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Sökning: L4X0:0346 6612 > (1985-1989)

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  • Alafuzoff, Irina, 1952- (författare)
  • Histopathological and immunocytochemical studies in age-associated dementias the importance of rigorous histopathological criteria for classification of progressive dementia disorders
  • 1985
  • Ingår i: digitalisering@umu. - Umeå : Umeå universitet.
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>Dementia is an age-associated organic brain disorder, recogniz­able by the essential features of psychological or behavioral abnormality associated with permanent dysfunction of the brain interfering with social and occupational functioning.</p><p>There are two clinical and three histopathological forms of dementia 1) primary degenerative dementia, (PDD), or Alzhei­mer's dementia/Senile dementia of Alzheimers type (AD/SDAT) which is associated with clinical features of uniform progres­sion and insidious onset of symptoms and histopathologically i- dentified by the occurrence of neurofibrillary tangles (NFT) and senile/neuritic plaques (SP/NP) in various cortical and subcor- tical regions; 2) vascular dementia, or multi-infarct dementia (MID), which is associated with clinical features of stepwise progress and patchy distribution of deficits, and histopatholo­gically identified by the occurrence of multiple large and/or small haemorrhagic and/or ischaemic infarcts in various cortical and subcortical regions and 3) intermediate form of dementia or "mixed” ("combined") dementia (AD-MID), which is histopatho- logically associated with the coexistance of symptoms and le­sions observed in AD/SDAT and MID, and clinically referred to the MID group. The DSM-III criteria separate the demented into two groups, AD/SDAT and MID, while there are no unique clinical criteria for the AD-MID patients. The clinical diagnosis of dementia according to the DSM-III criteria was shown to be in­sufficient . Histopathological diagnostic criteria were postu­lated by us for 1) pathological changes developing in mentallyunimpaired ageing, 2) AD/ SPAT, 3) MID and 4) AD-MID.</p><p>These histopathological classes could be separated, by means of multivariate data analysis. The pathology in AD-MID was shown not to be merely a linear combination of the AD/SDATand MID pathology.</p><p>Intrathecal synthesis of Ig, oligoclonal bands or other abnormal proteins in the CSF could not be demonstrated in aged non-demen- ted and demented patients.</p><p>The blood-cerebrospinal barrier (B-CSF-B) or blood-brain barrier (BBB) function alters with age and this alteration was shown to be more pronounced in MID and AD-MID patients. In MID and AD-MID patients the BBB alteration involves primarily the grey matter while in AD/SDAT patients the alteration would appear to involve only the white matter. The BBB dysfunction and a possible complement activation, either through antibody-anti- gen activation or other complement activators, was visualized in MID and AD-MID patients as perivascular serum protein depo­sits in the grey matter, always with a capillary in the center. The occurrence of some serum proteins in plaques, and the previously descibed localization of plaques in close relation­ship to the capillaries, suggest that altered BBB function and serum factors may be involved in the etiology and maturation of plaques while the etiology and maturation of tangles may not be directly dependent on these factors, as they were never labelled with any of the antisera studied.</p>
  • Albiin, Nils, 1955- (författare)
  • Middle ear structure in relation to function the rat in middle ear research
  • 1985
  • Ingår i: digitalisering@umu. - Umeå : Umeå universitet.
