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  • 151.
    Tillander, Bo
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Nordqvist, P.
    Melerit Medical AB, Linköping, Sweden.
    Skarman, E.
    Melerit Medical AB, Linköping, Sweden.
    Wahlström, Ola
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    A virtual reality trauma simulator2004In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 26, no 2, p. 189-191Article in journal (Refereed)
    Abstract [en]

    The authors have evaluated a trauma simulator based on virtual reality techniques. Ten surgeons and 15 medical students performed distal locking of a femoral nail (A). Furthermore, 10 medical students performed simulated osteosynthesis of a femoral neck fracture (B). Total surgery time (A) (mean value) was shorter for surgeons (108 s) compared with students (157 s) at the first (p = 0.033), second (102 respectively 138 s, p = 0.13) and third (96 respectively 160 s, p = 0.15) operation. Total fluoroscopy time (A) (mean value) was shorter for surgeons compared with students at the first (45 respectively 89s p = 0.001), second (48 respectively 83 s, p = 0.02) and third (50 respectively 107 s, p = 0.10) operation. The positioning of the hip nails (B) improved between the first and last trial. Total surgery and fluoroscopy time were reduced. All participants thought that this and similar simulators should be part of the programme and that this simulator would be helpful if they were about to learn the procedures).

  • 152.
    Uusimaa, J.
    et al.
    Department of Paediatrics, University of Oulu, Oulu, Finland, Clinical Research Center, Oulu University Hospital, Oulu, Finland.
    Moilanen, J.S.
    Department of Clinical Genetics, University of Oulu, Oulu, Finland, Institute of Medical Technology, University of Tampere, Tampere, Finland.
    Vainionpaa, L.
    Vainionpää, L., Department of Paediatrics, University of Oulu, Oulu, Finland.
    Tapanainen, P.
    Department of Paediatrics, University of Oulu, Oulu, Finland.
    Lindholm, P.
    Department of Otorhinolaryngology, University of Oulu, Oulu, Finland, Department of Child Psychiatry, University of Oulu, Oulu, Finland.
    Nuutinen, M.
    Department of Paediatrics, University of Oulu, Oulu, Finland.
    Lopponen, T.
    Löppönen, T., Department of Clinical Genetics, University of Oulu, Oulu, Finland, Department of Paediatrics, University of Kuopio, Kuopio, Finland.
    Maki-Torkko, E.
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery .
    Rantala, H.
    Department of Paediatrics, University of Oulu, Oulu, Finland.
    Majamaa, K.
    Clinical Research Center, Oulu University Hospital, Oulu, Finland, Department of Neurology, University of Oulu, Oulu, Finland, Department of Neurology, University of Turku, Turku, Finland, Department of Neurology, University of Turku, FIN-20014 Turku, Finland.
    Prevalence, segregation, and phenotype of the mitochondrial DNA 3243A>G mutation in children2007In: Annals of Neurology, ISSN 0364-5134, E-ISSN 1531-8249, Vol. 62, no 3, p. 278-287Article in journal (Refereed)
    Abstract [en]

    Objective: We studied the prevalence, segregation, and phenotype of the mitochondrial DNA 3243A>G mutation in children in a defined population in Notthern Ostrobothnia, Finland. Methods: Children with diagnoses commonly associated with mitochondrial diseases were ascertained. Blood DNA from 522 selected children was analyzed for 3243A>G. Children with the mutation were clinically examined. Information on health history before the age of 18 years was collected from previously identified adult patients with 3243A>G. Mutation segregation analysis in buccal epithelial cells was performed in mothers with 3243A>G and their children whose samples were analyzed anonymously. Results: Eighteen children were found to harbor 3243A>G in a population of 97,609. A minimum estimate for the prevalence of 3243A>G was 18.4 in 100,000 (95% confidence interval, 10.9-29.1/100,000). Information on health in childhood was obtained from 37 adult patients with 3243A>G. The first clinical manifestations appearing in childhood were sensorineural hearing impairment, short stature or delayed maturation, migraine, learning difficulties, and exercise intolerance. Mutation analysis from 13 mothers with 3243A>G and their 41 children gave a segregation rate of 0.80. The mothers with hetetoplasmy greater than 50% tended to have offspring with lower or equal heteroplasmy, whereas the opposite was true for mothers with heteroplasmy less than or equal to 50% (p = 0.0016). Interpretation: The prevalence of 3243A>G is relatively high in the pediatric population, but the morbidity in children is relatively low. The random genetic drift model may be inappropriate for the transmission of the 3243A>G mutation. © 2007 American Neurological Association.

