| 1. |
- Bergqvist, David, et al.
(författare)
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Inga dödsfall/slaganfall efter kirurgi vid asymtomatisk karotisstenos : femårsresultat redovisat i riksstäckande register
- 2006
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 103:5, s. 301-302
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Tidskriftsartikel (refereegranskat)abstract
- In the Swedish vascular registry 7473 carotid endarterectomies are registered, in 10% the indication being a symptomatic stenosis. There are great variations in indication for carotid endarterectomy within Sweden. During the last five years the combined postoperative mortality and/or postoperative permanent stroke has varied between 3% in 1999 and 1.5% in 2003. During the same period not a single patient operated on for a symptomatic carotid stenosis experienced these complications.
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| 2. |
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| 3. |
- Björck, M, et al.
(författare)
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Twenty years with the Swedvasc Registry.
- 2008
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Ingår i: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 35:2, s. 129-30
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Hörer, Tal, 1971-, et al.
(författare)
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Intra-peritoneal microdialysis and intra-abdominal pressure after endovascular repair of ruptured aortic aneurysms
- 2013
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 45:6, s. 596-606
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study aims to evaluate intra-peritoneal (ip) microdialysis after endovascular aortic repair (EVAR) of ruptured abdominal aortic aneurysm (rAAA) in patients developing intra-abdominal hypertension (IAH), requiring abdominal decompression.Design: Prospective study.Material and methods: A total of 16 patients with rAAA treated with an emergency EVAR were followed up hourly for intra-abdominal pressure (IAP), urine production and ip lactate, pyruvate, glycerol and glucose by microdialysis, analysed only at the end of the study. Abdominal decompression was performed on clinical criteria, and decompressed (D) and non-decompressed (ND) patients were compared.Results: The ip lactate/pyruvate (l/p) ratio was higher in the D group than in the ND group during the first five postoperative hours (mean 20 vs. 12), p = 0.005 and at 1 h prior to decompression compared to the fifth hour in the ND group (24 vs. 13), p = 0.016. Glycerol levels were higher in the D group during the first postoperative hours (mean 274.6 vs. 121.7 mu M), p = 0.022. The IAP was higher only at 1 h prior to decompression in the D group compared to the ND group at the fifth hour (mean 19 vs. 14 mmHg).Conclusions: lp l/p ratio and glycerol levels are elevated immediately postoperatively in patients developing IAH leading to organ failure and subsequent abdominal decompression.
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| 5. |
- Jonsson, Thomas Björn, 1971-, et al.
(författare)
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Cloxacillin concentrations in serum, subcutaneous fat, and muscle in patients with chronic critical limb ischemia
- 2014
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Ingår i: European Journal of Clinical Pharmacology. - : Springer. - 0031-6970 .- 1432-1041. ; 70:8, s. 957-963
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Tidskriftsartikel (refereegranskat)abstract
- Patients suffering from critical limb ischemia (CLI) have poor wound healing in the ankle and foot areas. Secondary wound infections are frequent and often treated with prolonged courses of antibiotics.This study set out to investigate to what extent the unbound fraction of 4 g of cloxacillin i.v. reaches its target organ in poorly vascularized tissues, i.e., the calf and foot of patients suffering from CLI.Cloxacillin concentrations were measured by HPLC in serum and in microdialysis samples from skin and muscle of the lower part of the calf and as reference subcutaneously at the pectoral level in eight patients suffering from CLI (four males, four females, mean age 78 years, range 66-85 years) and in three healthy controls (two females, one male, mean age 67, range 66-68 years).In patients suffering from CLI, the tissue penetration of cloxacillin after a single 4 g dose was comparable to that of healthy controls, despite impaired blood circulation.The reduced blood flow in the peripheral vessels of the CLI patients presented here apparently is not the rate-limiting factor for delivery or tissue penetration of cloxacillin.
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| 6. |
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| 7. |
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| 8. |
- Petzold, Axel, et al.
(författare)
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Neurofilament ELISA validation
- 2010
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Ingår i: JOURNAL OF IMMUNOLOGICAL METHODS. - 0022-1759. ; 352:1-2, s. 23-31
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Tidskriftsartikel (refereegranskat)
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| 9. |
- Petzold, Axel, et al.
(författare)
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Neurofilament ELISA validation
- 2010
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Ingår i: JIM - Journal of Immunological Methods. - : Elsevier BV. - 0022-1759 .- 1872-7905. ; 352:1-2, s. 23-31
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Neurofilament proteins (Nf) are highly specific biomarkers for neuronal death and axonal degeneration. As these markers become more widely used, an inter-laboratory validation study is required to identify assay criteria for high quality performance. METHODS: The UmanDiagnostics NF-light (R)enzyme-linked immunoabsorbent assays (ELISA) for the neurofilament light chain (NfL, 68kDa) was used to test the intra-assay and inter-laboratory coefficient of variation (CV) between 35 laboratories worldwide on 15 cerebrospinal fluid (CSF) samples. Critical factors, such as sample transport and storage, analytical delays, reaction temperature and time, the laboratories' accuracy and preparation of standards were documented and used for the statistical analyses. RESULTS: The intra-laboratory CV averaged 3.3% and the inter-laboratory CV 59%. The results from the test laboratories correlated with those from the reference laboratory (R=0.60, p<0.0001). Correcting for critical factors improved the strength of the correlation. Differences in the accuracy of standard preparation were identified as the most critical factor. Correcting for the error introduced by variation in the protein standards improved the correlation to R=0.98, p<0.0001 with an averaged inter-laboratory CV of 14%. The corrected overall inter-rater agreement was subtantial (0.6) according to Fleiss' multi-rater kappa and Gwet's AC1 statistics. CONCLUSION: This multi-center validation study identified the lack of preparation of accurate and consistent protein standards as the main reason for a poor inter-laboratory CV. This issue is also relevant to other protein biomarkers based on this type of assay and will need to be solved in order to achieve an acceptable level of analytical accuracy. The raw data of this study is available online.
