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  • 151. Brunne, M.
    et al.
    Falk, B.
    Hellström, S.
    Magnusson, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    The character and consequenses of disturbing sound sensations in retraction type middle ear disease.1999In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 51, p. 11-21Article in journal (Refereed)
  • 152.
    Brändström, Sven
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Richter, Jörg
    Clinical of Psychiatry and Psychotherapy, Rostock University, Germany.
    Nylander, Per-Olof
    Linköping University, Department of Neuroscience and Locomotion.
    Further development of the Temperament and Character Inventory2001In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 93, p. 995-1002Article in journal (Refereed)
    Abstract [en]

    The Temperament and Character Inventory is an internationally used personality questionnaire based on Cloninger’s psychobiological theory of personality. Given some limitations of Version 9 a revised version was developed. The structural equivalence of the two versions was demonstrated from a cross-cultural perspective with 309 and 173 healthy volunteers from Sweden and Germany, respectively, who completed both versions in one session. In testing for the replicability of the factors across both samples as well as across both versions, an orthogonal Procrustes rotation method was used. The reliability coefficients for the revision were higher than the former version for both samples. The factor structures of the inventory remain highly equivalent across cultures and across versions. The results indicate a cross-cultural transferability of the Temperament and Character dimensions of the inventory. The stability and the validity of the 7-factor model of personality, as suggested by Cloninger, are supported. The Temperament and Character Inventory-Revised represents an important and useful method for the assessment of personality.

  • 153.
    Brändström, Sven
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry.
    Richter, Jörg
    Nylander, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry.
    Further development of the temperament and character inventory2003In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 93, no 3 II, p. 995-1002Article in journal (Refereed)
    Abstract [en]

    The Temperament and Character Inventory is an internationally used personality questionnaire based on Cloninger's psychobiological theory of personality. Given some limitations of Version 9 a revised version was developed. The structural equivalence of the two versions was demonstrated from a cross-cultural perspective with 309 and 173 healthy volunteers from Sweden and Germany, respectively, who completed both versions in one session. In testing for the replicability of the factors across both samples as well as across both versions, an orthogonal Procrustes rotation method was used. The reliability coefficients for the revision were higher than the former version for both samples. The factor structures of the inventory remain highly equivalent across cultures and across versions. The results indicate a cross-cultural transferability of the Temperament and Character dimensions of the inventory. The stability and the validity of the 7-factor model of personality, as suggested by Cloninger, are supported. The Temperament and Character Inventory-Revised represents an important and useful method for the assessment of personality.

  • 154.
    Brändström, Sven
    et al.
    Linköping University, Department of Neuroscience and Locomotion. Linköping University, Faculty of Health Sciences.
    Schlette, Paul
    Department of Psychology, Stockholm University, Stockholm, Sweden/Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA/Departments of Psychiatry and Social Medicine, Umeå University, Umeå, Sweden.
    Przybeck, Thomas R.
    Department of Psychology, Stockholm University, Stockholm, Sweden/Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA/Departments of Psychiatry and Social Medicine, Umeå University, Umeå, Sweden.
    Lundberg, Mattias
    Department of Psychology, Stockholm University, Stockholm, Sweden/Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA/Departments of Psychiatry and Social Medicine, Umeå University, Umeå, Sweden.
    Forsgren, Thomas
    Department of Psychology, Stockholm University, Stockholm, Sweden/Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA/Departments of Psychiatry and Social Medicine, Umeå University, Umeå, Sweden.
    Sigvardsson, Sören
    Department of Psychology, Stockholm University, Stockholm, Sweden/Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA/Departments of Psychiatry and Social Medicine, Umeå University, Umeå, Sweden.
    Nylander, Per-Olof
    Department of Psychology, Stockholm University, Stockholm, Sweden/Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA/Departments of Psychiatry and Social Medicine, Umeå University, Umeå, Sweden.
    Nilsson, Lars-Göran
    Department of Psychology, Stockholm University, Stockholm, Sweden/Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA/Departments of Psychiatry and Social Medicine, Umeå University, Umeå, Sweden.
    Cloninger, Robert C.
    Department of Psychology, Stockholm University, Stockholm, Sweden/Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA/Departments of Psychiatry and Social Medicine, Umeå University, Umeå, Sweden.
    Adolfsson, Rolf
    Departments of Psychiatry and Social Medicine, Umeå University, Umeå, Sweden/Department of Psychology, Stockholm University, Stockholm, Sweden c Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
    Swedish normative data on personality using the Temperament and Character Inventory1998In: Comprehensive Psychiatry, ISSN 0010-440X, E-ISSN 1532-8384, Vol. 39, no 3, p. 122-128Article in journal (Refereed)
    Abstract [en]

    The Temperament and Character Inventory (TCI) is a self-report personality questionnaire based on Cloninger's psychobiological model of personality, which accounts for both normal and abnormal variation in the two major components of personality, temperament and character. Normative data for the Swedish TCI based on a representative Swedish sample of 1,300 adults are presented, and the psychometric properties of the questionnaire are discussed. The structure of the Swedish version replicates the American version well for the means, distribution of scores, and relationships within the between scales and subscales. Further, the Swedish inventory had a reliable factor structure and test-retest performance. The results of this study confirm the theory of temperament and character as a seven-factor model of personality.

  • 155.
    Buciuto, Robert
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics. Linköping University, Faculty of Health Sciences.
    Hammer, Richard
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics. Linköping University, Faculty of Health Sciences.
    Herder, Anders
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Spontaneous Subcapital Femoral Neck Fracture After Healed Trochanteric Fracture1997In: Clinical Orthopaedics and Related Research, ISSN 0009-921X, E-ISSN 1528-1132, Vol. 352, p. 156-163Article in journal (Refereed)
    Abstract [en]

    Two hundred thirty-three patients with an unstable trochanteric hip fracture were randomized prospectively for stabilization with a fixed angle blade plate or a compression hip screw. Twenty patients had the implant removed after the fracture was healed (average, 20.5 months; range, 12-42 months). In seven of these 20 patients, a spontaneous fracture of the femoral neck occurred at an average of 19 days after implant removal. Four of the these seven patients had been treated with the fixed angle blade plate and three with the sliding screw plate. The histologic examination of three specimens was inconclusive. The authors have not observed subcapital fracture among patients whose implants were not removed. The mechanism behind this complication is unknown.

  • 156.
    Budh Norrbrink, Cecilia
    et al.
    Spinalis SCI unit, Karolinska Hospital and Faculty of Public Health Sciences, Karolinska Institutet, Stockholm.
    Lund, Irene
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm.
    Ertzgaard, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Hulting, Claes
    Spinalis SCI unit, Karolinska Hospital and Faculty of Public Health Sciences, Karolinska Institutet, Stockholm.
    Holtz, Anders
    Department of Neurosurgery, University Hospital, Uppsala.
    Levi, Richard
    Frösunda Center, Solna and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Werhagen, Lars
    Spinalis SCI unit, Karolinska Hospital, Stockholm.
    Lundeberg, Thomas
    Spinalis SCI Unit, Karolinska Hospital, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Pain in a Swedish spinal cord injury population2003In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 17, no 6, p. 685-690Article in journal (Refereed)
    Abstract [en]

    Objective: To describe pain and associated variables in a prevalence group of persons with a sustained spinal cord injury (SCI) in the Swedish capital and its surroundings. Setting: Spinalis SCI Unit (outpatient clinic), Stockholm, Sweden. Design: Assessment over a 12-month period in a yearly health control. Subjects: Four hundred and fifty-six SCI patients. Results: Two hundred and ninety-one out of 456 SCI patients (63.7%) suffered from pain, and in 45.7% of these it was classified as being neurogenic. Aching pain was the most used descriptor (38.5%). The onset of pain was commonly within three months (73.5%). In 70.4% of patients pain occurred below the level of the lesion. Most patients identified pain as coming from one (55.0%) or two (28.2%) body regions. Rating of the general pain intensity on a visual analogue scale (VAS) was 46 out of 100 and rating of the worst pain intensity was 78 out of 100. Ninety-four out of 276 patients (32.3%) considered that their quality of life was significantly affected by pain. Conclusion: Pain was most common in patients with incomplete lesions (ASIA impairment grade D) and there was a correlation between pain and higher mean age at injury and between pain and female gender.

  • 157. Bunne, M
    et al.
    Falk, B
    Magnusson, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Hellström, S.
    Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Eustachian tube function varies over time in children with secretory otitis media.2000In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 120, p. 716-723Article in journal (Refereed)
  • 158. Bunne, Marie
    et al.
    Falk, Berndt
    Magnusson, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Hellström, Sten
    Variability of Eustachian tube function: Comparison of ears with retraction disease and normal middle ears2000In: The Laryngoscope, ISSN 0023-852X, E-ISSN 1531-4995, Vol. 110, no 8, p. 1389-1395Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the short-term and long-term variability of tubal opening and closing in ears with advanced retractions and in healthy ears. Study Design/Methods: Twenty ears with retraction type middle ear disease (R-MED) and 20 normal ears underwent direct recording of the middle ear pressure during repeated forced openings, equalization of +100 daPa and -100 daPa by swallowing, Valsalva inflation, and forceful sniffing. Tests were performed twice (separated by 30 min) on each of 2 days separated by 3 to 4 months. Results: There was considerable intraindividual variability of the forced opening pressure and the closing pressure in both groups, within as well as between sessions and test days. Although the variability was 1.5 to 2 times higher in ears with retraction than in the normal group, mean Po and Pc did not differ between the groups. Compared with normal ears, ears with retraction changed more frequently from a positive to negative test response, or vice versa, when re-tested after 30 minutes. Rates of positive response in the equalization and Valsalva tests were significantly lower in diseased ears compared with normal ears. Conclusions: Eustachian tube opening and closing functions vary more in ears with retraction disease than in normal ears, which is consistent with the variable clinical course of R-MED and implies that single tubal function tests have little prognostic value on the individual level.