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>The present study was undertaken to evaluate the rat as a model for middle ear re­search. The rat was chosen primarily because the gross structure of its middle ear shows several similarities to that of man. It was considered of great importance to make a thorough structural study of the rat middle ear and to compare the results with those reported for the human middle ear. The thesis therefore includes indepen­dent studies on various aspects of rat middle ear structure and function as well as a review of the literature. The most pertinent findings in the experimental part of this study were the following.</p><p>The rat Eustachian tube consists of a nasopharyngeal, and a cartilaginous and bony portion. The orifice of the nasopharyngeal portion is composed of two soft tissue lips, which appear to be opened mainly by the action of the salpingopharyngeal mus­cle, but also by the levator and tensor veli palatini muscles. The cartilaginous por­tion appears to be opened solely by the tensor veli palatini muscle. The tensor tympani muscle seems to have no effect on the tube.</p><p>A ciliated and secretory epithelium lines the inferomedial walls of the tube throughout its length. In the tympanic cavity these thelial cell types extend as two tracts - one anterior and the other inferoposterior to  the promontory - which communicate with the epitympanic/attic compartments. The remaining parts of the tube and the tympanic cavity are covered by a squamous/cuboidal, non-ciliated epithelium. The subepithelial loose connective tissue contains vessels, nerves, and connective tissue cells, among these mast cells. The mast cells are confined to areas covered by the ciliated epithelium, and in the floor of the bulla, in the pars flaccida, and along the manubrial vessels. Glands are restricted to the Eustachian tube.</p><p>In the clearance/transport of serum-like material, from the epitympanum towards the tube, hydrostatic forces appear to be important.</p><p>The tympanic membrane is vascularized from meatal and tympanal vessels. Meatal ves­sels branch in the pars flaccida and along the handle of the malleus, where they are localized directly beneath the outer, keratinizing, stratified, squamous epithelium. Furthermore, meatal vessels form a vascular network at the junction between the fi­brocartilaginous annulus and the tympanic sulcus. Tympanal vessels send branches to the periphery of the pars tensa, where they run immediately beneath the tympanal, simple, squamous epithelium. In the major portion of the pars tensa, no blood vessels were found.</p><p>The rat stapedial artery is a thin-walled vessel with a wide lumen. Without branch­ing, it runs through the tympanic cavity to the extratympanal regions it supplies. In contrast to the corresponding artery in man, the rat stapedial artery persists throughout life. The artery does not seem to be affected by the fluid produced during experimentally induced otitis media with effusion.</p><p>The middle ear structure in the rat and in man show both similarities and differ­ences. If the differences are kept in mind and considered, it would seem that the rat is indeed a suitable model for experimental middle ear research.</p>
  • Axelsson, Karin (författare)
  • Eating problems and nutritional status after stroke
  • 1988
  • Ingår i: digitalisering@umu. - Umeå : Umeå universitet. - 91-7174-360-X
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>Eating problems and nutritional status were studied in a consecutive series of 104 stroke patients admitted to emergency hospital care. During their stay in hospital eating problems were observed in 46 patients. Certain common types of eating problems were identified: aberrant eating behaviour as regards chewing,lokalization or swallowing, eating small amounts, hoarding of food in the mouth, leakage of food from the mouth and unawareness of eating problems. Poor nutritional status occurred in 16 % of the patients on admission and in 22 % on discharge from the stroke unit.</p><p>A subgroup of 32 patients hospitalized for 21 days or longer was studied for three weeks. On at least one occasion during these three weeks a poor nutritional status was observed in 18 patients, of whom 17 had eating problems.</p><p>All subjects who had eating problems during their hospital stay, plus those patients without eating problems but with neurological deficits and those living in a nursing home one year after the stroke (n=36) were selected for a longitudinal study 18 months after the onset of stroke. Eating problems were identified in 23 of these patients during their hospital stay while 21 had such problems when they were followed up.</p><p>Two patients who could not eat due to severe dysphagia (after a stroke) for three years and 18 months respectively, were successfully trained to eat normally. One patient exhibited impaired oral and hypopharyngeal function and the other impaired hypo- pharyngeal function and a spastic crico-pharyngeal muscle. In both patients training in swallowing was the main remedical measure and one of them also had a myotomy of the spastic muscle.</p>
  • Bergman, Birgitta (författare)
  • Being a physiotherapist professional role, utilization of time an d vocational strategies
  • 1989
  • Ingår i: digitalisering@umu.se. - Umeå : Umeå universitet. - 9176260895