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| 10. |
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| 11. |
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| 12. |
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| 13. |
- Albertsson-Wikland, Kerstin, et al.
(författare)
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Mortality Is Not Increased in Recombinant Human Growth Hormone-treated Patients When Adjusting for Birth Characteristics
- 2016
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : ENDOCRINE SOC. - 0021-972X .- 1945-7197. ; 101:5, s. 2149-2159
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to investigate whether reported high mortality in childhood recombinant human GH (rhGH)-treated patients was related to birth-characteristics and/or rhGH treatment. Design and Setting: We sought to develop a mortality model of the Swedish general population born between 1973 and 2010, using continuous-hazard functions adjusting for birth characteristics, sex, age intervals, and calendar year to estimate standardized mortality ratio (SMR) and to apply this model to assess expected deaths in Swedish rhGH-treated patients with idiopathic isolated GH deficiency (IGHD), idiopathic short stature (155) or born small for gestational age (SGA). Participants:The general population: Swedish Medical Birth Register (1973-2010: 1 880 668 males; 1 781 131 females) and Cause of Death Register (1985-2010). Intervention Population: Three thousand eight hundred forty-seven patients starting rhGH treatment between 1985 and 2010 and followed in the National GH Register and/or in rhGH trials diagnosed with IGHD (n = 1890), ISS (n = 975), or SGA (n=982). Main Outcome Measures: Death. Results: Using conventional models adjusting for age, sex, and calendar-year, the SMR was 1.43 (95% confidence interval, 0.89-2.19), P = .14, observed/expected deaths 21/14.68. The rhGH population differed (P amp;lt; .001) from the general population regarding birth weight, birth length, and congenital malformations. Application of an Advanced Model: When applying the developed mortality model of the general population, the ratio of observed/expected deaths in rhGH-treated patients was 21/21.99; SMR = 0.955 (0.591-1.456)P = .95. Model Comparison: Expected number of deaths were 14.68 (14.35-14.96) using the conventional model, and 21.99 (21.24-22.81) using the advanced model, P amp;lt; .001, which had at all ages a higher gradient of risk per SD of the model, 24% (range, 18-42%; P amp;lt; .001). Conclusions: Compared with the general Swedish population, the ratio of observed/expected deaths (21/21.99) was not increased in childhood rhGH-treated IGHD, ISS, and SGA patients when applying an advanced sex-specific mortality model adjusting for birth characteristics.
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| 14. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Mortality is not increased in rhGH-treated patients when adjusting for birth characteristics.
- 2016
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 101:5, s. 2149-2159
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to investigate whether reported high mortality in childhood recombinant human GH (rhGH)-treated patients was related to birth-characteristics and/or rhGH treatment. Design and Setting: We sought to develop a mortality model of the Swedish general population born between 1973 and 2010, using continuous-hazard functions adjusting for birth characteristics, sex, age intervals, and calendar year to estimate standardized mortality ratio (SMR) and to apply this model to assess expected deaths in Swedish rhGH-treated patients with idiopathic isolated GH deficiency (IGHD), idiopathic short stature (155) or born small for gestational age (SGA). Participants:The general population: Swedish Medical Birth Register (1973-2010: 1 880 668 males; 1 781 131 females) and Cause of Death Register (1985-2010). Intervention Population: Three thousand eight hundred forty-seven patients starting rhGH treatment between 1985 and 2010 and followed in the National GH Register and/or in rhGH trials diagnosed with IGHD (n = 1890), ISS (n = 975), or SGA (n=982). Main Outcome Measures: Death. Results: Using conventional models adjusting for age, sex, and calendar-year, the SMR was 1.43 (95% confidence interval, 0.89-2.19), P = .14, observed/expected deaths 21/14.68. The rhGH population differed (P < .001) from the general population regarding birth weight, birth length, and congenital malformations. Application of an Advanced Model: When applying the developed mortality model of the general population, the ratio of observed/expected deaths in rhGH-treated patients was 21/21.99; SMR = 0.955 (0.591-1.456)P = .95. Model Comparison: Expected number of deaths were 14.68 (14.35-14.96) using the conventional model, and 21.99 (21.24-22.81) using the advanced model, P < .001, which had at all ages a higher gradient of risk per SD of the model, 24% (range, 18-42%; P < .001). Conclusions: Compared with the general Swedish population, the ratio of observed/expected deaths (21/21.99) was not increased in childhood rhGH-treated IGHD, ISS, and SGA patients when applying an advanced sex-specific mortality model adjusting for birth characteristics.
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| 15. |
- Arfvidsson, Berndt, et al.