  • 159. Bunne, Marie
    et al.
    Falk, Bernt
    Hellström, Sten
    Magnusson, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Variability of Eustachian tube function in children with secretory otitis media. Evaluations at tube insertion and at follow-up2000In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 52, no 2, p. 131-141Article in journal (Refereed)
    Abstract [en]

    Objective: Despite the variable clinical course of diseases related to Eustachian tube function, the variability of tubal function has been less focused than outcomes of single tests. This study aimed to compare the passive and active tubal function and its variability in children with secretory otitis media (SOM) at tube insertion and at follow-up. Method: Thirty-eight ears in 19 children aged 4-10 years (mean 7.0 years) with long-standing SOM were examined 4-6 h after tube insertion, at 4 months and at 9 months. The pressure in the middle ear and the nasopharynx were recorded while performing (1) forced opening test, (2) equalization of +100 and −100 daPa, (3) Valsalva test, and (4) sniff test. The procedure was repeated after 30 min. Relationships were analyzed by uni- and multi-variate analysis of variance. Results: From tube insertion to 4 months, the mean forced opening pressure increased from 282±128 to 355±153 daPa (P<0.01), and the mean closing pressure from 91±51 to 126±82 daPa (P<0.01). There was no further change at 9 months. Female gender, serous effusion (in contrast to mucoid), and more than three previous episodes of acute otitis media were related to higher opening and closing pressures. At tube insertion, 60% and 16% equalized +100 and −100 daPa, respectively, and 28% succeeded in performing Valsalva inflation. The sniff test was positive in 32%, indicating a closing failure. These rates did not change significantly over time. For individual ears, outcomes of all tests varied considerably when retested after 30 min; Po changed by ±12% and Pc by ±26%, and 9-29% of the ears changed from a positive to negative response, or vice versa, in the equalization, Valsalva, and sniff tests. Conclusions: The unexpected finding of weaker closing forces at the day of tube insertion and increased tubal resistance at follow-up might be ascribed to changes in the muco-adhesive forces related to the disease and tube treatment. The pronounced intra-individual variability of test outcomes indicates that tubal function is dynamic and variable in ears prone to SOM, which emphasizes that results of single tubal function tests have very low prognostic value.

  • 160. Burckhardt, Carol. S
    et al.
    Henriksson, Chris
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy.
    The coping strategies questionnaire - Swedish version: Evidence of reliability and validity in patients with fibromyalgia2001In: Scandinavian Journal of Behaviour Therapy, ISSN 0284-5717, Vol. 30, p. 97-107Article in journal (Refereed)
  • 161. Buss, Joan L
    et al.
    Neuzil, Jiri
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology.
    Gellert, Nina
    Weber, Christian
    Ponka, Prem
    Pyridoxal isonicotinoyl hydrazone analogs induce apoptosis in hematopoietic cells due to their iron-chelating properties2003In: Biochemical Pharmacology, ISSN 0006-2952, E-ISSN 1356-1839, Vol. 65, no 2, p. 161-172Article in journal (Refereed)
    Abstract [en]

    Analogs of pyridoxal isonicotinoyl hydrazone (PIH) are of interest as iron chelators for the treatment of secondary iron overload and cancer. PIH, salicylaldehyde isonicotinoyl hydrazone (SIH), and 2-hydroxy-1-naphthylaldehyde isonicotinoyl hydrazone (NIH), the toxicity of which vary over two orders of magnitude, were selected for a study of their mechanisms of toxicity. PIH analogs and their iron complexes caused concentration- and time-dependent apoptosis in Jurkat T lymphocytes and K562 cells. Bcl-2 overexpression was partially anti-apoptotic, suggesting mitochondrial mediation of apoptosis. Since the pan-caspase inhibitor zVAD-fmk did not reduce lysosomal and mitochondrial destabilization, these events occur upstream of caspase activation. In contrast, phosphatidylserine externalization and the development of apoptotic morphology were inhibited significantly, indicating the role of caspases in mediating these later events. Since overexpression of CrmA had no effect on apoptosis, caspase-8 is not likely involved. Fe3+ complexes of SIH and NIH, which accumulated in 59Fe-labeled mouse reticulocytes during incubation with the chelators, also caused apoptosis. BSA, which promotes release of the complexes from cells, reduced the toxicity of SIH and NIH, suggesting that the induction of apoptosis by PIH analogs involves toxic effects mediated by their Fe3+ complexes. Moreover, analogs of these agents lacking the iron-chelating moiety were non-toxic. ⌐ 2002 Published by Elsevier Science Inc.

  • 162. Buss, Joan L
    et al.
    Neuzil, Jiri
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology.
    Ponka, Prem
    Oxidative stress mediates toxicity of pyridoxal isonicotinoyl hydrazone analogs2004In: Archives of Biochemistry and Biophysics, ISSN 0003-9861, E-ISSN 1096-0384, Vol. 421, no 1Article in journal (Refereed)
    Abstract [en]

    Pyridoxal isonicotinoyl hydrazone (PIH) and many of its analogs are effective iron chelators in vivo and in vitro, and are of interest for the treatment of secondary iron overload. Because previous work has implicated the Fe3+-chelator complexes as a determinant of toxicity, the role of iron-based oxidative stress in the toxicity of PIH analogs was assessed. The Fe3+ complexes of PIH analogs were reduced by K562 cells and the physiological reductant, ascorbate. Depletion of the antioxidant, glutathione, sensitized Jurkat T lymphocytes to the toxicity of PIH analogs and their Fe 3+ complexes, and toxicity of the chelators increased with oxygen tension. Fe3+ complexes of pyridoxal benzoyl hydrazone (PBH) and salicyloyl isonicotinoyl hydrazone (SIH) caused lipid peroxidation and toxicity in K562 cells loaded with eicosapentenoic acid (EPA), a readily oxidized fatty acid, whereas Fe(PIH)2 did not. The lipophilic antioxidant, vitamin E, completely prevented both the toxicity and lipid peroxidation caused by Fe(PBH)2 in EPA-loaded cells, indicating a causal relationship between oxidative stress and toxicity. PBH also caused concomitant lipid peroxidation and toxicity in EPA-loaded cells, both of which were reversed as its concentration increased. In contrast, PIH was inactive, while SIH was equally toxic toward control and EPA-loaded cells, without causing lipid peroxidation, indicating a much smaller contribution of oxidative stress to the mechanism of toxicity of these analogs. In summary, PIH analogs and their Fe3+ complexes are redox active in the intracellular environment. The contribution of oxidative stress to the overall mechanism of toxicity varies across the series. © 2003 Elsevier Inc. All rights reserved.

  • 163.
    Bylund, P-O
    et al.
    Umeå Unviersitet.
    Wretstrand, Anders
    Lunds Universitet.
    Falkmer, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Lövgren, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine.
    Petzäll, Jan
    Vägverket, Borlänge.
    Injuries in special transportation services for elderly and disabled - A multi-methodology approach to estimate incidence and societal costs2007In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 8, no 2, p. 180-188Article in journal (Refereed)
    Abstract [en]

    Objective. Previous research has shown that elderly and disabled travelers using Special Transportation Services (STS) are injured without being involved in a vehicle crash. In order to estimate the true costs for these vehicle-related injuries, the focus needs to be adjusted towards an incident/traveler-oriented perspective. The aim of the project was thus to utilize such a perspective, in order to make a best estimation of the true costs for injury incidents, related to STS in Sweden. Methods. In order to address the chosen perspective, a mixed-method approach was used, involving quantitative as well as qualitative research methods applied on four different sets of data, the hospital-based material (n = 32), two sets of STS material (n = 127), and interview-based material (n = 1,000). Results. The results showed that the injury incidence rate in STS is considerable, i.e., 3.2 per 100,000 trips (ranging from 1.5-1.9 in STS taxis and 3.6-5.6 in STS special vehicles). However, this high incidence rate is not due to road traffic crashes, but to non-collision injury incidents involving elderly and frail passengers, easily sustaining injuries from minor to moderate external violence. Typically, this violence is affecting an older female STS user, while entering and exiting the vehicle. The true costs were estimated to be $35 million per annum or $2.6 per trip. Conclusion. Future injury prevention measures should thus focus on safety in entering and exiting procedures.

  • 164.
    Bång, Magnus
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces.
    Timpka, Toomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Eriksson, Henrik
    Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces.
    Holm, Einar
    Nordin, Conny
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Mobile phone computing for in-situ cognitive-behavioral therapy2007In: MedINFO 2007,2007, IOS Press, 2007, p. 1078-1082Conference paper (Refereed)
    Abstract [en]

    Cognitive behavioral therapy (CBT) for psychological disorders is becoming increasingly popular on the Internet. However when using this workstation approach, components such as training and learning relaxation skills, problem solving, exposure exercises, and sleep management guidance must be done in the domestic environment. This paper describes design concepts for providing spatially explicit CBT with mobile phones. We reviewed and analyzed a set of treatment manuals to distinguish elements of CBT that can be improved and supported using mobile phone applications. The key advantage of mobile computing support in CBT is that multimedia can be applied to record, scale, and label anxiety-provoking situations where the need arises, which helps the CBT clients formulate and convey their thoughts and feelings to relatives and friends, as well as to therapists at subsequent treatment sessions.

