| 1. |
- Abrahamsson, Sven Olof, et al.
(författare)
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Dehydration inhibits matrix synthesis and cell proliferation : An in vitro study of rabbit flexor tendons
- 1991
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 62:2, s. 159-162
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Tidskriftsartikel (refereegranskat)abstract
- Segments of the deep flexor tendon of the rabbit were exposed to air; the effects of dehydration on in vitro synthesis of proteoglycan, collagen, non-collagenous protein, and cell proliferation were compared with tendon segments that were kept moist with physiologic saline. After 20 min of expo-sure to air, the tendons lost half and after 40 min all of their ability to synthesize matrix components and to proliferate, whereas irrigated tendons remained viable during the entire experiment.
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| 2. |
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| 3. |
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| 4. |
- Ageberg, Eva, et al.
(författare)
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Principles of brain plasticity in improving sensorimotor function of the knee and leg in healthy subjects: A double-blind randomized exploratory trial
- 2009
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Principles of brain plasticity is used in the treatment of patients with functional limitations to improve sensorimotor function. Training is included in the treatment of knee injury to improve both patient-reported function and sensorimotor function. However, impairment in sensorimotor function often persists despite training. Therefore, it was suggested that training programs need to be more effective to improve sensorimotor function after knee injury. The aim of the current study was to investigate if principles of brain plasticity that have been successfully used on the hand and foot to improve sensorimotor function can be applied on the knee. We hypothesized that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg. Methods: In this first double-blind exploratory study, 28 uninjured subjects (mean age 26 years, range 19-34, 50% women) were randomized to temporary local cutaneous application of anesthetic (EMLA (R)) (n=14) or placebo cream (n=14). Fifty grams of EMLA, or placebo, was applied on the leg 10 cm above and 10 cm below the center of patella, leaving the area around the knee without cream. Measures of sensory function (perception of touch, vibration sense, knee kinesthesia) and motor function (knee muscle strength, hop test) were assessed before and after 90 minutes of treatment with EMLA or placebo. The paired t-test was used for comparisons within groups and the independent t-test for comparisons between groups. The number of subjects needed was determined by an a priori sample size calculation. Results: No statistically significant or clinically relevant differences were seen over time (before vs. after) in the measures of sensory or motor functions in the EMLA group or in the placebo group. There were no differences between the groups due to treatment effect (EMLA vs. placebo). Conclusion: We found no effect of temporary cutaneous anesthesia on sensorimotor function of the ipsilateral knee and leg in uninjured subjects. The principles used in this study remain to be tested in subjects with knee injury.
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| 5. |
- Antfolk, Christian, et al.
(författare)
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A Tactile Display System for Hand Prostheses to Discriminate Pressure and Individual Finger Localization
- 2010
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Ingår i: Journal of Medical and Biological Engineering. - : Taiwanese Society of Biomedical Engineering. - 1609-0985. ; 30:6, s. 355-359
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Tidskriftsartikel (refereegranskat)abstract
- No current commercially available myoelectrically controlled prosthetic hands provide conscious sensory feedback to the user. A system aiming at relocation of sensory input from a prosthetic hand equipped with force sensors to the forearm skin of amputees, a tactile display, has been developed and constructed. The system consists of five piezoresistive force sensors or, alternatively, a prosthetic hand equipped with force sensors, five digital servomotors with a lever and a circular plastic disk pushing on the skin, control electronics based on an MSP430 microcontroller and a test application implemented in LabVIEW running on a PC. The tactile display system is intended to be integrated into the socket of a hand prosthesis and used as a conscious sensory feedback system for hand amputees using a myoelectrically controlled hand prosthesis. The system will provide continuous force feedback from sensors in the fingertips of each prosthetic finger and will likely improve the users' controllability and perception of the prosthetic hand. Here we report on tests made on "a five site" localization discrimination task and three pressure level discrimination tasks on the forearm of five healthy participants (non-amputees) using the LabView application to generate the stimulations. A mean five-finger discrimination accuracy of 86% and a mean three-level pressure discrimination accuracy of 93% were achieved, indicating the system to be a viable method of producing sensory feedback on the level of individual fingers.
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| 6. |
- Antfolk, Christian, et al.
(författare)
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Artificial Redirection of Sensation From Prosthetic Fingers to the Phantom Hand Map on Transradial Amputees: Vibrotactile Versus Mechanotactile Sensory Feedback
- 2013
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Ingår i: IEEE Transactions on Neural Systems and Rehabilitation Engineering. - 1534-4320. ; 21:1, s. 112-120
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Tidskriftsartikel (refereegranskat)abstract
- This work assesses the ability of transradial amputees to discriminate multi-site tactile stimuli in sensory discrimination tasks. It compares different sensory feedback modalities using an artificial hand prosthesis in: 1) a modality matched paradigm where pressure recorded on the five fingertips of the hand was fed back as pressure stimulation on five target points on the residual limb; and 2) a modality mismatched paradigm where the pressures were transformed into mechanical vibrations and fed back. Eight transradial amputees took part in the study and were divided in two groups based on the integrity of their phantom map; group A had a complete phantom map on the residual limb whereas group B had an incomplete or nonexisting map. The ability in localizing stimuli was compared with that of 10 healthy subjects using the vibration feedback and 11 healthy subjects using the pressure feedback (in a previous study), on their forearms, in similar experiments. Results demonstrate that pressure stimulation surpassed vibrotactile stimulation in multi-site sensory feedback discrimination. Furthermore, we demonstrate that subjects with a detailed phantom map had the best discrimination performance and even surpassed healthy participants for both feedback paradigms whereas group B had the worst performance overall. Finally, we show that placement of feedback devices on a complete phantom map improves multi-site sensory feedback discrimination, independently of the feedback modality.
