture of a purulent labyrinthitis in both, together with a facial palsy in one, had a substantial degree of dysfunction. Although the number of patients in this study is relatively low our findings show that inner ear complications and facial palsy due to AOM can be of both bacterial and viral origin. Severe sequelae were found only where a bacterial origin was proven. Objectives. Inner ear complications and/or peripheral facial palsy secondary to AOM are rare. The general understanding is that they are due to bacterial infections. However, in some of these patients there are no clinical or laboratory signs of bacterial infections and they have negative bacterial cultures. During recent years different viruses have been isolated from the middle ear or serologically proven in AOM patients and are thought to play a pathogenetic role. We suggest that in some cases of AOM complications from the inner ear and the facial nerve can be caused by viruses. The purpose of our study was to analyze infectious agents present in patients with inner ear complications and/or facial palsy arising from AOM. Patients and methods. The medical records of 20 patients who had inner ear complications and/or facial palsy following AOM (unilateral in 18, bilateral in 2) between January 1989 and March 2003 were evaluated. Bacterial cultures were carried out for all patients. Sera from 12 of the patients were stored and tested for a battery of specific viral antibodies. In three patients, investigated between November 2002 and March 2003, viral cultures were also performed on samples from the middle ear and nasopharynx. Results. Nineteen patients had inner ear symptoms. Eight of them had a unilateral sensorineural hearing loss and vertigo, three had vertigo as an isolated symptom and one, with bilateral AOM, had bilateral sensorineural hearing loss. Seven patients had a combination of facial palsy and inner ear symptoms (unilateral sensorineural hearing loss in three, unilateral sensorineural hearing loss and vertigo in two, bilateral sensorineural hearing loss and vertigo in one, with bilateral AOM, and vertigo alone in one). One patient had an isolated facial palsy. Healing was complete in 11 of the 20 patients. In seven patients a minor defect remained at follow-up (a sensorineural hearing loss at higher frequencies in all). Only two patients had obvious defects (a pronounced hearing loss in combination with a moderate to severe facial palsy (House-Brackman grade 4) in one, distinct vestibular symptoms and a total caloric loss in combination with a high-frequency loss in the other. Eight patients had positive bacteriological cultures from middle ear contents: Streptococcus pneumoniae in two, beta-hemolytic Streptococcus group A in two, beta-hemolytic Streptococcus group A together with Staphylococcus aureus in one, Staph. aureus alone in one and coagulase-negative staphylococci (interpreted as pathogens) in two. In the 12 patients with negative cultures, there was a probable bacteriological cause due to the outcome in SR/CRP and leukocyte count in five. In four patients serological testing showed a concomitant viral infection that was interpreted to be the cause (varicella zoster virus in two, herpes simplex virus in one and adenovirus in one.) In three there was a probable viral cause despite negative viral antibody test due to normal outcome in SR/CRP, normal leukocyte count, serous fluid at myringotomy and a relatively short pre-complication antibiotic treatment period. © 2006 Taylor & Francis.

  • 22.
    Hägg, Mary
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Hudiksvall, Uppsala University/County Council of Gävleborg, Gävle, Uppsala, Sweden.
    Tibbling, Lita
    Hudiksvall, Uppsala University/County Council of Gävleborg, Gävle, Uppsala, Sweden.
    Effect of oral IQoro(R) and palatal plate training in post-stroke, four-quadrant facial dysfunction and dysphagia: A comparison study2015In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 9, p. 962-968Article in journal (Refereed)
    Abstract [en]

    Conclusion: Training with either a palatal plate (PP) or an oral IQoro(R) screen (IQS) in patients with longstanding facial dysfunction and dysphagia after stroke can significantly improve facial activity (FA) in all four facial quadrants as well as swallowing capacity (SC). Improvements remained at late follow-up. The training modalities did not significantly differ in ameliorating facial dysfunction and dysphagia in these patients. However, IQS training has practical and economic advantages over PP training. Objectives: This study compared PP and oral IQS training in terms of (i) effect on four-quadrant facial dysfunction and dysphagia after a first-ever stroke, and (ii) whether the training effect persisted at late follow-up. Methods: Patients were included during two periods; 13 patients in 2005-2008 trained with a PP, while 18 patients in 2009-2012 trained with an IQS. Four-quadrant facial dysfunction was assessed with an FA test and swallowing dysfunction with a SC test: before and after a 3-month training period and at late follow-up. FA and SC significantly improved (p less than 0.001) in both groups. FA test scores after training and at late follow-up did not differ significantly between the groups, irrespective of whether the interval between stroke incidence and the start of training was long or short.

  • 23.
    Hägg, Mary
    et al.
    Hudiksvall Hospital, Sweden; Uppsala University, Sweden.
    Tibbling, Lita
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Franzen, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Norrköping.
    Effect of IQoro(R) training in hiatal hernia patients with misdirected swallowing and esophageal retention symptoms2015In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 7, p. 635-639Article, review/survey (Refereed)
    Abstract [en]

    Conclusion: Misdirected swallowing can be triggered by esophageal retention and hiatal incompetence. The results show that oral IQoro(R) screen (IQS) training improves misdirected swallowing, hoarseness, cough, esophageal retention, and globus symptoms in patients with hiatal hernia. Objectives: The present study investigated whether muscle training with an IQS influences symptoms of misdirected swallowing and esophageal retention in patients with hiatal hernia. Methods: A total of 28 adult patients with hiatal hernia suffering from misdirected swallowing and esophageal retention symptoms for more than 1 year before entry to the study were evaluated before and after training with an IQS. The patients had to fill out a questionnaire regarding symptoms of misdirected swallowing, hoarseness, cough, esophageal retention, and suprasternal globus, which were scored from 0-3, and a VAS on the ability to swallow food. The effect of IQS traction on diaphragmatic hiatus (DH) pressure was recorded in 12 patients with hiatal hernia using high resolution manometry (HRM). Results: Upon entry into the study, misdirected swallowing, globus sensation, and esophageal retention symptoms were present in all 28 patients, hoarseness in 79%, and cough in 86%. Significant improvement was found for all symptoms after oral IQS training (p less than 0.001). Traction with an IQS resulted in a 65 mmHg increase in the mean HRM pressure of the DH.

