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  • 301.
    Frennesson, Christina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Nilsson, Sven Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Angiogeneshämmare vid neovaskulär åldersrelaterad makuladegeneration - lovande terapi eller risk för oönskade effekter?2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, p. 1969-1969Article in journal (Other academic)
  • 302.
    Frennesson, Christina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Nilsson, Sven Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Encouraging results of photodynamic therapy with Visudyne in a clinical patient material of age-related macular degeneration2004In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 82, no 6, p. 645-650Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the effects of photodynamic therapy (PDT) on subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD) in a Swedish patient material with smaller lesions than those investigated in the TAP (Treatment of Age-related Macular Degeneration with Photodynamic Therapy) and VIP (Verteporfin in Photodynamic Therapy) Studies. Methods: Photodynamic therapy with verteporfin was performed according to the results and recommendations of the TAP and VIP Studies. The patients were followed up for 12 months and retreatment was performed every 12 weeks when leakage from CNV was present. Of the 100 eyes in the first 100 patients with a follow-up period of 12 months, 59% had a predominantly classic lesion, 36% had an occult-only lesion and 5% had a minimally classic lesion. The greatest linear dimension (GLD) was ≤3 NIPS (Macular Photocoagulation Study) disc diameters (DD) in 73%, 39% and 20% of lesions, respectively, for the three groups. The actual lesion area was ≤3 MPS disc areas (DA) in 85%, 50% and 40% of lesions, respectively. There was a positive correlation (p < 0.05) between the duration of symptoms and GLD, as well as between the duration of symptoms and the lesion area (p < 0.02). Results: At 12 months, visual acuity had remained stable or increased by ≥3 lines (ETDRS) in 61% of patients with predominantly classic lesions, in 61% of patients with occult-only lesions and in 60% of patients with minimally classic lesions. Leakage had stopped after 2.9 ± 0.9 treatments in 77% of the total group of patients. Conclusion: The visual outcome was comparable to those of the TAP and VIP Studies (p > 0.3). Regarding the effect on leakage, however, our results are far better than those of the TAP and VIP Studies. The proportion of patients in which leakage had stopped was almost three times that of the TAP (27%) and VIP (26%) Studies. It seems likely that this difference was caused by the fact that the lesions in our study were much smaller, on average, than those in the TAP and VIP Studies.

  • 303.
    Frennesson, Christina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Nilsson, Sven Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    In eccentric viewing, reading performance is better when using the upper compared to the lower retina2007In: ARVO E-abstract 3551 Invest ophthalmol vis sci,2007, 2007Conference paper (Other academic)
  • 304.
    Frennesson, Christina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Nilsson, Sven Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Åldersrelaterad makuladegeneration - nya möjligheter för profylax och terapi2002In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 99, p. 3194-3197Article in journal (Other academic)
  • 305.
    Fridriksson, Steen
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Hillman, Jan
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Boive, Jörgen
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Education of referring doctors about sudden onset headache in subarachnoid hemorrhage2001In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 103, no 4, p. 238-242Article in journal (Refereed)
    Abstract [en]

    Objectives – Forty percent of patients with aneurysmal subarachnoid hemorrhage have prodromal warning episodes and difficulties in identifying these events are repeatedly documented. Modifications of diagnostic and referral patterns through educational programs of local doctors may help to identify such patients before a major devastating rupture occurs.

    Materials and methods– A teaching program about sudden onset headache, targeting referring doctors, was systematically applied and its impact on early misdiagnosis of ruptured aneurysms was prospectively studied.

    Results– Forty percent of all studied patients experienced a warning episode, manifested as apoplectic headache, prior to hospitalization. An initial diagnostic error was evident in 12% of the patients. Diagnostic errors were reduced by 77% as a result of continuous interaction between neurosurgeons and local physicians.

    Conclusion– Misdiagnosed warning episodes cause greater loss of lives and higher morbidity on a population basis than does delayed ischemic complications from vasospasm in aneurysmal SAH. Teaching programs focused on local physicians have a profound impact on outcome at low cost.

  • 306.
    Fridriksson, Steen
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Kimme, Peter
    Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Faculty of Health Sciences.
    Yu, Zhengquan
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Mellergård, Pekka
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Hillman, Jan
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Routine application of neuroprotection in surgery of intracranial aneurysmsManuscript (preprint) (Other academic)
    Abstract [en]

    To evaluate the value of routine application ofneuroprotection and the use of temporary clips (TCL) in every day aneurysm surgery 203 patients with a total of 236 aneurysms were included in the a perioperative moderate hypothermia (MHT, <34° C) protocol. Poor grade patients (Hunt & Hess IV-V) were excluded fi·om the study. Induction of MHT averaged 0.98+/-0.37 hours and was based on a protocol for administration of cold, intravenous crystalloid fluid and barbiturates. Blood pressure was stable throughout MHT. 40% of the patients needed inotropic support during the first 12 postoperative hours. Cardiac arrhythmia was infrequent and when occurring always of benign character. In 8%, pulmonary problems with central venous congestion and/or poor systemic oxygenation occurred.

    In total, temporary clipping was used in 66 cases (mean occlusion time being 10.5 ±7.3 min), 50% of which had not been expected pre-operatively. Overall, 40 aneurysms (75% 1-12 mm in size) ruptured during dissection - corresponding to 20% of the cases without preplanned use of TCL.

    Excluding biasing confounding factors, TCL did not affect the outcome following aneurismal surgery. The study lends support to the idea that TCL should be considered a routine method for all aneurysm surgery.

  • 307.
    Fridriksson, Steen M.
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Changing strategies in the treatment of aneurysmal subarachnoid haemorrhage: challenging the second bleed2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Despite considerable advances in the management of aneurysmal subarachnoid haemorrhage (SAH) over the past decades, the overall outcome is still disappointing. Currently, not more than six patients out of every ten with a ruptured aneurysm, reaching hospital alive, will recover to a normal life. Apart from the direct effects of the initial haemorrhage, vasospasm and rebleeding clearly stand out as the leading causes of unfavourable results in this capricious disease, and both of these factors seem potentially amenable to further improvement in therapeutic intervention.

    Ever since the concept of early aneurysm surgery gained wider acceptance, the focus of the neurosurgical community has shifted from re bleeding towards the problem of vasospasm and delayed ischaemic neurological deficits (DIND). During recent years, vasospasm has attracted at least five times more attention than rebleeding in terms of published articles, and huge research efforts have been offered in the pursuit of a medical solution to this problem. Although progress has been made in the treatment of vasospasm during the last decades, DIND continues to contribute significantly to unfavourable outcome in the management of aneurysmal SAH victims. Recent series report an average of 13.5% of patients suffering DIND, leading to unfavourable outcome in 7% of all cases reaching hospital for treatment. Contrary to rebleeding, there is a dominance of morbidity (4.5%) over mortality (2.5%).

    Historically, the efforts aimed at reducing the risk of rebleeding have mostly been related to the controversial question of the timing of surgery. The current performance in many centers, with over 90% of all ruptured aneurysms seen being occluded within 24 hours from the haemorrhage, gives the impression that we have reached the ultimate protection against rebleeding, with little left to improve in that field. However, the term rebleeding, as we are used to defming it, apparently only represents a part of a wider spectrum of recurrent aneurysm ruptures. Index haemorrhages preceeded by warning leaks and intraoperative ruptures occurring after index haemonhages also share the features of devastating impact on clinical condition and on outcome, and from a practical point of view it may be meaningful to consider all these recurrent ruptures as a common entity - the second bleed.

    In the studies presented in this thesis, the second bleed has shown to have a profound impact on management outcome in aneurysmal SAH. It accounts for morbidity and mortality in at least 12% of all patients receiving treatment, which is roughly one-third of all patients with poor management outcome. Evidently, prevention of most recurrent bleeds are within the reach of current management protocols. Modifications of strategies in use are presented, that include new guidelines for the pre-neurosurgical care to ensure detection of warning leaks and to provide protection against ultra-early rebleeds, that cannot be reached by early aneurysm occlusion. In the neurosurgical phase, modifications of the surgical protocol allowing for a routine application of intraoperative neuroprotection and liberal use of temporary clipping are advocated.

    By refocusing the second bleed, identification of it's various forms and modification of treatment protocols for ruptured aneurysms aimed at reducing these recurrent bleeds, many losses can be turned into good outcome, at a cost that is much lower than the cost of pursuing the final solution of vasospasm.

    List of papers
    1. Sudden onset headache: a prospective study of features, incidence and causes
    Open this publication in new window or tab >>Sudden onset headache: a prospective study of features, incidence and causes
    Show others...
    2002 (English)In: Cephalalgia, ISSN 0333-1024, E-ISSN 1468-2982, Vol. 22, no 5, p. 354-360Article in journal (Refereed) Published
    Abstract [en]

    Sudden onset headache is a common condition that sometimes indicates a life- threatening subarachnoid haemorrhage (SAH) but is mostly harmless. We have performed a prospective study of 137 consecutive patients with this kind of headache (thunderclap headache = TCH). The examination included a CT scan, CSF examination and follow-up of patients with no SAH during the period between 2 days and 12 months after the headache attack. The incidence was 43 per 100 000 inhabitants > 18 years of age per year; 11.3% of the patients with TCH had SAH. Findings in other patients indicated cerebral infarction (five), intracerebral haematoma (three), aseptic meningitis (four), cerebral oedema (one) and sinus thrombosis (one). Thus no specific finding indicating the underlying cause of the TCH attack was found in the majority of the patients. A slightly increased prevalence of migraine was found in the non-SAH patients (28%). The attacks occurred in 11 cases (8%) during sexual activity and two of these had an SAH. Nausea, neck stiffness, occipital location and impaired consciousness were significantly more frequent with SAH but did not occur in all cases. Location in the temporal region and pressing headache quality were the only features that were more common in non-SAH patients. Recurrent attacks of TCH occurred in 24% of the non-SAH patients. No SAH occurred later in this group, nor in any of the other patients. It was concluded that attacks caused by a SAH cannot be distinguished from non-SAH attacks on clinical grounds. It is important that patients with their first TCH attack are investigated with CT and CSF examination to exclude SAH, meningitis or cerebral infarction. The results from this and previous studies indicate that it is not necessary to perform angiography in patients with a TCH attack, provided that no symptoms or signs indicate a possible brain lesion and a CT scan and CSF examination have not indicated SAH.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26956 (URN)10.1046/j.1468-2982.2002.00368.x (DOI)11589 (Local ID)11589 (Archive number)11589 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    2. Education of referring doctors about sudden onset headache in subarachnoid hemorrhage
    Open this publication in new window or tab >>Education of referring doctors about sudden onset headache in subarachnoid hemorrhage
    2001 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 103, no 4, p. 238-242Article in journal (Refereed) Published
    Abstract [en]

    Objectives – Forty percent of patients with aneurysmal subarachnoid hemorrhage have prodromal warning episodes and difficulties in identifying these events are repeatedly documented. Modifications of diagnostic and referral patterns through educational programs of local doctors may help to identify such patients before a major devastating rupture occurs.

    Materials and methods– A teaching program about sudden onset headache, targeting referring doctors, was systematically applied and its impact on early misdiagnosis of ruptured aneurysms was prospectively studied.