  • 165. Börelius, Lisbeth
    et al.
    Foldemo, Anniqa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Holmberg, Tommy
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Schöld, Anna-Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Thorell, Lars-Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Ylikivelä, Rita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Nettelbladt, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Själen i primärvården - psykisk ohälsa hos unga vuxna och deras upplevelser av vården2007Report (Other academic)
  • 166.
    Börjesson, L.
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Stockhaus, J.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Gauffin, Helena
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Ragnehed, Mattias
    Linköping University, Department of Medicine and Care, Medical Radiology. Linköping University, Faculty of Health Sciences.
    Lundberg, Peter
    Linköping University, Department of Medicine and Care, Radiation Physics. Linköping University, Faculty of Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Söderfeldt, Birgitta
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Comparison between fMRI and Wada test2004In: Epilepsia, ISSN 0013-9580, E-ISSN 1528-1167, Vol. 45, no Suppl. 3, p. 84-84Article in journal (Refereed)
    Abstract [en]

    Purpose: Language lateralisation in patients with epilepsy is more often atypical compared to a normal population. The Wada procedure for testing language and memory has some shortcomings; it is invasive and there is always a risk that the patient becomes too sedated, leading to difficulties in performing the tests. fMR1have shown promising results, showing good correlation to the Wadaprocedure concerning language-lateralisation. The aim of this studywas to investigate if fMRI could be used to determine which hemisphere was language dominant and compare the fMR1 results with the Wada-tests with a focus on patients with a complicated lateralisation.

    Method: 4 subjects were tested and they had a heterogeneous (I left handed, I ambidexter and 2 right handed) lateralisation and one had a severe dyslexia. A standard Wada procedure was used and compared with a fMRl investigation using a language paradigm.

    Results: The patients studied showed different language lateralisation patterns (2 left hemisphere and 2 bilateral). In two patients the two tests were fully concordant, in the others the fMRI showed a more bilateral pattern.

    Conclusion: fMR1 adds valuable information in the pre-surgical investigation for patients with a complex language lateralisation.

  • 167.
    Börsbo, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine.
    Lemming, Dag
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Utredning och klinisk undersökning av personer med kronisk smärta2006In: Rehabiliteringsmedicin - Teori och praktik / [ed] Jörgen Borg, Lund: Studenlitteratur , 2006, 1, p. 91-96Chapter in book (Other academic)
    Abstract [sv]

      Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat  stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin.

  • 168. Caceres, R
    et al.
    Leerbeck, K
    Landtblom, Anne-Marie
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Neurology. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Cardiac symptoms in epilepsy: Monitoring strategies2005In: Epilepsia, ISSN 0013-9580, E-ISSN 1528-1167, Vol. 6, p. 889-889Article in journal (Other academic)
  • 169.
    Callander, Margarita
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Haghighi, S.
    Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Landtblom, Anne-Marie
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Ahlgren, C. E.
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nilsson, S. I.
    Department of Mathematical Statistics, Chalmers University of Technology, Gothenburg, Sweden.
    Rydberg, L.
    Department of Transplantation Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Al Khoury, H.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Rosengren, L.
    Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Andersen, O.
    Gothenburg University, Gothenburg, Sweden.
    Multiple sclerosis immunopathic trait and HLA-DR(2)15 as independent risk factors in multiple sclerosis2007In: Multiple Sclerosis, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 13, no 4, p. 441-445Article in journal (Refereed)
    Abstract [en]

    We analysed HLA haplotypes in pairs of 78 sporadic multiple sclerosis (MS) patients and 78 healthy siblings. The presence of 2 oligoclonal IgG bands, detected by immunoblotting of the cerebrospinal fluid in healthy siblings, has previously been defined as MS immunopathic trait (MSIT), based on a cut-off derived from healthy unrelated volunteers. The frequency of MSIT was 17.9% (n=14/78 siblings). The HLA-DR(15)2 allelle was present in 21.4% (n=3/14) of the siblings with MSIT, in 40.6% (n =26/64) of the siblings without MSIT, and in 59% (n =46/78) of the patients with clinically-definite (CD) MS. The distribution of zero, one or two HLA-DR(2)15 alleles was significantly skewed towards a lower allelle count in the siblings with MSIT compared with the group of unrelated siblings with MS (P=0.002), and also lower than their related siblings with MS (P=0.1). These results suggest that the MS susceptibility gene, HLA-DR(2)15 type, does not induce MSIT, and conceivably these are two separate risk factors in the development of MS. The effect of HLA-DR(2)15 and MSIT in sporadic MS appears to be synergistic.

  • 170.
    Callander, Margarita
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    A cluster of multiple sclerosis cases in Lysvik in the Swedish county of Värmland2004In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 110, no 1, p. 14-22Article in journal (Refereed)
    Abstract [en]

    Objectives – When surveying the county of Värmland in Sweden in order to determine the prevalence of multiple sclerosis (MS), we observed an aggregation of MS cases originating from the parish of Lysvik in the local region called Fryksdalen. Our intention was to analyse this cluster thoroughly, confirming the MS diagnosis and seeing if a hereditary or environmental background was plausible.

    Methods – The medical files were studied and the cases were classified by a neurologist according to Poser's criteria. Hereditary factors were analysed.

    Results – Sixteen living cases of MS were found, either living in the parish (n = 6) or born or raised there and had later moved to another place (n = 10). All patients had clinically definite MS. Eleven patients had relatives with MS, all of these being descendants of the Suhoinen family. Another two cases were Suhoinen descendants who did not have relatives with MS. Other common ancestors were also identified. Two cases were adopted. Eleven deceased MS patients from Lysvik were found, 10 of them had Suhoinen ancestry.

    Conclusion – We report a cluster of MS cases with a common ancestry indicating heredity for MS in 85% of the cases. Lysvik is a parish where Finnish immigration was pronounced in the 17th century and there has been inbreeding to a certain extent through marriage between cousins. Thus, we interpret this aggregation as possibly being genetically based, and neurogenetic studies are now being performed. However, as two of the cases were adopted environmental factors must also be considered.

  • 171.
    Callerborn, Anna
    et al.
    Linköping University, Department of Neuroscience and Locomotion.
    Holstein, Jane
    Linköping University, Department of Neuroscience and Locomotion.
    Arbetsterapeuters pedagogiska förhållningssätt i gruppverksamhet - en kvalitativ studie2005Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    The occupational therapist uses meaningful activities to promote health and accomplish functional progress. The professional role is to support and enable for the client to change his/her life. One way to accomplish this is to use the group as a tool. Knowledge is needed about how learning works and which teaching methods exist to promote learning, so it is adapted after the clients´ personal way of learning. The aim of this study was to investigate which pedagogical approaches occupational therapists use in group activities. Interviews were conducted with ten occupational therapists in the southern part of Sweden. During the qualitative data analysis, three different approaches to learning emerged among the interviewed occupational therapists. The leader-centred approach meant that the occupational therapist was authoritarian and controlled the group by giving instructions. In the client-centred approach the occupational therapist first let the clients test the activity and then gave feedback. In the group-centred approach the occupational therapist had a flexible role and let the group work independently. The occupational therapists that took part in this study used one of these three approaches or a combination of these. Clear traces of different educationalists can be found in the approaches. The authors maintain that the need of mapping the use of pedagogy is of great importance since it is a basic ability to able to reach the clients with information in the best way.

  • 172.
    Carlsson, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Olsson, Gunilla
    Reis, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry.
    Wålinder, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Nordin, Conny
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Lundmark, Jöns
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Adolescents on chronic oral dosing with racemic citalopram. Enantioselective analysis of citalopram and CYP2D6/CYP2C19 genotyping. 5 th Congress of the European Association for Clinical Pharmacology and Therapuetics, Odense, Denmark 12-15 september 20012001In: Pharmacology and Toxicology,2001, 2001, p. 132-132Conference paper (Refereed)
  • 173.
    Carlsson, Björn
    et al.
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Olsson, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences.
    Reis, Margareta
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Wålinder, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Nordin, Conny
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Lundmark, Jöns
    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.
    Scordo, M. G.
    Dahl, M-L.
    Bengtsson, Finn
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Ahlner, Johan
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Enantioselective Analysis of Citalopram and Metabolites in Adolescents2001In: Therapeutic drug monitoring, ISSN 0163-4356, Vol. 23, no 6, p. 658-664Article in journal (Refereed)
    Abstract [en]

    Studies of the antidepressant effect and pharmacokinetics of citalopram have been performed in adults, but the effects on children and adolescents have only been studied to a minor extent despite its increasing use in these age groups. The aim of this study was to investigate a group of adolescents treated for depression, with respect to the steady-state plasma concentrations of the enantiomers of citalopram and its demethylated metabolites desmethylcitalopram and didesmethylcitalopram. Moreover, the authors studied the genotypes for the polymorphic cytochrome P450 enzymes CYP2D6 and CYP2C19 in relation to the different enantiomers. The S/R ratios of citalopram and desmethylcitalopram found in this study of 19 adolescents were similar to studies involving older patients. The concentrations of the R-(-)- and S-(+)-enantiomers of citalopram and desmethylcitalopram were also in agreement with values from earlier studies, the R-(-)-enantiomer (distomer) being the major enantiomer. The results indicate that the use of oral contraceptives may have some influence on the metabolism of citalopram. This might be because of an interaction of the contraceptive hormones with the CYP2C19 enzyme.

