| 1. |
- Dahlin, L B, et al.
(författare)
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Mechanical effects of compression of peripheral nerves
- 1986
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Ingår i: Journal of Biomechanical Engineering. - 0148-0731. ; 108:2, s. 2-120
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Tidskriftsartikel (refereegranskat)abstract
- Effects of graded compression on nerve function were analyzed in order to evaluate the relative importance of pressure level and duration of compression for functional deterioration. The pressure was applied by means of a small inflatable cuff. The effects of two pressure levels, i.e., 80 mm Hg applied for 2 hr or 400 mm Hg applied for 15 min, were studied in rabbit tibial nerves. The lower pressure tested, which is known to induce ischemia of the compressed nerve segment, also causes some degree of mechanical deformation of the nerve trunk, which leads to incomplete recovery following pressure release. The duration of compression is of importance for the degree of nerve injury even at the higher pressure level tested.
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| 2. |
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| 3. |
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| 4. |
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| 5. |
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| 6. |
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| 7. |
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| 8. |
- Arai, Takeru, et al.
(författare)
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Axonal outgrowth in muscle grafts made acellular by chemical extraction
- 2000
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Ingår i: Restorative Neurology and Neuroscience. - 0922-6028. ; 17:4, s. 165-174
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare nerve regeneration in autologous detergent extracted and freeze-thawed muscle grafts and to electrophoretically characterize the grafts. Methods: Autologous acellular muscle grafts were created either by freeze/thawing or by detergent extraction and then used to bridge a 10 mm gap in rat sciatic nerve. The autologous grafts were compared with respect to protein content, using electrophoresis preimplantation, and axonal outgrowth, Schwann cell and macrophage content, using immunocytochemistry (neurofilaments, S-100 protein, ED 1 macrophages) at 5-20 days postimplantation. Results: The extracted muscle grafts were elastic, but the amount of several proteins was reduced and laminin was still present at a position of basal laminae of the muscle fibers. The freeze/thawed grafts were brittle and lacked elasticity, but resulted in minor changes in major proteins. The axons regenerated through both types of grafts (initial delay 6 days and rate 0.7-0.8 mm/day), which shrunk in length by 25 %. There were no apparent differences with respect to Schwann cells and macrophages. Conclusions: The results suggest that detergent extracted mucle tissue, in which some basal lamina proteins remain but cells are removed, could present a new favourable option for nerve grafting.
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| 9. |
- Arai, Takeru, et al.
(författare)
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Bioartificial nerve graft for bridging extended nerve defects in rat sciatic nerve based on resorbable guiding filaments
- 2000
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 0284-4311. ; 34:2, s. 101-108
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Tidskriftsartikel (refereegranskat)abstract
- A long defect (15 mm) in rat sciatic nerve was repaired with a bioartificial nerve graft composed of a silicone tube and seven synthetic filaments of five types (polyamide, catgut, polydioxanone, and two types of polyglactin, normal and quickly-absorbed) inserted longitudinally into the tube. In all cases in which filaments were used a regenerating bridge was obtained in the tube after three months in contrast to empty silicone tubes, in which no structure was observed. There was a 6% ~ 46% recovery of isometric muscle contractility of the anterior tibial and gastrocnemius muscles with positive pinch reflex test in most cases. Myelinated axons were seen in the regenerating tissue between the filaments but not directly in contact with them, and there were varying numbers of macrophages close to the filaments. Silicone tubes with filaments, regardless of type of filament, induced nerve tissue to regenerate and resulted in functional recovery through a 15 mm nerve gap not achieved with empty tubes. Nerve promoting factors may be applied to the filaments and the model is a valuable tool for further development of artificial nerve grafts.
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| 10. |
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| 11. |
- Blomqvist, P, et al.
(författare)
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Untitled -: Introduction
- 2000
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Ingår i: ACTA ORTHOPAEDICA SCANDINAVICA. - 0001-6470. ; 71
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 12. |
- Brandt, J., et al.
