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- Björkman, Anders, et al.
(författare)
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Factor V leiden and prothrombin gene mutation: risk factors for osteonecrosis of the femoral head in adults.
- 2004
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Ingår i: Clinical Orthopaedics and Related Research. - 0009-921X. ; :425, s. 168-172
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the current study was to determine whether factor V Leiden and the prothrombin 20210A gene mutation are risk factors for osteonecrosis of the femoral head in different etiologic groups of osteonecrosis in adults and whether patients with idiopathic osteonecrosis of the femoral head have a higher frequency of thromboembolic events compared with the general population. We investigated 63 adult patients with nontraumatic osteonecrosis of the femoral head for etiologic factors, such as corticosteroid medication and alcohol abuse, and the occurrence of factor V Leiden and the prothrombin 20210A gene mutation. In 35 patients, the disease was considered idiopathic and 10 of these patients (29%) had factor V Leiden or the prothrombin 20210A gene mutation or both. Mutations in factor V or the prothrombin 20210A gene were significantly more frequent in patients with idiopathic osteonecrosis than in a population of healthy control subjects (odds ratio, 2.7; 95% confidence interval range, 1.2-5.8) and in patients with osteonecrosis caused by corticosteroid medication or alcohol abuse (odds ratio, 10.8; 95% confidence interval range, 1.4-84). 36% of patients with a gene mutation had had a thromboembolic event compared with 8% of patients without a gene mutation. Thromboembolic events were more common among patients with idiopathic osteonecrosis (17%) compared with the general population (4%) and with patients with osteonecrosis caused by corticosteroid medication or alcohol abuse (7%).
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2. |
- Andersson, Gunnar, et al.
(författare)
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Skolkulturer - tröghet, förändring, framgång
- 2003
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Ingår i: Skolkulturer. - Lund : Studentlitteratur. - 9144028806 ; , s. 11-32, s. 11-32
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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- Björkman, Anders, et al.
(författare)
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Phantom digit somatotopy: a functional magnetic resonance imaging study in forearm amputees.
- 2012
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Ingår i: European Journal of Neuroscience. - : Wiley. - 1460-9568 .- 0953-816X. ; 36:1, s. 2098-2106
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Tidskriftsartikel (refereegranskat)abstract
- Forearm amputees often experience non-painful sensations in their phantom when the amputation stump is touched. Cutaneous stimulation of specific stump areas may be perceived as stimulation of specific phantom fingers (stump hand map). The neuronal basis of referred phantom limb sensations is unknown. We used functional magnetic resonance imaging to demonstrate a somatotopic map of the phantom fingers in the hand region of the primary somatosensory cortex after tactile stump stimulation. The location and extent of phantom finger activation in the primary somatosensory cortex corresponded well to the location of normal fingers in a reference population. Stimulation of the stump hand map resulted in an increased bilateral activation of the primary somatosensory cortex compared with stimulation of forearm regions outside the stump hand map. Increased activation was also seen in contralateral posterior parietal cortex and premotor cortex. Ipsilateral primary somatosensory cortex activation might represent a compensatory mechanism and activation of the non-primary fronto-parietal areas might correspond to awareness of the phantom limb, which is enhanced when experiencing the referred sensations. It is concluded that phantom sensation elicited by stimulation of stump hand map areas is associated with activation of finger-specific somatotopical representations in the primary somatosensory cortex. This suggests that the primary somatosensory cortex could be a neural substrate of non-painful phantom sensations. The stump hand map phenomenon might be useful in the development of prosthetic hand devices.
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7. |
- Björkman, Anders, et al.
(författare)
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Sensory qualities of the phantom hand map in the residual forearm of amputees
- 2016
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 48:4, s. 70-365
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Most amputees experience referred sensations, known as a phantom hand map, on the residual forearm, where touch on specific areas is perceived as touch on the amputated hand. The aim of this study was to evaluate the sensory qualities of the phantom hand map.METHODS: In 10 traumatic forearm-amputees touch thres-holds and discriminative touch of the phantom hand map were assessed and compared with corresponding areas on the contralateral forearm. The study assessed the localization of touch on the phantom hand map, and how distinct and similar to normal touch the referred feeling was.RESULTS: Similar touch thresholds were seen in the phantom hand map and the control site. Tactile discrimination, requiring both detection of stimulus and interpretation, was significantly better in the phantom hand map.CONCLUSION: This explorative study suggests that the phantom hand map and the superior tactile discrimination seen in the phantom hand map are based on adaptations within the brain. Further studies investigating the neural basis for the phantom hand map are needed.
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9. |
- Götestrand, Simon, et al.
(författare)
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Visualization of wrist anatomy - a comparison between 7T and 3T MRI
- 2022
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 32:2, s. 1362-1370
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Tidskriftsartikel (refereegranskat)abstract
- Objective Injuries to the wrist are, due to its small size and complex anatomical structures, difficult to assess by MR, and surgical interventions such as diagnostic arthroscopy are often necessary. Therefore, improved visualization using non-invasive methods could be of clinical value. As a first step of improvement, the purpose of this study was to evaluate visualization of anatomical structures at 7T compared with 3T MR. Methods Eighteen healthy volunteers (three males and three females from each age decade between 20 and 49 years) were examined with 7T and 3T MR. Four musculoskeletal radiologists graded 2D and 3D images on a five-level grading scale for visibility of ligaments, cartilage, nerves, trabecular bone, and tendons, as well as overall image quality (i.e., edge sharpness, perceived tissue contrast, and presence of artefacts). Statistical analysis was done using a visual grading characteristics (VGC) analysis. Results Visibility of cartilage, trabecular bone, tendons, nerves, and ligaments was graded significantly higher at 7T with an area under the curve (AUC(VGC)) of 0.62-0.88 (95% confidence interval [CI] 0.50-0.97, p = < 0.0001-0.03) using either 2D or 3D imaging. Imaging with 3T was not graded as superior to 7T for any structure. Image quality was also significantly superior at 7T, except for artefacts, where no significant differences were found. Conclusions Tendons, trabecular bone, nerves, and ligaments were all significantly better visualized at 7T compared to 3T.