(författare)
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S100B concentrations increase perioperatively in jugular vein blood despite limited metabolic and inflammatory response to clinically uneventful carotid endarterectomy
- 2015
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Ingår i: Clinical Chemistry and Laboratory Medicine. - : Walter de Gruyter GmbH. - 1434-6621 .- 1437-4331. ; 53:1, s. 111-117
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Tidskriftsartikel (refereegranskat)abstract
- Background: Our aim was to test the hypothesis that metabolic and inflammatory responses of the brain perioperatively during carotid endarterectomy (CEA) might affect blood brain barrier (BBB) integrity.Methods: Twenty patients with >70% stenosis of internal carotid artery (ICA) were prospectively included. Surgery was performed under general anaesthesia. Blood was sampled from ipsilateral internal jugular vein and radial artery: just before, during, and after ICA clamping S100B protein, glucose, lactate, 20 amino acids, and key cytokines were analysed.Results: Jugular vein S100B increased during clamping and reperfusion, while a marginal systemic increase was recorded, unrelated to stump pressure during clamping. Glucose increased during clamping in jugular vein blood and even more systemically, while jugular lactate values were higher than systemic values initially. Most amino acids did not differ significantly between jugular vein and systemic levels: glutamic acid and aspartic acid decreased during surgery while asparagine increased. Jugular vein interleukin (IL)-6 showed a transient non-significant increase during clamping and decreased systemically. IL-8 and IL-10 increased over time.Conclusions: Rising jugular vein S100B concentrations indicated reduced BBB integrity, and marginal secondary increase of S100B systemically. Limited ischaemic effects on the brain during cross-clamping, unrelated to S100B concentrations, were confirmed by lower brain glucose levels and higher lactate levels than in systemic blood. The lack of increased jugular vein glutamic acid disproves any major ischaemic brain injury following CEA. The inflammatory response was limited, did not differ greatly between jugular and systemic blood, and was unrelated to S100B.
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| 16. |
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| 17. |
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| 18. |
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| 19. |
- Blomgren, Lena, 1957-
(författare)
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Varicose Veins : Aspects on Diagnosis and Surgical Treatment
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Treatment for varicose veins (VV) is insufficiently evidence based and recurrence rates are high. The aim of this thesis was to study the long-term results after VV surgery, risk factors for recurrences and the effect of preoperative duplex scanning on recurrence rate, quality of life (QoL) and costs.In a follow-up study 89 patients with 100 legs operated on for VV 6–10 years earlier were re-examined with duplex, in 13 cases also with varicography. 57% had incompetent vessels in the groin visible with duplex, equally well defined by varicography. Residual branches could not be differentiated from new vessel formation. The recurrence rate did not correlate to the surgeon’s level of experience or perioperative difficulties at primary surgery. In a prospective randomized study 293 patients (343 legs) were operated on for primary VV with or without preoperative duplex. Duplex was done postoperatively, at 2 months and 2 years. QoL was measured with SF-36 preoperatively, at 1 month, 1 year and 2 years. After 2 years the number of reoperations were 2 in the group with preoperative duplex and 14 in the group without (p=0.002). Incompetent veins were seen in the saphenofemoral or saphenopopliteal junction in 19 and 53 legs respectively (p<0.001).Preoperative QoL was worse in the VV patients compared to a reference population, and was normalised 2 years postoperatively. The improved surgical result in the duplex group was not reflected in a significantly higher QoL. The lower costs for redo surgery in the duplex group did not offset the costs for duplex, partly due to more extensive primary surgery. A significant proportion of recurrences after 2 years was new vessel formation and progression of disease. Preoperative perforating vein incompetence did not influence recurrence rate, and was abolished without specific interruption in 60% at 2 years postoperatively.
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| 20. |
- Bruhn, Fredrik, et al.
(författare)
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Introducing Radiation Tolerant Heterogeneous Computers for Small Satellites
- 2015
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Ingår i: IEEE Aerospace Conference Proceedings, vol. 2015. - 9781479953790 ; , s. Article number 7119158-
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Konferensbidrag (refereegranskat)abstract
- This paper presents results and conclusions from design, manufacturing, and benchmarking of a heterogeneous computing low power fault tolerant computer, realized on an industrial Qseven® small form factor (SFF) platform. A heterogeneous computer in this context features multi-core processors (CPU), a graphical processing unit (GPU), and a field programmable gate array (FPGA). The x86 compatible CPU enables the use of vast amounts of commonly available software and operating systems, which can be used for space and harsh environments. The developed heterogeneous computer shares the same core architecture as game consoles such as Microsoft Xbox One and Sony Playstation 4 and has an aggregated computational performance in the TFLOP range. The processing power can be used for on-board intelligent data processing and higher degrees of autonomy in general. The module feature quad core 1.5 GHz 64 bit CPU (24 GFLOPs), 160 GPU shader cores (127 GFLOPs), and a 12 Mgate equivalent FPGA fabric with a safety critical ARM® Cortex-M3 MCU.
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| 21. |
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| 22. |
- Cronberg, Carin, et al.
(författare)
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Peripheral arterial disease.
- 2003
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Ingår i: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 44:1, s. 59-66
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Tidskriftsartikel (refereegranskat)
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| 23. |
- Dahlström, Christina, 1977-, et al.
(författare)
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Ion conductivity through TEMPO-mediated oxidated and periodate oxidated cellulose membranes
- 2020
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Ingår i: Carbohydrate Polymers. - : ELSEVIER SCI LTD. - 0144-8617 .- 1879-1344. ; 233
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Tidskriftsartikel (refereegranskat)abstract
- Cellulose in different forms is increasingly used due to sustainability aspects. Even though cellulose itself is an isolating material, it might affect ion transport in electronic applications. This effect is important to understand for instance in the design of cellulose-based supercapacitors. To test the ion conductivity through membranes made from cellulose nanofibril (CNF) materials, different electrolytes chosen with respect to the Hofmeister series were studied. The CNF samples were oxidised to three different surface charge levels via 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO), and a second batch was further cross-linked by periodate oxidation to increase wet strength and stability. The outcome showed that the CNF pre-treatment and choice of electrolyte are both crucial to the ion conductivity through the membranes. Significant specific ion effects were observed for the TEMPO-oxidised CNF. Periodate oxidated CNF showed low ion conductivity for all electrolytes tested due to an inhibited swelling caused by the crosslinking reaction.