  • 174.
    Cederbrant, Karin
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Molecular and Immunological Pathology. Linköping University, Faculty of Health Sciences.
    Gunnarsson, L-G
    Department of Neurology and Neurophysiology and Centre for Environmental Sensitivity, Örebro Medical Centre Hospital, Örebro, Sweden.
    Hultman, Per
    Linköping University, Department of Molecular and Clinical Medicine, Molecular and Immunological Pathology. Linköping University, Faculty of Health Sciences.
    Norda, R.
    Department of Transfusion Medicine and Immunohaemotherapy, Örebro Medical Centre Hospital, Örebro, Sweden.
    Tibbling-Grahn, L.
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    In vitro Lymphoproliferative Assays with HgCl2 Cannot Identify Patients with Systemic Symptoms Attributed to Dental Amalgam1999In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 78, no 8, p. 1450-1458Article in journal (Refereed)
    Abstract [en]

    Dental amalgam is suspected, by some exposed individuals, to cause various systemic psychological, sensory, and neurological symptoms. Since not all amalgam-bearers experience such reactions, an individual characteristic—for example, a susceptible immune system—might explain these conditions. In vitro lymphocyte proliferation is a valuable tool in the diagnosis of allergy. With HgCl2 as the antigen, however, the test is hampered, because Hg2+ can cause unspecific lymphocyte proliferation, optimal at 1.4 to 9.5 μg HgCl2/mL. Recently, the use of suboptimal HgCl2 concentrations (≤ 0.5 μg/mL) has been suggested to circumvent these problems. The main aim of this study was to investigate whether patients with systemic symptoms alleged to result from the presence of dental amalgam differ from healthy controls, with reference to in vitro lymphoproliferative responses to HgCl2 ≤ 0.5 μg/mL. Three different test protocols—lymphocyte transformation test (LTT) in micro- and macro-cultures, and the memory lymphocyte immunostimulation assay (MELISA®)—were used. Other immune parameters—such as a standard patch test for dental materials, the number of T- and B-lymphocytes, monocytes, granulocytes, and NK cells in peripheral blood, allergic symptoms, and predisposition-were also investigated. Twenty-three amalgam patients, 30 healthy blood donors with amalgam, ten healthy subjects without amalgam, and nine patients with oral lichen planus (OLP) adjacent to dental amalgam and a positive patch test to Hg0 were tested. None of the investigated immune parameters revealed any significant differences between amalgam patients and controls. The sensitivity of in vitro lymphocyte proliferation ranged from 33 to 67%, with the OLP patients as a positive control group, and the specificity from 0 to 70% for healthy controls with a negative patch test to Hg°. Thus, despite the use of HgCl2 ≤ 0.5 μg/mL, a high frequency of positive results was obtained among healthy subjects with or without dental amalgam. Consequently, in vitro lymphocyte proliferation with HgCl2 cannot be used as an objective marker for mercury allergy in dental amalgam-bearers.

  • 175.
    Cederbrant, Karin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Hultman, Per
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Marcusson, Jan A.
    Department of Dermatology, Huddinge Hospital, Huddinge.
    Tibbling, Lita
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    In vitro Lymphocyte Proliferation as Compared to Patch Test Using Gold, Palladium and Nickel1997In: International Archives of Allergy and Immunology, ISSN 1018-2438, E-ISSN 1423-0097, Vol. 112, no 3, p. 212-217Article in journal (Refereed)
    Abstract [en]

    Background: A conventional lymphocyte transformation test (LTT) was compared to the commercially available MELISA® (memory lymphocyte immuno-stimulation assay), a lymphoproliferative assay that has been suggested to be a valuable instrument for the diagnosis of metal allergy. Sensitivity and specificity of the two assays were calculated using a patch test as a reference method.

    Methods: 34 patients were patch-tested for gold sodium thiosulfate, palladium chloride and nickel sulfate, and the lymphocyte proliferation to these metals was tested in vitro using mononuclear cells from peripheral blood.

    Results: No significant differences regarding sensitivity and specificity were found between MELISA and conventional LTT. The sensitivity varied between 55 and 95% and the specificity between 17 and 79%.

    Conclusions: The low specificity of the two in vitro assays suggests that they are not useful for diagnosis of contact allergy to the metals gold, palladium and nickel, since a large number of false-positive results will be obtained.

  • 176. Cheng, Q
    et al.
    Jiang, GX
    Fredrikson, S
    Link, H
    de Pedro-Cuesta, J
    Vrethem, Magnus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Epidemiological surveillance of Guillain-Barré syndrome in Sweden, 1996-1997.2000In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 101, p. 104-111Article in journal (Refereed)
  • 177. Cheng, Q.
    et al.
    Jiang, GX
    Fredrikson, S
    Link, H
    de Pedro-Cuesta, J
    Vrethem, Magnus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Incidence of Guillain-Barré syndrome in Sweden 1996.2000In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 7, p. 11-16Article in journal (Refereed)
  • 178. Cheng, Q.
    et al.
    Jiang, GX
    Press, R.
    Andersson, M.
    Ekstedt, B.
    Vrethem, Magnus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Clinical epidemiology of Guillain-Barre syndrome in Sweden 1996-1997: a prospective study.2000In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 7, p. 685-692Article in journal (Refereed)
  • 179. Chong, Victor N H
    et al.
    Keonin, Jason
    Luthert, Phil J
    Frennesson, Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Weingeist, David M
    Wolf, Rachel L
    Mullins, Robert F
    Hageman, Gregory S
    Decreased thickness and integrity of the macular elastic layer of Bruch's membrane correspond to the distribution of lesions associated with age-related macular degeneration2005In: American Journal of Pathology, ISSN 0002-9440, E-ISSN 1525-2191, Vol. 166, no 1, p. 241-251Article in journal (Refereed)
    Abstract [en]

    Age-related macular degeneration (AMD) is a leading cause of blindness in the elderly. In its severest form, choroidal neovessels breach the macular Bruch's membrane, an extracellular matrix compartment comprised of elastin and collagen laminae, and grow into the retina. We sought to determine whether structural properties of the elastic lamina (EL) correspond to the region of the macula that is predilected toward degeneration in AMD. Morphometric assessment of the macular and extramacular regions of 121 human donor eyes, with and without AMD, revealed a statistically significant difference in both the integrity (P < 0.0001) and thickness (P < 0.0001) of the EL between the macular and extramacular regions in donors of all ages. The EL was three to six times thinner and two to five times less abundant in the macula than in the periphery. The integrity of the macular EL was significantly lower in donors with early-stage AMD (P = 0.028), active choroidal neovascularization (P = 0.020), and disciform scars (P = 0.003), as compared to unaffected, age-matched controls. EL thickness was significantly lower only in individuals with disciform scars (P = 0.008). The largest gaps in macular EL integrity were significantly larger in all categories of AMD (each P < 0.0001), as compared to controls. EL integrity, thickness, and gap length in donors with geographic atrophy did not differ from those of controls. These structural properties of the macular EL correspond spatially to the distribution of macular lesions associated with AMD and may help to explain why the macula is more susceptible to degenerative events that occur in this disease.

  • 180.
    Chowdhury, Shamsul
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Mathiesen, Ulrik
    Oskarshamns sjukhus .
    Krusinska, Ewa
    Technical University of Wroclaw, Poland .
    Franzén, Lennart
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Wigertz, Ove
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Bodemar, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Design and delivery of information resources and knowledge bases for the diagnosis and managementof liver disorders1994In: ANZIIS-94,1994, Brisbane: IEEE , 1994Conference paper (Refereed)
  • 181. Claesson, M
    et al.
    Armitage, W J
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Stenevi, U
    Visual outcome in corneal grafts: a preliminary analysis of the Swedish Corneal Transplant Register2002In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 86, p. 174-180Article in journal (Refereed)
  • 182.
    Clinchy, Birgitta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery.
    Fransson, Annelie
    Druvefors, Pelle
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Hellsten, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery.
    Håkansson, Annika
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Gustafsson, Bertil
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Sjödahl, Rune
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Håkansson, Leif
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Preoperative interleukin-6 production by mononuclear blood cells predicts survival after radical surgery for colorectal carcinoma2007In: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 109, no 9, p. 1742-1749Article in journal (Refereed)
    Abstract [en]

    BACKGROUND. Colorectal cancer is one of the most common forms of cancer in the Western world. Staging based on histopathology is currently the most accurate predictor of outcome after surgery. Colorectal cancer is curable if treated at an early stage (stage I-III). However, for tumors in stages II and III there is a great need for tests giving more accurate prognostic information defining the patient population in need of closer follow-up and/or adjuvant therapy. Furthermore, tests that provide prognostic information preoperatively could provide a guide both for preoperative oncologic treatment and the surgical procedure. METHODS. Peripheral blood mononuclear cells (PBMCs) were isolated preoperatively, within a week before primary surgery, from 39 patients undergoing surgery for colorectal cancer. The PBMCs were cultured in vitro for 24 hours in the presence of autologous serum and lipopolysaccharide (LPS). Interleukin-6 (IL-6) production was measured with enzyme-linked immunosorbent assay (ELISA). Staging based on histopathology was performed in all patients. Patients were followed for at least 54 months. RESULTS. A production of >5000 pg/mL of IL-6 identified colorectal cancer patients with a poor prognosis. Eight out of 13 patients with >5000 pg/mL IL-6 died from cancer within the follow-up period, whereas no cancer-related deaths were recorded among 21 patients with 5000 pg/mL IL-6 or less. A multivariate Cox regression analysis, stratified for T- and N-stage, identified IL-6 production as an independent prognostic factor. CONCLUSIONS. IL-6 production in vitro by PBMC can predict survival after radical surgery for colorectal cancer. © 2007 American Cancer Society.