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10. |
- Götestrand, Simon, et al.
(författare)
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Visualization of wrist ligaments with 3D and 2D magnetic resonance imaging at 3 Tesla
- 2022
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Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 63:3, s. 368-375
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Tidskriftsartikel (refereegranskat)abstract
- Background Wrist ligaments are challenging to visualize using magnetic resonance imaging (MRI). Injuries involving the scapholunate ligament (SLL), the lunotriquetral ligament (LTL), and the triangular fibrocartilage complex (TFCC) are common and difficult to diagnose, often requiring diagnostic arthroscopy. Purpose To compare the visualization of wrist ligaments on a three-dimensional (3D) sequence with two-dimensional (2D) sequences on 3-T MRI. Material and Methods Eighteen healthy volunteers were examined with a 3D SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) sequence and 2D coronal, axial, and sagittal proton density-weighted (PD) sequences. Four musculoskeletal radiologists graded the anatomical visibility of the SLL, LTL, TFCC, and the image quality, using five grades in a visual grading characteristics (VGC) evaluation. After Bonferroni correction, a P value <= 0.005 was considered statistically significant. Results The 3D images were graded significantly better than the 2D images in the visualization of the dorsal and palmar parts of the SLL and the LTL. Regarding the TFCC, the 3D images were graded significantly better for visualization of the foveal attachment. 2D imaging was not found significantly superior to 3D imaging in any aspect. Conclusion The 3D SPACE sequence was scored as superior to the 2D sequences at 3 T in the assessment of the SLL, the LTL, and the foveal attachment of the TFCC. Thus, 3D SPACE can replace 2D PD sequences when these ligaments need to be assessed.
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- Jörgsholm, Peter, et al.
(författare)
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Extension block pinning of mallet fractures.
- 2010
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Medical Journals Sweden AB. - 1651-2073. ; 44:1, s. 54-58
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Tidskriftsartikel (refereegranskat)abstract
- The operative treatment of mallet fractures of more than one third of the articular surface is controversial. The purpose of this study was to evaluate the complications and functional outcome of extension block pinning technique. Thirty-six consecutive patients with mallet fractures that involved more than one third of the joint surface were treated by extension block pinning a median of 3 days after injury (range 0-35, mean 7). Clinical outcome was graded according to Crawford's criteria. At a median follow-up of 16.5 months (range 2.5-52, mean 20) 23 patients had an excellent or good result, 11 patients had a fair, and 2 patients a poor, clinical outcome according to Crawford's criteria. None of the patients complained of pain. The median extension loss was 0 degrees (range 0-20, mean 4) and the median flexion was 70 degrees (range 30-95, mean 68). Eight patients had operative or direct postoperative complications including superficial infection (n = 6), loss of Kirschner wire (K-wire) fixation (n = 1), and K-wire mal position (n = 1). The extension block pinning technique is a minimally invasive method of treating mallet fractures with low morbidity and a good functional outcome.
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14. |
- Källberg, Eva, et al.
(författare)
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S100A9 Interaction with TLR4 Promotes Tumor Growth
- 2012
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Ingår i: PLOS ONE. - San Francisco : Public Library of Science. - 1932-6203. ; 7:3, s. e34207-
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Tidskriftsartikel (refereegranskat)abstract
- By breeding TRAMP mice with S100A9 knock-out (S100A9(-/-)) animals and scoring the appearance of palpable tumors we observed a delayed tumor growth in animals devoid of S100A9 expression. CD11b(+) S100A9 expressing cells were not observed in normal prostate tissue from control C57BL/6 mice but were readily detected in TRAMP prostate tumors. Also, S100A9 expression was observed in association with CD68(+) macrophages in biopsies from human prostate tumors. Delayed growth of TRAMP tumors was also observed in mice lacking the S100A9 ligand TLR4. In the EL-4 lymphoma model tumor growth inhibition was observed in S100A9(-/-) and TLR4(-/-), but not in RAGE(-/-) animals lacking an alternative S100A9 receptor. When expression of immune-regulating genes was analyzed using RT-PCR the only common change observed in mice lacking S100A9 and TLR4 was a down-regulation of TGF beta expression in splenic CD11b(+) cells. Lastly, treatment of mice with a small molecule (ABR-215050) that inhibits S100A9 binding to TLR4 inhibited EL4 tumor growth. Thus, S100A9 and TLR4 appear to be involved in promoting tumor growth in two different tumor models and pharmacological inhibition of S100A9-TLR4 interactions is a novel and promising target for anti-tumor therapies.
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15. |
- Maripuu, Amanda, et al.
(författare)
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Reconstruction of sciatic nerve after traumatic injury in humans - factors influencing outcome as related to neurobiological knowledge from animal research
- 2012
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Ingår i: Journal of Brachial Plexus and Peripheral Nerve Injury. - : Georg Thieme Verlag KG. - 1749-7221. ; 7:1, s. 40-52
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Forskningsöversikt (refereegranskat)abstract
- Background: The aim was to evaluate what can be learned from rat models when treating patients suffering from a sciatic nerve injury.Methods: Two patients with traumatic sciatic nerve injury are presented with examination of motor and sensory function with a five-year follow-up. Reconstruction of the nerve injury was performed on the second and third day, respectively, after injury using sural nerve grafts taken from the injured leg. The patients were examined during follow-up by electromyography (EMG), MRI and functionalMRI (fMRI) to evaluate nerve reinnervation, cell death in dorsal root ganglia (DRG) and cortical activation; factors that were related to clinical history in the patients.Results: One patient regained good motor function of the lower leg and foot, confirmed by EMG showing good activation in the leg muscles and some reinnervation in the foot muscles, as well as some sensory function of the sole of the foot. The other patient regained no motor (confirmed by EMG) or sensory function in the leg or foot. Factors most influential on outcome in two cases were type of injury, nerve gap length and particularly type of reconstruction. A difference in follow-up and rehabilitation likely also influence outcome. MRI did not show any differences in DRG size of injured side compared to the uninjured side. fMRI showed normal activation in the primary somatosensory cortex as a response to cutaneous stimulation of the normal foot. However, none of the two patients showed any activation in the primary somatosensory cortex following cutaneous stimulation of the injured foot.Conclusions: In decision making of nerve repair and reconstruction data from animal experiments can be translated to clinical practice and to predict outcome in patients, although such data should be interpreted with caution and linked to clinical experience. Rat models may be useful to identify and study factors that influence outcome after peripheral nerve repair and reconstruction; procedures that should be done correctly and with a competent team. However, some factors, such as cognitive capacity and coping, known to influence outcome following nerve repair, are difficult to study in animal models. Future research has to find and develop new paths and techniques to study changes in the central nervous system after nerve injury and develop strategies to utilize brain plasticity during the rehabilitation.