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| 7. |
- Antfolk, Christian, et al.
(författare)
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Design and technical construction of a tactile display for sensory feedback in a hand prosthesis system
- 2010
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Ingår i: BioMedical Engineering Online. - 1475-925X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The users of today's commercial prosthetic hands are not given any conscious sensory feedback. To overcome this deficiency in prosthetic hands we have recently proposed a sensory feedback system utilising a "tactile display" on the remaining amputation residual limb acting as man-machine interface. Our system uses the recorded pressure in a hand prosthesis and feeds back this pressure onto the forearm skin. Here we describe the design and technical solution of the sensory feedback system aimed at hand prostheses for trans-radial/humeral amputees. Critical parameters for the sensory feedback system were investigated. Methods: A sensory feedback system consisting of five actuators, control electronics and a test application running on a computer has been designed and built. Firstly, we investigate which force levels were applied to the forearm skin of the user while operating the sensory feedback system. Secondly, we study if the proposed system could be used together with a myoelectric control system. The displacement of the skin caused by the sensory feedback system would generate artefacts in the recorded myoelectric signals. Accordingly, EMG recordings were performed and an analysis of the these are included. The sensory feedback system was also preliminarily evaluated in a laboratory setting on two healthy non-amputated test subjects with a computer generating the stimuli, with regards to spatial resolution and force discrimination. Results: We showed that the sensory feedback system generated approximately proportional force to the angle of control. The system can be used together with a myoelectric system as the artefacts, generated by the actuators, were easily removed using a simple filter. Furthermore, the application of the system on two test subjects showed that they were able to discriminate tactile sensation with regards to spatial resolution and level of force. Conclusions: The results of these initial experiments in non-amputees indicate that the proposed tactile display, in its simple form, can be used to relocate tactile input from an artificial hand to the forearm and that the system can coexist with a myoelectric control systems. The proposed system may be a valuable addition to users of myoelectric prosthesis providing conscious sensory feedback during manipulation of objects.
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| 8. |
- Antfolk, Christian, et al.
(författare)
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Sensory feedback from a prosthetic hand based on air-mediated pressure from the hand to the forearm skin.
- 2012
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 44:8, s. 702-707
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Lack of sensory feedback is a drawback in today's hand prostheses. We present here a non-invasive simple sensory feedback system, which provides the user of a prosthetic hand with sensory feedback on the arm stump. It is mediated by air in a closed loop system connecting silicone pads on the prosthetic hand with pads on the amputation stump. The silicone pads in a "tactile display" on the amputation stump expand when their corresponding sensor-bulb in the prosthesis is touched, evoking an experience of "real touch". Methods: Twelve trans-radial amputees and 20 healthy non-amputees participated in the study. We investigated the capacity of the system to mediate detection of touch, discrimination between different levels of pressure and, on the amputees also, the ability to locate touch. Results: The results showed a median touch threshold of 80 and 60 g in amputees and non-amputees, respectively, and 90% and 80% correct answers, respectively, in discrimination between 2 levels of pressure. The amputees located touch (3 sites) correctly in 96% of trials. Conclusion: This simple sensory feedback system has the potential to restore sensory feedback in hand amputees and thus it could be a useful tool to enhance prosthesis use.
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| 9. |
- Antfolk, Christian, et al.
(författare)
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Sensory feedback in upper limb prosthetics.
- 2013
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Ingår i: Expert Review of Medical Devices. - : Informa UK Limited. - 1745-2422 .- 1743-4440. ; 10:1, s. 45-54
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Tidskriftsartikel (refereegranskat)abstract
- One of the challenges facing prosthetic designers and engineers is to restore the missing sensory function inherit to hand amputation. Several different techniques can be employed to provide amputees with sensory feedback: sensory substitution methods where the recorded stimulus is not only transferred to the amputee, but also translated to a different modality (modality-matched feedback), which transfers the stimulus without translation and direct neural stimulation, which interacts directly with peripheral afferent nerves. This paper presents an overview of the principal works and devices employed to provide upper limb amputees with sensory feedback. The focus is on sensory substitution and modality matched feedback; the principal features, advantages and disadvantages of the different methods are presented.
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| 10. |
- Antfolk, Christian, et al.
(författare)
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SmartHand tactile display: A new concept for providing sensory feedback in hand prostheses.
