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  • 201. Sarve, H.
    et al.
    Lindblad, J.
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    Franke-Stenport, V.
    Bernhard, R.
    Scharnweber, D.
    Borgefors, G.
    Image analysis of bone tissue remodelling around biomaterials2007Conference paper (Refereed)
  • 202. Sarve, H.
    et al.
    Lindblad, J.
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    Franke-Stenport, V.
    Bernhard, R.
    Scharnweber, D.
    Borgefors, G.
    Sul, Y. T.
    Image analysis of bone tissue remodelling around implants2007Conference paper (Refereed)
  • 203. Sarve, Hamid
    et al.
    Johansson, Carina B.
    Örebro University, Department of Health Sciences. Örebro University, Department of Clinical Medicine.
    Lindblad, Joakim
    Borgefors, Gunilla
    Franke-Stenport, Victoria
    Quantification of bone remodeling in the proximity of implants2007In: Proceedings of the 12th International Conference on Computer Analysis of Images and Patterns (CAIP07) / [ed] Waalter G. Kropatsch, Martin Kampel, Allan Hanbury, Berlin: Springer , 2007, p. 253-260Conference paper (Refereed)
    Abstract [en]

    In histomorphometrical investigations of bone tissue modeling around screw-shaped implants, the manual measurements of bone area and bone-implant contact length around the implant are time consuming and subjective. In this paper we propose an automatic image analysis method for such measurements. We evaluate different discriminant analysis methods and compare the automatic method with the manual one. The results show that the principal difference between the two methods occurs in length estimation, whereas the area measurement does not differ significantly. A major factor behind the dissimilarities in the results is believed to be misclassification of staining artifacts by the automatic method.

  • 204. Shalepo, Kira
    et al.
    Savicheva, Alevtina
    Shipitsyna, Elena
    Unemo, Magnus
    Örebro University, Department of Clinical Medicine.
    Domeika, Marius
    Diagnosis of Chlamydia trachomatis in Russia--in-house PCR assays may be effective but overall optimization and quality assurance are urgently needed2006In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 114, no 7-8, p. 500-507Article in journal (Refereed)
    Abstract [en]

    In the present study, the performance of the cell culture method, two non-Russian direct immunofluorescence (DIF) assays, and three different in-house polymerase chain reaction (PCR) tests used in St. Petersburg, Russia, for detection of Chlamydia trachomatis in urogenital specimens was evaluated. A total of 650 patients were examined and it was most disquieting that previous C. trachomatis positivity with Russian DIF assays could - 7 days later - be confirmed only in 26% of the women and 30% of the men. Overall, the highest diagnostic sensitivity was obtained using PCR analysis. However, the sensitivity varied significantly: from 79% to 100% between the different PCR assays, sex of the patients, and type of samples. The highest sensitivity was obtained for female vaginal and male urine samples (100%). The specificity of the PCR assays varied from 97% to 100%. The sensitivity of cell culture and both the examined DIF assays was low, i.e. it varied from 46% to 56% and 55% to 75%, respectively. Meanwhile, cell culture was 100% specific and the DIFs showed a specificity varying from 99% to 100%. In conclusion, in a Russian perspective, adequate in-house PCR methods may be used quite effectively for detection of C. trachomatis in invasive as well as non-invasive clinical material. Simultaneous analysis of two different specimens from women resulted in a significantly increased detection rate of C. trachomatis. Nevertheless, in Russia the need for optimization and quality assurance of diagnostic methods for C. trachomatis, especially Russian DIF assays, has to be emphasized.

  • 205. Sjöström, Michael
    et al.
    Yngve, Agneta
    Poortvliet, Eric
    Ekelund, Ulf
    Örebro University, School of Health and Medical Sciences.
    Hurtig-Wennlöf, Anita
    Örebro University, Department of Clinical Medicine.
    Nilsson, Andreas
    Hagströmer, Maria
    Adolescent nutrition: a multidimensional challenge2003In: Modern aspects of nutrition: present knowledge and future perspectives / [ed] I. Elmadfa, E. Anklam, J. König, 2003, Vol. 56, p. 253-254Conference paper (Refereed)
  • 206. Stavropoulos, Franci
    et al.
    Dahlin, Christer
    Ruskin, James D.
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    A comparative study of barrier membranes as graft protectors in the treatment of localized bone defects: An esperimental study in a canine model2004In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 15, no 4, p. 435-442Article in journal (Refereed)
    Abstract [en]

    Guided bone regeneration is a predictable and well-documented surgical approach for the treatment of deficient alveolar ridges prior to endosseous implant placement. The purpose of this study was to compare a new resorbable membrane (GORE RESOLUT ADAPT Regenerative Membrane, i.e. 67% glycolide (PGA) : 33% trimethyline carbonate (TMC)) with Bio-Gide®, a resorbable collagen membrane. Five canines were used in the study. Three saddle-type osseous defects were created bilaterally in edentulous areas of the mandible. The defects were filled with assayed, canine demineralized freeze-dried bone (DFDB) in a thermoplastic gelatin matrix. Using a randomized block design, four sites were covered with PGA : TMC membranes of four different porosities, one site was covered with a collagen membrane and one site consisted of DFDB alone (control). At 3 months, the animals were euthanized and the mandibles were removed en bloc for laboratory processing. A total of 30 sites were reviewed microradiographically and underwent histomorphometric analysis for bone regeneration, soft tissue presence and remaining graft material. All sites exhibited uneventful healing. A significantly higher percentage of bone regeneration was seen in the sites protected by the PGA : TMC membrane. A higher component of soft tissue was visible beneath the collagen membrane as compared with the PGA : TMC membrane. The control sites exhibited noticeable deformation of the regenerated bone secondary to collapse of the overlying periosteum. The authors conclude that the PGA : TMC membrane protected the DFDB-filled defect and allowed a greater amount of bone regeneration than the defect protected by the collagen membrane or the control.

  • 207. Stjernman, Henrik
    et al.
    Grännö, Christer
    Bodemar, Göran
    Järnerot, Gunnar
    Ockander, Leif
    Tysk, Curt
    Örebro University, Department of Clinical Medicine.
    Blomberg, Björn
    Almer, Sven
    Ström, Magnus
    Hjortswang, Henrik
    Evaluation of the inflammatory bowel disease questionnaire in Swedish patients with Crohn's disease2006In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 41, no 8, p. 934-943Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Health-related quality of life (HRQoL) is an important measure of inflammatory bowel disease (IBD) health outcome. The Inflammatory Bowel Disease Questionnaire (IBDQ) comprising 32 items grouped into four dimensions is a widely used IBD-specific HRQoL instrument. The purpose of this study was to evaluate the validity, reliability and responsiveness of the Swedish translation of the IBDQ in patients with Crohn's disease (CD). MATERIAL AND METHODS: Four hundred and forty-eight patients with CD completed the IBDQ and three other HRQoL questionnaires (Rating Form of IBD Patient Concerns; Short Form-36; and the Psychological General Well-Being Index) in connection with their regular visit at the outpatient clinic. Disease activity was assessed by the physician on a 4-point Likert scale. Thirty-two patients who were stable in remission completed the questionnaires a second time, 4 weeks later. A total of 418 patients repeated all measurements after 6 months. RESULTS: The dimensional scores were highly correlated with other measures of corresponding aspects of HRQoL and were significantly better in remission than in relapse. High test-retest correlations indicated good reliability. Responsiveness was confirmed in patients whose disease activity changed over time. However, high correlations between the dimensions, poor correlations between items within each dimension, and factor analysis all indicated that the original grouping of the items is not valid for Swedish CD patients. CONCLUSIONS: Although the Swedish IBDQ has good external validity, reliability and responsiveness for patients with CD, our results did not support the original grouping of the items.

  • 208. Strålin, Kristoffer
    et al.
    Söderquist, Bo
    Örebro University, Department of Clinical Medicine.
    Staphylococcus aureus in community-acquired pneumonia2006In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 130, no 2, p. 623-623Article in journal (Refereed)
  • 209. Sul, Y. T.
    et al.
    Jeong, Y.
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    Albrektsson, T.
    Rate and strength of osseointegration of oxidized and machined turned titanium implants in rabbit bone for 3 and 6 weeks2006Conference paper (Refereed)
  • 210. Sul, Y. T.
    et al.
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    Albrektsson, T.
    What surface properties determine significant differences of bone respons to oxidized Mg-incorporated, Ti-unite and Osseotite implants?2006Conference paper (Refereed)
  • 211. Sul, Young-Taeg
    et al.
    Johansson, Carina B
    Örebro University, Department of Clinical Medicine.
    Albrektsson, T.
    Which surface properties enhance bone response to implants?: Comparison of oxidized magnesium, TiUnite, and Osseotite implant surfaces2006In: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 19, no 4, p. 319-328Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study compared the speed and strength of osseointegration and osteoconductivity between an oxidized experimental magnesium (Mg) implant, an oxidized commercially available TiUnite implant, and a dual acid-etched surface Osseotite implant. The aim was to investigate which surface properties enhance bone response to implants, and thereby to test a biochemical bonding theory. MATERIALS AND METHODS: A total of 60 screw implants (20 of each design) were inserted through 1 cortex into the tibiae of 10 rabbits. Surface chemistry, oxide thickness, morphology, crystal structure, and surface roughness were evaluated. After healing times of 3 and 6 weeks, all bone implants were unscrewed with removal torque (RTQ) devices, and the bone specimens were subjected to histomorphometry. RESULTS: RTQ values for Mg, TiUnite, and Osseotite implants were 27.1, 21.3, and 15.4 Ncm, with new bone formation values of 29%, 18%, and 15%, respectively, at 3 weeks. At 6 weeks the RTQ values were 37.5, 36.4, and 21.5 Ncm, with new bone formation values of 39%, 31%, and 26%, respectively. Discussion: Mg implants demonstrated significantly greater RTQ values (P = .008 and P = .0001) and more new bone formation (P = .031 and P = .030) than Osseotite at 3 and 6 weeks, respectively. Mg implants also showed higher RTQ values at 3 weeks and new bone formation at 6 weeks than TiUnite, but neither were significant (P > .05). TiUnite showed significantly higher RTQ values than Osseotite at 6 weeks (P = .001), but was not significant at 3 weeks (P > .05). Osseointegration rate (deltaRTQ/deltaweeks) was significantly faster for Mg (P = .011) and TiUnite (P = .001) implants between 3 and 6 weeks of healing time, but was not significant for Osseotite. CONCLUSIONS: The results indicate that surface chemistry facilitated more rapid and stronger osseointegration of the Mg implants despite their minimal roughness compared to the moderately roughened TiUnite. This suggests potential advantages of Mg implants for reducing high implant failure rates in the early postimplantation stage and in compromised bone, making it possible to shorten bone healing time from surgery to functional loading, and enhancing the possibility of immediate/early loading.

