| 1. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Child Behavior and Quality of Life Before and After Tonsillotomy versus Tonsillectomy
- 2008
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Ingår i: Swedish Sleep Medicine Congress.
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Konferensbidrag (refereegranskat)abstract
- Objective: to compare two techniques for tonsil surgery with respect to postoperative pain and morbidity and changes in sleep, behavior, health related quality of life (HRQL) and benefit due to surgery. Methods: 67 pre-school children with tonsillar hypertrophy were randomized to regular tonsillectomy (TE) or tonsillotomy (TT) with Radiofrequency surgical technique. The parents completed a validated quality of life survey, Obstructive Sleep Apnea-18 (OSA18) , assessed the children’s behavior with the Child Behavior Checklist (CBCL) before and six month after surgery and evaluated the post-operative health related benefits using the Glasgow Children’s Benefit Inventory (GCBI). Results: TT-children recorded less pain from the first day, and were pain-free 3 days earlier than TE-children. Six months post-surgery, there was no difference between TT and TE with regard to snoring and ENT-infections. The total scores in all the individual domains between the initial OSA-18 and post-surgery scores differed (p<0.0001). Improvement in CBCL score was also significant (p<0.01) . There were no differences between TT- and TE-children. GCBI indicated a significant health benefit of both methods. Conclusions: Tonsillar hypertrophy shows impact on HRQL and behavior. After tonsillar operation, improvements occur as much after TT as after TE. TT should be first choice for treatment.
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| 2. |
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| 3. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Child behavior and quality of life before and after tonsillotomy versus tonsillectomy
- 2008
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Ingår i: International conference in pediatric otorhinolaryngology, 2008. ; , s. 40-40
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The objective of the present investigation was to compare two techniques for pediatric tonsil surgery with respect to postoperative pain and morbidity and changes in sleep behavior, health related quality of life (HRQL) and benefit due to surgery. Methods: 67 children (4,5-5,5 years) with tonsillar hypertrophy and obstructive sleep related distress with or without recurrent tonsillitis were randomized to either regular tonsillectomy (TE)(n=32) or intracapsular tonsillectomy/tonsillotomy (TT) (n=35) with Radiofrequency surgical technique (Ellman Int) Before TT/TE, the parents completed a validated Quality of Life survey of pediatric obstructive sleep apnea, the OSA18 (Obstructive Sleep Apnea-18) and a standardized assessment of their children-s behavior with the Child Behavior Checklist (CBCL). Six months after surgery, the parents repeated these measurements, and assessed the health related benefits of the surgery using the Glasgow Children´s Benefit Inventory (GCBI). Results: In the TT group, the children recorded less pain from the first day after surgery onwards, used fewer doses of painkillers and were pain-free 3 days earlier than the children in the TE group. Six months after surgery, there was no significant difference between TT and TE with regard to snoring and ENT-infections. The differences were all significant in the total scores and in all the individual domains between the initial OSA-18 and post-surgery scores (p<0.0001). The improvement in the total problem score measured with CBCL was also significant (p<0.01) and there were no differences between the TT and TE children. The improvements in all sub scores of the GCBI indicated a significant health benefit of both TT and TE. Conclusions: TT with RF-surgery is a safe method, which causes less pain and postoperative morbidity than regular TE and has a similar effect on snoring and recurrent infections. Young children with tonsillar hypertrophy and different degrees of obstructive sleep related distress all show an impact on HRQL and behavior. All improve dramatically after a tonsillar operation-improving just as much after TT as after TE. Based on these results, TT should be the first choice for treatment of these small children. Support: Financial support from the Research Council of South East Sweden (FORSS).
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| 4. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Intracapsular tonsillectomy with RF-surgery : Effects on snoring one-year results
- 2004
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Ingår i: 17th congress of the European Sleep research Sociaty, Prag, Tjeckien 5-9 okt, 2004.
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Konferensbidrag (refereegranskat)abstract
- Objektive: To compare two techniques for pediatric tonsil surgery with respect to postoperative pain and the long-term effects (one year) on snoring. Methods: 92 children with a history of snoring and few to several tonsillitis, were randomized to either regular tonsillectomy (T)(n=43) or intracapsular tonsillectomy (TT) with RF surgical technique, where only the obstructive parts of the tonsils were removed. Results: In the TT group, the children recorded less pain from the second hour after surgery onwards, and were back in school and pain-free 3 days earlier than the children in the T group. The TT children used fewer doses of painkillers and did not lose weight postoperatively compared to the T-children, who lost a mean of 660g in 10 days. Effect on snoring was the same in both groups. One year after surgery, some children in both groups still had slight snoring, but no apneás. Both groups were satisfied and in good health. The T-children remembered their pain more than TT-children. A surgical technique, which results in less suffering and a shorter time the child and a parent have to stay at home postoperatively, is a health- and socioeconomic gain. Is it defendable to continue performing traditional tonsillectomy? Intracapsular tonsillectomy with RF-surgery is a safe method, which causes less pain and morbidity than regular tonsillectomy and has the same effect on snoring.
