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  • 201.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Bragg-Gray Dosimetry: Theory of Burch2001Report (Other academic)
    Abstract [en]

    The theoretical approach to Bragg-Gray dosimetry is: a Bragg-Gray cavity is a cavity (detector) so small that, when inserted into a medium, it does not disturb the fluence of charged particles existing in the medium.

    This means that the ideal Bragg-Gray cavity (detector) is one of infinitesimal dimensions, a "point" detector. In practice, such detectors do not exist but many real detectors may, in a first approximation, be treated as Bragg-Gray detectors to a high degree of accuracy. Corrections needed (so called perturbation corrections) to account for the deviation of the signal from a practical detector from that of an ideal one has been treated by, e.g., ICRU 1984, Alm Carlsson, 1985, Svensson and Brahme 1986, Alm Carlsson 1987.

    Derivation of "perturbation corrections" needs careful consideration and under-standing of the ideal case, i.e., that from which deviations are to be corrected for. The ideal case of a Bragg-Gray detector has been treated by Bragg 1912, Gray 1936, Laurence 1937, Spencer and Attix 1955 and Burch 1955.

    The formulation of Bragg-Gray theory by Spencer and Attix has found wide practical application and has been treated in detail elsewhere. The theory of Burch treats the same problem as did Spencer and Attix, viz., the significance of generation and slowing down of delta-particles in both medium and detector. Burch treated the problem in considerable detail but didn't find a solution for practical calculations. From a physical point of view, however, there is much to learn from Burch's approach. Also, his treatment of so called track ends, evaluated in some detail by Burch 1957, has been adapted in later versions of the Spencer-Attix formulation of Bragg-Gray theory.

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    Bragg-Gray Dosimetry : Theory of Burch
  • 202.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Burlins kavitetsteori1979Report (Other academic)
    Abstract [sv]

    Burlins kavitetsteori är en generell teori i den meningen att inga krav finns på detektorns dimensioner jämfört med sekundärelektronernas räckvidder. Detektorn måste dock vara "tunn" för fotonerna dvs inte ge någon nämnvärd attenuering av de mot detektorn infallande fotonerna

     

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    Burlins kavitetsteori
  • 203.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Effective use of Monte Carlo methods for simulating photon transport with special reference to slab penetration problems in X-raydiagnostics1981Report (Other academic)
    Abstract [sv]

    The analys is of Monte Carlo methods here has been made in connection with a particular problem concerning the transport of low energy photons (30-140 keV) through layers of water with thicknesses between 5 and 20 cm.

    While not claiming to be a complete exposition of available Monte Carlo techniques, the methodological analyses are not restricted to this particular problem. The report describes in a general manner a number of methods which can be used in order to obtain results of greater precision in a fixed computing time.

    Monte Carlo methods have been used for many years in reactor technology, particularly for solving problems associated with neutron transport, but also for studying photon transport through radiation shields. In connection with these particular problems, mathematically and statistically advanced methods have been worked out. The book by Spanier and Gelbard (1969) is a good illustration of this.

    In the present case, a more physical approach to Monte Carlo methods for solving photon transport problems is made (along the lines employed by Fano, Spencer and Berger (1959)) with the aim of encouraging even radiation physicists to use more sophisticated Monte Carlo methods. Today, radiation physicists perform Monte Carlo calculations with considerable physical significance but often with unnecessarily straightforward methods.

    As Monte Carlo calculations can be predicted to be of increasing importance in tackling problems in radiation physics, e.g., in X-ray diagnostics, it is worthwhile to study the Monte Carlo approach for its own sake.

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    Effective use of Monte Carlo methods for simulating photon transport with special reference to slab penetration problems in X-raydiagnostics
  • 204.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Fanos Teorem2002Report (Other academic)
    Abstract [sv]

    I ett oändligt medium erhålles en fullt uppbyggd fluens i alla punkter av mediet. I ett ändligt medium erhålles inte full uppbyggnad av fluensen på avstånd mindre än en maximal "partikelräckvidd" från begränsningsytorna. Fanos teorem har visats gälla för alla punkter i ett oändligt medium men kan endast gälla i det inre av ett ändligt medium där förhållandena är ekvivalenta med dem i det oändliga mediet.

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    Fanos Teorem
  • 205.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Fotonspridningsprocessen vid röntgendiagnostiska strålkvaliteter1981Report (Other academic)
    Abstract [sv]

    Spridd strålning utgör ett allvarligt problem inom röntgendiagnostiken. Kunskap om den spridda strålningen, dess uppträdande i patient och detektor, är en förutsättning för att finna effektiva metoder att reducera den och begränsa dess negativa inverkan på bildkvaliten. Denna kunskap kan vinnas genom transportberäkningar, t ex Monte Carlo simulering (ALM CARLSSON). Detaljerad kännedom om tvärsnitten för inkoherent och koherent spridning är därvid av stor betydelse. Vid utnyttjandet av datortomografi för bestämning av elektrontäthet eller benmineralhalt och annan s.k. tomokemi krävs också välbestämda totala attenueringstvärsnitt, varav Compton och koherent spridning utgör en icke försumbar andel av attenueringen i energiområdet 10-100 keV.

    Fotonspridningen kan också utnyttjas positivt för att ge information om den kropp i vilken spridningen ägt rum. En review över metoder att använda Comptonspridningen till att göra elektrontäthetsbestämningar, såväl i enskilda volymer som i tomografiska snitt har publicerats av CARLSSON och ALM CARLSSON (1979).

    En viktig applikation av Comptonspridningen (inkoherent spridning) i diagnostisk radiologi är metoden att ur mätningar av antalet och energifördelningen av de fotoner, som spridits en viss vinkel bestämma energispektret av den primära röntgenstrålningen. Även här är kännedom om spridningstvärsnitten av vital betydelse för noggrannheten i bestämningen.

    Jag skall här ge en redogörelse för vår aktuella kunskap om tvärsnitten för koherent och inkoherent spridning för fotoner av röntgendiagnostisk kvalitet (10-200 keV). För dessa är det inte tillräckligt att applicera Klein-Nishina tvärsnittet, som gäller för spridning mot fria elektroner i vila utan hänsyn måste tas till att de atomära elektronerna är bundna och i rörelse i kollisionsögonblicket. Speciellt kommer konsekvenserna för metoden att bestämma primärstrålningsspektrum ur uppmätta spektra av spridd strålning att belysas.

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    Fotonspridningsprocessen vid röntgendiagnostiska strålkvaliteter
  • 206.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Kavitetsteori: allmänna grunder1981Report (Other academic)
    Abstract [sv]

    Kavitetsteori är av fundamental betydelse för dosimetrin. Dess uppgift är att relatera den absorberade dosen i en dosimeter till den absorberade dosen i en given punkt i det medium dosimetern är placerad. Idealt har dosimetern samma strålningsabsorberande egenskaper som mediet. Detta är emellertid nästan aldrig möjligt att uppnå.

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    Kavitetsteori : allmänna grunder
  • 207.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Klassisk elektrodynamik: Växelverkan mellan laddade partiklar och elektromagnetiska fält1975Report (Other academic)
    Abstract [sv]

    Varifrån kommer det elektromagnetiska fältet? Elektromagnetiska fält genereras av laddningar i rörelse (en laddning i vila genererar ett elektrostatiskt fält). I definitionen av fältstorheterna ovan tänks i första hand att det elektromagnetiska fält i vilket den betraktade laddningen q rör sig härstammar från alla de övriga laddningarna och deras rörelser i rymden. (Laddningen q genererar även själv ett elektromagnetiskt fält, som under vissa omständigheter återverkar på dess egen rörelse. Denna effekt diskuteras i ett senare avsnitt).

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    Klassisk elektrodynamik : Växelverkan mellan laddade partiklar och elektromagnetiska fält
  • 208.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Kvantelektrodynamik för elektroner: Feynmandiagram och strålningskorrektioner av tvärsnitt1975Report (Other academic)
    Abstract [sv]

    Utvecklingen av kvantelektrodynamiken startade strax efter det att den icke-relativistiska kvantmekaniken fullbordats och innebär en kombination av kvantmekaniska principer och klassisk elektrodynamik. Upphovsmän till kvantelektrodynamiken var Dirac, Heisenberg och Pauli. Diracs relativistiska, kvantmekaniska teori för elektroner ledde till den så kallade hålteorin för och förutsägelsen av en positivt laddad elektron = positronen. Väsentliga insatser inom kvantelektrodynamiken har gjorts av R.P. Feynman från vilken de så kallade Feynmandiagrammen härstammar. Genom en omtolkning av lösningarna till Diracs relativistiska, kvantmekaniska ekvation för elektronerna ersättes hålteorin för positroner med en beskrivning enligt vilken positronen representeras av vågor, som går bakåt i tiden. Denna tolkning av positronen möjliggör väsentliga förenklingar i beräkningen av tvärsnitt för växelverkansprocesser mellan elektroner och elektromagnetiska fält -förenklingar, som blir speciellt betydelsefulla vid behandlingen av mer komplicerade växelverkansprocesser inkluderande de så kallade strålningskorrektionerna till de enklare processerna. Feynmandiagram över även enklare växelverkansprocesser börjar dyka upp i moderna läroböcker (t ex Roy & Reed: "Interactions of photons and leptons with matter". Academic Press 1968) liksom tabellverk som ger strålningskorrektioner till olika elektrodynamiska växelverkansprocesser, (t ex Hubbell: "Photon cross sections, attenuation coefficients, and energy absorption coefficients from 10 keV to 100 GeV. NSRDS-NBS 29 (1969)). I det följande göres ett försök att kvalitativt redogöra för innebörden av Feynmandiagrammen och strålningskorrektionerna. (Analoga diagram kan användas vid beskrivningen av växelverkansprocesserna mellan nukleoner och mesonfält. För dessa redogöres dock inte här).

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    Kvantelektrodynamik för elektroner : Feynmandiagram och strålningskorrektioner av tvärsnitt
  • 209.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Kärnfysikaliska grunder för radioaktiva nuklider1974Report (Other academic)
    Abstract [sv]

    Förståelsen av den joniserande strålningen och dess växelverkan med materia förutsätter kännedom om atomens natur. Atomen (grekiska "atomos" = odelbar) är den minsta del av ett grundämne, som bibehåller ämnets identitet, dvs. uppvisar dess karakteristiska kemiska egenskaper. Individuella atomer är för små för att direkt kunna observeras. Man kan däremot observera vissa egenskaper hos atomen. Med hjälp av dessa försöker man bygga upp en enkel och åskådlig bild av atomen, en atommodell, med vars hjälp man kan förklara experimentellt gjorda observationer.

    Atomen består av en central, elektriskt positivt laddad kärna, till vilken den största delen av atomens massa är koncentrerad. Runt kärnan kretsar elektriskt negativt laddade elektroner, vilka neutraliserar kärnans positiva laddning, så att atomen utåt verkar elektriskt neutral.

    Atomkärnan är uppbyggd av två sorters elementarpartiklar, protoner och neutroner. En proton och en neutron har ungefär samma massa, men medan protonen är bärare av en positiv laddning lika stor som elektronens negativa laddning är neutronen elektriskt neutral. En elektriskt neutral atom innehåller alltså lika många protoner i kärnan som elektroner i det omgivande elektronskalet. Ett gemensamt namn på protoner och neutroner är nukleon.

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    Kärnfysikaliska grunder för radioaktiva nuklider
  • 210.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Skalära och vektoriella fysikaliska storheter: Deras betydelse för förståelsen av röntgendetektorernas uppträdande i ett strålningsfält1981Report (Other academic)
    Abstract [sv]

    Joniserande strålning är ett fysikaliskt fenomen. Varje del av rymden där detta fenomen uppträder utgör ett strålningsfält. För att kunna ge ett mått på "mängden strålning" i fältet krävs att vi först definierar en storhet och därefter mäter eller beräknar storleken på denna uttryckt i antalet enheter av storheten i fråga. Det förekommer alltför ofta att man talar om att "mäta strålningen", vilket egentligen är en omöjlighet. Om man t.ex. anger att ett visst raster "reducerar den spridda strålningen med en faktor 2" så säger detta ingenting om man inte samtidigt anger vilken storhet man avser; fluensen, energifluensen, antalet fotoner som träffar en detektor, summaenergin hos fotonerna som träffar detektorn eller energin absorberad (energy imparted) i detektorn.