  • 212. Sul, Young-Taeg
    et al.
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    Byon, E.
    Albrektsson, T.
    The bone response of oxidized bioactive and non-bioactive titanium implants2005In: Biomaterials, ISSN 0142-9612, E-ISSN 1878-5905, Vol. 26, no 33, p. 6720-6730Article in journal (Refereed)
    Abstract [en]

    A number of experimental and clinical data on so-called oxidized implants have reported promising outcomes. However, little is investigated on the role of the surface oxide properties and osseointegration mechanism of the oxidized implant. Sul [On the Bone Response to Oxidized Titanium Implants: The role of microporous structure and chemical composition of the surface oxide in enhanced osseointegration (thesis). Göteborg: Department of Biomaterials/Handicap Research, University of Göteborg, Sweden; 2002; Biomaterials 2003; 24: 3893-3907] recently proposed two action mechanisms of osseointegration of oxidized implants, i.e. mechanical interlocking through bone growth in pores/other surface irregularities (1) and biochemical bonding (2). The aim of the present study is two-fold: (i) investigating the role of the implant surface chemistry on bone responses; (ii) investigating the validity of the biochemical bonding theory of the oxidized, bioactive bone implants with specific implant surface chemistry. Two groups of oxidized implants were prepared using micro arc oxidation process and were then inserted in rabbit bone. One group consisted of magnesium ion incorporated implants (MgTiO implant), the other consisted of TiO2 stoichiometry implants (TiO implant). Surface oxide properties of the implants were characterized with various surface analytic techniques. After 6 weeks of follow up, the mean peak values of removal torque of Mg implants dominated significantly over TiO implants (p < or = 0.0001). Bonding failure generally occurred in the bone away from the bone to implant interface for the MgTiO implant and mainly occurred at the bone to implant interface for the TiO implant that consisted mainly of TiO2 chemistry and significantly rougher surface as compared to the MgTiO implant. Between bone and the Mg- incorporated implant surface, ionic movements and ion concentrations gradient were detected. The current in vivo experimental data may provide positive evidence for the surface chemistry-mediated biochemical bonding theory of oxidized bioactive implants. However, the present study does not rule out potential synergy effects of the oxide thickness, micro-porous structure, crystal structure and surface roughness on improvements of bone responses to oxidized bioactive implants.

  • 213. Sul, Young-Taeg
    et al.
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    Wennerberg, A.
    Cho, L. R.
    Chang, B. S.
    Albrektsson, T.
    Optimum surface properties of oxidized implants for reinforcement of osseointegration: surface chemistry, oxide thickness, porosity, roughness, and crystal structure2005In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 20, no 3, p. 349-359Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate detailed surface characterization of oxidized implants in a newly invented electrolyte system and to determine optimal surface oxide properties to enhance the bone response in rabbits. MATERIALS AND METHODS: A total of 100 screw-type titanium implants were prepared and divided into 1 control group (machine-turned implants) and 4 test groups (magnesium ion-incorporated oxidized implants). Forty implants were used for surface analyses. A total of 60 implants, 12 implants from each group, were placed in the tibiae of 10 New Zealand white rabbits and measured with a removal torque test after a healing period of 6 weeks. RESULTS: For the test groups, the oxide thicknesses ranged from about 1,000 to 5,800 nm; for the control group, mean oxide thickness was about 17 nm. The surface morphology showed porous structures for test groups and nonporous barrier film for the control group. Pore diameter ranged from < or = 0.5 microm to < or = 3.0 microm. In regard to surface roughness, arithmetic average height deviation (Sa) values varied from 0.68 to 0.98 microm for test implants and 0.55 microm for control implants; developed surface ratio (Sdr) values ranged from 10.6% to 46% for the test groups and were about 10.6% for the control group. A mixture of anatase and rutile-type crystals were observed in the test groups; amorphous-type crystals were observed in the control group. After a healing period of 6 weeks, removal torque measurements in all 4 test groups demonstrated significantly greater implant integration as compared to machine-turned control implants (P < or = .033). DISCUSSION: Determinant oxide properties of oxidized implants are discussed in association with bone responses. Of all surface properties, RTVs were linearly increased as relative atomic concentrations of magnesium ion increase. CONCLUSIONS: Surface properties of the oxidized implants in the present study, especially surface chemistry, influenced bone responses. The surface chemistry of the optimal oxidized implant should be composed of approximately 9% magnesium at relative atomic concentration in titanium oxide matrix and have an oxide thickness of approximately 1,000 to 5,000 nm, a porosity of about 24%, and a surface roughness of about 0.8 microm in Sa and 27% to 46% in Sdr; its oxide crystal structure should be a mixture of anatase- and rutile-phase crystals.

  • 214. Sul, Young-Taeg
    et al.
    Kang, Byung-Soo
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    Um, Heung-Sik
    Park, Chan-Jin
    Albrektsson, Tomas
    The roles of surface chemistry and topography in the strength and rate of osseointegration of titanium implants in bone2008In: Journal of Biomedical Materials Research, ISSN 0021-9304, E-ISSN 1097-4636, Vol. 89A, no 4, p. 942-950Article in journal (Refereed)
    Abstract [en]

    The present study investigated the effects of surface chemistry and topography on the strength and rate of osseointegration of titanium implants in bone. Three groups of implants were compared: (1) machine-turned implants (turned implants), (2) machine-turned and aluminum oxide-blasted implants (blasted implants), and (3) implants that were machine-turned, aluminum oxide-blasted, and processed with the micro-arc oxidation method (Mg implants). Three and six weeks after implant insertion in rabbit tibiae, the implant osseointegration strength and rate were evaluated. Surface chemistry revealed characteristic differences of nine at.% Mg for Mg implants and 11 at.% Al for blasted implants. In terms of surface roughness, there was no difference between Mg implants and blasted implants in developed surface ratio (Sdr; p = 0.69) or summit density (Sds; p = 0.96), but Mg implants had a significantly lower arithmetic average height deviation (Sa) value than blasted implants (p = 0.007). At both 3 and 6 weeks, Mg implants demonstrated significantly higher osseointegration strength compared with turned (p = 0.0001, p = 0.0001) and blasted (p = 0.0001, p = 0.035) implants, whereas blasted implants showed significantly higher osseointegration than turned implants at 6 weeks (p = 0.02) but not at 3 weeks (p = 0.199). The present results not only support the hypothesis that biochemical bonding facilitates rapid and strong integration of implants in bone, but also provide evidence for biochemical bonding theory previously proposed by Sul.

  • 215. Summerlad, Susan
    et al.
    Mackenzie, Deborah
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    Atwell, Rick
    Guided Bone Augmentation around a Titanium Bone-Anchored Hearing Aid Implant in Canine Calvarium: An Initial Comparison of Two Barrier Membranes2007In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 9, no 1, p. 22-33Article in journal (Refereed)
    Abstract [en]

    Background: The placement of a bone-anchored hearing aid (BAHA) implant in young children may be hampered by the presence of thin, poor-quality calvarial bone. The use of extraskeletal guided skull bone augmentation around the titanium implant is one potential solution.

    Purpose: To compare the effectiveness of a collagen membrane BioSISt (Cook Biotech Inc., Lafayette, IN, USA) and a PGA/PLA barrier membrane, Osseoquest (W.L. Gore & Associates, Flagstaff, AZ, USA) in promoting extraskeletal bone formation, when combined with cancellous bone graft, around a titanium implant in the canine calvarium. The quality and quantity of bone tissue was compared.

    Materials and Methods: A 4-mm titanium BAHA implant was placed in the cranial parietal bone of 11 dogs. The implant protruded from the bone surface by a measured distance. Two groups, each of three dogs, received an implant, cancellous bone graft, and either a BioSISt or Osseoquest membrane. Three dogs received implant and bone graft (positive controls), and two received an implant only (negative controls). Samples were retrieved at 3, 6, and 9 months after placement. Undecalcified histologic and histomorphometric assessments were made of the augmented bone thickness, and bone gain factors were calculated for each sample group.

    Results: The process of osseointegration of the implants was ongoing and increased over time. Bone generation occurred with both test membranes and the early trabecular bone that formed, matured, and remodelled to compact bone at 9 months. BioSISt membrane samples showed superior quality and quantity of augmented bone compared with Osseoquest samples that exhibited thinner bone with persistent inflammation. Quantitatively, the BioSISt samples showed statistically greater new bone contact and bone area than both the positive and negative controls, whereas Osseoquest samples did not. The bone gain factor was statistically greater for BioSiSt samples when compared to the positive and negative controls whereas the Osseoquest samples were not.