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| 5. |
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| 6. |
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| 7. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Pediatric Tonsillotomy with the Radiofrequency Technique : Long-term Follow-up
- 2006
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Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 116:10, s. 1851-1857
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Compare the effects of partial tonsil resection using a radiofrequency technique, tonsillotomy (TT), with total tonsillectomy (TE, blunt dissection) after 1 and 3 years. Compare frequency of relapse in snoring or infections and possible long-term changes in behavior among TT children with those in TE children.Method: Ninety-two children (5-15 yr) randomized to TT (n = 49) or TE (n = 43) groups because of obstructive problems with or without recurrent tonsillitis. One year after surgery, general health, degree of obstruction, history of infections, and behavior were investigated using two questionnaires, the Qu1 and Child Behavior Checklist, as well as an ENT visit. After 3 years, two questionnaires, Qu2 and the Glasgow Children's Benefit Inventory, were answered by mail.Results: After 1 year, both groups were in good health. The effect on snoring and total behavior was the same for both groups, and the rate of recurrence of infections was not higher in the TT group. After 3 years, two children in the TT group were tonsillectomized (4%, 2/49), one because of peritonsillitis and another because of increased snoring. Otherwise, no differences existed between the groups in general health, snoring, or number of infections.Conclusion: Removing only the protruding parts of the tonsils has the same beneficial long-term effect on obstructive symptoms and recurrent throat infections as complete TE in the majority of cases. The need for re-operation is low; therefore, it appears inadvisable to follow the current common practice of routinely removing the whole tonsil given its higher morbidity and risk for serious complications.
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| 8. |
- Ericsson, Elisabeth, et al.
(författare)
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Tonsillotomy versus tonsillectomy on young children : 2 year post surgery follow-up
- 2014
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Ingår i: Journal of Otolaryngology - Head & Neck Surgery. - : BioMed Central (BMC). - 1916-0216. ; 43
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the long-term effect of tonsillotomy and tonsillectomy in young children after two years in comparison to the results after six months. Method: Children, age 4-5 with Sleep Disordered Breathing (SDB) and tonsil hyperplasia, were randomized to TE (32) or TT (35). TT was performed ad modum Hultcrantz with radiofrequency technique (Ellman). An adenoidectomy with cold steel was performed in the same session for 80% of cases. The patients were assessed prior to surgery, at six and 24 months postoperatively. Effects of surgery were evaluated clinically, through questionnaire (general health/snoring/ENT-infections), Quality of Life (QoL), survey of pediatric obstructive sleep apnea with OSA-18, and childrens behavior with the Child Behavior Checklist. Results: After two years there was still no difference between the groups with respect to snoring and frequency or severity of upper airway infections. Both TT and TE had resulted in large improvement in short and long term QoL and behavior. Three TT-children and one TE child had been re-operated due to recurrence of obstructive problems, the TE-child and one of the TT-children with adenoidectomy and two of the TT-children with tonsillectomy. Three of the TT-children had tonsil tissue protruding slightly out of the tonsil pouch and twelve TE-children had small tonsil remnants within the tonsil pouches, but with no need for surgery. Conclusion: Younger children have a small risk of symptom-recurrence requiring re-surgery within two years after TT. For the majority, the positive effect on snoring, infections, behavior and quality of life remain and is similar to TE.
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| 9. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Tonsillotomy versus tonsillectomy on young children : 2 year post surgery follow-up
- 2014
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Ingår i: Journal of Otolaryngology - Head & Neck Surgery. - London, United Kingdom : BioMed Central (BMC). - 1916-0216. ; 43:26
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the long-term effect of tonsillotomy and tonsillectomy in young children after two years in comparison to the results after six months.Method: Children, age 4-5 with Sleep Disordered Breathing (SDB) and tonsil hyperplasia, were randomized to TE (32) or TT (35). TT was performed ad modum Hultcrantz with radiofrequency technique (Ellman). An adenoidectomy with cold steel was performed in the same session for 80% of cases. The patients were assessed prior to surgery, at six and 24 months postoperatively. Effects of surgery were evaluated clinically, through questionnaire (general health/snoring/ENT-infections), Quality of Life (QoL), survey of pediatric obstructive sleep apnea with OSA-18, and children’s behavior with the Child Behavior Checklist.Results: After two years there was still no difference between the groups with respect to snoring and frequency or severity of upper airway infections. Both TT and TE had resulted in large improvement in short and long term QoL and behavior. Three TT-children and one TE child had been re-operated due to recurrence of obstructive problems, the TE-child and one of the TT-children with adenoidectomy and two of the TT-children with tonsillectomy. Three of the TT-children had tonsil tissue protruding slightly out of the tonsil pouch and twelve TE-children had small tonsil remnants within the tonsil pouches, but with no need for surgery.Conclusion: Younger children have a small risk of symptom-recurrence requiring re-surgery within two years after TT. For the majority, the positive effect on snoring, infections, behavior and quality of life remain and is similar to TE.
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| 10. |
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Graf, Jonas, et al.
(författare)
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Tonsillotomi på förskolebarn : räcker det?