    Signalen från en detektor, som placeras i strålningsfältet beror i första hand av den i detektorn absorberade strålningsenergin även om modifikationer till följd av den aktuella fördelningen i tid och rum kan förekomma. Förståelsen aven detektors uppträdande i strålningsfältet är i första hand av dosimetrisk natur.

    Vi skall här närmare betrakta de storheter, som används för att beskriva strålningsfältet och hur dessa kan användas för att bestämma väntevärdet av den i en strålningsdetektor absorberade strålningsenergin. Samtidigt ges tillfälle att presentera de nya storheter och den nya terminologi, som infördes i senaste ICRU-rapporten över kvantiteter och enheter.

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    Skalära och vektoriella fysikaliska storheter : Deras betydelse för förståelsen av röntgendetektorernas uppträdande i ett strålningsfält
  • 211.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Spencer-Attix Cavity Theory2002Report (Other academic)
    Abstract [en]

    The cavity theory by Spencer and Attix treats the energy deposition in a Bragg-Gray (B-G) cavity (detector). Originally the theory was developed for the case of a B-G detector inside a medium irradiated with photons and assuming electronic equilibrium in the medium at the position of the cavity. The theory is also applicable in media irradiated with other types of uncharged ionizing particles (e.g., neutrons) and charged particles such as electrons and protons.

    The special case of photon irradiation under CPE (charged particle equilibrium) conditions was coupled to a model for calculating the energy spectrum of the equilibrium fluence of electrons in the undisturbed medium. For other situations, e.g., in a medium externally irradiated with electrons, the problem is to evaluate the energy spectrum of the electron fluence at the point considered in the medium. Today, this is mostly accomplished using Monte Carlo simulations.

    A Bragg-Gray cavity is regarded to be so small that:

    • the energy imparted to the cavity from electrons released by photons in the cavity is negligible compared to the energy imparted from electrons released by photons in the surrounding medium and passing through the cavity
    • the cavity should not disturb the fluence of electrons in the medium, i. e., the fluence of electrons traversing the cavity is assumed to be identical to that existing at the point of interest in the medium in the absence of the cavity.
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    Spencer-Attix Cavity Theory
  • 212.
    Alm Carlsson, Gudrun
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Spencer-Attix kavitetsteori2001Report (Other academic)
    Abstract [en]

    Spencer-Attix kavitetsteori behandlar energideponeringen i en Bragg-Gray kavitet (detektor) inuti ett medium bestrålat med fotoner och med elektronjämvikt i mediet på kavitetens plats. Med en Bragg-Gray kavitet menas en kavitet så liten att

    • energideponeringen i kaviteten från elektroner frigjorda av fotoner i kaviteten är försumbar jämfört med energideponeringen från elektroner frigjorda av fotoner i omgivande mediet och som passerar in kaviteten
    • kaviteten skall inte nämnvärt störa fluensen av elektronerna i mediet, dvs kaviteten antas i varje punkt genomkorsad av samma fluens av elektroner, som finns i mediet i frånvaro av kaviteten
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    Spencer-Attix kavitetsteori
  • 213.
    Alm Carlsson, Gudrun
    et al.
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Carlsson, Carl A.
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Statistisk precision vid radioaktivitetsmätning och Aktivitetsbestämning ur uppmätt räknehastighet1974Report (Other academic)
    Abstract [sv]

    Radioaktiva sönderfall sker slumpmässigt och det är omöjligt att i förväg veta exakt när en viss atom sönderfaller. Allt man kan säga är att under en halveringstid är sannolikheten 0.5 att en atom sönderfaller och 0.5 att den förblir i sitt ursprungliga radioaktiva tillstånd. Detta gäller en enstaka atom, är det ett stort antal atomer kan man förutsäga att hälften av dem kommer att sönderfalla inom en halveringstid.

    Antag att i ett experiment aktiviteten av ett prov bestäms under en minut. Räknaren anger 1000 cpm, counts per minute. Om man räknar en gång till kanske scalern anger 985 cpm, nästa gång 1023 cpm osv Skulle man utföra mätningen 1000 gånger skulle man få värdet 1000 12 - 13 gånger, 960 och faktiskt 1040 skulle man få 5-6 gångeroch 940 eller 1060 2 gånger. Detta beror inte på något experimentellt fel eller på någon speciell teknik som experimenttorn använder utan på de statistiska fluktuationerna. (Skulle man få värdet 1000 varje gång skall man kontrollera räknaren, någon kanske har ställt in pre-set counts 1000, dvs då är något fel).

    Vi skall i denna rapport se hur de statistiska fluktuationerna påverkar mätresultaten, hur osäkerheten presenteras och hur man gör en aktivitetsbestämning ur en uppmätt räknehastighet.

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    Statistisk precision vid radioaktivitetsmätning och Aktivitetsbestämning ur uppmätt räknehastighet
  • 214.
    Alm Carlsson, Gudrun
    et al.
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Carlsson, Carl A.
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Pettersson, Håkan
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Riskuppskattningar och strålskydds-rekommendationer: Vår strålningsmiljö1991Report (Other academic)
    Abstract [sv]

    Människan har i alla tider varit utsatt för joniserande strålning. Kosmiskstrålning och naturligt radioaktiva nuklider i vår omgivning och i vår kropp ger ett årligtbidrag till den absorberade dosen i hela kroppen, som i genomsnitt för människorna påjorden uppgår till 1 mGy/år (1Gy = 1 J/kg). Det finns områden på jorden där stråldosenfrån naturlig strålning är 10-100 ggr större, jfr avsnittet "Vår strålningsmiljö".

    I slutet av 1800-talet upptäckte Röntgen röntgenstrålningen och Becquerel den naturligaradioaktiviteten. Människan fick därmed för första gången tillgång till starka källor avjoniserande strålning. Dessa togs snabbt i bruk framförallt inom medicinsk röntgendiagnostikoch radioterapi. Man gjorde snart bittra erfarenheter av den joniserandestrålningens skadliga biologiska verkningar efter höga stråldoser. Fram till år 1922 hadec:a 100 radiologer dött av strålskador. Man insåg att något måste göras för att förbättraläget för personalen och år 1928 bildades ICRP (International Commission on RadiationProtection). ICRP ger ut rekommendationer för strålskydd, som ligger till grund förnationella lagar och förordningar över hela världen.

    Den förhållandevis långa erfarenhet människan har av joniserande strålning och denlätthet med vilken även små stråldoser kan mätas har gett oss stränga normer vad gällerhanteringen av producerade strålkällor. Många har därför uppfattningen att joniserandestrålning är en exklusiv miljökomponent. Så är knappast fallet. Förutom att vi alltid varitnaturligt bestrålade finns det idag anledning att förmoda att den kemiska nedsmutsningenav miljön är ett långt allvarligare hot mot vårt välbefinnande än den nuvarandeanvändningen av producerade strålkällor. En rättvis bedömning av olika miljökomponenterkan endast göras den gång alla mäts med samma mått. Arbete med dennainriktning pågår med strålskydds-verksamheten som förebild.

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    Riskuppskattningar och strålskydds-rekommendationer : Vår strålningsmiljö
  • 215.
    Alm Carlsson, Gudrun
    et al.
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Ekberg, Stefan
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Helmrot, Ebba
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Lindström, Jan
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Lund, Eva
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Matscheko, Georg
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Nilsson, Håkan
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Persliden, Jan
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Sandborg, Michael
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Stenström, Mats
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Monte Carlo metoden: ett verktyg inom strålningsfysiken1995Report (Other academic)
    Abstract [sv]

    Detta kompendium är tänkt att användas som ett propedeutiskt kursmaterial för kursdeltagare i kursen "Monte Carlo simulering av foton- och elektrontransport vid diagnostiska och radioterapeutiska strålkvaliteter".

    Först följer en kort repetition av den grundläggande statistik som utnyt1jas i beräkningarna. Därefter följer en beskrivning av slumptal. det fundament som metoden bygger på. Vidare beskrivs val ur olika frekvensfunktioner. Valet kan även göras ur så kallade falska fördelningar för att reducera variansen i den skattade storheten. Metoderna belyses i ett avsnitt om problemlösningsmetodik. först i allmänna termer för att sen gå in på ett specifikt problem (Buffons nålproblem) där en analys och strukturering av problemet görs varefter flödesschema och kodning exemplifieras. Så följer två moment där en beskrivning görs av färderna av fotoner respektive elektroner genom materia. För elektronfärderna gör man en indelning i klass 1- och klass II-färder. Vad detta innebär och hur deltapartiklar tas om hand beskrivs i ett kapitel. Till sist kommer en kort introduktion till de tre laborationerna med laborationshandledningar. Speciell vikt har lagts vid att initiera laboranten att fundera på fysiken i de simulerade experimenten.

    Detta kompendium har tillkommit som examinationsarbete vid en kurs i "Monte Carlo simulering av foton- och elektrontransport vid diagnostiska och radioterapeutiska strålkvaliteter", med andra ord den kurs du själv nu ämnar studera. Författarna önskar dig lycka till med kursen och hoppas att du kommer att få glädje av den. Speciellt hoppas vi att denna skrift ska underlätta för dig att tillgodogöra dig informationen vid föreläsningarna och under laborationerna.

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    Monte Carlo metoden : ett verktyg inom strålningsfysiken
  • 216.
    Almby, Kristina
    et al.
    Uppsala Univ, Sweden.
    Edholm, David
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Anastomotic Strictures After Roux-en-Y Gastric Bypass: a Cohort Study from the Scandinavian Obesity Surgery Registry2019In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 29, no 1, p. 172-177Article in journal (Refereed)
    Abstract [en]

    BackgroundRoux-en-Y gastric bypass (RYGB) is the most common bariatric procedure worldwide. Anastomotic stricture is a known complication of RYGB. The aim was to explore the incidence and outcomes of strictures within the Scandinavian Obesity Surgery Registry (SOReg).MethodSOReg included prospective data from 36,362 patients undergoing bariatric surgery in the years 2007-2013. Outcomes were recorded at 30-day and at 1-year follow-up according to the standard SOReg routine. The medical charts of patients suffering from stricture after RYGB were requested and assessed.SettingNational bariatric surgery registryResultsAnastomotic stricture within 1year of surgery was confirmed in 101 patients representing an incidence of 0.3%. Risk factors for stricture were patient age above 60years (odds ratio (OR), 6.2 95% confidence interval (CI) 2.7-14.3), circular stapled gastrojejunostomy (OR 2.7, 95% CI 1.4-5.5), postoperative anastomotic leak (OR 8.9 95%, CI 4.7-17.0), and marginal ulcer (OR 30.0, 95% CI 19.2-47.0). Seventy-five percent of the strictures were diagnosed within 70days of surgery. Two dilatations or less was sufficient to successfully treat 50% of patients. Ten pecent of patients developed perforation during dilatation, and the risk of perforating at each dilatation was 3.8%. Perforation required surgery in six cases but there was no mortality. Strictures in SOReg may be underreported, which could explain the low incidence in the study.ConclusionMost strictures present within 2months and are successfully treated with two dilatations or less. Dilating a strictured gastrojejunostomy entails a risk of perforation (3.8%).