  • 153.
    Wahlberg, Jeanette
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Ledin, Torbjön
    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.
    Bågesund, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Public Dental Health Care, Centre for Orthodontics and Paediatric Dentistry.
    Ekman, Bertil
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Impaired Postural Balance in Turner Syndrom2013In: Hormone and Metabolic Research, ISSN 0018-5043, E-ISSN 1439-4286, Vol. 45, no 7, p. 537-540Article in journal (Refereed)
    Abstract [en]

    An impaired body balance has been found in Turner syndrome (TS) in clinical tests like Rombergs’s test and walking on a balance beam. The aim of the study was to assess postural balance in TS subjects with specific balance testing using dynamic posturography and relate to body composition. Nineteen TS subjects (20–57 years) were included. Balance was measured with dynamic posturography (Equitest) and compared with 19 sex and age-matched controls (22–59 years). Equitest, visual, vestibular, and somatosensory systems were provoked with increasing difficulty (6 tests, SO1–SO6) and body sway was measured with a dual forceplate. Body composition was measured with DXA. No difference was found between the TS subjects and the controls on fixed platform with open eyes (SO1), with closed eyes (SO2), with stable platform and visual disorientation (SO3), or on unstable platform with open eyes (SO4). In the difficult tests on unstable platform the TS subjects did worse compared with controls both in the test with eyes closed (SO5), p<0.01, and in the test with visual disorientation (SO6), p<0.05. Composite (a merge of all six recordings) was significantly lower in the TS-group, p<0.05. In the TS group high total body weight was related to worse outcome on tests SO5, SO6, and composite, while total bone mass, age, height, or waist showed no significant association with balance scores. Our findings indicate that TS could have an increased risk for falling due to impaired ability to manage complex coordination tasks.

  • 154.
    Wahlström, Ola
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Linder, Cecilia
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
    Ansell, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Kalén, Anders
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Söderström, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Magnusson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
    Acidic preparations of lysed platelets upregulate proliferative pathways in osteoblast-like cells as demonstrated by genome-wide microarray analysis2011In: Platelets, ISSN 0953-7104, E-ISSN 1369-1635, Vol. 22, no 6, p. 452-460Article in journal (Refereed)
    Abstract [en]

    latelets contain numerous growth factors essential for wound and fracture healing. We investigated the gene expression in human osteoblast-like cells stimulated with lysed platelets prepared in acidic, neutral, or alkaline buffers. Lysed platelets prepared in buffers at pH 5.4, 7.4, and 7.9, were added after neutralization to hFOB 1.19 cells. Genome-wide microarray analysis was performed using the Affymetrix GeneChip 7G Scanner. Biometric, cluster, and pathway analyses were performed with GeneSpring GX. Biometric analyses demonstrated that 53 genes were differentially regulated (p andlt;= 0.005, andgt;= 2-fold increase). Pathway analysis revealed 10 significant pathways of which eight are common ones regulating bone formation and cancer growth. Eleven genes were selected for quantitative real-time polymerase chain reaction (PCR) based on the microarray analysis of the lysed platelets prepared in the pH 5.4 experiments. In conclusion, acidic preparations of lysed platelet concentrates release factors essential for cell proliferation and particularly cell metabolism under hypoxic conditions. The genetic response from these factors was dominated by genes associated with the same pathways observed in bone formation and cancer growth. Activation of TGF-beta in the acidic preparation could be a stimulatory key factor of cell proliferation. These results support the hypothesis that acidification of platelets modifies the stimulatory response of mesenchymal cells in vitro, which is analogous with the observed milieu of a low pH present in wound and fracture sites, as well as in growing tumors.