    Conclusions: In this study, the collagen BioSISt membrane promoted bone formation of superior quality and quantity compared with the polyglycolic/polylactic acid-based Osseoquest membrane and positive and negative controls over 9 months. Further investigation of the use of the collagen BioSISt membrane for cranial bone augmentation is warranted.

  • 216. Sundfeldt, Mikael
    et al.
    Johansson, Carina B.
    Örebro University, Department of Health Sciences. Örebro University, Department of Clinical Medicine.
    Regnér, Lars
    Albrektsson, Tomas
    Carlsson, Lars V.
    Long-term results of a cementless knee prosthesis with a metal-backed patellar component: clinical and radiological follow-up with histology from retrieved components2003In: Journal of long-term effects of medical implants, ISSN 1050-6934, E-ISSN 1940-4379, Vol. 13, no 4, p. 341-354Article in journal (Refereed)
    Abstract [en]

    Aseptic loosening of cemented knee arthroplasties has encouraged development of uncemented fixation. The Miller-Galante I (MG I) prosthesis was designed to achieve permanent stability through ingrowth into a titanium fiber mesh. Thirty-five knees in 30 patients with MG I knee replacements have been followed clinically and radiologically with a mean follow-up of 12 years. Twenty knees were revised with a mean follow-up of 5 years. Patellofemoral problems, especially avulsion of the polyethylene from the metal-backed patella and in some cases severe metallosis, have been the main reason for revision. Metal-backed patellar component should be avoided. In addition, instability has been a problem. However, the fixation of the components has been excellent, with a high degree of osseous ingrowth displayed at histological analysis of retrieved components. The clinical and radiological results after revision are in most cases good, despite the femoral component having been left in situ.

  • 217.
    Svantesson, Mia
    et al.
    Örebro University, Department of Clinical Medicine.
    Sjökvist, Peter
    Thorsén, Håkan
    Örebro University, Department of Health Sciences.
    Ahlström, Gerd
    Nurses’ and physicians’ opinions on aggressiveness of treatment for general ward patients2006In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 2, p. 147-162Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate agreement between nurses’ and physicians’ opinions regarding aggressiveness of treatment and to investigate and compare the rationales on which their opinions were based. Structured interviews regarding 714 patients were performed on seven general wards of a university hospital. The data gathered were then subjected to qualitative and quantitative analyses. There was 86% agreement between nurses’ and physicians’ opinions regarding full or limited treatment when the answers given as ‘uncertain’ were excluded. Agreement was less (77%) for patients with a life expectancy of less than one year. Disagreements were not associated with professional status because the physicians considered limiting life-sustaining treatment as often as the nurses. A broad spectrum of rationales was given but the results focus mostly on those for full treatment. The nurses and the physicians had similar bases for their opinions. For the majority of the patients, medical rationales were used, but age and quality of life were also expressed as important determinants. When considering full treatment, nurses used quality-of-life rationales for significantly more patients than the physicians. Respect for patients’ wishes had a minor influence.

  • 218.
    Särnblad, Stefan
    et al.
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden .
    Ekelund, Ulf
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Medical Research Council Epidemiology Unit, Cambridge, U.K. .
    Åman, Jan
    Örebro University, Department of Clinical Medicine. Department of Pediatrics, University Hospital, Örebro, Sweden; Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden .
    Dietary fat intake predicts 1-year change in body fat in adolescent girls with type 1 diabetes2006In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 29, no 6, p. 1227-1230Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The purpose of this study was to determine whether objectively measured physical activity and dietary macronutrient intake differentially predict body fat in adolescent girls with type 1 diabetes and control girls.

    RESEARCH DESIGN AND METHODS: This study comprised 23 girls (12-19 years) with type 1 diabetes and 19 age-matched healthy control girls. At baseline, physical activity and energy intake were assessed for 7 consecutive days by accelerometry and a structured food diary, respectively. Body composition was measured by dual-energy X-ray absorptiometry at baseline and after 1 year.

    RESULTS: Fat intake was positively related to a 1-year change in percentage body fat (P = 0.006), after adjustment for total energy intake. No significant interaction was observed (case-control group x main exposure), indicating that the association between fat intake and gain in body fat was similar in both groups. Physical activity did not predict gain in body fat; however, total physical activity was positively associated with a gain in lean body mass (P < 0.01). Girls treated with six daily dosages of insulin increased their percentage of body fat significantly more than those treated with four daily injections (P < 0.05).

    CONCLUSIONS: In this prospective case-control study, we found that fat intake predicted gain in percentage of body fat in both adolescent girls with type 1 diabetes and healthy control girls. The number of daily insulin injections seems to influence the accumulation of body fat in girls with type 1 diabetes.

  • 219.
    Söderquist, Bo
    et al.
    Örebro University, Department of Clinical Medicine.
    Alriksson, Ingegerd
    Källman, Jan
    Örebro University, Department of Clinical Medicine.
    Kihlström, Erik
    The influence of adhesive and invasive properties of Staphylococcus aureus defective in fibronectin-binding proteins on secretion of interleukin-6 by human endothelial cells2006In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 114, no 2, p. 112-116Article in journal (Refereed)
    Abstract [en]

    Fibronectin-binding proteins (FnBP) are surface adhesins of Staphylococcus aureus documented to be virulence attributes in, for example, endovascular infections. By using mutants of S. aureus defective in the FnBPA and B genes we have investigated whether these adhesins affect cytokine expression in human umbilical vein endothelial cells (HUVEC). S. aureus expressing FnBPA and B adhered to and were internalized into HUVEC to a greater extent compared to mutants defective in expression of FnBP. Production and release of IL-6 was higher from endothelial cells infected with the parent FnBP-expressing strain compared to the FnBP-defective mutants. These results indicate that adhesion to and invasion of S. aureus into endothelial cells are important regulators of cytokine expression.

  • 220.
    Söderquist, Bo
    et al.
    Örebro University, Department of Clinical Medicine.
    Berglund, C.
    Strålin, K.
    Community-acquired pneumonia and bacteremia caused by an unusual methicillin-resistant Staphylococcus aureus (MRSA) strain with sequence type 36, staphylococcal cassette chromosome mec type IV and Panton-Valentine leukocidin genes2006In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 25, no 9, p. 604-606Article in journal (Refereed)
  • 221.
    Thuresson, Marie
    et al.
    Örebro University, Department of Clinical Medicine.
    Berglin Jarlöv, Marianne
    Lindahl, Bertil
    Svensson, Leif
    Zedigh, Crister
    Herlitz, Johan
    Symptoms and type of symptom onset in acute coronary syndrome in relation to ST elevation, sex, age, and a history of diabetes2005In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 150, no 2, p. 234-242Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Various efforts to reduce patient delay in acute coronary syndrome (ACS) have had limited success. One reason might be a misinterpretation of the symptoms of ACS. The aim of this study was therefore to explore the characteristics and severity of symptoms among patients with an ACS in overall terms and in relation to the type of ACS, sex, age, and diabetes.

    METHODS:

    A total of 1939 patients at 11 hospitals in Sweden answered a questionnaire containing questions relating to the localization and intensity of symptoms, the presence of associated symptoms, the characteristics and experience of pain/symptoms, and the type of symptom onset.

    RESULTS:

    Patients with ST elevation differed from those without by more frequently having associated symptoms. They had higher pain/discomfort intensity and more frequently had pain with abrupt onset reaching maximum intensity within minutes. However, this type of symptom onset was only seen in less than half the patients with ST elevation and only 1 in 5 fulfilled all the criteria usually associated with a severe heart attack. Women differed from men in a few respects. They more frequently reported pain/discomfort in the neck or jaw and back, vomiting, and scored their pain/discomfort slightly higher than men. Differences between age groups were minor and there was no difference between patients with and without diabetes.

    CONCLUSIONS:

    The most striking finding was the low proportion of patients with the type of symptoms that are commonly associated with ACS. This is important for the planning of educational campaigns/programs to reduce patient delay.

  • 222.
    Thuresson, Marie
    et al.
    Örebro University, Department of Clinical Medicine.
    Berglin Jarlöv, Marianne
    Lindahl, Bertil
    Svensson, Leif
    Zedigh, Crister
    Herlitz, Johan
    Thoughts, actions, and factors associated with prehospital delay in patients with acute coronary syndrome2007In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 36, no 6, p. 398-409Article in journal (Refereed)
    Abstract [en]

    Objective The objective was to study patients’ interpretations, thoughts, and actions after symptom onset in acute coronary syndrome (ACS) in total and in relation to gender, age, history of coronary artery disease, type of syndrome, and residential area and its influence on prehospital delay. Setting We performed a national survey comprising intensive cardiac care units at 11 hospitals in Sweden. Method A total of 1939 patients with diagnosed ACS and symptom onset outside hospital completed a questionnaire containing standardized questions within 3 days after admission. Results Three-quarters of the patients interpreted their symptoms as cardiac in origin, and the most common reason was that they knew someone who had had an acute myocardial infarction. The majority contacted a family member, whereas only 3% directly called for an ambulance. Interpreting the symptoms as cardiac in origin and severe pain were major reasons for deciding to seek medical care. Approaching someone after symptom onset and the belief that the symptoms were cardiac in origin were factors associated with a shorter prehospital delay, whereas taking medication to relieve pain resulted in the opposite. The reaction pattern was influenced by gender, age, a history of coronary artery disease, and the type of ACS, but to a lesser extent by residential area. Conclusions Interpreting symptoms as cardiac in origin and approaching someone after symptom onset were major reasons for a shorter prehospital delay in ACS.