  • 24.
    Kammerlind, Ann-Sofi
    et al.
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Skargren, Elisabeth
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ödkvist, Lars
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Long-term follow-up after acute unilateral vestibular loss and comparison between subjects with and without remaining symptoms2005In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 125, no 9, p. 946-953Article in journal (Refereed)
    Abstract [en]

    Conclusions. About half of the subjects in this study reported remaining symptoms 3–6 years after acute unilateral vestibular loss. Differences could be seen between subjects with and without remaining symptoms regarding health-related quality of life, anxiety and depression.

    Objective. To evaluate the presence of self-rated remaining symptoms 3–6 years after acute unilateral vestibular loss, and to compare subjects with and without such symptoms.

    Material and methods. Firstly, 51 subjects answered a questionnaire which included the EuroQol EQ-5D, the Hospital Anxiety and Depression Scale, the University of California Los Angeles Dizziness Questionnaire, visual analogue scales and the Dizziness Handicap Inventory. Secondly, nine subjects with and nine without remaining symptoms participated in an extended testing procedure, including electronystagmography (ENG), determination of vestibular-evoked myogenic potentials (VEMPs) and clinical balance tests.

    Results. In the first part of the study, 27 subjects reported remaining symptoms, 3 reported 1 additional period of symptoms and 21 had not experienced any symptoms at all in the 3–6 years since acute unilateral vestibular loss. In the second part, the group with remaining symptoms rated a lower health-related quality of life and a higher level of anxiety and depression. There were no differences between the two groups in terms of ENG tests, VEMPs or clinical balance tests.

  • 25. Kogler, A.
    et al.
    Lindfors, J.
    Ödkvist, Lars
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Postural stability using different neck positions in normal subjects and patients with neck trauma2000In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 120, no 2, p. 151-155Article in journal (Refereed)
    Abstract [en]

    Subjects with neck problems, such as whiplash injuries, often complain of disturbed equilibrium and, in some instances, provocation of the neck position can elicit such problems. The importance of neck proprioceptors for maintaining balance is gaining increased interest, moreover the function or malfunction of the otoliths may disturb equilibrium in certain head positions. The aim of the study was to create a reference material for postural control and its dependence on head position in healthy subjects and to compare this with a set of patients with known neck problems and associated vertiginous problems. A total of 32 healthy subjects (16 men, 16 women, age range 21-58 years) as well as 10 patients age range 27-62 years (mean 44 years) with neck problems and associated balance problems since a whiplash injury were tested for postural control using the EquiTest dynamic posturographic model. The normal subjects were initially split into four age groups in order to estimate the effects of age on performance. The postural stability was evaluated for dependence of support surface conditions (stable or sway-referenced), visual input (eyes open or closed) and head position (neutral, left rotated, right rotated, extended backwards or flexed forward) using analysis of variance (ANOVA) with Tukey's post hoc test in case of a significant factor effect. As expected, visual cues as well as stable support surface improve postural stability (p < 0.001). Postural stability is statistically different in the head extended backwards condition compared with the other four head positions (p < 0.001 in all cases) in both patients and controls. Eliminating this test condition from the analysis, only a slight (p < 0.05) difference between head forwards and head turned left remained. This pattern of results remained if the normal subjects were only split into two age groups instead of four. Finally, the patient group exhibited significantly lower postural performance than all the groups of normal subjects (p < 0.01), but none of the normal groups differed significantly from each other. It is concluded that the postural control system is significantly challenged in the head extended backwards condition in both normal subjects and patients with previous whiplash injury and persistent neck problems. The patient group differed statistically from all groups of normal subjects. This suggests that neck problems impair postural control, and that the head extended position is a more challenging task for the postural system to adapt to. Whether this is due to utricular malpositioning, central integrative functions or cervical proprioceptive afferents is not within the scope of this study to answer. ⌐ 2000 Taylor & Francis.

  • 26.
    Larsby, Birgitta
    et al.
    Linköping University. Department of Oto-Rhino-Laryngology, Linköping University, Linköping, Sweden.
    Hydén, Dag
    Linköping University. Department of Oto-Rhino-Laryngology, Linköping University, Linköping, Sweden.
    Ödkvist, Lars
    Linköping University. Department of Oto-Rhino-Laryngology, Linköping University, Linköping, Sweden.
    Gain and phase characteristics of compensatory eye movements in light and darkness: A study with a broad frequency-band rotatory test1984In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 97, no 3-4, p. 223-232Article in journal (Refereed)
    Abstract [en]

    Thirteen normal subjects were investigated with a broad frequency-band (up to 4.5 Hz) rotatory test. The vestibular stimulation consisted of either a pseudo-random or a sinusoidal frequency sweep oscillation. Eye movements were recorded by EOG. Head movements were recorded either by a potentiometer attached to the chairs axis of rotation or by an angular rate sensor attached to a biteboard. Gain and phase values between eye and head movements were calculated. Measurements were performed in light and darkness during the execution of various fixation tasks. In the higher frequency range there was a difference in gain and phase between potentiometer and rate sensor measurements due to movement of the head relative to the headholder. Visual suppression, in agreement with earlier studies, was more effective during a sinusoidal stimulation than during a pseudorandom stimulation at low frequencies, using the more precise rate sensor measurement technique. Different instructions in the dark could alter the gain values at lower frequencies (up to 2 Hz) during sinusoidal stimulation. During pseudo-random stimulation no such differences could be elicited. Under all test conditions with the rate sensor, the gain values approached unity at about 3 Hz.

