| 1. |
- Battersby, Nick, et al.
(author)
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Evaluating the incidence of pathological complete response in current international rectal cancer practice : the barriers to widespread safe deferral of surgery
- 2018
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In: Colorectal Disease. - : Wiley. - 1462-8910. ; 2020 Suppl 6, s. 58-68
-
Journal article (peer-reviewed)abstract
- INTRODUCTION: The mainstay of management for locally advanced rectal cancer is chemoradiotherapy followed by surgical resection. Following chemoradiotherapy, a complete response may be detected clinically and radiologically (cCR) prior to surgery or pathologically after surgery (pCR). We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR by conventional pre-operative imaging.METHODS: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients treated by elective rectal resection were included. A pCR was defined as a ypT0 N0 EMVI negative primary tumour; a partial response represented any regression from baseline staging following chemoradiotherapy. The primary endpoint was the pCR rate. The secondary endpoint was agreement between post-treatment MRI restaging (yMRI) and final pathological staging.RESULTS: Of 2572 patients undergoing rectal cancer surgery in 277 participating centres across 44 countries, 673 (26.2%) underwent chemoradiotherapy and surgery. The pCR rate was 10.3% (67/649), with a partial response in 35.9% (233/649) patients. Comparison of AJCC stage determined by post-treatment yMRI with final pathology showed understaging in 13% (55/429) and overstaging in 34% (148/429). Agreement between yMRI and final pathology for T-stage, N-stage, or AJCC status were each graded as 'fair' only (n = 429, Kappa 0.25, 0.26 and 0.35 respectively).CONCLUSION: The reported pCR rate of 10% highlights the potential for non-operative management in selected cases. The limited strength of agreement between basic conventional post-chemoradiotherapy imaging assessment techniques and pathology suggest alternative markers of response should be considered, in the context of controlled clinical trials.
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| 2. |
- Bergqvist, D, et al.
(author)
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Extraanatomic vascular reconstruction in patients with aorto-iliac arteriosclerosis
- 1984
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In: Acta Chirurgica Scandinavica. - 0001-5482. ; 150:3, s. 205-209
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Journal article (peer-reviewed)abstract
- During an 11-year period 117 extraanatomic reconstructions were made for aorto-iliac arteriosclerosis; 36 axillofemoral and 81 femorofemoral crossover bypasses. The patients were old and had several factors making them poor risks for surgery. Axillofemoral grafts were more often used in patients with malignant disease. Postoperative mortality was 10% without difference between the two types of reconstruction. Both early and late complications were significantly more frequent in patients with axillofemoral bypass. Reoperations for occlusion and symptoms from the donor side also were significantly more common among axillofemoral patients. Life table analysis showed a higher survival and patency rate among patients with crossover grafts.
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| 3. |
- Buchwald, Pamela, et al.
(author)
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ABC om divertikulit
- 2009
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In: Läkartidningen. - 0023-7205. ; 106:9, s. 594-597
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Journal article (peer-reviewed)
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| 4. |
- Halvarsson, Britta, et al.
(author)
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Phenotypic heterogeneity in hereditary nonpolyposis colorectal cancer: identical germline mutations associated with variable tumor morphology and immunohistochemical expression.
- 2007
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In: Journal of Clinical Pathology. - : BMJ. - 1472-4146 .- 0021-9746. ; 60:7, s. 781-786
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Hereditary non-polyposis colorectal cancer (HNPCC) is associated with high risks for colorectal and endometrial cancer, young age at onset and an increased risk of multiple primary tumours. Colorectal cancer in HNPCC is characterised by poor tumour differentiation, an expanding growth pattern, and a pronounced lymphocytic reaction with tumour-infiltrating lymphocytes. Aims and METHODS: The mutation spectrum in HNPCC is diverse and in order to clarify whether the HNPCC tumour phenotype is influenced by the underlying genetic alteration, 29 colorectal cancers and 12 adenomas from 24 individuals in two HNPCC families were morphologically and immunohistochemically characterised. RESULTS: The tumour morphology as well as the immunohistochemical expression of beta-catenin varied extensively within the families as well as between synchronous/metachronous colorectal cancers from the same individual. Poor tumour differentiation, an expanding growth pattern, and tumour-infiltrating lymphocytes occurred at higher frequencies in proximal tumours, whereas distal colorectal cancers often lacked distinct HNPCC-associated morphological features. CONCLUSIONS: The clinical, morphological and immunohistochemical variability observed within these families indicates that other mechanisms than the underlying germline mutation influence the HNPCC phenotype. Since morphological features linked to HNPCC are less frequent in distal cancers, it may be particularly relevant to obtain family history and age of onset in these tumours in order to identify individuals with HNPCC.