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>In a research series carried out between 1984 and 1988 in the county of Västerbotten in northern Sweden, various aspects of the professional role and work of physiotherapists were studied. A variety of research methods were used: questionnaires (n = 163), a time budget study (n = 149), and a qualitative interview (n = 24). Physiotherapy was considered varied and creative, but not well defined or very specific in its objectives. Physiotherapy is still a predominantly female profession, though the proportion of male physiotherapists was increasing. The proportion entering full-time employment in physiotherapy increased due both to the greater number of male graduates and the increasing number of women working full-time. A partial internal division of work between the sexes has arisen. More women than men are employed in in-patient care, while proportionately more men worked outside institutions. Most respondents were firmly in control of their treatment methods, but were somewhat restricted in their freedom to decide whom to treat, and when to terminate treatment. Few had carried out any research concerning treatment and results. The time budget study showed that the treatment of patients took up on average 33% of the physiotherapists’ gross working hours and was the largest single task. Continuing education accounted for 5%, development work for 1% and the remaining occupational tasks for 38%. Occupational area was the most important factor in explaining the distribution of working hours, when other factors were kept constant. Neither sex nor gender markedly affects the carrying out of tasks other than treatment. Nor does professional post particularly affect time utilization other than for administrative tasks. This profession has a double objective: care and service more generally and to provide physiotherapy in particular—both equally important. In order to improve the quality of physiotherapy, and at the same time to extend their own specific, theoretical body of knowledge, a number of physiotherapists have reappraised and extended their concept of the profession to include management and research in their everyday work.</p><p>Conclusion: The fact that occupational area exercises such a profound influence on the work of physiotherapists, taken together with the slight influence that professional post has, reveals that the individual physiotherapist must be prepared to play a broadly defined professional role. There seems to be a wealth of skill and expertise available within the profession, which could, however, be more efficiently used if the management and organization of physiotherapy service were better adapted to serve its objectives, and if these were better delineated and communicated.</p>
  • Bernspång, Birgitta, 1951- (författare)
  • Consequences of stroke aspects of impairments, disabilities and life satisfaction : with special emphasis on perception and on occupational therapy
  • 1987
  • Ingår i: digitalisering@umu. - Umeå : Umeå universitet. - 91-7174-310-3
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>Perceptual and motor functions and self-care ability after stroke were assessed within two weeks (n:109; mean age 69±10) and 4-6 years (n:75;70±9) after admission to a non-intensive care stroke unit. Sixty-two of the long-term stroke survivors reported on their life satisfaction (7 items) as experienced (in retrospect) before the stroke and at the time of the investigation. Perceptual functions and actual levels of life satisfaction were registered in 60 clinically healthy subjects aged about 60 or about 80 years.</p><p>Both early on and late after stroke the 16 items of perceptual function were clearly grouped into two factors, which neatly fitted an ecological perceptual concept. One factor characterized low-order and the other higher-order perception. Impairments of low-order perception occurred for about 10% of the patients, whether investigated early or late after stroke. No one among the reference populations had such impairments. Higher-order perceptual impairments prevailed in 60% early on and in 57% late after stroke and were often more pronounced than those occurring in the reference populations, among whom 35% of the 60 year olds and significantly more - 77% - of the 80 year olds had such impairments. Hence, perceptual impairments are common after stroke, but slight age-dependent reductions should be considered when higher-order perceptual function is assessed and treated after stroke.</p><p>Together with motor function, which was impaired in 52% of the early and 36% of the late stroke samples, higher-order perceptual function and to a limited extent low-order perception could predict the level of self-care ability in 70% and 62% of the early and late samples, respectively.</p><p>Whereas levels of global and of domain specific variables of life satisfaction were similar in the two reference populations, the stroke had lead to a reduction in life satisfaction for 61% of the long-term survivors. Reductions were particularly pronounced for global life satisfaction and for satisfaction with leisure and sexuality. Although significantly associated with motor impairment and self-care disability, these reductions could not be attributed only to impairments and disability.</p><p>The findings are discussed with particular reference to assessment and treatment in occupational therapy.</p>
  • Bixo, Marie, 1957- (författare)
  • Ovarian steroids in rat and human brain effects of different endocrine states
  • 1987
  • Ingår i: digitalisering@umu. - Umeå : Umeå universitet. - 91-7174-313-8