  • 183. Cox, Robyn
    et al.
    Hyde, Martyn
    Arlinger, Stig
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Technical Audiology. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Optimal outcome measures, research priorities, and international cooperation.2000In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 21, p. 106-115Article in journal (Refereed)
  • 184.
    Crafoord, Sven
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Experimental transplantation of retinal and iris pigment epithelial cells into the subretinal space2000Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    A dysfunction of the retinal pigment epithelium (RPE) is the main cause for the development of age-related macular degeneration (ARMD) and visual loss in elderly people. For about 10 years experimental and clinical attempts to transplant RPE cells have been performed. The aims of this study were to elucidate the long term results of RPE allografts, to develop an atraumatic transplantation technique, and to explore the cellular response to RPE allografts, melanin granules, and autologous IPE cells.

    Surgery was performed on rabbits with a follow-up period of up to six months. After a pars plan vitrectomy, a subretinal bleb was created into which a suspension of RPE/IPE donor cells or melanin granules was injected. Pigmented RPE donor cells or preparations of melanin granules were implanted subretinally in albino rabbits. Pigmented rabbits were used in IPE transplantation. The eyes were monitored with ophthalmoscopy, fundus photography, light microscopy, electron microscopy and immunohistochemistry.

    Transplantation of suspensions of fresh pigmented RPE cells to the subretinal space in rabbits is feasible and induces virtually no complications when an atraumatic surgical procedure is used. The allograft forms a monolayer in conjunction with the native RPE and persists almost intact up to three months. At six months after transplantation, there was a cellular response exhibiting multilayers of cells, such as RPE and macrophages. Damage to adjacent photoreceptors in combination with melanin granules in the subretinal space indicates graft failure. No infiltration of lymphocytes was seen. Whether the cellular response was due to immunological or non-immunological mechanisms could not be determined from this experiment.

    Cyclosporine (CsA) could not prevent disintegration of the RPE transplant and graft failure. CsA was not capable of promoting graft survival as compared to the controls. The transplant seems to be disrupted either by immunological mechanisms that are not inhibited by CsA, or by non-immunologic events.

    Implantation of melanin granules to the subretinal space of albino rabbits induces a considerable phagocytic cellular response involving the host’s RPE, macrophages and glial cells. The migration of pigment-laden cells into the neural retina was frequently associated with focal photoreceptor damage. The cellular response was identical to that ensuing RPE cell transplantation. These findings support the concept that non-immunological events have a considerable influence on the outcome.

    In order to evaluate the impact of non-immunological mechanisms, a technique of transplanting fresh autologous IPE cells to the subretinal space of the same eye was developed. Grafted IPE cells were seen to survive for six months. There was a remodeling of the compound cellular layers in the subretinal space over time where grafted IPE cells joined the native RPE cells. The cellular response that developed exhibited macrophages, but no lymphocytes, and was in this respect similar to that observed following RPE transplantation.

    In RPE allografts, the photoreceptors appeared normal on light microscopy at three months, but at six months, the photoreceptors overlying the transplants generally exhibited pathological changes. In autologous IPE grafts, on the other hand, the photoreceptors displayed normal outer segment length and outer nuclear layer on top of grafted IPE cells. Focally, multilayers of both grafted IPE and RPE cells, together with macrophages, induce damage to adjacent photoreceptors as observed at 6 months. Cellular multilayers in the subretinal space, irrespective of genesis, are likely to have adverse effects on photoreceptors. The experiments using autologous IPE grafts show that non-immunogenic mechanisms have a decisive impact on the outcome of the transplant in the subretinal space.

    List of papers
    1. Long-term outcome of RPE allografts to the subretinal space of rabbits
    Open this publication in new window or tab >>Long-term outcome of RPE allografts to the subretinal space of rabbits
    1999 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 77, no 3, p. 247-254Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To determine the long-term RPE allograft survival in the subretinal space using suspensions of RPE cells and atraurnatic transplantation surgery.

    Methods: Nineteen albino rabbits were transplanted with suspensions of pigmented RPE cells from brown rabbits. Following pars plana vitrectomy, the RPE cell suspension was injected through a small retinotomy using a glass micropipette into the subretinal space under microscopic control. No immunosuppression was used. The eyes were monitored by biomicroscopy, color fundus photography, and fluorescein angiography. Rabbits were sacrificed at 1, 3 and 6 months, respectively, and the eyes processed for light and electron microscopy, using monoclonal antibodies for identifying macrophages.

    Results: Transplanted RPE cells were present in the subretinal space in all eyes at 6 months. There was no fluorescein leakage. Generally, the RPE allograft formed a monolayer, but focal fragmentation and disruption with dispersion of melanin pigment occurred. Foci of multilayers of cells in the subretinal space, containing large macrophages, were associated with adjacent photoreceptor damage. There was no infiltration of lymphocytes but macrophages and glial cells were contiguous to the transplant. Cells harboring intracytoplasmatic melanin pigment were observed in the neural retina.

    Conclusion: Transplantation of RPE cell suspensions to the subretinal space generally forms a monolayer that persists at 6 months, However, in areas of multilayers of RPE cells and macrophages, graft failure occurs in combination with adjacent photoreceptor damage. Graft failure is not associated with the infiltration of lymphocytes, but other mechanisms seem to occur.

    Keywords
    retina, RPE transplantation, allograft, subretinal space, graft survival, graft failure, macrophages
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27595 (URN)10.1034/j.1600-0420.1999.770301.x (DOI)12325 (Local ID)12325 (Archive number)12325 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    2. Cyclosporine treatment of RPE allografts in the rabbit subretinal space
    Open this publication in new window or tab >>Cyclosporine treatment of RPE allografts in the rabbit subretinal space
    2000 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 78, no 2, p. 122-129Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To determine the effects of systemic cyclosporine A (CsA) on the survival of retinal pigment epithelial (RPE) allografts in the subretinal space in an animal model using atraumatic transplantation surgery.

    Methods: Following pars plana vitrectomy, an RPE cell suspension from brown rabbits was injected with a glass micropipette into the subretinal space of 39 albino rabbits. For immunosuppression, 22 rabbits were given an injection of CsA, 20 mg daily intramuscularly, 17 rabbits with RPE grafts were controls. The grafts were monitored by biomicroscopy, color fundus photography, and fluorescein angiography. Rabbits were sacrificed at 1, 3 and 6 months, respectively, and the eyes processed for light and electron microscopy including immunohistochemistry.

    Results: After three months, the transplanted RPE cells, in both the CsA group and the controls, formed a monolayer in the subretinal space. Although a few macrophages were encountered, there was no massive cellular infiltration and the photoreceptor layer was well preserved. After six months, however, there was a disruption of grafted RPE cells in both groups, characterized by dispersion of melanin pigment in the subretinal space, and invasion of macrophages with focal photoreceptor damage but no infiltration of lymphocytes in the retina or choroid. No significant differences between the CsA treated and the control eyes were discernible.

    Conclusion: Although the subretinal space has been considered an immunologically privileged site, we found that the survival of RPE allografts was limited. CsA did not prevent RPE allograft destruction in the subretinal space. The transplant seems to be disrupted either by immunological mechanisms that are not inhibited by CsA, or by nonimmunologic events.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27598 (URN)10.1034/j.1600-0420.2000.078002122.x (DOI)12328 (Local ID)12328 (Archive number)12328 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Cellular migration into neural retina following implantation of melanin granules in the subretinal space
    Open this publication in new window or tab >>Cellular migration into neural retina following implantation of melanin granules in the subretinal space
    2000 (English)In: Graefe's Archives for Clinical and Experimental Ophthalmology, ISSN 0721-832X, E-ISSN 1435-702X, Vol. 238, no 8, p. 682-689Article in journal (Refereed) Published
    Abstract [en]

    Background: In some retinal diseases and following transplantation of retinal pigment epithelium (RPE), melanin granules are liberated to the subretinal space. Our aim was to investigate the cellular response to implanted extracellular melanin.

    Methods: After pars plana vitrectomy, 17 albino rabbits received a suspension of melanin granules in the subretinal space. Postoperative examination included ophthalmoscopy, color fundus photography, histology using monoclonal antibodies identifying RPE cells (AE1/3), macrophages (RAM 11), B-lymphocytes (CD20) and T-lymphocytes (CD45), and electron microscopy. The follow-up time was 2 weeks, 4 weeks and 6 months.

    Results: On fundus photographs, the layer of melanin showed focal attenuation with lighter areas at 6 months. Melanin granules were phagocytosed by RPE cells and macrophages at 2 weeks, as identified by monoclonal antibodies. In areas where an abundance of melanin was present, multilayers of macrophages were seen associated with considerable photoreceptor damage. Pigment-laden cells invaded the neural retina. The cellular infiltration of the retina was focal, and when it involved the outer nuclear layer the photoreceptor damage was severe. Electron microscopy demonstrated the presence of melanosomes intracellularly in Müller glia. The process of phagocytosis and removal of melanin granules from the subretinal space was slow and not completed at 6 months.

    Conclusion: Our experiments show that implantation of melanin granules in the subretinal space of albino rabbits may induce a considerable phagocytic cellular response featuring the host’s RPE, macrophages and glial cells. The migration of pigment-laden cells into the neural retina was associated with focal photoreceptor damage.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27593 (URN)10.1007/s004170000131 (DOI)12323 (Local ID)12323 (Archive number)12323 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. Transplantation of Autologous Iris Pigment Epithelial Cells to the Subretinal Space: I. Morphological Features
    Open this publication in new window or tab >>Transplantation of Autologous Iris Pigment Epithelial Cells to the Subretinal Space: I. Morphological Features
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: To investigate the cellular morphology in the subretinal space following transplantation of iris pigment epithelial (IPE) cells from the same eye.