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| 5. |
- Hansen, F, et al.
(author)
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Diameter and compliance in the human common carotid artery--variations with age and sex
- 1995
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In: Ultrasound in Medicine and Biology. - : Elsevier BV. - 0301-5629. ; 21:1, s. 1-9
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Journal article (peer-reviewed)abstract
- In this study, age and sex differences in diameter and compliance of the common carotid artery (CCA) were evaluated in 119 healthy subjects with a phase-locked echo-tracking system. The diameter and pulsatile diameter changes were measured, and pressure strain elastic modulus (Ep) and stiffness (beta) were calculated and used as the inverse estimate of compliance. The carotid diameter increased more rapidly in males and was larger than in females from 25 years of age. The relative diameter change was equal in both sexes, and decreased from 12% to 14% in younger subjects to approximately 5% in elderly subjects. Compliance decreased almost linearly and in parallel in males and females up to 45 years of age. Between 45 and 60 years the decrease was more marked in females than in males, whereas it was by far more marked in males between 60 and 70 years of age.
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| 6. |
- Hansen, F, et al.
(author)
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Non-invasive measurement of pulsatile vessel diameter change and elastic properties in human arteries: a methodological study
- 1993
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In: Clinical Physiology. - 1365-2281. ; 13:6, s. 631-643
-
Journal article (peer-reviewed)abstract
- A recently developed ultrasound phase-locked echo-tracking system makes it possible to measure non-invasive pulsatile vessel diameter changes, and, in combination with blood-pressure measurement, to calculate pressure strain elastic modulus (Ep) and stiffness (beta). The reproducibility in measurements of pulsatile diameter changes with this system was evaluated. Also the precision of indirect blood-pressure measurements, as compared to the simultaneously measured intra-arterial blood pressure was tested. The resulting reproducibility in pressure strain elastic modulus (Ep) and stiffness (beta) was evaluated. Intra-observer variabilities in measuring pulsatile diameter changes were 16% for the abdominal aorta, 10% for the common carotid artery, and 15% for the common femoral artery, respectively. Intra-observer variabilities for Ep and beta were 21% for both in the abdominal aorta, 17% for both in the common carotid artery, and 18% for both in the common femoral artery, respectively. There were only small differences in indirect and direct measurement of systolic blood pressure, whereas indirect blood pressure measurement systematically overestimated the diastolic blood pressure, on average by 20%. The variabilities in indirect blood pressure measurements were 2% for the systolic and 3% for the diastolic blood pressure, respectively. Inter-observer variability in the investigation of the common carotid artery was 10% for the pulsatile diameter changes, and 21% and 23% for Ep and beta, respectively. Thus, the echo-tracking system represents a reliable system for estimation of pressure strain elastic modulus and stiffness. However, Ep and beta are systematically underestimated by 25-30%, when used in combination with indirect blood pressure measurements.
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| 7. |
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| 8. |
- Jeppsson, Bengt, et al.
(author)
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Bacterial translocation: Impact of probiotics
- 2004
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In: Scandinavian Journal of Nutrition. - : Informa UK Limited. - 1102-6480 .- 1651-2359. ; 48:1, s. 37-41
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Journal article (peer-reviewed)abstract
- There is a considerable amount of data in humans showing that patients who cannot take in nutrients enterally have more organ failure in the intensive care unit, a less favourable prognosis, and a higher frequency of septicaemia, in particular involving bacterial species from the intestinal tract. However, there is little evidence that this is connected with translocation of bacterial species in humans. Animal data more uniformly imply the existence of such a connection. The main focus of this review is to describe different ways to alter the luminal milieu to decrease bacterial translocation. It is possible to reduce absorption of endotoxin by administration of bile salts in obstructive jaundice. Increasing the oral intake of glutamine will reduce bacterial translocation in rats with radiation-induced gut injury. The bacterial microflora plays a very important role in maintaining the normal intestinal ecological environment and supplying preferred fuels to the intestinal wall, consequently supporting the intestinal barrier. Disruption of the balance of intestinal bacterial microflora may increase the incidence of bacterial translocation by modifying intestinal barrier function. Bacterial species such as enteric Gram-negatives and Gram-positive cocci are more prone to translocation, whereas lactobacilli seem to have a protective effect. Administration of live lactobacilli either orally or by enema will reduce translocation. The mechanisms underlying the decreased translocation are not obvious. One effect may be mediated via an action on the intestinal wall and its permeability. Recently, the results of three randomized studies on the use of L. plantarum in patients with pancreatitis, undergoing liver transplantation or upper gastrointestinal surgery have been published, which all indicate a potential role for lactobacilli in translocation. In conclusion, by altering the luminal content of bacteria it seems possible to reduce the incidence of secondary infections. The influence of the luminal milieu on bacterial translocation is not fully understood. There is convincing evidence from experimental studies, but only circumstantial evidence from clinical studies.