  • 27.
    Larsby, Birgitta
    et al.
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Tham, Richard
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Eriksson, Birgitta
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Hydén, Dag
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Ödkvist, Lars
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Liedgren, Christer
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Bunnfors, Irja
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Effects of Trichloroethylene on the human vestibulo-oculomotor system1986In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 101, no 3-4, p. 193-199Article in journal (Refereed)
    Abstract [en]

    Ten healthy volunteers were subjected to a vestibulo-oculomotor test battery before, during and 1 hour after trichloroethylene exposure. The concentration of trichloroethylene in in-spiratory air was 32–78 ppm (176429 mg/m3). The concentration of trichloroethylene in venous blood was followed throughout the experiment. The mean pulmonary uptake was estimated. Each test person was also subjected to a control experiment, breathing air free of trichloroethylene. A decreased ability to visually suppress the vestibulo-oculomotor reflex during sinusoidal stimulation was noticed during trichloroethylene exposure. One hour after exposure the test subjects showed a decreased maximum velocity of the voluntary saccade and a decreased ability to follow a sinusoidally moving target.

     

  • 28.
    Larsby, Birgitta
    et al.
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Tham, Richard
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Eriksson, Birgitta
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Ödkvist, Lars
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    The effect of toluene on the vestibulo- and opto-oculomotor system in rats: A computerized nystagmographic study1986In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 101, no 5-6, p. 422-428Article in journal (Refereed)
    Abstract [en]

    The short-term effect of exposure to toluene on the vestibulo- and opto-oculomotor system in rats was investigated. Stimulation of the vestibulo- and opto-oculomotor system was either a constant rotatory acceleration, a sinusoidal oscillation, a randomized oscillation or an optokinetic stimulation. Eye movements in response to the different stimulations were recorded by EOG and fed into a computer for analysis. Due to toluene exposure the slow phase velocity gain during constant acceleration increased and the post-acceleratory nystagmus response was prolonged. The optokinetic gain at stimulation velocities above 10 deg/sec decreased during toluene exposure. Toluene also prolonged the duration of optokinetic after-and after-afternystagmus. The findings in this study strongly suggest an effect of toluene on the cerebellum.

     

  • 29.
    Larsby, Birgitta
    et al.
    Linköping University. Department of Otolaryngology, University Hospital, Linkoping, Sweden.
    Thell, Jan
    Östergötlands Läns Landsting. Department of Otolaryngology, University Hospital, Linkoping, Sweden.
    Möller, Claes
    Östergötlands Läns Landsting. Department of Otolaryngology, University Hospital, Linkoping, Sweden.
    Ödkvist, Lars
    Linköping University. Department of Otolaryngology, University Hospital, Linkoping, Sweden.
    The effect of stimulus predictability and age on human tracking eye movements1988In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 105, p. 21-30Article in journal (Refereed)
    Abstract [en]

    Human tracking eye movements were recorded in healthy volunteers of varying age. The target motion was either predictable (pure sinusoids or sinusoidal frequency sweep) or unpredictable (pseudorandomized). Gain and phase values for the tracking and the smooth pursuit eye movement signal were calculated as a function of target frequency from 0.2 to 2 Hz. Max. target velocity was 20 or 40 deg/sec. In the low frequency area the smooth pursuit gain for predictable stimulation was higher than the gain elicited by the pseudorandomized stimulation. In the high-frequency area, gain values did not differ significantly. For the predictable stimulation, the phase of the smooth component was always a lag, increasing with increasing frequency. At low frequencies of the pseudorandomized signal a phase lead was observed. At higher frequencies the lead turned into a lag that was greater than for the predictable stimulation. The young and old groups showed reduced smooth pursuit gain values, compared with the main group specially when the target waveform was pseudorandomized. The reduced smooth pursuit ability was mostly compensated for by an increased amount of saccades.

  • 30.
    Ledin, Torbjörn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Hafström, A
    Lun.
    Fransson, P.A
    Lund.
    Magnusson, M
    Lund.
    Influence of neck proprioception on vibration-induced postural sway2003In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 123, no 5, p. 594-599Article in journal (Refereed)
    Abstract [en]

    Objective - Several reports have shown that the direction of the postural responses induced by vestibular stimulation is affected by the positions of the neck and torso. The aim of this study was to investigate whether the postural responses to vibratory proprioceptive stimulation of the calf muscles are affected by the position of the head and thus by proprioceptive and vestibular information from the neck and head. Material and Methods - Ten normal subjects were exposed to vibratory proprioceptive stimulation of the calf muscles when the head was maintained in five different positions: in a neutral position facing forwards, with the head turned to the right or left sides or with the head tilted backwards or forwards. Body movements were evaluated by analyzing the anteroposterior and lateral torques induced towards the supporting surface. Results - The analysis showed that only the anteroposterior body sway was significantly affected by the position of the head. The anteroposterior postural responses were primarily increased during the tests with the head tilted backwards or forwards, whereas the postural responses were unaffected by head torsion towards the sides. The lateral responses were primarily affected by vision and not by the position of the head. Conclusions - The findings suggest that the responses evoked by vibratory proprioceptive stimulation of the calf muscles may be affected by different mechanisms, either by purely proprioceptive information or by an interaction between proprioceptive and vestibular information. Moreover, the increasing difference between the test conditions over time suggests that fatigue of the neck muscles may be one of the factors affecting the responses induced by the perturbations.