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| 24. |
- Danielsson, Gudmundur, et al.
(författare)
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A randomised controlled trial of micronised purified flavonoid fraction vs placebo in patients with chronic venous disease
- 2002
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 23:1, s. 73-76
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to evaluate the efficacy of a micromised purified flavonoid fraction (MPFF) in the treatment of chronic venous disease (CVD). Design: prospective doable blind, randomised, control shady. Patients and methods: one hundred and one patients with symptomatic CVD were randomly allocated to treatment for 60 days with either MPFF (51 patients) or placebo (50 patients) 500 mg twice daily. There were 28 men and 73 women, aged 22-65 years (mean age 48 years). No difference regarding age, gender, clinical class or duration of symptoms was recorded between the treatment and placebo groups. A global score for evaluation of symptoms was used. Patients were investigated with plethysmography (foot-volumetry) and duplex-ultrasonography before and after the treatment period. For statistical comparison Cochran-Mantel-Haenszel test, two-sided Student t-test and covariance analysis were used and p<0.05 was regarded significant. Results: improvement of the global score of symptoms was reported by 21 patients in the MPFF group and by 16 in the placebo group (N.S.). For the whole groups, no significant differences were recorded before and after treatment regarding foot-volumetric or ultrasonography parameters. On the other hand, in patients with edema (20 in the MPFF group, 23 in tire placebo group) ultrasonographic reflux time was significantly reduced for those in the treatment group (p=0.03). This finding did not correlate to clinical symptoms. Conclusion: in this study, MPFF dirt trot change the symptoms of CVD, except might cramps. A secondary finding was reduced reflux times in patients with oedema, although no ultrasonographic or foot-volumetric parameters changed significantly for the whole group. The role of MPFF in treatment of patients with CVD needs to be further analysed in a large population.
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| 25. |
- Danielsson, Gudmundur, et al.
(författare)
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Flavonoid treatment in patients with healed venous ulcer: flow cytometry analysis suggests increased CD11b expression on neutrophil granulocytes in the circulation
- 2003
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Ingår i: Vascular Medicine. - : SAGE Publications. - 1477-0377 .- 1358-863X. ; 8:2, s. 83-88
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to determine the activation of white blood cells (WBCs) and endothelial cells in patients with healed venous ulcer and the influence of the standing position and of treatment with flavonoids. Ten patients with a healed venous ulcer were treated with flavonoid substance (90% diosmin), 1000 mg three times daily for 30 days. Blood samples were taken from arm and dorsal foot veins before and after standing for 30 minutes. Blood sampling was performed before treatment, after three days, one month and three months. The activation of WBCs was determined by measuring adhesion molecule CD11b and CD18 expression on the surface of granulocytes and monocytes. In addition, interleukin 6 (IL-6), IL-8, soluble E-selectin (sE-selectin), sL-selectin and sICAM-1 levels in serum were quantified. The results showed that standing did not influence any of the measured parameters significantly. Expression of CD11b adhesion molecules on granulocytes was significantly up-regulated (p=0.044) after treatment with flavonoids for one month, but this increase was not significant (p=0.056) two months after the treatment period compared with the baseline level. The expression of CD18 remained unchanged. Baseline expression of CD11b or CD18 on monocytes did not change significantly during the study period. Neither was any significant change observed in the levels of IL-6, IL-8 or the soluble adhesion molecules. It was concluded that flavonoid treatment for 30 days increased the expression of CD11b adhesion molecules on circulating granulocytes. No general effect on the inflammatory process could be observed as assessed by levels of cytokines and soluble adhesion molecules. Possible explanations for these findings could be that a decreased number of primed granulocytes leave the circulation due to a changed WBC/endothelial cell interaction or that flavonoids have a direct effect on granulocytes. Further studies are needed to clarify the mode of action of flavonoids in chronic venous disease.
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| 26. |
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| 27. |
- Danielsson, Gudmundur, et al.
(författare)
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Percutaneous transluminal angioplasty of crural arteries: diabetes and other factors influencing outcome
- 2001
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 21:5, s. 432-436
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to evaluate the efficacy of percutaneous transluminal angioplasty (PTA) of the crural arteries. PATIENTS AND METHODS: a retrospective review of patients treated with PTA of at least one crural artery during an 8-year period (1990--1997). RESULTS: one hundred and fifty-five legs in 140 consecutive patients (mean age 74 years, range 38--91 years) were treated. In 76% a more proximal lesion was also treated. After 1 year, results were significantly better in non-diabetics (improvement rate of 66% vs 32%p <0.05). The outcome for patients with a combination of diabetes, heart disease and renal disease was significantly worse compared to all other patients with an improvement rate of only 9% after 1 year. Patients alive and not amputated at 1 year were significantly more common (p <0.05) among non-diabetics (90%), compared to diabetics (66%). The 1-year mortality for the whole group was 15%, significantly higher for diabetic patients (p =0.04). CONCLUSION: PTA of crural arteries produces reasonably good results in non-diabetic patients. Diabetic patients were doing worse than non-diabetics after a year, though 1-month results were not significantly different. Patients with diabetes, heart disease and renal disease make a high-risk group that has a significantly worse outcome.