  • 217.
    Almeida, A. M.
    et al.
    CVZ Centre Vet and Zootecnia, Portugal; CIISA Centre Interdisciplinar Invest Sanidade Anim, Portugal; UNL, Portugal; IBET Institute Biol Expt and Tecnol, Portugal.
    Bassols, A.
    University of Autonoma Barcelona, Spain.
    Bendixen, E.
    Aarhus University, Denmark.
    Bhide, M.
    University of Vet Medical and Pharm, Slovakia.
    Ceciliani, F.
    University of Milan, Italy.
    Cristobal, Susana
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Health Sciences. University of Basque Country, Spain.
    Eckersall, P. D.
    University of Glasgow, Scotland.
    Hollung, K.
    Nofima AS, Norway.
    Lisacek, F.
    Swiss Institute Bioinformat, Switzerland.
    Mazzucchelli, G.
    University of Liege, Belgium.
    McLaughlin, M.
    University of Glasgow, Scotland.
    Miller, I.
    University of Vet Med, Austria.
    Nally, J. E.
    ARS, IA 50010 USA.
    Plowman, J.
    AgResearch, New Zealand.
    Renaut, J.
    Centre Rech Public Gabriel Lippmann, Luxembourg.
    Rodrigues, P.
    University of Algarve, Portugal.
    Roncada, P.
    University of Milan, Italy.
    Staric, J.
    University of Ljubljana, Slovenia.
    Turk, R.
    University of Zagreb, Croatia.
    Animal board invited review: advances in proteomics for animal and food sciences2015In: Animal, ISSN 1751-7311, E-ISSN 1751-732X, Vol. 9, no 1Article, review/survey (Refereed)
    Abstract [en]

    Animal production and health (APH) is an important sector in the world economy, representing a large proportion of the budget of all member states in the European Union and in other continents. APH is a highly competitive sector with a strong emphasis on innovation and, albeit with country to country variations, on scientific research. Proteomics (the study of all proteins present in a given tissue or fluid - i.e. the proteome) has an enormous potential when applied to APH. Nevertheless, for a variety of reasons and in contrast to disciplines such as plant sciences or human biomedicine, such potential is only now being tapped. To counter such limited usage, 6 years ago we created a consortium dedicated to the applications of Proteomics to APH, specifically in the form of a Cooperation in Science and Technology (COST) Action, termed FA1002 - Proteomics in Farm Animals: www.cost-faproteomics.org. In 4 years, the consortium quickly enlarged to a total of 31 countries in Europe, as well as Israel, Argentina, Australia and New Zealand. This article has a triple purpose. First, we aim to provide clear examples on the applications and benefits of the use of proteomics in all aspects related to APH. Second, we provide insights and possibilities on the new trends and objectives for APH proteomics applications and technologies for the years to come. Finally, we provide an overview and balance of the major activities and accomplishments of the COST Action on Farm Animal Proteomics. These include activities such as the organization of seminars, workshops and major scientific conferences, organization of summer schools, financing Short-Term Scientific Missions (STSMs) and the generation of scientific literature. Overall, the Action has attained all of the proposed objectives and has made considerable difference by putting proteomics on the global map for animal and veterinary researchers in general and by contributing significantly to reduce the East-West and North-South gaps existing in the European farm animal research. Future activities of significance in the field of scientific research, involving members of the action, as well as others, will likely be established in the future.

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  • 218.
    Almer, Sven
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Befrits, R.
    Gastrocentrum medicin, Karolinska universitetssjukhuset, Solna, Sweden.
    Eriksson, A.S.
    Medicinkliniken, Sahlgrenska universitetssjukhuset/Östra, Göteborg, Sweden.
    Halfvarson, J.
    Sektionen för gastroenterologi, Medicinska kliniken, Universitetssjukhuset, Örebro, Sweden.
    Hindorf, U.
    VO gastroenterologi, Universitetssjukhuset i Lund, Sweden.
    Lofberg, R.
    IBD-enheten, Sophiahemmet, Stockholm, Sweden.
    Modern läkemedelsterapi vid crohn - Nationella riktlinjer2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 45, p. 2988-2993Article in journal (Refereed)
    Abstract [sv]

    Lättanvända begrepp och definitioner på sjukdomsaktivitet och behandlingseffekt bör få ökad spridning inom sjukvården.

    Majoriteten av patienter med Crohns sjukdom behöver långvarig läkemedelsbehandling, och ungefär hälften genomgår en eller flera operationer någon gång under sjukdomstiden.

    Det är viktigt att tidigt i sjukdomsförloppet identifiera riskfaktorer för utveckling av komplicerad och aggressiv sjukdom och behandla intensivt i dessa fall.

    En aktiv strategi med regelbundet övervägande av tillgängliga behandlingsalternativ medför att de flesta patienter med Crohns sjukdom behåller en god livskvalitet.

  • 219.
    Almqvist, Bengt
    et al.
    Lunds universitet.
    Arlinger, Stig
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Handbok i hörselmätning1990Book (Other academic)
    Abstract [sv]

    Denna bok ger en grundläggande kunskap om hörseln samt förmedlar förutsättningar för olika hörselmätmetoder. Viktiga inslag är felkällor vid hörselmätning, tolkning av mätresultat och lämplig teststrategi i olika tillämpningar. Inläst ur LIC, 1990

  • 220.
    Almqvist, Bengt
    et al.
    Lunds universitet.
    Arlinger, Stig
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Metodbok i praktisk hörselmätning1983Book (Other academic)
    Abstract [sv]

    Denna bok är avsedd att användas vid utbildning av audionomer. Den kan dessutom vara en viktig referenskälla för alla övriga yrkesgrupper inom hörselvården. De metodbeskrivningar som presenteras i boken har goda förutsättningar att bidra till förbättrad hörselmätning

  • 221.
    Almroth, Gabriel
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Nephrology. Linköping University, Department of Medical and Health Sciences, Division of Drug Research.
    Lönn, Johanna
    Örebro Universitet, Sweden.
    Uhlin, Fredrik
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Nephrology. Linköping University, Department of Medical and Health Sciences, Division of Drug Research.
    Brudin, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Department of Physiology, County Hospital, Kalmar, Sweden.
    Andersson, Bengt Andersson
    Sahlgrenska University Hospital, Göteborg, Sweden.
    Hahn-Zoric, Mirjana
    Sahlgrenska University Hospital, Göteborg, Sweden.
    Sclerostin, TNF-alpha and Interleukin-18 Correlate and are Together with Klotho Related to Other Growth Factors and Cytokines in Haemodialysis Patients2016In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 83, no 1, p. 58-63Article in journal (Refereed)
    Abstract [en]

    Patients with chronic renal failure are known to have renal osteodystrophy (bone disease) and increased calcification of vessels. A new marker of bone disease, sclerostin, the two pro-inflammatory cytokines tumour necrosis factor-alpha (TNF-alpha) and interleukin-18 (IL-18), and the fibroblast growth factor-23 (FGF-23) receptor-associated marker Klotho were tested in 84 haemodialysis (HD) patients and in healthy controls. The patients had significantly higher levels of the three former markers than of the controls while Klotho was significantly higher in the controls. Low level, but significant, correlations were observed in the patient group when the levels of these four markers were compared to each other and to those of 5 cytokines and growth factors tested earlier; high-sensitive CRP (hsCRP), interleukin-6 (IL-6), hepatocyte growth factor (HGF), fibroblast growth factor-23 (FGF-23) and soluble urokinase plasminogen activator (suPAR). Ln sclerostin correlated positively to Ln hsTNF-alpha, Ln HGF and Ln suPAR. Ln hsTNF-alpha correlated positively to Ln sclerostin, Ln hsCRP, Ln IL-6, Ln FGF-23, Ln suPAR and Ln IL-18. Ln IL-18 correlated positively to Ln suPAR and Ln TNF-alpha. Ln Klotho correlated negatively to Ln hsCRP but did not correlate to Ln FGF-23. The markers studied here may be involved in the calcification of vessels seen in HD patients due to a combination of inflammation and bone disease. The mechanisms are still not fully known but may be of importance for future therapeutic possibilities in this group of patients.

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  • 222.
    Almroth, Gabriel
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Nephrology.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Recidivating thrombocytopenia, renal failure and thymitis2017In: Recidivating thrombocytopenia, renal failure and thymitis, 2017Conference paper (Other academic)
  • 223.
    Almroth, Gabriel
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Nephrology.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Recurrent thrombocytopenia, renal failure and thymitis of unknown cause. A case report2017In: Vaskulär medicin, Vol. 33, no 3, p. 24-25Article in journal (Refereed)
    Abstract [en]

    A 45-year old man was admitted to an intensive care unit with flank pain and thrombocytopenia. He was treated for a suspected septicaemia but turned out to have signs of an unknown collagenosis which responded to plasma exchange, thymectomi and corticosteroids. Kidney biopsy revealed an intense tubulointerstitial reaction with suspected microthrombotic lesions in the vessels. The condition reoccurred with thrombocytopenia a couple of months later but responded to plasma exchange, corticosteroids and mycophenolate mofetil. An unknown collagenosis with findings of autoimmune thymitis and tubulointerstitial nephritis is the most probable cause of the condition.

  • 224.
    Alping, P.
    et al.
    Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden.
    Askling, J.
    Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden.
    Burman, J.
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Fink, K.
    Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.
    Fogdell-Hahn, A.
    Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    Gunnarsson, M.
    Department of Neurology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Hillert, J.
    Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
    Langer-Gould, A.
    Clinical and Translational Neuroscience, Southern California Permanente Medical Group, Kaiser Permanente, Pasadena, CA, United States.
    Lycke, J.
    Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Gothenburg, Sweden.
    Nilsson, P.
    Department of Clinical Sciences/Neurology, Lund University, Lund, Sweden.
    Salzer, J.
    Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.
    Svenningsson, A.
    Department of Clinical Sciences, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
    Vrethem, Magnus
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Neurology in Linköping.
    Olsson, T.
    Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.
    Piehl, F.
    Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.
    Frisell, T.
    Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden.
    Cancer Risk for Fingolimod, Natalizumab, and Rituximab in Multiple Sclerosis Patients2020In: Annals of Neurology, ISSN 0364-5134, E-ISSN 1531-8249, Vol. 87, no 5, p. 688-699Article in journal (Refereed)
    Abstract [en]

    Objective: Novel, highly effective disease-modifying therapies have revolutionized multiple sclerosis (MS) care. However, evidence from large comparative studies on important safety outcomes, such as cancer, is still lacking. Methods: In this nationwide register-based cohort study, we linked data from the Swedish MS register to the Swedish Cancer Register and other national health care and census registers. We included 4,187 first-ever initiations of rituximab, 1,620 of fingolimod, and 1,670 of natalizumab in 6,136 MS patients matched for age, sex, and location to 37,801 non-MS general population subjects. Primary outcome was time to first invasive cancer. Results: We identified 78 invasive cancers among treated patients: rituximab 33 (incidence rate [IR] per 10,000 person-years = 34.4, 95% confidence interval [CI] = 23.7–48.3), fingolimod 28 (IR = 44.0, 95% CI = 29.2–63.5), and natalizumab 17 (IR = 26.0, 95% CI = 15.1–41.6). The general population IR was 31.0 (95% CI = 27.8–34.4). Adjusting for baseline characteristics, we found no difference in risk of invasive cancer between rituximab, natalizumab, and the general population but a possibly higher risk with fingolimod compared to the general population (hazard ratio [HR] = 1.53, 95% CI = 0.98–2.38) and rituximab (HR = 1.68, 95% CI = 1.00–2.84). Interpretation: In this first large comparative study of 3 highly effective MS disease-modifying therapies, no increased risk of invasive cancer was seen with rituximab and natalizumab, compared to the general population. However, there was a borderline-significant increased risk with fingolimod, compared to both the general population and rituximab. It was not possible to attribute this increased risk to any specific type of cancer, and further studies are warranted to validate these findings. 

