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  • 1.
    Agvald-Ohman, C
    et al.
    Karolinska University.
    Struwe, J
    Karolinska Institute.
    Hanberger, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Infectious Diseases . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Infectious Diseases in Östergötland.
    Walther, Sten
    Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    PROMOTING INFECTION CONTROL IN THE ICU USING A TARGETED PUSH-AND-PULL INTERVENTION2009In: in INTENSIVE CARE MEDICINE, vol 35, 2009, Vol. 35, p. 176-176Conference paper (Refereed)
    Abstract [en]

    n/a

  • 2.
    Agvald-Öhman, Christina
    et al.
    Anestesioch intensivvårdskliniken, Karolinska universitetssjukhuset, Huddinge, CLINTEC, Karolinska institutet, Stockholm, Sweden.
    Hanberger, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Infectious Diseases . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Infectious Diseases in Östergötland.
    Struwe, Johan
    Strama och avdelningen för epidemiologi, Smittskyddsinstitutet, Stockholm, Sweden.
    Walther, Sten M.
    Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    »Skjut på« och »dra« metod för att minska vårdrelaterade infektioner på IVA: Pilotprojekt med aktiv uppföljning2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 1-2Article in journal (Refereed)
    Abstract [sv]

    Vårdrelaterade infektioner är ett särskilt stort problem inom intensivvården där patienterna är kritiskt sjuka och har många riskfaktorer.

    För att minska frekvensen vårdrelaterade infektioner måste ett strukturerat arbete bedrivas från flera olika utgångspunkter.

    Vi måste bli bättre på att dia­gnostisera, dokumentera och förebygga dessa infektioner.

    Kombinerad intervention av typen »push« och »pull« visade på lovande resultat med införande av bättre diagnostiska metoder och en upplevelse av ökad motivation hos personalen efter besöket.

  • 3. Ahlgren, AR
    et al.
    Piitulainen, E
    Sandgren, T
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Alfa1-antitrypsin deficiency and blood pressure regulation2003In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 21, p. S151-S151Conference paper (Other academic)
  • 4.
    Ahlgren, Ewa
    Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery. Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Faculty of Health Sciences.
    Cerebral complications after cardiac surgery2002Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Cerebral injuty remains a major cause of morbidity and mortality after cardiac surgery. Previous studies have mainly focused on preoperative risk factors and intraoperative events but cerebral complications may also occur in the postoperative period. Cognitive impairment is common after cardiac surgery but the consequences of this complication for activities of daily life are less known. Safe driving involves a complex set of skills requiring preserved cognitive function. A substantial number of patients with heart disease are active drivers. The impact of postoperative cognitive dysfunction on driving performance, however, has not previously been investigated in this large patient group.

    In this thesis pre-, intra- and postoperative risk factors for focal cerebral complications were determined and the onset time of cerebral symptoms were evaluated in two cohorts of cardiac surgical patients, comprising 2480 and 3282 patients respectively. Data analysed were drafted from a clinical register and the surgical database of Linköping University Hospital Heart Center. Cerebral complication was delayed, i.e occurred after a free interval, in about one third of patients suggesting causes other than intraoperative events. Different risk factors were found for early and delayed cerebral complications suggesting different mechanisms of cerebral injury. Advanced age, preoperative hypertension, aortic surgery, prolonged cardiopulmonary bypass (CPB) time, intraoperative hypotension after completion of CPB, and arrhytlunia in the early postoperative period increased the risk for early cerebral complication. Female gender, diabetes, previous cerebrovascular disease, combined coronary artery bypass grafting (CABG) and valve surgery and arrhythmia on the thoracic ward increased the risk for delayed cerebral complication. Cognitive function and driving performance were evaluated in 27 patients before and 4-6 weeks after CABG. The patients underwent neuropsychological testing, an on-road driving test and a test in an advanced driving simulator. Twenty patients scheduled for percutaneous coronary intervention (PCI) served as controls. Complete data were obtained in 23 and 19 patients respectively. Furthermore cognitive function and driving performance in on-road driving of the 44 patients with complete tests before intervention were compared with controls of similar age without heart symptoms. Cognitive function and driving performance were already impaired in patients with coronary artery disease before intervention when compared with controls. After surgery 48% of the patients showed cognjtive decline compared to 10% after PCI. These patients also scored less in the on-road driving test to a greater extent than did patients without postoperative cognitive decline.

    List of papers
    1. Cerebral complications after coronary artery bypass and heart valve surgery: Risk factors and onset of symptoms
    Open this publication in new window or tab >>Cerebral complications after coronary artery bypass and heart valve surgery: Risk factors and onset of symptoms
    1998 (English)In: Journal of Cardiothoracic and Vascular Anesthesia, ISSN 1053-0770, E-ISSN 1532-8422, Vol. 12, no 3, p. 270-273Article in journal (Refereed) Published
    Abstract [en]

    Objectives: Cerebral complications continue to be a major cause of morbidity after cardiac surgery. Earlier studies have mainly focused on intraoperative events, but symptoms may also occur later in the postoperative period. The purpose of this study was to determine the incidence and risk factors of focal neurologic complications and timing of cerebral symptoms.

    Design: A retrospective study.

    Setting: Linköping University Hospital.

    Participants: Two thousand four hundred eighty patients who underwent cardiac surgery from 1992 to 1995.

    Interventions: Standard cardiopulmonary bypass (CPB) technique was used in all patients. Anticoagulant treatment included heparin and patients with coronary artery surgery were also administered acetylsalicylic acid and valve-surgery patients received warfarin or dicumarol.

    Measurements and Main Results: Seventy-five patients (3%) had focal neurologic deficits and/or confusion postoperatively. In 32 patients (43%), the onset was not intraoperative but occurred later in the postoperative period. The lowest incidence of cerebral complications was found in patients who underwent single-valve replacement (1.2%) and the highest incidence was found in patients who underwent combined procedures (valve and coronary artery surgery; 7.6%). Patients greater than 70 years of age had a complication rate of 4.1% compared with 2.5% in patients aged 70 years and less (p < 0.05). The incidence of diabetes mellitus was 11.4% in the entire series, but was more common (18.7%; p < 0.05) in patients with cerebral symptoms. Also, 5.9% of all patients had a history of cerebrovascular disease compared with 14.7% (p < 0.01) of patients with cerebral complications.