  • 223. Thurfjell, Barbro
    et al.
    Eliasson, Mona
    Swenne, Ingemar
    von Knorring, Anne-Liis
    Engström, Ingemar
    Örebro University, Department of Clinical Medicine.
    Perceptions of gender ideals predict outcome of eating disorders in adolescent girls2006In: Eating Disorders, ISSN 1064-0266, E-ISSN 1532-530X, Vol. 14, no 4, p. 287-304Article in journal (Refereed)
    Abstract [en]

    Clinical features have low predictive value for the outcome of eating disorders. This study focuses on the possible predictive value of gender ideals. Data was from adolescent girls thoroughly assessed both at presentation and at a three-year follow up. Few variables differed between the outcome groups. However, perceptions of gender ideals, as measured by the Three Questions of Ideals, were found to contribute to the prediction of outcome. A discriminant analysis showed that gender ideals, maturity fears, sexual debut, and vomiting were significant discriminators in a set of factors, which correctly classified the outcome for 75.3% of the sample.

  • 224. Thurfjell, Barbro
    et al.
    von Knorring, Anne-Liis
    Eliasson, Mona
    Swenne, Ingemar
    Engström, Ingemar
    Örebro University, Department of Clinical Medicine.
    Perceived and individual ideals of gender in Swedish adolescents with and without an eating disorder2006In: Eating Disorders, ISSN 1064-0266, E-ISSN 1532-530X, Vol. 14, no 1, p. 55-72Article in journal (Refereed)
    Abstract [en]

    Three open-ended questions based on Steiner-Adair (1986) were used to study gender concepts in relation to ideals in adolescent boys and girls and eating-disordered girls. The answers were coded according to themes emanating from the collected data and not predetermined. Dichotomous differences were found between the genders regarding perceived ideals of body size, but clinical and nonclinical girls perceived ideals of society and media similarly. Individual gender concepts differed substantially from the perceived ideals, and were most often focused on lifestyle and life conditions. However, the clinical girls were somewhat more likely to emphasize appearance and loving relationships.

  • 225.
    Uggla, Bertil
    et al.
    Department of Medicine, Örebro University Hospital, Örebro; Karolinska Institute, Stockholm.
    Ståhl, Elisabet
    Clinical Research Centre, Örebro University Hospital, Örebro.
    Wågsäter, Dick
    Örebro University, Department of Nursing and Caring Sciences.
    Paul, Christer
    Department of Haematology, Huddinge University Hospital, Stockholm; Karolinska Institute, Stockholm.
    Karlsson, Mats G.
    Department of Pathology, Örebro University Hospital, Örebro.
    Sirsjö, Allan
    Örebro University, Department of Nursing and Caring Sciences.
    Tidefelt, Ulf
    Örebro University, Department of Clinical Medicine. Department of Medicine, Örebro University Hospital, Örebro.
    BCRP mRNA expression v. clinical outcome in 40 adult AML patients2005In: Leukemia research: a Forum for Studies on Leukemia and Normal Hemopoiesis, ISSN 0145-2126, E-ISSN 1873-5835, Vol. 29, no 2, p. 141-146Article in journal (Refereed)
    Abstract [en]

    Efflux pumps are considered being mechanisms behind drug resistance in acute myeloid leukaemia (AML). A recently described efflux pump, breast cancer resistance protein (BCRP), can be expressed in AML, but its clinical importance is uncertain. In this study BCRP mRNA expression was determined in samples from 40 AML patients by real-time RT-PCR. The expression varied from negative to 76 times that of control cells. There was no difference in BCRP mRNA expression between patients responding to induction treatment and non-responders. However, in the group of responders, the 14 patients with the highest expression had significantly shorter overall survival (mean 38 months, SEM 15 months) than the 14 patients with the lowest (74 months, SEM 16 months) (P = 0.047). This suggests a possible role of BCRP in drug resistance in AML.

  • 226.
    Uggla, Bertil
    et al.
    Department of Medicine, Örebro University Hospital, Örebro.
    Tina, Elisabet
    Clinical Research Centre, Örebro University Hospital, Örebro.
    Nahi, Hareth
    Department of Clinical Hematology, Karolinska University Hospital, Huddinge, Stockholm; Karolinska Institute, Stockholm.
    Paul, Christer
    Department of Clinical Hematology, Karolinska University Hospital, Huddinge, Stockholm; Karolinska Institute, Stockholm.
    Höglund, Martin
    Department of Haematology, Uppsala University Hospital, Uppsala,.
    Sirsjö, Allan
    Örebro University, Department of Clinical Medicine.
    Tidefelt, Ulf
    Örebro University, Department of Clinical Medicine. Department of Medicine, Örebro University Hospital, Örebro.
    Topoisomerase IIα mRNA and protein expression vs. in vitro drug resistance and clinical outcome in acute leukaemia2007In: International Journal of Oncology, ISSN 1019-6439, Vol. 31, no 1, p. 153-160Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to correlate the expression of topoisomerase (topo) IIalpha to in vitro drug sensitivity and to the clinical outcome in patients with acute leukaemia. Leukaemic cells were isolated from bone marrow or blood from 94 patients. Topo IIalpha mRNA (n=58) and protein (n=60) expression was determined by real-time RT-PCR and flow cytometry, respectively. In both groups, chemosensitivity testing by a bioluminescence ATP assay was performed to a variable extent for both topo IIalpha poisons and non-topo IIalpha targeting drugs. Topo IIalpha mRNA expression varied with relative values ranging from 0.03 to 14.20 (median 1.10). The median value for topo IIalpha protein-positive cells was 23% (range 0-99%). Cell samples from patients with a high (>median value) percentage of topo IIalpha-positive cells were significantly more sensitive to the topo IIalpha active drugs etoposide and daunorubicin, and showed a borderline value for idarubicin (p=0.08), while there was no difference for non-topo IIalpha targeting drugs. However, we did not find any significant differences in mRNA expression or the percentage of topo IIalpha-positive cells in patients who achieved complete remission after at most two induction courses compared with those who did not, nor did we find any difference in survival when patients with high mRNA expression/percentage of topo IIalpha-positive cells were compared with patients with low values. We conclude that expression of topo IIalpha, determined as percentage of topo IIalpha-positive cells, in leukaemic cells correlates to chemosensitivity in vitro against topoisomerase poisons but that it does not predict clinical outcome in acute leukaemia.

  • 227.
    Unemo, Magnus
    et al.
    Örebro University, Department of Clinical Medicine.
    Savicheva, A.
    Budilovskaya, O.
    Sokolovsky, E.
    Larsson, M.
    Domeika, M.
    Laboratory diagnosis of Neisseria gonorrhoeae in St Petersburg, Russia: inventory, performance characteristics and recommended optimisations2006In: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 82, no 1, p. 41-44Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To perform a comprehensive inventory of the number of samples, performance characteristics, and quality assurance of the laboratory diagnosis of Neisseria gonorrhoeae at five laboratories in St Petersburg and Leningradskaya Oblast, Russia, in 2004, and to recommend optimisations for an increased adherence to international evidence based recommendations of diagnostics. METHODS: Surveillance data were obtained with questionnaire and site visits. For evaluation of the culture media utilised at the laboratories, N gonorrhoeae reference strains (n = 29) were used. RESULTS: During 2004 the total numbers of N gonorrhoeae samples analysed at the five laboratories using microscopy of stained smears and culturing were 330 879 (407 positive) and 38 020 (420 positive), respectively. Four laboratories used a Russian non-selective culture medium-that is, Complegon, and one laboratory utilised Biocult-GC. Both media seemed suboptimal. Only two of the laboratories used any species confirmative assay. Antibiotic susceptibility testing of N gonorrhoeae was performed at only two of the laboratories and each year only occasional isolates were analysed. None of the laboratories comprised a complete laboratory quality assurance system. CONCLUSIONS: According to international recommendations, the diagnosis of N gonorrhoeae in St Petersburg and Leningradskaya Oblast, Russia, is suboptimal. More samples need to be analysed by culturing on a highly nutritious and selective medium and, furthermore, species confirmation and antibiotic susceptibility testing should be more frequently performed. In addition, the utilised methods for culturing and antibiotic susceptibility testing, including medium and interpretative criteria used, ought to be optimised, standardised, and quality assured using systematic internal and external quality controls.

  • 228. Vagoras, A.
    et al.
    Butylkina, R.
    Juseviciute, V.
    Hallén, A.
    Unemo, Magnus
    Örebro University, Department of Clinical Medicine.
    Domeika, M.
    Diagnosis of non-viral sexually transmitted infections in Lithuania and international recommendations2006In: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 11, no 7, p. 161-164Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to evaluate the range, quality and availability of diagnostic services for non-viral sexually transmitted infections (STIs), i.e. C. trachomatis, N. gonorrhoeae, T. vaginalis and T. pallidum, in Lithuania from September 2002 to December 2003. Surveillance data describing the organisation and performance characteristics of non-viral STI diagnostic services in Lithuania were collected using a questionnaire and subsequent site-visits. International evidence-based recommendations for non-viral STI diagnosis were used to evaluate the quality of the STI diagnostics. There were 171 facilities providing non-viral STI diagnostic services for the 3.5 million inhabitants of Lithuania. However, only 6% (n=9) of the respondents (n=153) could provide a confirmatory diagnosis, in accordance with international recommendations, for the full minimum range of relevant non-viral STIs in Lithuania, i.e. C. trachomatis, N. gonorrhoeae, T. pallidum, and T. vaginalis. In addition, accessibility to STI diagnostic services differed significantly among the different counties in Lithuania. Several of the respondents analysed low numbers of samples each year, and overall the sampling size was extremely low, especially for C. trachomatis diagnostics. In Lithuania, optimisation of non-viral STI diagnostics as well as of epidemiological surveillance and management of STIs is crucial. It may be worth considering a decrease in the number of laboratories, with those remaining having the possibility of performing STI diagnostic services that are optimised, in concordance with international recommendations, standardised, and quality assured using systematic internal and external quality controls and systems. In addition, establishment of national inter-laboratory networks and reference centres for non-viral STIs is recommended.