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  • 225.
    Alstad, V.
    et al.
    Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Abtahi, Jahan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Surgical removal of keratocystic odontogenic tumours via a Le Fort I osteotomy approach: a retrospective study of the recurrence rate2017In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 46, no 4, p. 6p. 434-439Article in journal (Refereed)
    Abstract [en]

    The keratocystic odontogenic tumour (KCOT) is one of the most aggressive odontogenic cysts and has a high recurrence rate. The treatment of these tumours is the subject of debate. A KCOT in the posterior maxilla with sinus involvement is rare. Few reports have been published in the literature. The purpose of this study was to evaluate the recurrence rate after surgical removal of maxillary KCOTs via a Le Fort I osteotomy. A search was performed to identify patients with a follow-up time of at least 5 years. Nine patients were included in the study. The following clinical variables were analyzed: age at surgery, sex, symptoms, site and size of the tumour, surgical approach, and recurrence rate. The surgical approaches were curettage (n=6) and enucleation (n=3). Recurrence was seen in three patients (33%); all had multilocular tumours. No recurrence was seen in patients with unilocular tumours. The Le Fort I osteotomy approach allows direct visualization and ensures wide excision, minimizing the risk of recurrence. In this series, cases with a multilocular KCOT showed a higher risk of recurrence due to the difficulty of removing the tumour in total. All recurrences took place within 2 years of the intervention; a 5-year follow-up is recommended.

  • 226.
    Altgärde, Jakob
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Redéen, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Hilding, Niclas
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care in Linköping.
    Drott, Peder
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Horse-related trauma in children and adults during a two year period2014In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 22, no 40Article in journal (Refereed)
    Abstract [en]

    Introduction: Horse riding, with almost 200,000 participants, is the eighth most popular sport in Sweden. Severe injuries can occur with horse riding accidents which is well documented. This study was undertaken to investigate if injuries associated with horse riding are common, which type of injuries occur, what mechanisms are involved and to estimate the costs to the society. Material and methods: All patients attending the emergency department at Link ping University Hospital, during the years 2003-2004, due to horse related trauma were prospectively recorded. The patients were divided into two groups according to age, 147 children and 141 adults. The medical records were retrospectively scrutinized. Results: The most common mechanism of injury was falling from the horse. Most commonly, minor sprains and soft tissue injuries were seen, but also minor head injuries and fractures, mainly located in the upper limb. In total 26 adults and 37 children were admitted. Of these 63 patients 19 were considered having a serious injury. In total, four patients needed treatment in intensive care units. The total cost in each group was 200,000 Euro/year. Conclusion: Horse riding is a sport with well known risks. Our results corresponds to the literature, however we have not observed the same incidence of serious injuries. In contrast we find these to be fairly uncommon. The injuries are mainly minor, with a small risk of long term morbidity. Over time regulations and safety equipment seem to have decreased the number of serious accidents.

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  • 227.
    Altgärde, Noomi
    Linköping University, Department of Physics, Chemistry and Biology.
    Local release of lithium from sol-gel coated orthopaedic screws: an in vitro and in vivo study2009Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

     

    In orthopaedic practice, fractures are usually stabilised with metal screws or rods. This is done in order to keep the fracture parts in place during the rather slow healing process. The healing time can potentially be reduced by local- or systemic treatment with different bone promoting drugs. In later years, lithium, otherwise used to treat bipolar disease, has shown promise to be such a drug.

     

    The aim of this master thesis was to find a way to coat metal bone screws with lithium and to characterise the coating. The coating was to be designed in such a way that it could release lithium to the surrounding bone tissue.

     

    Lithium chloride was incorporated into a titanate sol-gel and attached to silicon wafers and stainless steel screws by dip coating. Wafers were used for initial in vitro studies of how lithium changed coating characteristics. This was studied using ellipsometry, AFM and SEM. Lithium is most probably physisorbed and not incorporated into the network building up the sol-gel. Coating structure is changed as more lithium is incorporated. For large amounts of lithium, the nanoparticles normally formed when curing the sol-gel are inhibited. One effect of this is reduced bioactivity, seen as a reduced ability for calcium phosphate crystals to nucleate on the coating when immersed in simulated body fluid.

    Lithium release was investigated using AAS. Lithium is released from the coating, showing a burst effect. By changing the number of coating layers used, the release profile can be partly altered. The coating was also applied to screws, showing good attachment, and the lithium release profile was similar to the one seen from wafers.

    Finally, a screw model was used in rats to assess the effect of local lithium treatment from screws and systemic lithium treatment on fracture healing. In the model, a screw was inserted in tibia, mimicking a fracture. When the bone around the screw was healed, a pullout test was performed, giving information about the strength of the bone surrounding the screw. No significant difference could be found for either local- or systemic lithium treatment compared to control. However, when evaluating the strength of intact bone in a similar way, a positive effect of systemic lithium treatment could be seen. Therefore, it is still likely that lithium has a positive effect on bone and further studies are needed to fully evaluate its role in fracture healing.

     

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  • 228.
    Alvaeus, Julia
    et al.
    Umea Univ, Sweden.
    Rosenblatt, Robert
    Umea Univ, Sweden; Stockholm South Gen Hosp, Sweden.
    Johansson, Markus
    Umea Univ, Sweden; Sundsvall Hosp, Sweden.
    Alamdari, Farhood
    Vastmanland Hosp, Sweden.
    Jakubczyk, Tomasz
    Lanssjukhuset Ryhov, Sweden.
    Holmstrom, Benny
    Uppsala Univ, Sweden.
    Hemdan, Tammer
    Uppsala Univ, Sweden.
    Huge, Ylva
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Abdul-Sattar Aljabery, Firas
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Gabrielsson, Susanne
    Karolinska Inst, Sweden.
    Riklund, Katrine
    Umea Univ, Sweden.
    Winqvist, Ola
    Karolinska Univ Hosp, Sweden.
    Sherif, Amir
    Umea Univ, Sweden.
    Fewer tumour draining sentinel nodes in patients with progressing muscle invasive bladder cancer, after neoadjuvant chemotherapy and radical cystectomy2019In: World journal of urology, ISSN 0724-4983, E-ISSN 1433-8726Article in journal (Refereed)
    Abstract [en]

    Purpose To examine the relationship between the number of tumour draining sentinel nodes (SNs) and pathoanatomical outcomes, in muscle-invasive bladder cancer (MIBC), in patients undergoing neoadjuvant chemotherapy (NAC) and radical cystectomy (RC). Materials and Methods In an ongoing prospective multicenter study, we included 230 patients with suspected urothelial MIBC from ten Swedish urological centers. All underwent TURb and clinical staging. From the cohort, 116 patients with urothelial MIBC; cT2-cT4aN0M0, underwent radical cystectomy (RC) and lymphadenectomy with SN-detection (SNd). 83 patients received cisplatin-based NAC and 33 were NAC-naive. The number and locations of detected SNs and non-SNs were recorded for each patient. The NAC treated patients were categorized by pathoanatomical outcomes post-RC into three groups: complete responders (CR), stable disease (SD) and progressive disease (PD). Selected covariates with possible impact on SN-yield were tested in uni -and multivariate analyses for NAC-treated patients only. Results In NAC treated patients, the mean number of SNs was significantly higher in CR patients (3.3) and SD patients (3.6) compared with PD patients (1.4) (p = 0.034). In a linear multivariate regression model, the number of harvested nodes was the only independent variable that affected the number of SNs (p = 0.0004). Conclusions The number of tumor-draining SNs in NAC-treated patients was significantly lower in patients with progressive disease.

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  • 229.
    Alvarez-Rodriguez, Manuel
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Alvarez, M.
    University of Leon, Spain.
    Anel-Lopez, L.
    SaBio IREC CSIC UCLM JCCM, Spain.
    Lopez-Uruena, E.
    University of Leon, Spain.
    Manrique, P.
    University of Leon, Spain.
    Borragan, S.
    Cabarceno Pk, Spain.
    Morrell, J. M.
    Swedish University of Agriculture Science SLU, Sweden.
    de Paz, P.
    University of Leon, Spain.
    Anel, L.
    University of Leon, Spain.
    Effect of colloid (Androcoll-Bear, Percoll, and PureSperm) selection on the freezability of brown bear (Ursus arctos) sperm2016In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 85, no 6, p. 1097-1105Article in journal (Refereed)
    Abstract [en]

    The development of a species-specific conservation protocol that involves artificial insemination with frozen semen needs to validate an effective methodology for freezing semen. Colloid centrifugation has been suggested and widely applied as an effective tool for selecting animal spermatozoa for artificial breeding. The objective of the present study was to compare different methods of centrifugation, single layer using Androcoll-Bear and Percoll and double layer using PureSperm 100 (in two different discontinuous gradients 40%-80% and 45%-90%), for the selection of fresh brown bear sperm samples. In the before freezing group, all selected samples showed a higher progressive motility and viability (except Percoll for motility 43.0 +/- 5.3 [P < 0.051); all colloids except PureSperm 45/90% rendered samples with fewer damaged acrosomes. In the after thawing group, all tested centrifugation colloids showed a good capacity to decrease the number of damaged acrosomes. Furthermore, PureSperm treatment (45/90%) resulted in an increase in apoptotic-like changes not only immediately after thawing but also after the incubation test, leading us to suggest that this gradient could induce some kind of deleterious effects on the sperm samples. On the other hand, PureSperm treatment (40/80%) yielded a quality preservation capacity similar to Androcoll-Bear in number of damaged acrosomes, different relative to the control (control, 5.3 +/- 0.6; PureSperm 80, 2.0 +/- 0.3; Androcoll, 2.1 +/- 0.9 [P < 0.051) but a decrease in the number of viable spermatozoa recovered after thawing relative to the control (control, 21.2 +/- 3.1; PureSperm 80, 13.7 +/- 2.7 [P < 0.051). In conclusion, Androcoll-Bear constitutes a useful tool for handling of brown bear ejaculates owing to its simple handling and procedure with a reliable sperm selection and freezability. This colloid yielded an improvement in several sperm parameters in brown bear frozen-thawed semen; the selected spermatozoa of fresh samples with this colloid showed a better resistance to freezing compared with the control sample not only for motility but also for viability. (C) 2016 Elsevier Inc. All rights reserved.

  • 230.
    Alvarez-Rodriguez, Manuel
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Ljunggren, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Karlsson, Helen
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Rodriguez-Martinez, Heriberto
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Exosomes in specific fractions of the boar ejaculate contain CD44: A marker for epididymosomes?2019In: Theriogenology, ISSN 0093-691X, E-ISSN 1879-3231, Vol. 140, p. 143-152Article in journal (Refereed)
    Abstract [en]

    Seminal plasma (SP) is a complex fluid containing proteins, peptides, enzymes, hormones as well as extracellular vesicles (EVs). The SP interacts with spermatozoa and the inner cell lining of the female genital tract, adsorbing proteins and exosomes that modulate sperm functions and female immune responsiveness. In the present study, boar sperm-free SP was studied using flow cytometry (FC) after membrane tetraspanins (CD9, CD63 and CD81) and membrane receptor CD44 marking of non-enriched (whole SP) or gradient fractions enriched through two-step discontinuous KBr-density-gradient ultracentrifugation, in whole ejaculate or in selected ejaculate fractions. The results, evaluated by transmission electron microscopy, confirmed the presence of exosomes in all fractions of the pig SP. Noteworthy, these pig SP-exosomes were CD44-bearing when analysed by FC, with bands detected by western blotting (WB) at the expected 85 kD size. The two-step discontinuous KBr-density-gradient ultracentrifugation enriched the population of exosomes in two specific gradient fractions, indicating exosomes (either prostasomes or epididymosomes) could be separated from low-density lipoprotein (LDL) but they co-sediment with the high-density lipoprotein (HDL)-bearing fraction. The findings pave for the selective isolation of exosomes in functional studies of their function when interacting with spermatozoa, the oocyte and/or the female genitalia, including hyaluronan-CD44 interplay. (C) 2019 Elsevier Inc. All rights reserved.