    Results– Forty percent of all studied patients experienced a warning episode, manifested as apoplectic headache, prior to hospitalization. An initial diagnostic error was evident in 12% of the patients. Diagnostic errors were reduced by 77% as a result of continuous interaction between neurosurgeons and local physicians.

    Conclusion– Misdiagnosed warning episodes cause greater loss of lives and higher morbidity on a population basis than does delayed ischemic complications from vasospasm in aneurysmal SAH. Teaching programs focused on local physicians have a profound impact on outcome at low cost.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27678 (URN)10.1034/j.1600-0404.2001.d01-27.x (DOI)12416 (Local ID)12416 (Archive number)12416 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Immediate administration of tranexamic acid and reduced incidence of early rebleeding after aneurysmal subarachnoid hemorrhage: a prospective randomized study
    Open this publication in new window or tab >>Immediate administration of tranexamic acid and reduced incidence of early rebleeding after aneurysmal subarachnoid hemorrhage: a prospective randomized study
    Show others...
    2002 (English)In: Journal of Neurosurgery, ISSN 0022-3085, E-ISSN 1933-0693, Vol. 97, no 4, p. 771-778Article in journal (Refereed) Published
    Abstract [en]

    Object. By pursuing a policy of very early aneurysm treatment in neurosurgical centers, in-hospital rebleeds can be virtually eliminated. Nonetheless, as many as 15% of patients with aneurysm rupture suffer ultraearly rebleeding with high mortality rates, and these individuals are beyond the reach of even the most ambitious protocol for diagnosis and referral. Only drugs given immediately after the diagnosis of subarachnoid hemorrhage (SAH) has been established at the local hospital level can, in theory, contribute to the minimization of such ultraearly rebleeding. The object of this randomized, prospective, multicenter study was to assess the efficacy of short-term antifibrinolytic treatment with tranexamic acid in preventing rebleeding.

    Methods. Only patients suffering SAH verified on computerized tomography (CT) scans within 48 hours prior to the first hospital admission were included. A 1-g dose of tranexamic acid was given intravenously as soon as diagnosis of SAH had been verified in the local hospitals (before the patients were transported), followed by doses of 1 g every 6 hours until the aneurysm was occluded; this treatment did not exceed 72 hours. In this study, 254 patients received tranexamic acid and 251 patients were randomized as controls. Age, sex, Hunt and Hess and Fisher grade distributions, as well as aneurysm locations, were congruent between the groups. Outcome was assessed at 6 months post-SAH by using the Glasgow Outcome Scale (GOS). Vasospasm and delayed ischemic neurological deficits were classified according to clinical findings as well as by transcranial Doppler (TCD) studies. All events classified as rebleeding were verified on CT scans or during surgery.

    Conclusions. More than 90% of patients reached the neurosurgical center within 12 hours of their first hospital admission after SAH; 70% of all aneurysms were clipped or coils were inserted within 24 hours of the first hospital admission. Given the protocol, only one rebleed occurred later than 24 hours after the first hospital admission. Despite this strong emphasis on early intervention, however, a cluster of 27 very early rebleeds still occurred in the control group within hours of randomization into the study, and 13 of these patients died. In the tranexamic acid group, six patients rebled and two died. A reduction in the rebleeding rate from 10.8 to 2.4% and an 80% reduction in the mortality rate from early rebleeding with tranexamic acid treatment can therefore be inferred. Favorable outcome according to the GOS increased from 70.5 to 74.8%. According to TCD measurements and clinical findings, there were no indications of increased risk of either ischemic clinical manifestations or vasospasm that could be linked to tranexamic acid treatment. Neurosurgical guidelines for aneurysm rupture should extend also into the preneurosurgical phase to guarantee protection from ultraearly rebleeds. Currently available antifibrinolytic drugs can provide such protection, and at low cost. The number of potentially saved lives exceeds those lost to vasospasm.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27755 (URN)10.3171/jns.2002.97.4.0771 (DOI)12500 (Local ID)12500 (Archive number)12500 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. Intraoperative complications in aneurysm surgery: a prospective national study
    Open this publication in new window or tab >>Intraoperative complications in aneurysm surgery: a prospective national study
    Show others...
    2002 (English)In: Journal of Neurosurgery, ISSN 0022-3085, E-ISSN 1933-0693, Vol. 96, no 3, p. 515-522Article in journal (Refereed) Published
    Abstract [en]

    Object. With increasing use of endovascular procedures, the number of aneurysms treated surgically will decline. In this study the authors review complications related to the surgical treatment of aneurysms and address the issue of maintaining quality standards on a national level.

    Methods. A prospective, nonselected amalgamation of every aneurysm case treated in five of six neurosurgical centers in Sweden during 1 calendar year was undertaken (422 patients; 7.4 persons/100,000 population/year). The treatment protocols at these institutions were very similar. Outcome was assessed using clinical end points. In this series, 84.1% of the patients underwent surgery, and intraoperative complications occurred in 30% of these procedures. Poor outcome from technical complications was seen in 7.9% of the surgically treated patients. Intraoperative aneurysm rupture accounted for 60% and branch sacrifice for 12% of all technical difficulties. Although these complications were significantly related to aneurysm base geometry and the competence of the surgeon, problems still occurred apparently at random and also in the best of hands (17%). The temporary mean occlusion time in the patients who suffered intraoperative aneurysm rupture was twice as long as the temporary arrest of blood flow performed to aid dissection.

    Conclusions. The results obtained in this series closely reflect the overall management results of this disease and support the conclusion that surgical complications causing a poor outcome can be estimated on a large population-based scale. Intraoperative aneurysm rupture was the most common and most devastating technical complication that occurred. Support was found for a more liberal use of temporary clips early during dissection, regardless of the experience of the surgeon. Temporary regional interruption of arterial blood flow should be a routine method for aneurysm surgery on an everyday basis. A random occurrence of difficult intraoperative problems was clearly shown, and this factor of unpredictability, which is present in any preoperative assessment of risk, strengthens the case for recommending neuroprotection as a routine adjunct to virtually every aneurysm operation, regardless of the surgeon's experience.

    Keywords
    intracranial aneurysm, intraoperative aneurysm rupture, complication, hypothermia, neuroprotection
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27754 (URN)10.3171/jns.2002.96.3.0515 (DOI)12499 (Local ID)12499 (Archive number)12499 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    5. Routine application of neuroprotection in surgery of intracranial aneurysms
    Open this publication in new window or tab >>Routine application of neuroprotection in surgery of intracranial aneurysms
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    To evaluate the value of routine application ofneuroprotection and the use of temporary clips (TCL) in every day aneurysm surgery 203 patients with a total of 236 aneurysms were included in the a perioperative moderate hypothermia (MHT, <34° C) protocol. Poor grade patients (Hunt & Hess IV-V) were excluded fi·om the study. Induction of MHT averaged 0.98+/-0.37 hours and was based on a protocol for administration of cold, intravenous crystalloid fluid and barbiturates. Blood pressure was stable throughout MHT. 40% of the patients needed inotropic support during the first 12 postoperative hours. Cardiac arrhythmia was infrequent and when occurring always of benign character. In 8%, pulmonary problems with central venous congestion and/or poor systemic oxygenation occurred.

    In total, temporary clipping was used in 66 cases (mean occlusion time being 10.5 ±7.3 min), 50% of which had not been expected pre-operatively. Overall, 40 aneurysms (75% 1-12 mm in size) ruptured during dissection - corresponding to 20% of the cases without preplanned use of TCL.

    Excluding biasing confounding factors, TCL did not affect the outcome following aneurismal surgery. The study lends support to the idea that TCL should be considered a routine method for all aneurysm surgery.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-84851 (URN)
    Available from: 2012-10-24 Created: 2012-10-24 Last updated: 2012-10-24Bibliographically approved
  • 308.
    Fridriksson, Steen
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Säveland, Hans
    Jakobsson, Karl-Erik
    Edner, Göran
    Zygmunt, Stefan
    Brandt, Lennart
    Hillman, Jan
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Intraoperative complications in aneurysm surgery: a prospective national study2002In: Journal of Neurosurgery, ISSN 0022-3085, E-ISSN 1933-0693, Vol. 96, no 3, p. 515-522Article in journal (Refereed)
    Abstract [en]

    Object. With increasing use of endovascular procedures, the number of aneurysms treated surgically will decline. In this study the authors review complications related to the surgical treatment of aneurysms and address the issue of maintaining quality standards on a national level.

    Methods. A prospective, nonselected amalgamation of every aneurysm case treated in five of six neurosurgical centers in Sweden during 1 calendar year was undertaken (422 patients; 7.4 persons/100,000 population/year). The treatment protocols at these institutions were very similar. Outcome was assessed using clinical end points. In this series, 84.1% of the patients underwent surgery, and intraoperative complications occurred in 30% of these procedures. Poor outcome from technical complications was seen in 7.9% of the surgically treated patients. Intraoperative aneurysm rupture accounted for 60% and branch sacrifice for 12% of all technical difficulties. Although these complications were significantly related to aneurysm base geometry and the competence of the surgeon, problems still occurred apparently at random and also in the best of hands (17%). The temporary mean occlusion time in the patients who suffered intraoperative aneurysm rupture was twice as long as the temporary arrest of blood flow performed to aid dissection.

    Conclusions. The results obtained in this series closely reflect the overall management results of this disease and support the conclusion that surgical complications causing a poor outcome can be estimated on a large population-based scale. Intraoperative aneurysm rupture was the most common and most devastating technical complication that occurred. Support was found for a more liberal use of temporary clips early during dissection, regardless of the experience of the surgeon. Temporary regional interruption of arterial blood flow should be a routine method for aneurysm surgery on an everyday basis. A random occurrence of difficult intraoperative problems was clearly shown, and this factor of unpredictability, which is present in any preoperative assessment of risk, strengthens the case for recommending neuroprotection as a routine adjunct to virtually every aneurysm operation, regardless of the surgeon's experience.

  • 309.
    Friman, Ola
    et al.
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Cedefamn, Jonny
    Linköping University, Department of Neuroscience and Locomotion. Linköping University, Faculty of Health Sciences.
    Lundberg, Peter
    Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics. Linköping University, Faculty of Health Sciences.
    Borga, Magnus
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Knutsson, Hans
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Detection of neural activity in functional MRI using canonical correlation analysis2001In: Magnetic Resonance in Medicine, ISSN 0740-3194, E-ISSN 1522-2594, Vol. 45, no 2, p. 323-330Article in journal (Refereed)
    Abstract [en]

    A novel method for detecting neural activity in functional magnetic resonance imaging (fMRI) data is introduced. It is based on canonical correlation analysis (CCA), which is a multivariate extension of the univariate correlation analysis widely used in fMRI. To detect homogeneous regions of activity, the method combines a subspace modeling of the hemodynamic response and the use of spatial relationships. The spatial correlation that undoubtedly exists in fMR images is completely ignored when univariate methods such as as t-tests, F-tests, and ordinary correlation analysis are used. Such methods are for this reason very sensitive to noise, leading to difficulties in detecting activation and significant contributions of false activations. In addition, the proposed CCA method also makes it possible to detect activated brain regions based not only on thresholding a correlation coefficient, but also on physiological parameters such as temporal shape and delay of the hemodynamic response. Excellent performance on real fMRI data is demonstrated.

