| 1. |
- Kohl, A., et al.
(författare)
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Two-year results of the randomized clinical trial DILALA comparing laparoscopic lavage with resection as treatment for perforated diverticulitis
- 2018
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 105:9, s. 1128-1134
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTraditionally, perforated diverticulitis with purulent peritonitis was treated with resection and colostomy (Hartmann's procedure), with inherent complications and risk of a permanent stoma. The DILALA (DIverticulitis - LAparoscopic LAvage versus resection (Hartmann's procedure) for acute diverticulitis with peritonitis) and other randomized trials found laparoscopic lavage to be a feasible and safe alternative. The medium-term follow-up results of DILALA are reported here. MethodsPatients were randomized during surgery after being diagnosed with Hinchey grade III perforated diverticulitis at diagnostic laparoscopy. The primary outcome was the proportion of patients with one or more secondary operations from 0 to 24 months after the index procedure in the laparoscopic lavage versus Hartmann's procedure groups. The trial was registered as ISRCTN82208287. ResultsForty-three patients were randomized to laparoscopic lavage and 40 to Hartmann's procedure. Patients in the lavage group had a 45 per cent reduced risk of undergoing one or more operations within 24 months (relative risk 055, 95 per cent c.i. 036 to 084; P = 0012) and had fewer operations (ratio 051, 95 per cent c.i. 031 to 087; P = 0024) compared with those in the Hartmann's group. No difference was found in mean number of readmissions (137 versus 150; P = 0221) or mortality between patients randomized to laparoscopic lavage or Hartmann's procedure. Three patients in the lavage group and nine in the Hartmann's group had a colostomy at 24 months. ConclusionLaparoscopic lavage is a better option for perforated diverticulitis with purulent peritonitis than open resection and colostomy.
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| 2. |
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| 3. |
- Angenete, Eva, 1972, et al.
(författare)
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Laparoscopic Lavage Is Feasible and Safe for the Treatment of Perforated Diverticulitis With Purulent Peritonitis The First Results From the Randomized Controlled Trial DILALA
- 2016
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Ingår i: Annals of Surgery. - : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 263:1, s. 117-122
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To evaluate short-term outcomes of a new treatment for perforated diverticulitis with purulent peritonitis in a randomized controlled trial.Background:Perforated diverticulitis with purulent peritonitis (Hinchey III) has traditionally been treated with surgery including colon resection and stoma (Hartmann procedure) with considerable postoperative morbidity and mortality. Laparoscopic lavage has been suggested as a less invasive surgical treatment.Methods:Laparoscopic lavage was compared with colon resection and stoma in a randomized controlled multicenter trial, DILALA (ISRCTN82208287). Initial diagnostic laparoscopy showing Hinchey III was followed by randomization. Clinical data was collected up to 12 weeks postoperatively.Results: Eighty-three patients were randomized, out of whom 39 patients in laparoscopic lavage and 36 patients in the Hartmann procedure groups were available for analysis. Morbidity and mortality after laparoscopic lavage did not differ when compared with the Hartmann procedure. Laparoscopic lavage resulted in shorter operating time, shorter time in the recovery unit, and shorter hospital stay.Conclusions:In this trial, laparoscopic lavage as treatment for patients with perforated diverticulitis Hinchey III was feasible and safe in the short-term.
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| 4. |
- Kjaer, Josefin, et al.
(författare)
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Long-term outcome after resection and thermal hepatic ablation of pancreatic neuroendocrine tumour liver metastases
- 2021
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Ingår i: BJS open. - : Oxford University Press (OUP). - 2474-9842. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Pancreatic neuroendocrine tumours (Pan-NETs) are rare tumours that often present with or develop liver metastases. The aim of this retrospective study was to evaluate liver surgery and thermal hepatic ablation (THA) of Pan-NET liver metastases and to compare the outcomes with those of a control group. METHOD: Patients with Pan-NET treated in Uppsala University Hospital and Sahlgrenska University Hospital from 1995-2018 were included. Patient records were scrutinized for baseline parameters, survival, treatment and complications. RESULTS: Some 108 patients met the criteria for inclusion; 57 patients underwent treatment with liver surgery or THA and 51 constitute the control group. Median follow-up was 3.93years. Five-year survival in the liver surgery/THA group was 70.6 (95 per cent c.i. 0.57 to 0.84) per cent versus 42.4 (95 per cent c.i. 40.7 to 59.1) per cent in the control group (P=0.016) and median survival was 9.1 (95 per cent c.i. 6.5 to 11.7) versus 4.3 (95 per cent c.i. 3.4-5.2) years. In a multivariable analysis, surgery or THA was associated with a decreased death-years rate (hazard ratio 0.403 (95 per cent c.i. 0.208 to 0.782, P=0.007). CONCLUSION: Liver surgery and/or THA was associated with longer overall survival in Pan-NET with acceptable mortality and morbidity rates. These treatments should thus be considered in Pan-NET patients with reasonable tumour burden in an intent to alleviate symptoms and to improve survival.
