| 651. |
- Johansson, Gustav, et al.
(författare)
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Monitoring circulating tumor DNA during surgical treatment in patients with gastrointestinal stromal tumors
- 2021
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Ingår i: Molecular Cancer Therapeutics. - 1535-7163 .- 1538-8514. ; 20:12, s. 2568-2576
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Tidskriftsartikel (refereegranskat)abstract
- The majority of patients diagnosed with advanced gastrointestinal stromal tumors (GISTs) are successfully treated with a combination of surgery and tyrosine kinase inhibitors (TKIs). However, it remains challenging to monitor treatment efficacy and identify relapse early. Here, we utilized a sequencing strategy based on molecular barcodes and developed a GIST-specific panel to monitor tumor-specific and TKI resistance mutations in cell-free DNA and applied the approach to patients undergoing surgical treatment. Thirty-two patients with GISTs were included, and 161 blood plasma samples were collected and analyzed at routine visits before and after surgery and at the beginning, during, and after surgery. Patients were included regardless of their risk category. Our GIST-specific sequencing approach allowed detection of tumor-specific mutations and TKI resistance mutations with mutant allele frequency < 0.1%. Circulating tumor DNA (ctDNA) was detected in at least one timepoint in nine of 32 patients, ranging from 0.04% to 93% in mutant allele frequency. High-risk patients were more often ctDNA positive than other risk groups (P < 0.05). Patients with detectable ctDNA also displayed higher tumor cell proliferation rates (P < 0.01) and larger tumor sizes (P < 0.01). All patients who were ctDNA positive during surgery became negative after surgery. Finally, in two patients who progressed on TKI treatment, we detected multiple resistance mutations. Our data show that ctDNA may become a clinically useful biomarker in monitoring treatment efficacy in patients with high-risk GISTs and can assist in treatment decision making.
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| 652. |
- Johansson, Hans, et al.
(författare)
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Compositions of glass in proximal tephras from eruptions in the Azores archipelago and their links with distal sites in Ireland
- 2017
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Ingår i: Quaternary Geochronology. - : Elsevier BV. - 1871-1014 .- 1878-0350. ; 40, s. 120-128
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Tidskriftsartikel (refereegranskat)abstract
- The Azores archipelago is one of the most active volcanic areas in the North Atlantic region, with approximately 30 eruptions during the last 600 years. The geochemical composition of associated tephra-derived glass is, however, not well characterized. This study presents major element compositions of glass shards from five major eruptives on the Azores: a trachybasaltic eruptive on the island of Faial (Capelinhos AD, 1957) and four explosive trachytic eruptives on the island of Sao Miguel (Fogo A c. 5600 cal yrs. BP, Sete Cidades c. AD 1440, Fogo AD 1563 and Furnas AD 1630). The major element compositions suggest that tephras from three active stratovolcanoes on Sao Miguel, Sete Cidades, Fogo and Furnas, can be distinguished from one another using bi-plots of FeOtot vs. TiO2 and FeOtot vs. CaO. Late Holocene tephras found on Ireland have previously been attributed to eruptions occurring on Jan Mayen but possess a strong geochemical similarity to proximal tephras from the Azores, especially those from the Furnas volcano. The similarity of the proximal tephras on Sao Miguel, especially Furnas AD 1563 and Furnas AD 1630 and distal tephras in Ireland is demonstrated by strong similarity coefficients (>0.95) and the closeness of major element composition. The dominant wind direction over the Azores is favourable for tephra dispersal to western Europe and we suggest that at least three tephras found in Ireland were erupted from the Furnas volcano, and that trachytic tephras erupted from explosive eruptions on Sao Miguel have a potential to contribute to the construction of a European-wide tephrostratigraphic framework.
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| 653. |
- Johansson, Henrik, et al.
(författare)
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Immune checkpoint therapy for pancreatic cancer
- 2016
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Ingår i: World Journal of Gastroenterology. - : Baishideng Publishing Group Inc.. - 1007-9327. ; 22:43, s. 9457-9476
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Forskningsöversikt (refereegranskat)abstract
- Novel treatment modalities are necessary for pancreatic cancer. Immunotherapy with immune checkpoint inhibition has shown effect in other solid tumors, and could have a place in pancreatic cancer treatment. Most available clinical studies on immune checkpoint inhibitors for pancreatic cancer are not yet completed and are still recruiting patients. Among the completed trials, there have been findings of a preliminary nature such as delayed disease progression and enhanced overall survival after treatment with immune checkpoint inhibitors in mono- or combination therapy. However, due to small sample sizes, major results are not yet identifiable. The present article provides a clinical overview of immune checkpoint inhibition in pancreatic cancer. PubMed, ClinicalTrials.gov and American Society of Clinical Oncology's meeting abstracts were systematically searched for relevant clinical studies. Four articles, five abstracts and 25 clinical trials were identified and analyzed in detail.
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| 654. |
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| 655. |
- Johansson, Helena, 1981, et al.