  • 310.
    Friström, Björn
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Aspects of the diagnosis and treatment of glaucoma2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Glaucoma is one of the most common causes of blindness in the world, and it is important that screening tests as well as treatment possibilities are improved continuously. A reliable but more rapid screening test than those already available would be of great interest. In addition, new and more effective treatment options would be most valuable. The aims of the present thesis were to evaluate the reliability of a new and rapid peripheral colour contrast sensitivity test as a tool for glaucoma screening and to gain more information on latanoprost, a recently developed prostaglandin analogue, in glaucoma treatment.

    Colour contrast sensitivity was analysed with a system described by Arden and co-workers, using a computer controlled colour monitor. The test objects for the central test were letters of standard optotype subtending a visual angle of 3° . For the peripheral test, the test object was a colour contrasting annulus concentric with a fixation spot. The annulus had a radius of 12.5° in the extramacular field and a width of 1°. The colour contrast of the letter or the annulus in relation to the background could be changed, and a colour contrast threshold value could be obtained in the protan, deutan and tritan colour axes.

    In a study of glaucoma patients, ocular hypertensive patients and normals, the peripheral colour contrast sensitivity test was found to distinguish the glaucoma patients from the normals. However, it was difficult to find a reliable cut-off point if the test is to be used as a screening test.

    In a five-year prospective study of ocular hypertensive patients, the peripheral colour contrast sensitivity test could not clearly predict which patients would develop glaucoma and which would not, given that the Glaucoma Herrrifield Test is used as the golden standard. A change over time in the protan axis may, however, indicate glaucoma development. For a test to be used in glaucoma screening, it is necessary to know whether other common eye diseases such as diabetes and cataract affect the outcome. Therefore, the influence of diabetes and cataract on peripheral and central colour contrast sensitivity was also studied.

    Diabetes type II was found to affect both peripheral and central colour contrast sensitivity, the tritan axis being the most affected one. For the tritan axis, the central colour contrast sensitivity seemed to correlate well with the degree of diabetic retinopathy, indicating the possibility of a new functional test of diabetic retinopathy.

    Cataract, even moderately developed, affected both peripheral and central colour contrast sensitivity. Central colour contrast sensitivity seemed to be poorer in pseudophakic eyes than in normal eyes. Thus, both diabetes type II and moderate to severe cataract must be considered if the colour contrast sensitivity test is to be used for glaucoma screening. The choice of material for the IOL may also be of importance for postoperative central colour contrast sensitivity.

    The prostaglandin analogue latanoprost effectively reduces the IOP at the original concentration of 0.005%. However, several patients need additional treatment. Therefore, the effect of pilocarpine in combination with latanoprost was studied. When pilocarpine was added to latanoprost, there was an additional reduction in the intraocular presure (IOP) (7.4%), and when latanoprost was added to pilocarpine the reduction was even more pronounced (142%). Therefore, it seems that latanoprost and pilocarpine can be combined in glaucoma treatment.

    In certain eyes, an increased iris pigmentation was seen as a side-effect of latanoprost. This side-effect may be dose-dependent. Therefore, the original concentration of 0.005% was compared to a lower concentration, 0.001%. Latanoprost 0.005% was more effective than latanoprost 0.001% in reducing the IOP. However, the lower concentration was sufficiently effective to have a potential for clinical use in many patients. Latanoprost 0.005% gave an lOP reduction of 35% after four weeks of treatment, which was in agreement with earlier results. The lower concentration was, however, surprisingly effective and gave an IOP reduction of 27.7%.

    List of papers
    1. Peripheral colour contrast thresholds in ocular hypertension and glaucoma
    Open this publication in new window or tab >>Peripheral colour contrast thresholds in ocular hypertension and glaucoma
    1997 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 75, no 4, p. 376-382Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To evaluate a new test for peripheral colour contrast sensitivity as a tool for early diagnosis of glaucoma.

    Patients and Methods: Peripheral colour contrast sensitivity was measured by a computer and colour monitor system developed by Arden and co-workers. The monitor displays an annulus subtending 25° at the retina. During the test, 45° of the annulus is removed in one of four quadrants. The patient is asked to identify this quadrant, first at suprathreshold levels and then as the colour contrast between the annulus and the background is varied in order to establish the threshold for identification. The tested colours were varied along the protan, deutan and tritan colour confusion axes, respectively. Thirty-three normal subjects, 22 glaucoma patients and 69 ocular hypertensive patients were examined. The ocular hypertensive patients were divided into a low risk group, a medium risk group and a high risk group.

    Results: The colour contrast thresholds for the glaucoma group and the high risk ocular hypertensive group were significantly (p<0.001) higher for all three colour axes compared with the normal group. There were also significant (p < 0.05-0.001) differences for all axes between the glaucoma group on the one hand and the ocular hypertensive low risk group on the other hand. There were, however, overlaps in colour contrast thresholds between all groups.

    Conclusion: Although there is a large and statistically significant difference in average colour contrast thresholds between normals and glaucoma patients, it was difficult to find an appropriate cut-off point to separate the two groups. Further studies must clarify the influence of early stages of common diseases such as cataract, diabetes and age-related maculopathy on colour contrast sensitivity.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-80117 (URN)10.1111/j.1600-0420.1997.tb00393.x (DOI)
    Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2017-12-07Bibliographically approved
    2. Peripheral and central colour contrast sensitivity in diabetes
    Open this publication in new window or tab >>Peripheral and central colour contrast sensitivity in diabetes
    1998 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 76, no 5, p. 541-545Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To study the influence of diabetes, with or without early retinopathy, on peripheral and central colour contrast sensitivity.

    Methods: The study included 32 patients with diabetes mellitus type II and 47 age-matched normals. The patients were divided into three sub-groups. 1. Diabetics with no retinopathy (on photographs or biomicroscopy). 2. Diabetics with microaneurysms only. 3. Diabetics with microaneurysms and hard exudates. Colour contrast sensitivity was measured with a computer graphics system along the protan, deutan and tritan axes.

    Results: The peripheral colour contrast thresholds were significantly elevated for all axes when comparing the group with microaneurysms and exudates to normals. There were also significant differences between the group with microaneurysms and hard exudates and the two other diabetic groups, respectively, but only for the tritan axis. Diabetics with no retinopathy or with microaneurysms only did not differ significantly from normals.

    The central colour contrast thresholds showed significant differences between normals and the group with microaneurysms, but only for the protan and deutan axes. There were significant differences for all three axes between normals and the group with microaneurysms and hard exudates. There were also significant differences between the group with microaneurysms and hard exudates and the two other diabetic groups, but only for the tritan axis. Diabetics with no retinopathy did not differ significantly from normals.

    Conclusion: Peripheral colour contrast sensitivity was affected by low-grade diabetes type II retinopathy. This finding has to be considered if the method is to be used in screening for glaucoma. The central colour contrast sensitivity test seems to correlate to the degree of retinopathy and thereby perhaps provides a new screening method for diabetes retinopathy. Further studies are required in order to evaluate such a possibility.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-80118 (URN)10.1034/j.1600-0420.1998.760506.x (DOI)
    Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2017-12-07Bibliographically approved
    3. Colour contrast sensitivity in cataract and pseudophakia
    Open this publication in new window or tab >>Colour contrast sensitivity in cataract and pseudophakia
    2000 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 78, no 5, p. 506-511Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To study the influence of cataract on peripheral and central colour contrast sensitivity.

    Methods: Peripheral and central colour contrast sensitivity was measured with a computer graphics system along the protan, deutan and tritan axes. Included were 30 patients with cataract divided into three sub-groups: cortical cataract, nuclear sclerosis and posterior subcapsular cataract. Colour contrast was measured before and after cataract operation.

    Results: There were significant differences in peripheral colour contrast thresholds comparing the preoperative and postoperative results. This difference existed even in patients (n=19) with a pre-operative visual acuity ≥0.5 (mean 0.6). The tritan axis was the one most affected by cataract. There was no significant difference between cataract sub-groups. Also, the central colour contrast sensitivity was affected by cataract. Again, the tritan axis was the most affected one. There was no significant difference between the cataract sub-groups. We also found large and significant differences in central colour contrast thresholds between normal subjects and postoperative values from the cataract group in all colour axes. The colour contrast sensitivity was poorer in pseudophakes than in normals. There was a difference between the three groups of different IOL material used (PMMA, acrylic and silicone). The difference was significant in the protan axis, the acrylic group having the best colour contrast sensitivity.

    Conclusion: Peripheral colour contrast sensitivity was affected by cataract, even when only moderately developed. This finding is of importance and should be considered when the method is used to study other eye diseases e.g. glaucoma. Central colour contrast sensitivity was also affected by cataract. The pseudophakes were found to have poorer colour contrast sensitivity than normals. The material in the IOL seemed to be of importance for colour contrast.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27756 (URN)10.1034/j.1600-0420.2000.078005506.x (DOI)12501 (Local ID)12501 (Archive number)12501 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. Colour contrast sensitivity in ocular hypertension: A five-year prospective study
    Open this publication in new window or tab >>Colour contrast sensitivity in ocular hypertension: A five-year prospective study
    2002 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 80, no 2, p. 155-162Article in journal (Refereed) Published
    Abstract [en]

    Purpose:  To evaluate a peripheral colour contrast sensitivity test as a tool for early diagnosis of glaucoma in a five-year prospective study.

    Patients and methods: Peripheral colour contrast sensitivity was measured with a computer graphics system developed by Arden et al. The test colours were varied along the protan, deutan and tritan colour confusion axes on a scale from 0 to 100 percentage units. Fifty-five ocular hypertensive (OH) patients examined with the colour contrast test, stereoscopic photography of the optic discs, and measurements of visual fields (Humphrey 24–2 glaucoma hemifield test (GHT)) in 1994, were re-examined after five years.

    Results:  Ten patients were ‘outside normal limits’ in the GHT at follow-up. This group of 10 patients did not differ in colour contrast thresholds at the test in 1994 from the 45 who were still ‘normal’ (or ‘borderline’) at follow-up. Neither were there proportionally more patients with GHT ‘outside normal values’ for the patients with high colour contrast thresholds (> 30% units) in 1994 regarding any of the three colour axes. As judged from patient files, 27 patients had developed glaucoma during follow-up. Although there were differences between these 27 glaucoma patients and the remaining OH group at the colour contrast test in 1994, these differences did not reach statistical significance for any of the colour axes (largest difference in the tritan axis: 6.2% units, P = 0.0745). At follow-up, however, there was a significant difference in colour contrast for the protan axis between the clinical glaucoma group and the OH group (6.7% units, P = 0.0105).

    Conclusion: The method used for colour contrast measurement did not reveal glaucomatous changes before conventional perimetry (Humphrey 24–2, GHT). Neither did it predict the patients who, in our clinic, subsequently developed glaucoma during a five-year period. A change over time in colour contrast in the protan axis for an OH patient may, however, indicate glaucoma development.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27757 (URN)10.1034/j.1600-0420.2002.800207.x (DOI)12502 (Local ID)12502 (Archive number)12502 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    5. Interaction of PhXA41, a New Prostaglandin Analogue, With Pilocarpine: A Study on Patients With Elevated Intraocular Pressure
    Open this publication in new window or tab >>Interaction of PhXA41, a New Prostaglandin Analogue, With Pilocarpine: A Study on Patients With Elevated Intraocular Pressure
    1993 (English)In: Archives of ophthalmology (1960), ISSN 0003-9950, Vol. 111, no 5, p. 662-665Article in journal (Refereed) Published
    Abstract [en]

    Objective.  —To evaluate the effects of PhXA41, a new prostaglandin analogue, on the intraocular pressure (IOP) in patients receiving pilocarpine treatment and the effects of pilocarpine in patients receiving PhXA41 treatment.