  • 31. Loord, Helena
    et al.
    Hultcrantz, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Positioner-a method for preventing sleep apnea2007In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 127, no 8, p. 861-868Article in journal (Refereed)
    Abstract [en]

    Conclusions. A 'Positioner' preventing sleeping on the back can effectively reduce obstructive sleep apnea (OSA), but not always snoring for patients with long-term OSA. By preference, the device should be used for younger snorers without OSA as a training tool to avoid sleeping on the back. Instructions and support by a nurse are necessary for compliance. Objectives. Snoring is a progressive condition with a prevalence of 25-30% among the adult male population. Long-term snoring seems to be the basis for apneas caused by vibration damage to the pharyngeal tissue. Patients with OSA often have more apneas in the supine position than in the lateral position. Preventing sleeping on the back is a way to treat OSA. The aim of this study was to evaluate the efficacy and comfort of a recently developed Positioner. Subjects and methods. A total of 23 patients diagnosed with positional sleep apnea (AHI>15 in supine position and AHI<5 in lateral position), were included. The Positioner - a soft vest, attached to a board placed under the pillow, makes it impossible for the patient to sleep on his back. It was fitted and tried out individually. Patients answered sleep questionnaires and kept sleep diaries before beginning use. After 3 months, a new sleep study was done while using the Positioner and new questionnaires were filled out. Results. Eighteen patients (5 women and 13 men) completed the study. The rest could not tolerate being strapped into the Positioner. Of those participating, 61% demonstrated a decrease of AHI to<10 using the Positioner. The Epworth Sleepiness Scale (ESS) decreased from a mean of 12.3 to 10.2. Half of the patients snored more frequently with the Positioner. The evaluation of comfort showed that minor adjustments are desirable. © 2007 Taylor & Francis.

  • 32.
    Lundquist, Per-Gotthard
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Andersson, Rolf
    Effect of carbon dioxide on cochlear blood flow in guinea pigs2000In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 120, no 1, p. 11-18Article in journal (Refereed)
    Abstract [en]

    The influence of carbon dioxide (CO2) on cochlear blood flow (CBF), blood pressure (SBP) and skin blood flow (SBF) was studied in anaesthetized guinea pigs. A transient acute respiratory acidosis was produced by inhalation of CO2 and oxygen (O2) gas mixtures. The blood flows were measured by laser Doppler flowmetry (LDF). High CO2 increased CBF and SBP, and decreased SBF in a dose-dependent manner. The responses of CBF, SBP and SBF to high CO2 were reversible. Our results indicate that high CO2 (and low pH) dilates the smooth muscle of the blood vessels, resulting in an increase in CBF. CO2 also activates the sympathetic nervous system in the whole body, producing an increase in SBP. The distribution of alpha- adrenergic fibres/receptors is abundant in skin and scarce in the cochlea. The constrictive effect on blood vessels is much greater in the skin than in the cochlea, thus our results showed a decrease in SBF during stimulation with higher CO2.

  • 33.
    Mjönes, Anna-Britta
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Ledin, Torbjörn
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Tibbling Grahn, Lita
    Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: gastromed.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences.
    Hoarseness and misdirected swallowing before and after antirefluxsurgery2005In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 125, no 1, p. 82-85Article in journal (Refereed)
    Abstract [en]

    Conclusion Patients with hiatus hernia can be relieved from H, MSL and MSN by hiatus hernia repair.

    Objective It has been hypothesized that respiratory symptoms in patients with gastro-oesophageal reflux disease (GORD) may, in some cases, be due to misdirected swallowing as a consequence of defective opening of the upper oesophageal sphincter. The aim of this study was to investigate whether patients with hiatus hernia are relieved from symptoms of misdirected swallowing to the larynx (MSL) and nose (MSN), as well as hoarseness (H), as a result of hiatus hernia repair.

    Material and methods A questionnaire concerning symptoms of H, MSL and MSN was administered to 90 patients under investigation for hiatus hernia repair before and after surgery.

    Results Before surgery, MSL occurred in 30% of patients, MSN in 30% and H in 25%. These symptoms were significantly interrelated (p<0.008). After antireflux surgery, all symptoms were significantly reduced (p<0.001). Symptom reduction was not related to the weight of the patients.

  • 34.
    Möller, Claes
    et al.
    Östergötlands Läns Landsting. Department of Otolaryngology and Head and Neck Surgery, University Hospital, Linköping, Sweden.
    Ödkvist, Lars
    Linköping University. Department of Otolaryngology and Head and Neck Surgery, University Hospital, Linköping, Sweden.
    Thell, Jan
    Östergötlands Läns Landsting. Department of Otolaryngology and Head and Neck Surgery, University Hospital, Linköping, Sweden.
    Larsby, Birgitta
    Linköping University. Department of Otolaryngology and Head and Neck Surgery, University Hospital, Linköping, Sweden.
    Hydén, Dag
    Linköping University. Department of Otolaryngology and Head and Neck Surgery, University Hospital, Linköping, Sweden.
    Bergholtz, Lars
    Östergötlands Läns Landsting. Department of Otolaryngology and Head and Neck Surgery, University Hospital, Linköping, Sweden.
    Otoneurological findings in psycho-organic syndrome caused by industrial solvent exposure1989In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 107, no 1-2, p. 5-12Article in journal (Refereed)
    Abstract [en]