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- Zander, Maria, 1978, et al.
(författare)
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Retrospective analysis of scaphoid trapezium pyrocarbon implant intervention in STT arthritis: a 3-year follow-up study
- 2024
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Ingår i: JOURNAL OF PLASTIC SURGERY AND HAND SURGERY. - 2000-656X .- 2000-6764. ; 59, s. 40-45
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Tidskriftsartikel (refereegranskat)abstract
- Aim:The purpose of this study was to evaluate clinical, patient rated and radiological outcome of the scaphoid trapezium pyrocarbon implant (STPI) at a minimum of three years follow-up. Methods: Consecutive patients operated with the STPI due to scaphotrapeziotrapezoidal (STT) arthritis between 2012 and 2019 were included. Patients were evaluated preoperatively and annually after surgery for range of motion, grip strength, key pinch, quick -DASH, pain, and satisfaction. Radiographs were evaluated for implant position, signs of dorsal intercalated segment instability (DISI), capitolunate (CL) angle, scapholunate (SL) distance, and presence of osteophytes. Results: Twenty-six patients (29 implants) were included. Seven implants were revised during the follow up, mainly due to pain: three implants were removed, four patients received a new STPI of a different size, leaving 22 implants in 20 patients available for follow up, 9 males and 11 females. Median age was 61.7 years (51-78 years). Median follow-up time was 68 months (37-105 months). Comparing preoperative status to the last follow-up, wrist extension and deviation, thumb abduction, and grip strength did not change. Key Pinch, quick DASH, pain, and patient satisfaction improved significantly at last follow-up. Radiographic signs of DISI were seen in six cases preoperatively and in 12 cases at last follow-up. Conlusion: At a minimum of three years follow-up, the STPI used for STT-arthritis improve pain, quick -DASH result, and patient satisfaction significantly. ROM and grip strength did not change compared to preoperative values. Radiographic signs of carpal instability were common at the follow-up and the revision rate was high.
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18. |
- Abul-Kasim, Kasim, et al.
(författare)
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Advanced radiological work-up as an adjunct to decision in early reconstructive surgery in brachial plexus injuries
- 2010
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Ingår i: Journal of Brachial Plexus and Peripheral Nerve Injury. - : BioMed Central. - 1749-7221. ; 5, s. 14-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAs neurophysiologic tests may not reveal the extent of brachial plexus injury at the early stage, the role of early radiological work-up has become increasingly important. The aim of the study was to evaluate the concordance between the radiological and clinical findings with the intraoperative findings in adult patients with brachial plexus injuries.MethodsSeven consecutive male patients (median age 33; range 15-61) with brachial plexus injuries, caused by motor cycle accidents in 5/7 patients, who underwent extensive radiological work-up with magnetic resonance imaging (MRI), computed tomography myelography (CT-M) or both were included in this retrospective study. A total of 34 spinal nerve roots were evaluated by neuroradiologists at two different occasions. The degree of agreement between the radiological findings of every individual nerve root and the intraoperative findings was estimated by calculation of kappa coefficient (К-value). Using the operative findings as a gold standard, the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the clinical findings and the radiological findings were estimated.ResultsThe diagnostic accuracy of radiological findings was 88% compared with 65% for the clinical findings. The concordance between the radiological findings and the intraoperative findings was substantial (К = 0.76) compared with only fair (К = 0.34) for the clinical findings. There were two false positive and two false negative radiological findings (sensitivity and PPV of 0.90; specificity and NPV of 0.87).ConclusionsThe advanced optimized radiological work-up used showed high reliability and substantial agreement with the intraoperative findings in adult patients with brachial plexus injury.
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19. |
- Adman, Per, 1970-
(författare)
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Arbetslöshet, arbetsplatsdemokrati och politiskt deltagande
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this thesis is to test two hypotheses about how work affects political participation. The first concerns unemployment, and states that unemployment has strong and negative effects on political activity. The second hypothesis is found in theories of participatory democracy, and claims that more democratic workplaces lead to more political participation. Existing empirical evidence on both of the hypotheses is not conclusive. Furthermore, studies have mainly been carried out using data collected in the United States. Here empirical tests of the hypotheses are undertaken using a Swedish survey.The results confirm the first hypothesis; unemployment has negative effects on political participation. The reasons for these negative effects are that the unemployed become less active in organisational life, fall outside of the recruitment networks where people are being asked to participate in politics, and experience a decrease in income. The second hypothesis is not supported. Workplace participation does not affect political participation, according to the analyses. The results are surprising for both hypotheses, and contradict previous empirical findings. The differences in results are likely due to differences in research design and differences in approaches to analysing political participation. Previous studies are inadequate in these perspectives, it is maintained.The thesis ends with a discussion of the results from the perspective of normative democratic theory. It is argued that the lack of political equality is particularly acute when the low participation among the unemployed is considered.
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22. |
- Ageberg, Eva, et al.