(författare)
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Acutely-dissociated Schwann cells used in tendon autografts for bridging nerve defects in rats: a new principle for tissue engineering in nerve reconstruction
- 2005
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Ingår i: Scand J Plast Reconstr Surg Hand Surg. - 0284-4311. ; 39:6, s. 321-5
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Tidskriftsartikel (refereegranskat)abstract
- A new method of acute dissociation of Schwann cells was used to study the effect of addition of such cells to a tendon autograft--a recently-described graft material--on peripheral nerve regeneration in rats. Autologous Schwann cells were obtained from enzymatic dissociation of predegenerated nerves. The tendon autografts were supplied with Schwann cells through brief in vitro coincubation. Schwann cell-free tendon autografts were used as controls. Axonal outgrowth was measured immunohistochemically after four, seven, and 10 days. At seven days, outgrowth was significantly longer in the pretreated autografts. The use of acutely-dissociated Schwann cells is a new approach to tissue engineering in nerve reconstruction, and may abolish the need for time-consuming culture of Schwann cells.
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| 13. |
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| 14. |
- Cowper, Patricia A., et al.
(författare)
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Economic Analysis of Ticagrelor Therapy From a US Perspective
- 2015
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Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 65:5, s. 465-476
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Based on results of the PLATO (Platelet Inhibition and Patient Outcomes) trial comparing ticagrelor with clopidogrel therapy, the U.S. Food and Drug Administration approved ticagrelor in 2011 for reducing thrombotic cardiovascular events in patients with acute coronary syndrome (ACS) with the proviso that it be taken with low-dose aspirin. OBJECTIVES This study sought to assess the cost and cost effectiveness of ticagrelor therapy relative to clopidogrel in treating ACS patients from the perspective of the U.S. health care system. METHODS We estimated within-trial resource use and costs using U.S. low-dose aspirin patients in PLATO (n = 547). Quality-adjusted life expectancy was estimated using the total PLATO population (n = 18,624), combined with baseline risk and long-term survival data from an external ACS patient cohort. Study drugs were valued at current costs. Cost effectiveness was assessed, as was the sensitivity of results to sampling and methodological uncertainties. RESULTS One year of ticagrelor therapy, relative to that of generic clopidogrel, cost $29,665/quality-adjusted life-year gained, with 99% of bootstrap estimates falling under a $100,000 willingness-to-pay threshold. Results were robust to extensive sensitivity analyses, including variations in clopidogrel cost, exclusion of costs in extended years of life, and a recalibrated estimate of survival reflecting a lower underlying mortality risk in the United States. CONCLUSIONS For PLATO-eligible ACS patients, a U.S. perspective comparison of the current standard of dual antiplatelet therapy of aspirin with clopidogrel versus aspirin plus ticagrelor showed that the ticagrelor regimen increased life expectancy at an incremental cost well within accepted benchmarks of good value for money. (C) 2015 by the American College of Cardiology Foundation.
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| 15. |
- Dahlin, L B, et al.
(författare)
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Axonal growth in mesothelial chambers : effects of a proximal preconditioning lesion and/or predegeneration of the distal nerve stump
- 1988
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Ingår i: Experimental Neurology. - : Elsevier BV. - 0014-4886. ; 99:3, s. 63-655
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Tidskriftsartikel (refereegranskat)abstract
- Preformed, autologous mesothelial chambers were utilized to study axonal growth following selective predegeneration of the distal nerve stump and/or preconditioning of the proximal nerve stump. The left and/or right sciatic nerve of rats was exposed and transected in the thigh. Two weeks after transection, the left proximal nerve stump was cross-anastomosed with the right distal nerve stump by using a mesothelial chamber leaving a 15-mm gap between the two nerve stumps. Previous studies have shown that axonal overgrowth normally does not occur over this gap distance to the distal stump. Three months after cross-anastomosing, regeneration across the 15-mm gap was evaluated by muscle action potential recordings and light microscopical examination. In experiments in which a distal nerve stump was selectively degenerated and the proximal segment was freshly cut, axons had bridged the 15-mm gap in six of seven rats. When a proximal preconditioned nerve stump was matched with a freshly cut distal stump, axonal overgrowth occurred in only 4 of 10 experiments. In experiments including a proximal preconditioned nerve stump and a distal predegenerated stump, axons bridged the gap in 6 of 8 experiments. We concluded that a priming lesion, including manipulation with proximal and/or distal stump, enhances axonal growth in mesothelial chambers.
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| 16. |
- Dahlin, Lars B., et al.