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| 28. |
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| 29. |
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| 30. |
- Danielsson, Peter, et al.
(författare)
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Inflammatory markers and IL-6 polymorphism in peripheral arterial disease with and without diabetes mellitus.
- 2005
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Ingår i: Vascular Medicine. - : SAGE Publications. - 1477-0377 .- 1358-863X. ; 10:3, s. 191-198
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Tidskriftsartikel (refereegranskat)abstract
- Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis, recognized as an inflammatory disease of the vessel wall, probably accelerated by diabetes mellitus (DM). Elevated interleukin (IL)-6 levels have been associated with increased cardiovascular morbidity and a common polymorphism has been identified in the promoter region of the IL-6 gene. The aim of this prospective study was to investigate inflammatory mediators in PAD patients (±DM) and to investigate a possible relationship to the IL-6 gene polymorphism. Five groups of patients (DM, intermittent claudication ±DM, critical limb ischemia (CLI) ±DM) and a control group of 20 individuals each were included. Hemoglobin, high sensitive C-reactive protein (hsCRP), creatinine, blood lipids, white blood cells (WBC); CD11b/CD18; vascular cell adhesion molecule (sVCAM-1), intercellular adhesion molecule (sICAM-1), sE-selectin, sP-selectin; IL-6, IL-8, tumour necrosis factor (TNF)α, sTNFα-R1 and sTNFα-R2 were analysed. The IL-6 gene polymorphism was determined in all groups and also compared with 200 healthy controls from a larger study of blood donors. In a multiple regression analysis, adjusted for gender, smoking and age, the effect of CLI was significantly ( p < 0.05) associated with elevated levels of the WBC count, hsCRP, proinflammatory cytokines (IL-6, TNFα-R1-2) and endothelial (sICAM, sVCAM) and WBC (CD11b gran) markers. The effect of less advanced PAD (intermittent claudication) was related to an increased concentration of sVCAM-1 and the number of monocytes and granulocytes. DM or leg ulcers were not significantly related to any of the markers. No significant difference in frequency of the various IL-6 genotypes was found between the groups or when compared with the group of 200 blood donors ( p > 0.3). Activation of cytokines, endothelial cells and WBC was related to the Fontaine stage of PAD but not to the presence of DM or ulcers. No association was found between the polymorphism in the IL-6 promoter region and PAD.
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| 31. |
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| 32. |
- Danielsson, P., et al.
(författare)
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Systemic white blood and endothelial cell response after revascularization of critical limb ischemia is only influenced in case of ischemic ulcers
- 2006
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Ingår i: International Journal of Angiology. - 0392-9590 .- 1827-1839. ; 25:3, s. 310-315
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to study the inflammatory response to open revascularization of an ischemic leg in terms of activation of white blood cells (WBC), platelets and endothelial cells. DESIGN: prospective study. METHODS: Venous samples from 21 patients suffering critical limb ischemia (CLI) were drawn before, and 4 weeks after (20 patients) revascularization. Total WBC, differentiated WBC, and platelets were counted. Expression of CD11b/CD18 on granulocytes and monocytes and CD41 on platelets was measured by flow cytometry. Soluble endothelial markers (sICAM-1, sVCAM-1, sE-selectin and sP-selectin) were analysed with ELISA. RESULTS: WBC and granulocyte count decreased in the subgroup of patients with ulcer and gangrene but no change in activation of WBC was recorded. The endothelial marker sICAM-1 decreased while VCAM-1 increased following surgery, most evident in the subgroup with ulcers and gangrene. CONCLUSIONS: This study shows that revascularization of CLI does not significantly influence the inflammatory response in patients with rest pain only, but a limited response of down regulation was found in the ulcer/gangrene patients probably as an effect of healing ulcers.
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| 33. |
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| 34. |
- Dormandy, J. A., et al.
(författare)
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Impact of peripheral arterial disease in patients with diabetes : results from PROactive (PROactive 11)
- 2009
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Ingår i: Atherosclerosis. - Amsterdam : Elsevier. - 0021-9150 .- 1879-1484. ; 202:1, s. 272-281
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Tidskriftsartikel (refereegranskat)abstract
- We compared cardiovascular disease outcomes according to the presence of peripheral arterial disease (PAD) at baseline in a post hoc analysis from the PROactive study. Of the 5238 patients in PROactive (a study of pioglitazone versus placebo in patients with type 2 diabetes and macrovascular disease; mean follow-up=34.5 months), 1274 had PAD at baseline (619=pioglitazone; 655=placebo). Patients with PAD at baseline showed significantly higher rates of the primary endpoint, main secondary endpoint, all-cause mortality (all P<0.0001), and stroke (P=0.0175) than those with no PAD at baseline. The risk of PAD alone was similar to that of myocardial infarction alone. In patients with no PAD at baseline, the event rates of the primary endpoint (P=0.0160), main secondary endpoint (P=0.0453), and acute coronary syndrome (P=0.0287) were significantly lower with pioglitazone than with placebo. This beneficial effect of pioglitazone was not seen in patients with PAD at baseline. In the total population, there was a higher frequency of leg revascularizations with pioglitazone than placebo-this was wholly due to first events that occurred within the initial 12 months of treatment. The presence of PAD increased the risk of all major cardiovascular events. Those without PAD at baseline seemed to benefit more from pioglitazone treatment than the overall PROactive population.