(författare)
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Principles of brain plasticity in improving sensorimotor function of the knee and leg in healthy subjects: A double-blind randomized exploratory trial
- 2009
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Principles of brain plasticity is used in the treatment of patients with functional limitations to improve sensorimotor function. Training is included in the treatment of knee injury to improve both patient-reported function and sensorimotor function. However, impairment in sensorimotor function often persists despite training. Therefore, it was suggested that training programs need to be more effective to improve sensorimotor function after knee injury. The aim of the current study was to investigate if principles of brain plasticity that have been successfully used on the hand and foot to improve sensorimotor function can be applied on the knee. We hypothesized that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg. Methods: In this first double-blind exploratory study, 28 uninjured subjects (mean age 26 years, range 19-34, 50% women) were randomized to temporary local cutaneous application of anesthetic (EMLA (R)) (n=14) or placebo cream (n=14). Fifty grams of EMLA, or placebo, was applied on the leg 10 cm above and 10 cm below the center of patella, leaving the area around the knee without cream. Measures of sensory function (perception of touch, vibration sense, knee kinesthesia) and motor function (knee muscle strength, hop test) were assessed before and after 90 minutes of treatment with EMLA or placebo. The paired t-test was used for comparisons within groups and the independent t-test for comparisons between groups. The number of subjects needed was determined by an a priori sample size calculation. Results: No statistically significant or clinically relevant differences were seen over time (before vs. after) in the measures of sensory or motor functions in the EMLA group or in the placebo group. There were no differences between the groups due to treatment effect (EMLA vs. placebo). Conclusion: We found no effect of temporary cutaneous anesthesia on sensorimotor function of the ipsilateral knee and leg in uninjured subjects. The principles used in this study remain to be tested in subjects with knee injury.
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23. |
- Ageberg, Eva, et al.
(författare)
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Principles of brain plasticity in improving sensorimotor function of the knee and leg in patients with anterior cruciate ligament injury: a double-blind randomized exploratory trial
- 2012
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 13:68
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Tidskriftsartikel (refereegranskat)abstract
- Background: Severe traumatic knee injury, including injury to the anterior cruciate ligament (ACL), leads to impaired sensorimotor function. Although improvements are achieved by training, impairment often persists. Because good sensorimotor function is associated with better patient-reported function and a potential lower risk of future joint problems, more effective treatment is warranted. Temporary cutaneous anesthesia of adjacent body parts was successfully used on the hand and foot to improve sensorimotor function. The aim of this study was to test whether this principle of brain plasticity could be used on the knee. The hypothesis was that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg in subjects with ACL injury. Methods: In this double-blind exploratory study, 39 subjects with ACL injury (mean age 24 years, SD 5.2, 49% women, mean 52 weeks after injury or reconstruction) and self-reported functional limitations and lack of trust in the knee were randomized to temporary local cutaneous application of anesthetic (EMLA (R)) (n = 20) or placebo cream (n = 19). Fifty grams of EMLA (R), or placebo, was applied on the leg 10 cm above and 10 cm below the center of patella, leaving the area around the knee without cream. Measures of sensory function (perception of touch, vibration sense, knee kinesthesia) and motor function (knee muscle strength, hop test) were assessed before and after 90 minutes of treatment with EMLA (R) or placebo. The paired t-test was used for comparisons within groups and analysis of variance between groups, except for ordinal data where the Wilcoxon signed rank test, or Mann-Whitney test, was used. The number of subjects needed was determined by an a priori sample size calculation. Results: No statistically significant or clinically relevant differences were seen over time (before vs. after) in the measures of sensory or motor functions in the EMLA (R) group or in the placebo group. There were no differences between the groups due to treatment effect (EMLA (R) vs. placebo). Conclusions: Temporary cutaneous anesthesia of adjacent body parts had no effect in improving sensorimotor function of the knee and leg in subjects with severe traumatic knee ligament injury.
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24. |
- ALANKO BLOMÉ, MARIANNE, et al.
(författare)
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Minimal transmission of HIV despite persistently high transmission of hepatitis C virus in a Swedish needle exchange program.
- 2011
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Ingår i: Journal of Viral Hepatitis. - : Wiley. - 1365-2893 .- 1352-0504. ; 18, s. 831-839
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Tidskriftsartikel (refereegranskat)abstract
- Summary. The aim of this study was to examine the prevalence and incidence of HIV and hepatitis B and C (HBV and HCV) among injecting drug users in a Swedish needle exchange programme (NEP) and to identify risk factors for blood-borne transmission. A series of serum samples from NEP participants enrolled from 1997 to 2005 were tested for markers of HIV, HBV and HCV (including retrospective testing for HCV RNA in the last anti-HCV-negative sample from each anti-HCV seroconverter). Prevalence and incidence were correlated with self-reported baseline characteristics. Among 831 participants available for follow-up, one was HIV positive at baseline and two seroconverted to anti-HIV during the follow-up of 2433 HIV-negative person-years [incidence 0.08 per 100 person-years at risk (pyr); compared to 0.0 in a previous assessment of the same NEP covering 1990-1993]. The corresponding values for HBV were 3.4/100 pyr (1990-1993: 11.7) and for HCV 38.3/100 pyr (1990-1993: 27.3). HCV seroconversions occurred mostly during the first year after NEP enrolment. Of the 332 cases testing anti-HCV negative at enrolment, 37 were positive for HCV RNA in the same baseline sample (adjusted HCV incidence 31.5/100 pyr). HCV seroconversion during follow-up was significantly associated with mixed injection use of amphetamine and heroin, and a history of incarceration at baseline. In this NEP setting, HIV prevalence and incidence remained low and HBV incidence declined because of vaccination, but transmission of HCV was persistently high. HCV RNA testing in anti-HCV-negative NEP participants led to more accurate identification of timepoints for transmission.
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- Andersson, Maria Eva, et al.
(författare)
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Rapid Clearance and Frequent Reinfection With Enteric Pathogens Among Children With Acute Diarrhea in Zanzibar.
