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Träfflista för sökning "WFRF:(Thorlacius Henrik) srt2:(2015-2019)"

Sökning: WFRF:(Thorlacius Henrik) > (2015-2019)

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  • Föregående 1234[5]6Nästa
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41.
  • Thorlacius, Henrik, et al. (författare)
  • Serrated polyps–a concealed but prevalent precursor of colorectal cancer
  • 2017
  • Ingår i: Scandinavian Journal of Gastroenterology. - Taylor & Francis. - 0036-5521. ; 52:6-7, s. 654-661
  • Forskningsöversikt (refereegranskat)abstract
    • Serrated polyps have long been considered to lack malignant potential but accumulating data suggest that these lesions may cause up to one-third of all sporadic colorectal cancer. Serrated polyps are classified into three subtypes, including sessile serrated adenomas/polyps (SSA/Ps), traditional serrated adenomas (TSAs), and hyperplastic polyps (HPs). SSA/P and TSA harbour malignant potential but TSA represents only 1–2%, wheras SSA/P constitute up to 20% of all serrated lesions. HPs are most common (80%) of all serrated polyps but are considered to have a low potential of developing colorectal cancer. Due to their subtle appearence, detection and removal of serrated polyps pose a major challenge to endoscopists. Considering that precancerous serrated polyps are predominately located in the right colon could explain why interval cancers most frequently appear in the proximal colon and why colonoscopy is less protective against colon cancer in the proximal compared to the distal colon. Despite the significant impact on colorectal cancer incidence, the aetiology, incidence, prevalence, and natural history of serrated polyps is incompletely known. To effectively detect, remove, and follow-up serrated polyps, endoscopists and pathologists should be well-informed about serrated polyps. This review highlights colorectal serrated polyps in terms of biology, types, diagnosis, therapy, and follow-up.
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42.
  • Thorlacius, Henrik, et al. (författare)
  • Sågtandande polyper en dold men vanlig orsak till kolorektal cancer : Serrated polyps is a hidden but common cause of colorectal cancer
  • 2015
  • Ingår i: Läkartidningen. - Swedish Medical Association. - 0023-7205. ; 112:34-35, s. 1401-1405
  • Tidskriftsartikel (övrigt vetenskapligt)abstract
    • Konceptet att sågtandande polyper kan leda till kolorektal cancer är relativt nytt. Sågtandade polyper orsakar upp till en tredjedel av all sporadisk kolorektal cancer. Trots detta är kunskaperna om sågtandade polypers etiologi, incidens, prevalens och naturalförlopp ofullständiga. Sågtandade polyper är svåra att identifiera och ta bort endoskopiskt. Endoskopister och patologer måste ha kunskaper om sågtandade adenom för att effektivt kunna detektera, diagnostisera och ta bort dem som led i att minska antalet personer som drabbas av kolorektal cancer. The concept that serrated polyps can cause colorectal cancer is relatively new and not very well-known. Serrated polyps are difficult to identify and treat endoscopically. This together with the fact that premalignant serrated polyps are mainly located in the proximal colon might help explain why colonoscopy is less effective against right-sided compared to left-sided colorectal cancers and why interval cancers usually appear in the proximal colon. In fact, serrated polyps may cause up to one third of all sporadic colorectal cancers. In spite of this, the aetiology, incidence, prevalence and natural history of serrated polyps remains elusive. Endoscopists and pathologists must have a good understanding of serrated polyps in order to effectively diagnose, treat and follow up these lesions. This review focuses on the pathophysiology, types, work-up, treatment and follow-up of serrated polyps in the colon and rectum.
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43.