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  • 231.
    Amirhosseini, Mehdi
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Andersson, Göran
    Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.
    Aspenberg, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Fahlgren, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Mechanical instability and titanium particles induce similar transcriptomic changes in a rat model for periprosthetic osteolysis and aseptic loosening2017In: Bone Reports, ISSN 2352-1872, Vol. 7, p. 17-25Article in journal (Refereed)
    Abstract [en]

    Wear debris particles released from prosthetic bearing surfaces and mechanical instability of implants are two main causes of periprosthetic osteolysis. While particle-induced loosening has been studied extensively, mechanisms through which mechanical factors lead to implant loosening have been less investigated. This study compares the transcriptional profiles associated with osteolysis in a rat model for aseptic loosening, induced by either mechanical instability or titanium particles. Rats were exposed to mechanical instability or titanium particles. After 15 min, 3, 48 or 120 h from start of the stimulation, gene expression changes in periprosthetic bone tissue was determined by microarray analysis. Microarray data were analyzed by PANTHER Gene List Analysis tool and Ingenuity Pathway Analysis (IPA). Both types of osteolytic stimulation led to gene regulation in comparison to unstimulated controls after 3, 48 or 120 h. However, when mechanical instability was compared to titanium particles, no gene showed a statistically significant difference (fold change = ± 1.5 and adjusted p-value = 0.05) at any time point. There was a remarkable similarity in numbers and functional classification of regulated genes. Pathway analysis showed several inflammatory pathways activated by both stimuli, including Acute Phase Response signaling, IL-6 signaling and Oncostatin M signaling. Quantitative PCR confirmed the changes in expression of key genes involved in osteolysis observed by global transcriptomics. Inflammatory mediators including interleukin (IL)-6, IL-1ß, chemokine (C-C motif) ligand (CCL)2, prostaglandin-endoperoxide synthase (Ptgs)2 and leukemia inhibitory factor (LIF) showed strong upregulation, as assessed by both microarray and qPCR. By investigating genome-wide expression changes we show that, despite the different nature of mechanical implant instability and titanium particles, osteolysis seems to be induced through similar biological and signaling pathways in this rat model for aseptic loosening. Pathways associated to the innate inflammatory response appear to be a major driver for osteolysis. Our findings implicate early restriction of inflammation to be critical to prevent or mitigate osteolysis and aseptic loosening of orthopedic implants.

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  • 232.
    Anagnostopoulos, Dimitris C.
    et al.
    University of Athens, Greece.
    Heberbrand, Johannes
    University of Duisburg Essen, Germany.
    Eliez, Stephan
    University of Geneva, Switzerland.
    Doyle, Maeve B.
    St Davnets Hospital, Ireland.
    Klasen, Henrikje
    Leiden University, Netherlands.
    Crommen, Sofie
    Flemish Assoc Child and Adolescent Psychiat, Belgium.
    Cetin Cuhadaroglu, Fusun
    Hacettepe University, Turkey.
    Pejovic-Milovancevic, Milica
    University of Belgrade, Serbia.
    Herreros, Oscar
    Hospital University of Virgen de las Nieves, Spain.
    Minderaa, Ruud
    European Soc Child and Adolescent Psychiat, Belgium.
    Karwautz, Andreas
    Medical University of Vienna, Austria.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Raynaud, Jean Philippe
    Centre Hospital University of Toulouse, France.
    Editorial Material: European Society of Child and Adolescent Psychiatry: position statement on mental health of child and adolescent refugees in EUROPEAN CHILD and ADOLESCENT PSYCHIATRY, vol 25, issue 7, pp 673-6762016In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 25, no 7, p. 673-676Article in journal (Other academic)
    Abstract [en]

    n/a

  • 233.
    Andelin, M.
    et al.
    Department of Medicine, NU Hospital Group, Uddevalla, Sweden..
    Kropff, J.
    Department of Endocrinology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands..
    Matuleviciene, V.
    Institute of Medicine, University of Gothenburg, Gothenburg, Sweden..
    Joseph, J.I.
    Department of Anaesthesiology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA..
    Attvall, S.
    Institute of Medicine, University of Gothenburg, Gothenburg, Sweden..
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Hirsch, I.B.
    University of Washington, Seattle, WA, USA.
    Imberg, H.
    Statistiska Konsultgruppen, Gothenburg, Sweden..
    Dahlqvist, S.
    Department of Medicine, NU Hospital Group, Uddevalla, Sweden.
    Klonoff, D.
    Diabetes Research Institute, Mills-Peninsula Health Services, San Mateo, CA, USA..
    Haraldsson, B.
    Institute of Medicine, University of Gothenburg, Gothenburg, Sweden..
    DeVries, J.H.
    Department of Endocrinology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands..
    Lind, M.
    Department of Medicine, NU Hospital Group, Uddevalla, Sweden Institute of Medicine, University of Gothenburg, Gothenburg, Sweden lind.marcus@telia.com..
    Assessing the Accuracy of Continuous Glucose Monitoring (CGM) Calibrated With Capillary Values Using Capillary or Venous Glucose Levels as a Reference.2016In: Journal of Diabetes Science and Technology, E-ISSN 1932-2968, Vol. 10, no 4, p. 876-884Article in journal (Refereed)
    Abstract [en]

    Background: Using the standard venous reference for the evaluation of continuous glucose monitoring (CGM) systems could possibly negatively affect measured CGM accuracy since CGM are generally calibrated with capillary glucose and venous and capillary glucose concentrations differ. We therefore aimed to quantify the effect of using capillary versus venous glucose reference samples on estimated accuracy in capillary calibrated CGM.less thanbr /greater thanMethods: We evaluated 41 individuals with type 1 diabetes mellitus (T1DM) using the Dexcom G4 CGM system over 6 days. Patients calibrated their CGM devices with capillary glucose by means of the HemoCue system. During 2 visits, capillary and venous samples were simultaneously measured by HemoCue and compared to concomitantly obtained CGM readings. The mean absolute relative difference (MARD) was calculated using capillary and venous reference samples.less thanbr /greater thanResults: Venous glucose values were 0.83 mmol/L (15.0 mg/dl) lower than capillary values over all glycemic ranges, P less than .0001. Below 4 mmol/l (72 mg/dl), the difference was 1.25 mmol/l (22.5 mg/dl), P = .0001, at 4-10 mmol/l (72-180 mg/dl), 0.67 mmol/l (12.0 mg/dl), P less than .0001 and above 10 mmol/l (180 mg/dl), 0.95 mmol/l (17.1 mg/dl), P less than .0001. MARD was 11.7% using capillary values as reference compared to 13.7% using venous samples, P = .037. Below 4 mmol/l (72 mg/dl) MARD was 16.6% and 31.8%, P = .048, at 4-10 mmol/l (72-180 mg/dl) 12.1% and 12.6%, P = .32, above 10 mmol/l (180 mg/dl) 8.7% and 9.2%, P = .82.less thanbr /greater thanConclusion: Using capillary glucose concentrations as reference to evaluate the accuracy of CGM calibrated with capillary samples is associated with a lower MARD than using venous glucose as the reference. Capillary glucose concentrations were significantly higher than venous in all glycemic ranges.less thanbr /greater than (© 2016 Diabetes Technology Society.)

  • 234.
    Andell, Pontus
    et al.
    Lund Univ, Sweden.
    Berntorp, Karolina
    Lund Univ, Sweden.
    Christiansen, Evald H.
    Aarhus Univ Hosp, Denmark.
    Gudmundsdottir, Ingibjorg J.
    Univ Hosp Iceland, Iceland.
    Sandhall, Lennart
    Helsingborg Hosp, Sweden.
    Venetsanos, Dimitrios
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Erlinge, David
    Lund Univ, Sweden.
    Frobert, Ole
    Orebro Univ, Sweden.
    Koul, Sasha
    Lund Univ, Sweden.
    Reitan, Christian
    Lund Univ, Sweden.
    Gotberg, Matthias
    Lund Univ, Sweden.
    Reclassification of Treatment Strategy With Instantaneous Wave-Free Ratio and Fractional Flow Reserve A Substudy From the iFR-SWEDEHEART Trial2018In: JACC: Cardiovascular Interventions, ISSN 1936-8798, E-ISSN 1876-7605, Vol. 11, no 20, p. 2084-2094Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES The authors sought to compare reclassification of treatment strategy following instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR). BACKGROUND iFR was noninferior to FFR in 2 large randomized controlled trials in guiding coronary revascularization. Reclassification of treatment strategy by FFR is well-studied, but similar reports on iFR are lacking. METHODS The iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome Trial) study randomized 2,037 participants with stable angina or acute coronary syndrome to treatment guided by iFR or FFR. Interventionalists entered the preferred treatment (optimal medical therapy [OMT], percutaneous coronary intervention [PCI], or coronary artery bypass grafting [CABG]) on the basis of coronary angiograms, and the final treatment decision was mandated by the iFR/FFR measurements. RESULTS In the iFR/FFR (n = 1,009/n = 1,004) populations, angiogram-based treatment approaches were similar (p = 0.50) with respect to OMT (38%/35%), PCI of 1 (37%/39%), 2 (15%/16%), and 3 vessels (2%/2%) and CABG (8%/8%). iFR and FFR reclassified 40% and 41% of patients, respectively (p = 0.78). The majority of reclassifications were conversion of PCI to OMT in both the iFR/FFR groups (31.4%/29.0%). Reclassification increased with increasing number of lesions evaluated (odds ratio per evaluated lesion for FFR: 1.46 [95% confidence interval: 1.22 to 1.76] vs. iFR 1.37 [95% confidence interval: 1.18 to 1.59]). Reclassification rates for patients with 1, 2, and 3 assessed vessels were 36%, 52%, and 53% (p amp;lt; 0.01). CONCLUSIONS Reclassification of treatment strategy of intermediate lesions was common and occurred in 40% of patients with iFR or FFR. The most frequent reclassification was conversion from PCI to OMT regardless of physiology modality. Irrespective of the physiological index reclassification of angiogram-based treatment strategy increased with the number of lesions evaluated. (c) 2018 by the American College of Cardiology Foundation.

  • 235.
    Anders Eriksson, Mats
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden; Gothenburg University, Sweden.
    Lieden, Agne
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Westerlund, Joakim
    Stockholm University, Sweden.
    Bremer, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics. Division of Clinical Genetics, University Hospital, Link.
    Wincent, Josephine
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Sahlin, Ellika
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Gillberg, Christopher
    Gothenburg University, Sweden.
    Fernell, Elisabeth
    Gothenburg University, Sweden.
    Anderlid, Britt-Marie
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Rare copy number variants are common in young children with autism spectrum disorder2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 6, p. 610-618Article in journal (Refereed)
    Abstract [en]

    AimSeveral studies have suggested that rare copy number variants (CNVs) are an important genetic contributor to autism spectrum disorders. The aims of the study were to use chromosomal microarray to investigate the presence of rare copy number variants in a population-based cohort of well-characterised young children with autism spectrum disorders and to relate the genetic results to neurodevelopmental profiles and medical conditions. MethodsWe performed chromosomal microarray on samples from 162 children who had been referred to the Stockholm Autism Centre for Young Children in Sweden after being diagnosed with autism spectrum disorder between 20 and 54months of age. ResultsPathogenic aberrations were detected in 8.6% of the children and variants of uncertain significance were present in another 8.6%. CNVs were more frequent in children with congenital malformations or dysmorphic features as well as in the subgroup with intellectual disability. ConclusionOur results support the use of chromosomal microarray methods for the first tier genetic analysis of autism spectrum disorder. However, it is likely in the near future that chromosomal microarray methods will probably be replaced by whole-exome and whole-genome sequencing technologies in clinical genetic testing.