- 2010
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Medical Journals Sweden AB. - 1651-2073. ; 44, s. 50-53
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Tidskriftsartikel (refereegranskat)abstract
- Abstract A major drawback with myoelectric prostheses is that they do not provide the user with sensory feedback. Using a new principle for sensory feedback, we did a series of experiments involving 11 healthy subjects. The skin on the volar aspect of the forearm was used as the target area for sensory input. Experiments included discrimination of site of stimuli and pressure levels at a single stimulation point. A tactile display based on digital servomotors with one actuating element for each of the five fingers was used as a stimulator on the forearm. The results show that the participants were able to discriminate between three fingers with an accuracy of 97%, between five fingers with an accuracy of 82%, and between five levels with an accuracy of 79%. The tactile display may prove a helpful tool in providing amputees with sensory feedback from a prosthetic hand by transferring tactile stimuli from the prosthetic hand to the skin at forearm level.
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| 11. |
- Antfolk, Christian, et al.
(författare)
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Transfer of tactile input from an artificial hand to the forearm: experiments in amputees and able-bodied volunteers
- 2013
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Ingår i: Disability and Rehabilitation: Assistive Technology. - : Informa UK Limited. - 1748-3115 .- 1748-3107. ; 8:3, s. 249-254
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in UndeterminedPurpose:This study explores the possibilities of transferring peripheral tactile stimulations from an artificial hand to the forearm skin.Method:A tactile display applied to the forearm skin was used to transfer tactile input to the forearm from various locations on a hand displayed on a computer screen. Discernment of location, levels of pressure and a combination of the two in simulated functional grips was tested to quantify the participants' ability to accurately perceive the tactile stimulations presented. Ten participants (5 forearm amputees and 5 able-bodied volunteers) unfamiliar with the equipment participated in the three-stage experiments comprising a learning session with vision, a reinforced learning session without vision and a validation session without vision.Results:The location discernment accuracy was high in both groups (75.2% and 89.6% respectively). The capacity to differentiate between three different levels of pressure was also high (91.7% and 98.1% respectively in the two groups). Recognition of simulated grip was slightly more difficult with the groups scoring 58.7% and 68.0% respectively for accuracy in the validation session.Conclusions:This study demonstrates that it is possible, following a brief training period, to transfer tactile input from an artificial hand to the forearm skin. The level of accuracy was lower for the more complex task, simulated grip recognition, possibly because this represents a more complex task requiring higher order brain functions. These results could form the basis for developing sensory feedback in hand prostheses. [Box: see text].
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| 12. |
- Antfolk, Christian, et al.
(författare)
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Using EMG for Real-time Prediction of Joint Angles to Control a Prosthetic Hand Equipped with a Sensory Feedback System
- 2010
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Ingår i: Journal of Medical and Biological Engineering. - : Taiwanese Society of Biomedical Engineering. - 1609-0985. ; 30:6, s. 399-405
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Tidskriftsartikel (refereegranskat)abstract
- All commercially available upper limb prosthesis controllers only allow the hand to be commanded in an open and close fashion without any sensory feedback to the user. Here the evaluation of a multi-degree of freedom hand controlled using a real-time EMG pattern recognition algorithm and incorporating a sensory feedback system is reported. The hand prosthesis, called SmartHand, was controlled in real-time by using 16 myoelectric signals from the residual limb of a 25-year old male transradial amputee in a two day long evaluation session. Initial training of the EMG pattern recognition algorithm was performed with a dataglove fitted to the contralateral hand recording joint angle positions of the fingers and mapping joint angles of the fingers to the EMG data. In the following evaluation sessions, the myoelectric signals were classified using local approximation and lazy learning, producing finger joint angle outputs and consequently controlling the prosthetic hand. Sensory information recorded from force sensors in the artificial hand was relayed to actuators, integrated in the socket of the prosthesis, continuously delivering force sensory feedback stimulations to the stump of the amputee. The participant was able to perform several dextrous movements as well as functional grip tasks after only two hours of training and increased his controllability during the two day session. In the final evaluation session a mean classification accuracy of 86% was achieved.
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| 13. |
- 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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| 14. |
- 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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| 15. |
- Bentzer, Peter, et al.
(författare)
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Supersensitivity in rat micro-arteries after short-term denervation
- 1997
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Ingår i: Acta Physiologica Scandinavica. - 0001-6772. ; 161:2, s. 125-133
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Tidskriftsartikel (refereegranskat)abstract
- Contractile responses to phenylephrine and high-K+ were investigated in vitro in microvascular preparations from the rat medial plantar artery, a branch from the saphenous artery, obtained after short-term denervation in vivo. Two groups of animals were studied: (1) animals undergoing surgical resection of the saphenous nerve, and (2) animals undergoing surgical resection of both the sciatic and saphenous nerves. The animals were operated on one side only. Microvascular preparations (diameter about 325 microns) were obtained 10 days after surgery. Vessels from the non-operated side served as controls. Immunocytochemistry showed a decreased number of both neuropeptide Y (NPY) and calcitonin gene-related peptide (CGRP) immunoreactive nerve fibres in vessels after resection of the saphenous nerve only. Resection of both the saphenous and the sciatic nerve caused a complete loss of immunoreactive nerve fibres. Mechanical measurements were performed using a wire myograph. In vessels subjected to resection of the saphenous nerve the sensitivity to phenylephrine was similar to controls. Vessels denervated by resection of both the saphenous and sciatic nerves showed significant increases in phenylephrine and potassium sensitivity. When depolarized in high-K+ solution the denervated vessels showed an increased sensitivity to extracellular Ca2+. The results show that complete short-term denervation of the rat medial plantar artery in vivo causes a pronounced supersensitivity in the vascular smooth muscle. The supersensitivity appears not to be restricted to the sympathetic alpha-receptors but also associated with changes in the cellular excitation-contraction coupling. Such altered reactivity of the vascular smooth muscle may contribute to vascular disturbances observed in vivo after nerve damage or surgical denervation.