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| 5. |
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| 6. |
- Lekholm, Ville, 1976-, et al.
(författare)
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High-temperature zirconia microthruster with integrated flow sensor
- 2013
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Ingår i: Journal of Micromechanics and Microengineering. - : IOP Publishing. - 0960-1317 .- 1361-6439. ; 23:5, s. 055004-
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Tidskriftsartikel (refereegranskat)abstract
- This paper describes the design, fabrication and characterization of a ceramic, heated cold-gas microthruster device made with silicon tools and high temperature co-fired ceramic processing. The device contains two opposing thrusters, each with an integrated calorimetric propellant flow sensor and a heater in the stagnation chamber of the nozzle. The exhaust from a thruster was photographed using schlieren imaging to study its behavior and search for leaks. The heater elements were tested under a cyclic thermal load and to the maximum power before failure. The nozzle heater was shown to improve the efficiency of the thruster by 6.9%, from a specific impulse of 66 to 71 s, as calculated from a decrease of the flow rate through the nozzle of 13%, from 44.9 to 39.2 sccm. The sensitivity of the integrated flow sensor was measured to 0.15 m Omega sccm(-1) in the region of 0-15 sccm and to 0.04 m Omega sccm(-1) above 20 sccm, with a zero-flow sensitivity of 0.27 m Omega sccm(-1). The choice of yttria-stabilized zirconia as a material for the devices makes them robust and capable of surviving temperatures locally exceeding 1000 degrees C.
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| 7. |
- Lekholm, Ville, 1976-, et al.
(författare)
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Investigation of a zirconia co-fired ceramic calorimetric microsensor for high-temperature flow measurements
- 2015
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Ingår i: Journal of Micromechanics and Microengineering. - : IOP Publishing. - 0960-1317 .- 1361-6439. ; 25:6
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Tidskriftsartikel (refereegranskat)abstract
- This paper describes the design, fabrication and characterization of a flow sensor for high-temperature, or otherwise aggressive, environments, like, e.g. the propulsion system of a small spacecraft. The sensor was fabricated using 8 mol% yttria stabilized zirconia (YSZ8) high-temperature co-fired ceramic (HTCC) tape and screen printed platinum paste. A calorimetric flow sensor design was used, with five 80 mu m wide conductors, separated by 160 mu m, in a 0.4 mm wide, 0.1 mm deep and 12.5 mm long flow channel. The central conductor was used as a heater for the sensor, and the two adjacent conductors were used to resistively measure the heat transferred from the heater by forced convection. The two outermost conductors were used to study the influence of an auxiliary heat source on the sensor. The resistances of the sensor conductors were measured using four-point connections, as the gas flow rate was slowly increased from 0 to 40 sccm, with different power supplied through the central heater, as well as with an upstream or downstream heater powered. In this study, the thermal and electrical integrability of microcomponents on the YSZ8 substrate was of particular interest and, hence, the influence of thermal and ionic conduction in the substrate was studied in detail. The effect of the ion conductivity of YSZ8 was studied by measuring the resistance of a platinum conductor and the resistance between two adjacent conductors on YSZ8, in a furnace at temperatures from 20 to 930 degrees C and by measuring the resistance with increasing current through a conductor. With this design, the influence of ion conductivity through the substrate became apparent above 700 degrees C. The sensitivity of the sensor was up to 1 m Omega sccm(-1) in a range of 0-10 sccm. The results show that the signal from the sensor is influenced by the integrated auxiliary heating conductors and that these auxiliary heaters provide a way to balance disturbing heat sources, e.g. thrusters or other electronics, in conjunction with the flow sensor.
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| 8. |
- Santos, Licínia, et al.
(författare)
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Characterization of glycosphingolipids from gastrointestinal stromal tumours.
