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  • Elmberg, Maria, et al. (författare)
  • Cancer risk in patients with hereditary hemochromatosis and in their first-degree relatives
  • 2003
  • Ingår i: Gastroenterology. - 0016-5085 .- 1528-0012. ; 125:6, s. 1733-41
  • Tidskriftsartikel (refereegranskat)abstract
    • Background & Aims: Iron overload may be carcinogenic. Patients with hereditary hemochromatosis (HH) are reportedly at a 20-200-fold risk of intrahepatic cancer, but the reported risks for nonhepatobiliary cancers are conflicting. The risk of cancer in heterozygous individuals (estimated allele frequency, 1/10 to 1/20) is unknown. This study aimed to better assess these risks. Methods: We performed a population-based cohort study of 1847 Swedish patients with HH and 5973 of their first-degree relatives using nationwide, population-based health and census registers. We used standardized incidence ratios (SIRs) as relative risk. Results: With 62 liver cancers and 128 nonhepatobiliary cancers, patients with HH were at a 20-fold risk of liver cancer (SIR, 21, 95% confidence interval [Cl], 16-22) but an almost unaltered risk of all other cancers (SIR, 1.2, 95% Cl, 1.0-1.4), including nonelevated risks for several gastrointestinal tract cancers. At 10 years of follow-up, the absolute risk of liver cancer was 6% among men and 1.5% among women. With 21 liver cancers and 508 nonhepatobiliary cancers, first-degree relatives were at an unaltered risk of extrahepatic cancer (SIR, 1.0, 95% Cl, 0.9-1.1, including unelevated risks for gastrointestinal cancers) but at a modest and historic increased risk of hepatobiliary cancer (SIR, 1.5, 95% Cl, 1.0-2.4), the histopathologic spectrum of which differed from the patients. Conclusions: Patients (particularly men) with HH are at increased risk for hepatocellular cancer, although the magnitude of the risk is lower than previous estimates. Overall cancer risk in first-degree relatives does not seem to be increased.
  • Bergquist, Annika, et al. (författare)
  • Hepatic and extrahepatic malignancies in primary sclerosing cholangitis
  • 2002
  • Ingår i: Journal of Hepatology. - Elsevier. - 0168-8278. ; 36:3, s. 321-327
  • Tidskriftsartikel (refereegranskat)abstract
    • Background/Aims: To assess the risk of hepatic and extrahepatic malignancies in a large cohort of Swedish primary sclerosing cholangitis (PSC) patients compared with that of the general Swedish population. Methods: The study cohort comprised 604 PSC patients identified between 1970 and 1998. Follow-up was provided through linkages to the Swedish Cancer and Death registries. Cumulative incidence of malignancies and standard incidence ratio were calculated with the incidence rates in the Swedish population, taking into account: sex, age and calendar year as comparison group. Results: Median time of follow-up was 5.7 years (range 0-27.8). Seventy-nine percent had concomitant inflammatory bowel disease. The cause of death was cancer in 44%. The frequency of hepatobillary malignancies was 13.3% (81/604). Thirty-seven percent (30/81) of all hepatobiliary malignancies were diagnosed less than 1 year after the diagnosis of PSC. The risk for hepatobiliary malignancy was increased 161 times, for colorectal carcinoma 10 times and for pancreatic carcinoma 14 times, compared with that of the general population. Conclusions: In this national-based study including the largest cohort of PSC patients ever presented, the frequency of cholangiocarcinoma is 13%. The risk of hepatobiliary carcinoma is constant after the first year after PSC diagnosis with an incidence rate of 1.5% per year. The risk of pancreatic carcinoma is increased 14 times compared with the general Swedish population. These results are suggestive of an increased risk of pancreatic carcinoma in patients with PSC.
  • Bergquist, Annika, et al. (författare)
  • Increased risk of primary sclerosing cholangitis and ulcerative colitis in first-degree relatives of patients with primary sclerosing cholangitis
  • 2008
  • Ingår i: Clinical Gastroenterology and Hepatology. - 1542-3565. ; 6:8, s. 939-943
  • Tidskriftsartikel (refereegranskat)abstract
    • Background & Aims: The importance of genetic factors for the development of primary sclerosing cholangitis (PSC) is incompletely understood. This study assessed the risk of PSC and inflammatory bowel disease (IBD) among first-degree relatives of patients with PSC, compared with the first-degree relatives of a cohort without PSC. Methods: Subjects from the national Swedish cohort of PSC patients (n = 678) were matched for date of birth, sex, and region to up to 10 subjects without a diagnosis of PSC (n = 6347). Linkage through general population registers identified first-degree relatives of subjects in both the PSC and comparison cohorts (n = 34,092). Diagnoses among first-degree relatives were identified by using the Inpatient Register. Results: The risk of cholangitis was statistically significantly increased in offspring, siblings, and parents of the PSC patient cohort, compared with relatives of the comparison cohort, with the hazard ratios and 95% confidence intervals, 11.5 (1.6–84.4), 11.1 (3.3–37.8), and 2.3 (0.9–6.1), respectively. The hazard ratios for ulcerative colitis (UC) among first-degree relatives of all PSC patients was 3.3 (2.3–4.9) and for Crohn's disease 1.4 (0.8–2.5). The risk of UC for relatives of PSC patients without IBD was also increased, 7.4 (2.9–18.9). Conclusions: First-degree relatives of patients with PSC run an increased risk of PSC, indicating the importance of genetic factors in the etiology of PSC. First-degree relatives of PSC patients without IBD are also at an increased risk of UC, which might indicate shared genetic susceptibility factors for PSC and UC. 