- 2008
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Ingår i: The Annual General Meeting for the Swedish Society for Medicine, 2008.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BakgrundUnder förskoleålder sker en fysiologisk ökning av den sk Waldeyerska ringen med tillväxt av tonsiller och adenoid som del i utvecklingen av barnets immunförsvar Många barn kan under denna tid debutera med obstruktionsbesvär(snarkning och sömnapné). Traditionellt har tonsillerna och adenoiden genom tonsillektomi och abrasio helt avlägsnats för att komma till rätta med dessa symptom, kirurgi förenad med hög postoperativ smärtnivå. På senare tid har tonsillotomi, dvs partiellt borttagande av tonsillerna, återinförts som en något mer skonsam operationsmetod. Immunsystemetpåverkas möjligtvis inte heller i lika stor omfattning. Frågan är om detta ingrepp är tillfyllest på barn som är i den ålder då tonsillerna fortfarande växer? Syftet med föreliggande studie var att jämföra tonsillotomi med radiofrekvenskirurgi med fullständig tonsillektomi på förskolebarn vad beträffar postoperativ morbiditet och långtidseffekt på snarkning och infektionsnbenägenhet upp till två år efter operation med tonsillektomi.Metod67 förskolebarn(4-5 år)med symtomgivade tonsillhypertrofi randomiserades till reguljär tonsillektomi(TE) eller tonsillotomi(TT) med radiofrekvensteknik. I de flesta fall utfördes samtidigt abrasio. 6 månader efter operationen svarade alla på frågeformulär och 2 år efter operationen bedömdes de åter av ÖNH-läkare. Snarkningen före, direkt efter operationen och vid tiden för läkarbesöket utvärderades då med VASResultatTT barnen registrerade lägre smärta från första dagen efter operation och var helt smärtfria 3 dagar tidigare än TE-barnen. Sex månader efter operationen förelåg ingen skillnad på grupperna vad gäller snarkning och infektionsbenägehet. Efter två år hade två av de 34 TT-barnen och ett av de 33 TE-barnen blivit re-opererade pga recidiv av obstruktionsbesvär, TE-barnet med reabrasio. Övriga barn i båda grupperna var i stort sett besvärsfria vad gäller snarkning och ingen ökad infektionsbenägehet noterades hos något barn. VAS före/ två år efter operationen var 8,4/1,3 för TE och 8,5/1,6 för TT. Tre av TT barnen hade tonsillvävnad något utanför tonsillogen och hälften av TE barnen hade små tonsillrester i logerna.SammanfattningCirka 6 % risk föreligger att ett yngre barn som opereras med tonsillotomi för obstruktionsbesvär behöver göra om operationen inom 2 år. Denna risk bör vägas mot den betydligt lägre postoperativa morbiditeten för tonsillotomi jämfört med tonsillektomi
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| 15. |
- Graf, Jonas, 1971-, et al.
(författare)
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Tonsillotomi på förskolebarn-räcker det?
- 2008
-
Ingår i: The Annual General Meeting for the Swedish Society for Medicine,2008.
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Konferensbidrag (refereegranskat)abstract
- Under förskoleålder sker en fysiologisk ökning av den sk Waldeyerska ringen med tillväxt av tonsiller och adenoid som del i utvecklingen av barnets immunförsvar Många barn kan under denna tid debutera med obstruktionsbesvär(snarkning och sömnapné). Traditionellt har tonsillerna och adenoiden genom tonsillektomi och abrasio helt avlägsnats för att komma till rätta med dessa symptom, kirurgi förenad med hög postoperativ smärtnivå. På senare tid har tonsillotomi, dvs partiellt borttagande av tonsillerna, återinförts som en något mer skonsam operationsmetod. Immunsystemetpåverkas möjligtvis inte heller i lika stor omfattning. Frågan är om detta ingrepp är tillfyllest på barn som är i den ålder då tonsillerna fortfarande växer? Syftet med föreliggande studie var att jämföra tonsillotomi med radiofrekvenskirurgi med fullständig tonsillektomi på förskolebarn vad beträffar postoperativ morbiditet och långtidseffekt på snarkning och infektionsnbenägenhet upp till två år efter operation med tonsillektomi. 67 förskolebarn(4-5 år)med symtomgivade tonsillhypertrofi randomiserades till reguljär tonsillektomi(TE) eller tonsillotomi(TT) med radiofrekvensteknik. I de flesta fall utfördes samtidigt abrasio. 6 månader efter operationen svarade alla på frågeformulär och 2 år efter operationen bedömdes de åter av ÖNH-läkare. Snarkningen före, direkt efter operationen och vid tiden för läkarbesöket utvärderades då med VAS TT barnen registrerade lägre smärta från första dagen efter operation och var helt smärtfria 3 dagar tidigare än TE-barnen. Sex månader efter operationen förelåg ingen skillnad på grupperna vad gäller snarkning och infektionsbenägehet. Efter två år hade två av de 34 TT-barnen och ett av de 33 TE-barnen blivit re-opererade pga recidiv av obstruktionsbesvär, TE-barnet med reabrasio. Övriga barn i båda grupperna var i stort sett besvärsfria vad gäller snarkning och ingen ökad infektionsbenägehet noterades hos något barn. VAS före/ två år efter operationen var 8,4/1,3 för TE och 8,5/1,6 för TT. Tre av TT barnen hade tonsillvävnad något utanför tonsillogen och hälften av TE barnen hade små tonsillrester i logerna. Cirka 6 % risk föreligger att ett yngre barn som opereras med tonsillotomi för obstruktionsbesvär behöver göra om operationen inom 2 år. Denna risk bör vägas mot den betydligt lägre postoperativa morbiditeten för tonsillotomi jämfört med tonsillektomi.
