| 1. |
- Arver, Brita, et al.
(författare)
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Bilateral Prophylactic Mastectomy in Swedish Women at High Risk of Breast Cancer: A National Survey.
- 2011
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Ingår i: Annals of surgery. - : Lippincott Williams and Wilkins; 1999. - 1528-1140 .- 0003-4932. ; 253:6, s. 1147-1154
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/OBJECTIVE:: This study attempted a national inventory of all bilateral prophylactic mastectomies performed in Sweden between 1995 and 2005 in high-risk women without a previous breast malignancy. The primary aim was to investigate the breast cancer incidence after surgery. Secondary aims were to describe the preoperative risk assessment, operation techniques, complications, histopathological findings, and regional differences. METHODS:: Geneticists, oncologists and surgeons performing prophylactic breast surgery were asked to identify all women eligible for inclusion in their region. The medical records were reviewed in each region and the data were analyzed centrally. The BOADICEA risk assessment model was used to calculate the number of expected/prevented breast cancers during the follow-up period. RESULTS:: A total of 223 women operated on in 8 hospitals were identified. During a mean follow-up of 6.6 years, no primary breast cancer was observed compared with 12 expected cases. However, 1 woman succumbed 9 years post mastectomy to widespread adenocarcinoma of uncertain origin. Median age at operation was 40 years. A total of 58% were BRCA1/2 mutation carriers. All but 3 women underwent breast reconstruction, 208 with implants and 12 with autologous tissue. Four small, unifocal, invasive cancers and 4 ductal carcinoma in situ were found in the mastectomy specimens. The incidence of nonbreast related complications was low (3%). Implant loss due to infection/necrosis occurred in 21 women (10%) but a majority received a new implant later. In total, 64% of the women underwent at least 1unanticipated secondary operation. CONCLUSIONS:: Bilateral prophylactic mastectomy is safe and efficacious in reducing future breast cancer in asymptomatic women at high risk. Unanticipated reoperations are common. Given the small number of patients centralization seems justified.
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| 2. |
- Henriksson, Isabelle, et al.
(författare)
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Hereditary colorectal cancer diagnostics in southern Sweden : retrospective evaluation and future considerations with emphasis on Lynch syndrome
- 2019
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Ingår i: Journal of Community Genetics. - : Springer Science and Business Media LLC. - 1868-310X .- 1868-6001. ; 10:2, s. 259-266
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Tidskriftsartikel (refereegranskat)abstract
- Overlapping phenotypes between different hereditary colorectal cancer (CRC) syndromes together with a growing demand for cancer genetic testing and improved sequencing technology call for adjusted patient selection and adapted diagnostic routines. Here we present a retrospective evaluation of family history of cancer, laboratory diagnostic procedure, and outcome for 372 patients tested for Lynch syndrome (LS), i.e., the single most common hereditary cause of CRC. Based on number of affected family members and age at cancer diagnosis in families with genetically confirmed LS, we developed local patient selection criteria for a simplified one-step gene panel mutation screening strategy targeting also less common Mendelian CRC syndromes. Pros and cons of this strategy are discussed.
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| 3. |
- Magnusson, Hans, 1943-
(författare)
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From recovery boiler to integration of a textile fiber plant : Combination of mass balance analysis and chemical engineering
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Modern chemical technology is an efficient tool for solving problems, particularly within the complex environment of the pulp and paper industry, and the combination of experimental studies, mill data and mass balance calculations are of fundamental importance to the development of the industry. In this study various examples are presented, whereby chemical technology is of fundamental importance.It is well documented that under normal conditions the molten salt mixture from the kraft recovery boiler flows down into the dissolving tank without problems. However, in the case of alternatives to the kraft recovery boiler, knowledge of more precise data of the molten salts is required for the design calculations. In this study the viscosity for the case of sodium carbonate and 30 mole% sulphide has been measured and is of the magnitude 2 – 3 cP at temperatures relevant for a recovery boiler, i.e. similar to water at room temperature.The presence of non-process elements (NPE) in a typical pulp mill has been investigated. The main input is with regards to the wood, and anticipated problems include; deposits in evaporators, high dead-load in liquor streams, plugging of the upper part of the recovery boiler and decreasing efficiency in the causticization department. Efficient green liquor clarification is of the greatest importance as an efficient kidney for many NPE. Mill data and calculations show that the magnesium added in the oxygen delignification does not form a closed loop.Integration of a prehydrolysis kraft pulp mill producing dissolving pulp with a plant producing viscose textile fiber could be highly beneficial. The prehydrolysis liquor will contain both sugars and acetic acid. It is however not possible to fully replace the sulphuric acid of the viscose spinning bath with acetic acid of own production. The sulphuric chemicals from the viscose plant can be partly taken care of in the kraft recovery area as well as the viscose plant which can be supplied with alkali and sulphuric acid. Zinc-containing effluents from the viscose plant can be treated with green liquor to precipitate zinc sulphide.