    Nine subjects with long-term (8-30 years) occupational exposure to industrial solvents and a confirmed diagnosis of psycho-organic syndrome (POS) have been studied with audiological and otoneurological test batteries. The results were compared to a matched control group of nine industrial workers not exposed to solvents and to normal data from healthy volunteers. In the clinical examination, the Romberg test identified 5/9 workers as pathologic and concurrently the stabilometry showed significantly larger sway areas in the POS-group. In the audiological test battery, the significantly pathologic tests were discrimination of interrupted speech and evoked cortical responses to frequency glides (CRA-delta-f). The saccade test disclosed abnormal findings in 5/9 workers. In the smooth pursuit test, abnormality was found at some test frequencies using pseudorandomized stimulus. The VOR-suppression test was significantly abnormal at all test frequencies. The test battery used strongly indicates CNS lesions due to industrial solvents.

  • 35. Nordgård, S
    et al.
    Franzén, G
    Boysen, M.
    Tytor, Maria
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    DNA Analysis of mailgnant salivary gland carcinomas: Comparison of different tissue preparations and measuring techniques.1999In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 119, p. 510-515Article in journal (Refereed)
  • 36.
    Nosrati-Zarenoe, Ramesh
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Arlinger, Stig
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Idiopathic sudden sensorineural hearing loss: results drawn from the Swedish national database2007In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 127, no 11, p. 1168-1175Article in journal (Refereed)
    Abstract [en]

    A national database was developed in Linköping by the authors to gather data from patients with Sudden Sensorineural Hearing Loss (SSNHL). A form was used for data collection covering background, current disease, examinations and treatment. Audiograms at the onset of SSNHL and after three months are analyzed. The aim of the study was to investigate the treatment policy of SSNHL in Sweden, the effect of treatments on outcome, and which variables are of value in predicting the outcome.

    Out of the first 300 patients reported to the database 208 patients were considered to have idiopathic SSNHL. 50% were treated with corticosteroids, 44% did not receive any treatment. The treated patients had the same outcome as the non-treated patients. The time interval from onset of SSNHL to start of treatment was of importance for the outcome irrespective of type of audiogram or results from laboratory tests. Higher age and heredity for hearing loss gave significant lower chance for improvement.

    The first results from 300 patients in the national database demonstrate that corticosteroids or “no treatment at all” are the treatment options in use today. No significant difference in outcome was seen between treated and non-treated patients. Since spontaneous recovery might be the cause, a placebo-controlled randomized study is required before a positive effect of corticosteroids can be asserted.

  • 37.
    Nylén, Per
    et al.
    National Institute of Occupational Health, Solna, Sweden.
    Larsby, Birgitta
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Johnsson, Ann-Christin
    National Institute of Occupational Health, Solna, Sweden.
    Eriksson, Birgitta
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Höglund, Gunnar
    National Institute of Occupational Health, Solna, Sweden.
    Tham, Richard
    Linköping University. Department of Otolaryngology, University Hospital, Linköping, Sweden.
    Vestibular-oculomotor, opto-oculomotor and visual function in the rat after long-term inhalation exposure to toluene1991In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 111, no 1, p. 36-43Article in journal (Refereed)
    Abstract [en]

    Pigmented rats were exposed to toluene (1000 ppm, 21 h/day) for 6 or 11 weeks. The function of the vestibulo- and opto-oculomotor systems was tested one month after the end of the exposure by recording of nystagmus, induced by vestibular or optokinetic stimuli. The eye movements were recorded by a magnetic search coil technique. The optokinetic gain in the exposed animals was reduced compared to a control group. There was also a slight reduction in gain during sinusoidal oscillatory vestibular stimulation. No effect of the toluene exposure on the gain or duration of nystagmus during acceleratory or deceleratory rotatory stimulation was demonstrated, nor was there any change in the duration of the optokinetic after-nystagmus. The function of the visual system was tested 2 to 5 days after exposure by recording the electroretinogram and the visual evoked response. The conduction velocity in peripheral nerve was also measured. No effect of the toluene exposure on these variables was seen. The results indicate that long-term inhalation of toluene causes a long-lasting, possibly permanent, lesion within the vestibulo-cerebellum. They gave no evidence that such exposure affects peripheral vestibular or visual function.

  • 38.
    Qiu, Jianxin
    et al.
    Karlinska Hospital, Stockholm, Sweden.
    Olivius, Petri
    Karlinska Hospital, Stockholm, Sweden.
    Tong, Bushen
    Karlinska Hospital, Stockholm, Sweden.
    Borg, Erik
    Örebro University, Sweden.
    Duan, Maoli
    Karlinska Hospital, Stockholm, Sweden.
    Ventral approach to rat inner ear preserves cochlear function2007In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 127, no 3, p. 240-243Article in journal (Refereed)
    Abstract [en]

    CONCLUSION:

    This technique enabled us to visualize the cochlea without causing damage.

    OBJECTIVE:

    The mammalian inner ear is difficult to approach surgically. This is particularly true in the cases of the rat and mouse, which both have small cochleae. Rat and mouse research is particularly important because their genomes are well characterized, and significantly similar to that of the human. The aim of the present study was to develop a method of accessing the rat cochlea without affecting its function.