- 2017
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Ingår i: Clinical Infectious Diseases. - : Oxford University Press (OUP). - 1058-4838 .- 1537-6591. ; 65:8, s. 1371-1377
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Tidskriftsartikel (refereegranskat)abstract
- Background: Acute infectious gastroenteritis is an important cause of illness and death among children in low-income countries. In addition to rotavirus vaccination, actions to improve nutrition status, sanitation, and water quality are important to reduce enteric infections, which are frequent also among asymptomatic children. The aim of this study was to investigate if the high prevalence of these infections reflects that they often are not cleared properly by the immune response or rather is due to frequent pathogen exposure.Methods: Rectal swabs were collected at time of acute diarrhea and 14 days later from 127 children, aged 2-59 months and living in rural Zanzibar, and were analyzed by real-time polymerase chain reaction targeting multiple pathogens.Results: At baseline, detection rates >20% were found for each of enterotoxigenic Escherichia coli, Shigella, Campylobacter, Cryptosporidium, norovirus GII, and adenovirus. At follow-up, a large proportion of the infections had become cleared (34-100%), or the pathogen load reduced, and this was observed also for agents that were presumably unrelated to diarrhea. Still, the detection frequencies at follow-up were for most agents as high as at baseline, because new infections had been acquired. Neither clearance nor reinfection was associated with moderate malnutrition, which was present in 21% of the children.Conclusions: Children residing in poor socioeconomic conditions, as in Zanzibar, are heavily exposed to enteric pathogens, but capable of rapidly clearing causative and coinfecting pathogens.
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27. |
- Antfolk, Christian, et al.
(författare)
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Sensory feedback from a prosthetic hand based on air-mediated pressure from the hand to the forearm skin.
- 2012
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 44:8, s. 702-707
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Lack of sensory feedback is a drawback in today's hand prostheses. We present here a non-invasive simple sensory feedback system, which provides the user of a prosthetic hand with sensory feedback on the arm stump. It is mediated by air in a closed loop system connecting silicone pads on the prosthetic hand with pads on the amputation stump. The silicone pads in a "tactile display" on the amputation stump expand when their corresponding sensor-bulb in the prosthesis is touched, evoking an experience of "real touch". Methods: Twelve trans-radial amputees and 20 healthy non-amputees participated in the study. We investigated the capacity of the system to mediate detection of touch, discrimination between different levels of pressure and, on the amputees also, the ability to locate touch. Results: The results showed a median touch threshold of 80 and 60 g in amputees and non-amputees, respectively, and 90% and 80% correct answers, respectively, in discrimination between 2 levels of pressure. The amputees located touch (3 sites) correctly in 96% of trials. Conclusion: This simple sensory feedback system has the potential to restore sensory feedback in hand amputees and thus it could be a useful tool to enhance prosthesis use.
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28. |
- Antfolk, Christian, et al.
(författare)
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Transfer of tactile input from an artificial hand to the forearm: experiments in amputees and able-bodied volunteers
- 2013
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Ingår i: Disability and Rehabilitation: Assistive Technology. - : Informa UK Limited. - 1748-3115 .- 1748-3107. ; 8:3, s. 249-254
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in UndeterminedPurpose:This study explores the possibilities of transferring peripheral tactile stimulations from an artificial hand to the forearm skin.Method:A tactile display applied to the forearm skin was used to transfer tactile input to the forearm from various locations on a hand displayed on a computer screen. Discernment of location, levels of pressure and a combination of the two in simulated functional grips was tested to quantify the participants' ability to accurately perceive the tactile stimulations presented. Ten participants (5 forearm amputees and 5 able-bodied volunteers) unfamiliar with the equipment participated in the three-stage experiments comprising a learning session with vision, a reinforced learning session without vision and a validation session without vision.Results:The location discernment accuracy was high in both groups (75.2% and 89.6% respectively). The capacity to differentiate between three different levels of pressure was also high (91.7% and 98.1% respectively in the two groups). Recognition of simulated grip was slightly more difficult with the groups scoring 58.7% and 68.0% respectively for accuracy in the validation session.Conclusions:This study demonstrates that it is possible, following a brief training period, to transfer tactile input from an artificial hand to the forearm skin. The level of accuracy was lower for the more complex task, simulated grip recognition, possibly because this represents a more complex task requiring higher order brain functions. These results could form the basis for developing sensory feedback in hand prostheses. [Box: see text].
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30. |
- Askling, Helena H, et al.
(författare)
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Serologic Analysis of Returned Travelers with Fever, Sweden
- 2009
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Ingår i: Emerging Infectious Diseases. - Atlanta, GA, USA : U.S. Department of Health and Human Services * Centers for Disease Control and Prevention. - 1080-6040 .- 1080-6059. ; 15:11, s. 1805-1808
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Tidskriftsartikel (refereegranskat)abstract
- We studied 1,432 febrile travelers from Sweden who had returned from malaria-endemic areas during March 2005-March 2008. In 383 patients, paired serum samples were blindly analyzed for influenza and 7 other agents. For 21% of 115 patients with fever of unknown origin, serologic analysis showed that influenza was the major cause.
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31. |
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32. |
- Aydin-Schmidt, Berit, et al.
(författare)
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Field Evaluation of a High Throughput Loop Mediated Isothermal Amplification Test for the Detection of Asymptomatic Plasmodium Infections in Zanzibar
- 2017
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background New field applicable diagnostic tools are needed for highly sensitive detection of residual malaria infections in pre-elimination settings. Field performance of a high throughput DNA extraction system for loop mediated isothermal amplification (HTP-LAMP) was therefore evaluated for detecting malaria parasites among asymptomatic individuals in Zanzibar. Methods HTP-LAMP performance was evaluated against real-time PCR on 3008 paired blood samples collected on filter papers in a community-based survey in 2015. Results The PCR and HTP-LAMP determined malaria prevalences were 1.6% (95% CI 1.3-2.4) and 0.7% (95% CI 0.4-1.1), respectively. The sensitivity of HTP-LAMP compared to PCR was 40.8% (CI95% 27.0-55.8) and the specificity was 99.9% (CI95% 99.8-100). For the PCR positive samples, there was no statistically significant difference between the geometric mean parasite densities among the HTP-LAMP positive (2.5 p/mu L, range 0.2-770) and HTP-LAMP negative (1.4 p/mu L, range 0.1-7) samples (p = 0.088). Two lab technicians analysed up to 282 samples per day and the HTP-LAMP method was experienced as user friendly. Conclusions Although field applicable, this high throughput format of LAMP as used here was not sensitive enough to be recommended for detection of asymptomatic low-density infections in areas like Zanzibar, approaching malaria elimination.