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>Ovarian steroid hormones are known to produce several different effects in the brain. In addition to their role in gonadotropin release, ovulation and sexual behaviour they also seem to affect mood and emotions, as shown in women with the premenstrual tension syndrome. Some steroids have the ability to affect brain excitability. Estradiol decreases the electroshock threshold while progesterone acts as an anti-convulsant and anaesthetic in both animals and humans. Several earlier studies have shown a specific uptake of several steroids in the animal brain but only a few recent studies have established the presence of steroids in the human brain.</p><p>In the present studies, the dissections of rat and human brains were carried out macroscopically and areas that are considered to be related to steroid effects were chosen. Steroid concentrations were measured by radioimmunoassay after extraction and separation with celite chromatography. The accuracy and specificity of these methods were estimated.</p><p>In the animal studies, immature female rats were treated with Pregnant Mare's Serum Gonadotropin (PMSG) to induce simultaneous ovulations. Concentrations of estradiol and progesterone were measured in seven brain areas pre- and postovulatory. The highest concentration of estradiol, pre- and postovulatory, was found in the hypothalamus and differences between the two cycle phases were detected in most brain areas. The preovulatory concentrations of progesterone were low and the highest postovulatory concentration was found in the cerebral cortex.</p><p>In one study, the rats were injected with pharmacological doses of progesterone to induce "anaesthesia". High uptake of progesterone was found and a regional variation in the formation of 5&lt;*-pregnane-3,20-dione in the brain with the highest ratio in the medulla oblongata.</p><p>Concentrations of progesterone, 5a-pregnane-3*20-dione, estradiol and testosterone were determined in 17 brain areas of fertile compared to postmenopausal women. All steroids displayed regional differences in brain concentrations. Higher concentrations of estradiol and progesterone were found in the fertile compared to the postmenopausal women.</p><p>In summary, these studies show that the concentrations of ovarian steroids in the brain are different at different endocrine states in both rats and humans and that there are regional differences in brain steroid distribution.</p>
  • Björnstig, Ulf (författare)
  • Snowmobile, motorcycle and moose-car accidents aspects on injury control
  • 1985
  • Ingår i: digitalisering@umu. - Umeå : Umeå universitet.
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>Injuries related to snowmobiles, motorcycles and moose-car collisions have increased. The aim of the present thesis was to analyse mechanisms and consequences in fatal and non-fatal accidents of these types, and to penetrate possible preventive measures.</p><p><strong>Snowmobiles</strong></p><p>The median age of the injured was 30 and of the killed 32, males pre­dominating. A majority of the accidents occurred during weekends, and especially the fatal accidents occurred after dark. The extremities were the most commonly injured parts of the body, however, drowning, crushed chest and cranial injuries caused most of the fatalities. Among the fatalities, four out of five were under the influence of alcohol. The present Swedish laws regarding snowmobiles seem well motivated. "Built-in" safety measures in the construction of the snowmobiles, pro­perly designed snowmobile tracks and functional search and rescue sys­tems could reduce the injuries.</p><p><strong>Motorcycles</strong></p><p>The median age was 19 years for both the traffic injured and the kil­led. Half of the traffic accidents were collisions with other motor ve­hicles. In the fatally injured group, also collisions with fixed road­side objects were common. Of the fatally injured, more than every fifth person died in an accident where alcohol was an influential factor. In the injured group, lower extremity injuries (especially in off-road riding) were common and among the fatalities most riders died from injuries to the head or chest. Out of one thousand motorcycle riders interviewed, 45% reported wobbling experiences (8% reported severe wobbling). Possible injury reducing measures include increasing the licensing age, more discriminating driving test, "built-in" restriction of the motorcycle's top speed, elimination of motorcycles prone to wobbling, and a more intensive traffic supervision (speeding, alco­hol).</p><p><strong>Moose-car collisitions</strong></p><p>The median age of the drivers was 38 years. Most collisions happened at dusk or when dark (3/4). The median collision speed was 70 km/h. The damage to the car was typical, the roof and the windshield pillars were deformed downwards and backwards. The broken windshield was often pressed into the passenger compartment. Most of the injured car occu­pants suffered cuts predominantly to the head and upper extremities. Nearly all the fatally injured died of head and neck injuries. The injuries may be reduced by strengthening the roof and the windshield pillars, and by introducing anti 1 acerati ve windshields.</p><p></p>
  • Damber, Lena, 1950- (författare)
  • Lung cancer in males an epidemiological study in northern Sweden with special regard to smoking and occupation
  • 1986
  • Ingår i: digitalisering@umu. - Umeå : Umeå universitet. - 91-7174-240-9