  • 236.
    Andersen Amofah, Hege
    et al.
    Haukeland Hospital, Norway.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Bergen University of Coll, Norway; Jonköping University, Sweden.
    Fridlund, Bengt
    Haukeland Hospital, Norway; Bergen University of Coll, Norway; Jonköping University, Sweden.
    Bjorvatn, Bjorn
    Norwegian Competence Centre Sleep Disorders, Norway; University of Bergen, Norway.
    Haaverstad, Rune
    Haukeland Hospital, Norway; University of Bergen, Norway.
    Ove Hufthammer, Karl
    Haukeland Hospital, Norway.
    Kuiper, Karel K. J.
    Haukeland Hospital, Norway.
    Hylen Ranhoff, Anette
    University of Bergen, Norway; Haraldsplass Hospital, Norway.
    Norekval, Tone M.
    Haukeland Hospital, Norway; Bergen University of Coll, Norway; University of Bergen, Norway.
    Sleep in octogenarians during the postoperative phase after transcatheter or surgical aortic valve replacement2016In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 2, p. 168-177Article in journal (Refereed)
    Abstract [en]

    Background: Octogenarians with aortic stenosis are an increasing population of patients admitted for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Although adequate sleep is important after illness and surgery, it has scarcely been studied in the immediate postoperative phase. Aims: To determine and compare the nature of self-reported sleep and insomnia, and recorded sleep-wake patterns in octogenarians during the in-hospital postoperative phase after SAVR or TAVI. Methods: A prospective cohort design was used that included octogenarian patients undergoing SAVR or TAVI at a regional university hospital. Self-reports were used to document sleep and insomnia, and actigraphy was used to record sleep-wake patterns. Data were collected at baseline preoperatively, and then daily for the first five postoperative days. Results: SAVR patients experienced the most insomnia on postoperative nights later in recovery, while TAVI patients experienced the most insomnia on postoperative nights early in recovery. The median total sleep time, as measured by actigraphy, was 6.4 h, and the median sleep efficiency was 79% for the five postoperative nights, but no differences were found between SAVR and TAVI patients on this parameter. All patients slept more during daytime than at night, with SAVR patients having significantly more total sleep hours for all five days than TAVI patients (p < 0.01). Conclusion: Octogenarians with aortic stenosis had disturbed self-reported sleep, increased insomnia, and disturbed sleep-wake patterns postoperatively, resulting in more daytime sleep and inactivity. In patients undergoing SAVR or TAVI, sleep evolves differently during the in-hospital postoperative phase.

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  • 237.
    Andersen Helland, Wenche
    et al.
    Universitetet i Bergen, Norge.
    Biringer, Eva
    Helse Fonna HF, Norge.
    Helland, Turid
    Universitetet i Bergen, Norge.
    Heimann, Mikael
    Linköping University, Department of Behavioural Sciences and Learning, Developmental Psychology. Linköping University, Faculty of Arts and Sciences.
    Exploring language profiles for children with AD/HD and children with Asperger syndrome2012In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 16, no 1, p. 34-43Article in journal (Refereed)
    Abstract [en]

    Objective: The aims of the present study was to investigate communication impairments in a Norwegian sample of children with ADHD and children with Asperger syndrome (AS) and to explore whether children with ADHD can be differentiated from children with AS in terms of their language profiles on the Norwegian adaptation of the Children’s Communication Checklist Second Edition (CCC-2). Method: The CCC-2 was completed by the parents, and altogether, 77 children aged between 6 and 15 years participated in the study. Results: Communication impairments were as common in a group of children with ADHD as in a group of children with AS. Although a similar pattern appeared on most CCC-2 scales, children with ADHD and children with AS could be distinguished from each other in terms of their language profiles on the subscales assessing stereotyped language and nonverbal communication. Conclusion: Language abilities should be taken into account when standard assessments of ADHD and AS are performed and before therapies are initiated

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  • 238.
    Andersen Helland, Wenche
    et al.
    Universitetet i Bergen, Norge.
    Helland, Turid
    Universitetet i Bergen, Norge.
    Heimann, Mikael
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Language profiles and mental health problems in children with specific language imapirment and children with AD/HD2014In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 18, no 3, p. 226-235Article in journal (Refereed)
    Abstract [en]

    Objective: This study aimed to explore whether children with specific language impairment (SLI) and children with ADHDcan be differentiated from each other in terms of their language profiles, and also to investigate whether these two clinicalgroups differ regarding mental health problems. Method: A total of 59 children in the age range 6 to 12 years participatedin the study. The parents completed the Children’s Communication Checklist–Second Edition and the Strengths andDifficulties Questionnaire. Results: Communication impairments were as prominent in the ADHD group as in the SLIgroup; however, the groups were separable from each other in terms of their language profiles. Furthermore, the ADHDgroup experienced significantly more mental health problems compared with the SLI group. Conclusion: Language shouldbe assessed in children with ADHD and instruments sensitive to ADHD should be included when assessing children withSLI. Mental health should be an area of concern to be addressed in both groups. (J. of Att. Dis. 2012; XX(X) 1-XX)

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  • 239. Andersson, A
    et al.
    Carlsson, J
    Lundberg, Peter
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics.
    Hansson, T
    Söderfeldt, B
    Comparison of sign language production and meaningless hand movements by fMRI1998Conference paper (Other academic)
  • 240.
    Andersson, Anna-Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Andersson, Blanka
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Lorell, Christoffer
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Raffetseder, Johanna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Larsson, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Blomgran, Robert
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Autophagy induction targeting mTORC1 enhances Mycobacterium tuberculosis replication in HIV co-infected human macrophages2016In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 6, no 28171Article in journal (Refereed)
    Abstract [en]

    To survive and replicate in macrophages Mycobacterium tuberculosis (Mtb) has developed strategies to subvert host defence mechanisms, including autophagy. Autophagy induction has the potential to clear Mtb, but little is known about its effect during controlled tuberculosis and HIV co-infection. Mammalian target of rapamycin complex1 (mTORC1) inhibitors were used to induce autophagy in human macrophages pre-infected with HIV-1(BaL) and infected with a low dose of Mtb (co-infected), or single Mtb infected (single infected). The controlled Mtb infection was disrupted upon mTOR inhibition resulting in increased Mtb replication in a dose-dependent manner which was more pronounced during co-infection. The increased Mtb replication could be explained by the marked reduction in phagosome acidification upon mTOR inhibition. Autophagy stimulation targeting mTORC1 clearly induced a basal autophagy with flux that was unlinked to the subcellular environment of the Mtb vacuoles, which showed a concurrent suppression in acidification and maturation/flux. Overall our findings indicate that mTOR inhibition during Mtb or HIV/Mtb co-infection interferes with phagosomal maturation, thereby supporting mycobacterial growth during low-dose and controlled infection. Therefore pharmacological induction of autophagy through targeting of the canonical mTORC1-pathway should be handled with caution during controlled tuberculosis, since this could have serious consequences for patients with HIV/Mtb co-infection.

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  • 241.
    Andersson, B.
    et al.
    University of Gothenburg, Sweden.
    Swolin-Eide, D.
    University of Gothenburg, Sweden.
    Kristroem, B.
    Umeå University, Sweden.
    Gelander, L.
    University of Gothenburg, Sweden; Angered Hospital, Sweden.
    Magnusson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry. Linköping University, Faculty of Medicine and Health Sciences.
    Albertsson-Wikland, K.
    University of Gothenburg, Sweden.
    Seasonal variations in vitamin D in relation to growth in short prepubertal children before and during first year growth hormone treatment2015In: Journal of Endocrinological Investigation, ISSN 0391-4097, E-ISSN 1720-8386, Vol. 38, no 12, p. 1309-1317Article in journal (Refereed)
    Abstract [en]

    Purpose This study investigated the relationship between seasonal variations in 25-hydroxyvitamin D (25(OH) D) levels and growth in prepubertal children during both the pretreatment year and the first year of GH treatment. Methods The study included 249 short prepubertal children with a broad range of GH secretion, GH(max) during a 24 h profile median 23; range 1-127 mU/L, 191 boys (mean age +/- SD, 8.6 +/- 2.6 years), 58 girls (7.5 +/- 1.9 years) receiving GH treatment (mean 43 mu g/kg/day; range 17-99 mu g/kg/day). Serum 25(OH) D was measured using an automated IDS-iSYS immunoassay. Results 25(OH) D levels showed seasonal variation, and decreased significantly during GH treatment. 25(OH) D levels at start and first year reduction in 25(OH) D, correlated (-) with the first year growth response during treatment. The degree of GH secretion capacity within our study population of mainly non-GH deficient children and 25(OH) D sufficient (67 +/- 29 nmol/L) had no influence on 25(OH) D levels. Growth during GH treatment were independent of seasonal variations in 25(OH) D. Multiple regression analysis showed that 25(OH) D levels at treatment start, together with auxological data and IGF-binding protein-3(SDS), explained 61 % of the variation in first year gain in height(SDS). Conclusion 25(OH) D levels were associated with first year growth response to GH and may be a useful contribution to future growth prediction models.

  • 242. Order onlineBuy this publication >>
    Andersson, Bengt-Åke
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Laboratory Medicine, Region Jönköping County.
    Circulating Biomarkers in Patients with Head and Neck Cancer and the Influence of Cigarette Smoking2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Head and neck cancer (HNC) is a collective name for heterogeneous tumors located in the head and neck regions for which smoking, alcohol and human papillomavirus (HPV) are documented risk factors. The survival of HNC patients has only improved marginally during the last decade. The most important prognostic factors are tumor size, local spread and distant metastases, tumor node metastasis (TNM) staging. Prognostic biomarkers are needed as a complement to TNM staging.

    The aim for this thesis was to investigate rapid and low cost blood based biomarkers which could indicate the risk of HNC, recurrence of the disease or the survival of HNC patients. Furthermore, the aim was to examine how cigarette smoking influences the levels of biomarkers.

    In paper I, a possible role of plasma cytokines or proteins associated with immune response or inflammation, as biomarkers for the survival of HNC patients was investigated. Higher levels of C-reactive protein (CRP) and tumor necrosis factor alpha (TNF-α) were detected in plasma of the patients compared with the levels in the controls. The elevated levels of these two biomarkers detected in patients were associated with decreased survival.

    In paper II, the influence of 45 single nucleotide polymorphisms (SNPs) located in 41 genes associated with cell cycle progression, cell death, DNA repair or immune response on cancer risk, tumor recurrence and survival in HNC patients were investigated. SNPs in immune response genes were associated with risk for HNC, an elevated risk for recurrence and a decreased survival in HNC patients.

    In paper III, the influence of cigarette smoking on levels of inflammatory cells, proteins or cytokines/chemokines, microRNAs (miRNAs) and SNPs was analysed in healthy smokers and non-smokers. Higher levels of total white blood cells (WBCs), neutrophils, monocytes, lymphocytes, neutrophil to lymphocyte ratio (NLR), CRP, monocyte chemoattractant protein- 1 (MCP-1) and interferon gamma (IFN-γ) were detected in smokers compared to non-smokers and indicate an inflammatory response. Also, a lower level of oncomiRNA miR-21was detected in smokers. This alteration, in combination with the elevated levels of IFN-γ in smokers could be a protective response to cigarette smoke. The higher levels of IFN-γ in smokers compared to non-smokers were however only detected in individuals with SNP rs2069705 genotype AG/GG. This indicates a genetic association of the levels of IFN-γ.

    In paper IV, the separate effects of cigarette smoking and HNC on inflammatory or immune biomarkers and the impact of high risk human papillomavirus, age and gender were investigated. Comparisons of circulating levels of WBCs and its subpopulations, plasma proteins or cytokines/chemokines between smoking and non-smoking patients, smoking and non-smoking controls and between the patient and control groups were analysed. Smoking had highest impact on elevated levels of WBCs, IFN-γ and MCP-1, and HNC had highest impact on elevated levels of neutrophils, monocytes, NLR, CRP, macrophage inflammatory protein 1 beta and TNF-α.

    In conclusion, host immune response associated parameters could be suitable as biomarkers for the risk of HNC, risk of recurrence or in predicting survival of HNC patients. This thesis show that HNC are associated with systemic inflammatory response and upregulated CRP and TNF-α is related to shorter survival in HNC patients. Additionally, SNPs in immune response genes such as rs1800629 in the TNF-α gene indicates a risk for HNC or an elevated risk for recurrence and a decreased survival in HNC patients. These rapid and low cost blood based biomarkers could be used in combination or as a supplement to established biomarkers in the clinic for a more personalized treatment modality.