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| 4. |
- Rosdahl, Hans, et al.
(författare)
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Effect of physiological hyperinsulinemia on blood flow and interstitial glucose concentration in human skeletal muscle and adipose tissue studied by microdialysis
- 1998
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Ingår i: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 47:8, s. 1296-1301
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Tidskriftsartikel (refereegranskat)abstract
- The effect of an euglycemic-hyperinsulinemic glucose clamp (94 +/- 5 microU/ml) on blood flow and glucose extraction fraction in human skeletal muscle and adipose tissue was investigated. Limb blood flow was measured by venous occlusion pletysmography and tissue blood flow by the microdialysis ethanol technique. Insulin infusion resulted in an increased blood flow in the calf and forearm (64 and 36%, respectively; P < 0.01) but not in the studied muscles of these limbs (ethanol outflow-to-inflow ratio: m. gastrocnemius 0.144 +/- 0.009 to 0.140 +/- 0.011, NS; m. brachioradialis 0.159 +/- 0.025 to 0.168 +/- 0.027, NS). This was accompanied by an increased extraction fraction of glucose, as measured by an increased arteriovenous difference over the forearm (0.16 +/- 0.04 to 0.70 +/- 0.10 mmol/l; P < 0.001) and by an increase in the estimated arterial-interstitial glucose difference in the gastrocnemius (0.82-1.42 mmol/l) and brachioradialis muscle (0.82-1.97 mmol/l). The blood flow in adipose tissue was significantly increased during insulin infusion, as evidenced by a decreased ethanol outflow-to-inflow ratio (0.369 +/- 0.048 to 0.325 +/- 0.046; P < 0.01). This was accompanied by an unchanged concentration of glucose in the dialysate (-2.6%, NS). In summary, during physiological hyperinsulinemia 1) a blood flow increase was detected in the calf and forearm, but not in the studied muscles of these limbs; 2) the blood flow increased in the subcutaneous adipose tissue; and 3) the estimated arterial-interstitial glucose difference increased in both muscles studied and was larger in the forearm muscle than the arteriovenous glucose difference over the forearm. The present study shows that microdialysis is a useful tool to obtain tissue-specific information about the effect of insulin on blood flow and glucose extraction in human skeletal muscle and adipose tissue.
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| 5. |
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| 6. |
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| 7. |
- Andersson, Swen-Olof, et al.
(författare)
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Managing localized prostate cancer by radical prostatectomy or watchful waiting: Cost analysis of a randomized trial (SPCG-4)
- 2011
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Ingår i: SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY. - : Informa Healthcare. - 0036-5599 .- 1651-2065. ; 45:3, s. 177-183
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The cost of radical prostatectomy (RP) compared to watchful waiting (WW) has never been estimated in a randomized trial. The goal of this study was to estimate long-term total costs per patient associated with RP and WW arising from inpatient and outpatient hospital care. Material and methods. This investigation used the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial, comparing RP to WW, and included data from 212 participants living in two counties in Sweden from 1989 to 1999 (105 randomized to WW and 107 to RP). All costs were included from randomization date until death or end of follow-up in July 2007. Resource use arising from inpatient and outpatient hospital costs was measured in physical units and multiplied by a unit cost to come up with a total cost per patient. Results. During a median follow-up of 12 years, the overall cost in the RP group was 34% higher (p andlt; 0.01) than in the WW group, corresponding to euroa,not sign6123 in Sweden. The difference was driven almost exclusively by the cost of the surgical procedure. The cost difference between RP and WW was two times higher among men with low (2--6) than among those with high (7--10) Gleason score. Conclusion. In this economic evaluation of RP versus WW of localized prostate cancer in a randomized study, RP was associated with 34% higher costs. This difference, attributed exclusively to the cost of the RP procedure, was not overcome during extended follow-up.