(författare)
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Tissue response to silicone tubes used to repair human median and ulnar nerves
- 2001
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 35:1, s. 29-34
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Tidskriftsartikel (refereegranskat)abstract
- Silicone tubes of appropriate sizes were used to enclose the injured zone of transsected ulnar and median nerves in the human forearm as an alternative to conventional microsurgical repair of the nerve trunk. A gap measuring 3-5 mm was left intentionally between the nerve ends inside the tube. The clinical early results from a prospective randomised study that compared these two principles have recently been presented. Seven patients (five men and two women), aged 15-49 years (median 20) were reexplored 12-44 months (median 22) after the initial procedure because of local discomfort from the tube in four patients. There was a new nerve structure bridging the former gap and in most cases it was impossible to distinguish the site of the injury. In all cases there was a thin capsule around the silicone tube that microscopically consisted of connective tissue with thin walls and no signs of inflammation granuloma or macrophages (n = 4), while in two cases a mild foreign body reaction was seen at a single site (n = 1) or at patchy areas (n = 1). These results indicate that after more than one year there is a limited tissue reaction around silicone tubes used to repair median and ulnar nerves in humans.
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| 17. |
- Danielsen, N, et al.
(författare)
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Axonal growth in mesothelial chambers. The role of the distal nerve segment
- 1983
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery. - 0036-5556. ; 17:2, s. 25-119
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Tidskriftsartikel (refereegranskat)abstract
- An experimental model is presented for studying nerve regeneration over gaps of various lengths between the both ends of a severed nerve. After transferring left and right sciatic nerves of rat to the back, the gap between the two nerve ends could be bridged by a preformed, tube-shaped mesothelial chamber of a desired length. When the gap length was 10 mm or less, a well developed nerve structure was generated in the chamber between the nerve ends, and axons from the left sciatic nerve reinnervated muscles in the right limb via the right sciatic nerve. When the gap length was extended to 15 mm or more no such regeneration occurred. When no distal nerve end was introduced into the chamber, there was a limited growth into this chamber over only 5-6 mm. This "limited growth phenomenon" is discussed with respect to a lack of "trophic" or cellular support from a distal nerve segment. It is also proposed that the termination of growth, seen under these circumstances, may suggest a new principle for avoiding the development of neuromas after nerve transections.
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| 18. |
- Danielsen, N, et al.
(författare)
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Experimental hyperthyroidism stimulates axonal growth in mesothelial chambers
- 1986
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Ingår i: Experimental Neurology. - : Elsevier BV. - 0014-4886. ; 94:1, s. 54-65
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Tidskriftsartikel (refereegranskat)abstract
- An experimental model is presented for studying axonal growth after experimental hyperthyroidism and hypothyroidism. The left sciatic nerve of the rat was transected and transposed to the back. The proximal nerve stump was inserted into a 50-mm-long mesothelial chamber leaving the distal end of the chamber open. Different groups of young adult rats were given daily injections of thyroxine (10 micrograms/100 g body weight) or the goitrogen, thiamazol, in the drinking water (0.125 g/liter) for 12 weeks. Thyroxine treatment increased significantly the extent of axonal outgrowth from the proximal nerve stump compared with untreated rats. Experimental hypothyroidism (thiamazol treatment), evidenced by a retarded body growth, did not affect the extent of axonal outgrowth. In other experiments the left proximal nerve stump was cross-anastomosed with the right distal nerve stump. The two nerve stumps were bridged with a mesothelial chamber leaving a 15-mm gap. This gap distance is known from our previous studies to inhibit axonal overgrowth to the distal nerve stump. As evidenced by histological evaluation, in three of six thyroxine-treated rats, axons had bridged the 15-mm gap. We conclude that experimentally induced hyperthyroidism enhances axonal growth in mesothelial chambers.
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| 19. |
- Danielsen, N, et al.
(författare)
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Peripheral nerve regeneration in Gore-tex chambers
- 1988
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - 0284-4311. ; 22:3, s. 10-207
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Tidskriftsartikel (refereegranskat)abstract
- Gore-tex chambers were used to bridge a 6 mm gap between the proximal and distal nerve stumps of a rat sciatic nerve. The wall structure of these chambers is characterized by "nodes" interconnected by smaller fibrils. Chambers with internodal distances of 5, 10 and 30 microns were used. Some 30 microns chambers were coated from the outside with Gore-tex (0.2 micron internodal distance) and others were coated from the inside. Regeneration after 12 weeks, as evidenced by muscle action potential recordings and light microscopy, was successful regardless of what type of chamber had been used. The organization of the nerve structure varied among different chamber types. A well organized coaxial nerve structure with myelinated axons was observed if inner-coated chambers were used. In chambers that were not coated or in outer-coated chambers tissue completely filled the chambers, and myelinated axons were arranged in mini-fascicles surrounded by loose connective tissue.