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| 35. |
- Dreifaldt, Mats, 1959-
(författare)
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Conduits in coronary artery bypass grafting surgery : Saphenous vein, radial and internal thoracic arteries
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A novel technique for saphenous vein (SV) graft harvesting, the No-touch technique (NT), has been developed at the Dept. of Cardiovascular surgery, Örebro University hospital. With NT the SV is harvested with a pedicle of surrounding tissue. This avoids graft spasm and eliminates the need for distension. The surrounding tissue acts as a structural support and is a rich source of vaso-dilating agents. A randomized controlled trial (RCT) has shown a significantly higher patency rate for NT SV grafts compared to SV grafts harvested with conventional technique (CT). This thesis evaluates some of the properties of the surrounding tissue and compares patency rates between NT SV and radial artery (RA) grafts and patency rates for internal thoracic artery (ITA) grafts harvested with and without surrounding tissue. Paper I investigated vasa vasorum (VV) in SV grafts and showed that the NT preserves an intact VV whereas CT does not. This could be one of the mechanisms underlying the improved patency for NT SV grafts. Paper II evaluated VV and associated nitric oxide (NO) in SV and arterial grafts. SV grafts showed a higher number and larger VV, which correlated with NO production, compared to arterial grafts. NT SV grafts showed higher activity for e-NOS compared to CT SV grafts. Paper III is a RCT comparing patency rates between NT SV and RA grafts, three years after surgery, showing a significantly higher patency rate for NT SV grafts. Paper IV is a RCT comparing patency rates for ITA graft harvested with and without surrounding tissue and did not show any difference between graft preparations. In conclusion, the NT for SV graft harvesting preserves an intact vasa vasorum and associated NO production. NT SV grafts show a higher patency rate than RA grafts. Harvesting of ITA with or without surrounding tissue does not affect patency rate.
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| 36. |
- Dreifaldt, Mats, et al.
(författare)
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The ‘‘no-touch’’ harvesting technique for vein grafts in coronary artery bypass surgery preserves an intact vasa vasorum
- 2011
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Ingår i: The Internet Journal of Thoracic and Cardiovascular Surgery. - New York, USA : Elsevier. - 1524-0274 .- 0022-5223. ; 141:1, s. 145-150
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Our objective was to evaluate the impact of vein graft harvesting technique on structure and function of vasa vasorum.Methods: Paired segments of great saphenous veins harvested either with conventional harvesting technique or no-touch technique were obtained from 9 consecutive patients undergoing coronary artery bypass grafting. Quantitative measurements, using immunohistochemistry and morphometry, were performed. Ultrastructural analyses of vasa vasorum were performed with electron microscopy. Video footage of superficial vasa vasorum in an implanted saphenous vein graft harvested with the no-touch technique was captured during a coronary bypass operation and is presented for online viewing.Results: The total area of vasa vasorum in vein grafts harvested with the conventional technique was significantly reduced both in the media (P¼.007) and in the adventitia (P¼.014) compared with vein grafts harvested with the no-touch technique. Ultrastructural findings indicated that the no-touch technique preserved an intact vasa vasorum whereas the conventional technique did not. Video footage showed retrograde flow in the vasa vasorum in vein graft harvested with the no-touch technique.Conclusions: These findings showthat the no-touch technique for saphenous vein graft harvesting for coronary bypass grafting preserves an intact vasa vasorum. This could represent one of the mechanisms underlying the improved patency of saphenous vein grafts harvested with this technique.
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| 37. |
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| 38. |
- El Marghani, Ahmed M., et al.
(författare)
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High MAPK p38 activity and low level of IL-10 in intermittent claudication as opposed to stable angina
- 2010
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Ingår i: International Journal of Angiology. - Torino : Minerva Medica. - 0392-9590 .- 1827-1839. ; 29:4, s. 331-337
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Tidskriftsartikel (refereegranskat)abstract
- AIM:The aim of the present pilot study was to relate the activity of MAPK p38 with the levels of pro- and anti-inflammatory cytokines in a small cohort of patients with either stable angina (N=5) or intermittent claudication (N=5) compared to healthy controls (N=10).METHODS:The activity of MAPK p38 was determined in peripheral blood mononuclear cells, isolated from whole blood by western blot using phospho-specific anti-MAPK p38 antibodies. Cytokine levels of 11 pro- and anti-inflammatory cytokines were determined from the serum using flow cytometry.RESULTS:We found a significant elevation of the MAPK p38 activity in the intermittent claudication group (P=0.0027) compared with the healthy control group whereas the stable angina group showed similar MAPK p38 activity as the healthy control group. The IL-10 level in serum found in the stable angina group was significantly higher compared with both the healthy control group (P=0.0116) and the intermittent claudication group (P=0.0317).CONCLUSION:Our results imply that there is a casual relationship between increased levels of the anti-inflammatory cytokines IL-10 and IL-4 and the activity of the MAPK p38. Possibly has IL-10 a protective role that down-regulates the activity of MAPK p38 and thereby further inflammatory processes in stable angina patients.