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| 9. |
- Jeppsson, Bengt, et al.
(author)
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Use of Probiotics as Prophylaxis for Postoperative Infections
- 2011
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In: Nutrients. - : MDPI AG. - 2072-6643. ; 3:5, s. 604-612
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Research review (peer-reviewed)abstract
- Postoperative bacterial infections are common despite prophylactic administration of antibiotics. The wide-spread use of antibiotics in patients has contributed to the emergence of multiresistant bacteria. A restricted use of antibiotics must be followed in most clinical situations. In surgical patients there are several reasons for an altered microbial flora in the gut in combination with an altered barrier function leading to an enhanced inflammatory response to surgery. Several experimental and clinical studies have shown that probiotics (mainly lactobacilli) may reduce the number of potentially pathogenia bacteria (PPM) and restore a deranged barrier function. It is therefore of interest to test if these abilities of probiotics can be utilized in preoperative prophylaxis. These factors may be corrected by perioperative administration of probiotics in addition to antibiotics. Fourteen randomized clinical trials have been presented in which the effect of such regimens has been tested. It seems that in patients undergoing liver transplantation or elective surgery in the upper gastrointestinal tract prophylactic administration of different probiotic strains in combination with different fibers results in a three-fold reduction in postoperative infections. In parallel there seems to be a reduction in postoperative inflammation, although that has not been studied in a systematic way. The use of similar concepts in colorectal surgery has not been successful in reducing postoperative infections. Reasons for this difference are not obvious. It may be that higher doses of probiotics with longer duration are needed to influence microbiota in the lower gastrointestinal tract or that immune function in colorectal patients may not be as important as in transplantation or surgery in the upper gastrointestinal tract. The favorable results for the use of prophylactic probiotics in some settings warrant further controlled studies to elucidate potential mechanisms, impact on gut microbiota and influence on clinical management. The use of probiotics must be better delineated in relation to type of bacteria, dose and length of administration.
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| 10. |
- Lanne, T, et al.
(author)
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Differences in mechanical properties of the common carotid artery and abdominal aorta in healthy males
- 1994
-
In: Journal of Vascular Surgery. - 1097-6809. ; 20:2, s. 218-225
-
Journal article (peer-reviewed)abstract
- PURPOSE: Vascular disease is differentiated throughout the vascular regions, with central arteries more prone to dilation and with peripheral arteries more prone to occlusive disease. In this study we investigated the diameter and compliance in the common carotid artery and abdominal aorta in healthy males at varying ages to assess potential differences in the aging process. METHODS: An ultrasound phase-locked echo-tracking system was used to determine differences in diameter and pulsatile diameter changes of the common carotid artery and abdominal aorta in 56 healthy Caucasian males ages 10 to 74 years. Pressure strain elastic modulus (Ep) and stiffness (beta) were calculated from diameter, pulsatile diameter change, and blood pressure obtained by the auscultatory method. Compliance was defined as the inverse of Ep and stiffness. RESULTS: The diameter of both common carotid artery and abdominal aorta increases not only when a person is a child, but also when they are between 25 and 70 years old. The dilation in adults seems to be more accentuated in the abdominal aorta (27%) than in the common carotid artery (17%). Ep and stiffness (beta) are higher in the common carotid artery when a person is 10 years of age (p < 0.01 and 0.05). However, during aging, Ep and stiffness (beta) increase to a higher extent in the aorta than in the common carotid artery, with a significantly higher Ep and stiffness (beta) in the aorta when a person is 45 years and older (45 years: p < 0.05 and p = NS; 60 years: p < 0.001 and p < 0.001; 70 years: p < 0.01 and p < 0.01). CONCLUSIONS: This investigation demonstrates regional differences in diameter change and compliance in the common carotid artery and abdominal aorta and implies that the abdominal aorta is more prone to degenerative changes than the common carotid artery. This may be one etiologic factor for the regional differences in vascular disease.