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| 16. |
- Bjorkman, A, et al.
(författare)
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Cortical reintegration of a replanted hand and an osseointegrated thumb prosthesis
- 2007
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Ingår i: Acta Neurochirurgica. Supplementum. - 0065-1419. ; 100, s. 109-112
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Following a peripheral nerve repair the injured nerve has to re-innervate its original cortical area, a process, which is poorly understood. Errors in this cortical re-innervation have been suggested as one key reason for the generally poor clinical outcome following nerve injuries in the hand. METHOD: Functional magnetic resonance imaging (fMRI) was used to assess cortical reintegration following amputation and reattachment of bodyparts in two different situations: a patient with a hand amputation followed by immediate surgical replantation and a patient with an osseointegrated thumb prosthesis. FINDINGS: The primary motor cortex rapidly returns to a normal activation pattern after amputation followed by replantation or application of an osseointegrated prosthesis. The primary somatosenory cortex changes from an initial ipsilateral to a bilateral activation pattern. Sensory stimulation of an osseointegrated prosthesis also shows a bilateral activation pattern in the primary somatosenory cortex. CONCLUSIONS: The primary motor cortex shows a more normal activation pattern possibly because most muscles controlling the hand are proximal to the injury and can be activated after an amputation. The primary somatosensory cortex reorganises more and the activation pattern is more bilateral compared to a healthy hand. This bilateral activation pattern could represent a compensatory mechanism for the inferior tactile function in the replanted hand and the osseointegrated prosthesis.
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| 17. |
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| 18. |
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| 19. |
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| 20. |
- Björkman, Anders, et al.
(författare)
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Cortical sensory and motor response in a patient whose hand has been replanted: One-year follow up with functional magnetic resonance imaging
- 2007
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 41:2, s. 70-76
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Tidskriftsartikel (refereegranskat)abstract
- Functional magnetic resonance imaging (fMRI) was used to study how a replanted hand regained its cortical territory parallel to recovery. The cortical response to sensory stimulation shifts from an ipsilateral to a bilateral pattern, and then to a predominantly contralateral activation. The cortical response to motor stimulation was normal from the first investigation.
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| 21. |
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| 22. |
- Björkman, Anders, et al.
(författare)
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Rapid cortical reorganisation and improved sensitivity of the hand following cutaneous anaesthesia of the forearm.
- 2009
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Ingår i: European Journal of Neuroscience. - : Wiley. - 1460-9568 .- 0953-816X. ; 29:4, s. 837-844
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Tidskriftsartikel (refereegranskat)abstract
- The cortical representation of various body parts constantly changes based on the pattern of afferent nerve impulses. As peripheral nerve injury results in a cortical and subcortical reorganisation this has been suggested as one explanation for the poor clinical outcome seen after peripheral nerve repair in humans. Cutaneous anaesthesia of the forearm in healthy subjects and in patients with nerve injuries results in rapid improvement of hand sensitivity. The mechanism behind the improvement is probably based on a rapid cortical and subcortical reorganisation. The aim of this work was to study cortical changes following temporary cutaneous forearm anaesthesia. Ten healthy volunteers participated in the study. Twenty grams of a local anaesthetic cream (EMLA) was applied to the volar aspect of the right forearm. Functional magnetic resonance imaging was performed during sensory stimulation of all fingers of the right hand before and during cutaneous forearm anaesthesia. Sensitivity was also clinically assessed before and during forearm anaesthesia. A group analysis of functional magnetic resonance image data showed that, during anaesthesia, the hand area in the contralateral primary somatosensory cortex expanded cranially over the anaesthetised forearm area. Clinically right hand sensitivity in the volunteers improved during forearm anaesthesia. No significant changes were seen in the left hand. The clinically improved hand sensitivity following forearm anaesthesia is probably based on a rapid expansion of the hand area in the primary somatosensory cortex which presumably results in more nerve cells being made available for the hand in the primary somatosensory cortex.
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| 23. |
- Björkman, Anders, et al.
(författare)
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Recovery of nerve injury-induced alexia for Braille using forearm anaesthesia.
- 2008
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Ingår i: NeuroReport. - 1473-558X. ; 19:6, s. 683-685
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Tidskriftsartikel (refereegranskat)abstract
- Nerve injuries in the upper extremity may severely affect hand function. Cutaneous forearm anaesthesia has been shown to improve hand sensation in nerve-injured patients. A blind man who lost his Braille reading capability after an axillary plexus injury was treated with temporary cutaneous forearm anaesthesia. After treatment sensory functions of the hand improved and the patient regained his Braille reading capability. The mechanism behind the improvement is likely unmasking of inhibited or silent neurons, but after repeated treatment sessions at increasing intervals the improvement has remained at 1-year follow-up, implying a structural change in the somatosensory cortex.