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| 20. |
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| 21. |
- Das, S, et al.
(författare)
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Disinfection of Multidrug Resistant Escherichia coli by Solar-Photocatalysis using Fe-doped ZnO Nanoparticles
- 2017
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 7:1, s. 104-
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Tidskriftsartikel (refereegranskat)abstract
- Spread of antibiotic resistant bacteria through water, is a threat to global public health. Here, we report Fe-doped ZnO nanoparticles (Fe/ZnO NPs) based solar-photocatalytic disinfection (PCD) of multidrug resistant Escherichia coli (MDR E. coli). Fe/ZnO NPs were synthesized by chemical precipitation technique, and when used as photocatalyst for disinfection, proved to be more effective (time for complete disinfection = 90 min) than ZnO (150 min) and TiO2 (180 min). Lipid peroxidation and potassium (K+) ion leakage studies indicated compromisation of bacterial cell membrane and electron microscopy and live-dead staining confirmed the detrimental effects on membrane integrity. Investigations indicated that H2O2 was the key species involved in solar-PCD of MDR E. coli by Fe/ZnO NPs. X-ray diffraction and atomic absorption spectroscopy studies showed that the Fe/ZnO NPs system remained stable during the photocatalytic process. The Fe/ZnO NPs based solar-PCD process proved successful in the disinfection of MDR E. coli in real water samples collected from river, pond and municipal tap. The Fe/ZnO NPs catalyst made from low cost materials and with high efficacy under solar light may have potential for real world applications, to help reduce the spread of resistant bacteria.
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| 22. |
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| 23. |
- Gherm, VE, et al.
(författare)
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The two-frequency coherence function for the fluctuating ionosphere: Narrowband pulse propagation
- 1997
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Ingår i: JOURNAL OF ATMOSPHERIC AND SOLAR-TERRESTRIAL PHYSICS. - : PERGAMON-ELSEVIER SCIENCE LTD. - 1364-6826. ; 59:14, s. 1831-1841
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This article presents a detailed numerical investigation of the two-frequency coherence function for HF wave propagation in the fluctuating ionosphere. Earlier published expressions for the coherence function are transformed to a form suitable for numeric
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| 24. |
- Gherm, VE, et al.
(författare)
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The two-frequency, two-time coherence function for the fluctuating ionosphere: wideband pulse propagation
- 1997
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Ingår i: JOURNAL OF ATMOSPHERIC AND SOLAR-TERRESTRIAL PHYSICS. - : PERGAMON-ELSEVIER SCIENCE LTD. - 1364-6826. ; 59:14, s. 1843-1854
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This article presents a numerical investigation of the two-frequency, two-lime coherence function for HF wave propagation in the fluctuating ionosphere. Earlier published results of numerical calculations, with an empirical plane-stratified background ion
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| 25. |
- Gherm, VE, et al.
(författare)
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Wideband scattering functions for HF ionospheric propagation channels
- 2001
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Ingår i: Journal of Atmospheric and Solar-Terrestrial Physics. - 1364-6826 .- 1879-1824. ; 63:14, s. 1489-1497
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Tidskriftsartikel (refereegranskat)abstract
- A physically based method has been developed to simulate the wideband HF ionospheric propagation channel relevant to the case of wideband spread spectrum HF communications and also other HF applications such as digital broadcasting and over-the-horizon radar, It is based on the consideration and solution of the equations governing pulse signal propagation through a fluctuating time varying random ionosphere. The wideband scattering function has been constructed as the appropriate Fourier transform of the correlation function of a channel impulse response. Numerical codes have been written, which allow numerical simulation of the wideband scattering function of the HF sky wave ionospheric fluctuation channel for any given model of the background ionosphere and time varying ionospheric turbulence with an anisotropic inverse power law spatial spectrum and frozen drift of the ionospheric inhomogeneitics. When employed in the simulation of the scattering function for real conditions of propagation, the method provides the possibility of analysing the propagation effects for different relative bandwidths of the background channel, fluctuating channel and transmitted pulse. The effects of the transmitted pulse bandwidth and anisotropy of the irregularities have been studied. The numerical results have been obtained and presented, which demonstrate the contribution of the effects enumerated in the wideband scattering function of the HF ionospheric channel. (C) 2001 Elsevier Science Ltd. All rights reserved.