  • 229. van Ampting, Marleen T. J.
    et al.
    Schonewille, Arjan J.
    Vink, Carolien
    Brummer, Robert
    Örebro University, Department of Clinical Medicine.
    van der Meer, Roelof
    Bovee-Oudenhoven, Ingeborg M. J.
    Intestinal barrier function in response to abundant or depleted mucosal glutathione in Salmonella-infected rats2009In: BMC Physiology, ISSN 1472-6793, E-ISSN 1472-6793, Vol. 9, p. 6-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Glutathione, the main antioxidant of intestinal epithelial cells, is suggested to play an important role in gut barrier function and prevention of inflammation-related oxidative damage as induced by acute bacterial infection. Most studies on intestinal glutathione focus on oxidative stress reduction without considering functional disease outcome. Our aim was to determine whether depletion or maintenance of intestinal glutathione changes susceptibility of rats to Salmonella infection and associated inflammation.Rats were fed a control diet or the same diet supplemented with buthionine sulfoximine (BSO; glutathione depletion) or cystine (glutathione maintenance). Inert chromium ethylenediamine-tetraacetic acid (CrEDTA) was added to the diets to quantify intestinal permeability. At day 4 after oral gavage with Salmonella enteritidis (or saline for non-infected controls), Salmonella translocation was determined by culturing extra-intestinal organs. Liver and ileal mucosa were collected for analyses of glutathione, inflammation markers and oxidative damage. Faeces was collected to quantify diarrhoea. RESULTS: Glutathione depletion aggravated ileal inflammation after infection as indicated by increased levels of mucosal myeloperoxidase and interleukin-1beta. Remarkably, intestinal permeability and Salmonella translocation were not increased. Cystine supplementation maintained glutathione in the intestinal mucosa but inflammation and oxidative damage were not diminished. Nevertheless, cystine reduced intestinal permeability and Salmonella translocation. CONCLUSION: Despite increased infection-induced mucosal inflammation upon glutathione depletion, this tripeptide does not play a role in intestinal permeability, bacterial translocation and diarrhoea. On the other hand, cystine enhances gut barrier function by a mechanism unlikely to be related to glutathione.

  • 230. van Steenberghe, Daniel
    et al.
    Johansson, Carina B.
    Örebro University, Department of Health Sciences. Örebro University, Department of Clinical Medicine.
    Quirynen, Marc
    Molly, Liene
    Albrektsson, Tomas
    Naert, Ignace
    Bone augmentation by means of a stiff occlusive titanium barrier: a study in rabbits and humans2003In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 14, no 1, p. 63-71Article in journal (Refereed)
    Abstract [en]

    It has already been shown that occlusive titanium barriers have osteoconductive properties. These barriers, however, cover only a limited surface area and have only been used in animal experiments. The aim of this study was to evaluate bone neogenesis under a pre-shaped titanium barrier placed over the top of the rabbit skull and the top of highly resorbed edentulous upper-jaw bone in patients. Computed tomography (CT) scans made it possible to pre-shape the titanium barrier according to individual bone shape in human experiments. On the rabbit skull, tissue augmentation of up to 6 mm 1 year after barrier placement was observed, while the original thickness of skull bone was on average between 1.5 and 2.5 mm. The bone, which remained histologically immature for 1 year, grew systematically along the titanium surface, illustrating its osteoconductivity. Even after removal of the barrier, on average, 75.3 and 59.4% of the newly created tissue volume was maintained after 3 and 9 months, respectively. Clinical observations on 10 consecutive patients showed that, in those (5/10) in which the barrier remained unexposed for several months, an increase of the jawbone height and width of up to 16 mm could be observed when the barrier was removed after 12-18 months. As in the rabbits at barrier removal, the bone demonstrated a limited degree of mineralization as ascertained from biopsies. This newly formed osteoid tissue allowed the insertion of 33 screw-shaped titanium implants which in most cases (30/33) successfully osseointegrated to support a fixed prosthesis. The surrounding marginal bone level remained stable even up to 5 years after implant placement. Both animal and clinical data demonstrate that guided bone neogenesis under a subperiosteally placed titanium barrier can reach large volumes.

  • 231. Veldhorst, Margriet A. B.
    et al.
    Nieuwenhuizen, Arie G.
    Hochstenbach-Waelen, Ananda
    Westerterp, Klaas R.
    Engelen, Marielle P. K. J.
    Brummer, Robert
    Örebro University, Department of Clinical Medicine.
    Deutz, Nicolaas E. P.
    Westerterp-Plantenga, Margriet S.
    A breakfast with alpha-lactalbumin, gelatin, or gelatin+TRP lowers energy intake at lunch compared with a breakfast with casein, soy, whey, or whey-GMP2009In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 28, no 2, p. 147-155Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: Dietary protein plays a role in body weight regulation, partly due to its effects on satiety. The objective was to compare the effects of casein-, soy-, whey-, whey without glycomacropeptide (GMP)-, alpha-lactalbumin-, gelatin-, or gelatin with tryptophan (TRP)-protein breakfasts at two concentrations on subsequent satiety and energy intake (EI). METHODS: Twenty-four healthy subjects (mean+/-SEM BMI: 24.8+/-0.5 kg/m(2); age: 25+/-2 years) received a breakfast; a custard with casein, soy, whey, whey-GMP, alpha-lactalbumin, gelatin, or gelatin+TRP as protein source with either 10/55/35 (normal) or 25/55/20 (high) En% protein/carbohydrate/fat in a randomized, single-blind design. At the precedingly determined time point for lunch, 180 min, subjects were offered an ad lib lunch. Appetite profile (Visual Analogue Scales, VAS) and EI were determined. RESULTS: Both at the level of 10 and 25 En% from protein, EI at lunch was approximately 20% lower after an alpha-lactalbumin or gelatin (+TRP) breakfast (2.5+/-0.2 MJ) compared with after a casein, soy, or whey-GMP breakfast (3.2+/-0.3 MJ, p<0.05). Appetite ratings at 180 min differed 15-25 mm (approximately 40%, p<0.05) between types of protein. Differences in EI were a function of differences in appetite ratings (R(2)=0.4, p<0.001). CONCLUSIONS: Different proteins (alpha-lactalbumin, gelatin, gelatin+TRP) that are approximately 40% more satiating than other proteins (casein, soy, whey, whey-GMP) induce a related approximately 20% reduction of subsequent energy intake.

  • 232. Vignoletti, Fabio
    et al.
    Johansson, Carina B.
    Örebro University, Department of Clinical Medicine.
    Albrektsson, Tomas
    Sanctis, Massimo De
    Roman, Fidel San
    Sanz, Mariano
    Early healing of implants placed into fresh extraction sockets: an experimental study in the beagle dog. De novo bone formation2009In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, no 3, p. 265-277Article in journal (Refereed)
    Abstract [en]

    Objectives: Describe the early phases of tissue integration in implants placed into fresh extraction sockets and test whether a new implant surface nano-topography (DCD nano-particles, Nanotite) promotes early osseointegration when compared with minimally rough surface implants (DAE, Osseotite®).

    Material and Methods: Sixteen beagle dogs received 64 test and control implants randomly installed into the distal socket of 3P3 and 4P4. Histomorphometric analysis of bone to implant contact (BIC) and bone area was performed at 4 h, 1, 2, 4 and 8 weeks.

    Results: Wound healing initiated with a coagulum that was substituted by a provisional matrix at 1 week. Bone formation started concomitant to a marked bone resorption. At 2 weeks, woven bone formation was evident and gradually remodelled into lamellar bone at 4 and 8 weeks. BIC increased similarly throughout the study in both groups with a tendency to higher percentages for the test devices at 2 and 4 weeks. The influence of the DCD nano-particles was more evident at the fourth premolar site.

    Conclusion: Osseointegration occurred similarly at both implant groups, although the socket dimension appeared to influence bone healing. It is suggested that the enhanced nano-topography has a limited effect in the immediate implant surgical protocol.

  • 233.
    von Beckerath, Mathias P.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Dept Otolaryngol & Head & Neck Surg, Örebro University Hospital, Örebro, Sweden.
    Reizenstein, Johan A.
    Dept Oncol, Örebro Univ Hosp, Örebro, Sweden.
    Berner, Attila L.
    Dept Otolaryngol & Head & Neck Surg, Örebro Univ Hosp, Örebro, Sweden.
    Nordqvist, Kent W. O.
    Dept Logoped & Phoniatr, Örebro Univ Hosp, Örebro, Sweden.
    Landström, Fredrik J.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Dept Otolaryngol & Head & Neck Surg, Örebro Univ Hosp, Örebro, Sweden.
    Löfgren, Axel Lennart
    Örebro University, Department of Clinical Medicine. Dept Otolaryngol & Head & Neck Surg, Örebro Univ Hosp, Örebro, Sweden.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Audiology Reseach Center, Örebro University Hospital, Örebro, Sweden.
    Outcome of primary treatment of early laryngeal malignancies using photodynamic therapy2014In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, no 8, p. 852-858Article in journal (Refereed)
    Abstract [en]

    Conclusion: Photodynamic therapy (PDT) is a viable and safe option for early laryngeal cancer that would be less suitably treated with radiation or trans-oral laser surgery (TLS). The cure rates with PDT appear to be comparable to those of conventional therapy, and the voice outcomes are also comparable. In the case of many sarcomas, PDT appears to be an organ- and function-sparing therapy, although it is more costly than other treatments.