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| 16. |
- Graf, Jonas, et al.
(författare)
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Tonsillotomy with RF on young children with obstructive sleep disorder in ashort and long term perspective. Does the risk for recurrence balance the gain ofless surgical trauma and morbidity?
- 2010
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Konferensbidrag (refereegranskat)abstract
- OBJECTIVES To compare two methods of tonsil surgery with respect to long term effect in a group of pre-school children METHODS 67 pre-school children, age 4-5 with symptoms of tonsillar hyperplasia were randomized to conventional tonsillectomy,TE,(n: 32) or tonsillotomy using radio frequency technique,TT(n:35). 28 TT patients and 25 TE patients underwent adenoidectomy at the same occasion. 5 TT and 1 TE had already undergone an adenoidectomy. Six months and two years after surgery all children were evaluated through questionnaires including the OSA-18 quality of life survey and two years after surgery they were again evaluated by an ENT-specialist, speech therapist and dentist. RESULTS The TT-children experienced less pain from the first day after surgery and were free from pain three days earlier than the TE-children. Six months after surgery there was no difference between the groups concerning snoring and frequency and severity of upper airway infections. After two years, three of the 35 TT-children and one of the TE children had been reoperated due to recurring obstructive problems, the TEchild and one of the TT-children with adenoidectomy, two TT-children with tonsillectomy. The otherchildren did not snore and no increased tendency towards infections was noted in any child. Evaluation with VAS before/two years after surgery was 8,4/1,3 for TE and 8,5/1,6 for TT.(Median). The total OSA-18 score and the scores for all domains within OSA 18 showed significant improvement after surgery for both groups of children(p<.0001) in short- and long term scores. Three of the TT-children had some tonsillar tissue protruding from the tonsillar cleft and half of the TEchildren had small tonsillar remains in the tonsillar clefts. CONCLUSIONS Young children in an age with rapid immunological development have a six percent risk of recurrence of tonsil hyperplasia-related obstructive symptoms within two years after tonsillectomy, and may need to be reoperated. This risk should be weighed against the much lower postoperative morbidity of tonsillotomy as compared to tonsillectomy.ral
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| 17. |
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| 18. |
- Lundeborg, Inger, et al.
(författare)
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Effects of tonsil surgery on speech and oral-motor function
- 2007
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Ingår i: 27th World Congress International Association of Logopedics and Phonoiatrics, Köpenhamn, Danmark.
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Konferensbidrag (refereegranskat)abstract
- Large tonsils decrease the oropharyngeal airspace and cause upper respiratory obstruction and consequently mouth breathing in children. If mouth breathing is prolonged, it leads to muscular and postural alterations which, in turn cause dentoskeletal changes. In Sweden 6% of all children are surgically treated for hypertrophy of the tonsils. The indications for surgery are recurrent tonsillitis or severe obstructive-sleep-disorder. Oral motor dysfunction including swallowing problems, disordered speech and aberrant dentofacial growth are less recognized problems as indications for treatment. We report preliminary results from an ongoing project aiming at comparing outcome of oral motor function and speech in children treated with two different surgical methods, tonsillectomy (TE)and partial tonsil resection, tonsillotomy (TT). 67 children aged 4-5 years old on waiting list for tonsil surgery were randomized to either TE or TT. They were assessed before surgery with the Swedish version of Nordic Orofacial Test (NOT-S) and a Swedish phonological test. A voice recording was also made. The assessment was repeated 6 months after surgery. The results were compared with the assessment of a control group.No significant differences were found between the TE and the TT group. Both groups performed significantly better on the oral motor test at the postoperative assessment, and voice quality had improved. However the delay in the phonological development that was found preoperatively in the children with enlarged tonsils still remained at the 6-month postoperative control
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| 19. |
- Lundeborg, Inger, et al.
(författare)
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Oral Motor Dysfunction in Children with adenotonsillar hypertrophy : effects of Surgery
- 2009
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Ingår i: Logopedics, Phoniatrics, Vocology. - New York, USA : Informa Healthcare. - 1401-5439 .- 1651-2022. ; 34:3, s. 111-116
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Tidskriftsartikel (refereegranskat)abstract
- Adenotonsillar hypertrophy is associated with a wide range of problems. The enlargement causes obstructive symptoms and affects different functions such as chewing, swallowing, articulation, and voice. The objective of this study was to assess oral motor function in children with adenotonsillar hypertrophy using Nordic Orofacial Test-Screening (NOT-S) before and 6 months after surgery consisting of adenoidectomy combined with total or partial tonsil removal. A total of 67 children were assigned to either tonsillectomy (n33) or partial tonsillectomy, ‘tonsillotomy’ (n34); 76 controls were assessed with NOT-S and divided into a younger and older age group to match pre- and post-operated children. Most children in the study groups had oral motor problems prior to surgery including snoring, open mouth position, drooling, masticatory, and swallowing problems. Post-surgery oral motor function was equal to controls. Improvement was independent of surgery method.