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| 11. |
- Länne, T, et al.
(author)
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Improved reliability of ultrasonic surveillance of abdominal aortic aneurysms
- 1997
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In: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 13:2, s. 149-153
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: Small abdominal aortic aneurysms (AAA) are usually managed conservatively by serial ultrasound examinations to assess size. The development of the size of the AAA will determine whether the patient is a candidate for surgery. The precision of measurement is therefore of considerable importance. The aim of this study was to evaluate the accuracy and the reproducibility of a newly developed echo-tracking ultrasonic system in the size evaluation of AAA. DESIGN: Prospective study at a University Hospital. MATERIAL AND METHODS: An echo-tracking ultrasound system with a 3.5 MHz transducer was used in 54 patients with AAA. Thirty-six patients had repeated measurements by one technician to evaluate the intra-observer variability. In another 18 patients with aortic dilatation/AAA, the measurements were repeated by a second technician in a blinded fashion with calculation of inter-observer variability. The reproducibility was evaluated both using linear regression and plots according to the method described by Bland and Altman. RESULTS: The mean diameter of the aorta was 37 mm (range 21-51 mm). The coefficient of correlation of repetitive measurements with one observer was r = 0.99 and with two observers r = 0.99. The intra-observer variability was 0.78 mm (S.D.) and the inter-observer variability 0.93 mm (S.D.). The intra- and inter-observer coefficient of variation (CV) was 2-3%. CONCLUSIONS: The newly developed echo-tracking ultrasonography seems at present to be the most accurate and reliable method to follow the diameter of an abdominal aortic aneurysm detecting relevant changes in the diameter exceeding 2 mm (2 S.D.). Thus it fulfils the requirements both for follow-up of conservatively managed AAAs and endovascularly treated aneurysms.
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| 12. |
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| 13. |
- Mangell, Peter, et al.
(author)
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Are self-expanding stents superior to balloon-expanded in dilating aortas? An experimental study in pigs
- 1996
-
In: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 12:3, s. 287-294
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To study the stent/vessel interaction and distensibility following the natural increase in vascular diameter using self-expanding and balloon-expanded stents. DESIGN: Open experimental study. SETTING: Animal laboratory, university hospital. MATERIALS AND METHODS: Eight Palmaz (P) and eight Gianturco (G) stents were transluminally placed in the infrarenal aortas of 16 pigs. Pulsatile diameter changes above, at and below the stents were non-invasively monitored with an ultrasound phase-locked echo-tracking system before and immediately after stenting and at 4 and 18 weeks. Blood pressure was registered intra-arterially and stiffness (beta) was calculated. Intravascular ultrasound (IVUS) was performed at 18 weeks. RESULTS: Median weight increased from 20 kg (19-26) to 93 kg (62-130). Diameter of the aorta increased 60%. In group P no pulsatile diameter change could be measured at the stent (beta = infinity). In group G stenting increased stiffness from beta 20.7 (9.2) to 43.2 (8.0) (p < 0.05). After 18 weeks stiffness returned to beta 20.1 (12.4). Expanded, median diameter of the P stents was 7.4 (0.8) mm, not increasing after 18 weeks. Initial diameter of the G stents was 7.8 (1.0) mm, increasing 56% to 12.2 (2.3) mm (p < 0.05). IVUS revealed the G stents to be well attached to the vascular wall, but five P stents were detached within half of the circumference. CONCLUSION: Self-expanding stents follow the pulsatile diameter change of the vessel wall, not adversely affecting distensibility after 18 weeks. They show good attachment despite 56% dilation. In contrast, the balloon-expanded stents do not show pulsatile movement and may detach during vessel diameter increase. This may be of importance when choosing stents for endovascular treatment of abdominal aortic aneurysms.
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| 14. |
- Mangell, Peter, et al.
(author)
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Critical role of P-selectin-dependent leukocyte recruitment in endotoxin-induced intestinal barrier dysfunction in mice.