  • 155.
    Wahlström, Ola
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Risto, Olof
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Kalén, Anders
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Linder, Cecilia
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Chemistry.
    Ansell, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Söderström, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Magnusson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Chemistry.
    Acidic preparations of lysed platelets up-regulate proliferative and vascular genes, and the TGFBR pathway in osteoblast-like cells in BONE, vol 48, issue , pp S118-S1182011In: BONE, Elsevier Science B.V., Amsterdam. , 2011, Vol. 48, p. S118-S118Conference paper (Refereed)
    Abstract [en]

    n/a

  • 156.
    Wass, Malin
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Sahlé, Birgitta
    Deparment of Logopedics, Lund University, Sweden.
    Asker-Árnason, Lena
    Deparment of Logopedics, Lund University, Sweden.
    Ibertsson, Tina
    Deparment of Logopedics, Lund University, Sweden.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Hällgren, Mattias
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Cognitive Skills and Reading Ability in Children with Cochlear Implants2010In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 11, no Suppl. 1, p. 395-398Article in journal (Refereed)
    Abstract [en]

    n/a

  • 157.
    Wass, Malin
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Sahlén, Birgitt
    Department of Logopedics, Phoniatrics and Audiology, Lund University, Sweden.
    Asker-Árnason, Lena
    Department of Logopedics, Phoniatrics and Audiology, Lund University, Sweden.
    Ibertsson, Tina
    Department of Logopedics, Phoniatrics and Audiology, Lund University, Sweden.
    Mäki-Torkko, Elina
    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.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Reading Strategies and Cognitive Skills in Children with Cochlear Implants2010In: Acta Neuropsychologica, ISSN 1730-7503, E-ISSN 2084-4298, Vol. 8, no 2, p. 143-180Article in journal (Refereed)
    Abstract [en]

    The present study investigated WM capacity, lexical access, phonological skills and reading ability in 6 children with cochlear implants (CI), attending grades 1-3. For each test measure, the individual performance of the children with CI was compared to a grade-matched comparison group of children with normal hearing. Performance was also studied in relation to demographic factors. The results reveal that the children with CI have specific difficulties in tasks of phonological skills and phonological working memory (WM) where nonwords are used as test stimuli. They do not seem to have problems with phonological processing of words for which they have a well defined phonological representation. They also experienced relatively more difficulties in tasks on lexical access without any contextual info. We suggest that children with CI are particularly efficient in using compensatory strategies in situations where their auditory perception does not provide sufficient information to correctly match the incoming speech signal to a corresponding representation in the long-term phonological storage. The children with CI in this study are skilled readers, both for decoding of words and nonwords and for reading comprehension. They may use both orthographic and phonological reading strategies although most of them seem to be dependent on phonological decoding to some extent.

  • 158.
    Westerberg, J
    et al.
    Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery VHN.
    Harder, Henrik
    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.
    Magnuson, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery.
    Westerberg, L
    Skovde University.
    Hydén, Dag
    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.
    Ten-year myringoplasty series: does the cause of perforation affect the success rate?2011In: JOURNAL OF LARYNGOLOGY AND OTOLOGY, ISSN 0022-2151, Vol. 125, no 2, p. 126-132Article in journal (Refereed)
    Abstract [en]

    Objective: To present the results of primary myringoplasty procedures together with the perforation cause, perforation size and site, surgeons experience, and surgical method, and to investigate how these factors relate to graft take rates. Study design: Retrospective chart review of 243 consecutive patients undergoing primary myringoplasty with temporalis fascia underlay over a 10-year period from 1994 to 2004. Results: The overall graft take rate was 95 per cent. The retroauricular approach resulted in a 97 per cent graft take rate, whereas a significantly lower rate (77 per cent) was seen for surgery conducted via the endaural approach, or via an ear speculum. There was no relationship between other factors and tympanic membrane healing. Conclusion: No association was found between perforation cause and graft take rate. The underlay technique is safe and reliable, and the retroauricular approach is preferable as it enables good surgical access and has better results.