    MATERIALS AND METHODS:

    In the ventral approach, a small hole was made for access to the scala tympani. Cochlear function was assessed through auditory brainstem response (ABR) threshold measurements.

    RESULTS:

    The ventral approach enabled the direct visualization of the tympanic bulla. Thus, the tympanic bulla could be easily opened in a manner that was benign to cochlear function. There was no significant difference in ABR threshold before and after surgery.

  • 39.
    Rahman, Anisur
    et al.
    Karolinska Institute/Karolinska University Hospital, Stockholm, Sweden.
    Olivius, Petri
    Karolinska Institute/Karolinska University Hospital, Stockholm, Sweden.
    Dirckx, Joris
    University of Antwerp, Groenenburgerlaan, Belgium .
    Von Unge, Magnus
    Karolinska Institute/Karolinska University Hospital, Stockholm, Sweden.
    Hultcrantz, Malou
    Karolinska Institute/Karolinska University Hospital, Stockholm, Sweden.
    Stem cells and enhanced healing of chronic tympanic membrane perforation2008In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 128, no 4, p. 352-359Article in journal (Refereed)
    Abstract [en]

    CONCLUSIONS:

    Important information about the basic reparative process of tympanic membrane (TM) healing is shown, which can be incorporated for further clinical understanding. This provides a basis for the exploration of stem cell treatment for TM perforations and holds promise for future improvements.

    OBJECTIVES:

    This study aimed to analyse the healing of TM perforation by using stem cells and the stiffness of the membrane was tested in an acute and long-term study.

    MATERIALS AND METHODS:

    Sprague-Dawley rats were used in a model of TM perforation. The perforation was performed with a laser system. Stem cells were applied and the healing time and morphological analysis were performed with light and transmission electron microscope. Stiffness was examined by moiré interferometry.

    RESULTS:

    The stiffness of the perforated and healed TM was restored after just 2 weeks. In the chronic perforation model, mesenchymal stem cells enhanced the healing.

  • 40.
    Rubin, Allan
    et al.
    Linköping University. University of Toronto, Canada.
    Liedgren, Christer
    Linköping University. University of Toronto, Canada.
    Ödkvist, Lars
    Linköping University. University of Toronto, Canada.
    Larsby, Birgitta
    Linköping University. University of Toronto, Canada.
    Aschan, Gunnar
    Linköping University. University of Toronto, Canada.
    Limb input to the cat vestibular nuclei1979In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, ISSN ISSN 0001-6489, Vol. 87, no 1-2, p. 113-122Article in journal (Refereed)
    Abstract [en]

    The input from fore- and hindlimbs to the vestibular nuclear complex (VNC) was investigated in awake cats. Electrical stimulus was given to the sciatic, radial and vestibular nerves bilaterally and single unit responses were recorded in the VNC with extracellular technique. The position of the microelectrode was histologically confirmed. All four major vestibular nuclei received fore- as well as hindlimb input. Forty per cent of the neurons with limb input also received vestibular afferents. No major distinguishing features appeared between the different nuclei with regard to response characteristics. Certain differences in laterality of response, quantitative fore-hindlimb ratio and somatosensory-labyrinthine convergence were observed however. Response latencies to sciatic and radial nerve stimuli always exceeded a 3 msec and were grouped around 8 and 16 msec. A third population of vestibular neurons had latencies over 20 msec. Both excitatory and inhibitory responses were recorded, with the latter not always following an activation. The findings illustrate the complex nature of the ascending pathway to the VNC and the integrative properties of this complex.

  • 41.
    Stalfors, J
    et al.
    Sahlgrenska Universitetssjukhuset, Göteborg.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Hemlin, Claes
    Aleris, Sabbatsberg, Stockholm.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Månsson, Ingemar
    Sahlgrenska Universitetssjukhuset, Göteborg.
    Roos, Kristian
    Capio Lundby, Göteborg.
    Hessén Söderman, Anne-Charlotte
    Karolinska Universitetssjukhuset, Stockholm.
    Tonsil surgery efficiently relieves symptoms, Analysis of 54 696 paqtients in The National Tonsil Surgery Register in Sweden2012In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 132, no 5, p. 533-539Article in journal (Refereed)
    Abstract [en]

    CONCLUSION:

    Patients operated with tonsillar surgery report a high degree of symptom relief 6 months after surgery.

    OBJECTIVE:

    The purpose of this study was to analyze symptom relief 6 months after tonsil surgery in relation to age, indication, surgical procedure, primary bleeding and unplanned postoperative visits. The National Tonsil Surgery Register in Sweden offers data from 54,696 patients registered during 1997-2008.

    METHODS:

    This was a prospective assessment by questionnaire. Data were collected using three questionnaires, two completed by professionals and one 6 months postoperatively by the parents/patients.

    RESULTS:

    Among 54,696 patients, the most common surgical indications were obstruction (49.7%), followed by recurrent tonsillitis (35.2%). Symptom relief 6 months after surgery was high in all indication groups (>92%), and highest for patients operated on the indication peritonsillitis (>98%). The indications obstruction, recurrent tonsillitis or chronic tonsillitis reported a high degree (>96%) of symptom relief. Of the patients who underwent tonsillectomy with adenoidectomy, 97.5% were symptom-free compared to 96% of patients who had tonsillectomy alone and 96.1% who underwent tonsillotomy (p < 0.0001). In all, 13.9% of patients required an unplanned visit to the clinic postoperatively. Only 148 of 54,696 patients reported worsening of symptoms after surgery.