    Design.  —Twenty patients with ocular hypertension were randomized into two parallel groups. The treatment period was 2 weeks. Ten patients in group 1 were given PhXA41 twice daily during week 1 and, in addition, pilocarpine three times daily during week 2. Ten patients in group 2 received pilocarpine three times daily during week 1 and PhXA41 twice daily in addition during week 2. PhXA41 was used in a concentration of 0.006%, and pilocarpine was given in a concentration of 2%.

    Main Outcome Measures.  —In group 1, the mean IOP on day 0 was 25.1 mm Hg; on day 7,19.1 mm Hg; and on day 14,17.6 mm Hg. In group 2, the mean IOP on day 0 was 23.8 mm Hg; on day 7,20.4 mm Hg; and on day 14,17.7 mm Hg.

    Results.  —PhXA41 had a clinically significant IOP-lowering effect (23.4% reduction on day 7 as compared with baseline day (P<.001). The corresponding value with pilocarpine was 14.3% (P<.001). When pilocarpine was added to PhXA41, the additional IOP reduction was 7.4% (P<.01) compared with 14.2% (P<.01) when PhXA41 was added to pilocarpine. The two groups were found to have an almost equal reduction in IOP on day 14 (group 1,29.4%; group 2, 26.6%). No serious adverse reactions were seen. Some conjunctival hyperemia in the PhXA41-treated eyes was noted on day 7, as compared with the pilocarpine-treated eyes, but there were few complaints of discomfort.

    Conclusions.  —This study indicated that PhXA41 could be useful in the treatment of glaucoma, as monotherapy, or in certain cases in combination with pilocarpine.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-80119 (URN)8489450 (PubMedID)
    Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2017-12-07Bibliographically approved
    6. A double masked comparison of the intraocular pressure reducing effect of latanoprost 0.005% and 0.001% administered once daily in open angle glaucoma and ocular hypertension
    Open this publication in new window or tab >>A double masked comparison of the intraocular pressure reducing effect of latanoprost 0.005% and 0.001% administered once daily in open angle glaucoma and ocular hypertension
    1997 (English)In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 81, no 10, p. 867-870Article in journal (Refereed) Published
    Abstract [en]

    AIM To compare the intraocular pressure (IOP) reducing effect of latanoprost 0.005% and 0.001%.

    METHODS Twenty four patients with glaucoma or ocular hypertension were randomised into two groups. Twelve patients (group 1) were given latanoprost 0.005% once daily for 4 weeks and then latanoprost 0.001% once daily for the following 4 weeks. Twelve patients (group 2) were given latanoprost 0.001% once daily for 4 weeks and then latanoprost 0.005% for the following 4 weeks.

    RESULTS There was a significant IOP reduction from baseline in both groups on day 28 as well as on day 56. When the results from both groups were used for calculations, the mean IOP reduction from baseline after 4 weeks of treatment with latanoprost 0.005% (day 28 or 56) was 9.6 (SD 3.3) mm Hg (35.0%). After 4 weeks of treatment with latanoprost 0.001%, the IOP reduction (day 28 or 56) was 7.6 (3.4) mm Hg (27.7%). The difference in IOP reduction between the two concentrations was 2.0 (2.3) mm Hg (p<0.001).

    CONCLUSIONS Latanoprost 0.005% was more effective than latanoprost 0.001% in reducing IOP. Even the lower concentration was surprisingly effective, and potentially may be of importance for use in clinical practice. Furthermore, it is at present unknown whether the increase in iris pigmentation seen in certain patients treated with latanoprost 0.005% is dose dependent and might be less pronounced with latanoprost 0.001%. Long term studies with a larger number of patients are required in order to answer this question.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-80120 (URN)10.1136/bjo.81.10.867 (DOI)
    Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2017-12-07Bibliographically approved
  • 311.
    Friström, Björn
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Colour contrast sensitivity in ocular hypertension: A five-year prospective study2002In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 80, no 2, p. 155-162Article in journal (Refereed)
    Abstract [en]

    Purpose:  To evaluate a peripheral colour contrast sensitivity test as a tool for early diagnosis of glaucoma in a five-year prospective study.

    Patients and methods: Peripheral colour contrast sensitivity was measured with a computer graphics system developed by Arden et al. The test colours were varied along the protan, deutan and tritan colour confusion axes on a scale from 0 to 100 percentage units. Fifty-five ocular hypertensive (OH) patients examined with the colour contrast test, stereoscopic photography of the optic discs, and measurements of visual fields (Humphrey 24–2 glaucoma hemifield test (GHT)) in 1994, were re-examined after five years.

    Results:  Ten patients were ‘outside normal limits’ in the GHT at follow-up. This group of 10 patients did not differ in colour contrast thresholds at the test in 1994 from the 45 who were still ‘normal’ (or ‘borderline’) at follow-up. Neither were there proportionally more patients with GHT ‘outside normal values’ for the patients with high colour contrast thresholds (> 30% units) in 1994 regarding any of the three colour axes. As judged from patient files, 27 patients had developed glaucoma during follow-up. Although there were differences between these 27 glaucoma patients and the remaining OH group at the colour contrast test in 1994, these differences did not reach statistical significance for any of the colour axes (largest difference in the tritan axis: 6.2% units, P = 0.0745). At follow-up, however, there was a significant difference in colour contrast for the protan axis between the clinical glaucoma group and the OH group (6.7% units, P = 0.0105).

    Conclusion: The method used for colour contrast measurement did not reveal glaucomatous changes before conventional perimetry (Humphrey 24–2, GHT). Neither did it predict the patients who, in our clinic, subsequently developed glaucoma during a five-year period. A change over time in colour contrast in the protan axis for an OH patient may, however, indicate glaucoma development.

  • 312.
    Friström, Björn
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Peripheral and central colour contrast sensitivity in diabetes1998In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 76, no 5, p. 541-545Article in journal (Refereed)
    Abstract [en]

    Purpose: To study the influence of diabetes, with or without early retinopathy, on peripheral and central colour contrast sensitivity.

    Methods: The study included 32 patients with diabetes mellitus type II and 47 age-matched normals. The patients were divided into three sub-groups. 1. Diabetics with no retinopathy (on photographs or biomicroscopy). 2. Diabetics with microaneurysms only. 3. Diabetics with microaneurysms and hard exudates. Colour contrast sensitivity was measured with a computer graphics system along the protan, deutan and tritan axes.

    Results: The peripheral colour contrast thresholds were significantly elevated for all axes when comparing the group with microaneurysms and exudates to normals. There were also significant differences between the group with microaneurysms and hard exudates and the two other diabetic groups, respectively, but only for the tritan axis. Diabetics with no retinopathy or with microaneurysms only did not differ significantly from normals.

    The central colour contrast thresholds showed significant differences between normals and the group with microaneurysms, but only for the protan and deutan axes. There were significant differences for all three axes between normals and the group with microaneurysms and hard exudates. There were also significant differences between the group with microaneurysms and hard exudates and the two other diabetic groups, but only for the tritan axis. Diabetics with no retinopathy did not differ significantly from normals.

    Conclusion: Peripheral colour contrast sensitivity was affected by low-grade diabetes type II retinopathy. This finding has to be considered if the method is to be used in screening for glaucoma. The central colour contrast sensitivity test seems to correlate to the degree of retinopathy and thereby perhaps provides a new screening method for diabetes retinopathy. Further studies are required in order to evaluate such a possibility.

  • 313.
    Friström, Björn
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Peripheral colour contrast thresholds in ocular hypertension and glaucoma1997In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 75, no 4, p. 376-382Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate a new test for peripheral colour contrast sensitivity as a tool for early diagnosis of glaucoma.

    Patients and Methods: Peripheral colour contrast sensitivity was measured by a computer and colour monitor system developed by Arden and co-workers. The monitor displays an annulus subtending 25° at the retina. During the test, 45° of the annulus is removed in one of four quadrants. The patient is asked to identify this quadrant, first at suprathreshold levels and then as the colour contrast between the annulus and the background is varied in order to establish the threshold for identification. The tested colours were varied along the protan, deutan and tritan colour confusion axes, respectively. Thirty-three normal subjects, 22 glaucoma patients and 69 ocular hypertensive patients were examined. The ocular hypertensive patients were divided into a low risk group, a medium risk group and a high risk group.

    Results: The colour contrast thresholds for the glaucoma group and the high risk ocular hypertensive group were significantly (p<0.001) higher for all three colour axes compared with the normal group. There were also significant (p < 0.05-0.001) differences for all axes between the glaucoma group on the one hand and the ocular hypertensive low risk group on the other hand. There were, however, overlaps in colour contrast thresholds between all groups.

    Conclusion: Although there is a large and statistically significant difference in average colour contrast thresholds between normals and glaucoma patients, it was difficult to find an appropriate cut-off point to separate the two groups. Further studies must clarify the influence of early stages of common diseases such as cataract, diabetes and age-related maculopathy on colour contrast sensitivity.

  • 314.
    Friström, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Synpunkter på diagnos och behandling av glaukom2003In: Incitament, ISSN 1103-503X, Vol. 1, p. 61-64Article in journal (Other (popular science, discussion, etc.))
  • 315.
    Friström, Björn
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Lundh, Björn
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Colour contrast sensitivity in cataract and pseudophakia2000In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 78, no 5, p. 506-511Article in journal (Refereed)
    Abstract [en]

    Purpose: To study the influence of cataract on peripheral and central colour contrast sensitivity.

    Methods: Peripheral and central colour contrast sensitivity was measured with a computer graphics system along the protan, deutan and tritan axes. Included were 30 patients with cataract divided into three sub-groups: cortical cataract, nuclear sclerosis and posterior subcapsular cataract. Colour contrast was measured before and after cataract operation.

    Results: There were significant differences in peripheral colour contrast thresholds comparing the preoperative and postoperative results. This difference existed even in patients (n=19) with a pre-operative visual acuity ≥0.5 (mean 0.6). The tritan axis was the one most affected by cataract. There was no significant difference between cataract sub-groups. Also, the central colour contrast sensitivity was affected by cataract. Again, the tritan axis was the most affected one. There was no significant difference between the cataract sub-groups. We also found large and significant differences in central colour contrast thresholds between normal subjects and postoperative values from the cataract group in all colour axes. The colour contrast sensitivity was poorer in pseudophakes than in normals. There was a difference between the three groups of different IOL material used (PMMA, acrylic and silicone). The difference was significant in the protan axis, the acrylic group having the best colour contrast sensitivity.

    Conclusion: Peripheral colour contrast sensitivity was affected by cataract, even when only moderately developed. This finding is of importance and should be considered when the method is used to study other eye diseases e.g. glaucoma. Central colour contrast sensitivity was also affected by cataract. The pseudophakes were found to have poorer colour contrast sensitivity than normals. The material in the IOL seemed to be of importance for colour contrast.