  • 159.
    Westin, Vendela
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Educational Sciences.
    Schulin, Mikael
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Stalby, Magnus
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Wisung, Gisela
    Hesser, Hugo
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zarenoe, Reza
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Karlsson, M
    Olofsson, U
    Ermedahl-Bydairk, Ulrika
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Randomized Controlled trial of Acceptance and Commitment Therapy for tinnitus distress2008Conference paper (Other academic)
  • 160.
    Wilhelmsson, Niklas
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Dahlgren, Lars Owe
    Linköping University, Department of Behavioural Sciences and Learning, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Educational Sciences.
    Hult, Håkan
    Linköping University, Department of Behavioural Sciences and Learning, Education and Adult Learning. Linköping University, Faculty of Educational Sciences.
    Wirell, Staffan
    Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    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.
    Josephson, Anna
    Karolinska Institutet, Stockholm, Sweden.
    Phenomenographic study of basic science understanding-senior medical students' conceptions of fatigue2013In: Education for Health, ISSN 1357-6283, E-ISSN 1469-5804, Vol. 26, no 3, p. 156-163Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Helping students learn to apply their newly learned basic science knowledge to clinical situations is a long-standing challenge for medical educators. This study aims to describe how medical students' knowledge of the basic sciences is construed toward the end of their medical curriculum, focusing on how senior medical students explain the physiology of a given scenario. Methods A group of final-year medical students from two universities was investigated. Interviews were performed and phenomenographic analysis was used to interpret students' understanding of the physiology underlying the onset of fatigue in an individual on an exercise bicycle.

    RESULTS: Three categories of description depict the qualitatively different ways the students conceptualized fatigue. A first category depicts well integrated physiological and bio-chemical knowledge characterized by equilibrium and causality. The second category contains conceptions of finite amount of substrate and juxtaposition of physiological concepts that are not fully integrated. The third category exhibits a fragmented understanding of disparate sections of knowledge without integration of basic science and clinical knowledge.

    DISCUSSION: Distinctive conceptions of fatigue based with varying completeness of students' understanding characterized the three identified categories. The students' conceptions of fatigue were based on varying understanding of how organ systems relate and of the thresholds that determine physiological processes. Medical instruction should focus on making governing steps in biological processes clear and providing opportunity for causal explanations of clinical scenarios containing bio-chemical as well as clinical knowledge. This augments earlier findings by adding descriptions in terms of the subject matter studied about how basic science is applied by students in clinical settings.

  • 161.
    Wireklint, Sara
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ericsson, 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, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Health-related quality of life after tonsillotomy versus tonsillectomy in young adults: 6 years postsurgery follow-up2012In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 269, no 8, p. 1951-1958Article in journal (Refereed)
    Abstract [en]

    The indication for tonsil surgery is tonsillitis or obstructive symptoms due to tonsillar hypertrophy, associated with morbidity affecting health related quality of life (HRQL). Surgery performed is either tonsillectomy (TE) or partial intra capsular tonsillectomy/tonsillotomy (TT). TT is associated with fewer postoperative complications and rapid recovery, but with risk for regrowth of tonsillar tissue and return of sleep disordered breathing (SDB) or infections. The aim of this study was to investigate the long-term effects of TT and TE in young adults relating to HRQL and well-being as consequence of obstructive symptoms or ENT-infections after 6 years versus effect after 1 year. Young adults with symptoms of tonsillar hyperplasia were randomized to TE (44) or TT (32). Patients were assessed prior to surgery and 1 and 6 years postoperatively. Short Form 36 and the EuroQul Visual Analog Scale evaluated HRQL. Questionnaire was used to explore well-being, obstruction symptoms and infections. Patient BMI was calculated. Six years after surgery, 91 % of young adults (TE39/TT29) reported persisting benefits in well-being, reduced obstructive problems and fewer infections. Some patients in both groups reported a slight increase in snoring compared to 1 year after surgery, but still less than before surgery. Obesity was more frequent among those snoring. Both TT and TE in young adults yielded HRQL improvements and reduction in symptoms defining SDB persisting through 6 years postsurgery. Results indicated that both surgical methods were equally effective. Findings favor choice of TT due to lesser postoperative morbidity.

  • 162.
    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.