  • Toth, Ervin, et al. (författare)
  • Colonic obstruction caused by video capsule entrapment in a metal stent
  • 2017
  • Ingår i: Annals of Translational Medicine. - AME Publishing Company. - 2305-5839. ; 5:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Video capsule endoscopy (VCE) has become the method of choice for visualizing the small bowel mucosa and is generally considered to be a safe method. Although uncommon, the most feared complication of VCE is capsule retention that can potentially lead to life-threatening bowel obstruction. Herein, we present for the first time a case of capsule retention in a colonic stent. The patient had known Crohn's disease with colonic involvement and underwent an uneventful but incomplete small bowel VCE for assessment of disease activity and extension for optimizing medical treatment. Five months later, the patient presented with intestinal obstruction due to a Crohn's-stricture in the sigmoid colon, which was successfully decompressed with a self-expandable metal stent. Nonetheless, two days later the patient showed signs of bowel obstruction again and abdominal X-ray showed that the capsule was trapped in the metal stent in the sigmoid colon. Subsequently, emergency surgery was performed and the patient fully recovered. Intestinal capsule retention necessitating interventional removal is rare. This report describes a unique case of capsule retention in a colonic metal stent and highlights the potential risk of performing capsule endoscopy examinations in patients with gastrointestinal stents.
44.
  • Toth, Ervin, et al. (författare)
  • Video capsule colonoscopy in routine clinical practice
  • 2017
  • Ingår i: Annals of Translational Medicine. - AME Publishing Company. - 2305-5839. ; 5:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Colon capsule endoscopy (CCE) offers direct mucosal visualisation without sedation or gas insufflation required in conventional colonoscopy (CC). However, evidence for the role of CCE as an adjunct or alternative to CC remains equivocal. In this observational cohort study, we report our experience of using CCE to investigate patients with suspected colon pathology at a tertiary referral centre. Methods: From 2007-2015, consecutive patients requiring colonoscopy were recruited from a tertiary care centre in Malmo, Sweden. Data collected: patient demographics, indication for CCE, findings, bowel cleansing, colon transit time (CTT) and completeness of colon examination. Results: Seventy-seven patients (57 F/20 F, median age 56 years) were included. The reason for CCE was previously incomplete or refused CC in 39 and 26 cases, and follow up of previous findings in 12 cases, respectively. The main clinical indications were gastrointestinal (GI) bleeding (n=28; 36%) and suspected inflammatory bowel disease (IBD) or follow-up of known IBD (n=23; 30%). CCE was complete in 58/77 (75%) patients. In 3 patients the colon was not reached; in the other 16, the capsule reached the rectum (n=4), sigmoid (n=6), descending colon (n=5) and transverse colon (n=1). Findings were: normal CCE (n=15; 19%) colonic diverticula (n=29; 38%), polyps (n=17; 22%), active IBD (n=12; 16%), haemorrhoids (n=8; 10%), colonic angioectasia (n=4; 5%) and cancer (n=1; 1%). Small-bowel findings were recorded in 8 (10%) patients. All patients tolerated bowel preparation and CCE well. Two patients with an ulcerated small-bowel stricture and cancer respectively experienced temporary capsule retention with spontaneous resolution. Conclusions: CCE is a well-tolerated alternative to CC, but requires technological improvement and optimisation of clinical practice to meet current reference standards. Although further technical development is required, CCE may complement or even replace CC for certain clinical indications.
45.
  • Uedo, Noriya, et al. (författare)
  • Underwater endoscopic mucosal resection of large colorectal lesions.
  • 2015
  • Ingår i: Endoscopy. - Georg Thieme Verlag KG. - 1438-8812. ; 47:2, s. 172-174
  • Tidskriftsartikel (refereegranskat)abstract
    • In this prospective study, 11 consecutive patients with neoplastic colorectal lesions (median size 20 mm, range 15 - 25 mm) underwent endoscopic polyp removal by underwater endoscopic mucosal resection (EMR). Six lesions were removed en bloc and five lesions were removed by piecemeal resection. Pathological examination revealed seven R0 resections, and in four cases the pathology could not be determined. Two cases of procedure-related bleeding occurred but these were easily managed using hemostatic forceps and clip application. No perforations or delayed bleedings were observed. Underwater EMR is a relatively simple, safe, and useful method for the removal of large colorectal lesions.
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46.
  • Vilhjalmsson, Dadi, et al. (författare)
  • Compression anastomotic ring-locking procedure (CARP) is a safe and effective method for intestinal anastomoses following left-sided colonic resection.