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| 24. |
- Bontioti, Eleana, et al.
(författare)
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End-to-side nerve repair in the upper extremity of rat.
- 2005
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Ingår i: Journal of the Peripheral Nervous System. - : Wiley. - 1085-9489 .- 1529-8027. ; 10:1, s. 58-68
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Tidskriftsartikel (refereegranskat)abstract
- The end-to-side nerve-repair technique, i.e., when the distal end of an injured nerve is attached end-to-side to an intact nerve trunk in an attempt to attract nerve fibers by collateral sprouting, has been used clinically. The technique has, however, been questioned. The aim of the present study was to investigate end-to-side repair in the upper extremity of rats with emphasis on functional recovery, source, type, and extent of regenerating fibers. End-to-side repair was used in the upper limb, and the radial or both median/ulnar nerves were attached end-to-side to the musculocutaneous nerve. Pawprints and tetanic muscle force were used to evaluate functional recovery during a 6-month recovery period, and double retrograde labeling was used to detect the source of the regenerated nerve fibers. The pawprints showed that, in end-to-side repair of either one or two recipient nerves, there was a recovery of toe spreading to 60-72% of the preoperative value (lowest value around 47%). Electrical stimulation of the end-to-side attached radial or median/ulnar nerves 6 months after repair resulted in contraction of muscles in the forearm innervated by these nerves (median tetanic muscle force up to 70% of the contralateral side). Retrograde labeling showed that both myelinated (morphometry) sensory and motor axons were recruited to the end-to-side attached nerve and that these axons emerged from the motor and sensory neuronal pool of the brachial plexus. Double retrograde labeling indicated that collateral sprouting was one mechanism by which regeneration occurred. We also found that two recipient nerves could be supported from a single donor nerve. Our results suggest that end-to-side repair may be one alternative to reconstruct a brachial plexus injury when no proximal nerve end is available.
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| 25. |
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| 26. |
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| 27. |
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| 28. |
- Carlsson, Ingela, et al.
(författare)
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Hand injuries and cold sensitivity: Reliability and validity of cold sensitivity questionnaires.
- 2008
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 30:25, s. 1920-1928
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. Sensitivity to cold is a common consequence of hand injuries and other conditions, and this phenomenon has a profound effect on health-related quality of life and upper-extremity disability. The aim of the present study was to examine the reliability and validity of the Swedish version of the Cold Sensitivity Severity (CSS) scale and Cold Intolerance Symptom Severity (CISS) questionnaire and the reliability of the Potential Work Exposure Scale in a group of patients with traumatic hand-injury or vibration-induced problems. Method. We translated the self-administered questionnaires into Swedish and performed tests of reliability and validity. The questionnaire was sent to 159 patients with hand injuries. Results. Validity and internal-consistency results are based on a sample of 122. Test - retest results are based on a sample of 100. Good construct validity was demonstrated via correlation statistics. There were high correlations for both the CSS scale and CISS questionnaire scores with single questions concerning cold sensitivity, with the Disability of the Arm, Shoulder and Hand scale, and with the bodily-pain subscale of the SF-36 questionnaire. Reliability (both internal consistency and test - retest) was excellent. Conclusions. We conclude that the Swedish versions of the CSS scale and CISS questionnaire are reliable, and that this study provides evidence of the validity of the scales. The Potential Work Exposure Scale is reliable method of assessing exposure in the workplace.
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| 29. |
- Cars, Otto, et al.
(författare)
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Building bridges to operationalise one health : A Sino-Swedish collaboration to tackle antibiotic resistance
- 2016
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Ingår i: One Health. - : Elsevier. - 2352-7714. ; 2, s. 139-143
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Tidskriftsartikel (refereegranskat)abstract
- Antibiotic resistance is a complex global health challenge. The recent Global Action Plan on antimicrobial resistance highlights the importance of adopting One Health approaches that can cross traditional disciplinary boundaries. We report on the early experiences of a multisectoral Sino-Swedish research project that aims to address gaps in our current knowledge and seeks to improve the situation through system-wide interventions. Our research project is investigating antibiotic use and resistance in a rural area of China through a combination of epidemiological, health systems and laboratory investigations. We reflect here on the challenges inherent in conducting long distance cross-disciplinary collaborations, having now completed data and sample collection for a baseline situation analysis. In particular, we recognise the importance of investing in aspects such as effective communication, shared conceptual frameworks and leadership. We suggest that our experiences will be instructive to others planning to develop similar international One Health collaborations.
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| 30. |
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| 31. |
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| 32. |
- Cederlund, Ragnhild, et al.
(författare)
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Hand function tests and questions on hand symptoms as related to the stockholm workshop scales for diagnosis of hand-arm vibration syndrome.