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33. |
- Aydin-Schmidt, Berit, et al.
(författare)
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Loop mediated isothermal amplification (LAMP) accurately detects malaria DNA from filter paper blood samples of low density parasitaemias
- 2014
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:8, s. e103905-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Loop mediated isothermal amplification (LAMP) provides an opportunity for improved, field-friendly detection of malaria infections in endemic areas. However data on the diagnostic accuracy of LAMP for active case detection, particularly low-density parasitaemias, are lacking. We therefore evaluated the performance of a new LAMP kit compared with PCR using DNA from filter paper blood spots.METHODS AND FINDINGS:Samples from 865 fever patients and 465 asymptomatic individuals collected in Zanzibar were analysed for Pan (all species) and Pf (P. falciparum) DNA with the Loopamp MALARIA Pan/Pf kit. Samples were amplified at 65°C for 40 minutes in a real-time turbidimeter and results were compared with nested PCR. Samples with discordant results between LAMP and nested PCR were analysed with real-time PCR. The real-time PCR corrected nested PCR result was defined as gold standard. Among the 117 (13.5%) PCR detected P. falciparum infections from fever patients (mean parasite density 7491/µL, range 6-782,400) 115, 115 and 111 were positive by Pan-LAMP, Pf-LAMP and nested PCR, respectively. The sensitivities were 98.3% (95%CI 94-99.8) for both Pan and Pf-LAMP. Among the 54 (11.6%) PCR positive samples from asymptomatic individuals (mean parasite density 10/µL, range 0-4972) Pf-LAMP had a sensitivity of 92.7% (95%CI 80.1-98.5) for detection of the 41 P. falciparum infections. Pan-LAMP had sensitivities of 97% (95%CI 84.2-99.9) and 76.9% (95%CI 46.2-95) for detection of P. falciparum and P. malariae, respectively. The specificities for both Pan and Pf-LAMP were 100% (95%CI 99.1-100) in both study groups.CONCLUSION:Both components of the Loopamp MALARIA Pan/Pf detection kit revealed high diagnostic accuracy for parasite detection among fever patients and importantly also among asymptomatic individuals of low parasite densities from minute blood volumes preserved on filter paper. These data support LAMPs potential role for improved detection of low-density malaria infections in pre-elimination settings.
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34. |
- Aydin-Schmidt, Berit, et al.
(författare)
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Usefulness of Plasmodium falciparum-specific rapid diagnostic tests for assessment of parasite clearance and detection of recurrent infections after artemisinin-based combination therapy.
- 2013
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Ingår i: Malaria journal. - : Springer Science and Business Media LLC. - 1475-2875. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Rapid diagnostic test (RDT) is an important tool for parasite-based malaria diagnosis. High specificity of RDTs to distinguish an active Plasmodium falciparum infection from residual antigens from a previous infection is crucial in endemic areas where residents are repeatedly exposed to malaria. The efficiency of two RDTs based on histidine-rich protein 2 (HRP2) and lactate dehydrogenase (LDH) antigens were studied and compared with two microscopy techniques (Giemsa and acridine orange-stained blood smears) and real-time polymerase chain reaction (PCR) for assessment of initial clearance and detection of recurrent P. falciparum infections after artemisinin-based combination therapy (ACT) in a moderately high endemic area of rural Tanzania.
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36. |
- Barrling Hermansson, Katarina, 1969-
(författare)
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Partikulturer : Kollektiva självbilder och normer i Sveriges riksdag
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation addresses party-culture in political parties represented in the Swedish parliament. Party-culture is investigated by studying collective self-images and norms in Swedish parliamentary party-groups (PPG). The aim of this investigation is to contribute to understanding of the conditions under which parliamentary work is carried out. In order to expand our understanding of these conditions this dissertation looks beyond the formal processes by which party-groups deliver their political message and make decisions, and instead highlights the cultural aspects of these party organizations in the parliament.The method of analysis is qualitative and the material for the study consists of 53 interviews with members of parliament from all represented parties. The parties studied are thus the Social Democratic, Moderate, Liberal, Christian Democrats, Left, Centre, and Green. In addition, some participant observation for the 1998-2002 mandate period in used.The empirical investigation shows that party-culture is revealed via four basic themes: political ability, feelings of political responsibility, the importance social fellowship, and the party’s strength in relation to individual party members.The party’s culture based on the four themes noted above provides a theoretical structure for interpretation that combines an Aristotelian idea about basic knowledge types, sophia and phronesis, with cultural theorists Mary Douglas’ grid-group-analysis. Based on this interpretation method it is shown that party-cultures distinguish themselves from each other in a way that diverges from the left-right spectrum that dominates Swedish politics. At the same time as the parties demonstrate differences in party-culture, there are also some similarities between the parties, and these similarities suggest that the parties have adjusted themselves to a more general culture within the parliament, most visibly the focus on factual knowledge and a certain requirement for modesty from party members.
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37. |
- Beer, Netta, et al.
(författare)
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A qualitative study on caretakers' perceived need of bed-nets after reduced malaria transmission in Zanzibar, Tanzania
- 2012
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12, s. 606-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The elimination of malaria in Zanzibar is highly dependent on sustained effective coverage of bed-nets to avoid malaria resurgence. The Health Belief Model (HBM) framework was used to explore the perceptions of malaria and bed-net use after a noticeable reduction in malaria incidence. Methods: Nineteen in-depth interviews were conducted with female and male caretakers of children under five in North A district, Zanzibar. Deductive content analysis was used to identify meaning units that were condensed, coded and assigned to pre-determined elements of the HBM. Results: Awareness of malaria among caretakers was high but the illness was now seen as easily curable and uncommon. In addition to the perceived advantage of providing protection against malaria, bed-nets were also thought to be useful for avoiding mosquito nuisance, especially during the rainy season when the malaria and mosquito burden is high. The discomfort of sleeping under a net during the hot season was the main barrier that interrupted consistent bed-net usage. The main cue to using a bed-net was high mosquito density, and children were prioritized when it came to bed-net usage. Caretakers had high perceived self-efficacy and did not find it difficult to use bed-nets. Indoor Residual Spraying (IRS), which was recognized as an additional means of mosquito prevention, was not identified as an alternative for bed-nets. A barrier to net ownership was the increasingly high cost of bed-nets. Conclusions: Despite the reduction in malaria incidence and the resulting low malaria risk perceptions among caretakers, the benefit of bed-nets as the most proficient protection against mosquito bites upholds their use. This, in combination with the perceived high self-efficacy of caretakers, supports bed-net usage, while seasonality interrupts consistent use. High effective coverage of bed-nets could be further improved by reinforcing the benefits of bed-nets, addressing the seasonal heat barrier by using nets with larger mesh sizes and ensuring high bed-net ownership rates through sustainable and affordable delivery mechanisms.