    List of papers
    1. Plasma tumor necrosis factor-α and C-reactive protein as biomarker for survival in head and neck squamous cell carcinoma.
    Open this publication in new window or tab >>Plasma tumor necrosis factor-α and C-reactive protein as biomarker for survival in head and neck squamous cell carcinoma.
    Show others...
    2014 (English)In: Journal of Cancer Research and Clinical Oncology, ISSN 0171-5216, E-ISSN 1432-1335, Vol. 140, no 3, p. 515-519Article in journal (Refereed) Published
    Abstract [en]

    PURPOSE: Tumor TNM staging is the main basis for prognosis and treatment decision for head and neck squamous cell carcinoma (HNSCC) despite significant heterogeneity in terms of outcome among patients with the same clinical stage. In this study, a possible role of plasma interleukin-2 (IL-2), interleukin-6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) as biomarkers for survival of HNSCC patients was investigated.

    METHODS: In this prospective study, plasma levels of IL-2, IL-6, GM-CSF, TNF-α and CRP in patients (n = 100) and controls (n = 48) were analyzed.

    RESULTS: Significantly elevated levels of CRP and TNF-α (p < 0.001) were found in the patients. Combination of upregulated CRP and TNF-α in the patient plasma was significantly related to shorter patient survival, independent of clinical stage.

    CONCLUSIONS: Our findings indicate that CRP and TNF-α might be suitable as biomarkers in combination with tumor TNM staging for predicting survival and individualized treatment of HNSCC patients. Plasma CRP and TNF-α analysis are simple, rapid, cost effective and suitable for clinical practice.

    Keywords
    Head and neck squamous cell carcinoma, Biomarkers, Survival, CRP, TNF-α
    National Category
    Cancer and Oncology
    Identifiers
    urn:nbn:se:liu:diva-162092 (URN)10.1007/s00432-014-1592-8 (DOI)24481866 (PubMedID)
    Available from: 2019-11-19 Created: 2019-11-19 Last updated: 2019-11-19Bibliographically approved
    2. Single-Nucleotide Polymorphisms and Cancer Risk, Tumor Recurrence, or Survival of Head and Neck Cancer Patients
    Open this publication in new window or tab >>Single-Nucleotide Polymorphisms and Cancer Risk, Tumor Recurrence, or Survival of Head and Neck Cancer Patients
    Show others...
    2017 (English)In: Oncology, ISSN 0030-2414, E-ISSN 1423-0232, Vol. 92, no 3, p. 161-169Article in journal (Refereed) Published
    Abstract [en]

    Objective: This paper aims at studying the influence of single-nucleotide polymorphisms (SNPs) on cancer risk, tumor recurrence, and survival in head and neck (Hamp;N) cancer patients. Methods: A total of 45 SNPs in 41 genes were investigated. A total of 174 Caucasian Hamp;N cancer patients and 245 healthy blood donors were enrolled in the study. Results: Ten SNPs were associated with Hamp;N cancer risk, but the identified SNPs differed among males and females. Some of the SNPs were related to immune response genes. The immune response gene SNPs were also related to survival. In particular, we noted that the tumor necrosis factor alpha (TNF alpha) rs1800629 could have an influence on cancer risk; tumor recurrence as well as survival. Conclusion: Genetic variation of the TNFa rs1800629 might be useful as a biomarker in clinical decision-making since it was found to be related to cancer risk, tumor recurrence, and survival of Hamp;N cancer patients. (C) 2016 S. Karger AG, Basel

    Place, publisher, year, edition, pages
    KARGER, 2017
    Keywords
    Head and neck cancer; Tumor recurrence; Survival time; Single-nucleotide polymorphisms
    National Category
    Cancer and Oncology
    Identifiers
    urn:nbn:se:liu:diva-136217 (URN)10.1159/000452278 (DOI)000395366800005 ()27997918 (PubMedID)
    Note

    Funding Agencies|Jonkoping Clinical Cancer Research Foundation; Futurum; FORSS; Swedish Laryngeal Foundation

    Available from: 2017-03-31 Created: 2017-03-31 Last updated: 2019-11-19
    3. Cigarette smoking affects microRNAs and inflammatory biomarkers in healthy individuals and an association to single nucleotide polymorphisms is indicated
    Open this publication in new window or tab >>Cigarette smoking affects microRNAs and inflammatory biomarkers in healthy individuals and an association to single nucleotide polymorphisms is indicated
    Show others...
    2019 (English)In: Biomarkers, ISSN 1354-750X, E-ISSN 1366-5804, Vol. 24, no 2, p. 180-185Article in journal (Refereed) Published
    Abstract [en]

    Background: Cigarette smoke induces inflammation and remodels immune response. Genetic and epigenetic alterations might be involved in the pathogenesis of smoking related diseases. In this study, we investigated the effect of smoking on systemic inflammation biomarkers and epigenetic changes at microRNA (miRNA) expression level. We also examined if the levels of inflammatory biomarkers were associated with selected single nucleotide polymorphisms (SNPs). Method: From 39 smokers and 101 non-smokers, levels of total white blood cells (WBCs) and its subpopulations, plasma cytokines/chemokines/proteins and miRNAs were analysed. For three biomarkers, C-reactive protein (CRP), MCP-1 and IFN-gamma that were affected by smoking, the influence of SNPs was analyzed. Result: Elevated levels of total WBCs, neutrophils, monocytes, lymphocytes, CRP, MCP-1, IFN-gamma and lower levels of miR-21 were detected in smokers. The elevated levels of IFN-gamma in smokers was only statistically significantly associated with rs2069705 AG/GG SNP-genotype. Conclusions: A lower level of oncomir miRNA-21 and a higher level of immune modelling cytokine IFN-gamma detected in smokers could be a protective immune response to cigarette smoke. The higher level of IFN-gamma in smokers with a specific SNP genotype also suggests that a genetic interaction with smoking might predict the pathobiology of smoking related disease.

    Place, publisher, year, edition, pages
    TAYLOR & FRANCIS LTD, 2019
    Keywords
    Immune respons; single nucleotide polymorphism; microRNA; smoking related diseases; cigarette smoking
    National Category
    Rheumatology and Autoimmunity
    Identifiers
    urn:nbn:se:liu:diva-157272 (URN)10.1080/1354750X.2018.1539764 (DOI)000465158700011 ()30375257 (PubMedID)
    Note

    Funding Agencies|Forskningsradet i Sydostra Sverige; Futurum-Academy of HealthCare at Jonkoping County Council [477461, 490031, 669631]; Foundation of Clinical Cancer Research in Jo nkoping [110426-1]; Medical Research Council of Southeast Sweden (FORSS) [567001]

    Available from: 2019-06-12 Created: 2019-06-12 Last updated: 2019-11-19
    4. Impact of Cigarette Smoking and Head and Neck Squamous Cell Carcinoma on Circulating Inflammatory Biomarkers
    Open this publication in new window or tab >>Impact of Cigarette Smoking and Head and Neck Squamous Cell Carcinoma on Circulating Inflammatory Biomarkers
    Show others...
    2020 (English)In: Oncology, ISSN 0030-2414, E-ISSN 1423-0232, Vol. 98, no 1, p. 42-47Article in journal (Refereed) Published
    Abstract [en]

    INTRODUCTION: Smoking induces inflammation and an immune response. A cancer-related inflammatory response has been seen in smoking and nonsmoking head and neck squamous cell carcinoma (HNSCC) patients.

    OBJECTIVES: The aim of this study was to analyze the possible separated effects of smoking or HNSCC on 18 inflammatory or immune regulatory biomarkers.

    METHODS: Fifty-one nonsmoking and 36 smoking pretreated HNSCC patients and 101 nonsmoking and 39 smoking controls were included in this study. The levels of 18 inflammatory or immune regulatory biomarkers were analyzed. A multivariable linear regression model was used to predict the impact of smoking and HNSCC on the levels of the biomarkers.

    RESULTS: Smoking had the highest impact on total WBC, IFN-γ, and MCP-1 levels. The highest impact of HNSCC was found on neutrophils, neutrophil-to-lymphocyte ratio, HsCRP, MIP-1b, and TNF-α levels.

    CONCLUSION: Identifying HNSCC or smoking-related inflammatory biomarkers might contribute to the understanding of the immune response in HNSCC patients. This study could provide information of inflammatory biomarkers in HNSCC patients.

    Place, publisher, year, edition, pages
    S. Karger, 2020
    Keywords
    Biomarkers, Head and neck squamous cell carcinoma, Immune response, Inflammation, Smoking
    National Category
    Cancer and Oncology
    Identifiers
    urn:nbn:se:liu:diva-162093 (URN)10.1159/000502651 (DOI)000522873100007 ()31437849 (PubMedID)
    Note

    Funding agencies: 

    Futurum-Academy of HealthCare at Jonkoping County Council [696261]; Foundation of Clinical Cancer Research in Jonkoping [110426]

    Available from: 2019-11-19 Created: 2019-11-19 Last updated: 2020-04-21Bibliographically approved
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  • 243.
    Andersson, Bengt-Åke
    et al.
    Microbiology Laboratory, Division of Medical Services, Department of Laboratory Services, Ryhov County Hospital, Jönköping.
    Lewin, Freddi
    Department of Oncology, Ryhov County Hospital, Jönköping.
    Lundgren, Jan
    Department of ENT, Karolinska University Hospital, Stockholm.
    Nilsson, Mats
    Futurum - The Academy for Healthcare, County Council, Ryhov County Hospital, Jönköping.
    Rutqvist, Lars-Erik
    Department of Scientific Affairs, Swedish Match AB, Stockholm.
    Löfgren, Sture
    Microbiology Laboratory, Division of Medical Services, Department of Laboratory Services, Ryhov County Hospital, Jönköping.
    Laytragoon-Lewin, Nongnit
    Microbiology Laboratory, Division of Medical Services, Department of Laboratory Services, Ryhov County Hospital, Jönköping.
    Plasma tumor necrosis factor-α and C-reactive protein as biomarker for survival in head and neck squamous cell carcinoma.2014In: Journal of Cancer Research and Clinical Oncology, ISSN 0171-5216, E-ISSN 1432-1335, Vol. 140, no 3, p. 515-519Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Tumor TNM staging is the main basis for prognosis and treatment decision for head and neck squamous cell carcinoma (HNSCC) despite significant heterogeneity in terms of outcome among patients with the same clinical stage. In this study, a possible role of plasma interleukin-2 (IL-2), interleukin-6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) as biomarkers for survival of HNSCC patients was investigated.

    METHODS: In this prospective study, plasma levels of IL-2, IL-6, GM-CSF, TNF-α and CRP in patients (n = 100) and controls (n = 48) were analyzed.

    RESULTS: Significantly elevated levels of CRP and TNF-α (p < 0.001) were found in the patients. Combination of upregulated CRP and TNF-α in the patient plasma was significantly related to shorter patient survival, independent of clinical stage.

    CONCLUSIONS: Our findings indicate that CRP and TNF-α might be suitable as biomarkers in combination with tumor TNM staging for predicting survival and individualized treatment of HNSCC patients. Plasma CRP and TNF-α analysis are simple, rapid, cost effective and suitable for clinical practice.

  • 244.
    Andersson, Bengt-Åke
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Department of Laboratory Medicine, Region Jönköping County.
    Löfgren, Sture
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Department of Laboratory Medicine, Region Jönköping County.
    Lewin, Freddi
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Department of Oncology, Region Jönköping County.
    Nilsson, Mats
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Futurum, Academy for Health and Care, Jönköping.
    Laytragoon-Lewin, Nongnit
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Laboratory Medicine, Region Jönköping County.
    Impact of Cigarette Smoking and Head and Neck Squamous Cell Carcinoma on Circulating Inflammatory Biomarkers2020In: Oncology, ISSN 0030-2414, E-ISSN 1423-0232, Vol. 98, no 1, p. 42-47Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Smoking induces inflammation and an immune response. A cancer-related inflammatory response has been seen in smoking and nonsmoking head and neck squamous cell carcinoma (HNSCC) patients.

    OBJECTIVES: The aim of this study was to analyze the possible separated effects of smoking or HNSCC on 18 inflammatory or immune regulatory biomarkers.