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| 20. |
- Lundeborg, Inger, et al.
(författare)
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Phonological Development in Children with Obstructive Sleep Disordered Breathing
- 2009
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Ingår i: Clinical Linguistics & Phonetics. - Oxon, United Kingdom : Taylor & Francis. - 0269-9206 .- 1464-5076. ; 23:10, s. 751-61
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Tidskriftsartikel (refereegranskat)abstract
- Adeno-tonsillar hypertrophy with obstructive sleep disordered breathing (OSDB) is known to affect oral-motor function, behaviour, and academic performance. Adeno-tonsillectomy is the most frequently performed operation in children, with total tonsillectomy (TE) being more common than partial resection, ‘tonsillotomy’ (TT). In the present study 67 children, aged 50–65 months, with OSBD were randomized to TE or TT. The children’s phonology was assessed pre-operatively and 6 months post-operatively. Two groups of children served as controls. Phonology was affected in 62.7% of OSBD children before surgery, compared to 34% in the control group (p < .001). Also, OSBDchildren had more severe phonological deficits than the controls (p < .001). Phonology improved 6 months equally after both surgeries. Despite improvement post-operatively, the gap to the controls increased. Other functional aspects, such as oral motor function, were normalized regardless of surgical method—TE or TT. The impact of OSBD should be considered as one contributing factor in phonological impairment.
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| 21. |
- Persson, Pekka, et al.
(författare)
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Jämförande studie av smärta och sjukskrivningslängd efter tonsillectomi och tonsillotomi med RF-teknik för 16-25 år.
- 2005
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Ingår i: Mediciniska Riksstämman, Stockholm 2005.
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Konferensbidrag (refereegranskat)abstract
- Bakgrund: Tonsillotomi (TT) har i en tidigare studie hos barn 5-15 år visat sig vara en mindre smärtsam operationsmetod jämfört med tonsillektomi (TE) och dessutom inte visat ökad infektionsbenägenhet vid långtidsuppföljning. I denna studie har patienter i åldern 16-25 år med tonsillhypertrofi och infektionstendens i svalget opererats med TT respektive TE i syfte att utvärdera postoperativ smärta, sjukskrivningstidens längd, frekvens av halsinfektioner och infektionsrelaterade besvär, samt studera hur livskvaliteten påverkades av operation. Metod: 60 patienter mellan 16-25 år med tonsillhypertrofi samt återkommande halsinfektioner har randomiserats i en multicenterstudie till TE eller TT med RF teknik (Surgitron™, Ellman). Smärta liksom förbrukning av analgetika mäts postoperativt samt sjukskrivningstidens längd. Återbesök görs dag 7 då svalgstatus noteras, vikt registreras samt protokoll inhämtas. Vid planerad halvårsuppföljning utvärderas effekten på obstruktiva besvär, infektioner samt upplevd livskvalitet. Resultat: Postoperativt fann man att i TT gruppen förelåg signifikant lägre upplevd smärta, lägre analgetikaförbrukning samt kortare sjukskrivningstid (5.1 dagar TT, 9.3 dagar TE) jämfört med TE gruppen. TT patienterna kunde i högre grad än TE patienterna skrivas hem på operationsdagen. I TT gruppen kunde man snabbare återgå till normalkost och den postoperativa viktminskningen var mindre än i TE gruppen. Slutsats: Preliminära resultat visar att tonsillotomi med RF-teknik är en metod som även för åldersgruppen 16-25 år visar lägre postoperativ morbiditet med lägre analgetikaförbrukning samt förkortad sjukskrivningstid som följd, jämfört med tonsillektomi. Hälsoekonomiska vinster kunde ses då tonsillotomigruppen i större utsträckning hemskrevs på operationsdagen och hade halverad sjukskrivningstid.
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| 22. |
- Dengler, Jürgen, et al.