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38. |
- Beer, Netta, et al.
(författare)
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High effective coverage of vector control interventions in children after achieving low malaria transmission in Zanzibar, Tanzania.
- 2013
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Ingår i: Malaria journal. - : Springer Science and Business Media LLC. - 1475-2875. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: Background: Formerly a high malaria transmission area, Zanzibar is now targeting malaria elimination. A major challenge is to avoid resurgence of malaria, the success of which includes maintaining high effective coverage of vector control interventions such as bed nets and indoor residual spraying (IRS). In this study, caretakers' continued use of preventive measures for their children is evaluated, following a sharp reduction in malaria transmission. Methods: A cross-sectional community-based survey was conducted in June 2009 in North A and Micheweni districts in Zanzibar. Households were randomly selected using two-stage cluster sampling. Interviews were conducted with 560 caretakers of under-five-year old children, who were asked about perceptions on the malaria situation, vector control, household assets, and intention for continued use of vector control as malaria burden further decreases. Results: Effective coverage of vector control interventions for under-five children remains high, although most caretakers (65%; 363/560) did not perceive malaria as presently being a major health issue. Seventy percent (447/643) of the under-five children slept under a long-lasting insecticidal net (LLIN) and 94% (607/643) were living in houses targeted with IRS. In total, 98% (628/643) of the children were covered by at least one of the vector control interventions. Seasonal bed-net use for children was reported by 25% (125/508) of caretakers of children who used bed nets. A high proportion of caretakers (95%; 500/524) stated that they intended to continue using preventive measures for their under-five children as malaria burden further reduces. Malaria risk perceptions and different perceptions of vector control were not found to be significantly associated with LLIN effective coverage. Conclusions: While the majority of caretakers felt that malaria had been reduced in Zanzibar, effective coverage of vector control interventions remained high. Caretakers appreciated the interventions and recognized the value of sustaining their use. Thus, sustaining high effective coverage of vector control interventions, which is crucial for reaching malaria elimination in Zanzibar, can be achieved by maintaining effective delivery of these interventions.
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39. |
- Berti, Valentino, et al.
(författare)
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Datakommunikation
- 2012. - 7
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Denna bok ger en bred introduktion till datakommunikation i allmänhet och internetteknologi i synnerhet. Vad Internet är beror helt på vem du frågar, och detsamma gäller ämnet datakommunikation. Från att ha varit ett specialämne som studenter möjligtvis läste i årskurs 3 eller 4 på datatekniska universitetsutbildningar så kan man idag lära sig grunderna i datakommunikation på flera gymnasieprogram. Författarna till denna bok har alla personlig erfarenhet av att undervisa i ämnet datakommunikation på olika nivåer. Bokens struktur möjliggör olika sätt att tillgodogöra sig materialet beroende på vad som är mest tilltalande för respektive målgrupp.
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40. |
- Bhattarai, Achuyt, et al.
(författare)
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Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zanzibar
- 2007
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Ingår i: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 4:11, s. e309-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe Roll Back Malaria strategy recommends a combination of interventions for malaria control. Zanzibar implemented artemisinin-based combination therapy (ACT) for uncomplicated malaria in late 2003 and long-lasting insecticidal nets (LLINs) from early 2006. ACT is provided free of charge to all malaria patients, while LLINs are distributed free to children under age 5 y (“under five”) and pregnant women. We investigated temporal trends in Plasmodium falciparum prevalence and malaria-related health parameters following the implementation of these two malaria control interventions in Zanzibar.Methods and FindingsCross-sectional clinical and parasitological surveys in children under the age of 14 y were conducted in North A District in May 2003, 2005, and 2006. Survey data were analyzed in a logistic regression model and adjusted for complex sampling design and potential confounders. Records from all 13 public health facilities in North A District were analyzed for malaria-related outpatient visits and admissions. Mortality and demographic data were obtained from District Commissioner's Office. P. falciparum prevalence decreased in children under five between 2003 and 2006; using 2003 as the reference year, odds ratios (ORs) and 95% confidence intervals (CIs) were, for 2005, 0.55 (0.28–1.08), and for 2006, 0.03 (0.00–0.27); p for trend < 0.001. Between 2002 and 2005 crude under-five, infant (under age 1 y), and child (aged 1–4 y) mortality decreased by 52%, 33%, and 71%, respectively. Similarly, malaria-related admissions, blood transfusions, and malaria-attributed mortality decreased significantly by 77%, 67% and 75%, respectively, between 2002 and 2005 in children under five. Climatic conditions favorable for malaria transmission persisted throughout the observational period.ConclusionsFollowing deployment of ACT in Zanzibar 2003, malaria-associated morbidity and mortality decreased dramatically within two years. Additional distribution of LLINs in early 2006 resulted in a 10-fold reduction of malaria parasite prevalence. The results indicate that the Millennium Development Goals of reducing mortality in children under five and alleviating the burden of malaria are achievable in tropical Africa with high coverage of combined malaria control interventions.
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41. |
- Björkman, Andrea, et al.
(författare)
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Aberrant recombination and repair during immunoglobulin class switching in BRCA1-deficient human B cells.