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>In a case-control study comprising 589 cases of male lung cancer in northern Sweden longitudinal data concerning occupations, employments and smoking habits were collected by questionnaires.</p><p>Pipe smoking was as common as cigarette smoking and gave very similar relative risk. The pipe smoking cases, however, had significantly higher mean age and mean smoking years at the time of diagnosis than the cigarette smoking cases. In ex- smokers, the relative risk gradually decreased from 5 years after smoking cessation but this decrease was much less pronounced in ex-pipe smokers than in ex-cigarette smokers. High relative risks were obtained for small cell and squamous cell carcinomas. For adenocarcinoma the relative risk was considerably lower but still significantly increased. The population etiologic fraction attributable to smoking was about 80% in this series.</p><p>Some occupational groups (underground miners, copper smelter workers, electricians and plumbers) exposed to previously known lung carcinogenic agents had considerably increased odds ratios, which persisted after adjustment for smoking. A slightly elevated odds ratio was observed in a group of blue collar workers potentially exposed to lung carcinogenic agents but this elevation generally disappeared after adjustment for smoking. For two specific subgroups, asphalt and concrete workers and pulp workers, the overrisk persisted after adjustment for smoking. Farmers and foresters had strikingly low odds ratios, which could only partly be explained by their more moderate smoking habits. The population etiologic fraction attributable to occupation was in the reported material assessed to 9 per cent.</p><p>Professional drivers had higher average tobacco consumption than non-drivers, which explained the slightly increased crude odds ratio found for the occupational group as a whole. Smoking drivers in an upper age group (70 and over), however, had a high relative risk of lung cancer, while in a lower age group (under 70) no significant increase was found. The results in the older age group suggested a multiplicative effect between smoking and the occupational exposure.</p><p>The study clearly verified the increased lung cancer risk in underground miners. An obvious dose-response relation was found with high risk after long time exposure. All analyses concerning underground miners suggested an interaction of a multiplicative type between underground mining and smoking in the causation of lung cancer. The cases of small cell carcinoma among the underground miners had shorter average latency time and in contrast to the other part of the material, shorter average age than the cases with epidermoid cancer.</p>
  • Edin, Benoni B., 1956- (författare)
  • Classification of muscle stretch receptor afferents in humans
  • 1988
  • Ingår i: digitalisering@umu. - Umeå : Umeå universitet. - 91-7174-324-3
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>The response patterns of human stretch receptors in the finger extensor muscles of the forearm were studied using the microneurography technique. Single-unit recordings were obtained from one-hundred and twenty-four afferents. A procedure was developed to classify the units in muscle spindle primary afferents, secondary afferents, and Golgi tendong organ afferents. The procedure allows an objective and reproducible classification on the basis of the afferents’ responses to a series of tests which individually are non-conclusive.</p><p>It was demonstrated that maximal twitch contractions can be elicited in the finger extensor muscles of the forearm, without causing undue discomfort to the subjects, or hazarding the single-unit recording. The response of the units to this test allowed, in most cases but not always, a separation in muscle spindle and tendon organ afferents. Thus the test was not adequate for an unequivocal classification.</p><p>Three discrete response parameters were extracted from ramp-and-hold stretches, <em>viz. </em>the presence or absence of an initial burst and a deceleration response, and prompt silencing at slow muscle shortening. The distributions of the parameters were significantly different among the three unit types. These parameters which were pair-wise independent constituted a set of considerable discriminative power. It was shown that human muscle spindles have about the same static position sensitivity to fractional muscle stretch as previously found in animals.</p><p>Stretch sensitization was demonstrated by rapid, repeated stretches of the muscle which enhanced the réponse to subsequent slow stretches of muscle spindles. Sensitization was different with primary and secondary muscle spindle afferents whereas Golgi tendon organ afferents never displayed stretch sensitization.</p><p>One-to-one driving with small-amplitude sinusoidal stretches superimposed on ramp-and- hold stretches was almost exclusively seen with primary muscle spindle afferents, whereas secondaries seldom and tendon organ afferents never displayed driving.</p><p>The afferent responses during slowly increasing isometric contractions and rapid relaxations were analysed. An increased discharge rate on relaxation was common among spindle afferents whereas it was never seen in tendon organs afferents. Two separate groups of spindles afferents were found with regard to fusimotor recruitment. The largest group was recruited at rather low and variable contractile forces whereas the smaller group was not recruited at all.</p><p>The proportions of the three unit types, spindle primary, spindle secondary, and Golgi tendon organ afferents were estimated from a preliminary classification and the distribution of the eight response features were analyzed for each class of afferents. On the basis of these estimates and the response pattern of the individual unit Bayes’ theorem was used to calculate the probabilities that the unit was a spindle primary, a spindle secondary, or a tendon organ afferent. Estimates indicate that about 19 out of 20 muscle afferents are correctly classified when all eight features are analyzed.</p>
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