    Methods: Following an iridectomy, fresh IPE cells were prepared. After pars plana vitrectomy, a suspension of autologous IPE cells was injected into the subretinal space in 37 rabbits. The grafts were monitored by ophthalmoscopy and calor fundus photography. Rabbits were sacrificed at 1, 2, 3 and 6 months, respectively, and the eyes examined with light and electron microscopy.

    Results: The grafted area retained the same configuration over 6 months but then appeared less pigmented. At 1-3 months, the IPE formed one or more contiguous layers on top of native RPE. At 6 months, cells compatible with grafted IPE were present in the subretinal space forming mono-layer like chains integrating with the native RPE. Depigmented cells of presumed IPE origin were seen. lt was commonly observed that the apical portion of RPE cells disclosed abundant melanin granules. With time the grafted cells appeared to decrease in number but focal clusters of IPE cells and large macrophages were present.

    Conclusion: Transplanted IPE cells survived for up to 6 months in the subretinal space. Our observations suggest a scenario of remodeling of the cellular layers in the subretinal space over time where grafted IPE cells formed a compound layer with the native RPE. Transplantation of autologous IPE cells may have a potential as a treatment modality in selected cases of age-related macular degeneration with impending degeneration of RPE and choriocapillaris.

    Keywords
    Retina, IPE cells transplantation, Autologous transplantation, Subretinal space, Blood-retinal barrier (BRB), Macrophages, Melanin pigment, Photoreceptor damage
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-79525 (URN)
    Available from: 2012-08-07 Created: 2012-08-07 Last updated: 2012-08-07Bibliographically approved
    5. Transplantation of Autologous Iris Pigment Epithelial Cells To the Subretinal Space: II. Photoreceptor Survival and Consequences of Cellular Multilayers
    Open this publication in new window or tab >>Transplantation of Autologous Iris Pigment Epithelial Cells To the Subretinal Space: II. Photoreceptor Survival and Consequences of Cellular Multilayers
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: To study the effects of transplanted iris pigment epithelial (IPE) cells in the subretinal space on the survival of adjacent photoreceptors.

    Methods: An upper iridectomy was made on the right eye of 37 pigmented rabbits. Suspensions of autologous IPE cells were prepared and injected into the subretinal space of the same eye. Follow- up examinations was performed using ophthalmoscopy and calor fundus photography. At 1, 2, 3 and 6 months, respectively, the rabbits were sacrificed and the eyes examined with light and electron microscopy.

    Results: On histological examination, the photoreceptor cells were well preserved in grafted areas at 1-3 months. At 6 months, also, the photoreceptors generally disclosed a normal nuclear layer and long outer segments when overlying areas with single cells or clusters of IPE. However, multilayers of transplanted I PE, native RPE cells and macrophages in the subretinal space were frequently associated with photoreceptor damage and nuclear drop out from the outer retinal layer.

    Conclusion: In this experimental model, the photoreceptors generally survive adjacent to grafted IPE cells for 6 months. Multilayers of subretinal cells are likely to induce adverse effects on adjacent photoreceptors which is a new finding that requires further investigation.

    Keywords
    Retina, IPE transplantation, Autologous, Subretinal space, Melanin pigment distribution, Macrophages, Photoreceptor damage
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-79528 (URN)
    Available from: 2012-08-07 Created: 2012-08-07 Last updated: 2012-08-07Bibliographically approved
  • 185.
    Crafoord, Sven
    et al.
    Department of Ophthalmology, Örebro Medical Center, Örebro.
    Algvere, Peep
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Dafgård-Kopp, Eva
    Department of Ophthalmology, Karolinska Institutet, St Erik’s Eye Hospital, Stockholm, Sweden.
    Seregard, Stefan
    Department of Ophthalmology, Karolinska Institutet, St Erik’s Eye Hospital, Stockholm, Sweden.
    Cyclosporine treatment of RPE allografts in the rabbit subretinal space2000In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 78, no 2, p. 122-129Article in journal (Refereed)
    Abstract [en]

    Purpose: To determine the effects of systemic cyclosporine A (CsA) on the survival of retinal pigment epithelial (RPE) allografts in the subretinal space in an animal model using atraumatic transplantation surgery.

    Methods: Following pars plana vitrectomy, an RPE cell suspension from brown rabbits was injected with a glass micropipette into the subretinal space of 39 albino rabbits. For immunosuppression, 22 rabbits were given an injection of CsA, 20 mg daily intramuscularly, 17 rabbits with RPE grafts were controls. The grafts were monitored by biomicroscopy, color fundus photography, and fluorescein angiography. Rabbits were sacrificed at 1, 3 and 6 months, respectively, and the eyes processed for light and electron microscopy including immunohistochemistry.

    Results: After three months, the transplanted RPE cells, in both the CsA group and the controls, formed a monolayer in the subretinal space. Although a few macrophages were encountered, there was no massive cellular infiltration and the photoreceptor layer was well preserved. After six months, however, there was a disruption of grafted RPE cells in both groups, characterized by dispersion of melanin pigment in the subretinal space, and invasion of macrophages with focal photoreceptor damage but no infiltration of lymphocytes in the retina or choroid. No significant differences between the CsA treated and the control eyes were discernible.

    Conclusion: Although the subretinal space has been considered an immunologically privileged site, we found that the survival of RPE allografts was limited. CsA did not prevent RPE allograft destruction in the subretinal space. The transplant seems to be disrupted either by immunological mechanisms that are not inhibited by CsA, or by nonimmunologic events.

  • 186.
    Crafoord, Sven
    et al.
    Department of Ophtalmology, Örebro Medical Center, Örebro.
    Algvere, Peep
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Seregard, Stefan
    Department of Ophtalmology, Karolinska Insitutet, St Erik's Eye Hospital, Stockholm Sweden.
    Dafgård Kopp, Eva
    Department of Ophtalmology, Karolinska Insitutet, St Erik's Eye Hospital, Stockholm Sweden.
    Long-term outcome of RPE allografts to the subretinal space of rabbits1999In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 77, no 3, p. 247-254Article in journal (Refereed)
    Abstract [en]

    Purpose: To determine the long-term RPE allograft survival in the subretinal space using suspensions of RPE cells and atraurnatic transplantation surgery.

    Methods: Nineteen albino rabbits were transplanted with suspensions of pigmented RPE cells from brown rabbits. Following pars plana vitrectomy, the RPE cell suspension was injected through a small retinotomy using a glass micropipette into the subretinal space under microscopic control. No immunosuppression was used. The eyes were monitored by biomicroscopy, color fundus photography, and fluorescein angiography. Rabbits were sacrificed at 1, 3 and 6 months, respectively, and the eyes processed for light and electron microscopy, using monoclonal antibodies for identifying macrophages.

    Results: Transplanted RPE cells were present in the subretinal space in all eyes at 6 months. There was no fluorescein leakage. Generally, the RPE allograft formed a monolayer, but focal fragmentation and disruption with dispersion of melanin pigment occurred. Foci of multilayers of cells in the subretinal space, containing large macrophages, were associated with adjacent photoreceptor damage. There was no infiltration of lymphocytes but macrophages and glial cells were contiguous to the transplant. Cells harboring intracytoplasmatic melanin pigment were observed in the neural retina.

    Conclusion: Transplantation of RPE cell suspensions to the subretinal space generally forms a monolayer that persists at 6 months, However, in areas of multilayers of RPE cells and macrophages, graft failure occurs in combination with adjacent photoreceptor damage. Graft failure is not associated with the infiltration of lymphocytes, but other mechanisms seem to occur.

  • 187.
    Crafoord, Sven
    et al.
    Department of Ophthalmology, Örebro Medical Center, Örebro, Sweden.
    Dafgård-Kopp, Eva
    Department of Ophthalmology, Karolinska Institutet, St. Eriks Eye Hospital, Stockholm, Sweden.
    Seregard, Stefan
    Department of Ophthalmology, Karolinska Institutet, St. Eriks Eye Hospital, Stockholm, Sweden.
    Algvere, Peep
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Cellular migration into neural retina following implantation of melanin granules in the subretinal space2000In: Graefe's Archives for Clinical and Experimental Ophthalmology, ISSN 0721-832X, E-ISSN 1435-702X, Vol. 238, no 8, p. 682-689Article in journal (Refereed)
    Abstract [en]

    Background: In some retinal diseases and following transplantation of retinal pigment epithelium (RPE), melanin granules are liberated to the subretinal space. Our aim was to investigate the cellular response to implanted extracellular melanin.

    Methods: After pars plana vitrectomy, 17 albino rabbits received a suspension of melanin granules in the subretinal space. Postoperative examination included ophthalmoscopy, color fundus photography, histology using monoclonal antibodies identifying RPE cells (AE1/3), macrophages (RAM 11), B-lymphocytes (CD20) and T-lymphocytes (CD45), and electron microscopy. The follow-up time was 2 weeks, 4 weeks and 6 months.

    Results: On fundus photographs, the layer of melanin showed focal attenuation with lighter areas at 6 months. Melanin granules were phagocytosed by RPE cells and macrophages at 2 weeks, as identified by monoclonal antibodies. In areas where an abundance of melanin was present, multilayers of macrophages were seen associated with considerable photoreceptor damage. Pigment-laden cells invaded the neural retina. The cellular infiltration of the retina was focal, and when it involved the outer nuclear layer the photoreceptor damage was severe. Electron microscopy demonstrated the presence of melanosomes intracellularly in Müller glia. The process of phagocytosis and removal of melanin granules from the subretinal space was slow and not completed at 6 months.

    Conclusion: Our experiments show that implantation of melanin granules in the subretinal space of albino rabbits may induce a considerable phagocytic cellular response featuring the host’s RPE, macrophages and glial cells. The migration of pigment-laden cells into the neural retina was associated with focal photoreceptor damage.