    Conclusion: Cerebral complications may be delayed after cardiac surgery, suggesting causes of cerebral damage other than intraoperative events. Valve-surgery patients had the lowest incidence and patients with combined procedures had the highest incidence of cerebral complications. Advanced age, diabetes mellitus, and preexisting cerebrovascular disease increased the risk.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81345 (URN)10.1016/S1053-0770(98)90004-0 (DOI)
    Available from: 2012-09-12 Created: 2012-09-12 Last updated: 2017-12-07Bibliographically approved
    2. Risk factor analysis of early and delayed cerebral complications after cardiac surgery
    Open this publication in new window or tab >>Risk factor analysis of early and delayed cerebral complications after cardiac surgery
    2002 (English)In: Journal of Cardiothoracic and Vascular Anesthesia, ISSN 1053-0770, E-ISSN 1532-8422, Vol. 16, no 3, p. 278-285Article in journal (Refereed) Published
    Abstract [en]

    Objective: To report the incidence, severity, and possible risk factors for early and delayed cerebral complications.

    Design: Retrospective study.

    Setting: Linköping University Hospital, Sweden.

    Participants: Consecutive patients who underwent cardiac surgery in the period July 1996 through June 2000 (n = 3,282).

    Interventions: A standard cardiopulmonary bypass (CPB) technique was used for most patients. Postoperative anticoagulant treatment included heparin or anti-Xa dalteparin. Patients undergoing coronary artery bypass graft surgery received acetylsalicylic acid, and patients undergoing valve surgery received warfarin.

    Measurements and Main Results: Cerebral complications occurred in 107 patients (3.3%). Of these, 60 (1.8%) were early, and 33 (1.0%) were delayed, and in 14 (0.4%) patients the onset was unknown. There were 37 variables in univariate analysis (p < 0.15) and 14 variables in multivariate analysis (p < 0.05) associated with cerebral complications. Predictors of early cerebral complications were older age, preoperative hypertension, aortic aneurysm surgery, prolonged CPB time, hypotension at CPB completion and soon after CPB, and postoperative arrhythmia and supraventricular tachyarrhythmia. Predictors of delayed cerebral complications were female gender, diabetes, previous cerebrovascular disease, combined valve surgery and coronary artery bypass graft surgery, postoperative supraventricular tachyarrhythmia, and prolonged ventilator support. Early cerebral complications seem to be more serious, with more permanent deficits and a higher overall mortality (35.0% v 18.2%).

    Conclusion: Most cerebral complications had an early onset. The results of this study suggest that aggressive antiarrhythmic treatment and blood pressure control may imfurther prove the cerebral outcome after cardiac surgery.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-29550 (URN)10.1053/jcan.2002.124133 (DOI)14921 (Local ID)14921 (Archive number)14921 (OAI)
    Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
    3. Patients with Coronary Artery Disease Are Active Car Drivers Both Before and Soon After Heart Surgery
    Open this publication in new window or tab >>Patients with Coronary Artery Disease Are Active Car Drivers Both Before and Soon After Heart Surgery
    2002 (English)In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 3, no 3, p. 205-208Article in journal (Refereed) Published
    Abstract [en]

    Cognitive ability is essential for the fitness to drive. Impaired cognitive functions are common after cardiac surgery. Little is known about driving habits and influence of postoperative cognitive decline on driving performance in these patients. The aim of this study was to investigate the extent of driving activity of patients before and after cardiac surgery. Ninety-seven cardiac surgical patients were interviewed about their driving habits before and 12 weeks after surgery. The mean age was 66. Before the operation, 78% were active car drivers. They drove several times a week including longer than 100 km distances. After the operation, 64% continued to drive and most of them (69%) had commenced driving within 6 weeks. The majority (79%) reported unchanged driving habits, while 13 patients (21%) had reduced their driving activity due to the cognitive symptoms they experienced. Patients with coronary artery disease are active car drivers both before and after heart surgery. Further evaluation of the ability of these patients to drive is required if we are to give advice and apply restrictions in the interest of traffic safety.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26733 (URN)10.1080/15389580213649 (DOI)11328 (Local ID)11328 (Archive number)11328 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. Neurocognitive impairment and driving performance after coronary artery bypass surgery
    Open this publication in new window or tab >>Neurocognitive impairment and driving performance after coronary artery bypass surgery
    Show others...
    2003 (English)In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 23, no 3, p. 334-340Article in journal (Refereed) Published
    Abstract [en]

    Objective: Neurocognitive impairment is common after cardiac surgery but few studies have examined the relationship between postoperative neuropsychological test performance and everyday behavior. The influence of postoperative cognitive impairment on car driving has previously not been investigated. The purpose of this study was to evaluate neurocognitive function and driving performance after coronary artery bypass grafting (CABG).

    Methods: Twenty-seven patients who underwent coronary artery bypass grafting with standard cardiopulmonary bypass technique and 20 patients scheduled for percutaneous coronary intervention (PCI) under local anesthesia (control group) were enrolled in this prospective study conducted from April 1999 to September 2000. Complete data were obtained in 23 and 19 patients, respectively. The patients underwent neuropsychological examination with a test battery including 12 tests, a standardized on-road driving test and a test in an advanced driving simulator before and 4–6 weeks after intervention.

    Results: More patients in the coronary artery bypass grafting group (n=11, 48%) than in the percutaneous coronary intervention group (n=2, 10%) showed a cognitive decline after intervention (P=0.01). In the on-road driving test, patients who underwent coronary artery bypass grafting deteriorated after surgery in the cognitive demanding parts like traffic behavior (P=0.01) and attention (P=0.04). Patients who underwent percutaneous intervention deteriorated in maneuvering of the vehicle (P=0.04). No deterioration was detected in the simulator in any of the groups after intervention. Patients with a cognitive decline after intervention also tended to drop in the on-road driving scores to a larger extent than did patients without a cognitive decline.

    Conclusion: This study indicates that cognitive functions important for safe driving may be influenced after cardiac surgery.

    Keyword
    Cardiac surgery, Cerebral complications, Cognitive decline, Driving performance
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-26290 (URN)10.1016/s1010-7940(02)00807-2 (DOI)10806 (Local ID)10806 (Archive number)10806 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    5. Driving performance of patients with coronary artery disease
    Open this publication in new window or tab >>Driving performance of patients with coronary artery disease
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives To compare patients with coronary artery disease and healthy controls with respect to cognitive function and driving performance.

    Design and setting A controlled study conducted between April 1999 and January 2001.

    Subjects Forty-four patients with stable coronary artery disease scheduled for cardiac intervention with coronary artery bypass surgery or percutaneous coronary intervention. Forty volunteers of similar age without symptoms of coronary artery disease served as controls.

    Main outcome measures On-road driving scores in five specific test areas with a rating scale from 1 to 5. Neuropsychological test scores, including 12 tests.

    Results Compared with controls, patients with coronary artery disease had lower scores in all areas of the on-road driving test (p<0.05) and in the neuropsychological tests assessing psychomotor speed, visual and verbal memory, focused attention and simultaneous capacity (p<0.05). The difference between the groups in the on-road driving test appeared to be more pronounced among those above 65 years-of-age. Both patients and controls rated their performance significantly higher than the traffic inspector (p<0.05).