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| 26. |
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| 27. |
- Hammarstedt, Anna, 1988-
(författare)
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The Governance of Missing Asylum-Seekers in Sweden : Managing "Missingness" Through Different Technologies of Power
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- For a highly controlled and comprehensive welfare state such as Sweden, one can assume that incorporating populations into a system of bureaucratic management (and keeping them there) is paramount to its overall functioning. Either subjects are incorporated into the system and thereby managed, or subjects are expelled from the system and no longer managed. However, as the Swedish asylum regime has attempted to exert "control" over migration by tightening its asylum policies and practices, it has also admitted that stricter asylum policies and practices will lead to more asylum-seekers with failed claims going missing. Hence, the Swedish asylum regime appears to be paradoxically partaking in the (in)direct creation and facilitation of a space that I call missingness: a space of inbetweeness that disrupts the overall governing logic of being fully present or absent within a bureaucratic system. This thesis aims to examine the governance of missingness within the asylum regime in Sweden. Examining the discourses produced through interviews with state employees who manage the asylum-seeking process, it explores how state employees at three key institutions struggle to deal with the uncertainty and ambiguity of missingness. By adopting a Foucauldian perspective on power, the governance of missingness is analyzed in relation to different technologies of power. This thesis finds that different states of missingness are governed in a multitude of ways, through technologies of disciplinary power, biopower, and pastoral power.
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| 28. |
- Hansson, H A, et al.
(författare)
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Evidence indicating trophic importance of IGF-I in regenerating peripheral nerves
- 1986
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Ingår i: Acta Physiologica Scandinavica. - : Wiley. - 0001-6772 .- 1365-201X. ; 126:4, s. 14-609
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Tidskriftsartikel (refereegranskat)abstract
- The mechanisms influencing regeneration of peripheral nerves are incompletely known, but growth factors are supposed to play a key role. In the present study, we demonstrate, with the aid of immunohistochemical methods, that somatomedin C (Sm-C/insulin-like growth factor I/IGF-I) rapidly increased from low to high concentrations, reaching peak values in 2 weeks, in regenerating sciatic nerves of adult rats. In addition, IGF-I was demonstrated extracellularly, never observed in the control nerves. Reactive Schwann cells appeared to be the major source for IGF-synthesis. Higher concentrations were seen in tubulated nerves as compared to sutured ones. It is proposed that IGF-I exerts important growth supporting effects on regenerating peripheral nerves.
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| 29. |
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| 30. |
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| 31. |
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| 32. |
- Lundborg, G, et al.
(författare)
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Intraneural edema following exposure to vibration
- 1987
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140. ; 13:4, s. 9-326
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Tidskriftsartikel (refereegranskat)abstract
- Peripheral neuropathy represents a well-known complication from long-term exposure to vibration. In the present study an experimental model is presented with the purpose of analyzing the formation of intraneural edema following vibration exposure. Vibration (82 Hz, peak-to-peak amplitude 0.21 mm) was induced in the hind limb of rats by the use of vibrating electric motors during 4 h/d for 5 d. Tracer techniques (with albumin Evans blue and horseradish peroxidase) were used to study the permeability of intraneural microvessels after the vibration exposure on day 5. It was found that the vibration trauma in this model induced epineurial edema in the sciatic nerve. It is hypothesized that the formation of intraneural edema may be an important pathophysiological factor in the occurrence of vibration-induced neuropathy.
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| 33. |
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| 34. |
- Lundborg, G, et al.
(författare)
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Reorganization and orientation of regenerating nerve fibres, perineurium, and epineurium in preformed mesothelial tubes - an experimental study on the sciatic nerve of rats
- 1981
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Ingår i: Journal of Neuroscience Research. - : Wiley. - 0360-4012 .- 1097-4547. ; 6:3, s. 81-265
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Tidskriftsartikel (refereegranskat)abstract
- Regeneration of severed peripheral nerves is unfortunately often incomplete, due to loss of nerve fibers and neuroma formation. A new approach is presented with the intention of improving the conditions for nerve repair. In the first of the two stages, a pseudosynovial tube is formed around a silicone rubber rod, surrounded by a stainless steel spiral, which was placed in the backs of rats. This tube, in the second stage, is used as a free "tube graft" to bridge gaps of about 10-12 mm lengths in the severed sciatic nerve. The tube was kept open by the metal spiral. Regenerating nerve fibers with their sprouts grew into the initially open space in the tube. A new nerve trunk was formed, comprised of closely packed myelinated and unmyelinated axons, organized into fascicles. Demonstration by electron microscopy and by EMG recording of reinnervation of foot muscles supported successful long-term results. The fascicles were delimited by perineurial and epineurial sheaths and, furthermore, showed signs of maturation. It was also demonstrated that the nerve-fiber regeneration ceased after a few weeks if there was no distal nerve inserted into the tube. The importance of optimizing the interaction between local factors and regenerating nerve fibers for reestablishment of functionally valuable motor units is discussed.