- 2007
-
In: Inflammation Research. - : Springer Science and Business Media LLC. - 1420-908X .- 1023-3830. ; 56:5, s. 189-194
-
Journal article (peer-reviewed)abstract
- Objective: To define the importance of leukocyte recruitment in endotoxin-induced gut permeability. Materials and methods: 31 male C57BL/6 mice were challenged with lipopolysaccharide (LPS). Ileal permeability was measured in Ussing chambers and leukocyte-endothelium interactions studied with intravital fluorescence microscopy after 18 h. Results: LPS caused a clear-cut increase in leukocyte accumulation and intestinal permeability. Immunoneutralisation of P-selectin not only reduced leukocyte recruitment significantly (54% reduction) but also abolished endotoxin-induced intestinal leakage. Intestinal levels of pro-inflammatory chemokines increased markedly in response to LPS but were not influenced by inhibition of P-selectin in vivo. Conclusion: The present study shows not only that endotoxin-induced leukocyte recruitment is mediated by P-selectin but also that sepsis-associated intestinal leakage in the gut is largely regulated by leukocyte accumulation. Thus, our novel data demonstrate a critical link between P-selectin-dependent leukocyte recruitment and gut barrier failure in endotoxemia.
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| 15. |
- Mangell, Peter, et al.
(author)
-
Lactobacillus plantarum 299v Does Not Reduce Enteric Bacteria or Bacterial Translocation in Patients Undergoing Colon Resection.
- 2012
-
In: Digestive Diseases and Sciences. - : Springer Science and Business Media LLC. - 1573-2568 .- 0163-2116. ; 57:7, s. 1915-1924
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Probiotics may exert beneficial effects in the gastrointestinal tract. This randomized trial investigated the effect of the probiotic Lactobacillus plantarum 299v on the intestinal load of potentially pathogenic bacteria, bacterial translocation, and cell proliferation in elective colon surgery. METHODS: Seventy-five patients were randomized to pre- and postoperative oral intake of Lactobacillus plantarum 299v or placebo. Rectal swabs and mucosal biopsies were taken before the start of intake, after 1 week, at surgery, and after 6 days, weeks, and months. Viable counts were quantified for clostridia, Enterobacteriaceae, Gram-negative anaerobes, and lactobacilli. Bacterial translocation was determined by the analysis of bacterial DNA genes in mesenteric lymph nodes. Ki-67 was used as a marker of cell proliferation in normal mucosa and tumor. RESULTS: Lactobacillus plantarum 299v was given without adverse effects. Lactobacillus plantarum 299v as well as Enterobacteriaceae and Gram-negative anaerobes increased in the colon 1 week after the administration of Lactobacillus plantarum 299v. There were no significant differences between patients receiving Lactobacillus plantarum 299v and placebo in the incidence of bacterial translocation (27 vs. 13 %) and postoperative complications (16 vs. 31 %). CONCLUSIONS: Lactobacillus plantarum 299v was established in the intestine, but no inhibitory effect on enteric bacteria, bacterial translocation, or postoperative complications was found. The mechanism behind the protective effects of probiotics found in animal and some human studies remain elusive and require further explorations. No adverse effects were recorded after the administration of high doses of Lactobacillus plantarum 299v.
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| 16. |
- Mangell, Peter, et al.
(author)
-
Lactobacillus plantarum 299v inhibits Escherichia coli-induced intestinal permeability.
- 2002
-
In: Digestive Diseases and Sciences. - 1573-2568. ; 47:3, s. 511-516
-
Journal article (peer-reviewed)abstract
- The purpose of this work was to investigate whether a probiotic bacterium, Lactobacillus plantarum 299v, could affect Escherichia coli-induced passage of mannitol across the intestinal wall. Sprague-Dawley rats were pretreated for one week by either tube feeding with L. plantarum 299v twice daily, free access to L. plantarum 299v by adding the bacterium in the drinking water, or negative control receiving regular feeding. Intestinal segments were mounted in Ussing chambers and the mucosa was exposed to control medium, E. coli, and L. plantarum 299v (alone or together). [14C]Mannitol was added as a marker of intestinal permeability and samples were taken from the serosal side. E. coli exposure induced a 53% increase in mannitol passage across the intestinal wall (P < 0.05). One week of pretreatment with L. plantarum 299v in the drinking water abolished the E. coli-induced increase in permeability. Tube feeding for one week or short-term addition of L. plantarum 299v in the Ussing chambers had no effect on the permeability provoked by E. coli challenge. Notably, L. plantanum 299v itself did not change the intestinal passage of mannitol. These data demonstrate that pretreatment with L. plantarum 299v, which is a probiotic bacterium, protects against E. coli-induced increase in intestinal permeability, and that L. plantarum 299v alone has no influence on the intestinal permeability. Thus, this study supports the concept that probiotics may exert beneficial effects in the gastrointestinal tract.