    Conclusions Cognitive function and driving performance may be impaired in patients with coronary artery disease.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81348 (URN)
    Available from: 2012-09-12 Created: 2012-09-12 Last updated: 2012-09-12Bibliographically approved
  • 5.
    Ahlström, Christer
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Johansson, Anders
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Ask, Per
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    A respiration monitor based on electrocardiographic and photoplethysmographic sensor fusion2004In: IEEE Engineering in Medical and Biological Society,2004, Piscataway, N.J. USA: IEEEEMBS , 2004, p. 2311-Conference paper (Refereed)
  • 6.
    Ahlström, Christer
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Johansson, Anders
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Ask, Per
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Monitorering av andning and blodtrycksförändringar baserat på EKG och hjärtljud2007In: Medicinteknik dagarna,2007, 2007Conference paper (Other academic)
  • 7.
    Ahlström, Christer
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Johansson, Anders
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Uhlin, Fredrik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology.
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Ask, Per
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Noninvasive investigation of blood pressure changes using the pulse wave transit time: A novel approach in the monitoring of hemodialysis patients2005In: Journal of Artificial Organs, ISSN 1434-7229, E-ISSN 1619-0904, Vol. 8, no 3, p. 192-197Article in journal (Refereed)
    Abstract [en]

    Severe blood pressure changes are well known in hemodialysis. Detection and prediction of these are important for the well-being of the patient and for optimizing treatment. New noninvasive methods for this purpose are required. The pulse wave transit time technique is an indirect estimation of blood pressure, and our intention is to investigate whether this technique is applicable for hemodialysis treatment. A measurement setup utilizing lower body negative pressure and isometric contraction was used to simulate dialysis-related blood pressure changes in normal test subjects. Systolic blood pressure levels were compared to different pulse wave transit times, including and excluding the cardiac preejection period. Based on the results of these investigations, a pulse wave transit time technique adapted for dialysis treatment was developed and tried out on patients. To determine systolic blood pressure in the normal group, the total pulse wave transit time was found most suitable (including the cardiac preejection period). Correlation coefficients were r = 0.80 ± 0.06 (mean ± SD) overall and r = 0.81 ± 0.16 and r = 0.09 ± 0.62 for the hypotension and hypertension phases, respectively. When applying the adapted technique in dialysis patients, large blood pressure variations could easily be detected when present. Pulse wave transit time is correlated to systolic blood pressure within the acceptable range for a trend-indicating system. The method's applicability for dialysis treatment requires further studies. The results indicate that large sudden pressure drops, like those seen in sudden hypovolemia, can be detected. © The Japanese Society for Artificial Organs 2005.

  • 8.
    Ahlström, Christer
    et al.
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, Faculty of Health Sciences.
    Länne, Toste
    Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Ask, Per
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, Faculty of Health Sciences.
    Johansson, Anders
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, Faculty of Health Sciences.
    A method for accurate localization of the first heart sound and possible applications2008In: Physiological Measurement, ISSN 0967-3334, E-ISSN 1361-6579, Vol. 29, no 3, p. 417-428Article in journal (Refereed)
    Abstract [en]

    We have previously developed a method for localization of the first heart sound (S1) using wavelet denoising and ECG-gated peak-picking. In this study, an additional enhancement step based on cross-correlation and ECG-gated ensemble averaging (EA) is presented. The main objective of the improved method was to localize S1 with very high temporal accuracy in (pseudo-) real time. The performance of S1 detection and localization, with and without EA enhancement, was evaluated on simulated as well as experimental data. The simulation study showed that EA enhancement reduced the localization error considerably and that S1 could be accurately localized at much lower signal-to-noise ratios. The experimental data were taken from ten healthy subjects at rest and during invoked hyper- and hypotension. For this material, the number of correct S1 detections increased from 91% to 98% when using EA enhancement. Improved performance was also demonstrated when EA enhancement was used for continuous tracking of blood pressure changes and for respiration monitoring via the electromechanical activation time. These are two typical applications where accurate localization of S1 is essential for the results.

  • 9.
    Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Mitral valve surgery - current results and future development to catheter based approaches2006In: International Society of Extracorporeal Circulation - Cardiac Surgery beyond 2006,2006, 2006Conference paper (Other academic)
  • 10.
    Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    The Impella temporary assist device, the Swedish experience2006In: International Society of Extracorporeal Circulation - Cardiac Surgery beyond 2006,2006, 2006Conference paper (Other academic)
  • 11.
    Ahn, Henrik Casimir
    et al.
    Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Baranowski, J
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Nielsen, Nils Erik
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Nylander, Eva
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Tamas, Eva
    Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Wallby, Lars
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Transcatheter aortic valve implantation in high-risk surgical candidates with low risk-scores1984Conference paper (Other academic)
  • 12.
    Ahn, Henrik Casimir
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Jodal, M.
    Lindhagen, J
    Lundgren, O.
    Nilsson, Gert
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Salerud, Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Bestämning av tunntarmsblodflödet med laser Doppler teknik1984In: Läkarsällskapets Riksstämma,1984, 1984Conference paper (Other academic)
  • 13.
    Ahn, Henrik Casimir
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Johansson, K.
    Lindhagen, J.
    Nilsson, Gert
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Salerud, Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Förändringar av blodflödet i ventrikeln i samband med mätt med laser Dopplerteknik1984In: Läkarsällskapets Riksstämma,1984, 1984Conference paper (Other academic)
  • 14.
    Ahn, Henrik Casimir
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Johansson, K.
    Lindhagen, J.
    Salerud, Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Laser Doppler flowmetry in the assessment of gastric blood flow1984In: man. Scand J of Gastroenterology,1984, 1984, p. 98:33-98:33Conference paper (Other academic)
  • 15.
    Ahn, Henrik Casimir
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Lindhagen, J.
    Nilsson, Gert
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Salerud, Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Jodal, M.
    Lundgren, O.
    Evaluation of Laser Doppler Flowmetry in the assessment of blood flow in the small intestine1984In: Third World Congress of Microcirculation,1984, 1984Conference paper (Other academic)
  • 16.
    Ahn, Henrik Casimir
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Lindhagen, J
    Nilsson, Gert
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Salerud, Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Jodal, M
    Lundgren, O
    Evaluation of Laser Doppler Flowmetry in the assessment of intestinal blood flow1985In: Gastroenterology, ISSN 0016-5085, E-ISSN 1528-0012, Vol. 4, no 88, p. 951-957Article in journal (Refereed)
    Abstract [en]

      