(författare)
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Ecological Indicator Values for Europe (EIVE) 1.0
- 2023
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Ingår i: Vegetation Classification and Survey. - 2683-0671. ; 4, s. 7-29
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To develop a consistent ecological indicator value system for Europe for five of the main plant niche dimensions: soil moisture (M), soil nitrogen (N), soil reaction (R), light (L) and temperature (T). Study area: Europe (and closely adjacent regions). Methods: We identified 31 indicator value systems for vascular plants in Europe that contained assessments on at least one of the five aforementioned niche dimensions. We rescaled the indicator values of each dimension to a continuous scale, in which 0 represents the minimum and 10 the maximum value present in Europe. Taxon names were harmonised to the Euro+Med Plantbase. For each of the five dimensions, we calculated European values for niche position and niche width by combining the values from the individual EIV systems. Using T values as an example, we externally validated our European indicator values against the median of bioclimatic conditions for global occurrence data of the taxa. Results: In total, we derived European indicator values of niche position and niche width for 14,835 taxa (14,714 for M, 13,748 for N, 14,254 for R, 14,054 for L, 14,496 for T). Relating the obtained values for temperature niche position to the bioclimatic data of species yielded a higher correlation than any of the original EIV systems (r = 0.859). The database: The newly developed Ecological Indicator Values for Europe (EIVE) 1.0, together with all source systems, is available in a flexible, harmonised open access database. Conclusions: EIVE is the most comprehensive ecological indicator value system for European vascular plants to date. The uniform interval scales for niche position and niche width provide new possibilities for ecological and macroecological analyses of vegetation patterns. The developed workflow and documentation will facilitate the future release of updated and expanded versions of EIVE, which may for example include the addition of further taxonomic groups, additional niche dimensions, external validation or regionalisation.
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| 23. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Tonsillotomi med radiovågsteknik vid snarkning och sömnapné hos barn
- 2004
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Ingår i: 3:e Nordisk kongress om Barn och smärta.
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Konferensbidrag (refereegranskat)abstract
- Bakgrund: Tonsillektomi (TE), är det vanligaste ingreppet som görs på barn med obstruktionsbesvär (snarkning och sömnapné). Operationen har en relativt hög postoperativ morbiditet. På senare tid olika metoder utvecklats för att minska mängden tonsillvävnaden utan att ta bort hela organet. Tonsillotomi (TT), partiell extirpation av tonsillen verkar ge färre komplikationer än TE. Syfte: att utvärdera en ny tonsillotomimetod med radiofrekvensteknik (RF) på barn med obstruktionsbesvär vad gäller postoperativ smärta och morbiditet. Metod: 92 barn mellan 5–15 års ålder randomiserades till TT (49) med RF och till sedvanlig TE (43). Postoperativ smärtskattning gjordes varje vaken timme av barn, föräldrar och vårdpersonal första dygnet och tre ggr/dag av föräldrar och barn i hemmet fram till återbesök på dag 7-9. Analgetikaförbrukning registrerades, liksom mängd och konsistens av intagen föda. Resultat: TT-barnen blödde mindre än TE–barnen. TT-gruppen skattade lägre smärta från andra timmen efter operationen, var tillbaka i skolan och smärtfria tre dagar tidigare än barnen i TE-gruppen. TT-barnen behövde mindre mängd analgetika än TE-barnen och minskade inte i vikt postoperativt. TE-barnen gick ner i vikt i medeltal 660g. Efter ett år efter mådde alla bra. TE- barnen kom ihåg sin operationssmärta mer än TT-barnen. Effekten på snarkning och sömnapné var lika god i båda grupperna. Slutsats: TT med RF teknik är en säker metod som i betydande grad ger mindre smärta och postop. morbiditet än sedvanlig TE och har samma effekt på snarkning. Är det försvarbart att fortsätta med tonsillektomi som rutin på snarkande barn?
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| 24. |
- Freischmidt, Axel, et al.
(författare)
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Haploinsufficiency of TBK1 causes familial ALS and fronto-temporal dementia
- 2015
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Ingår i: Nature Neuroscience. - : Springer Science and Business Media LLC. - 1097-6256 .- 1546-1726. ; 18:5, s. 631-
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Tidskriftsartikel (refereegranskat)abstract
- Amyotrophic lateral sclerosis (ALS) is a genetically heterogeneous neurodegenerative syndrome hallmarked by adult-onset loss of motor neurons. We performed exome sequencing of 252 familial ALS (fALS) and 827 control individuals. Gene-based rare variant analysis identified an exome-wide significant enrichment of eight loss-of-function (LoF) mutations in TBK1 (encoding TANK-binding kinase 1) in 13 fALS pedigrees. No enrichment of LoF mutations was observed in a targeted mutation screen of 1,010 sporadic ALS and 650 additional control individuals. Linkage analysis in four families gave an aggregate LOD score of 4.6. In vitro experiments confirmed the loss of expression of TBK1 LoF mutant alleles, or loss of interaction of the C-terminal TBK1 coiled-coil domain (CCD2) mutants with the TBK1 adaptor protein optineurin, which has been shown to be involved in ALS pathogenesis. We conclude that haploinsufficiency of TBK1 causes ALS and fronto-temporal dementia.
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| 25. |
- Karlina, Ruth, et al.