  • 163.
    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, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    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, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Corticosteroid Treatment of Idiopathic Sudden Sensorineural Hearing Loss: Randomized Triple-Blind Placebo-Controlled Trial2012In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 33, no 4, p. 523-531Article in journal (Refereed)
    Abstract [en]

    Objective: To compare the effect of Prednisolone and placebo on the recovery of unilateral idiopathic sudden sensorineural hearing loss. less thanbrgreater than less thanbrgreater thanStudy Design: Prospective, randomized, triple-blind, placebo-controlled multicenter trial. less thanbrgreater than less thanbrgreater thanSetting: Four tertiary and 10 secondary referral centers. less thanbrgreater than less thanbrgreater thanPatients: Of 103 patients randomly assigned, 93 were included in the modified intention-to-treat analysis. The patients, aged 18 to 80 years, were seeking care within 1 week after onset of acute unilateral sensorineural hearing loss with a mean decrease of 30 dB or greater in the 3 most affected contiguous frequencies. less thanbrgreater than less thanbrgreater thanIntervention: Patients were randomly assigned in permuted blocks of 10 to receive Prednisolone or placebo in tapering doses from 60 mg for 3 days and, thereafter, 10 mg less each day until Day 8. If complete recovery, no more medication given, otherwise medication continued at 10 mg per day until Day 30. Final follow-up was after 3 months with audiogram; 47 patients received Prednisolone and 46 placebo. less thanbrgreater than less thanbrgreater thanMain Outcome Measure: The primary endpoint was efficacy of treatment on recovery at Day 90. Secondary endpoints were prognostic factors for hearing recovery. Analyses were by modified intention-to-treat and per protocol. less thanbrgreater than less thanbrgreater thanResults: Hearing improvement for 47 Prednisolone-treated patients was 25.5 +/- 27.1 dB compared to 26.4 +/- 26.2 dB for 46 placebo-treated patients at Day 8 and 39 +/- 20.1 dB versus 35.1 +/- 38.3 dB after 3 months. Vertigo had significant negative effect on hearing improvement and inflammatory signs in the laboratory workup-a positive prognostic effect, irrespective of treatment. less thanbrgreater than less thanbrgreater thanConclusion: Prednisolone in customary dosage does not seem to influence recovery of idiopathic sudden sensorineural hearing loss.

  • 164.
    Zarenoe, Reza
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    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.
    A cohort study of patients with tinnitus and sensorineural hearing loss in a Swedish population2013In: Auris, nasus, larynx, ISSN 0385-8146, E-ISSN 1879-1476, Vol. 40, no 1, p. 41-45Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: We aimed to describe a large cohort of patients with tinnitus and sensorineural hearing loss (SNHL) in Sweden, and also to explore the possibility of finding potential possible differences between various diagnoses within SNHL. It is also of great interest to see how a multidisciplinary team was used in the different subgroups and the frequency of hearing aids use in patients with tinnitus.

    METHODS: Medical records of all patients who had received the diagnosis SNHL in Östergötland County, Sweden between 2004 and 2007 were reviewed. Patients between 20 and 80 years with tinnitus and a pure tone average (PTA) lower than 70dB HL were included in the study. Patients were excluded from the analyses if they had a cochlear implantation, middle ear disorders or had a hearing loss since birth or childhood. The investigators completed a form for each included patient, covering background facts, and audiograms taken at the yearly check up.

    RESULTS: Of a total 1672 patients' medical record review, 714 patients were included. The majority of patients (79%) were in the age group over 50 years. In male patients with bilateral tinnitus, the PTA for the left ear was significantly higher than for the right ear. The results regarding the configuration of hearing loss revealed that 555 patients (78%) had symmetric and 159 (22%) asymmetric hearing loss. Retrocochlear examinations were done in 372 patients and MRI was the most common examination. In all patients, 400 had no hearing aids and out of those 220 had unilateral tinnitus and 180 patients had bilateral tinnitus. 219 patients had a PTA>20dB HL and did not have any hearing aid. Results demonstrated that the Stepped Care model was not used widely in the daily practice. In our study, patients with bilateral-, unilateral hearing loss or Mb Ménière were the most common patients included in the Stepped Care model.

    CONCLUSION: In a large cohort of patients with SNHL and tinnitus, despite their hearing loss only 39% had hearing aids. It was observed that the medical record review often showed a lack of information about many background factors, such as; patients' general health condition, which could be a quality factor that needs improvement. Our results show that the Stepped Care model could be an effective option for providing a better access for tinnitus-focused treatment, although the number of patients in this study who were included in the Stepped Care model was low.