  • 17.
    Ahn, Henrik Casimir
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Lönn, Urban
    IMV/Thoraxkirurgi/Hjärtcentrum LiU/HU.
    Peterzén, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Alternatives to circulatory support during coronary artery surgery1999In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 16 suppl 2, p. 143-150Article in journal (Refereed)
  • 18. Alvsåker, K
    et al.
    Kvandal, P
    Hanoa, R
    Olafsen, K
    Grömer, G
    Kleffelgård, I
    Mongs, M
    Walther, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Tidlig rehabilitering av alvorlige traumatiske hoderskader ved en intensivavdeling. Erfaringer fra 2 års drift. En pilotstudie.2007In: Nasjonal konferanse om traumatisk hjerneskade,2007, 2007Conference paper (Refereed)
    Abstract [sv]

      

  • 19.
    Antonsson, Johan
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Babic, Ankica
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Quality of life using profile in coronary artery bypass surgery patients1999In: AMIA99,1999, Philadelphia: Hanley & Belfus Inc , 1999, p. 1013-Conference paper (Refereed)
  • 20.
    Antonsson, Johan
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Granfeldt, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Kircher, Albert
    Technical University Graz Austria.
    Babic, Ankica
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Lönn, Urban
    Uppsala .
    Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Design of a clinical decision support system for assist support devices in thoracic surgery2000In: AMIA,2000, Philadelphia: Hanley & Belfus Inc, , 2000Conference paper (Refereed)
  • 21.
    Arén, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Svenska hjärtkirurgregistrets kvalitetsprojekt. att studera andra kliniker för att lära, inte döma.1999In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 96, p. 2498-2502Article in journal (Other (popular science, discussion, etc.))
  • 22.
    Babic, Ankica
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Granfeldt, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Peeker, Martin
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Storm, Marcus
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Lönn, Urban
    Thoraxkirurgi Uppsala.
    Casimir Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Case-based reasoning in a web-based clinical decision support system for thoracic surgery2002In: Am Medic Inform Ass Annual Symposium,2002, 2002, p. 968-968Conference paper (Refereed)
  • 23.
    Babic, Ankica
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Koele, Werner
    Inst Biomed Engineering, Graz University Österike.
    Granfeldt, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Lönn, Urban
    Dept of Cardio-Thoracic Surgery, Uppsala Universiet.
    Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Help and advisory system in a Web-based system for data mining2001In: AMIA 2001,2001, Washington: Hanley&Belfus , 2001, p. 856-Conference paper (Refereed)
  • 24.
    Babic, Ankica
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Lönn, Urban
    Linköping Heart Center Linköping University.
    Peterzén, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Anaesthesiology and Surgical Centre, Department of Intensive Care UHL.
    Granfeldt, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Hemopump treatment in patients with postcardiotomy heart failure1995In: Annals of Thoracic Surgery, ISSN 0003-4975, E-ISSN 1552-6259, Vol. 60, p. 1067-1071Article in journal (Refereed)
  • 25.
    Bellinetto Ford, L
    et al.
    Lund University.
    Melander, O
    Lund University.
    Länne, Toste
    Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Nilsson, P M
    Lund University.
    INCREASED PULSE PRESSURE IS A MARKER FOR AORTIC STIFFNESS INDEPENDENT OF MEAN ARTERIAL PRESSURE, AGE, SEX, AND OTHER WELL-KNOWN CARDIOVASCULAR RISK FACTORS2009In: in JOURNAL OF HYPERTENSION, vol 27, 2009, Vol. 27, p. S23-S23Conference paper (Refereed)
    Abstract [en]

    n/a

  • 26.
    Berg, Sören
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Delude, RL
    Fink, MP
    Increased glycolysis maintains ATP levels after hypoxia and cytokine stimulation in rat enterocytes2002In: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 28, p. 236-Conference paper (Other academic)
  • 27.
    Berg, Sören
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Engman, A
    Stockholm.
    Holmgren, Susanna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Lundahl, T
    Västervik.
    Laurent, T
    Uppsala.
    Increased plasma hyaluronan in severe pre-eclampsia and eclampsia2001In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 61, no 2, p. 131-138Article in journal (Refereed)
    Abstract [en]

    Pre-eclampsia is a serious multi-system disorder with general endothelial disease, often with a component of hepatic dysfunction. The pathogenesis of pre-eclampsia is not fully understood, and no specific diagnostic tests are available for early and reliable diagnosis, or for monitoring of the disease process. Hyaluronan is an extracellular matrix polysaccharide present at low concentrations in plasma. Normally, it is rapidly eliminated from the blood by the liver. Increased concentrations of circulating hyaluronan are seen in conditions with impaired hepatic function such as liver cirrhosis, and hyaluronan concentrations have previously been used to evaluate hepatic function in other diseases. In the present study, 11 pregnant women admitted to the intensive care unit with severe pre-eclampsia or eclampsia were studied. As control 31 healthy pregnant women, 18 undergoing vaginal delivery and 13 caesarean section, were included. Plasma hyaluronan was measured before and after delivery. Increased concentrations of plasma hyaluronan were found in the pre-eclampsia group both before (171 (75-586) ╡g/L (p < 0.01) and after delivery (215 (124-768) ╡g/L (p < 0.001) (median and inter-quartile range), as compared to both caesarean section (13 (7-28) ╡g/L before and 28 (18-48) ╡g/L after delivery) and vaginal delivery healthy controls (12 (8-24) ╡g/L before and 30 (13-63) ╡g/L after delivery). In the control groups, a small increase in plasma hyaluronan was seen after delivery, after both caesarean section (p < 0.05) and vaginal delivery (p < 0.01). In conclusion, plasma hyaluronan is increased in severe pre-eclampsia and eclampsia. The cause of the increase is unknown.

  • 28.
    Berg, Sören
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Fink, MP
    Linkoping Univ, S-58183 Linkoping, Sweden Univ Pittsburgh, Dept Surg, Pittsburgh, PA USA Univ Pittsburgh, Dept Crit Care Med, Pittsburgh, PA USA.
    Delude, RL
    Linkoping Univ, S-58183 Linkoping, Sweden Univ Pittsburgh, Dept Surg, Pittsburgh, PA USA Univ Pittsburgh, Dept Crit Care Med, Pittsburgh, PA USA.
    Cytokine exposure prior to hypoxia modulates HIF-1 nuclear binding in response to hypoxia in cultured rat (IEC-6) enterocytes2001In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 29, no 12, p. 77-Conference paper (Other academic)
  • 29.
    Berg, Sören
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Golster, M
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, Anestesi.
    Lisander, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, Anestesi.
    Albumin extravasation and tissue washout of hyaluronan after plasma volume expansion with crystalloid or hypooncotic colloid solutions2002In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 46, no 2, p. 166-172Article in journal (Refereed)
    Abstract [en]