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| 35. |
- Lundborg, G, et al.
(författare)
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Tissue specificity in nerve regeneration
- 1986
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery. - 0036-5556. ; 20:3, s. 83-279
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Tidskriftsartikel (refereegranskat)abstract
- In 1944 Weiss & Taylor presented experimental evidence against "neurotropism" in nerve regeneration. We used a silicone Y-chamber system to repeat some of those experiments. The proximal stump of transected rat sciatic nerve was introduced into the proximal inlet of the Y. One of the distal outlets was left empty, plugged or occupied by a tendon graft, the other outlet being occupied by a nerve graft. Analysis after 4 and 12 weeks showed in all cases a preferential or exclusive axonal growth towards the nerve piece. The results, indicating the existence of "tissue specificity", are contradictory to the results reported by Weiss & Taylor (30). The findings are discussed with respect to possible influence of humoral, cellular and molecular factors associated with the distal nerve stump as well as the matrix, formed between both nerve segments.
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| 36. |
- Lundborg, G, et al.
(författare)
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Tubular repair of the median nerve in the human forearm. Preliminary findings
- 1994
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Ingår i: Journal of Hand Surgery: European Volume. - 0266-7681. ; 19:3, s. 273-276
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Tidskriftsartikel (refereegranskat)abstract
- Transected median nerves in the forearm of two male patients, 12 and 21 years of age, were treated with a chamber technique leaving a 3 to 5 mm gap between the nerve ends. The nerve ends were enclosed in a silicone tube of such a dimension that would not cause compression of the nerve. Post-operative examination including sensory evaluation and assessment of muscle contraction force was carried out after 3 years. In both cases there was excellent motor recovery of the thenar muscles. Outgrowth of sensory fibres was remarkably fast, resulting ultimately in functional sensibility allowing almost normal hand function. 2PD was < or = 6 mm (12-year-old patient) and 8 to 10 mm (21-year-old patient) respectively. In one case the silicone tube was re-explored because of minor local discomfort 2 years after the repair. The former gap was bridged by a smooth continuous nerve-like structure of the same diameter as the adjacent nerve trunk and with no signs of neuroma formation or compression of the nerve.
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| 37. |
- Lundborg, Göran, et al.
(författare)
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Tubular repair of the median or ulnar nerve in the human forearm: a 5-year follow-up.
- 2004
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Ingår i: Journal of Hand Surgery (British Volume). - : SAGE Publications. - 0266-7681. ; 29:2, s. 100-107
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Tidskriftsartikel (refereegranskat)abstract
- The long-term outcome from silicone tube nerve repair was compared with the outcome from routine microsurgical repair in a clinical randomized prospective study, comprising 30 patients with median or ulnar nerve injuries in the distal forearm. Postoperatively, the patients underwent neurophysiological and clinical assessments of sensory and motor function regularly over a 5-year period. After 5 years there was no significant difference in outcome between the two techniques except that cold intolerance was significantly less severe with the tubular technique. In the total group there was ongoing improvement of functional sensibility throughout the 5 years after repair. It is concluded that tubular repair of the median and ulnar nerves is at least as good as routine microsurgical repair, and results in less cold intolerance.
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| 38. |
- Lundborg, G, et al.