- 2020
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Gastrointestinal stromal tumours (GISTs) are the major nonepithelial neoplasms of the human gastrointestinal tract with a worldwide incidence between 11 and 15 per million cases annually. In this study the acid and non-acid glycosphingolipids of three GISTs were characterized using a combination of thin-layer chromatography, chemical staining, binding of carbohydrate recognizing ligands, and mass spectrometry. In the non-acid glycosphingolipid fractions of the tumors globotetraosylceramide, neolactotetraosylceramide, and glycosphingolipids with terminal blood group A, B, H, Lex, Lea, Ley and Leb determinants were found. The relative amounts of these non-acid compounds were different in the three tumour samples. The acid glycosphingolipid fractions had sulfatide, and the gangliosides GM3, GD3, GM1, Neu5Acα3neolactotetraosylceramide, GD1a, GT1b and GQ1b. In summary, we have characterized the glycosphingolipids of GISTs and found that the pattern differs in tumours from different individuals. This detailed characterization of glycosphingolipid composition of GISTs could contribute to recognition of new molecular targets for GIST treatment and sub-classification.
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| 9. |
- Säljö, Karin, 1981, et al.
(författare)
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Characterization of Glycosphingolipids in the Human Parathyroid and Thyroid Glands
- 2021
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Ingår i: International Journal of Molecular Sciences. - : MDPI AG. - 1422-0067 .- 1661-6596. ; 22:13
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Tidskriftsartikel (refereegranskat)abstract
- As part of a systematic investigation of the glycosphingolipids in human tissues, acid and non-acid glycosphingolipids from human thyroid and parathyroid glands were isolated and characterized with mass spectrometry and binding of carbohydrate-recognizing ligands, with a focus on complex compounds. The glycosphingolipid patterns of the human parathyroid and thyroid glands were very similar. The major acid glycosphingolipids were sulfatide and the gangliosides GM3, GD3, GD1a, GD1b, GT1b and Neu5Ac-neolactotetraosylceramide, and the major non-acid glycosphingolipids were globotriaosylceramide and globoside. We also found neolactotetra- and neolactohexaosylceramide, the x(2) glycosphingolipid, and complex glycosphingolipids with terminal blood group O and A determinants in both tissues. A glycosphingolipid with blood group Le(b) determinant was identified in the thyroid gland, and the parathyroid sample had a glycosphingolipid with terminal blood group B determinant. Immunohistochemistry demonstrated the expression of blood group A antigens in both the thyroid and parathyroid glands. A weak cytoplasmatic expression of the GD1a ganglioside was present in the thyroid, while the parathyroid gland had a strong GD1a expression on the cell surface. Thus, the glycosylation of human thyroid and parathyroid glands is more complex than previously appreciated. Our findings provide a platform for further studies of alterations of cell surface glycosphingolipids in thyroid and parathyroid cancers.
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| 10. |
- Säljö, Karin, 1981, et al.
(författare)
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Characterization of Human Medullary Thyroid Carcinoma Glycosphingolipids Identifies Potential Cancer Markers
- 2021
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Ingår i: International Journal of Molecular Sciences. - : MDPI AG. - 1422-0067 .- 1661-6596. ; 22:19
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Tidskriftsartikel (refereegranskat)abstract
- Medullary thyroid carcinoma (MTC) accounts for only 1-2% of thyroid cancers; however, metastatic MTC is a mortal disease with no cure. In this study, glycosphingolipids were isolated from human MTCs and characterized by mass spectrometry and binding of carbohydrate recognizing ligands. The tissue distribution of selected compounds was investigated by immunohistochemistry. The amount of acid glycosphingolipids in the MTCs was higher than in the normal thyroid glands. The major acid glycosphingolipid was the GD3 ganglioside. Sulfatide and the gangliosides GM3 and GD1a were also present. The majority of the complex non-acid glycosphingolipids had type 2 (Gal beta 4GlcNAc) core chains, i.e., the neolactotetraosylceramide, the Le(x), H type 2 and x(2) pentaosylceramides, the Le(y) and A type 2 hexaosylceramides, and the A type 2 heptaosylceramide. There were also compounds with globo (Gal alpha Gal beta 4Glc) core, i.e., globotriaosylceramide, globotetraosylceramide, the Forssman pentaosylceramide, and the Globo H hexaosylceramide. Immunohistochemistry demonstrated an extensive expression av Le(y) in the MTC cells and also a variable intensity and prevalence of Globo H and Le(x). One individual with multiple endocrine neoplasia type 2B expressed the Forssman determinant, which is rarely found in humans. This study of human MTC glycosphingolipids identifies glycans that could serve as potential tumor-specific markers.
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