  • 316.
    Friström, Björn
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Lundh, Björn
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Colour contrast sensitivity with different intraocular lens materials in the right and left eyes in same day surgery2005In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 83, no 4, p. 443-447Article in journal (Refereed)
    Abstract [en]

    Purpose: To study possible differences in colour contrast sensitivity between different intraocular lens (IOL) materials with consecutive same day cataract surgery performed in the right and left eyes.

    Methods: Central colour contrast sensitivity was measured with a computer graphics system along the protan, deutan and tritan axes. Thirty-four patients with cataract were studied. The patients were randomized to one of three groups: group 1 received a Clariflex (silicone) lens in one eye and an Akreos Fit (hydrophilic acrylic) lens in the other; group 2 received an Akreos lens in one eye and a Sensar AR40e (hydrophobic acrylic) lens in the other, and group 3 received a Clariflex lens in one eye and an AR40e lens in the other. Surgery was performed in both eyes on the same day. A postoperative questionnaire was distributed, asking the patients to describe any differences experienced between their two eyes.

    Results: There were no significant differences between the three different IOLs in any colour axis. There were no complications of importance during surgery. Thirty-two of the 34 patients answered the questionnaire. Twenty-one patients experienced some difference between their two eyes in distance vision and 23 noticed differences in near vision. For distance vision, nine reported better vision in the eye with the Akreos IOL, eight in the eye with the Clariflex IOL lens and four in the eye with the AR40e IOL. For near vision, 12 preferred the Akreos lens, eight the Clariflex lens and three the AR40e lens.

    Conclusion: There were no significant differences between the three different IOLs in any colour axis.

  • 317.
    Friström, Björn
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Nilsson, Sven Erik G.
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    A double masked comparison of the intraocular pressure reducing effect of latanoprost 0.005% and 0.001% administered once daily in open angle glaucoma and ocular hypertension1997In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 81, no 10, p. 867-870Article in journal (Refereed)
    Abstract [en]

    AIM To compare the intraocular pressure (IOP) reducing effect of latanoprost 0.005% and 0.001%.

    METHODS Twenty four patients with glaucoma or ocular hypertension were randomised into two groups. Twelve patients (group 1) were given latanoprost 0.005% once daily for 4 weeks and then latanoprost 0.001% once daily for the following 4 weeks. Twelve patients (group 2) were given latanoprost 0.001% once daily for 4 weeks and then latanoprost 0.005% for the following 4 weeks.

    RESULTS There was a significant IOP reduction from baseline in both groups on day 28 as well as on day 56. When the results from both groups were used for calculations, the mean IOP reduction from baseline after 4 weeks of treatment with latanoprost 0.005% (day 28 or 56) was 9.6 (SD 3.3) mm Hg (35.0%). After 4 weeks of treatment with latanoprost 0.001%, the IOP reduction (day 28 or 56) was 7.6 (3.4) mm Hg (27.7%). The difference in IOP reduction between the two concentrations was 2.0 (2.3) mm Hg (p<0.001).

    CONCLUSIONS Latanoprost 0.005% was more effective than latanoprost 0.001% in reducing IOP. Even the lower concentration was surprisingly effective, and potentially may be of importance for use in clinical practice. Furthermore, it is at present unknown whether the increase in iris pigmentation seen in certain patients treated with latanoprost 0.005% is dose dependent and might be less pronounced with latanoprost 0.001%. Long term studies with a larger number of patients are required in order to answer this question.

  • 318.
    Friström, Björn
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Nilsson, Sven Erik G.
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Interaction of PhXA41, a New Prostaglandin Analogue, With Pilocarpine: A Study on Patients With Elevated Intraocular Pressure1993In: Archives of ophthalmology (1960), ISSN 0003-9950, Vol. 111, no 5, p. 662-665Article in journal (Refereed)
    Abstract [en]

    Objective.  —To evaluate the effects of PhXA41, a new prostaglandin analogue, on the intraocular pressure (IOP) in patients receiving pilocarpine treatment and the effects of pilocarpine in patients receiving PhXA41 treatment.

    Design.  —Twenty patients with ocular hypertension were randomized into two parallel groups. The treatment period was 2 weeks. Ten patients in group 1 were given PhXA41 twice daily during week 1 and, in addition, pilocarpine three times daily during week 2. Ten patients in group 2 received pilocarpine three times daily during week 1 and PhXA41 twice daily in addition during week 2. PhXA41 was used in a concentration of 0.006%, and pilocarpine was given in a concentration of 2%.

    Main Outcome Measures.  —In group 1, the mean IOP on day 0 was 25.1 mm Hg; on day 7,19.1 mm Hg; and on day 14,17.6 mm Hg. In group 2, the mean IOP on day 0 was 23.8 mm Hg; on day 7,20.4 mm Hg; and on day 14,17.7 mm Hg.

    Results.  —PhXA41 had a clinically significant IOP-lowering effect (23.4% reduction on day 7 as compared with baseline day (P<.001). The corresponding value with pilocarpine was 14.3% (P<.001). When pilocarpine was added to PhXA41, the additional IOP reduction was 7.4% (P<.01) compared with 14.2% (P<.01) when PhXA41 was added to pilocarpine. The two groups were found to have an almost equal reduction in IOP on day 14 (group 1,29.4%; group 2, 26.6%). No serious adverse reactions were seen. Some conjunctival hyperemia in the PhXA41-treated eyes was noted on day 7, as compared with the pilocarpine-treated eyes, but there were few complaints of discomfort.

    Conclusions.  —This study indicated that PhXA41 could be useful in the treatment of glaucoma, as monotherapy, or in certain cases in combination with pilocarpine.

  • 319.
    Fälth-Magnusson, Karin
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Franzen, Lennart
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Jansson, Gunnar
    Department of Pediatrics, Motala, Sweden.
    Laurin, Pia
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Stenhammar, Lars
    Department of Pediatrics, Norrköping, Sweden.
    Infant feeding history shows distinct differences between Swedish celiac and reference children1996In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 7, no 1, p. 1-5Article in journal (Refereed)
    Abstract [en]

    Infant feeding history was investigated in 72 celiac and 288 age-matched reference children in a retrospective questionnaire study. The reply rate was 100% in celiac and 91. 6% in reference children. The celiac children were breast-fed for a significantly shorter time than reference children, and they were less often breast-fed at the introduction of gluten. The age of the children at gluten introduction was similar, but the cellac children were significantly more often introduced by a gluten-containing follow-up formula, while the reference children more often started on a gluten-containing porridge. The results can be interpreted in two ways. First, it could be argued that breast milk per se protects against symptoms of celiac disease in childhood. It could, however, also be claimed that breast-feeding merely modulates the gluten introduction, causing a less abrupt introduction of gluten in the baby diet and thereby fewer overt symptoms of the disease.

  • 320. Förstberg, Johan
    et al.
    Andersson, Evert
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Studie av åkkomfort och åksjuka för lutande tåg2001In: Svensk ÖNH tidskrift, ISSN 1400-0121, Vol. 8Article in journal (Other academic)
  • 321.
    Gan, Lisha
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Leukocytes in the early events of corneal neovascularization2001In: Cornea, ISSN 0277-3740, E-ISSN 1536-4798, Vol. 20, p. 96-99Article in journal (Refereed)
  • 322.
    Gan, Lisha
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Palmblad, Jan
    Expression of basic fibroblast growth factor in rabbit corneal alkali wounds in the presence and absence of granulocytes2005In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 83, no 3, p. 374-378Article in journal (Refereed)
    Abstract [en]

    Purpose: To study the expression of basic fibroblast growth factor (bFGF) in the early phases of corneal wound healing in the presence or absence of granulocytes. Methods: A central penetrating corneal alkali wound was inflicted to one eye in each of 14 rabbits under general anaesthesia. Subsequently, seven of the rabbits were given fucoidin i.v. for 36 hours in order to block the selectins on the vascular endothelium, thus preventing blood granulocytes from entering the tissues. Then, corneas were prepared, stained for bFGF and evaluated by light microscopy. Results: Whereas normal corneal epithelium expressed bFGF weakly, conjunctival epithelium did so strongly, particularly the goblet cells. The corneal endothelium showed medium staining, while keratocytes and vascular endothelial cells did not consistently express bFGF. After 36 hours of wound healing, a marked upregulation of bFGF expression was observed in the corneal epithelial and endothelial cells, as well as in the keratocytes, that were migrating into the wound. No other changes were noted. None of these features were modulated when granulocyte emigration was prevented by fucoidin administration. Conclusions: The difference in bFGF expression between the corneal and conjunctival epithelium suggests a role for this growth factor in the barrier function at the limbus. Moreover, the specific presence of bFGF in cells migrating into the wound indicates the participation of bFGF in corneal wound healing. Expression of bFGF was independent of granulocytes. Copyright © Acta Ophthalmol Scand 2005.

  • 323.
    Gan, Lisha
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Hamberg-Nyström, Hélene
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Van Setten, Gysbert
    Cellular proliferation and leukocyte infiltration in the rabbit cornea after photorefractive keratectomy2001In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 79, no 5, p. 488-492Article in journal (Refereed)
    Abstract [en]

    Purpose: To map the proliferative activity of corneal cells during wound healing following photorefractive keratectomy (PRK) and to compare two markers for proliferation. Methods: PRK, 5- mm in diameter with a -6 D setting, was performed in one eye of 28 New Zealand White Rabbits. The rabbits were sacrificed at time points between 12 hours and three months after surgery. The treated and fellow corneas were fixed in 10% formaldehyde, paraffin embedded, and immunohistochemically stained for proliferate cell nuclear antigen (PCNA) and at one time point, 1 week, also for Ki-67. Results: Following initial sliding of the epithelial cells, the proliferative activity in the wound area starts in the leading edge (24 hours) and is spread towards the periphery. The proliferative activity peaks after one week and subsides during the following two weeks. Early (24 hours) proliferative activity is also seen in the limbal epithelium which peaks after three days. The keratocytes express PCNA in the peripheral stroma 48 hours after injury. They then also migrate to repopulate the stroma under the wound area. The expression period lasts 1 week and subsides the following week. Leukocytes are found in the wound as early as 12 hours after injury. The cells disappear around the time of epithelial wound closure, i.e. after 3 days. The two proliferative markers PCNA and KI 67 show a similar distribution after surgery. Conclusion: Epithelial proliferative activity starts earlier after injury, and is preceded by leukocyte presence in the wound. The PCNA expression starts later in the keratocytes but lasts somewhat longer (3 weeks). PCNA expression appears more efficient than Ki-67 to show proliferative activity of slow cycling cells in the cornea.

  • 324.
    Ganowiak, Katarzyna
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Hultman, Per
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Engström, Ulla
    Ludwig Institute of Cancer Research, Uppsala Branch, Uppsala, Sweden.
    Gustavsson, Åsa
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Westermark, Per
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Fibrils from Synthetic Amyloid-Related Peptides Enhance Development of Experimental AA-Amyloidosis in Mice1994In: Biochemical and Biophysical Research Communications - BBRC, ISSN 0006-291X, E-ISSN 1090-2104, Vol. 199, no 1, p. 306-312Article in journal (Refereed)
    Abstract [en]

    Amyloid enhancing factor is an incompletely characterized activity of extracts from many amyloid-containing tissues and which greatly shortens the preamyloidotic phase during experimental induction of AA-amyloidosis. In this communication we show that amyloid-like fibrils made in vitro from synthetic peptides, corresponding to segments of amyloid fibril proteins, have amyloid enhancing factor-like activity. Thus, there is a possibility that amyloid enhancing factor activity depends on small fibrils serving as nucleation centers for fibril elongation.