    METHODS: Fifty-one nonsmoking and 36 smoking pretreated HNSCC patients and 101 nonsmoking and 39 smoking controls were included in this study. The levels of 18 inflammatory or immune regulatory biomarkers were analyzed. A multivariable linear regression model was used to predict the impact of smoking and HNSCC on the levels of the biomarkers.

    RESULTS: Smoking had the highest impact on total WBC, IFN-γ, and MCP-1 levels. The highest impact of HNSCC was found on neutrophils, neutrophil-to-lymphocyte ratio, HsCRP, MIP-1b, and TNF-α levels.

    CONCLUSION: Identifying HNSCC or smoking-related inflammatory biomarkers might contribute to the understanding of the immune response in HNSCC patients. This study could provide information of inflammatory biomarkers in HNSCC patients.

  • 245.
    Andersson, Bengt-Åke
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Cty Hosp, Sweden.
    Sayardoust, Shariel
    Inst Postgrad Dent Educ, Sweden.
    Lofgren, Sture
    Ryhov Cty Hosp, Sweden.
    Rutqvist, Lars Erik
    Swedish Match AB, Sweden.
    Lewin, Nongnit
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Cty Hosp, Sweden.
    Cigarette smoking affects microRNAs and inflammatory biomarkers in healthy individuals and an association to single nucleotide polymorphisms is indicated2019In: Biomarkers, ISSN 1354-750X, E-ISSN 1366-5804, Vol. 24, no 2, p. 180-185Article in journal (Refereed)
    Abstract [en]

    Background: Cigarette smoke induces inflammation and remodels immune response. Genetic and epigenetic alterations might be involved in the pathogenesis of smoking related diseases. In this study, we investigated the effect of smoking on systemic inflammation biomarkers and epigenetic changes at microRNA (miRNA) expression level. We also examined if the levels of inflammatory biomarkers were associated with selected single nucleotide polymorphisms (SNPs). Method: From 39 smokers and 101 non-smokers, levels of total white blood cells (WBCs) and its subpopulations, plasma cytokines/chemokines/proteins and miRNAs were analysed. For three biomarkers, C-reactive protein (CRP), MCP-1 and IFN-gamma that were affected by smoking, the influence of SNPs was analyzed. Result: Elevated levels of total WBCs, neutrophils, monocytes, lymphocytes, CRP, MCP-1, IFN-gamma and lower levels of miR-21 were detected in smokers. The elevated levels of IFN-gamma in smokers was only statistically significantly associated with rs2069705 AG/GG SNP-genotype. Conclusions: A lower level of oncomir miRNA-21 and a higher level of immune modelling cytokine IFN-gamma detected in smokers could be a protective immune response to cigarette smoke. The higher level of IFN-gamma in smokers with a specific SNP genotype also suggests that a genetic interaction with smoking might predict the pathobiology of smoking related disease.

  • 246.
    Andersson, Bjorn
    et al.
    University of Gothenburg, Sweden.
    Swolin-Eide, Diana
    University of Gothenburg, Sweden.
    Magnusson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Albertsson-Wikland, Kerstin
    University of Gothenburg, Sweden.
    Short-term changes in bone formation markers following growth hormone (GH) treatment in short prepubertal children with a broad range of GH secretion2015In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 82, no 1, p. 91-99Article in journal (Refereed)
    Abstract [en]

    ObjectivesGrowth hormone (GH) promotes longitudinal growth and bone modelling/remodelling. This study investigated the relationship between levels of bone formation markers and growth during GH treatment in prepubertal children with widely ranging GH secretion levels. MethodsThe study group comprised 113 short prepubertal children (mean ageSD, 937213years; 99 boys) on GH treatment (330 +/- 006g/kg/day) for 1year. Blood samples were taken at baseline and 1 and 2weeks, 1 and 3months, and 1year after treatment start. Intact amino-terminal propeptide of type I procollagen (PINP), bone-specific alkaline phosphatase (BALP) and osteocalcin were measured using an automated IDS-iSYS immunoassay system. ResultsIntact amino-terminal propeptide of type I procollagen (PINP), BALP and osteocalcin, increased in the short-term during GH treatment. PINP after 1week (P=000077), and BALP and osteocalcin after 1month (Pless than00001 and P=00043, respectively). PINP levels at 1 and 3months correlated positively, and osteocalcin levels at 1week and percentage change after 1month correlated negatively, with first year growth response. No significant correlations were found between BALP and first year growth. Multiple regression analysis showed that bone marker levels together with auxological data and insulin-like growth factor binding protein-3 explained the variation in first year growth response to 36% at start, 32% after 2weeks and 48% at 3months. ConclusionShort-term increases in levels of the bone formation markers PINP, BALP and osteocalcin showed different temporal patterns, but all correlated with first year growth response during GH treatment. These markers may be a useful addition to existing prediction models for growth response.

  • 247.
    Andersson, Björn
    et al.
    Institution of Clinical Sciences/Pediatrics, Umeå University, Umeå, Sweden.
    Swolin-Eide, Diana
    Göteborg Pediatric Growth Research Center (GP-GRC), Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
    Magnusson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Albertsson-Wikland, Kerstin
    Department of Physiology/Division of Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
    Vitamin D status in children over three decades – do children get enough vitamin D?2016In: Bone Reports, ISSN 2352-1872, Vol. 5, p. 150-152Article in journal (Refereed)
    Abstract [en]

    Vitamin D is a key player in the endocrine regulation of calcium and phosphate metabolism and plays a pivotal role in the acquisition of bone mass during childhood. This study investigated long-term data of vitamin D levels in children and adolescents between 1 and 18 years of age. Serum 25-hydroxyvitamin D (25(OH)D) was analyzed between 1982 and 2013 in 2048 Swedish Caucasian children (mean age ± SD, 8.59 ± 3.68 years; 1197 boys). Overall, 704 (34%) children had below recommended levels of 50 nmol/L; however, only 63 (3%) had levels below 25 nmol/L, i.e., vitamin D deficiency. No trend for decreased vitamin D levels over time was found in this population, with median 25(OH)D levels of 58.4 nmol/L, minimum–maximum 5.0–159.3 nmol/L. Younger children, independent of gender, had significantly higher levels 25(OH)D.

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    Vitamin D status in children over three decades – do children get enough vitamin D?
  • 248.
    Andersson, Charlotta
    et al.
    Region Östergötland, Center for Diagnostics, Department of Clinical Physiology in Norrköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Kihlberg, Johan
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Ebbers, Tino
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Lindström, Lena
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Carlhäll, Carljohan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Phase-contrast MRI volume flow - a comparison of breath held and navigator based acquisitions2016In: BMC Medical Imaging, ISSN 1471-2342, E-ISSN 1471-2342, Vol. 16, no 26Article in journal (Refereed)
    Abstract [en]

    Background: Magnetic Resonance Imaging (MRI) 2D phase-contrast flow measurement has been regarded as the gold standard in blood flow measurements and can be performed with free breathing or breath held techniques. We hypothesized that the accuracy of flow measurements obtained with segmented phase-contrast during breath holding, and in particular higher number of k-space segments, would be non-inferior compared to navigator phase-contrast. Volumes obtained from anatomic segmentation of cine MRI and Doppler echocardiography were used for additional reference. Methods: Forty patients, five women and 35 men, mean age 65 years (range 53-80), were randomly selected and consented to the study. All underwent EKG-gated cardiac MRI including breath hold cine, navigator based free-breathing phase-contrast MRI and breath hold phase-contrast MRI using k-space segmentation factors 3 and 5, as well as transthoracic echocardiography within 2 days. Results: In navigator based free-breathing phase-contrast flow, mean stroke volume and cardiac output were 79.7 +/- 17.1 ml and 5071 +/- 1192 ml/min, respectively. The duration of the acquisition was 50 +/- 6 s. With k-space segmentation factor 3, the corresponding values were 77.7 ml +/- 17.5 ml and 4979 +/- 1211 ml/min (p = 0.15 vs navigator). The duration of the breath hold was 17 +/- 2 s. K-space segmentation factor 5 gave mean stroke volume 77.9 +/- 16.4 ml, cardiac output 5142 +/- 1197 ml/min (p = 0.33 vs navigator), and breath hold time 11 +/- 1 s. Anatomical segmentation of cine gave mean stroke volume and cardiac output 91.2 +/- 20.8 ml and 5963 +/- 1452 ml/min, respectively. Echocardiography was reliable in 20 of the 40 patients. The mean diameter of the left ventricular outflow tract was 20.7 +/- 1.5 mm, stroke volume 78.3 ml +/- 15.2 ml and cardiac output 5164 +/- 1249 ml/min. Conclusions: In forty consecutive patients with coronary heart disease, breath holding and segmented k-space sampling techniques for phase-contrast flow produced stroke volumes and cardiac outputs similar to those obtained with free-breathing navigator based phase-contrast MRI, using less time. The values obtained agreed fairly well with Doppler echocardiography while there was a larger difference when compared with anatomical volume determinations using SSFP (steady state free precession) cine MRI.

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  • 249.
    Andersson, Christer
    et al.
    Region Östergötland, Operations management Region Östergötland, Övrig enhet.
    Magnusson, Martin
    Region Östergötland, Operations management Region Östergötland, Övrig enhet.
    Sjödahl, Rune
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Mortalitet bland sjukhusvårdade tycktes inte öka under sommaren [Mortality among hospitalized patients did not appear to increase during the summer]2019In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116Article in journal (Refereed)
    Abstract [en]

    A retrospective review of medical records (2017-2018) at Linköping University Hospital compared hospital mortality for the 2-month period of summer vacations (group A) with two months of regular activity (group B). The mortality was 163 patients in group A and 216 in group B. Emergency admittance dominated (95%) in both groups. Comorbidity was found in 81%, and at admittance the risk for death during the hospital stay was estimated to more than 50% in three out of four patients. There was no difference between the groups regarding demography, hospital stay, or diagnosis. Due to a 30% reduction of hospital beds during the summer some patients were relocated to other specialties. No relocated patient died in group A but six in group B. Eight deaths were judged as probably preventable, but none definitely preventable. The similarity between the groups regarding mortality does not allow estimations of differences in adverse events in general. Low mortality among relocated patients is probably due to identification of high-risk patients not suitable for relocation.

  • 250.
    Andersson, David
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Magnusson, Henrik
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Borgquist, Lars
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Co-morbidity and health care utilisation five years prior to diagnosis for depression: A register-based study in a Swedish population2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, p. 552-Article in journal (Refereed)
    Abstract [en]

    Background

    Depressive disorders have been associated with a number of co-morbidities, and we   hypothesized that patients with a depression diagnosis would be heavy users of health   care services, not only when first evaluated for depression, but also for preceding   years. The aim of this study was to investigate whether increased health care utilisation   and co-morbidity could be seen during five years prior to an initial diagnosis of   depression.

    Methods

    We used a longitudinal register-based study design. The setting comprised the general   population in the county of Östergötland, south-east Sweden. All 2470 patients who   were 20 years or older in 2006 and who received a new diagnosis of depression (F32   according to ICD-10) in 2006, were selected and followed back to the year 2001, five   years before their depression diagnosis. A control group was randomly selected among   those who were aged 20 years or over in 2006 and who had received no depression diagnosis   during the period 2001-2006.

    Results

    Predictors of a depression diagnosis were a high number of physician visits, female   gender, age below 60, age above 80 and a low socioeconomic status.

    Patients who received a diagnosis of depression used twice the amount of health care   (e.g. physician visits and hospital days) during the five year period prior to diagnosis   compared to the control group. A particularly strong increase in health care utilisation   was seen the last year before diagnosis. These findings were supported with a high   level of co-morbidity as for example musculoskeletal disorders during the whole five-year   period for patients with a depression diagnosis.

    Conclusions

    Predictors of a depression diagnosis were a high number of physician visits, female   gender, age below 60, age above 80 and a low socioeconomic status. To find early signs   of depression in the clinical setting and to use a preventive strategy to handle these   patients is important.

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