    Objectives: The aim of this study was to show the results of PDT when it is used as a primary treatment of early laryngeal cancer. Methods: We studied the results of PDT when used as a primary treatment. We looked at survival, effect on tumor, side effects, voice, and costs.

    Results: The follow-up period was a median of 59 months. Nine of 10 patients were cured of their laryngeal cancer. PDT alone cured seven patients. All four of the sarcomas were cured using temoporfin. Two of three tumors that involved the anterior commissure were cured using only interstitial illumination with PDT. No serious side effects were noted. The patient's voices were improved after treatment in 5 of 10 cases, and none had a worsened voice.

  • 234.
    von Wright, Moira
    et al.
    Örebro University, Department of Education.
    van Mansvelt, Erik
    Örebro University, Department of Clinical Medicine.
    Surprise and concerted action: an inquiry into changing patterns of interaction in communicative situations where lived experience breaks the monopoly of authoritative knowledge2006Conference paper (Other academic)
  • 235.
    Wegman [Palmebäck-Wegman], Pia
    et al.
    Örebro University, School of Health and Medical Sciences.
    Marcus, Nashwan J.
    Linköpings Universitet.
    Malakkaran [Lindqvist], Breezy Paul
    Örebro University, School of Health and Medical Sciences.
    Wingren, Sten
    Örebro University, Department of Clinical Medicine.
    Biological significance of allele specific loss of the p53 gene in breast carcinomas2009In: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 118, no 1, p. 15-20Article in journal (Refereed)
    Abstract [en]

    The p53 tumor suppressor gene has a central role in the defense against cancer, including breast cancer, and contains a polymorphic variant (Arg/Pro) at codon 72 that has been shown to have different biological properties regarding apoptosis and cell cycle arrest. Earlier studies have shown allele specific loss of heterozygosity (LOH) at this particular site and we aimed to investigate its biological relevance in codon 72 heterozygous breast cancer patients (i.e., survival and age of disease onset). 199 postmenopausal cases were analyzed for LOH using MegaBACE1000 and statistics was performed using Statistical Package for Social Sciences. LOH was found in totally 124 (62.3%) patients and the Pro allele (n = 103) was significantly more often deleted compared to the Arg allele (n = 21) (P = 0.001). Patients with LOH of the Arg allele were diagnosed at an earlier age (mean age 62.5 years) than those with loss of the Pro allele (mean age 69.2 years) (P = 0.011). LOH of the Arg allele was also associated with worse survival (P = 0.05). LOH in comparison to ROH correlated significantly with increased S-phase fraction. Tumor size, stage or number of positive lymph nodes was not related to LOH. Our results and earlier findings suggest a selective loss of the Pro allele during carcinogenesis that might confer a growth advantage for cancer cells. On the other hand, it appears to be more harmful for patients to loose the Arg allele since we found that loss of this allele was associated with earlier onset and worse prognosis.

  • 236.
    Westman, Anders
    et al.
    Örebro University, Department of Clinical Medicine.
    Linton, Steven J.
    Örebro University, Department of Behavioural, Social and Legal Sciences.
    Theorell, Töres
    Stressforskninginsinstitutet, Stockholms universitet.
    Öhrvik, John
    Inst för medicin, Enh för kardiologi, Karolinska institutet, Stockholm.
    Wahlén, Petra
    Centre for Clinical Research,Uppsala University-Västerås Hospital.
    Leppert, Jerzy
    Quality of life and maintenance of improvements after early multimodal rehabilitation: a 5-year follow-up2006In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 28, no 7, p. 437-446Article in journal (Refereed)
    Abstract [en]

    Purpose. There is a paucity of long-term evaluations on rehabilitation of musculoskeletal disorders, e.g., neck, shoulder or back pain. The aim of this study was to assess quality of life and the effect of early multimodal rehabilitation on 91 patients with musculoskeletal pain and disability at a 5-year follow-up.

    Method. The follow-up assessment, which included questions on pain, function, quality of life, perceived health, sick leave and psychosomatic symptoms, was performed 5 years after the assessment of baseline status.

    Results. Improvements in pain, perceived health and psychosomatic symptoms were maintained at the 5-year follow-up. In addition, improvements in function, quality of life, and level of acceptable pain were significant in comparison to baseline. At the time of the baseline assessment all patients were on sick leave (13% were on partial sick leave). At the 5-year follow-up, 58% of the patients were at work part or full time. The results show that those working differed significantly from those not working at the 5-year follow-up on almost all variables, indicating that those working enjoy better health. The most salient prognostic factors for return to work were perceived health and educational level at the time of the baseline evaluation.

    Conclusions. These results show that treatment improved quality of life and the effects were basically maintained at 5 years. Work capacity as reflected in return to work increased greatly (81%) at a 1-year follow-up and was substantial (58%) at the 5-year follow-up. Moreover, perceived health and educational levels were important prognostic factors. Finally, the fact that patients working reported better health underscores the probable importance of return to work. Our results imply that it may be feasible to obtain long-term benefits from such a primary care-based intervention.

  • 237.
    Westman, Anders
    et al.
    Örebro University, Department of Clinical Medicine. Psychosomat Med Clin, Västmanlands sjukhus, Västerås, Sweden.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Öhrvik, John
    Cent Hosp, Clin Res Ctr, Uppsala Univ, Västerås, Sweden.
    Wahlén, Petra
    Cent Hosp, Clin Res Ctr, Uppsala Univ, Västerås, Sweden.
    Theorell, Töres
    Stress Res Inst, Stockholm Univ, Stockholm, Sweden.
    Leppert, Jerzy
    Cent Hosp, Clin Res Ctr, Uppsala Univ, Västerås, Sweden.
    Controlled 3-year follow-up of a multidisciplinary pain rehabilitation program in primary health care2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 4, p. 307-316Article in journal (Refereed)
    Abstract [en]

    Purpose: The high prevalence of musculoskeletal pain generates significant costs for primary health care and the whole of society. The development of appropriate interventions is therefore necessary. The aim of this effectiveness study was to assess the long-term effects of a primary health care multidisciplinary rehabilitation program in Sweden.

    Methods: An experimental group comprising 89 patients from two primary health care units received individualised treatment interventions after a multidisciplinary investigation. A control group of 69 patients with the same inclusion criteria from four other primary health care units were treated according to routine. All participants completed questionnaires measuring pain, sick leave, quality of life, health care utilisation, drug consumption and psychosocial factors at baseline and at 3-year follow-up.

    Results: After 3 years, utilisation of primary health care was significantly lower in the experimental group and work capacity was slightly but not significantly higher. The control group showed a trend of having a higher risk of high consumption after 3 years compared to the intervention group. There was no significant difference between the two groups concerning remaining variables such as function, catastrophising and pain.

    Conclusion: Both groups demonstrated considerable improvement over the course of 3 years. The experimental group had lower health care utilisation and a reduced risk of using large amounts of medication at the 3-year follow-up, indicating that compared with participants in the control group they were coping in a better way with pain.

  • 238. Wickbom, Anna
    et al.
    Lindqvist, Magnus
    Bohr, Johan
    Ung, Kjell-Arne
    Bergman, Jan
    Eriksson, Sune
    Tysk, Curt
    Örebro University, Department of Clinical Medicine.
    Colonic mucosal tears in collagenous colitis2006In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 41, no 6, p. 726-729Article in journal (Refereed)
    Abstract [en]

    In general, the colonic mucosa is macroscopically normal in collagenous colitis, although minor, non-specific abnormalities may be found. Significant endoscopic abnormalities, "mucosal tears" representing longitudinal mucosal lacerations, have been reported in a few patients with collagenous colitis. We report the cases of three women with collagenous colitis and mucosal tears detected at the index colonoscopy in order to illustrate the endoscopic characteristics and review the literature. Including the present cases, a total of 12 patients with mucosal tears and collagenous colitis have been reported. In 10 patients, the mucosal lacerations involved the ascending or the transverse colon. Three of the 12 patients had a colonic perforation immediately after the colonoscopy. The colonoscopist should be aware that the risk of perforation is likely to be increased when mucosal tears are present.

  • 239.
    Wiesel, F.-A.
    et al.
    Department of Neuroscience Psychiatry, Uppsala University Hospital, Uppsala, Sweden.
    Bjerkenstedt, L.
    Department of Clinical Neuroscience, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden.
    Edman, G.
    Department of Psychiatry, R&D Section, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
    Flyckt, L.
    Department of Psychiatry, R&D Section, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
    Venizelos, Nikolaos
    Örebro University, Department of Clinical Medicine.
    The complexity of using D2-dopamine antagonists in the treatment of patients with schizophrenia2007In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 22, p. S5-S6Article in journal (Refereed)
    Abstract [en]

    Schizophrenia is a complex disorder and the view that schizophrenia is caused by hyperdopaminergic activity is an oversimplification. In fact, there are clinical evidence in accordance with a hypodopaminergic condition. Thus, untreated patients show motor disturbances in line with a decreased dopamine activity in the extrapyramidal system, likewise cognitive deficits and negative symptoms.

     

    In our research we have explored the evidence of schizophrenia as a hyper- or hypodopaminergic condition. With Positron Emission Tomography (PET) we have not seen any evidence of increased D2-dopamine receptors in the brain of never medicated patients. The major dopamine metabolite homovanillic acid (HVA) was lowered in CSF in line with a decreased dopamine turnover in the brain. Tyrosine is precursor to the synthesis of dopamine and for that aim we have made transport studies in an in vitro model with fibroblasts to determine tyrosine kinetics.

     

    The results demonstrated that tyrosine transport is lower in patients with schizophrenia in comparison to healthy controls. Tyrosine kinetics measured with PET demonstrated dysregulation of tyrosine transport into the brain.