(författare)
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Identification and characterization of distinct brown adipocyte subtypes in C57BL/6J mice
- 2021
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Ingår i: Life Science Alliance. - : Life Science Alliance, LLC. - 2575-1077. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Brown adipose tissue (BAT) plays an important role in the regulation of body weight and glucose homeostasis. Although increasing evidence supports white adipose tissue heterogeneity, little is known about heterogeneity within murine BAT. Recently, UCP1 high and low expressing brown adipocytes were identified, but a developmental origin of these subtypes has not been studied. To obtain more insights into brown preadipocyte heterogeneity, we use single-cell RNA sequencing of the BAT stromal vascular fraction of C57/BL6 mice and characterize brown preadipocyte and adipocyte clonal cell lines. Statistical analysis of gene expression profiles from brown preadipocyte and adipocyte clones identify markers distinguishing brown adipocyte subtypes. We confirm the presence of distinct brown adipocyte populations in vivo using the markers EIF5, TCF25, and BIN1. We also demonstrate that loss of Bin1 enhances UCP1 expression and mitochondrial respiration, suggesting that BIN1 marks dormant brown adipocytes. The existence of multiple brown adipocyte subtypes suggests distinct functional properties of BAT depending on its cellular composition, with potentially distinct functions in thermogenesis and the regulation of whole body energy homeostasis.
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| 26. |
- Larsen, Stein Gunnar, et al.
(författare)
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First experience with (224)Radium-labeled microparticles (Radspherin (R)) after CRS-HIPEC for peritoneal metastasis in colorectal cancer (a phase 1 study)
- 2023
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Ingår i: Frontiers in Medicine. - : Frontiers Media S.A.. - 2296-858X. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Peritoneal metastasis (PM) from colorectal cancer carries a dismal prognosis despite extensive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). With a median time to recurrence of 11-12 months, there is a need for novel therapies. Radspherin (R) consists of the alpha-emitting radionuclide radium-224 (Ra-224), which has a half-life of 3.6 days and is adsorbed to a suspension of biodegradable calcium carbonate microparticles that are designed to give short-range radiation to the serosal peritoneal surface linings, killing free-floating and/or tumor cell clusters that remain after CRS-HIPEC.Methods: A first-in-human phase 1 study (EudraCT 2018-002803-33) was conducted at two specialized CRS-HIPEC centers. Radspherin (R) was administered intraperitoneally 2 days after CRS-HIPEC. Dose escalation at increasing activity dose levels of 1-2-4-7-MBq, a split-dose repeated injection, and expansion cohorts were used to evaluate the safety and tolerability of Radspherin (R). The aim was to explore the recommended dose and biodistribution using gamma-camera imaging. The results from the planned safety interim analysis after the completion of the dose-limiting toxicity (DLT) period of 30 days are presented.Results: Twenty-three patients were enrolled: 14 in the dose escalation cohort, three in the repeated cohort, and six in the expansion cohort. Of the 23 enrolled patients, seven were men and 16 were women with a median age of 64 years (28-78). Twelve patients had synchronous PM stage IV and 11 patients had metachronous PM [primary stage II; (6) and stage III; (5)], with a disease-free interval of 15 months (3-30). The peritoneal cancer index was median 7 (3-19), operation time was 395 min (194-515), and hospital stay was 12 days (7-37). A total of 68 grade 2 adverse events were reported for 17 patients during the first 30 days; most were considered related to CRS and/or HIPEC. Only six of the TEAEs were evaluated as related to Radspherin (R). One TEAE, anastomotic leakage, was reported as grade 3. Accordion >= 3 grade events occurred in a total of four of the 23 patients: reoperation due to anastomotic leaks (two) and drained abscesses (two). No DLT was documented at the 7 MBq dose level that was then defined as the recommended dose. The biodistribution of Radspherin (R) showed a relatively even peritoneal distribution.Conclusion: All dose levels of Radspherin (R) were well tolerated, and DLT was not reached. No deaths occurred, and no serious adverse events were considered related to Radspherin (R).
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| 27. |
- Lorenzen, Eline D., et al.
(författare)
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Species-specific responses of Late Quaternary megafauna to climate and humans
- 2011
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 479:7373, s. 359-364
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Tidskriftsartikel (refereegranskat)abstract
- Despite decades of research, the roles of climate and humans in driving the dramatic extinctions of large-bodied mammals during the Late Quaternary period remain contentious. Here we use ancient DNA, species distribution models and the human fossil record to elucidate how climate and humans shaped the demographic history of woolly rhinoceros, woolly mammoth, wild horse, reindeer, bison and musk ox. We show that climate has been a major driver of population change over the past 50,000 years. However, each species responds differently to the effects of climatic shifts, habitat redistribution and human encroachment. Although climate change alone can explain the extinction of some species, such as Eurasian musk ox and woolly rhinoceros, a combination of climatic and anthropogenic effects appears to be responsible for the extinction of others, including Eurasian steppe bison and wild horse. We find no genetic signature or any distinctive range dynamics distinguishing extinct from surviving species, emphasizing the challenges associated with predicting future responses of extant mammals to climate and human-mediated habitat change.
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| 28. |
- Reinthaler, Eva M., et al.