  • 325.
    Gao, J.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Immunolocalization of types I, II, and X collagen in the tibial insertion sites of the medial meniscus2000In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 8, no 1, p. 61-65Article in journal (Refereed)
    Abstract [en]

    The medial meniscus of the rabbit knee joint attaches to the tibial plateau via anterior and posterior insertions. Intact meniscal tibial insertions are essential for meniscal function. In the present study the distributions of types I, II, and X collagen in meniscal tibial insertions were investigated by indirect immunohistochemistry in a rabbit model. Four tissue zones were histologically identified in the anterior insertion site, including the ligamentous zone, uncalcified and calcified fibrocartilaginous zones and bone, the ligamentous zone was not observed in the posterior insertion site. Labeling for type I collagen was found to be strong in the ligament tissue and bone, and weak in the fibrocartilages which were also labeled for type II collagen. Tissues positive for different types of collagen overlapped and formed an irregular interface with various angles and depths, especially at the interface between the calcified fibrocartilage and bone. Positive labeling for type X collagen was identified only in the calcified fibrocartilage zone. The coexistence of types I and II collagen in the meniscal tibial insertions may indicate that this structural unit is subjected to both compressive and tensile loads. Type X collagen may play a role in maintaining the calcifying status of this tissue zone, so that its mechanical stiffness is kept between that of uncalcified fibrocartilage and hard bone. Restoration of the insertional structure including the distinct collagen distribution should be considered for a functional meniscal substitution.

  • 326.
    Gao, Jizong
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    The Entheses of the Medial Meniscns and Ligaments of the Knee Joint: Descriptive and Experimental Studies1997Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Meniscal injuries are common in sports. Surgical removal of the meniscus to relieve symptoms is associated with a high risk for late knee joint osteoarthrosis and pain. Meniscal repair or replacement has therefore been advocated. In meniscal replacement procedures proper fixation of the substitute to bone is decisive to guarantee normal meniscal load transmitting function and prevention of osteoarthrosis. Secure fixation of the graft is also essential for the success of ligament reconstruction. Thus, this thesis concentrates on exploration of normal morphology of the insertions of the medial meniscus and other knee ligaments, their ultimate strength and failure mode, and finally the capacity of the meniscal insertion for repair and reconstruction in a rabbit animal model.

    Extreme mechanical demands are posed on the insertion which connects highly loaded and mobile ligamentous tissue to bone. The abrupt change in tissue stiffness in the insertion is made more gradual by interposition of uncalcified and calcified fibrocartilage tissues of intermediate stiffness between the soft ligament and the hard bone. The thickness of calcified fibrocartilage in an insertion seems to be related to the amount of bending at this site. The interface between calcified fibrocartilage and bone is irregular thereby increasing the contact area between these 2 mechanically different tissues and their resistance to separation; its configuration is individual in each ligament and seems adapted to the loads to which the insertion is subjected. During mechanical testing failures through insertional structures were rare, which confirmed the effectiveness of this tissue configuration. Presence of nerve fibres in meniscal insertional structures suggests sensory function beside the mechanical ones. Hence, all of these specific features need to be reestablished after a reconstructive procedure to ensure adequate insertional function.

    Transection of meniscal insertions without refixation resulted in repair which after 12 weeks showed tissue differentiation and maturation according to local loading conditions. The repair tissue in the anterior insertion which is mainly loaded in tension acquired ligament-like appearance; in the posterior insertion, which is subjected to compressive, shear and tensile loading, fibrocartilage-like tissue had formed. Calcified and uncalcified fibrocartilages mimicing insertional tissue formed after refixation of the insertion into a bone channel, but a nonnal collagen matrix, interface to bone and mechanical strength did not reestablish.

    A meniscal insertion healed in prolongated position after transection, and in a case with refixation, it was found partially pulled out. This resulted in both instances in a displacement of the meniscus to the joint periphery and signs for osteoarthrosis similar to what has been found after removal of the meniscus. Thus, despite some capacity of the repair tissue to differenciate and mature to insertionspecific tissue after transection or reconstruction a normal load transmission function of the meniscus probably did not reestablish, and osteoarthrosis was common. Further studies are necessary to improve the fixation of meniscal or ligament substitutes to bone.

  • 327. Garner, B.
    et al.
    Roberg, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Qian, M.
    Brunk, Ulf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Eaton, J W
    Truscott, RJW
    Redox availability of lens iron and copper: Implication for HO generation in cataract.1999In: Redox report, ISSN 1351-0002, E-ISSN 1743-2928, Vol. 4, p. 313-315Article in journal (Refereed)
  • 328. Garner, B
    et al.
    Roberg, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Qian, M
    Eaton, JW
    Truscott, RJW
    Distribution of ferritin and redox-active transition metals in normal and cataractous human lenses2000In: Experimental Eye Research, ISSN 0014-4835, E-ISSN 1096-0007, Vol. 71, no 6, p. 599-607Article in journal (Refereed)
    Abstract [en]

    Previous studies have shown that lenticular levels of Fe and Cu are elevated in age-related cataract. However, it is not known if these metals are present in a state that is permissive for redox reactions that may lead to the formation of free radicals. In addition, there is little data available concerning the concentration and lenticular distribution of ferritin, the major intracellular Fe-sequestering protein, in the lens. The aim of the present work was therefore to determine the distribution of ferritin and the redox-availability of Fe and Cu in healthy and cataractous lenses. Lens ferritin distribution was assessed by ELISA and immunohistochemistry. A modified ELISA detected ferritin in an 'insoluble' lens protein fraction. Ferritin levels were not significantly different in the cortex vs nucleus of healthy lenses. In contrast, ferritin levels in the cataractous lens nuclei appeared to be 70 % lower compared to the cortex. This was at least partially due to the presence of ferritin within an insoluble protein fraction of the homogenized lenses. In normal lenses, ferritin staining was most intense in the epithelium, with diffuse staining observed throughout the cortex and nucleus. The redox-availability of lenticular metals was determined using: (1) autometallography, (2) Ferene-S as a chromogenic Fe chelator, and (3) NO release from nitrosocysteine to probe for redox-active Cu. The antometallography studies showed that the cataractous lenses stained more heavily for redox-active metals in both the nucleus and cortex when compared to age-matched control lenses. Chelatable Fe was detected in homogenized control lenses after incubation with Ferene-S, with almost three-fold higher levels detected in the cataractous lenses on average. The Cu-catalysed liberation of NO from added nitrosocysteine was not demonstrated in any lens sample. When exogenous Cu (50 nM) was added to the lenses, it was rapidly chelated. The cataractous samples were approximately twice as effective at redox-inactivation of added Cu. These studies provide evidence that a chelatable pool of potentially redox-active Fe is present at increased concentrations in human cataractous lenses. In contrast, it seems that lenticular Cu may not be readily available for participation in redox reactions. (C) 2000 Academic Press.

  • 329.
    Garner, Brett
    et al.
    Department of Biomedical Science, University of Wollongong, Wollongong, NSW, Australia.
    Li, Wei
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Roberg, Karin
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Brunk, Ulf
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    On the cytoprotective role of ferritin in macrophages and its ability to enhance lysosomal stability1997In: Free radical research, ISSN 1071-5762, E-ISSN 1029-2470, Vol. 27, no 5, p. 487-500Article in journal (Refereed)
    Abstract [en]

    Macrophages have a great capacity to take up (eg. by endocytosis and phagocytosis) exogenous sources of iron which could potentially become cytotoxic, particularly following the intralysosomal formation of low-molecular weight, redox active iron, and under conditions of oxidative stress. Following autophago-cytosis of endogenous ferritin/apoferritin, these compounds may serve as chelators of such lysosomal iron and counteract the occurrence of iron-mediated intralysosomal oxidative reactions. Such redox-reactions have been shown to lead to destabilisation of lysosomal membranes and result in leakage of damaging lysosomal contents to the cytosol. In this study we have shown: (i) human monocyte-derived macrophages to accumulate ferritin in response to iron exposure; (ii) iron to destabilise macrophage secondary lysosomes when the cells are exposed to H2O2; and (iii) endocytosed apoferritin to act as a stabiliser of the acidic vacuolar compartment of iron-loaded macrophages. While the endogenous ferritin accumulation which was induced by iron exposure was not sufficient to protect cells from the damaging effects of H2O2, exogenously added apoferritin, as well as the potent iron chelator desferrioxamine, afforded significant protection. It is suggested that intralysosomal formation of haemosiderin, from partially degraded ferritin, is a protective strategy to suppress intralysosomal iron-catalysed redox reactions. However, under conditions of severe macrophage lysosomal iron-overload, induction of ferritin synthesis is not enough to completely prevent the enhanced cytotoxic effects of H2O2.

  • 330.
    Garvin, Stina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology.
    Öllinger, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Dabrosin, Charlotta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Resveratrol induces apoptosis and inhibits angiogenesis in human breast cancer xenografts in vivo2006In: Cancer Letters, ISSN 0304-3835, E-ISSN 1872-7980, Vol. 231, no 1, p. 113-122Article in journal (Refereed)
    Abstract [en]

    Resveratrol, a polyphenol found in grapes and wine, is considered a potential cancer chemopreventive agent. Resveratrol has been shown to induce transcription via both ERα and ERβ. We observed significantly lower tumor growth, decreased angiogenesis, and increased apoptotic index in ERα- ERβ+ MDA-MB-231 tumors in resveratrol-treated nude mice compared with controls. In vitro we found a significant increase in apoptosis in resveratrol-treated MDA-MB-231 cells in addition to significantly reduced extracellular levels of VEGF. This study supports the potential use of resveratrol as a chemotherapeutic agent in breast cancers. © 2005 Elsevier Ireland Ltd. All rights reserved.

  • 331.
    Gati, Istvan
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Danielsson, Olof
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Betmark, T
    Ernerudh, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Clinical Immunology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Öllinger, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Dizdar Segrell, Nil
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Neurology. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Effects of inhibitors of the arachidonic acid cascade on primary muscle culture from a Duchenne muscular dystrophy patient2007In: Prostaglandins, Leukotrienes and Essential Fatty Acids, ISSN 0952-3278, E-ISSN 1532-2823, Vol. 77, no 3-4, p. 217-223Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate the mechanisms of action for potential targets of therapeutic intervention related to the arachidonic acid cascade in muscular dystrophy. Primary cultures from a Duchenne patient were used to study the expression of dystrophin-1, utrophin, desmin, neonatal myosin heavy chain (MHCn) and Bcl-2 during inhibition of phospholipase A2 (PLA2), cyclooxygenase (COX) and lipoxygenase (LOX). Hypo-osmotic treatment was applied in order to trigger Ca2+ influx and PLA2 activity. Inhibition of PLA2 and LOX with prednisolone and nordihydroguaiaretic acid (NDGA) caused a semi-quantitative increase of utrophin and Bcl-2-, and a dose-dependent, quantitative increase of desmin expression, an effect that was augmented by hypo-osmotic treatment. Our results indicate that LOX inhibitors, similarly to corticosteroids, can be beneficial in the treatment of muscular dystrophies. © 2007 Elsevier Ltd. All rights reserved.