- 2003
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Ingår i: Journal of Hand Surgery (British Volume). - 0266-7681. ; 28:2, s. 165-171
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Tidskriftsartikel (refereegranskat)abstract
- The severity of hand-arm vibration syndrome (HAVS) is usually graded according to the Stockholm workshop scales. Although the Stockholm workshop scales are regarded the gold standard for assessing the severity of HAVS, they are based primarily on subjective symptoms. The aim of the present study was to explore the agreement between Stockholm workshop scales and the outcome from ten well-defined clinical tests commonly used in hand rehabilitation for assessment of hand function. One hundred and eleven vibration-exposed workers participated in the study. Ten objective tests of hand function and four questions on subjective hand symptoms were included. The results indicated that, out of these tests, perception of vibration, perception of touch/pressure and dexterity showed a moderate agreement with Stockholm workshop scales. Among specific questions on hand symptoms, cold intolerance and pain showed a high agreement with Stockholm workshop scales. It is concluded that defined objective tests combined with directed questions on specific hand symptoms, together with the Stockholm workshop scales, may be helpful for diagnosing HAVS.
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| 33. |
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| 34. |
- Cipriani, Christian, et al.
(författare)
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A novel concept for a prosthetic hand with bidirectional non-invasive interface: a feasibility study
- 2009
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Ingår i: IEEE Transactions on Biomedical Engineering. - 1558-2531. ; 56:11, s. 2739-2743
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in Undetermined A conceptually novel prosthesis consisting of a mechatronic hand, an electromyographic classifier, and a tactile display has been developed and evaluated by addressing problems related to controllability in prosthetics: intention extraction, perception, and feeling of ownership. Experiments have been performed, and encouraging results for a young transradial amputee are reported.
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| 35. |
- Cipriani, Christian, et al.
(författare)
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Online Myoelectric Control of a Dexterous Hand Prosthesis by Transradial Amputees
- 2011
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Ingår i: IEEE Transactions on Neural Systems and Rehabilitation Engineering. - 1534-4320. ; 19:3, s. 260-270
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Tidskriftsartikel (refereegranskat)abstract
- A real-time pattern recognition algorithm based on k-nearest neighbors and lazy learning was used to classify, voluntary electromyography (EMG) signals and to simultaneously control movements of a dexterous artificial hand. EMG signals were superficially recorded by eight pairs of electrodes from the stumps of five transradial amputees and forearms of five able-bodied participants and used online to control a robot hand. Seven finger movements (not involving the wrist) were investigated in this study. The first objective was to understand whether and to which extent it is possible to control continuously and in real-time, the finger postures of a prosthetic hand, using superficial EMG, and a practical classifier, also taking advantage of the direct visual feedback of the moving hand. The second objective was to calculate statistical differences in the performance between participants and groups, thereby assessing the general applicability of the proposed method. The average accuracy of the classifier was 79% for amputees and 89% for able-bodied participants. Statistical analysis of the data revealed a difference in control accuracy based on the aetiology of amputation, type of prostheses regularly used and also between able-bodied participants and amputees. These results are encouraging for the development of noninvasive EMG interfaces for the control of dexterous prostheses.
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| 36. |
- 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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| 37. |
- Dahlin, Lars, et al.
(författare)
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Granular cell tumour of the ulnar nerve in a young adult.
- 2002
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 36:1, s. 46-49
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Tidskriftsartikel (refereegranskat)
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| 38. |
- Dahlin, Lars, et al.
(författare)
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Nerve repair: an experimental and clinical update
- 2004
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Ingår i: Nerve Tendon and Other Disorders (Surgery of Disorders of the Hand and Upper Extremity). - 9781853174940 - 1853174947 ; , s. 95-95
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 39. |
- Dahlin, Lars, et al.
(författare)
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Schwann cells, acutely dissociated from a predegenerated nerve trunk, can be applied into a matrix used to bridge nerve defects in rats
- 2007
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Ingår i: Acta Neurochirurgica. Supplementum. - 0065-1419. ; 100, s. 57-60
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The gold standard to reconstruct a nerve defect is a conventional autologous nerve graft. There may be a lack of such grafts in severe nerve injuries. Alternatives to autologous nerve grafts are needed. METHODS: We have developed a technique where mainly Schwann cells are acutely dissociated from the ends of the severed nerve trunk after nerve injury. The technique does not require long-term cell culture procedures. The obtained cells, which can be dissociated within a few hours, are applied to a silicone tube or a tendon autograft used to bridge a nerve defect. FINDINGS: Dissociated cells from the ends of the severed nerve ends consist of more than 85% of Schwann cells. The remaining cells are ED1 stained macrophages. The cells survive transfer to a silicone tube or a tendon autograft which bridge the nerve defect. Axons do grow through such a graft filled with dissociated cells. CONCLUSION: Our novel model to obtain mainly Schwann cells by dissociation of the cells from the severed nerve ends after injury and add them to a matrix, thereby creating an artificial nerve graft, may be a new technique with potential clinical application in nerve reconstruction.
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| 40. |
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| 41. |
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| 42. |
- Düppe, Henrik, et al.