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| 17. |
- Mangell, Peter
(author)
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On Lactobacillus plantarum 299v, bacterial translocation and intestinal permeability.
- 2007
-
Doctoral thesis (other academic/artistic)abstract
- The gastrointestinal tract harbours a huge load of bacteria which exerts important biological functions to maintain health. In certain conditions the relation between commensal bacteria and pathogens may be set off balance, with an increase in number of pathogens and risk of bacterial translocation (BT). Disease and trauma may also render the intestinal barrier dysfunctional, inducing BT and increased permeability. Probiotic bacteria, i.e. living bacteria which, when ingested, exerts beneficial effects on the host, have been found to stabilize the intestinal mucosa and affect the intestinal microflora. The aim of this thesis was to study the effects of Lactobacillus plantarum 299v in relation to intestinal permeability and BT. In study I L. plantarum 299v normalized E. coli-induced permeability in distal ileum of rats. This effect was achieved with a more continuous supply of L. plantarum 299v, rather than intermittent or acute pretreatment. Study II showed that pretreatment with L. plantarum 299v prevented BT in rats rendered septic with LPS. The protective effect seemed to be dependent on the ability of L. plantarum 299v to adhere to intestinal mucosa, indicating competitive inhibition as a possible mechanism behind prevention of translocation. Moreover, treatment with prebiotics, without a probioticum, did not prevent translocation. In study III LPS-induced intestinal barrier dysfunction on rats was found to be regulated by P-selectin-dependent leukocyte recruitment. With anti-P-selectin antibody intestinal permeability was attenuated, as well as leukocyte rolling and adhesion. This indicates anti-P-selectin treatment as a mean of ameliorating barrier dysfunction in sepsis. Finally, in study IV, it was found that high doses of L. plantarum 299v given to patients undergoing colon surgery were not able to reduce translocation of selected enteric bacteria but seemed to have a stimulatory effect on bacterial load in the colon. Further, L. plantarum 299v could be given to patients with malignancy without risk of tumour proliferation. Taken together, the findings herein indicates a potential of L. plantarum 299v pretreatment in reducing BT and intestinal permeability and warrants further studies in the clinical setting.
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| 18. |
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| 19. |
- Mangell, Peter, et al.
(author)
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Regional differences in mechanical properties between major arteries--an experimental study in sheep
- 1996
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In: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 12:2, s. 189-195
-
Journal article (peer-reviewed)abstract
- PURPOSE: To study possible differences in mechanical properties between central (abdominal aorta) and more peripheral (common carotid and common femoral) arteries validating an earlier non-invasive study in children showing that central arteries are more distensible than peripheral ones. As invasive blood pressure was needed, but ethically impossible to obtain in children in an experimental setting, an animal model was chosen. DESIGN: Open experimental study. SETTING: Animal laboratory at university hospital. MATERIAL AND METHODS: The pulsatile vessel wall movements of the abdominal aorta (AA), common femoral (CFA) and common carotid (CCA) artery of nine sheep were examined using an ultrasound phase-locked echo-tracking technique. Intra-arterial blood pressure was measured and pressure-diameter relations, pressure strain elastic modulus (Ep) and stiffness (beta) calculated. Distensibility was defined as the inverse of Ep and stiffness. RESULTS: The AA showed lower values for Ep and stiffness (beta) than the CFA (p = 0.002) and CCA (p = 0.006), i.e. the latter two vessels were stiffer. The pressure-diameter relations confirmed these differences and showed a non-linearity for all three vessels with increased stiffness above 70-90 mm Hg. CONCLUSION: This study on young animals supports earlier findings of differences in mechanical properties between central and more peripheral arteries seen in healthy children. As pathologies between these vessels differ, with dilatation of the abdominal aorta and occlusive disease in the more peripheral vessels, part of the explanation might be found in the mechanical properties of the healthy vessels, characterised here with the echo-tracking technique.