  • Bergquist, Annika, et al. (författare)
  • Perinatal events and the risk of developing primary sclerosing cholangitis
  • 2006
  • Ingår i: World Journal of Gastroenterology. - 1007-9327. ; 12:37, s. 6037-6040
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To investigate whether perinatal events, intrauterine or postpartum, are associated with the development of primary sclerosing cholangitis (PSC) later in life. METHODS: Birth records from 97 patients with adult PSC in Sweden were reviewed. Information on perinatal events including medications and complications during pregnancy, gestation length, birth weight and length were collected. Two control children of the same sex were selected for each subject. Conditional multiple logistic regression was used to assess associations of the perinatal measures with development of PSC. RESULTS: No significant associations were found between gestational age, birth length, breastfeeding, and the majority of medical complications including infections or medication during pregnancy for the mothers or postpartum for the children. Vaginal bleeding and peripheral oedema showed associations with PSC, with matched odds ratios of 5.70 (95% CI, 1.13-28.83) and 2.28 (95% CI, 1.04-5.03), respectively.   CONCLUSION: The associations of vaginal bleeding and oedema with subsequent PSC cannot readily be explained, so our findings do not strongly support the hypothesis of a significant role of perinatal events as a risk for the development of PSC later in life.
  • Blomdell, Anders, et al. (författare)
  • Extending an Industrial Robot Controller-Implementation and Applications of a Fast Open Sensor Interface
  • 2005
  • Ingår i: IEEE Robotics & Automation Magazine. - IEEE - Institute of Electrical and Electronics Engineers Inc.. - 1070-9932. ; 12:3, s. 85-94
  • Tidskriftsartikel (refereegranskat)abstract
    • Many promising robotics research results were obtained during the late 1970s and early 1980s. Some examples include Cartesian force control and advanced motion planning. Now, 20 years and many research projects later, many technologies still have not reached industrial usage. An important question to consider is how this situation can be improved for future deployment of necessary technologies. Today, modern robot control systems used in industry provide highly optimized motion control that works well in a variety of standard applications. To this end, computationally intensive, model-based robot motion control techniques have become standard during the last decade. While the principles employed have been known for many years, deployment in products required affordable computing power, efficientengineering tools, customer needs for productivity/performance, and improved end-user competence in the utilization of performance features. However, applications that are considered nonstandard today motivate a variety of research efforts and system development to package results in a usable form. Actually, robots are not useful for many manufacturing tasks today, in particular those found in small and medium enterprises (SMEs). Reasonsinclude complex configuration, nonintuitive (for the shop floor) programming, and difficulties instructing robots to deal with variations in their environment. The latter challenge includes both task definitions and definition of motion control utilizing external sensors. The key word here is flexibility, and flexible motion control is particularly difficult since the user or system integrator needs to influence the core real-time software functions that are critical for the performance and safe operation of the system. We must find techniques that permit real-time motion controllers to be extended for new, demanding application areas.
  • Burmakin, Mikhail, et al. (författare)
  • Imatinib increases oxygen delivery in extracellular matrix-rich but not in matrix-poor experimental carcinoma
  • 2017
  • Ingår i: Journal of Translational Medicine. - BioMed Central. - 1479-5876 .- 1479-5876. ; 15
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Imatinib causes increased turnover of stromal collagen, reduces collagen fibril diameter, enhances extracellular fluid turnover and lowers interstitial fluid pressure (IFP) in the human colonic carcinoma KAT-4/HT-29 (KAT-4) xenograft model. Methods: We compared the effects of imatinib on oxygen levels, vascular morphology and IFP in three experimental tumor models differing in their content of a collagenous extracellular matrix. Results: Neither the KAT4 and CT-26 colonic carcinoma models, nor B16BB melanoma expressed PDGF beta-receptors in the malignant cells. KAT-4 tumors exhibited a well-developed ECM in contrast to the other two model systems. The collagen content was substantially higher in KAT-4 than in CT-26, while collagen was not detectable in B16BB tumors. The pO(2) was on average 5.4, 13.9 and 19.3 mmHg in KAT-4, CT-26 and B16BB tumors, respectively. Treatment with imatinib resulted in similar pO(2)-levels in all three tumor models but only in KAT-4 tumors did the increase reach statistical significance. It is likely that after imatinib treatment the increase in pO(2) in KAT-4 tumors is caused by increased blood flow due to reduced vascular resistance. This notion is supported by the significant reduction observed in IFP in KAT-4 tumors after imatinib treatment. Vessel area varied between 4.5 and 7% in the three tumor models and was not affected by imatinib treatment. Imatinib had no effect on the fraction of proliferating cells, whereas the fraction of apoptotic cells increased to a similar degree in all three tumor models. Conclusion: Our data suggest that the effects of imatinib on pO(2)-levels depend on a well-developed ECM and provide further support to the suggestion that imatinib acts by causing interstitial stroma cells to produce a less dense ECM, which would in turn allow for an increased blood flow. The potential of imatinib treatment to render solid tumors more accessible to conventional treatments would therefore depend on the degree of tumor desmoplasia.