(författare)
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Tubular versus conventional repair of median and ulnar nerves in the human forearm : early results from a prospective, randomized, clinical study
- 1997
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Ingår i: The Journal of Hand Surgery. - 0363-5023. ; 22:1, s. 99-106
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Tidskriftsartikel (refereegranskat)abstract
- Injury to a peripheral nerve is followed by local synthesis and release of neurotrophic factors of importance for the regeneration process. This concept was adopted for repair of transected human median and ulnar nerves in the forearm. As an alternative to conventional microsurgical repair of the nerve trunk, silicone tubes of appropriate size were used to enclose the injury zone, intentionally leaving a gap measuring 3-4 mm between the nerve ends inside the tube. The early results from a prospective, randomized, clinical study comparing this principle with conventional microsurgical technique for repair of human median and ulnar nerves, is presented. Eighteen patients (14 men and 4 women), aged 12-72 (mean, 29.5) years, were randomized to either tubulization (11 cases) or conventional microsurgical repair (7 cases). A battery of tests for sensory and motor functions of the hand were carried out at regular intervals for up to 1 year after surgery. The results show no difference between the both techniques, with the exception of perception of touch, which showed a significant difference (p < .05) at the 3-month checkup in favor of the tubulization technique. At re-exploration 11 months after the initial procedure (1 case), the former gap was replaced by regenerated nerve tissue in direct continuity with the proximal and distal parts of the nerve trunk, the exact level of the former injury being impossible to identify. Study data demonstrate an intrinsic capacity of human major nerve trunks to reconstruct themselves in a preformed space when an optimal environment is offered and the surgical trauma is minimized.
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| 39. |
- Lundborg, G, et al.
(författare)
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Ulnar nerve repair by the silicone chamber technique. Case report
- 1991
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - 0284-4311. ; 25:1, s. 79-82
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Tidskriftsartikel (refereegranskat)abstract
- The ulnar nerve of a 21-year old man was repaired at the wrist by a silicone chamber technique 10 days after a traumatic transection. A 3 mm gap was left between the nerve ends inside the chamber. At follow-up three years later, motor and sensory recovery was excellent. At exploration at that time a macroscopically normal nerve was found in the tube.
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| 40. |
- Lundborg, M, et al.
(författare)
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Maintenance plus reliever budesonide/formoterol compared with a higher maintenance dose of budesonide/formoterol plus formoterol as reliever in asthma: an efficacy and cost-effectiveness study
- 2006
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Ingår i: Current Medical Research and Opinion. - 1473-4877. ; 22:5, s. 809-821
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate efficacy and cost-effectiveness of budesonide/formoterol (Symbicort*) maintenance (one dose once or twice daily) plus additional doses as needed (Symbicort Maintenance And Reliever Therapy, SMART) compared with a higher fixed dose of budesonide/ formoterol with formoterol as needed in patients with persistent asthma. Study design and methods: 6-month, open, randomised study of 465 patients either not well controlled on an inhaled corticosteroid (ICS), or well controlled on a combination of ICS and a long-acting beta(2)-agonist (LABA). Treatments: budesonide/ formoterol 160/4.5 mu g, one inhalation, once or twice daily maintenance plus additional doses as- needed (1 x SMART or 2 x SMART), or budesonide/ formoterol 160/4.5 mu g two inhalations twice daily plus formoterol 4.5 mu g as needed (2 x 2 FIX + F). Children 6-11 years old used an 80/4.5 mu g dose strength. Primary variables of efficacy were the changes in the Asthma Control Questionnaire (ACQ(5)) and morning peak expiratory flow (PEF). Results: Mean age of patients 40 years (range 6-82 years); 53% female. No differences between the groups were found in ACQ(5) scores or asthma exacerbation rates. Morning PEF was higher in the 2 x 2 FIX + F group vs. the 1 x SMART and 2 x SMART groups ( differences 13L/min and 9 L/min, respectively; p < 0.002). The 1 x SMART group showed a significant decrease in asthma controlled days compared with the two other groups. No difference was seen between the 2 x SMART group and the 2 x 2 FIX + F group. Treatment costs were significantly lower in the SMART groups compared with the 2 x 2 FIX + F group. Conclusion: Compared with the 2 x 2 FIX + F treatment the use of budesonide/formoterol was 30-40% lower in the SMART groups while maintaining equal ACQ5 scores. Daily asthma control improved equally with 2 x SMART compared to 2 x 2 FIX + F with a reduction in asthma medication cost. The one dose once daily maintenance treatment (1 x SMART) resulted in a low level of treatment failure (exacerbations) but led to more days with symptoms. Therefore, a daily dose of two inhalations seems to be the lowest appropriate dose in patients with moderate persistent asthma.
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| 41. |
- Machowska, A, et al.