  • 188.
    Crafoord, Sven
    et al.
    Department of Ophthalmology, Örebro Medical Center, Örebro.
    Geng, Lijun
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Algvere, Peep V.
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Transplantation of Autologous Iris Pigment Epithelial Cells To the Subretinal Space: II. Photoreceptor Survival and Consequences of Cellular MultilayersManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: To study the effects of transplanted iris pigment epithelial (IPE) cells in the subretinal space on the survival of adjacent photoreceptors.

    Methods: An upper iridectomy was made on the right eye of 37 pigmented rabbits. Suspensions of autologous IPE cells were prepared and injected into the subretinal space of the same eye. Follow- up examinations was performed using ophthalmoscopy and calor fundus photography. At 1, 2, 3 and 6 months, respectively, the rabbits were sacrificed and the eyes examined with light and electron microscopy.

    Results: On histological examination, the photoreceptor cells were well preserved in grafted areas at 1-3 months. At 6 months, also, the photoreceptors generally disclosed a normal nuclear layer and long outer segments when overlying areas with single cells or clusters of IPE. However, multilayers of transplanted I PE, native RPE cells and macrophages in the subretinal space were frequently associated with photoreceptor damage and nuclear drop out from the outer retinal layer.

    Conclusion: In this experimental model, the photoreceptors generally survive adjacent to grafted IPE cells for 6 months. Multilayers of subretinal cells are likely to induce adverse effects on adjacent photoreceptors which is a new finding that requires further investigation.

  • 189.
    Crafoord, Sven
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Geng, Lijun
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Seregard, Stefan
    Algvere, Peep
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Experimental transplantation of autologous iris pigment epithelial cells to the subretinal space2001In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 79, no 5, p. 509-514Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the cellular morphology in the subretinal space following transplantation of iris pigment epithelial (IPE) cells from the same eye. Methods: Following an iridectomy, fresh IPE cells were prepared and no culturing performed. After pars plana vitrectomy, a suspension of autologous IPE cells was injected into the subretinal space in 37 rabbits. The grafts were monitored by ophthalmoscopy and colour fundus photography. Rabbits were sacrificed at 1, 2, 3 and 6 months, respectively, and the eyes examined with light and electron microscopy. Results: The grafted area retained the same configuration over 6 months but then appeared less pigmented. At 1-3 months, the IPE formed one or more contiguous layers on top of native RPE. At 6 months, cells compatible with grafted IPE were present in the subretinal space, often forming monolayer-like chains integrating with the native RPE. Depigmented cells of presumed IPE origin were seen and frequently in association with abundant melanin granules located in the apical portion of adjacent RPE cells. In such areas, large macrophage-like cells were observed. Conclusion: Transplanted IPE cells survived for up to 6 months in the subretinal space. Our observations suggest a scenario of remodelling of the cellular layers in the subretinal space over time where grafted IPE cells formed a compound layer with the native RPE. Transplantation of autologous IPE cells may have a potential as a treatment modality in selected cases of age-related macular degeneration.

  • 190.
    Crafoord, Sven
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Geng, Lijun
    Seregard, Stefan
    Algvere, Peep V
    Photoreceptor survival in transplantation of autologous iris pigment epithelial cells to the subretinal space2002In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 80, no 4, p. 387-394Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate photoreceptor survival in transplantation of non-cultured iris pigment epithelial (IPE) cells to the subretinal space in a prospective experimental study. Methods: Upper iridectomies were carried out in the right eyes of 37 pigmented rabbits. Suspensions of freshly harvested autologous IPE cells (without culturing) were prepared and injected into the subretinal space of the same eye. Follow-up examinations were carried out using ophthalmoscopy and colour fundus photography. The rabbits were killed at 1, 2, 3 and 6 months, respectively, and the eyes examined with light and electron microscopy. Results: On histological examination, the photoreceptor cells were found to be well-preserved in grafted areas at 1-3 months. At 6 months, the photoreceptors generally disclosed a normal nuclear layer and long outer segments when overlying areas with single cells or clusters of transplanted IPE cells. Multilayers of cells in abundance, including native RPE cells and macrophages (stained with RAM 11), particularly under microfolds of the neural retina, were occasionally associated with photoreceptor damage and nuclear drop out from the outer retinal layer. There was no inflammatory response in the choroid and the choriocapillaris remained patent. Conclusion: The experiments show that grafting freshly harvested autologous IPE cells to the subretinal space is feasible and that the photoreceptors generally survive for at least 6 months when overlying the transplanted areas. Multi-layers of abundant cells in the subretinal space may induce adverse focal effects on adjacent photoreceptors.

  • 191.
    Crafoord, Sven
    et al.
    Department of Ophthalmology, Örebro Medical Center, Örebro.
    Geng, Lijun
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Seregard, Stefan
    Department of Ophthalmology, Karolinska lnstitutet, St Erik's Eye Hospital, Stockholm, Sweden.
    Algvere, Peep V.
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Transplantation of Autologous Iris Pigment Epithelial Cells to the Subretinal Space: I. Morphological FeaturesManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: To investigate the cellular morphology in the subretinal space following transplantation of iris pigment epithelial (IPE) cells from the same eye.

    Methods: Following an iridectomy, fresh IPE cells were prepared. After pars plana vitrectomy, a suspension of autologous IPE cells was injected into the subretinal space in 37 rabbits. The grafts were monitored by ophthalmoscopy and calor fundus photography. Rabbits were sacrificed at 1, 2, 3 and 6 months, respectively, and the eyes examined with light and electron microscopy.

    Results: The grafted area retained the same configuration over 6 months but then appeared less pigmented. At 1-3 months, the IPE formed one or more contiguous layers on top of native RPE. At 6 months, cells compatible with grafted IPE were present in the subretinal space forming mono-layer like chains integrating with the native RPE. Depigmented cells of presumed IPE origin were seen. lt was commonly observed that the apical portion of RPE cells disclosed abundant melanin granules. With time the grafted cells appeared to decrease in number but focal clusters of IPE cells and large macrophages were present.

    Conclusion: Transplanted IPE cells survived for up to 6 months in the subretinal space. Our observations suggest a scenario of remodeling of the cellular layers in the subretinal space over time where grafted IPE cells formed a compound layer with the native RPE. Transplantation of autologous IPE cells may have a potential as a treatment modality in selected cases of age-related macular degeneration with impending degeneration of RPE and choriocapillaris.

  • 192.
    Crafoord, Sven
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Stenkula, S.
    Carlsson, J.O.
    Shanks, G.
    Base up prism spectacles as visual aid in patients treated for macular hole.1999In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 77, p. 241-241Article in journal (Refereed)
  • 193. Crenshaw, A.G.
    et al.
    Gerdle, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Heiden, M.
    Karlsson, S.
    Fridén, J.
    Intramuscular pressure and electromyographic responses of the vastus lateralis muscle during repeated maximal isokinetic knee extensions.2000In: Acta Physiologica Scandinavica, ISSN 0001-6772, E-ISSN 1365-201X, Vol. 170, p. 119-126Article in journal (Refereed)
  • 194.
    Croné, Marie
    et al.
    Linköping University, Department of Neuroscience and Locomotion.
    Karlsson, Marie
    Linköping University, Department of Neuroscience and Locomotion.
    Afasi-vänlig information: inför funktionell undersökning av språk med magnetresonanstomografi (fMRI)2007Independent thesis Advanced level (degree of Magister), 20 points / 30 hpStudent thesis
    Abstract [en]

    Functional Magnetic Resonance Imaging, fMRI, can be used for analyzing brain activity in subjects performing language tasks. The purpose of this study was to develop aphasia-friendly information adjusted to aphasic subjects participating in fMRI studies. The objectives were to investigate if adjusted information was important for the ability to perform language tasks and if the information could be used for different types of aphasia.

    Sixteen aphasic subjects participated in the study, six of these underwent fMRI. The participants varied in grade and type of aphasia. They had Swedish as their native language and were aged between 26 and 89, mean 57. Information was developed in three versions. The participants performed word generation and sentence completion language tasks.

    Results showed that all the participants produced significantly more words (p < 0.05), and completed significantly more sentences (p < 0.001) in the final version. The fMRI results showed high intersession variability, therefore intra- or intersubject comparisons were difficult to make.

    It was found that increased amount of time to solve the task and removal of the control task together with aphasia-friendly, concrete information improved performance. This applies to all participants, irrespective of aphasia type.

  • 195.
    Dabrosin, Charlotta
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Effects of sex steroids on normal human breast: studies in vivo using microdialysis and in vitro in cell culture1998Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Prolonged exposure to sex steroids may constitute a risk factor for the development of breast cancer. The biological mechanisms involved in breast carcinogenesis are not well understood.

    Basic knowledge of sex steroid effects on the normal human breast is still limited, one reason being the lack of an available in vivo technique for investigations of breast tissue metabolism.