  • 332.
    Gauffin, Håkan
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Knee and ankle kinesiology and joint instability1991Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This study, comprising 7 separate papers, is concerned with the additional information supplied by a kinesiological approach for evaluation of patients with instability due to old ligamenta us injury to the knee or ankle joint. This approach required development of new methods for kinesiological analysis.

    Impaired performance in patients with old anterior cruciate ligament (ACL) rupture was mainly found in tests which greatly stress the knee joint, ie figure-of-eight running and one-legged jump for distance.

    A scaling model approach was constructed and found appropriate in evaluating knee and ankle function in patients with ligarnentous injuries.

    A dynamic, two-dimensional, biomechanical model was developed and implemented in a motion analysis system together with a force plate and EMG. This model was found useful for evaluation of kinematics, kinetics and muscular activation patterns at the ankle, knee and hip joints during functional movements such as walking and jumping.

    A movement analysis could reveal adapted movement- and muscular activation patterns for the ACL-deficient knee compared to the noninjured at touch down at one-legged jump. An internal knee model disclosed a simultaneous decrease in sagittal shear load which was interpreted as an adaptation to avoid increased intrinsic joint movements or gross subluxations.

    Unilateral injury to the lateral ligaments of the ankle is related to both ipsi- and contralateral functional alterations. There is a risk of underestimating the impairment of the injured joint in a function test using the noninjured side as a reference.

    A perturbation device was construcred and found useful for the analysis of postural strategies, reaction latencies and ankle joint function during single limb stance. The ankle joints were found to be of primary concern for postural corrections to retain equilibrium in single limb stance.

    A quasi static, three-dimensional ankle model was developed and implemented in a motion analysis system which made possible study of ankle joint function, load and instability. Different motor patterns were found for the functionally unstable foot compared to the stable in single limb stance.

  • 333. Gejrot, Tomas
    et al.
    Hydén, Dag
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Apropå otologins profiler2002In: Svensk ÖNH tidskrift, ISSN 1400-0121, Vol. 9, p. 17-17Article in journal (Other (popular science, discussion, etc.))
  • 334.
    Geng, L.
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Wihlmark, U.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Algvere, Peep
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Lipofuscin accumulation in iris pigment epithelial cells exposed to photoreceptor outer segments.1999In: Experimental Eye Research, ISSN 0014-4835, E-ISSN 1096-0007, Vol. 69, p. 539-546Article in journal (Refereed)
  • 335.
    Gentile, Massimiliano
    et al.
    Linköping University, Department of Biomedicine and Surgery, Oncology. Linköping University, Faculty of Health Sciences.
    Bergman Jungeström, Malin
    Linköping University, Department of Biomedicine and Surgery, Oncology. Linköping University, Faculty of Health Sciences.
    Olsen, K. E.
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Department of Molecular and Clinical Medicine, Forensic Medicine. Linköping University, Faculty of Health Sciences.
    Söderkvist, Peter
    Linköping University, Department of Biomedicine and Surgery, Cell biology. Linköping University, Faculty of Health Sciences.
    Wingren, Sten
    Linköping University, Department of Biomedicine and Surgery, Oncology. Linköping University, Faculty of Health Sciences.
    p53 and survival in early onset breast cancer: analysis of gene mutations, loss of heterozygosity and protein accumulation1999In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 35, no 8, p. 1202-1207Article in journal (Refereed)
    Abstract [en]

    The p53 protein has proven to be central in tumorigenesis by its cell cycle regulatory properties and both gene mutations and protein accumulation have been associated with poor prognosis in breast cancer. The present study was undertaken to investigate the prognostic significance of gene mutations, p53 protein accumulation and of loss of heterozygosity (LOH) at the TP53 locus in young (age <37 years) breast cancer patients. In total, gene mutations were found in 21 of the 123 patients (17%), LOH in 20 of the 47 informative cases (43%) and protein accumulation in 47 of the 102 available cases (46%). Log rank analysis revealed no significant association between survival and TP53 mutations (in general), p53 protein accumulation or LOH. However, missense mutations localised to the zinc binding domain were significantly (P=0.0007) associated with poorer prognosis. As indicated in this as well as other studies, p53 protein accumulation is frequently found in young breast cancer patients, but this protein overexpression appears to be of minor significance for survival. Nevertheless, the present report also suggests that specific mutations contribute substantially to tumour aggressiveness.

  • 336.
    Gentile, Massimiliano
    et al.
    Linköping University, Department of Biomedicine and Surgery, Oncology. Linköping University, Faculty of Health Sciences.
    Olsen, K.
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Department of Molecular and Clinical Medicine, Forensic Medicine. Linköping University, Faculty of Health Sciences.
    Dufmats, Monika
    Linköping University, Department of Biomedicine and Surgery, Oncology. Linköping University, Faculty of Health Sciences.
    Wingren, Sten
    Linköping University, Department of Biomedicine and Surgery, Oncology. Linköping University, Faculty of Health Sciences.
    Frequent allelic losses at 11q24.1–q25 in young women with breast cancer: association with poor survival1999In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 80, no 5/6, p. 843-849Article in journal (Refereed)
    Abstract [en]

    Previous studies have demonstrated that the pathological features of breast cancer are more aggressive in younger women than in their older counterparts, and that young age may be an independent marker for adverse prognosis. These findings have raised the question whether these differences are also present at the molecular level. In order to characterize the genetic alterations associated with early-onset breast cancer, 102 cases selected for age under 37 at diagnosis were examined for loss of heterozygosity (LOH) at nine different loci on chromosomes 11, 13 and 17. Ninety cases (88%), exhibited LOH for at least one marker. The D17S855 marker, intragenic in the BRCA1 gene, showed a high proportion of LOH (63%), whereas the intragenic marker for the TP53 gene, HP53, exhibited LOH in 43% of the cases. On chromosome 11, frequencies of LOH peaked at the D11S969 and D11S387 markers, which expressed LOH in 53% and 48% of the informative cases, whereas D11S1818, which is proximate to the ATM gene, exhibited an LOH frequency of 24%. A statistically significant correlation was found between LOH at the D11S387 marker and poor survival (P = 0.028). No such correlation was found for the adjacent D11S969 marker, located approximately 500 kb centromeric to D11S387. We conclude that one or more as yet unidentified genes, situated in chromosome bands 11q24.1–q25, could be involved in the initiation and/or progression of breast cancer in younger women.

  • 337.
    Gerdle, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Förekomst av kroniska/långvariga smärtor2006In: Rehabiliteringsmedicin Teori och praktik / [ed] Jörgen Borg,Björn Gerdle, Gunnar Grimby, Katharina Stibrant Sunnerhagen, Lund: Studenltitteratur , 2006, 1, p. 73-77Chapter in book (Other academic)
    Abstract [sv]

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

  • 338.
    Gerdle, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Björk, Jonas
    Lunds Universitet.
    Henriksson, Chris
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy.
    Bengtsson, Ann
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Rheumatology. Östergötlands Läns Landsting, Centre for Medicine, Department of Rheumatology in Östergötland.
    Prevalence of current and chronic pain and their influences upon work and healthcare-seeking: A population study2004In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 31, no 7, p. 1399-1406Article in journal (Refereed)
    Abstract [en]

    Objective. To investigate the prevalence of current and chronic pain and their relationship to pain intensity, sex, age, income, employment status, citizenship, marital status, urban residence, occupational activity, and healthcare-seeking based on a representative sample from a Swedish county. Methods. A cross-sectional survey using a postal questionnaire was sent to a representative sample (n = 9952) of the target population (284,073 people, age 18-74 yrs) in a county (Östergötland) in southern Sweden. A questionnaire was mailed and followed by 2 postal reminders if necessary. Results. The participation rate was 76.7% (n = 7637), nonparticipants were on average younger, male, and earned less money. The overall point prevalence of pain was 48.9%. The corresponding one-month period prevalence was 63.0%, and pain on several occasions during the previous 3 months was reported by 61.3% of participants. The prevalence of chronic pain (pain > 3 months) was 53.7%. Female sex, age, and sick leave/early retirement were generally of significant importance in the regressions of pain. No sex factor was found in the regressions of pain frequency and pain intensity. Chronic pain - especially frequent and intensive pain - showed clear associations with healthcare-seeking and occupational activity. Conclusion. High prevalence of current pain (48.9%) and chronic pain (53.7%) were found in this community-based study. Being female, older, and on sick leave or early retirement were generally of significant importance in the regressions of pain. Chronic pain showed clear associations with healthcare-seeking and occupational activity, indicating considerable socioeconomic costs.

  • 339.
    Gerdle, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Boivie, Jörgen
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Neurology. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Johansson, Eva
    Umeå Universitet.
    Inledning2006In: Metoder för behandling av långvarig smärta - en systematisk litteraturöversikt / [ed] Statens beredning för medicinsk utvärdering, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2006, 2, p. 47-107Chapter in book (Other academic)
    Abstract [sv]

      

    Syftet med rapporten är att sammanfatta det vetenskapliga underlaget rörande effekter, biverkningar samt kostnadseffektivitet för metoder som används för att behandla långvarig, icke-cancerrelaterad smärta. Behandling som innebär öppen kirurgi har exkluderats från genomgången.

  • 340.
    Gerdle, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Gullacksen, Ann-Christine
    Malmö Högskola.
    Multimodal rehabilitering2006In: Metoder för behandling av långvarig smärta - En systematisk litteraturöversikt / [ed] Statens beredning för medicinsk utvärdering, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2006, 2, p. 159-213Chapter in book (Other academic)
    Abstract [sv]

    Syftet med rapporten är att sammanfatta det vetenskapliga underlaget rörande effekter, biverkningar samt kostnadseffektivitet för metoder som används för att behandla långvarig, icke-cancerrelaterad smärta. Behandling som innebär öppen kirurgi har exkluderats från genomgången.