  • Holm, Magnus, et al. (författare)
  • Non-invasive assessment of the atrial cycle length during atrial fibrillation in man: introducing, validating and illustrating a new ECG method
  • 1998
  • Ingår i: Cardiovascular Research. - Elsevier. - 1755-3245. ; 38:1, s. 69-81
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: Atrial fibrillation (AF) in man has previously been shown to include a wide variety of atrial activity. Assessment of the characteristics of this arrhythmia with a commonly applicable tool may therefore be important in the choice and evaluation of different therapeutic strategies. As the AF cycle length has been shown to correlate locally with atrial refractoriness and globally with the degree of atrial organization, with, in general, shorter cycle length during apparently random AF compared to more organized AF, we have developed a new method for non-invasive assessment of the AF cycle length using the surface and the esophagus (ESO) ECG. METHODS AND RESULTS: From the frequency spectrum of the residual ECG, created by suppression of the QRST complexes, the dominant atrial cycle length (DACL) was derived. By comparison with multiple intracardiac simultaneously acquired right and left AF cycle lengths in patients with paroxysmal AF, we found that the DACL in lead V1, ranging from 130 to 185 ms, well represented a spatial average of the right AF cycle lengths, whereas the DACL in the ESO ECG, ranging from 140 to 185 ms, reflected both the right and the left AF cycle length, where the influence from each structure depended on the atrial anatomy of the individual, as determined by MRI. In patients with chronic AF, the method was capable of following changes in the AF cycle length due to administration of D,L-sotalol and 5 min of ECG recording was sufficient for the DACL to be reproducible. CONCLUSIONS: We conclude that this new non-invasive method, named 'Frequency Analysis of Fibrillatory ECG' (FAF-ECG), is capable of assessing both the magnitude and the dynamics of the atrial fibrillation cycle length in man.
  • Johansson, Rolf, et al. (författare)
  • Sensor Integration in Task-level Programming and Industrial Robotic Task Execution Control
  • 2004
  • Ingår i: Industrial Robot. - JAI Press. - 0143-991X. ; 31:3, s. 284-296
  • Tidskriftsartikel (refereegranskat)abstract
    • Presents an approach to improved performance and flexibility in industrial robotics by means of sensor integration and feedback control in task-level programming and task execution. Also presents feasibility studies in support of the ideas. Discusses some solutions to the problem using six degrees of freedom force control together with the ABB S4CPlus system as an illustrative example. Consider various problems in the design of an open sensor interface for industrial robotics and discusses possible solutions. Finally, presents experimental results from industrial force controlled grinding.
  • Olsson, Rolf, et al. (författare)
  • High-dose ursodeoxycholic acid in primary sclerosing cholangitis : a 5-year multicenter, randomized, controlled study.
  • 2005
  • Ingår i: Gastroenterology. - 0016-5085. ; 129:5, s. 1464-72
  • Tidskriftsartikel (refereegranskat)abstract
    • Background & Aims: There is no medical treatment of proven benefit for primary sclerosing cholangitis. This study aimed at studying the effect of a higher dose of ursodeoxycholic acid than previously used on survival, symptoms, biochemistry, and quality of life in this disease. Methods: A randomized placebo-controlled study was performed in tertiary and secondary gastroenterology units. A total of 219 patients were randomized to 17 to 23 mg/kg body weight per day of ursodeoxycholic acid (n = 110) or placebo (n = 109) for 5 years. Follow-up data are available from 97 patients randomized to ursodeoxycholic acid and for 101 randomized to placebo. Quality of life was assessed by using the Medical Outcomes Study 36-item Short-Form Health Survey. Results: The combined end point “death or liver transplantation” occurred in 7 of 97 (7.2%) patients in the ursodeoxycholic acid group vs 11 of 101 (10.9%) patients in the placebo group (P = .368; 95% confidence interval, −12.2% to 4.7%). The occurrence of liver transplantation as a single end point showed a similar positive trend for ursodeoxycholic acid treatment (5/97 [5.2%] vs 8/101 [7.9%]; 95% confidence interval, −10.4% to 4.6%). Three ursodeoxycholic acid and 4 placebo patients died from cholangiocarcinoma, and 1 placebo patient died from liver failure. Alkaline phosphatase and alanine aminotransferase tended to decrease during the first 6 months. There were no differences between the 2 groups in symptoms or quality of life. Analyses of serum ursodeoxycholic acid concentration gave no evidence that noncompliance may have influenced the results. Conclusions: This study found no statistically significant beneficial effect of a higher dose of ursodeoxycholic acid than previously used on survival or prevention of cholangiocarcinoma in primary sclerosing cholangitis.
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