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| 39. |
- Ellgardt, Anders, 1978-
(författare)
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Wide-angle scanning wide-band phased array antennas
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis considers problems related to the design and the analysis of wide-angle scanning phased arrays. The goals of the thesis are the design and analysis of antenna elements suitable for wide-angle scanning array antennas, and the study of scan blindness effects and edge effects for this type of antennas. Wide-angle scanning arrays are useful in radar applications, and the designs considered in the thesis are intended for an airborne radar antenna.After a study of the wide-angle scanning limits of three candidate elements, the tapered-slot was chosen for the proposed application.A tapered-slot antenna element was designed by using the infinitive array approach and the resulting element is capable of scanning out to 60° from broadside in all scan planes for a bandwidth of 2.5:1 and an active reflection coefficient less than -10 dB. This design was implemented on an experimental antenna consisting of 256 elements.The predicted performance of the antenna was then verified by measuring the coupling coefficients and the embedded element patterns, and the measurements agreed well with the numerical predictions.Since the radar antenna is intended for applications where stealth is important, an absorbing layer is positioned on top of the ground plane to reduce the radar cross section for the antenna's cross-polarization.This absorbing layer attenuates guided waves that otherwise lead to scan blindness, but does not adversely affect the antenna performance for the desired scan directions and frequencies.The highest frequency limit of the tapered-slot element is set by scan blindnesses. One of these scan blindnesses is found to be unique to tapered-slot elements positioned in triangular grids. This scan blindness is studied in detail and a scan blindness condition is presented and evaluated.The evaluation of the experimental antenna shows that edge effects reduce the H-plane performance of the central elements.These edge effects are further studied and characterized, by comparing the scattering parameters for finite-by-infinite arrays and infinite arrays.In this way it is possible to divide the edge effects into two categories: those caused by finite excitation, and those caused by perturbed currents due to the geometry of the edge. A finite difference time domain code with time shift boundaries is used to compute the active reflection coefficients needed to compute the scattering parameters, but this code cannot directly compute the active reflection coefficient for all the required phase shifts.Hence, an additional method is presented that makes it possible to compute arbitrary phase shifts between the elements using any numerical code with limited scan directions.
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| 40. |
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| 41. |
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| 42. |
- Engellau, Lena, et al.
(författare)
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Long-term results after endovascular repair of abdominal aortic aneurysms with the Stentor and Vanguard stent-graft.
- 2004
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Ingår i: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 45:3, s. 275-283
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To present a single institution experience of long‐term results after endovascular repair of abdominal aortic aneurysms (AAA) with the Stentor and Vanguard stent‐grafts. Material and Methods: Twenty‐three patients (20 men, 3 women; mean age 68 years, range 53–81 years) were included in this prospective study. A first generation nitinol stent‐graft (Stentor™) was used in 12 patients and a second generation (Vanguard™) in 11 patients. Follow‐up was performed with magnetic resonance imaging (MRI) with contrast‐enhanced MR angiography (CE MRA) at 1, 6, and 12 months, and thereafter annually (median follow‐up 3 years; range 8 months to 8 years). A conventional radiograph of the abdomen was also performed. Before secondary intervention the findings on MRI with CE MRA were confirmed with spiral computed tomography (CT) and/or angiography (DSA). Results: Only one patient (4%) had no complication. Endoleak was found in 15 patients (65%), graft migration in 8 (35%), and graft deformation in 18 (78%). Secondary endovascular repair was required in 7 patients (30%) and 7 (30%) were converted to open repair. Conclusion: Complications with the Stentor and Vanguard stent‐grafts were common. Long‐term follow‐up of endovascularly repaired AAA is mandatory.
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| 43. |
- Engellau, Lena, et al.
(författare)
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Magnetic resonance imaging and MR angiography of endoluminally treated abdominal aortic aneurysms
- 1998
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Ingår i: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 15:3, s. 212-219
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate magnetic resonance imaging (MRI) with gadolinium-based contrast medium-enhanced MR angiography (MRA) for the follow-up of endoluminally treated abdominal aortic aneurysms. DESIGN: MRI/MRA, angiography and computed tomography (CT) were performed 1 month after endoluminal stent-graft placement. MRI/MRA was repeated at 6 and 12 months and angiography and CT were added to confirm unexpected findings. MATERIALS: Fifteen male patients with endoluminally treated abdominal aortic aneurysms. METHODS: MRI with MRA, spiral CT with transverse images and angiography were performed. RESULTS: MRI/MRA demonstrated changes of stent-graft morphology, aortic neck- and aneurysmal diameter, stent-graft blood flow, stent-graft leakage, blood flow in lumbar arteries, intra-aneurysmal thrombus, periaortic inflammation and vertebral body infarction. For most of these features MRI/MRA provided more information than angiography and/or CT. MRI was the only method demonstrating thrombus reorganisation and vertebral body infarction. CONCLUSIONS: MRI with MRA provides the relevant information needed for follow-up of endoluminally treated abdominal aortic aneurysms (AAA). This may be the method of choice because of its use of contrast media with very low nephrotoxicity, lack of ionising radiation and non-invasiveness.
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| 44. |
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| 45. |
- Engellau, Lena, et al.