  • 165.
    Zetterqvist Westin, Vendela
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Educational Sciences.
    Schulin, Mikael
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Karlsson, Marianne
    Vrinnevisjukhuset, Norrköping.
    Zare Noe, Reza
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery.
    Olofsson, Ulrike
    Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Stalby, Magnus
    Psykologpartners, Linköping.
    Wisung, Gisela
    Psykologpartners, Linköping.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Acceptance and Commitment Therapy versus Tinnitus Retraining Therapy in the treatment of tinnitus: A randomised controlled trial2011In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 49, no 11, p. 737-747Article in journal (Refereed)
    Abstract [en]

    The study compared the effects of Acceptance and Commitment Therapy (ACT) with Tinnitus Retraining Therapy (TRT) on tinnitus impact in a randomised controlled trial. Sixty-four normal hearing subjects with tinnitus were randomised to one of the active treatments or a wait-list control (WLC). The ACT treatment consisted of 10 weekly 60min sessions. The TRT treatment consisted of one 150min session, one 30min follow-up and continued daily use of wearable sound generators for a recommended period of at least 8h/day for 18 months. Assessments were made at baseline, 10 weeks, 6 months and 18 months. At 10 weeks, results showed a superior effect of ACT in comparison with the WLC regarding tinnitus impact (Cohen's d=1.04), problems with sleep and anxiety. The results were mediated by tinnitus acceptance. A comparison between the active treatments, including all assessment points, revealed significant differences in favour of ACT regarding tinnitus impact (Cohen's d=0.75) and problems with sleep. At 6 months, reliable improvement on the main outcome measure was found for 54.5% in the ACT condition and 20% in the TRT condition. The results suggest that ACT can reduce tinnitus distress and impact in a group of normal hearing tinnitus patients.

  • 166.
    Zheng, Lin
    et al.
    Karolinska Inst, NVS, KI Alzheimers Dis Res Ctr, S-14186 Stockholm, Sweden.
    Cedazo-Minguez, Angel
    KI-AlzheimerDisease Research Center, NVS, Novum, Karolinska Institutet, SE-141 57, Stockholm,Sweden.
    Hallbeck, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Experimental Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics.
    Jerhammar, Fredrik
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Hultenby, Kjell
    Clinical Research Center, Department of Laboratory Medicine, Karolinska Institutet, SE-141 86 Stockholm, Sweden.
    Marcusson, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    Terman, Alexi
    Department of Clinical Pathology and Cytology, Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden.
    Intracellular localization of amyloid beta peptide in SH-SY5Y neuroblastoma cells2013In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 37, no 4, p. 713-733Article in journal (Refereed)
    Abstract [en]

    Amyloid-beta peptide (A beta), the main component of Alzheimer's disease (AD) senile plaques, has been found to accumulate within the lysosomal compartment of AD neurons. We have previously shown that in differentiated SH-SY5Y neuroblastoma cells cultured under normal conditions, the majority of A beta is localized extralysosomally, while oxidative stress significantly increases intralysosomal A beta content through activation of macroautophagy. It is, however, not clear which cellular compartments contain extralysosomal A beta in intact SH-SY5Y cells, and how oxidative stress influences the distribution of extralysosomal A beta. Using confocal laser scanning microscopy and immunoelectron microscopy, we showed that in differentiated neuroblastoma cells cultured under normal conditions A beta (A beta(40), A beta(42), and A beta oligomers) is colocalized with both membrane-bound organelles (endoplasmic reticulum, Golgi complexes, multivesicular bodies/late endosomes, lysosomes, exocytotic vesicles and mitochondria) and non-membrane-bound cytosolic structures. Neuroblastoma cells stably transfected with A beta PP Swedish KM670/671NL double mutation showed enlarged amount of A beta colocalized with membrane compartments. Suppression of exocytosis by 5 nM tetanus toxin resulted in a significant increase of the amount of cytosolic A beta as well as A beta colocalized with exocytotic vesicles, endoplasmic reticulum, Golgi complexes, and lysosomes. Hyperoxia increased A beta localization in the endoplasmic reticulum, Golgi apparatus, mitochondria, and lysosomes, but not in the secretory vesicles. These results indicate that in SH-SY5Y neuroblastoma cells intracellular A beta is not preferentially localized to any particular organelle and, to a large extent, is secreted from the cells. Challenging cells to hyperoxia, exocytosis inhibition, or A beta overproduction increased intracellular A beta levels but did not dramatically changed its localization pattern.

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