(författare)
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Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers
- 2018
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 29:3, s. 741-749
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty. Introduction The risks of hip fracture and hip arthroplasty are influenced by factors including socioeconomic status, education, urbanization, latitude of residence, and physical activity. Farming is an occupation encompassing rural living and high level of physical activity. Therefore, we aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Methods We studied the risk of hip fracture, and hip arthroplasty due to primary osteoarthritis, in all men and women aged 35 years or more in Sweden between 1987 and 2002. Documented occupations were available in 3.5 million individuals, of whom 97,136 were farmers. The effects of age, sex, income, education, location of residence, and occupation on risk of hip fracture or hip arthroplasty were examined using a modification of Poisson regression. Results A total of 4027 farmers and 93,109 individuals with other occupations sustained a hip fracture, while 5349 farmers and 63,473 others underwent a hip arthroplasty. Risk of hip fracture was higher with greater age, lower income, lower education, higher latitude, and urban area for all men and women. Compared to all other occupations, male farmers had a 20% lower age-adjusted risk of hip fracture (hazard ratio (HR) 0.80, 95% CI 0.77-0.84), an effect that was not seen in female farmers (HR 0.96, 95% CI 0.91-1.01). Both male and female farmers had a higher age-adjusted risk for hip arthroplasty. Conclusions Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.
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| 656. |
- Johansson, Håkan T, 1977, et al.
(författare)
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GGLAND - command line simulations
- 2014
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Ingår i: GSI Scientific Report 2013. - 0171-4546. ; 2014-1, s. 154-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 657. |
- Johansson, Hans, 1956-
(författare)
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Towards a Holocene tephrochronology for the Azores
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Azores is situated in the North Atlantic Ocean and is one of the most active volcanicregions in the Northern Hemisphere. The volcanic history of the islands is fairly wellknown and several explosive trachytic eruptions have been reported but the geochemicalcompositions of the glass component of the tephra as well as the dispersal oftephras to distal areas are less well known. The purpose of this study is twofold: (1) topresent major element geochemistry of the glass component from several historic aswell as prehistoric tephras, including the trachybasaltic Capelinhos AD 1957‐58eruption on the island of Faial, and the trachytic explosive eruptions of Sete Cidades(c. AD 1440), Fogo A (c. 5000 BP), Fogo AD 1563 and Furnas AD 1630 on the island ofSão Miguel; (2) to present a refined tephrostratigraphy for the island of Pico. Analyses ofmajor element geochemistry suggest that tephras from the three active stratovolcanoeson São Miguel can be separated in biplots showing e.g. FeOtot vs.TiO2 and FeOtot vs. CaO.The tephrostratigraphy of Caveiro bog on the island of Pico is based on a radiocarbondated core with eight tephra layers extending back to c. 7000 BP. All tephras are oftrachybasaltic/basaltic trachyandesitic composition except the oldest layer, which is ofbasanitic composition. An attempt was made to correlate the tephra record of Caveirobog with the previously investigated Lake Caveiro. A tephra‐based correlation betweenthe Caveiro bog and Lake Caveiro is not straightforward and only three tephras inCaveiro bog can possibly be correlated with tephras found in the sediments of LakeCaveiro.Proximal glass data from the Furnas volcano on São Miguel suggest that distal cryptotephrasfound in Ireland may have an origin in the Azores and not on Jan Mayen aspreviously has been suggested. The similarity of the proximal tephras on São Miguel anddistal tephras in Ireland is demonstrated by high similarity coefficients (>0.95) andbiplots showing major element composition also support a correlation between Azoreaneruptions and distal tephras in Ireland. Thus, trachytic tephras erupted from explosiveeruptions on the island of São Miguel may have a potential to contribute to theconstruction of a European‐wide tephrochronology framework.Trachytic tephras erupted from explosive eruptions on the Azores may be more widelydispersed than previously thought and may provide useful isochrones for correlation ofpaleoclimate archives in the north‐central Atlantic, North Africa and the Iberian regions.The trachybasaltic/basaltic trachyandesitic tephras erupted from cinder cones on PicoIsland are probably only useful for a local tephrochronology in the Azores region, andnot for a wider Atlantic or European framework.
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| 658. |
- Johansson, Jan, et al.