(författare)
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TPP2 mutation associated with sterile brain inflammation mimicking MS
- 2018
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Ingår i: NEUROLOGY-GENETICS. - 2376-7839. ; 4:6
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Tidskriftsartikel (refereegranskat)abstract
- Objective To ascertain the genetic cause of a consanguineous family from Syria suffering from a sterile brain inflammation mimicking a mild nonprogressive form of MS.Methods We used homozygosity mapping and next-generation sequencing to detect the disease-causing gene in the affected siblings. In addition, we performed RNA and protein expression studies, enzymatic activity assays, immunohistochemistry, and targeted sequencing of further MS cases from Austria, Germany, Canada and Jordan.Results In this study, we describe the identification of a homozygous missense mutation (c.82T>G, p.Cys28Gly) in the tripeptidyl peptidase II (TPP2) gene in all 3 affected siblings of the family. Sequencing of all TPP2-coding exons in 826 MS cases identified one further homozygous missense variant (c.2027C>T, p.Thr676Ile) in a Jordanian MS patient. TPP2 protein expression in whole blood was reduced in the affected siblings. In contrast, TPP2 protein expression in postmortem brain tissue from MS patients without TPP2 mutations was highly upregulated.Conclusions The homozygous TPP2 mutation (p.Cys28Gly) is likely responsible for the inflammation phenotype in this family. TPP2 is an ubiquitously expressed serine peptidase that removes tripeptides from the N-terminal end of longer peptides. TPP2 is involved in various biological processes including the destruction of major histocompatibility complex Class I epitopes. Recessive loss-of-function mutations in TPP2 were described in patients with Evans syndrome, a rare autoimmune disease affecting the hematopoietic system. Based on the gene expression results in our MS autopsy brain samples, we further suggest that TPP2 may play a broader role in the inflammatory process in MS.
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| 29. |
- Rieder, Stephan R., et al.
(författare)
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Dynamic modelling of the long term behaviour of cadmium, lead and mercury in Swiss forest soils using CHUM-AM
- 2014
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 468, s. 864-876
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Tidskriftsartikel (refereegranskat)abstract
- The applicability of the dynamic soil model CHUM-AM was tested to simulate concentrations of Cd, Pb and Hg in five Swiss forest soils. Soil cores of up to 50 cm depth were sampled and separated into two defined soil layers. Soil leachates were collected below the litter by zero-tension lysimeters and at 15 and 50 cm soil depths by tension lysimeters over two years. The concentrations of Cd, Pb and Hg in the solid phase and soil solution were measured by ICP-MS (Cd, Pb) or CV-AFS (Hg). Measured metal concentrations were compared with modelled concentrations using CHUM-AM. Additionally we ran the model with three different deposition scenarios (current deposition; maximum acceptable deposition according to the Swiss ordinance on Air Pollution Control; critical loads according to CLRTAP) to predict metal concentrations in the soils for the next 1000 years. Assuming current loads concentrations of Cd and Pb showed varying trends (increasing/decreasing) between the soils. Soils rich in organic carbon or with a high pH value showed increasing trends in Cd and Pb concentrations whereas the concentrations in the other soils decreased. In contrast Hg concentrations are predicted to further increase in all soils. Critical limits for Pb and Hg will partly be exceeded by current loads or by the critical loads proposed by the CLRTAP but the critical limits for Cd will rarely be reached within the next 1000 years. In contrast, maximal acceptable deposition will partly lead to concentrations above the critical limits for Pb in soils within the next 400 years, whereas the acceptable deposition of Cd will not lead to concentrations above the proposed critical limits. In conclusion the CHUM-AM model is able to accurately simulate heavy metal (Cd, Pb and Hg) concentrations in Swiss forest soils of various soil properties.
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| 30. |
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| 31. |
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| 32. |
- Winkelmann, Juliane, et al.
(författare)
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Mutations in DNMT1 cause autosomal dominant cerebellar ataxia, deafness and narcolepsy
- 2012
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Ingår i: Human Molecular Genetics. - : Oxford University Press (OUP). - 0964-6906 .- 1460-2083. ; 21:10, s. 2205-2210
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Tidskriftsartikel (refereegranskat)abstract
- Autosomal dominant cerebellar ataxia, deafness and narcolepsy (ADCA-DN) is characterized by late onset (30-40 years old) cerebellar ataxia, sensory neuronal deafness, narcolepsy-cataplexy and dementia. We performed exome sequencing in five individuals from three ADCA-DN kindreds and identified DNMT1 as the only gene with mutations found in all five affected individuals. Sanger sequencing confirmed the de novo mutation p.Ala570Val in one family, and showed co-segregation of p.Val606Phe and p.Ala570Val, with the ADCA-DN phenotype, in two other kindreds. An additional ADCA-DN kindred with a p.GLY605Ala mutation was subsequently identified. Narcolepsy and deafness were the first symptoms to appear in all pedigrees, followed by ataxia. DNMT1 is a widely expressed DNA methyltransferase maintaining methylation patterns in development, and mediating transcriptional repression by direct binding to HDAC2. It is also highly expressed in immune cells and required for the differentiation of CD4+ into T regulatory cells. Mutations in exon 20 of this gene were recently reported to cause hereditary sensory neuropathy with dementia and hearing loss (HSAN1). Our mutations are all located in exon 21 and in very close spatial proximity, suggesting distinct phenotypes depending on mutation location within this gene.
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