    Background: Intravascular volume expansion is followed by loss of fluid from the circulation. The extravasation of albumin in this readjustment is insufficiently known. Methods: Twelve male volunteers participated, each in three separate sessions, in a controlled, randomised, open fashion. They received one of the following: albumin 40g/L,(7.1mL/kg, i.e. 500mL per 70kg), Ringer's acetate (21.4mL/kg), or dextran 30g/L (7.1mL/kg). The fluids were infused during 30min and the subjects were followed for 180min. ECG, arterial oxygen saturation and non-invasive arterial pressure were recorded. Haemoglobin, haematocrit, serum albumin and osmolality, plasma colloid osmotic pressure and hyaluronan concentration were determined in venous samples. Results: The serum albumin concentration decreased (P < 0.05, ANOVA) following Ringer's acetate or dextran, whereas serum osmolality was unchanged in all groups. The colloid osmotic pressure decreased (P<0.05) after the Ringer solution. The blood volume increase was estimated from the decrease in haemoglobin concentration and did not differ between the three fluids. The cumulated extravasation of albumin was largest following albumin (10.4 ▒ 5.4g, mean ▒ SD), less following dextran (5.6 ▒ 5.0 g) and negligible in the Ringer group (0.5 ▒ 10.0 g, P < 0.05 against albumin). However, the Ringer solution increased the plasma concentration of hyaluronan drastically. Conclusions: Infusion of hypotonic colloidal solutions entails net loss of albumin from the vascular space. This is not the case after Ringer's acetate. Increased interstitial hydration from the latter fluid is followed by lymphatic wash out of hyaluronan. ⌐ Acta Anaesthesiologica Scandinavica.

  • 30.
    Berg, Sören
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Sappington, P.L.
    Department of Critical Care Medicine, Univ. of Pittsburgh Sch. of Medicine, Pittsburgh, PA, United States.
    Guzik, L.J.
    Department of Critical Care Medicine, Univ. of Pittsburgh Sch. of Medicine, Pittsburgh, PA, United States.
    Delude, R.L.
    Department of Critical Care Medicine, Univ. of Pittsburgh Sch. of Medicine, Pittsburgh, PA, United States, Department of Pathology, Univ. of Pittsburgh Sch. of Medicine, Pittsburgh, PA, United States.
    Fink, M.P.
    Department of Critical Care Medicine, Univ. of Pittsburgh Sch. of Medicine, Pittsburgh, PA, United States, Department of Surgery, Univ. of Pittsburgh Sch. of Medicine, Pittsburgh, PA, United States, 616 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261, United States.
    Proinflammatory cytokines increase the rate of glycolysis and adenosine-5'-triphosphate turnover in cultured rat enterocytes2003In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 31, no 4, p. 1203-1212Article in journal (Refereed)
    Abstract [en]

    Objective: Measurements of steady-state adenosine-5'-triphosphate (ATP) levels in tissue samples from patients or experimental animals with sepsis or endotoxemia provide little information about the rate of ATP production and consumption in these conditions. Accordingly, we sought to use an in vitro "reductionist" model of sepsis to test the hypothesis that proinflammatory cytokines modulate ATP turnover rate. Design: In vitro "reductionist" model of sepsis. Setting: University laboratory. Subjects: Cultured rat enterocyte-like cells. Interventions: IEC-6 nontransformed rat enterocytes were studied under control conditions or following incubation for 24 or 48 hrs with cytomix, a mixture of tumor necrosis factor-a (10 ng/mL), interleukin-1ß (1 ng/mL), and interferon-? (1000 units/mL). To measure ATP turnover rate, ATP synthesis was acutely blocked by adding to the cells a mixture of 2-deoxyglucose (10 mM), potassium cyanide (8 mM), and antimycin A (1 µM). ATP content was measured at baseline (before metabolic inhibition) and 0.5, 1, 2, 5, and 10 mins later. Log-linear ATP decay curves were generated and the kinetics of ATP utilization thereby calculated. Measurements and Main Results: ATP consumption rate was higher in cytomix-stimulated compared with control cells (3.11 ± 1.39 vs. 1.25 ± 0.66 nmol/min, respectively, p < .01). Similarly, the half-time for ATP disappearance was shorter in cytomix-stimulated compared with control cells (2.63 ± 1.00 vs. 6.21 ± 3.49, p < .05). In contrast to these findings, the rate of ATP disappearance was similar in cytokine-naïve and immunostimulated IEC-6 cells when protein and nucleic acid synthesis were inhibited by adding 50 µg/mL cycloheximide and 5 µg/mL actinomycin D to cultures for 4 hrs. The rates of glucose consumption and lactate production were significantly greater in cytomix-stimulated compared with controls cells. Conclusions: Incubation of IEC-6 cells with cytomix significantly increased ATP turnover. Increased ATP turnover rate was supported by increases in the rate of anaerobic glycolysis. These findings support the view that proinflammatory mediators impose a metabolic demand on visceral cells. In sepsis, cells may be more susceptible to dysfunction on the basis of diminished oxygen delivery and/or mitochondrial dysfunction.

  • 31.
    Berglund, Ulf
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Olin, Christian
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Diskutabel metodik ger missvisande resultat. SBU-studie av indikationer för ingrepp i hjärtats kranskärl kan ifrågasättas.1999In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 96, p. 700-702Article in journal (Other (popular science, discussion, etc.))
  • 32. Bergqvist, D
    et al.
    Bjorck, M
    Eliason, K
    Forssell, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Jansson, I
    Karlström, L
    Lundell, A
    Matmstedt, J
    Norgren, L
    Troeng, T
    No fatal cases/stroke cases following surgery in asymptomatic carotid stenosis. Five-year results presented in a nation-wide register.2006In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, p. 301-302Article in journal (Refereed)
  • 33.
    Bergstrand, Sara
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Länne, Toste
    Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Linden, Maria
    Mälardalen University.
    Lindgren, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype2010In: MICROCIRCULATION, ISSN 1073-9688, Vol. 17, no 4, p. 311-319Article in journal (Refereed)
    Abstract [en]

    Pandgt;Objective: The aim was to investigate the existence of sacral tissue blood flow at different depths in response to external pressure and compression in elderly individuals using a newly developed optical probe prototype. Methods: The tissue blood flow and tissue thickness in the sacral area were measured during load in 17 individuals using laser Doppler flowmetry and photoplethysmography in a combined probe, and digital ultrasound. Results: The mean age was 68.6 +/- 7.0 years. While loading, the mean compression was 60.3 +/- 11.9%. The number of participants with existing blood flow while loading increased with increased measurement depth. None had enclosed blood flow deep in the tissue and at the same time an existing more superficial blood flow. Correlation between tissue thickness and BMI in unloaded and loaded sacral tissue was shown: r = 0.68 (P = 0.003) and r = 0.68 (P = 0.003). Conclusions: Sacral tissue is highly compressed by external load. There seems to be a difference in responses to load in the different tissue layers, as occluded blood flow in deeper tissue layers do not occur unless the blood flow in the superficial tissue layers is occluded.