    In this study, the microdialysis technique was developed and evaluated as a method for measurements of tissue-specific concentrations of amino acids, lactate, pyruvate and glutathione in normal human breast tissue during the menstrual cycle. The technique was successfully applied to breast tissue and it was observed that the concentrations of several amino acids as well as glutathione changed during the menstrual cycle. Oxidative damage to cells is one of the mechanisms which may be involved in the development of breast cancer. Normal aerobic metabolism generates potentially dangerous oxidants which are controlled by a variety of antioxidant systems. The exact regulatory mechanisms of these systems are not yet fully understood. We studied the effects of estradiol and progesterone on antioxidative activity in normal human breast tissue, in vivo with the microdialysis technique, and in vitro using normal human breast epithelial cells in culture. The in vivo levels of the antioxidant glutathione were measured early and late in the menstrual cycle in breast tissue and subcutaneous fat. The glutathione levels were higher late in the menstrual cycle in both tissues, when the serum levels of estradiol and progesterone were high. In vitro, breast epithelium exposed to estradiol and progesterone exhibited decreased activity of the antioxidative enzymes catalase and glutathione reductase, whereas the activity of glutathione peroxidase tended to increase compared with cells grown in medium without added sex hormones. The vulnerability to oxidative stress, induced by hydrogen peroxide, increased in cells grown with estradiol and progesterone present in the media. α-Tocopherol, and α-tocopherol in combination with ascorbic acid, but not ascorbic acid alone, protected from cell death induced by hydrogen peroxide. This effect was not dependent on estradiol and progesterone exposure.

    In conclusion, the data suggest an effect of estradiol and progesterone on antioxidative activity in normal human breast tissue both in vivo and in vitro.

    Microdialysis will be a useful tool in future research of these and other aspects concerning human breast tissue.

  • 196.
    Dabrosin, Charlotta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Johansson, Ann-Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology.
    Öllinger, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Decreased secretion of Cathepsin D in breast cancer in vivo by tamoxifen: Mediated by the mannose-6-phosphate/IGF-II receptor?2004In: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 85, no 3, p. 229-238Article in journal (Refereed)
    Abstract [en]

    The lysosomal protease Catliepsin D (Cath D) is associated with increased invasiveness and metastasis in breast cancer. Both estrogen and tamoxifen have been reported to increase Cath D, which seems to contradict the efficacy of tamoxifen as an adjuvant for estrogen dependent breast cancer. Cath D is bioactive in the extracellular space but very little is known about hormonal regulation of secreted Cath D in vivo. In this study we used microdialysis to sample the extracellular fluid in estrogen receptor positive MCF-7 tumors in nude mice. We show that tamoxifen in combination with estradiol decreased secreted Cath D compared with estradiol treatment only in solid tumors in situ. Cell culture of MCF-7 cells revealed that estradiol and tamoxifen increased intracellular proteolytic activity of Cath D in a similar fashion whereas secretion of Cath D was increased by estradiol and inhibited by tamoxifen. Immunofluorescence showed that estradiol located Cath D to the cell surface, while tamoxifen accumulated Cath D to dense lysosomes in perinuclear regions. Moreover, tamoxifen increased the intracellular transporter of Cath D, the mannose 6-phosphate/IGF-II receptor (M6P/IGF2R). In contrast, estradiol decreased the levels of this receptor. Thus, secretion of Cath D is hormone dependent and may be mediated by altered expression of the M6P/IGF2R. Our results highlight the importance of measurements of proteins in all compartments where they are biological active and show that microdialysis is a viable technique for sampling of Cath D in vivo.

  • 197.
    Dabrosin, Charlotta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Öllinger, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Variability of glutathione during the menstrual cycle - Due to estrogen effects on hepatocytes?2004In: Free Radical Biology & Medicine, ISSN 0891-5849, E-ISSN 1873-4596, Vol. 36, no 2, p. 145-151Article in journal (Refereed)
    Abstract [en]

    Oxidative stress and alterations in the antioxidative defense system may be involved in carcinogenesis. We have previously shown that the levels of glutathione (GSH) in vivo in both breast tissue and subcutaneous fat were higher in the luteal phase compared with the follicular phase, suggesting an overall increase in GSH. This result was confirmed in the present study. Moreover, we exposed normal breast tissue in vivo, breast epithelial cells in vitro, and hepatocytes in culture to ovarian hormones. We found that local perfusion with estradiol, using microdialysis, in normal human breast tissue did not alter the local GSH levels in vivo. In vitro, treatment with estradiol and progesterone of normal human breast epithelial cells did not alter GSH levels. However, levels of GSH in hepatocytes were after 8 h estradiol exposure initially decreased, 76.6 ± 5% of control cells, p < .05, whereas 20 h exposure more than doubled GSH, 209 ± 26% compared with control cells, p < .01. Progesterone had no additional effect. Exposure of hepatocytes to estradiol increased the cellular content of γ-glutamylcysteine synthetase, the rate-limiting enzyme in GSH synthesis. In conclusion we suggest that estradiol affects the GSH homeostasis mainly by effects on hepatocytes, whereas local production in the breast is unaffected by estradiol.

  • 198.
    Dahle, Charlotte
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Transfusion Medicine and Clinical Immunology. Linköping University, Faculty of Health Sciences.
    Ekerfelt, Christina
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Vrethem, Magnus
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Samuelsson, Margareta
    Department of Neurology, County Hospital, Örebro, Sweden.
    Ernerudh, Jan
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Transfusion Medicine and Clinical Immunology.
    T helper type 2 like cytokine responses to peptides from P0 and P2 myelin proteins during the recovery phase of Guillain-Barré syndrome1997In: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 153, no 1, p. 54-60Article in journal (Refereed)
    Abstract [en]

    T-lymphocytes are probably involved in the pathogenesis of Guillain-Barré syndrome (GBS). T-helper-1 (Th1) cytokines activate macrophages and induce a delayed type hypersensitivity (DTH) inflammatory response, consistent with the morphology of the demyelination in GBS. Th2 cytokines encourage antibody production and downregulate Th1 responses. To study the Th1/Th2 cytokines in relation to the clinical course of GBS an ELISPOT method for determination of single cells secreting interferon-γ, IFN-γ (Th1) or interleukin-4, IL-4 (Th2) was used. We serially investigated antigen-induced cytokine secretion from circulating T-cells stimulated with human peptides from the P0 and P2 proteins in seven patients and compared to results from seven serially investigated healthy controls. Most patients (five of seven) showed IL-4 responses during the plateau- or recovery-phase as compared to controls. One patient with a prolonged disease course, on the other hand, had an IFN-γ dominated reactivity. We suggest that the IL-4 responses are beneficial in GBS, and may have a role in terminating the disease process in this self-limiting inflammatory disease.

  • 199.
    Dahle, Charlotte
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Department of Molecular and Clinical Medicine, Clinical Immunology. Linköping University, Faculty of Health Sciences.
    Kvarnström, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Immunology. Linköping University, Faculty of Health Sciences.
    Ekerfelt, Christina
    Linköping University, Department of Molecular and Clinical Medicine, Clinical Immunology. Linköping University, Faculty of Health Sciences.
    Samuelsson, Margareta
    Neurology Unit, Örebro University Hospital, Sweden.
    Ernerudh, Jan
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Department of Molecular and Clinical Medicine, Clinical Immunology. Linköping University, Faculty of Health Sciences.
    Elevated number of cells secreting transforming growth factor β in Guillain-Barré syndrome2003In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 111, no 12, p. 1095-1104Article in journal (Refereed)
    Abstract [en]

    We used ELISPOT and cell ELISA to study secretion of IL-4, IFN-γ, TGF-β, IL-6, and TNF-α by circulating mononuclear cells during the course of Guillain-Barré syndrome (GBS). Compared to healthy controls, patients with GBS had higher numbers of TGF-β-secreting cells and the number of individuals with myelin-peptide-induced IL-4 and TGF-β secretion was higher in the GBS group. No significant differences were seen concerning the predominantly pro-inflammatory cytokines IFN-γ, IL-6 or TNF-α. Our findings indicate a down-regulatory role for TGF-β and IL-4 in GBS.

  • 200.
    Dahle, Charlotte
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Vrethem, Magnus
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Ernerudh, Jan
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Transfusion Medicine and Clinical Immunology. Linköping University, Faculty of Health Sciences.
    T lymphocyte subset abnormalities in peripheral blood from patients with the Guillain-Barré syndrome1994In: Journal of Neuroimmunology, ISSN 0165-5728, E-ISSN 1872-8421, Vol. 53, no 2, p. 219-225Article in journal (Refereed)
    Abstract [en]

    T lymphocytes are probably of pathogenic importance in many autoimmune diseases. Recently, deviations of circulating T-helper (CD4+) subpopulations have been noticed. Blood samples from 12 patients with Guillain-Barré syndrome (GBS) were studied with flow cytometry during their disease to define circulating T cell populations. The proportion of T-helper cells (CD4+) was decreased (mean value 41±15%, P = 0.01) and the proportion of T cytotoxic/suppressor cells (CD8+) was increased (35±18%, P = 0.0006) as compared to the control group of healthy blood donors (47±8% and 26±7% respectively). The CD4+ population is divided into the helper/inducer (CD4+ CD29+) and suppressor/inducer (CD4+ CD45RA+) subsets. which normally are equally distributed (mean values in our control group were 45±15% and 44±15%, respectively). In patients with GBS, the helper/inducer (CD4+ CD29+) subset was increased (54±10%, P = 0.05) and the suppressor/inducer (CD4+ CD45RA+) subset was decreased (31±9, P = 0.005) compared to the controls. The proportion of activated HLA-DR-expressing T cells was increased (7±8%, P = 0.005) as compared to control (3±3%). The total proportions of T cells (CD2+), B cells (CD19+) and natural killer (NK) cells (CD56+) were similar in pateints and controls. The CD4+ and CD8+ populations, as well as the activated HLA-DR+ T cells, normalized during the disease course. The derivations within the CD4+ population also tended to normalize, but even at follow up after 6–33 (mean 23) months, some abnormalities remained. In conclusion, we confirm previous reports of T cell activation in peripheral blood from patients with GBS. A new finding is the derivation of T helper subpopulations with an increased helper/inducer (CD4+ CD29+) subset and a decreased suppressor/inducer (CD4+ CD45RA+) subset, which indicates a possible autoimmune character of GBS.

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