    We have found evidence of schizophrenia as a hypodopaminergic condition. This fact is a problem realizing that our antipsychotics are D2-dopamine antagonists, thus decreasing dopamine activity even further.

    The concept of schizophrenia as both a hypo- and hyperdopaminergic condition may explain why clozapine, a week D2-antagonist, works more efficiently than other antipsychotic compounds. It should be recognized that positive symptoms are, at least partly, related to changes in dopamine activity and therefore respond very efficiently to D2-dopamine antagonists.

  • 240.
    Windahl, Torgny
    Örebro University, Department of Clinical Medicine.
    Clinical aspect of laser treatment of lichen sclerosus and squamous cell carcinoma of the penis2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of these studies was to investigate the efficacy, complications and the long term results after laser treatment of lichen sclerosus et atrophicus and of squamous cell carcinoma of the penis.

    Patients and Methods: Paper I: In a prospective study from 1985-1991, 62 men with histologically verified lichen sclerosus et atrophicus were given carbon dioxide (CO2) laser treatment following the failure of local corticosteroid treatment. The study was subsequently updated at a median follow-up time of 14 years.

    Paper II-IV: Sixty-seven men aged 26 to 87 (mean 60 years) with newly diagnosed penile carcinoma were included in a prospective study. The patients were treated by a new combined laser method (CO2 and Nd:YAG) between 1986 and 2000. The median follow-up time was 42 months (range 12-186 months). All patients could be assessed for local recurrence, progression and survival at the end of 2001. Forty-six patients agreed to participate in face-to-face interviews addressing sexual activity, sexual function/dysfunction, satisfaction and cosmetic results.

    Results: Paper I: The laser treatment was successful in 47 patients (76%) with no local symptoms at a mean follow-up of 30 months. Fifty-three of the 62 men were alive when the update was carried out in February 2004, and we were able to get in contact with 50 of them. Forty of these patients (80%) had no local symptoms or visible lesion. We found concomitant squamous cell carcinoma of the penis in two patients and two further patients had died from anal cancer.

    Paper II-IV: Local recurrences appeared in 13 patients (19%) at a median follow up of 42 months, and 10 of these patients were successfully retreated with laser treatment. Two patients died from penile carcinoma. The disease-specific 5-years survival rate was 95%. Concomitant lichen sclerosus was found in 11 patients. All patients younger than 75 years reported that they were sexually active before the treatment, and 80% of them had resumed their sexual activity after the treatment. Ten patients (22%) reported decreased erectile function after the treatment, while 33 patients (72%) reported unaltered erectile function. The cosmetic result was regarded as satisfying or very satisfying in 78% of the patients.

    Conclusion: Carbon dioxide laser treatment is an efficient treatment for lichen sclerosus et atrophicus with excellent long-term results, and the side effects are few. One disadvantages of the treatment is a slow postoperative healing process. Combined CO2 and Nd:YAG laser treatment is effective for treatment of the primary tumour in patients with localized penile carcinoma. It can be safely carried out with good local tumour control and highly satisfactory results with respect to cosmetic aspects and sexual function.

    List of papers
    1. Carbon dioxide laser treatment of lichen sclerosus et atrophicus
    Open this publication in new window or tab >>Carbon dioxide laser treatment of lichen sclerosus et atrophicus
    1993 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 150, no 3, p. 868-870Article in journal (Refereed) Published
    Abstract [en]

    We followed 62 men treated with the carbon dioxide laser for lichen sclerosus et atrophicus for an average of 30 months (3 months to 7 years). Of the patients 47 (76%) became asymptomatic and 10 (16%) had minor residual symptoms. In 26 patients (40%) concomitant superficial meatal stenosis was simultaneously treated with laser meatotomy. The cosmetic and functional results of treatment were highly encouraging. Provided that radicality is achieved at the primary application, the carbon dioxide laser is an excellent therapeutic modality for lichen sclerosus et atrophicus.

    National Category
    Medical and Health Sciences
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-3148 (URN)8345602 (PubMedID)
    Available from: 2004-05-19 Created: 2004-05-19 Last updated: 2017-12-14Bibliographically approved
    2. Laser treatment of localized squamous cell carcinoma of the penis
    Open this publication in new window or tab >>Laser treatment of localized squamous cell carcinoma of the penis
    1995 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 154, no 3, p. 1020-1023Article in journal (Refereed) Published
    Abstract [en]

    PURPOSE:

    We evaluate the efficacy and morbidity of laser and conventional treatment in 32 men with penile cancer.

    MATERIALS AND METHODS:

    Of 32 men treated for squamous cell carcinoma of the penis observed for an average of 44 months 19 were treated with the combined carbon dioxide and neodymium: YAG lasers. The 13 patients treated conventionally had more advanced disease and they were a mean 17 years older than those in the laser treated group.

    RESULTS:

    All laser treated patients were disease-free after a mean of 31 months. Among the 13 conventionally treated patients there were only 5 long-term survivors.

    CONCLUSIONS:

    The cosmetic and functional outcome of laser treatment for stages Tis to T2N0M0, grades 1 and 2 squamous cell carcinoma of the penis is excellent, and the associated morbidity rate is low.

    National Category
    Medical and Health Sciences
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-3149 (URN)7637046 (PubMedID)
    Available from: 2004-05-19 Created: 2004-05-19 Last updated: 2017-12-14Bibliographically approved
    3. Combined laser treatment for penile carcinoma: results after long-term followup
    Open this publication in new window or tab >>Combined laser treatment for penile carcinoma: results after long-term followup
    2003 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 169, no 6, p. 2118-2121Article in journal (Refereed) Published
    Abstract [en]

    PURPOSE:

    We evaluated local disease control, side effects and cause specific survival of penile carcinoma treated with laser therapy.

    MATERIALS AND METHODS:

    In a prospective study from 1986 to 2002 we included 67 men with a mean age of 60 years with newly diagnosed penile carcinoma. No patient was lost to followup.

    RESULTS:

    At a median followup of 42 months (range 12 to 186) 59 patients were alive and 8 had died of penile carcinoma (2) and concurrent disease (6). Of the 13 patients (19%) with local recurrence during the study period 10 underwent repeat laser treatment successfully. Side effects were few but 5 patients (7%) had postoperative bleeding. Overall cosmetic and functional results were highly satisfactory.

    CONCLUSIONS:

    The results of this study show that treating penile carcinoma with the combination of carbon dioxide and neodymium:YAG lasers can safely be done with highly satisfactory cosmetic results as well as good local tumor control

    National Category
    Medical and Health Sciences
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-3150 (URN)10.1097/01.ju.0000067361.81295.a2 (DOI)12771731 (PubMedID)
    Available from: 2004-05-19 Created: 2004-05-19 Last updated: 2017-12-14Bibliographically approved
    4. Sexual function and satisfaction in men after laser treatment for penile carcinoma
    Open this publication in new window or tab >>Sexual function and satisfaction in men after laser treatment for penile carcinoma
    2004 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 172, no 2, p. 648-651Article in journal (Refereed) Published
    Abstract [en]

    Purpose:

    We evaluate sexual function, sexual satisfaction and cosmetic results after laser treatment of penile carcinoma.

    Materials and Methods:

    A total of 67 patients were treated at our clinic for penile cancer using combined carbon dioxide and neodymium:YAG lasers from 1986 to 2000. At the time of this study 58 men, with a mean age of 64 years were alive, of whom 46 (79%) agreed to participate in a structured face-to-face interview addressing sexual function, sexual satisfaction and cosmetic results. The length of time that had elapsed since treatment ranged from 6 months to 15 years (median 3 years).

    Results:

    Of 40 patients (87%) who had been sexually active before treatment 30 (75%) had resumed activities at the time of the interview. Unaltered erectile function after treatment was reported by 33 patients (72%), 10 patients (22%) reported decreased function and 3 (6%) reported improved function. Of the 46 patients 23 (50%) were satisfied/very satisfied with their sexual life. After treatment only 3 of 30 (10%) of the evaluable men had dyspareunia. The cosmetic results were considered satisfying/very satisfying by 36 (78%) men.

    Conclusions:

    Laser treatment of localized penile carcinoma preserves the penis and generally provides satisfactory sexual function and cosmetic results.

    National Category
    Medical and Health Sciences
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-3151 (URN)10.1097/01.ju.0000132891.68094.87 (DOI)
    Available from: 2004-05-19 Created: 2004-05-19 Last updated: 2017-12-14Bibliographically approved
  • 241.
    Windahl, Torgny
    et al.
    Örebro University, Department of Clinical Medicine.
    Andersson, Swen-Olof
    Combined laser treatment for penile carcinoma: results after long-term followup2003In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 169, no 6, p. 2118-2121Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    We evaluated local disease control, side effects and cause specific survival of penile carcinoma treated with laser therapy.

    MATERIALS AND METHODS:

    In a prospective study from 1986 to 2002 we included 67 men with a mean age of 60 years with newly diagnosed penile carcinoma. No patient was lost to followup.

    RESULTS:

    At a median followup of 42 months (range 12 to 186) 59 patients were alive and 8 had died of penile carcinoma (2) and concurrent disease (6). Of the 13 patients (19%) with local recurrence during the study period 10 underwent repeat laser treatment successfully. Side effects were few but 5 patients (7%) had postoperative bleeding. Overall cosmetic and functional results were highly satisfactory.