  • 34. Berkius, J
    et al.
    Nolin, T
    Mårdh, C
    Karlström, G
    Walther, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Respiratory failure due to acute on chronic obstructive pulmonary disease: an analysis of cases in the Swedish Intensive Care Registry during 2002-20062007In: in Intensive Care Medicine(ISSN 0342-4642), vol 33, 2007, Vol. 33, p. 15-15Conference paper (Refereed)
  • 35. Berkius, J
    et al.
    Walther, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Predictors of immediate and delayed endotracheal intubation in acute on chronic obstructive pulmonary disease (COPD)2007In: in Acta anaesthesiologica Scandinavica. Supplementum, ISSN 0515-2720, vol 51, 2007, Vol. 51, p. 22-22Conference paper (Refereed)
  • 36. Berkius, J
    et al.
    Walther, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Vårdprogram för KOL behöver implementeras bättre: Intensivvård vid kroniskt obstruktiv lungsjukdom med andningssvikt - från evidens till praxis (Acute respiratory failure in chronic obstructive lung disease - from evidence to clinical practice)2007In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 104, p. 1897-1901Article in journal (Other academic)
    Abstract [en]

      

  • 37.
    Berkius, Johan
    et al.
    Västervik hospital.
    Mårdh, C
    Central Hospital, Kristianstad.
    Karlström, G
    Landstinget i Värmland.
    Walther, Sten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Characteristics and long-term outcome of acute exacerbations in chronic obstructive pulmonary disease: An analysis of cases in the Swedish Intensive Care Registry during 2002-20062008In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 52, no 6, p. 759-765Article in journal (Refereed)
    Abstract [en]

    Background: Chronic obstructive pulmonary disease (COPD) represents a major and growing health problem. The purpose of this work was to examine characteristics, resource use and long-term survival in patients with an acute exacerbation of COPD that were admitted to Swedish intensive care units (ICU). Methods: Patient characteristics at admission, length of stay (LOS), resource use and outcome were collected for admissions due to COPD during 2002-2006 in the database of the Swedish Intensive Care Registry. Vital status was secured for 99.6% of the patients. Kaplan-Meier survival estimates were computed for index admissions only. Results: We identified 1009 patients with 1199 admissions due to COPD (1.3% of all intensive care admissions). The mean (SD) age was 70.2 (9.1) years and the proportion of women were 61.5%. Mean (SD) Acute Physiology and Chronic Health Evaluation II probability of hospital death was 0.31 (0.19). Median LOS was 28 (interquartile range 52) h. The number of readmissions was 190 during the 5-year study. Older patients had fewer readmissions (OR 0.96, 95% CI: 0.95-0.98/year increase in age). ICU mortality was 7.3% (87 of 1199 admissions) and 30-day mortality was 26.0% (262 of 1009 index admissions). Median survival was 14.5 months and 31% of patients survived 3 years after the index admission. Conclusions: Short (30 days) and long-term survival is poor in acute COPD. Readmissions are frequent reflecting the severity of this chronic illness. Patients are less likely to be readmitted with increasing age which may be due to withholding of further intensive care. © 2008 The Authors.

  • 38.
    Berkius, Johan
    et al.
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences.
    Sundh, Josefin
    Orebro University Hospital.
    Nilholm, Lennart
    Orebro University Hospital.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Walther, Sten
    Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Long-term survival according to ventilation mode in acute respiratory failure secondary to chronic obstructive pulmonary disease: A multicenter, inception cohort study2010In: JOURNAL OF CRITICAL CARE, ISSN 0883-9441, Vol. 25, no 3Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the study was to investigate 5-year survival stratified by mechanical ventilation modality in chronic obstructive pulmonary disease (COPD) patients treated in the ICU. Materials and Methods: Prospective, observational study of COPD patients with acute respiratory failure admitted to 9 multidisciplinary ICUs in Sweden. Characteristics on admission, including illness severity scores and the first blood gas, and survival were analyzed stratified by ventilation modality (noninvasive [NIV] vs invasive mechanical ventilation). Results: Ninety-three patients, mean age of 70.6 (SD, 9.6) years, were included. Sixteen patients were intubated immediately, whereas 77 were started on NIV. Patients who were started on NIV had a lower median body mass index (BMI) (21.9 vs 27.0; P andlt; .01) and were younger compared to those who were intubated immediately (median age, 70 vs 74.5 years; P andlt; .05). There were no differences in the initial blood gas results between the groups. Long-term survival was greater in patients with NIV (P andlt; .05, log rank). The effect of NIV on survival remained after including age, Acute Physiology and Chronic Health Evaluation II score, and BMI in a multivariate Cox regression model (NIV hazard ratio, 0.44; 95% confidence interval, 0.21-0.92). Fifteen patients with failed NIV were intubated and mechanically ventilated. Long-term survival in patients with failed NIV was not significantly different from patients who were intubated immediately. Conclusion: The short-term survival benefit of NIV previously found in randomized controlled trials still applies after 5 years of observation.

  • 39.
    Berterö, Carina
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Carlsson, Per
    Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Lundgren, Fredrik
    Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    The Lived Experience of 65-year-old Men Being Screened for Abdominal Aortic aneurysm; a Short-Term Perspective2009In: PRO-Newsletter, no 41, p. 1-5Article in journal (Refereed)
    Abstract [en]

    The purpose was to investigate whether screening for abdominal aortic aneurysm and the finding of an enlarged aorta in those men causes worries and affects the life-situation. Men at the age of 65 years were invited to ultrasound screening and they who had an enlarged aorta (≥30 mm), were invited for a qualitative interview analyzed by interpretive phenomenological method. Totally 11 men were interviewed. Three themes were identified: be under superintendence; affected, but live as usual; and hereditariness leading to fatalism. Although not unaffected by the screening result the men carry on with their life as usual. However, the need for a long term study to confirm the results is now in accomplishment.

  • 40.
    Berterö, Carina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Vanhanen, Maria
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Appelin, Gunilla
    Högskolan Jönköping.
    Receiving a diagnosis of inoperable lung cancer: Patients' perspectives of how it affects their life situation and quality of life2008In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 47, no 5, p. 862-869Article in journal (Refereed)
    Abstract [en]

    Lung cancer is a disease with many biomedical and psychological symptoms. The diagnosis and treatment of lung cancer induces adverse effects. Having an inoperable lung cancer there are few possibilities of being cured. Management of patients with inoperable disease is directed at relieving local or systemic symptoms. The purpose of this study is to describe how it affects the patients' life situation and quality of life. Data was collected by qualitative interviews where the patient's lived experiences were articulated. Twenty-three Swedish patients diagnosed and starting palliative treatment for inoperable lung cancer were interviewed. The interviews were audio-taped and transcribed verbatim. Data were interpreted trough interpretive phenomenology. Six themes were identified that were important for the informants' experience of their life situation and quality of life. The themes were: Experience of uncertainty, including time of waiting and thoughts, experience of hope, about a prolonged life, network as support, being treated as the person they are thoughts of death, is there time to conclude their lives?, feelings of shame and guilt, they have caused the disease by themselves and next of kin reactions, sadness, guilt, worries and anger. These six themes gave a structure presenting the essence: Living as usual. Maintaining independency and integrity were important, as well as maintaining status, being treated as the person they always had been and that they experience that they had a meaning to fulfill in life. They were living as usual. The findings of this study point out the importance of improving the care of people afflicted with lung cancer, as well as promoting support for the next of kin, since they are significantly important for these patients' experiences of quality of life. This knowledge and understanding will be useful for development of interventions and guidelines for treatment. © 2008 Taylor & Francis.