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| 20. |
- Marco, Maria L., et al.
(author)
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Convergence in probiotic Lactobacillus gut-adaptive responses in humans and mice
- 2010
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In: The Isme Journal. - : Springer Science and Business Media LLC. - 1751-7362 .- 1751-7370. ; 4:11, s. 1481-1484
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Journal article (peer-reviewed)abstract
- Probiotic bacteria provide unique opportunities to study the global responses and molecular mechanisms underlying the effects of gut-associated microorganisms in the human digestive tract. In this study, we show by comparative transcriptome analysis using DNA microarrays that the established probiotic Lactobacillus plantarum 299v specifically adapts its metabolic capacity in the human intestine for carbohydrate acquisition and expression of exopolysaccharide and protein-aceous cell surface compounds. This report constitutes the first application of global gene expression profiling of a commensal microorganism in the human gut. A core L. plantarum transcriptome expressed in the mammalian intestine was also determined through comparisons of L. plantarum 299v activities in humans to those found for L. plantarum WCFS1 in germ-free mice. These results identify the niche-specific adaptations of a dietary microorganism to the intestinal ecosystem and provide novel targets for molecular analysis of microbial-host interactions which affect human health. The ISME Journal (2010) 4, 1481-1484; doi: 10.1038/ismej.2010.61; published online 27 May 2010
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| 21. |
- Nilbert, Mef, et al.
(author)
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Broad phenotypic spectrum in familial adenomatous polyposis; from early onset and severe phenotypes to late onset of attenuated polyposis with the first manifestation at age 72
- 2008
-
In: BMC Medical Genetics. - : Springer Science and Business Media LLC. - 1471-2350. ; 9
-
Journal article (peer-reviewed)abstract
- Background: Familial adenomatous polyposis (FAP) is typically characterized by multiple colonic polyps and frequent extracolonic features. Whereas the number of colonic polyps has been linked to the APC gene mutation, possible genotype-phenotype correlations largely remain to be defined for the extracolonic manifestations. Methods: Full genomic sequencing combined with multiplex ligation-dependent probe amplification was used to identify APC gene mutations, which were correlated to the clinical presentations. Results: 10 novel APC gene mutations were identified in 11 families. A broad spectrum of extracolonic manifestations was identified in most of these individuals. Two sisters with an insertion in codon 528 (c.1582_1583insGC) both showed severe phenotypes with classical polyposis, upper gastrointestinal polyps and thyroid cancer. A woman with a 3'APC mutation (c.5030_5031 insAA) developed colon cancer at age 72 as the first manifestation of attenuated FAP. Conclusion: With an increasing number of FAP families diagnosed, a broad and variable tumor spectrum and a high frequency of extracolonic manifestations are gradually recognized. We report novel APC mutations and present two FAP cases that suggest familial aggregation of thyroid cancer and demonstrate the need to consider attenuated FAP also among elderly patients with colon cancer.
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| 22. |
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| 23. |
- Syk, Ingvar, et al.
(author)
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Systemic interleukin-6 response to colorectal surgery originates from the bowel.
- 2002
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In: Digestive Surgery. - : S. Karger AG. - 0253-4886 .- 1421-9883. ; 19:3, s. 210-215
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Journal article (peer-reviewed)abstract
- Background: Surgical trauma evokes a systemic cytokine response which is enhanced in patients with colorectal cancer. The aim of this study was to locate the origin of the systemic cytokine response to colorectal surgery. Methods: The concentrations of interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha) were analysed in systemic and mesenteric venous blood in 12 patients operated on with colorectal resections due to cancer or benign lesions. Immunohistochemical staining and analysis of tissue concentrations of IL-6 and TNF-alpha in homogenates from tumours and benign specimens were performed. Results: Mesenteric venous blood contained higher concentrations of IL-6 compared to systemic venous blood after resection, but not before. Tissue concentration of IL-6 was higher in the tumours compared to the benign specimens and immunohistochemistry revealed an abundance of IL-6 and TNF-alpha in malignant epithelium compared to benign mucosa. Conclusion: The higher concentration of IL-6 in venous blood from the mesenterium of the resected colonic segment compared to systemic levels, indicates that the bowel is the source of the IL-6 response to surgical trauma in colorectal surgery.
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| 24. |
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