- 2015
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Ingår i: Proceedings of the National Academy of Sciences. - : Proceedings of the National Academy of Sciences. - 1091-6490 .- 0027-8424. ; 112:7, s. 2157-2162
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer type 1 susceptibility protein (BRCA1) has a multitude of functions that contribute to genome integrity and tumor suppression. Its participation in the repair of DNA double-strand breaks (DSBs) during homologous recombination (HR) is well recognized, whereas its involvement in the second major DSB repair pathway, nonhomologous end-joining (NHEJ), remains controversial. Here we have studied the role of BRCA1 in the repair of DSBs in switch (S) regions during immunoglobulin class switch recombination, a physiological, deletion/recombination process that relies on the classical NHEJ machinery. A shift to the use of microhomology-based, alternative end-joining (A-EJ) and increased frequencies of intra-S region deletions as well as insertions of inverted S sequences were observed at the recombination junctions amplified from BRCA1-deficient human B cells. Furthermore, increased use of long microhomologies was found at recombination junctions derived from E3 ubiquitin-protein ligase RNF168-deficient, Fanconi anemia group J protein (FACJ, BRIP1)-deficient, or DNA endonuclease RBBP8 (CtIP)-compromised cells, whereas an increased frequency of S-region inversions was observed in breast cancer type 2 susceptibility protein (BRCA2)-deficient cells. Thus, BRCA1, together with its interaction partners, seems to play an important role in repairing DSBs generated during class switch recombination by promoting the classical NHEJ pathway. This may not only provide a general mechanism underlying BRCA1's function in maintaining genome stability and tumor suppression but may also point to a previously unrecognized role of BRCA1 in B-cell lymphomagenesis.
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46. |
- Björkman, Anders
(författare)
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Brain plasticity and hand function
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to investigate the effects of cortical reorganisational changes following experimental deafferentation and peripheral nerve injury and apply the concept of brain plasticity to enhance sensory re-education following peripheral nerve injury and repair in the hand. In the first two papers the effects on hand function of contralateral deafferentation was investigated. Tourniquet induced anaesthesia (paper I) resulted in significant improvement in perception of touch, tactile discrimination, and grip strength in the opposite hand during anaesthesia. In order to investigate the effects of contralateral deafferentation with the pain factor eliminated, 100 patients, operated on in axillary plexus anaesthesia, were investigated (paper II). Axillary plexus anaesthesia also resulted in rapid, significant improvement in sensibility in the contralateral hand. In paper III selective ipsilateral cutaneous anaesthesia of the forearm resulted in rapid significant improvement in ipsilateral hand function. In the last two studies previous findings were applied on patients with median or ulnar nerve injuries. Tourniquet induced anaesthesia (paper IV) of the healthy hand results in significant rapid improvement in sensibility in nerve-injured hands. Repeated ipsilateral cutaneous anaesthesia (paper V) in combination with intensive sensory re-education resulted in improved hand function in nerve injured hands lasting at least 4 weeks after the last episode of anaesthesia. In conclusion, hand function in both healthy persons and patients with median or ulnar nerve injuries can be improved by using the concept of brain plasticity. These findings have a potential clinical application in sensory re-education following nerve repair in the hand.
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47. |
- Björkman, Anders, et al.
(författare)
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Cerebral reorganization in patients with brachial plexus birth injury and residual shoulder problems
- 2016
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Ingår i: Frontiers in Neurology. - : Frontiers Media SA. - 1664-2295. ; 7:DEC
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Tidskriftsartikel (refereegranskat)abstract
- The functional outcome after a brachial plexus birth injury (BPBI) is based on changes in the peripheral nerve and in the central nervous system. Most patients with a BPBI recover, but residual deficits in shoulder function are not uncommon. The aim of this study was to determine cerebral activation patterns in patients with BPBI and also residual symptoms from the shoulder. In seven patients (six females and one male, aged 17-23 years) with a BPBI and residual shoulder problems (Mallet score IV or lower), the cerebral response to active movement of the shoulder and elbow of the injured and healthy arm was monitored using functional magnetic resonance imaging at 3 T. Movements, i.e., shoulder rotation or elbow flexion and extension, of the injured side resulted in a more pronounced and more extended activation of the contralateral primary sensorimotor cortex compared to the activation seen after moving the healthy shoulder and elbow. In addition, moving the shoulder or elbow on the injured side resulted in increased activation in ipsilateral primary sensorimotor areas an also increased activation in associated sensorimotor areas, in both hemispheres, located further posterior in the parietal lobe, which are known to be important for integration of motor tasks and spatial aspects of motor control. Thus, in this preliminary study based on a small cohort, patients with BPBI and residual shoulder problems show reorganization in sensorimotor areas in both hemispheres of the brain. The increased activation in ipsilateral sensorimotor areas and in areas that deal with both integration of motor tasks and spatial aspects of motor control in both hemispheres indicates altered dynamics between the hemispheres, which may be a cerebral compensation for the injury.
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48. |
- Björkman, Anders, et al.
(författare)
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Cortical changes in dental technicians exposed to vibrating tools.
- 2010
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Ingår i: NeuroReport. - 1473-558X. ; 21, s. 722-726
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Tidskriftsartikel (refereegranskat)abstract
- To study the cortical reorganization after long time exposure to hand-held vibrating tools, we investigated 10 dental technicians with sensory neuropathy after long time exposure to vibrating tools and 10 controls for cortical changes using functional magnetic resonance imaging at 3 T. The activated volumes corresponding to individual fingers in the hand area of S1 were significantly larger in the neuropathy group than in controls. Activation in the primary motor cortex did not differ significantly from controls. These changes are likely the result of cortical reorganization following long-term non-physiological sensory input and they can partly explain the symptoms seen in vibration-induced neuropathy.
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49. |
- Björkman, Anders, et al.
(författare)
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Cortical sensory and motor response in a patient whose hand has been replanted: One-year follow up with functional magnetic resonance imaging
- 2007
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 41:2, s. 70-76
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Tidskriftsartikel (refereegranskat)abstract
- Functional magnetic resonance imaging (fMRI) was used to study how a replanted hand regained its cortical territory parallel to recovery. The cortical response to sensory stimulation shifts from an ipsilateral to a bilateral pattern, and then to a predominantly contralateral activation. The cortical response to motor stimulation was normal from the first investigation.
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