  • 41. Bertges, DJ
    et al.
    Berg, Sören
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Fink, MP
    Delude, RL
    Regulation of hypoxia-inducible factor 1 in enterocytic cells2002In: Journal of Surgical Research, ISSN 0022-4804, E-ISSN 1095-8673, Vol. 160, p. 157-165Article in journal (Refereed)
  • 42.
    Bjarnegård, Niclas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences.
    Ahlgren, AR
    Sandgren, T
    Sonesson, B
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Effects of age and sympathetic stimulation on the mechanical properties of the proximal brachial artery2003In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 21, p. S248-S249Conference paper (Other academic)
  • 43.
    Bjarnegård, Niclas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences.
    Ahlgren, AR
    Sonesson, B
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    The effect of sympathetic stimulation on proximal brachial artery mechanics in humans - differential behaviour within the length of the brachial artery?2004In: Acta Physiologica Scandinavica, ISSN 0001-6772, E-ISSN 1365-201X, Vol. 182, no 1, p. 21-27Article in journal (Refereed)
    Abstract [en]

    Aims: The mechanical properties of arteries play a major role in the regulation of blood pressure and cardiac performance. The effect of sympathetic stimulation on the mechanical properties of the proximal brachial artery was analysed in 18 healthy volunteers, nine young (25 +/- 2 years) and nine elderly (69 +/- 2 years). Methods: A non-invasive ultrasonic echo-tracking system for measurement of systolic/diastolic variation of the proximal brachial artery diameter in combination with intra-arterial pressure measurements was used to determine wall mechanics. The pressure-diameter (P-D) relationship, distensibility coefficient (DC), compliance coefficient (CC) and stiffness(beta) were obtained at rest and during sympathetic stimulation induced by lower body negative pressure (LBNP). Results: The peripheral vascular resistance increased by 100 and 72%, respectively in the young and elderly during LBNP (P < 0.001). Simultaneously, the mechanical properties of the proximal brachial artery remained unaltered, as estimated from both P-D relationship and stiffness in young (beta-index rest: 5.2 +/- 0.9, LBNP: 5.5 +/- 1.3, NS) as well as elderly (beta-index rest: 13.6 +/- 4.6, LBNP: 16.1 +/- 4.7, NS). Conclusions: LBNP-induced sympathetic activation does not change proximal brachial artery mechanics, in contrast to earlier reports on the muscular distal brachial artery. This may imply that the transition between elastic and muscular artery behaviour is within the length of the brachial artery, where the site of transition from elastic to muscular wall structure needs to be specified in future studies.

  • 44.
    Bjarnegård, Niclas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences.
    Arnqvist, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences.
    Jonasson, Lena
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Jonsson, Anders
    Jönköping Hospital.
    Länne, Toste
    Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Long-term hyperglycaemia impairs vascular smooth muscle cell function in women with type 1 diabetes mellitus2009In: DIABETES and VASCULAR DISEASE RESEARCH, ISSN 1479-1641, Vol. 6, no 1, p. 25-31Article in journal (Refereed)
    Abstract [en]

    Observations of increased stiffness in the elastic aorta in women with diabetes, but not men, emphasise the need for further analysis regarding early abnormalities in arterial wall properties of women with type 1 diabetes mellitus (DM).

    Ultrasound was used to study the wall properties of the distal brachial artery (BA) in 37 type 1 diabetic women (aged 22-45 years) without evident complications and in 53 controls (C). Blood samples were drawn for later analysis.

    Flow-mediated dilatation (FMD) was slightly lower in DM than C, 8.1 +/- 4.3% vs. 10.3 +/- 4.9% (p&lt;0.05), and nitrate-mediated dilatation (NMD) was markedly lower, 21.7 +/- 6.6% vs. 31.4 +/- 5.7% (p&lt;0.001). Lumen diameter, intima-media thickness and distensibility were similar in DM and C. Insulin-like growth factor (IGF-1) was lower in DM than C, 231 +/- 65 vs. 349 +/- 68 ng/ml (p&lt;0.001). Glycosylated haemoglobin (HbA(1C)) and matrix metalloproteinase (MMP-9) were independent predictors of the reduced NMD in the DM.

    Brachial artery responsiveness to an exogenous donor of nitric oxide (NO) was markedly reduced in type 1 diabetic women despite only limited reduction in endothelium-dependent dilatation. The negative association between NMD and HbA(1C) suggests that long-term hyperglycaemia impairs vascular smooth muscle cell function in DM.

  • 45.
    Bjarnegård, Niclas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Bengtsson, C
    Sturfelt, G
    Nived, O
    Brodszki, J
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Increased aortic pulse wave velocity in middle ages women with systemic lupou erythematosus2004In: 14th meeting of hypertension,2004, 2004Conference paper (Other academic)
  • 46.
    Bjarnegård, Niclas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Bengtsson, C
    Sturfelt, G
    Nived, O
    Brodszki, J
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Ökad central puls¨vågshastighet hos medelålders kvinnor med systemic lupus erythematosus2004In: Svenska Läkaresällskapets Riksstämma,2004, 2004Conference paper (Other academic)
  • 47.
    Bjarnegård, Niclas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences.
    Länne, Toste
    Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Arterial properties along the upper arm in humans: age-related effects and the consequence of anatomical location2010In: JOURNAL OF APPLIED PHYSIOLOGY, ISSN 8750-7587, Vol. 108, no 1, p. 34-38Article in journal (Refereed)
    Abstract [en]

    The normal aging process of the brachial artery (BA) wall is of specific interest since it is often selected as a model artery in studies of vascular function. With echo-tracking ultrasound, diameter, absolute diameter change, and intima-media thickness (IMT) were registered in 60 healthy subjects, 21-86 yr (30 men), at a proximal, upper third, and distal arterial site along the upper arm. Blood pressure was recorded noninvasively, and the distensibility coefficient (DC) was calculated. The diameter at the proximal site increased with age from 5.5 +/- 0.2 mm in the young subjects to 6.9 +/- 0.3 mm (P andlt; 0.01) in the elderly subjects, concomitantly as IMT increased from 0.40 +/- 0.01 to 0.65 +/- 0.03 mm (P andlt; 0.001). The diameter at the other sites was similar in the young and elderly subjects, whereas IMT increased slightly with age. At the proximal site, DC decreased dramatically from 40.7 +/- 2.2 to 10.1 +/- 0.8 10(-3)/kPa (P andlt; 0.001) with age, whereas hardly no change was seen in the distal upper arm. The principal transit zone between elastic to predominantly muscular artery behavior seems to be located within the proximal part of the brachial artery, emphasizing the importance of carefully defining the arterial examination site.