(författare)
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Containment of Antibiotic REsistance-measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR
- 2020
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 10:11, s. e040334-
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Tidskriftsartikel (refereegranskat)abstract
- Antibiotics are essential to treat infections during pregnancy and to reduce both maternal and infant mortality. Overall use, but especially non-indicated use, and misuse of antibiotics are drivers of antibiotic resistance (ABR). High non-indicated use of antibiotics for uncomplicated vaginal deliveries is widespread in many parts of the world. Similarly, irrational use of antibiotics is reported for children. There is scarcity of evidence regarding antibiotic use and ABR in Lao PDR (Laos). The overarching aim of this project is to fill those knowledge gaps and to evaluate a quality improvement intervention. The primary objective is to estimate the proportion of uncomplicated vaginal deliveries where antibiotics are used and to compare its trend before and after the intervention.Methods and analysisThis 3-year, prospective, quasiexperimental study without comparison group includes a formative and interventional phase. Data on antibiotic use during delivery will be collected from medical records. Knowledge, attitudes and reported practices on antibiotic use in pregnancy, during delivery and for children, will be collected from women through questionnaires. Healthcare providers’ knowledge, attitudes and practices of antibiotics administration for pregnant women, during delivery and for children, will be collected via adapted questionnaires. Perceptions regarding antibiotics will be explored through focus group discussions with women and individual interviews with key stakeholders. Faecal samples for culturing of Escherichia coli and Klebsiella spp. and antibiotic susceptibility testing will be taken before, during and 6 months after delivery to determine colonisation of resistant strains. The planned intervention will comprise training workshops, educational materials and social media campaign and will be evaluated using interrupted time series analysis.Ethics and disseminationThe project received ethical approval from the National Ethics Committee for Health Research, Ministry of Health, Laos. The results will be disseminated via scientific publications, conference presentations and communication with stakeholders.Trail registration numberISRCTN16217522; Pre-results.
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| 43. |
- Narangifard, A., et al.
(författare)
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Human skin barrier formation takes place via a cubic to lamellar lipid phase transition as analyzed by cryo-electron microscopy and EM-simulation
- 2018
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Ingår i: Experimental Cell Research. - : Elsevier BV. - 0014-4827 .- 1090-2422. ; 366:2, s. 139-151
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Tidskriftsartikel (refereegranskat)abstract
- The skin's permeability barrier consists of stacked lipid sheets of splayed ceramides, cholesterol and free fatty acids, positioned intercellularly in the stratum corneum. We report here on the early stage of skin barrier formation taking place inside the tubuloreticular system in the secretory cells of the topmost viable epidermis and in the intercellular space between viable epidermis and stratum corneum. The barrier formation process was analysed in situ in its near-native state, using cryo-EM combined with molecular dynamics modeling and EM simulation. Stacks of lamellae appear towards the periphery of the tubuloreticular system and they are closely associated with granular regions. Only models based on a bicontinuous cubic phase organization proved compatible with the granular cryo-EM patterns. Only models based on a dehydrated lamellar phase organization agreed with the lamellar cryo-EM patterns. The data support that human skin barrier formation takes place via a cubic to lamellar lipid phase transition.
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| 48. |
- Pathak, Ashish, 1973-, et al.
(författare)
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Incidence and risk factors for surgical site infections in obstetric and gynecological surgeries from a teaching hospital in rural India
- 2017
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Ingår i: Antimicrobial Resistance and Infection Control. - : BIOMED CENTRAL LTD. - 2047-2994. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital.Methods: Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included. Surveillance for SSI was based on the Centre for Disease Control (CDC) definition and methodology. Incidence and risk factors for SSI, including those for specific procedure, were calculated from data collected on daily ward rounds.Results: A total of 1173 patients underwent a surgical procedure during the study period. The incidence of SSI in the cohort was 7.84% (95% CI 6.30-9.38). Majority of SSI were superficial. Obstetric surgeries had a lower SSI incidence compared to gynecological surgeries (1.2% versus 10.3% respectively). The risk factors for SSI identified in the multivariate logistic regression model were age (OR 1.03), vaginal examination (OR 1.31); presence of vaginal discharge (OR 4.04); medical disease (OR 5.76); American Society of Anesthesia score greater than 3 (OR 12.8); concurrent surgical procedure (OR 3.26); each increase in hour of surgery, after the first hour, doubled the risk of SSI; inappropriate antibiotic prophylaxis increased the risk of SSI by nearly 5 times. Each day increase in stay in the hospital after the surgery increased the risk of contacting an SSI by 5%.Conclusions: Incidence and risk factors from prospective SSI surveillance can be reported simultaneously for the Obstetric and Gynecological surgeries and can be part of routine practice in resource-constrained settings. The incidence of SSI was lower for Obstetric surgeries compared to Gynecological surgeries. Multiple risk factors identified in the present study can be helpful for SSI risk stratification in low-middle income countries.
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