    CONCLUSIONS:

    The results of this study show that treating penile carcinoma with the combination of carbon dioxide and neodymium:YAG lasers can safely be done with highly satisfactory cosmetic results as well as good local tumor control

  • 242.
    Windahl, Torgny
    et al.
    Örebro University, Department of Clinical Medicine.
    Hellsten, Sverker
    Carbon dioxide laser treatment of lichen sclerosus et atrophicus1993In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 150, no 3, p. 868-870Article in journal (Refereed)
    Abstract [en]

    We followed 62 men treated with the carbon dioxide laser for lichen sclerosus et atrophicus for an average of 30 months (3 months to 7 years). Of the patients 47 (76%) became asymptomatic and 10 (16%) had minor residual symptoms. In 26 patients (40%) concomitant superficial meatal stenosis was simultaneously treated with laser meatotomy. The cosmetic and functional results of treatment were highly encouraging. Provided that radicality is achieved at the primary application, the carbon dioxide laser is an excellent therapeutic modality for lichen sclerosus et atrophicus.

  • 243.
    Windahl, Torgny
    et al.
    Örebro University, Department of Clinical Medicine.
    Hellsten, Sverker
    Laser treatment of localized squamous cell carcinoma of the penis1995In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 154, no 3, p. 1020-1023Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    We evaluate the efficacy and morbidity of laser and conventional treatment in 32 men with penile cancer.

    MATERIALS AND METHODS:

    Of 32 men treated for squamous cell carcinoma of the penis observed for an average of 44 months 19 were treated with the combined carbon dioxide and neodymium: YAG lasers. The 13 patients treated conventionally had more advanced disease and they were a mean 17 years older than those in the laser treated group.

    RESULTS:

    All laser treated patients were disease-free after a mean of 31 months. Among the 13 conventionally treated patients there were only 5 long-term survivors.

    CONCLUSIONS:

    The cosmetic and functional outcome of laser treatment for stages Tis to T2N0M0, grades 1 and 2 squamous cell carcinoma of the penis is excellent, and the associated morbidity rate is low.

  • 244.
    Windahl, Torgny
    et al.
    Örebro University, Department of Clinical Medicine.
    Skeppner, Elisabet
    Örebro University, Department of Clinical Medicine.
    Andersson, Swen-Olof
    Sjögren Fugl-Meyer, Kerstin
    Sexual function and satisfaction in men after laser treatment for penile carcinoma2004In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 172, no 2, p. 648-651Article in journal (Refereed)
    Abstract [en]

    Purpose:

    We evaluate sexual function, sexual satisfaction and cosmetic results after laser treatment of penile carcinoma.

    Materials and Methods:

    A total of 67 patients were treated at our clinic for penile cancer using combined carbon dioxide and neodymium:YAG lasers from 1986 to 2000. At the time of this study 58 men, with a mean age of 64 years were alive, of whom 46 (79%) agreed to participate in a structured face-to-face interview addressing sexual function, sexual satisfaction and cosmetic results. The length of time that had elapsed since treatment ranged from 6 months to 15 years (median 3 years).

    Results:

    Of 40 patients (87%) who had been sexually active before treatment 30 (75%) had resumed activities at the time of the interview. Unaltered erectile function after treatment was reported by 33 patients (72%), 10 patients (22%) reported decreased function and 3 (6%) reported improved function. Of the 46 patients 23 (50%) were satisfied/very satisfied with their sexual life. After treatment only 3 of 30 (10%) of the evaluable men had dyspareunia. The cosmetic results were considered satisfying/very satisfying by 36 (78%) men.

    Conclusions:

    Laser treatment of localized penile carcinoma preserves the penis and generally provides satisfactory sexual function and cosmetic results.

  • 245.
    Wågsäter, Dick
    et al.
    Örebro University, Department of Clinical Medicine.
    Jatta, Ken
    Örebro University, Department of Clinical Medicine.
    Ocaya, Pauline
    Örebro University, Department of Clinical Medicine.
    Dimberg, Jan
    Sirsjö, Allan
    Örebro University, Department of Clinical Medicine.
    Expression of IL-1b, IL-1R1 I and IL-1Ra in human aortic smooth muscle cells: effects of all-trans retinoic acid2006Manuscript (preprint) (Other academic)
  • 246.
    Wågsäter, Dick
    et al.
    Örebro University, Department of Clinical Medicine.
    Jatta, Ken
    Örebro University, Department of Clinical Medicine.
    Ocaya, Pauline
    Örebro University, Department of Clinical Medicine.
    Dimberg, Jan
    Sirsjö, Allan
    Örebro University, Department of Clinical Medicine.
    Expression of IL-1β, IL-1 receptor type I and IL-1 receptor antagonist in human aortic smooth muscle cells: effects of all-trans-retinoic acid2006In: Journal of Vascular Research, ISSN 1018-1172, E-ISSN 1423-0135, Vol. 43, no 4, p. 377-382Article in journal (Refereed)
    Abstract [en]

    The proinflammatory cytokine interleukin (IL)-1β and the IL-1 receptor antagonist are expressed by atherosclerotic plaques and may be linked to the development of atherosclerosis. Existing evidence shows that retinoids and their receptors are involved in inflammatory response and that they are found in atherosclerotic plaques. In all-trans-retinoic acid (atRA)-treated human aortic smooth muscle cells (AOSMC), significant increases in IL-1β levels were observed, compared with untreated cells. Examination of IL-1 receptor antagonist and IL-1 receptor type I levels did not show any difference between atRA-treated and -untreated AOSMC. The results show that atRA-treated AOSMC express both the precursor (33 kDa) and the active form (17 kDa) of the IL-1β protein. atRA-treated carotid lesions showed significantly elevated IL-1β mRNA levels (2.9 ± 2.33) compared with untreated lesions (2.0 ± 1.77; p < 0.05). These results support the role of atRA as a regulator of inflammation such as in atherosclerosis.

  • 247.
    Wåhlin Larsson, Britta
    et al.
    Örebro University, Department of Clinical Medicine. Dalarna University, Falun, Sweden.
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ulfberg, Jan
    Avesta Hospital, Avesta, Sweden.
    Piehl Aulin, Karin
    Örebro University, Department of Clinical Medicine.
    Skeletal muscle morphology in patients with restless legs syndrome2007In: European Neurology, ISSN 0014-3022, E-ISSN 1421-9913, Vol. 58, no 3, p. 133-137Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of the study was to assess the cellular and structural properties of skeletal muscle in restless legs syndrome (RLS).

    METHOD: Twenty patients and 16 controls were included. Aerobic performance was assessed using a submaximal test. On muscle biopsies taken from the tibialis anterior, fiber distribution and fiber area were analyzed together with parameters surveying the microvascularization, especially the tortuosity, which is expressed as a percent of muscle fiber perimeter in contact with the wall of the microvessel, length of capillary/perimeter of fiber (LC/PF) index.

    RESULTS: The RLS group had significantly lower predicted maximal oxygen uptake (p = 0.01) and significantly higher LC/PF index (p = 0.01) compared to the controls.

    CONCLUSION: The higher capillary tortuosity in RLS patients indicates the occurrence of significant remodeling in capillary geometry in RLS.

  • 248.
    Åman, Jan
    et al.
    Örebro University, Department of Clinical Medicine.
    Östlund, Ingrid
    Örebro University, Department of Clinical Medicine.
    Preventivmedelsrådgivning2008In: Barn- och ungdomsdiabetes / [ed] Sture Sjöblad, Lund: Studentlitteratur , 2008, 2, p. 195-197Chapter in book (Other academic)
  • 249. Öberg, S.
    et al.
    Johansson, Carina B.
    Örebro University, Department of Health Sciences. Örebro University, Department of Clinical Medicine.
    Rosenquist, J. B.
    Bone formation after implantation of autolysed antigen extracted allogeneic bone in ovariectomized rabbits2003In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 32, no 6, p. 628-632Article in journal (Refereed)
    Abstract [en]

    This study was undertaken to evaluate the bone formation response to AAA bone in healthy and oestrogen deficient animals. Seventeen young healthy New Zealand female rabbits were used. Nine rabbits were subjected to ovariectomy and the remaining eight were sham-operated. Four weeks after ovariectomy standardized round cavities, 5 mm in diameter, were made medially in the cortical part of each proximal tibia. To half of the cavities autolysed antigen-extracted allogeneic AAA bone granules were added. After another 8 weeks the animals were sacrificed and sections of the tibial experimental areas were obtained. These were studied in light microscopy and the bone and non-bone areas were measured with computer support.

    The study showed that the addition of a bone inductive substance such as AAA bone enhances bone formation also in oestrogen deficient animals.

  • 250.
    Ökvist, Anna
    Örebro University, Department of Clinical Medicine.
    Magnetisk resonanstomografi vid Mb Perthes2006Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Mb Perthes är en höftledsjukdom som drabbar barn, framför allt pojkar. Sjukdomens etiologi antas vara vaskulär, men orsak till cirkulationsstörningen är fortfarande okänd. Därför är det viktigt att tidigt se förändringarna.

    Vid utredning av Mb Perthes är konventionell röntgen en rutinundersökningsmetod. I tidiga stadier eller om konventionell röntgenbild visar normala höftleder kan man använda sig av magnetisk resonanstomografi (MR).

    Syftet med min litteraturstudie var att undersöka vad MR har för betydelse vid diagnostik av Mb Perthes samt vidare om MR kan vara användbart för att bedöma sjukdomens förlopp.

    Min litteraturstudie har visat att MR vid misstanke om Mb Perthes kan vara ett gott komplement till konventionell röntgen för att få rätt diagnos och följa sjukdomens förlopp, då man med MR får en mycket tydligare bild av sjukdomens utbredning.

    MR är, i jämförelse med skelettscintigrafi och artrografi, lika bra eller bättre för att påvisa förändringar och hur de förändras över tiden.

    Detta är viktiga faktorer som har betydelse vid behandling och för bedömningen om operation ska ske eller inte. För att få ett säkrare resultat bör fler artiklar studeras och sammanställas.

23456 201 - 250 of 254
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