(författare)
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Long-term results of fracture of the scaphoid. A follow-up study of more than thirty years
- 1994
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Ingår i: Journal of Bone and Joint Surgery. American Volume. - 1535-1386. ; 76:2, s. 249-252
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Tidskriftsartikel (refereegranskat)abstract
- Fifty-six patients who had had a fracture of the scaphoid from January 1950 through December 1959 were interviewed, re-examined, and had radiographs made of both hands an average of thirty-six years (range, thirty-one to forty years) later. The average age at the time of the treatment was twenty-eight years (range, fifteen to forty-five years). Fifty-two of the fifty-six patients were treated at the time of the fracture; the other four had a non-union when first seen. The rate of non-union for the fresh fractures at the most recent follow-up examination was 10 per cent (five of fifty-two). Dorsal intercalated-segment instability was found in three of the fifty-six patients; all three had a pseudarthrosis and manifest radiocarpal osteoarthrosis. Marked radiocarpal osteoarthrosis developed in only one (2 per cent) of the forty-seven patients who had a healed fracture; it was far more common in the group that had a pseudarthrosis, in which the prevalence was five of nine patients. Manifest osteoarthrosis also seemed to be associated with pain or weakness: it had developed in only three (6 per cent) of the forty-nine patients who did not have any symptoms at the re-examination, compared with three of the seven who had symptoms.
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| 43. |
- Ehrsson, H. Henrik, et al.
(författare)
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Upper limb amputees can be induced to experience a rubber hand as their own
- 2008
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Ingår i: Brain. - : Oxford University Press (OUP). - 1460-2156 .- 0006-8950. ; 131:12, s. 3443-3452
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Tidskriftsartikel (refereegranskat)abstract
- We describe how upper limb amputees can be made to experience a rubber hand as part of their own body. This was accomplished by applying synchronous touches to the stump, which was out of view, and to the index finger of a rubber hand, placed in full view (26 cm medial to the stump). This elicited an illusion of sensing touch on the artificial hand, rather than on the stump and a feeling of ownership of the rubber hand developed. This effect was supported by quantitative subjective reports in the form of questionnaires, behavioural data in the form of misreaching in a pointing task when asked to localize the position of the touch, and physiological evidence obtained by skin conductance responses when threatening the hand prosthesis. Our findings outline a simple method for transferring tactile sensations from the stump to a prosthetic limb by tricking the brain, thereby making an important contribution to the field of neuroprosthetics where a major goal is to develop artificial limbs that feel like a real parts of the body.
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| 44. |
- Fontana, Carolina, et al.
(författare)
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Rapid structural elucidation of polysaccharides employing predicted functions of glycosyltransferases and NMR data : Application to the O-antigen of Escherichia coli O59
- 2014
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Ingår i: Glycobiology. - : Oxford University Press (OUP). - 0959-6658 .- 1460-2423. ; 24:5, s. 450-457
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Tidskriftsartikel (refereegranskat)abstract
- A computerized method that uses predicted functions of glycosyltransferases (GTs) in conjunction with unassigned NMR data has been developed for the structural elucidation of bacterial polysaccharides (PSs). In this approach, information about the action of GTs (consisting of possible sugar residues used as donors and/or acceptors, as well as the anomeric configuration and/or substitution position in the respective glycosidic linkages) is extracted from the Escherichia coli O-antigen database and is submitted, together with the unassigned NMR data, to the CASPER program. This time saving methodology, which alleviates the need for chemical analysis, was successfully implemented in the structural elucidation of the O-antigen PS of E. coli O59. The repeating unit of the O-specific chain was determined using the O-deacylated PS and has a branched structure, namely, -> 6)[alpha-d-GalpA3Ac/4Ac-(1 -> 3)]-alpha-d-Manp-(1 -> 3)-alpha-d-Manp-(1 -> 3)-beta-d-Manp-(1 -> 3)-alpha-d-GlcpNAc-(1 ->. The identification of the O-acetylation positions was efficiently performed by comparison of the H-1,C-13 HSQC NMR spectra of the O-deacylated lipopolysaccharide and the lipid-free PS in conjunction with chemical shift predictions made by the CASPER program. The side-chain d-GalpA residue carries one equivalent of O-acetyl groups at the O-3 and O-4 positions distributed in the LPS in a 3:7 ratio, respectively. The presence of O-acetyl groups in the repeating unit of the E. coli O59 PS is consistent with the previously proposed acetyltransferase WclD in the O-antigen gene cluster.
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| 45. |
- Fontana, Carolina, 1980-, et al.
(författare)
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Structural studies and biosynthetic aspects of the o antigen polysaccharide from Escherichia coli o174
- 2012
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Ingår i: Carbohydrate Research. - : Elsevier BV. - 0008-6215 .- 1873-426X. ; 354, s. 102-105
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Tidskriftsartikel (refereegranskat)abstract
- The structure of the repeating unit of the O-antigenic polysaccharide (PS) from Escherichia coli O174 has been determined. Component analysis together with H-1 and C-13 NMR spectroscopy experiments were employed to elucidate the structure. Inter-residue correlations were determined by H-1, C-13-heteronuclear multiple-bond correlation and H-1, H-1-NOESY experiments. The PS is composed of tetrasaccharide repeating units with the following structure: -> 4)-beta-D-GlcpA-(1 -> 3)-beta-D-Galp-(1 -> 3)-beta-D-GalpNAc-(1 -> vertical bar beta-D-GlcpNAc-(1 -> 2) Cross-peaks of low intensity were present in the NMR spectra consistent with a beta-D-GlcpNAc-(1 -> 2)-beta-D-GlcpA(1 -> structural element at the terminal part of the polysaccharide, which on average is composed of similar to 15 repeating units. Consequently the biological repeating unit has a 3-substituted N-acetyl-D-galactosamine residue at its reducing end.