(författare)
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En bloc vs transhiatal esophagectorny for stage T3 N1 adenocarcinorna of the distal esophagus
- 2004
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Ingår i: Archives of Surgery. - 0004-0010. ; 139:6, s. 627-631
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis: En bloc esophagectomy (EBE) provides improved survival over transhiatal esophagectomy (THE) in patients with similarly sized transmural tumors (T3) and lymph node metastases (N1). Design: A retrospective case-control study of 2 methods of esophageal resection for cancer. Setting: University hospital (tertiary referral center for esophageal disease). Patients: There were 49 patients (27 who underwent EBE and 22 who underwent THE) With similar T3 N1 disease and the following matched criteria: tumors of similar size and location, more than 20 lymph nodes in the surgical specimen, R0 resection, no previous chemotherapy or radiation therapy, and follow-up until death or for a minimum of 5 years. Main Outcome Measure: Survival adjusted for differences in demographic and patient characteristics. Results: The number of nodes harvested was greatest after EBE vs THE (median, 52 vs 29 [range, 21-85 vs 20-60]; P<.001). The median number of involved nodes was similar after EBE vs THE (median, 5 vs 7 [range, 1-19 vs 1-16]). The only 2 independent factors that affected survival. in a Cox analysis were the number of involved lymph nodes (P=.01) and the type of resection (P=.03). Patients who underwent EBE had a survival benefit over those who underwent THE (P=.01). The survival benefit of EBE was seen only in patients with fewer than 9 involved lymph nodes (P<.001). Conclusion: En bloc esophagectomy confers a better survival than THE in patients with T3 N1 disease and fewer than 9 lymph node metastases.
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| 659. |
- Johansson, Jan, et al.
(författare)
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Impact of Proton Pump Inhibitors on Benign Anastomotic Stricture Formations After Esophagectomy and Gastric Tube Reconstruction: Results From a Randomized Clinical Trial.
- 2009
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Ingår i: Annals of Surgery. - 1528-1140.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: The primary aim of this study was to evaluate if the use of proton pump inhibitors (PPIs) reduced the prevalence of benign anastomotic strictures after uncomplicated esophagectomies with gastric tube reconstruction and circular stapled anastomoses. SUMMARY BACKGROUND DATA:: Benign anastomotic strictures are associated with anastomotic leaks or conduit ischemia. Also patients without those complications develop benign anastomotic strictures. We hypothesize that patients without postoperative anastomotic complications may develop benign anastomotic strictures due to exposure of acid gastric tube contents to the anastomotic area, and that the formation of such strictures may be reduced by prophylactic use of PPIs. METHODS:: Eighty patients without preoperative chemo- or radiotherapy, without clinical or radiological signs of anastomotic leaks were included in this clinical trial. The patients were randomized to b.i.d. PPIs or no treatment for 1 year. Benign anastomotic strictures were defined as anastomotic narrowing not allowing a standard diagnostic endoscope to pass without dilatation. The study was registered in the EudraCT database (2009-009997-28) for clinical trials. RESULTS:: Seventy-nine patients were evaluated. Benign anastomotic strictures developed in 5/39 (13%) patients in the PPI group and in 18/40 (45%) in the control group (RR 5.6, 95% CI: 2.0-15.9, P = 0.001). The use of a narrower 25 mm cartridge as compared to a wider 28 or 31 mm cartridge significantly increased stricture formations (RR 2.9, 95% CI: 1.1-7.6, P = 0.025). CONCLUSIONS:: Prophylactic PPI treatment reduced the prevalence of benign anastomotic strictures following esophagectomy with gastric tube reconstruction and circular stapled anastomoses. Larger sized circular staple cartridges additionally reduced the stricture prevalence.
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| 660. |
- Johansson, Joel, et al.
(författare)
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Incidence of Appendiceal Malignancies in Sweden Between 1970 and 2012
- 2020
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Ingår i: World Journal of Surgery. - : SPRINGER. - 0364-2313 .- 1432-2323. ; 44, s. 4086-4092
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Tidskriftsartikel (refereegranskat)abstract
- Background There is limited knowledge about the epidemiology of the major histological subtypes of appendiceal malignancy: adenocarcinoma and neuroendocrine neoplasm of the appendix (A-NEN). The aims of this national cohort study were to assess the prevalence, incidence and trends of appendiceal malignancies in Sweden. Method All individuals who underwent appendicectomy and all diagnosed with appendiceal malignancy from 1970 to 2012 were identified from the National Patient Register and the Swedish Cancer Registry. Demographic data of the background population were obtained from Statistics Sweden. The incidence rate (IR) and the prevalence of appendiceal malignancy per performed appendicectomy were calculated. Results We identified 3774 patients with appendiceal malignancy. IR of A-NEN was 5.8/10(6)person-years with a peak of 8.4/10(6)at age 20-30 years, whereafter it plateaued at a somewhat lower level. IR for adenocarcinoma was 3.7/10(6)person-years, starting at a very low level among the youngest and increasing to 15.4/10(6)at age 80-89 years. The IR of adenocarcinoma increased from 2.6/10(6)in 1970-1979 to 5.4/10(6)in 2010-2012. The IR of A-NEN was stable during the study period. The prevalence per appendicectomy was low for both types of malignancies among the young but increased with age, most dramatically for adenocarcinoma. There was a trend during the study period towards more extensive surgery. Conclusion Adenocarcinoma is most common and increasing in the elderly, whereas A-NEN affects all ages with a peak in young age. This peak probably reflects removal of occult A-NEN due to the higher appendicectomy frequency in the young.
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