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| 8. |
- Angele, Kristian, et al.
(författare)
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Flow Mixing Inside a Control-Rod Guide Tube : Part 2—Experimental Tests and CFD-Simulations
- 2010
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Ingår i: 18th International Conference on Nuclear Engineering. - 9780791849323 ; , s. 655-663
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Konferensbidrag (refereegranskat)abstract
- Alarge number of control rod cracks were detected during therefuelling outage of the twin reactors Oskarshamn 3 and Forsmark3 in the fall of 2008. The extensive damage investigationfinally lead to the restart of both reactors at theend of 2008 under the condition that further studies wouldbe conducted in order to clarify all remaining matters. Also,all control rods were inserted 14% in order to locatethe welding region of the control rod stem away fromthe thermal mixing region of the flow. Unfortunately, this measureled to new cracks a few months later due toa combination of surface finish of the new stems andthe changed flow conditions after the partial insertion of thecontrol rods. The experimental evidence reported here shows an increasein the extension of the mixing region and in theintensity of the thermal fluctuations. As a part of thecomplementary work associated with the restart of the reactors, andto verify the CFD simulations, experimental work of the flowin the annular region formed by the guide tube andcontrol rod stem was carried out. Two full-scale setups weredeveloped, one in a Plexiglass model at atmospheric conditions (inorder to be able to visualize the mixing process) andone in a steel model to allow for a highertemperature difference and heating of the control rod guide tube.The experimental results corroborate the general information obtained through CFDsimulations, namely that the mixing region between the cold crud-removalflow and warm by-pass flow is perturbed by flow structurescoming from above. The process is characterized by low frequent,high amplitude temperature fluctuations. The process is basically hydrodynamic, causedby the downward transport of flow structures originated at theupper bypass inlets. The damping thermal effects through buoyancy isof secondary importance, as also the scaling analysis shows, howevera slight damping of the temperature fluctuations can be seendue to natural convection due to a pre-heating of thecold crud-removal flow. The comparison between numerical and experimental resultsshows a rather good agreement, indicating that experiments with plantconditions are not necessary since, through the existing scaling lawsand CFD-calculations, the obtained results may be extrapolated to plantconditions. The problem of conjugate heat transfer has not yetbeen addressed experimentally since complex and difficult measurements of theheat transfer have to be carried out. This type ofmeasurements constitutes one of the main challenges to be dealtwith in the future work.
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| 9. |
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| 10. |
- Antonson, Hans, et al.
(författare)
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People and parking requirements : Residential attitudes and day-to-day consequences of a land use policy shift towards sustainable mobility
- 2017
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Ingår i: Land use policy. - : Elsevier. - 0264-8377 .- 1873-5754. ; :62, s. 213-222
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Tidskriftsartikel (refereegranskat)abstract
- A land use policy shift is taking place in a growing number of cities regarding parking, whereby a conventional supply management approach is being replaced with a parking management approach. As part of this policy shift, many cities are lowering their parking requirements.This study analysed changes in car use, car ownership, spatial parking patterns and the consequences for the everyday life of residents in a housing area with a relatively restrictive parking requirement in Gothenburg, the second largest city in Sweden. The housing area, a concrete example of how lowering parking requirements can be used to achieve targets on reduced car use and sustainable urban development, is used to discuss how parking policy should be applied to achieve the desired effect.The results show that the consequences of the restrictive requirement was paradoxically small in the study area. In practice, the requirement did not result in a decrease in the number of parking spaces, because e.g. of access to parking in neighbouring residential areas. This shows how important it is to adopt a holistic approach in parking policy, by e.g.introducing more restrictive parking requirements in parallel with other measures, such as raising parking charges and decreasing the number of public parking spaces. It also shows that planning of parking must be coordinated with other urban planning functions. Otherwise, the actual contribution of a shift in parking policy to the development of a more environmentally friendly transport system and city risks being small, despite lower parking requirements
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