  • 42. Stenquist, Monika
    et al.
    Juhlin, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Åström, Gunnar
    Friberg, Ulla
    Case Report. Fourth branchial pouch sinus with recurrent deep cervical abscesses successfully treated with trichloroacetic acid cauterization2003In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 123, p. 879-882Article in journal (Refereed)
  • 43.
    Sundelin, Kaarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Roberg, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Grénman, Reidar
    Departments of Otorhinolaryngology—Head and Neck Surgery and Medical Biochemistry, University Hospital and University of Turku, Turku, Finland.
    Håkansson, Leif
    Department of Medical Oncology, University Hospital, Linköping, Sweden.
    Effects of cytokines on matrix metalloproteinase expression in squamous cell carcinoma in vitro2007In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 125, no 7, p. 765-773Article in journal (Refereed)
    Abstract [en]

    Objective: MMPs play an important role in enhanced intra-tumoral proteolytic activity, promoting angiogenesis and invasion by acting on extracellular matrix substances. Cytokines secreted by tumour-infiltrating immune cells, fibroblasts and tumour cells can modulate MMP expression and secretion by cancer cells. The objective of this study was to investigate the effects of IL-6, soluble IL-6 receptor (sIL-6R), HGF, TNF- and IL-8 on MMP-1, -2 and -9 expression by two oral squamous cell carcinoma cell lines (UT-SCC-20A and -24A).

    Material and methods: ELISA was used to analyse secretion of total MMP protein and gelatin zymography was used for activity analysis.

    Results: IL-6 had a moderate stimulatory effect on MMP-1 secretion in both cell lines, whereas sIL-6R had no effect. When these cytokines were added together, a dose-dependent, synergistic stimulatory effect was observed. HGF also upregulated MMP-1 secretion, especially in one cell line (UT-SCC-24A), and a synergistic effect was observed when HGF was added to IL-6 in both cell lines. MMP-9 secretion by UT-SCC-24A was increased when stimulated with HGF and IL-6 combined with sIL-6R, whereas no effect was found in the other cell line. TNF- stimulated MMP-9 secretion in both cell lines, but only stimulated MMP-1 secretion in one (UT-SCC-24A). The zymographic results were consistent with the ELISA results, indicating an upregulation of active enzyme when a stimulatory effect on protein expression was detected.

    Conclusions: The intra-tumoral cytokines IL-6, hepatocyte growth factor (HGF) and tumour necrosis factor- (TNF-) stimulate oral cancer cells to enhanced secretion of matrix metalloproteinase (MMP)-1 and -9. These results contribute to an understanding of the extracellular events necessary for tumour progression.

  • 44.
    Tham, Richard
    et al.
    Linköping University.
    Larsby, Birgitta
    Linköping University.
    Eriksson, Birgitta
    Linköping University.
    Bunnfors, Irja
    Linköping University.
    Ödkvist, Lars
    Linköping University.
    Liedgren, Christer
    Östergötlands Läns Landsting.
    Electronystagmographic findings in rats exposed to styrene or toluene1982In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 93, p. 107-112Article in journal (Refereed)
    Abstract [en]

    A previously described experimental model for studying the effect of industrial solvents in the vestibular system of rabbits has been applied to rats. To achieve a constant concentration, the solvent was infused intravenously, dissolved in a lipid emulsion. Arterial blood levels were estimated by gas chromatography. The vestibulo-oculomotor behaviour of rats during repeated rotatory acceleration was investigated by electronystagmography. The effect of two solvents-toluene and styrene-on the rotatory induced nystagmus was examined. Both solvents caused an exaggerated reaction at arterial blood  levels above 75 ppm. The investigation indicated that the rat will be suitable species for further electronystagmographic investigation of the influence of organic solvents on the vestibular system, for example in screening studies of the toxicity of these solvents.

  • 45.
    Tham, Richard
    et al.
    Linköping University. Department of Otorhinolaryngology, Linköping University, Sweden.
    Larsby, Birgitta
    Linköping University. Department of Otorhinolaryngology, Linköping University, Sweden.
    Eriksson, Birgitta
    Linköping University. Department of Otorhinolaryngology, Linköping University, Sweden.
    Ödkvist, Lars
    Linköping University. Department of Otorhinolaryngology, Linköping University, Sweden.
    Effects on the vestibulo- and opto-oculomotor system in rats by lesions of the commissural vestibular fibres1989In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 108, no 5-6, p. 372-377Article in journal (Refereed)
    Abstract [en]

    Eye movements were recorded from rats with a magnetic search coil system before and after sectioning of the midline commissural pathways in the brain stem at the level of the vestibular nuclei. After lesion, the findings were as follows: 1) During sinusoidal vestibular stimulation the eyes moved in a sinusoidal way similar to the head movement without any regular saccades. There was a reduced gain and a phase lead. 2) During optokinetic stimulation the eyes moved in the stimulus direction to an excentric position and stayed there until stimulation ceased. 3) During acceleratory/deceleratory rotation in the light there was a drift of the eyes in the direction of the expected slow phase movement to an excentric position. In some animals there was a directional asymmetry. The findings may be explained by a failure of the central neural integrator for horizontal eye movements. The results support the hypothesis that vestibular commissural fibres are of crucial importance for the function of this integrator system.

  • 46.
    Tibbling Grahn, Lita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Longitudinal oesophageal muscle and pharyngo-oesophageal dyshagia - a deductive study.2000In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 543, p. 239-240Article in journal (Refereed)
    Abstract [en]

    The hypothesis has been raised that a dysfunction of the longitudinal oesophageal muscle is the common denominator for pharyngeal and oesophageal dysphagia in patients with hiatal hernia, and that contraction of the: longitudinal muscle is a contributing factor for the opening of the upper oesophageal sphincter and for the stiffening: of the oesophageal wall when swallowing. Different studies were used to test the implications of this hypothesis. It was concluded that dysfunction of the longitudinal oesophageal muscle, caused by slipping of the distal end through the hiatal canal, can explain oesophageal dysphagia and inadequate opening of the upper oesophageal sphincter.