  • 48.
    Bjarnegård, Niclas
    et al.
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Rydén Ahlgren, Å.
    Department of Clinical Physiology, Malmö University Hospital, Malmö, Sweden .
    Sonesson, B.
    Department of Vascular Surgery, Malmö University Hospital, Malmö, Sweden.
    Länne, Toste
    Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    The effect of sympathetic stimulation on proximal brachial artery mechanics in humans: differential behaviour within the length of the brachial artery2004In: Acta physiologica Scandinavica, Vol. 182, no 1, p. 21-27Article in journal (Refereed)
    Abstract [en]

    Aims: The mechanical properties of arteries play a major role in the regulation of blood pressure and cardiac performance. The effect of sympathetic stimulation on the mechanical properties of the proximal brachial artery was analysed in 18 healthy volunteers, nine young (25 ± 2 years) and nine elderly (69 ± 2 years).

    Methods: A non-invasive ultrasonic echo-tracking system for measurement of systolic/diastolic variation of the proximal brachial artery diameter in combination with intra-arterial pressure measurements was used to determine wall mechanics. The pressure–diameter (P–D) relationship, distensibility coefficient (DC), compliance coefficient (CC) and stiffness(β) were obtained at rest and during sympathetic stimulation induced by lower body negative pressure (LBNP).

    Results: The peripheral vascular resistance increased by 100 and 72%, respectively in the young and elderly during LBNP (P < 0.001). Simultaneously, the mechanical properties of the proximal brachial artery remained unaltered, as estimated from both P–D relationship and stiffness in young (β-index rest: 5.2 ± 0.9, LBNP: 5.5 ± 1.3, NS) as well as elderly (β-index rest: 13.6 ± 4.6, LBNP: 16.1 ± 4.7, NS).

    Conclusions: LBNP-induced sympathetic activation does not change proximal brachial artery mechanics, in contrast to earlier reports on the muscular distal brachial artery. This may imply that the transition between elastic and muscular artery behaviour is within the length of the brachial artery, where the site of transition from elastic to muscular wall structure needs to be specified in future studies.

  • 49.
    Björck, Hanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences.
    Länne, Toste
    Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Alehagen, Urban
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Persson, Karin
    Linköping University, Department of Medical and Health Sciences, Pharmacology. Linköping University, Faculty of Health Sciences.
    Rundkvist, Louise
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Hamsten, A
    Karolinska Institute.
    Dahlström, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Eriksson, P
    Karolinska Institute, Stockholm.
    Association of genetic variation on chromosome 9p21.3 and arterial stiffness2009In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 265, no 3, p. 373-381Article in journal (Refereed)
    Abstract [en]

    Genome wide association studies have consistently reported associations between a region on chromosome 9p21.3 and a broad range of vascular diseases, such as coronary artery disease (CAD), aortic and intracranial aneurysms and type-2 diabetes (T2D). However, clear associations with intermediate phenotypes have not been described so far. To shed light on a possible influence of this chromosomal region on arterial wall integrity, we analysed associations between single nucleotide polymorphisms (SNPs) and degree of stiffness of the abdominal aorta in elderly individuals.

    A total of 400 subjects, 212 men and 188 women, aged 70-88 years were included. Arterial stiffness was examined at the midpoint between the renal arteries and the aortic bifurcation. Two CAD- and aneurysm-associated SNPs (rs10757274 and rs2891168) and one T2D-associated SNP (rs1081161) within the 9p21.3 region were genotyped. Aortic compliance and distensibility coefficients were higher in carriers of the rs10757274G and rs2891168G alleles in men reflecting a decrease in aortic stiffness. Adjustment for age and mean arterial pressure had no effect on these associations. The two SNPs were not associated with intima-media thickness or lumen diameter of the abdominal aorta. There were no associations between the rs10811661 SNP and any measure of aortic stiffness.

    Impaired mechanical properties of the arterial wall may explain the association between chromosome 9p21.3 polymorphisms and vascular disease.

  • 50.
    Borch, Kurt
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, MKC-2, GE: Gastrokir.
    Jönsson, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Vascular surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Tarpila, Erkki
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Franzén, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, MKC-2, GE: Gastrokir.
    Berglund, J
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Vascular surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Kullman, Eric
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery. Östergötlands Läns Landsting, MKC-2, GE: Gastrokir.
    Franzén, L
    Changing pattern of histological type, location, stage and outcome of surgical treatment of gastric carcinoma2000In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 87, no 5, p. 618-626Article in journal (Refereed)
    Abstract [en]

    Background: There are indications that some features of gastric carcinoma are changing, with a possible impact on prognosis. The aim of this study was to examine any changes in type, location, stage, resection rate, postoperative mortality rate or prognosis for patients with gastric carcinoma in a well defined population. Methods: During 1974-1991, 1161 new cases of gastric adenocarcinoma were diagnosed in Ostergotland County, Sweden. Tumour location, Lauren histological type, tumour node metastasis (TNM) stage, radicality of tumour resection and postoperative complications were recorded after histological re-evaluation of tissue specimens and examination of all patient records. Dates of death were obtained from the Swedish Central Bureau of Statistics. Time trends were studied by comparing the intervals 1974-1982 (period 1) and 1983-1991 (period 2). Results: The proportion of diffuse type of adenocarcinoma increased (from 27 to 35 per cent), while that of mixed type decreased (from 16 to 9 per cent) and that of intestinal type was unchanged. The proportion of tumours located in the proximal two-thirds of the stomach increased (from 32 to 42 per cent) and the proportion of patients with tumours in TNM stage IV decreased (from 32 to 25 per cent). Overall tumour resection rates were unchanged, although the proportion of radical total gastrectomies increased (from 36 to 50 per cent). Excluding tumours of the cardia or gastric remnant after previous ulcer surgery, the 5-year relative survival rate after radical resection increased from 25 to 36 per cent and the postoperative mortality rate decreased for both radical (from 11 to 4 per cent) and palliative (from 18 to 6 per cent) resection. Conclusion: The patterns of tumour histology, location and stage of gastric carcinoma have changed in the authors' region. These changes were paralleled by a significant improvement in survival and postoperative mortality rates.

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