  • 2015
  • Ingår i: International Journal of Colorectal Disease. - Springer. - 1432-1262. ; 30:7, s. 969-975
  • Tidskriftsartikel (refereegranskat)abstract
    • Compression anastomotic ring-locking procedure (CARP) is a novel procedure for creating colonic anastomoses. The surgical procedure allows perioperative quantification of the compression pressure between the intestinal ends within the anastomosis and postoperative monitoring of the anastomotic integrity. We have recently shown that CARP is a safe and effective method for colonic anastomoses in pigs, and the purpose of the present study was to evaluate CARP for colonic anastomoses in humans.
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47.
  • Vilhjalmsson, Dadi, et al. (författare)
  • The Compression Anastomotic Ring-Locking Procedure: A Novel Technique for Creating a Sutureless Colonic Anastomosis.
  • 2015
  • Ingår i: European Surgical Research. - Karger. - 0014-312X. ; 54:3-4, s. 139-147
  • Tidskriftsartikel (refereegranskat)abstract
    • Background/Aim: Compression anastomoses might represent an improvement over traditional hand-sewn or stapled techniques. Herein, we describe a novel concept of sutureless colonic anastomosis named compression anastomotic ring-locking procedure (CARP). Materials and Methods: The surgical device consists of two anastomotic rings and their associated helping tools, facilitating the placement of the rings into the intestinal ends. Furthermore, four catheters are connected to the surgical device, allowing the evaluation of the anastomosis during and after surgery. A total of 31 pigs underwent a low colocolic anastomosis using the anastomotic rings. The compression pressure was measured perioperatively and up to 96 h after surgery. Anastomotic integrity and morphology were analyzed by use of radiology and histology, respectively. A long-term follow-up was conducted in a subgroup of pigs up to 108 days after surgery when the bursting pressure and stricture formation were examined. Results: All animals recovered uneventfully, and macroscopic examination revealed intact anastomoses without signs of pathological inflammation or adhesions. The perioperative compression pressure was inversely proportional to the gap size between the anastomotic rings. For example, an anastomotic gap of 1.5 mm created a colonic anastomosis with a perioperative compression pressure of 91 mbar, which remained constant for up to 48 h and resulted in a markedly increased compression pressure. Contrast infusion via the catheters effectively visualized the anastomoses, and no leakage was detected within the study. The surgical device was spontaneously evacuated from the intestines within 6 days after surgery. Histology showed collagen bridging of the anastomoses already 72 h after surgery. Long-term follow-up (54-108 days) revealed no stricture formation in the anastomoses, and the bursting pressure ranged from 120 to 235 mbar. The majority of bursts (10/12) occurred distant from the anastomoses. Conclusion: We conclude that the surgical device associated to CARP is safe and efficient for creating colonic anastomoses. Further studies in patients undergoing colorectal surgery are warranted. © 2014 S. Karger AG, Basel.
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48.
  • Wang, Yongzhi, et al. (författare)
  • Monocytes regulate systemic coagulation and inflammation in abdominal sepsis.
  • 2015
  • Ingår i: American Journal of Physiology: Heart and Circulatory Physiology. - American Physiological Society. - 1522-1539. ; 308:5, s. 540-547
  • Tidskriftsartikel (refereegranskat)abstract
    • Abdominal sepsis is associated with significant changes in systemic inflammation and coagulation. The purpose of this study was to examine the role of peripheral blood monocytes for systemic coagulation, including thrombin generation and consumption of coagulation factors. Abdominal sepsis was induced by cecal ligation and puncture (CLP) in C57BL/6 mice. Plasma and lung levels of interleukin-6 (IL-6), CXC chemokines (CXCL1, CXCL2 and CXCL5) as well as pulmonary activity of myeloperoxidase (MPO), thrombin generation and coagulation factors were determined 6h after CLP induction. Administration of clodronate liposomes decreased circulating levels of monocytes by 96%. Time to peak thrombin formation was increased and peak and total thrombin generation was decreased in plasma from CLP animals. Monocyte depletion decreased time to peak formation of thrombin and increased peak and total generation of thrombin in septic animals. In addition, monocyte depletion decreased the CLP-induced increase in the levels of thrombin-antithrombin complexes in plasma. Depletion of monocytes increased plasma levels of prothrombin, factor V, factor X, protein C and in septic mice. Moreover, depletion of monocytes decreased CLP-induced levels of IL-6 and CXC chemokines in plasma and lung by more than 59% and 20%, respectively. CLP-induced MPO activity in the lung was attenuated by 44% in animals depleted of monocytes. Taken together, our findings show for the first time that peripheral blood monocytes regulates systemic coagulation and improve our understanding of the pathophysiology of sepsis and encourage further attempts to target innate immune cell functions in abdominal sepsis.