  • 47.
    Westerberg, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Harder, Henrik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Cholesteatoma surgery with the canal wall up technique combined with mastoid obliteration: results from primary surgery in 230 consecutive cases2018In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 138, no 5, p. 452-457Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the canal wall up (CWU) technique combined with mastoid obliteration used in cholesteatoma surgery from the aspects of safety and function.

    Study design: Retrospective chart review. Information was extracted from a medical database and complementary data from patient files and audiograms were collected and recorded retrospectively.

    Setting: A tertiary-stage hospital and a secondary-stage hospital. Surgeons of various levels of experience.

    Method: Data from a consecutive group of 230 primary operations for cholesteatoma surgery using CWU with obliteration employing the combined approach tympanoplasty (CAT) technique, from January 1994 to December 2009 were analyzed.

    Results: In 90% of the ears, the anatomy was normalized with an intact ear drum.

    The frequency of residual cholesteatoma was 1% and the frequency of recurrent cholesteatoma 8%. Hearing was improved one year postoperatively and remained improved three years postoperatively. No patient suffered a total hearing loss.

    Conclusions: CWU procedure comprising CAT with obliteration of the mastoid is a safe surgical method with a low frequency of residual and recurrent disease and a good hearing preservation.

  • 48.
    Zarenoe, Ramesh
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hansson, Magnus
    Karolinska University Hospital.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Assessment of diagnostic approaches to idiopathic sudden sensorineural hearing loss and their influence on treatment and outcome2010In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 130, no 3, p. 384-391Article in journal (Refereed)
    Abstract [en]

    Conclusion: Results from a database for sudden sensorineural hearing loss (SSNHL) demonstrate no correlation between laboratory findings, treatment, and outcome in 400 patients. The patients with pathological test results were not treated differently from those with normal test results. The value of laboratory findings and MRI might increase if the results are categorized to more specific diagnoses. Objectives: To investigate diagnostic test batteries for SSNHL and evaluate their value in the management of idiopathic SSNHL. Methods: A total of 400 patients submitted to the Swedish national database for SSNHL were analyzed. Information was collected about the patients past medical history, potential precipitating events, trauma, medical history, hearing loss, current disease, diagnostic protocol, and treatment, using questionnaires as well as two audiograms, one at the first ENT clinic visit and another 3 months later. Results: In all, 65% of these 400 patients underwent hematological tests and 40% had an MRI/CT scan. Twenty-two of 160 MRI investigated had pathological findings including 5 acoustic neuromas. Also, 300 of these 400 patients were evaluated as having idiopathic sudden sensorineural hearing loss (ISSNHL); 24% of them had one or more pathological test results. No significant correlation was found between either the MRI findings or the laboratory findings with regard to treatment or hearing recovery in patients with ISSNHL.

  • 49.
    Ödkvist, L
    Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Pressure treatment versus gentamicin for MΘniΦre's disease2001In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 121, no 2, p. 266-268Article in journal (Refereed)
    Abstract [en]

    MΘniΦre's disease may be treated in different ways. After obtaining a case history and performing auditory and vestibular tests the diagnosis should be obvious. In terms of treatment, the first steps are to provide the patient with information, institute a low-salt diet and regulate internal medical disorders. The next step is pharmacological treatment using diuretics, betahistine and other drugs. Local pulsated pressure treatment in the ear canal has been used in a placebo-controlled study and showed significant improvement, primarily of vertigo, but also in terms of tinnitus and hearing. Hence, this form of treatment can be used in some phases of the disease. In more severe cases gentamicin treatment has proved successful, in the present study, vertigo was cured in all but 3 of 35 patients. On average, no extra hearing loss was caused, however, one ear became deaf, some ears showed improvement and some ears showed a certain degree of hearing loss. In cases of escalation of MΘniΦre's disease, pressure treatment should be used initially, followed by gentamicin. These two methods of treatment are not in competition as they are used to treat different stages of the disease.

  • 50.
    Ödkvist, Lars
    et al.
    Östergötlands Läns Landsting. Department of Otolaryngology, University Hospital, Linkoping, Sweden.
    Fredrickson, John
    University of Toronto, Canada.
    Larsby, Birgitta
    Linköping University. Department of Otolaryngology, University Hospital, Linkoping, Sweden.
    Projection of the vestibular nerve to the SI arm field in the cerebral cortex of the cat1975In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 79, no 1-2, p. 88-95Article in journal (Refereed)
    Abstract [en]

    Evoked cortical focal potentials from electrical vestibular nerve stimulation were recorded in the Pcd-area in cats anaesthetized with Chloralose or Nembutal. For comparison, additional cortical projections were located for n. rad. superficialis and group Ia muscle afferents from n. rad. prof., n. fibularis prof., n. femuralis ramus muscularis and the motor nerve to the trapezoid muscle. Surface positive potentials, which reversed to negativity in middle cortical layers, were for vestibular nerve stimulation recorded in the S I forelimb field in a small area close to Pcd in the posterior medial part of the deep radial nerve projection field. The location of this field is compared with the vestibulo-cortical projections described earlier for rodents, squirrel monkey, and rhesus monkey. The histology shows that the field was within the cytoarchitectonic 3a area.

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