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| 46. |
- Hansson, Thomas, et al.
(författare)
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Sights of touching activates the somatosensory cortex in humans
- 2009
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 43:5, s. 267-269
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Tidskriftsartikel (refereegranskat)abstract
- We report our observations of cross-modal interactions between sight and touch using functional magnetic resonance imaging (fMRI). Experiments were devised to show that sight and touch are linked in a cross-modal arrangement, and two separate experiments were done in an MRI scanner. In the first, the subject's right hand was stimulated with a brush; in the second, a video sequence was presented to the subject inside the scanner through video goggles in visual three-dimensional stereo, showing one brushstroke every second on a hand in the same manner as the subject had just previously experienced. The result was that both the primary and the secondary somatosensory cortexes were activated in the participants when the hands were touched, and when the subjects saw only a hand being touched in the same manner. The results indicated cross-modal links between sight and touch of the hand in humans.
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| 47. |
- Kerns, JM, et al.
(författare)
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A comparison of peripheral nerve regeneration in acellular muscle and nerve autografts
- 2003
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 37:4, s. 193-200
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Tidskriftsartikel (refereegranskat)abstract
- Regeneration of the rat sciatic nerve through acellular muscle and nerve autografts was evaluated 6-28 days postoperatively by the sensory pinch test, immunocytochemical staining for neurofilaments, and light and electron microscopy. Data points generated by the pinch test were plotted against postoperative time periods and by the use of regression analysis the initial delay period for muscle grafts was determined to 10.3 days. This value was similar to that previously published for acellular nerve grafts (9.5 days), but significantly longer than that for fresh nerve grafts (3.6 days). The calculated regeneration rate (slope of the regression line) for muscle grafts (1.8 mm/day) did not differ significantly ( p >0.05) from that calculated for acellular nerve grafts (2.1 mm/day) or for fresh nerve grafts (1.5 mm/day). The front of regenerating axons shown by axonal neurofilament staining confirmed the pinch test results. Both types of acellular grafts were repopulated with host non-neuronal cells and the muscle graft contained occasional ectopic muscle fibres. Remnants of graft basal laminae were evident at the ultrastructural level. These results indicate the suitability of either acellular muscle or nerve grafts for nerve repair despite their prolonged initial delay periods compared with conventional fresh nerve grafts.
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| 48. |
- Kerns, James, et al.
(författare)
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Effects of gradual bone lengthening on the rabbit tibial nerve
- 2001
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 35:4, s. 361-368
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about the effect of gradual bone lengthening on peripheral nerves. In the present study, an external fixation device was applied to the rabbit tibia, which was then divided. After seven days, the tibia was subjected to 0.7 mm/day callus distraction for periods of up to one month. The tibial nerve was fixed in glutaraldehyde and plastic sections were cut in longitudinal and transverse planes for light and electron microscopy. Light microscopy showed a 64% increase in the gap length at the node of Ranvier in myelinated axons from the experimental side compared with the control side. The cross-sectional area of the non-myelinated axons was not altered significantly. We conclude that gradual stretching of the nerve elongates the nerve fibres at least at the region of the nodes, perhaps a point of least resistance. Diameters of fibres seem to be held more constant during the lengthening procedure.
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| 49. |
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| 50. |
- Krarup, Christian, et al.
(författare)
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Sensation, mechanoreceptor, and nerve fiber function after nerve regeneration
- 2017
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Ingår i: Annals of Neurology. - : Wiley. - 0364-5134 .- 1531-8249. ; 82:6, s. 940-950
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Sensation is essential for recovery after peripheral nerve injury. However, the relationship between sensory modalities and function of regenerated fibers is uncertain. We have investigated the relationships between touch threshold, tactile gnosis, and mechanoreceptor and sensory fiber function after nerve regeneration. Methods: Twenty-one median or ulnar nerve lesions were repaired by a collagen nerve conduit or direct suture. Quantitative sensory hand function and sensory conduction studies by near-nerve technique, including tactile stimulation of mechanoreceptors, were followed for 2 years, and results were compared to noninjured hands. Results: At both repair methods, touch thresholds at the finger tips recovered to 81 ± 3% and tactile gnosis only to 20 ± 4% (p < 0.001) of control. The sensory nerve action potentials (SNAPs) remained dispersed and areas recovered to 23 ± 2% and the amplitudes only to 7 ± 1% (P < 0.001). The areas of SNAPs after tactile stimulation recovered to 61 ± 11% and remained slowed. Touch sensation correlated with SNAP areas (p < 0.005) and was negatively related to the prolongation of tactile latencies (p < 0.01); tactile gnosis was not related to electrophysiological parameters. Interpretation: The recovered function of regenerated peripheral nerve fibers and reinnervated mechanoreceptors may differentially influence recovery of sensory modalities. Touch was affected by the number and function of regenerated fibers and mechanoreceptors. In contrast, tactile gnosis depends on the input and plasticity of the central nervous system (CNS), which may explain the absence of a direct relation between electrophysiological parameters and poor recovery. Dispersed maturation of sensory nerve fibers with desynchronized inputs to the CNS also contributes to the poor recovery of tactile gnosis. Ann Neurol 2017. Ann Neurol 2017;82:940–950.
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