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49.
  • Wang, Yongzhi, et al. (författare)
  • Neutrophil extracellular trap-microparticle complexes enhance thrombin generation via the intrinsic pathway of coagulation in mice
  • 2018
  • Ingår i: Scientific Reports. - Nature Publishing Group. - 2045-2322. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Abdominal sepsis is associated with dysfunctional hemostasis. Thrombin generation (TG) is a rate-limiting step in systemic coagulation. Neutrophils can expell neutrophil extracellular traps (NETs) and/or microparticles (MPs) although their role in pathological coagulation remains elusive. Cecal ligation and puncture (CLP)-induced TG in vivo was reflected by a reduced capacity of plasma from septic animals to generate thrombin. Depletion of neutrophils increased TG in plasma from CLP mice. Sepsis was associated with increased histone 3 citrullination in neutrophils and plasma levels of cell-free DNA and DNA-histone complexes and administration of DNAse not only eliminated NET formation but also elevated TG in sepsis. Isolated NETs increased TG and co-incubation with DNAse abolished NET-induced formation of thrombin. TG triggered by NETs was inhibited by blocking factor XII and abolished in factor XII-deficient plasma but intact in factor VII-deficient plasma. Activation of neutrophils simultaneously generated large amount of neutrophil-derived MPs, which were found to bind to NETs via histone-phosphatidylserine interactions. These findings show for the first time that NETs and MPs physically interact, and that NETs might constitute a functional assembly platform for MPs. We conclude that NET-MP complexes induce TG via the intrinsic pathway of coagulation and that neutrophil-derived MPs play a key role in NET-dependent coagulation.
50.
  • Wang, Yongzhi, et al. (författare)
  • Neutrophil extracellular trap-microparticle complexes trigger neutrophil recruitment via high-mobility group protein 1 (HMGB1)-toll-like receptors(TLR2)/TLR4 signalling
  • 2019
  • Ingår i: British Journal of Pharmacology. - The British Pharmacological Society. - 0007-1188. ; 176:17, s. 3350-3363
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and Purpose: Recent data suggest that neutrophil extracellular traps (NETs) form aggregates with microparticles (MPs) upon activation of neutrophils although the functional role of NET-MP complexes remain elusive. The objective of this study was to examine the role of NET-MP aggregates in leukocyte recruitment in vivo. Experimental Approach: PMA stimulation of murine bone marrow neutrophils generated NET-MP complexes and pretreatment with caspase and calpain inhibitors resulted in the formation of NETs depleted of MPs. Leukocyte–endothelium interactions were studied by using intravital microscopy of the mouse cremaster microcirculation. Key Results: Intrascrotal injection of NET-MP aggregates dose-dependently increased leukocyte recruitment. In contrast, leukocyte responses were markedly reduced after administration of NETs depleted of MPs. Neutrophil depletion abolished intravascular and extravascular leukocytes in response to challenge with NET-MP complexes. Electron microscopy revealed that NET-associated MPs express HMGB1. Notably, immunoneutralization of HMGB1 markedly decreased NET-MP complex-induced neutrophil accumulation. Moreover, inhibition of TLR2 and TLR4 significantly reduced neutrophil recruitment in response to NET-MP aggregates. Conclusions and Implications: These data show that NET-MP complexes are potent inducers of neutrophil recruitment, which is dependent on HMGB1 expressed on MPs and mediated via TLR2 and TLR4. Blocking MP binding to NETs or downstream inhibition of the HMGB1-TLR2/TLR4 axis might provide useful targets to attenuating NET-dependent tissue damage in acute inflammation.
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