  • 341.
    Gerdle, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Gullacksen, Ann-Christine
    Malmö Högskola.
    Rehabilitering vid kronisk smärta-särskilt multimodal rehabiltiering2006In: Rehabiliteringsmedicin - Teori och praktik / [ed] Jörgen Borg,Björn Gerdle, Gunnar Grimby, Katharina Stibrant Sunnerhagen, Lund: Studentlitteratur , 2006, 1, p. 97-107Chapter in book (Other academic)
    Abstract [sv]

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

  • 342.
    Gerdle, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Karlsson, S
    Crenshaw, AG
    Elert, Jessica
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Physiotherapy.
    Fridén, J
    The influences of muscle fibre proportions and areas upon EMG during maximal dynamic knee extensions2000In: European Journal of Applied Physiology and Occupational Physiology, ISSN 0301-5548, E-ISSN 1432-1025, Vol. 81, no 1-2Article in journal (Refereed)
    Abstract [en]

    This study is an investigation of the relationship between muscle morphology and surface electromyographic (EMG) parameters [mean frequency of the power spectrum (MNF), signal amplitude (root mean square, RMS) and the signal amplitude ratio (SAR, i.e. the ratio between the RMS level during the passive part of the contraction cycle and the RMS level during the active part of the contraction cycle)] during 100 maximal dynamic knee extensions at 90░.s-1. Each contraction cycle comprised of 1 s of active knee extension and 1 s of passive knee flexion. The surface EMG was recorded from the vastus lateralis muscle. Twenty clinically healthy subjects participated in the study, and muscle biopsy samples of the vastus lateralis were obtained from 19 of those subjects. The relationships between muscle morphology and EMG were investigated at three stages of the test: initially, during the fatigue phase (initial 40 contractions), and at the endurance level (the final 50 contractions). Major findings on correlations are that SAR and MNF tended to correlate positively with the proportion of type 1 fibres, and RMS correlated positively with the proportion of type 2 muscle fibres. The muscle fibre areas showed little correlation with the EMG variables under investigation. The results of the present study showed that the three EMG variables of a dynamic endurance test that were investigated (RMS, MNF and SAR were clearly correlated with the proportions of the different fibre types, but only to a small extent with fibre areas. These findings contradict some of the theoretical models of the EMG, especially for parameters in the frequency domain.

  • 343.
    Gerdle, Björn
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Pain and Rehabilitation Centre. Linköping University, Faculty of Health Sciences.
    Larsson, Barbro
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Karlsson, Stefan
    Department of Biomedical Engineering and Informatics, University Hospital, Umeå, Sweden.
    Criterion validation of surface EMG variables as fatigue indicators using peak torque: a study of repetitive maximum isokinetic knee extensions2000In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 10, no 4, p. 225-232Article in journal (Refereed)
    Abstract [en]

    A number of studies have been published that have used variables of the electromyogram (EMG) power spectrum during dynamic exercise. Despite these studies there is a shortage of studies of the validity of surface EMG registrations during repetitive dynamic contractions with respect to fatigue. The aim of this study was to investigate if the surface EMG variables mean frequency (MNF [Hz]) and the signal amplitude (RMS [μV]) are valid indicators of muscular fatigue (defined as “any exercise-induced reduction in the capacity to generate force or power output”) during maximum repeated isokinetic knee extensions (i.e. criterion validity using peak torque).

    Twenty-one healthy volunteers performed 100 isokinetic knee extensions at 90° s-1. EMG signals were recorded from the vastus lateralis, the rectus femoris and the vastus medialis of the right thigh by surface electrodes. MNF and RMS of the EMG together with peak torque (PT [Nm]) were determined for each contraction. MNF showed consequently higher correlation coefficients with PT than RMS did. Positive correlations generally existed between MNF and PT. The majority of the subjects had positive correlations between RMS and PT (i.e. decreases both in PT and in RMS).

    In conclusion, at the individual level MNF generally — in contrast to RMS — showed good criterion validity with respect to biomechanical fatigue during dynamic maximum contractions.

  • 344.
    Gerdle, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Sandberg, Margaretha
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Akuta och kroniska nociceptiva smärtor. Den biopsykosociala helhetssynen och aspekter på de neurobiologiska mekanismerna2006In: Rehabiliteringsmedicin - Teori och praktik / [ed] Jörgen Borg, Lund: Studenlitteratur , 2006, 1, p. 78-89Chapter in book (Other academic)
    Abstract [sv]

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

  • 345.
    Gerdle, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Sörensen, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Radiofrekvensbehandling2006In: Metoder för behandling av långvarig smärta: En systematisk litteraturöversikt / [ed] Statens beredning för medicinsk utvärdering, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2006, p. 339-343Chapter in book (Other academic)
    Abstract [sv]

    I denna rapport sammanfattas det vetenskapliga underlaget för behandling av långvariga smärttillstånd. Smärta vid cancer innefattas inte. Smärtlindrande effekter, liksom biverkningar och andra negativa konsekvenser av behandling berörs samt hälsoekonomiska aspekter.

  • 346.
    Germundsson, Johan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion.
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Ophthalmology . Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Phototherapeutic keratectomy in Salzmann's nodular degeneration2004In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 82, no 2, p. 148-153Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe the outcome in vision and refraction of phototherapeutic keratectomy (PTK) in Salzmann's nodular degeneration (SND). Methods: Five eyes of four patients underwent PTK with the objective of restoring an acceptable refractive status and improving visual acuity. This surgical technique aims to make the nodules level with the corneal surface using an excimer laser. Results: Best corrected visual acuity (BCVA) improved in all five eyes. Astigmatism was reduced in four eyes and increased somewhat in one. During the observation period one eye suffered a late recurrence that required a penetrating graft. Conclusion: Salzmann's nodular degeneration is a rare disease that is sometimes difficult to diagnose as it has some resemblance to other diseases. The aetiology of the disease is unknown. Phototherapeutic keratectomy is a safe and effective mode of treatment. Recurrences occur with time. Copyright © Acta Ophthalmol Scand 2004.

  • 347.
    Ghafouri, Bijar
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Irander, Kristina
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Lindbom, John
    Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Tagesson, Christer
    Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Lindahl, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Comparative proteomics of nasal fluid in seasonal allergic rhinitis2006In: Journal of Proteome Research, ISSN 1535-3893, E-ISSN 1535-3907, Vol. 5, no 2, p. 330-338Article in journal (Refereed)
    Abstract [en]

    A comparative proteomic approach was applied to examine nasal lavage fluid (NLF) from patients with seasonal allergic rhinitis (SAR, n = 6) and healthy subjects (controls, n = 5). NLF samples were taken both before allergy (pollen) season and during season, and proteins were analyzed by two-dimensional gel electrophoresis (2-DE) and matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) after tryptic cleavage. Twenty proteins were selected and quantified. During allergy season, the levels of six sialylated isoforms of PLUNC (palate lung nasal epithelial clone) were lower in SAR patients than controls, as were the levels of six isoforms of von Ebner's gland protein (VEGP), including a previously undescribed form with N-linked glycosylation, and of cystatin S. PLUNC is a new innate immunity protein and VEGP and cystatin S are two endogenous proteinase inhibitors. By contrast, the levels of an acidic form of alpha-1-antitrypsin were higher in SAR patients than controls. One previously unidentified NLF protein was found in all samples from the SAR patients during allergy season but not in any sample before allergy season:  this protein was identified as eosinophil lysophospholipase (Charcot-Leyden crystal protein/galactin 10). MS/MS analysis of the N-terminus of the protein showed removal of Met and acetylation of Ser. Altogether, these findings illustrate the potential use of proteomics for identifying protein changes associated with allergic rhinitis and for revealing post-translational modifications of such new potential markers of allergic inflammation.

  • 348.
    Ghassemifar, M. Reza
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Connective tissue contraction in wound healing: An experimental study in vivo and in vitro1996Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Contraction of connective tissue is an important part of tissue repair that reduces the wound space and helps to decrease the formation of scar tissue, both of which are needed to restore tissue integrity. In the present study, certain cellular mechanisms that are active during connective tissue contraction were assessed and the influence of transforming growth factor-.131 on these mechanisms was evaluated in normal rat and protracted mouse contraction. A new double-embedding technique for sectioning of thin tissue membranes was developed and a multisequence template was constructed that allowed quantification of a number of target mRNAs [:rGF -.131, TGF -.13 type li receptor, alpha-SM actin and .13-actin) from 0.5-2 11g of total RNA. The fibroblast-populated collagen lattice model (FPCL) was used for studies of contraction in vitro, and, in vivo, the perforated mesentery models of rat and mouse were employed. Fourier transformation image analysis was used to assess the orientation of actin in mesenteric wound fibroblasts.

    Studies in vitro showed that rat, but not mouse, macrophage conditioned medium stimulated contraction of FPCL in serum free medium and that supplementation with serum impaired FPCL contraction. In vivo, rat wound fibroblasts expressed alpha-SM actin during closure of perforations, as shown by in situ hybridization. Using quantitative RT-PCR, it was shown that the expression of alphaSM actin was increased lOO-fold in wounded as compared to unwounded tissue, and that TGF -.131, while stimulating closure of perforations, also increased alpha-SM actin mRNA 4-5 fold inwounded tissue of both rat and mouse. However, the expression of alpha-SM actin was considerably higher in the wounded mesenteriesof rats than in those of mice. TGF -.131 was expressed by normal, unstimulated peritoneal macrophages and, for the first time, shown tobe downregulated in activated, wound macrophages in both rat and mouse. The orientation of actin bundles in wound fibroblasts wasderanged in impaired healing in zinc deficiency but unaffected by TGF -.131 in stimulated contrition.

    In conclusion, the results have shed further light on various cellular activities during connective tissue contraction. A number of differences were found between rats and mice that help to clarify the mechanism of protracted healing in the mouse. The complex interaction of these mechanisms await to be further elucidated.

  • 349. Ghassemifar, M.R.
    et al.
    Tarnuzzer, R.W.
    Salerud, Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Schultz, G.S.
    Franzén, Lennart
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Alpha-smooth muscle actin expression in rat and mouse mesenteric wounds after TGF-ß1 treatment1997In: Wound Repair and Regeneration, ISSN 1067-1927, E-ISSN 1524-475X, Vol. 5, p. 339-347Article in journal (Refereed)
  • 350.
    Giedraitis, V.
    et al.
    Division of Neurology, Huddinge University Hospital, Karolinska Institute, Huddinge, Sweden.
    Modin, H.
    Division of Neurology, Huddinge University Hospital, Karolinska Institute, Huddinge, Sweden.
    Callander, Margarita
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Fossdal, R.
    deCODE Genetics, Reykjavik, Iceland.
    Stefansson, K.
    deCODE Genetics, Reykjavik, Iceland.
    Hillert, J.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Gulcher, J.
    deCODE Genetics, Reykjavik, Iceland.
    Genome-wide TDT analysis in a localized population with a high prevalence of multiple sclerosis indicates the importance of a region on chromosome 14q2003In: Genes and Immunity, ISSN 1466-4879, E-ISSN 1476-5470, Vol. 4, no 8, p. 559-563Article in journal (Refereed)
    Abstract [en]

    Epidemiological studies show that susceptibility to multiple sclerosis (MS) has a strong genetic component, but apart from the HLA gene complex, additional genetic factors have proven difficult to map in the general population. Thus, localized populations, where MS patients are assumed to be more closely related, may offer a better opportunity to identify shared chromosomal regions. We have performed a genome-wide scan with 834 microsatellite markers in a data set consisting of 54 MS patients and 114 healthy family members. A group of families from a small village were possible to track back to common ancestors living in the 17th century. We used single marker- and haplotype-based transmission disequilibrium test (TDT) analysis and nonparametric linkage analysis to analyze genotyping data. Regions on chromosomes 2q23–31, 6p24–21, 6q25–27, 14q24–32, 16p13–12 and 17q12–24 were found to be in transmission disequilibrium with MS. Strong transmission disequilibrium was detected in 14q24–32, where several dimarker haplotypes were in transmission disequilibrium in affected individuals. Several regions showed modest evidence for linkage, but linkage and TDT were both clearly positive only for 17q12–24. All patients and controls were also typed for HLA class II genes; however, no evidence for a gene–gene interaction was observed.

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