(författare)
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MR evaluation ex vivo and in vivo of a covered stent-graft for abdominal aortic aneurysms: ferromagnetism, heating, artifacts, and velocity mapping
- 2000
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Ingår i: Journal of Magnetic Resonance Imaging. - 1522-2586. ; 12:1, s. 112-121
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Tidskriftsartikel (refereegranskat)abstract
- Magnetic resonance imaging (MRI) safety was evaluated at 1.5 T in a covered nickel titanium stent-graft (Vanguard) used for endovascular treatment of abdominal aortic aneurysms (AAAs). Imaging artifacts were assessed on MRI with contrast-enhanced (CE) three-dimensional (3D) MR angiography (MRA) and spiral computed tomography (CT) in 10 patients as well as ex vivo. Velocity mapping was performed in the suprarenal aorta and femoral arteries in 14 patients before and after stent-graft placement. For comparison it was also performed in six healthy volunteers. No ferromagnetism or heating was detected. Metal artifacts caused minimal image distortion on MRI/MRA. The artifacts disturbed image evaluation on CT at the graft bifurcation and graft limb junction. No significant differences in mean flow were found in patients before and after stent-graft placement. Our study indicates that MRI at 1.5 T may be performed safely in patients with the (Vanguard) stent-graft. MRI/MRA provides diagnostic image information. Velocity mapping is not included in our routine protocol.
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| 46. |
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| 47. |
- Fall, Andreas, 1981-
(författare)
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Colloidal interactions and orientation of nanocellulose particles
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Nanoparticles are very interesting building blocks. Their large surface-to-bulk ratio gives them different properties from those of larger particles. Controlling their assembly can greatly affect macroscopic material properties. This often happens in nature, resulting in macroscopic materials with properties far better than those of similar human-made materials. However, in this fast-growing research field, we may soon compete with nature in certain areas. This thesis demonstrates that the distribution and orientation of nanocellulose particles can be controlled, which is crucial for many applications.Nanocellulose is an interesting nanoparticle, for example, because of its high strength, low thermal expansion, and high crystallinity. Nanocellulose particles are called nanofibrillated cellulose (NFC) or cellulose nanocrystals (CNCs). NFC is obtained from wood by mechanically shearing apart fibrils from the fiber wall and to obtain CNCs, parts of the cellulose are broken down by hydrolytic acidic reactions, most commonly, prior to homogenization. NFC particles are longer and less crystalline than are CNCs, but both are similar in width. The particles attract each other in aqueous dispersions and have a high aspect ratio and, thus, a large tendency to aggregate. The rate at which this occurs is typically reduced by charging the particles, generating an electrostatic repulsion between them.To fully utilize the many interesting properties of nanocellulose, the aggregation and orientation of the particles have to be controlled; examining this delicate task is the objective of this thesis. The limits for particle stability and aggregation are examined in papers 2–3 (as well as in this thesis) and orientation of the particles is investigated in papers 3–5. In addition, the liberation of the nanoparticles from different types of wood fibers is studied in papers 1 and 2.It was found that the liberation yield improved with increased fiber charge. In addition, the charge of the fibrils is higher than the charge of the original fibers, indicating that the fibrils were liberated from highly charged parts of the fibers and that the low-charge fraction was removed during processing.Aggregation was both theoretically predicted and experimentally studied. A theoretical model was formulated based on Derjaguin–Landau–Verwey–Overbeek theory, which is intended to predict the influence of salt, pH, and particle charge on the colloidal stability of the NFC. To predict the experimental trends, specific interactions between salt counterions and the particles charges had to be included in the model, which greatly increased the effect of salt on the NFC stability. Below the particle overlap concentration, instability induced by pH or salt created small sedimenting flocs, whereas above the overlap concentration the system gelled. Increasing the particle concentration further also gels the system.Orientation of nanocellulose was first achieved by shearing, salt- or acid-induced NFC gels. This oriented the fibrils and increased the gel modulus in the direction of shear. The orientation persisted after the shear strain was released and did not cause breakdown of the macroscopic gel. The orientation is probably due to rotation in the interfibril crosslinks, which is possible because the crosslinks are physical, not covalent. Second, orientation was also induced by elongational flow. Shear and acceleration forces were combined to align fibrils in the direction of the flow. The orientation was then frozen by gelation (adding salt or reducing the pH). Drying the gel threads created filaments of aligned fibrils with a higher specific strength than that of steel. Finally, CNC particles could be aligned on flat surfaces. The particles were first forced to align due to geometrical constraints in grooves on a nanowrinkled surface. The CNCs were then transferred to a flat surface using a contact-printing process. This created surfaces with lines of highly aligned CNCs, where the line–line spacing was controlled with nanometer precision.
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| 48. |
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| 49. |
- Franco, Irene, et al.
(författare)
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Whole genome DNA sequencing provides an atlas of somatic mutagenesis in healthy human cells and identifies a tumor-prone cell type
- 2019
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Ingår i: Genome Biology. - : Springer Science and Business Media LLC. - 1465-6906 .- 1474-760X. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The lifelong accumulation of somatic mutations underlies age-related phenotypes and cancer. Mutagenic forces are thought to shape the genome of aging cells in a tissue-specific way. Whole genome analyses of somatic mutation patterns, based on both types and genomic distribution of variants, can shed light on specific processes active in different human tissues and their effect on the transition to cancer. Results: To analyze somatic mutation patterns, we compile a comprehensive genetic atlas of somatic mutations in healthy human cells. High-confidence variants are obtained from newly generated and publicly available whole genome DNA sequencing data from single non-cancer cells, clonally expanded in vitro. To enable a well-controlled comparison of different cell types, we obtain single genome data (92% mean coverage) from multi-organ biopsies from the same donors. These data show multiple cell types that are protected from mutagens and display a stereotyped mutation profile, despite their origin from different tissues. Conversely, the same tissue harbors cells with distinct mutation profiles associated to different differentiation states. Analyses of mutation rate in the coding and non-coding portions of the genome identify a cell type bearing a unique mutation pattern characterized by mutation enrichment in active chromatin, regulatory, and transcribed regions. Conclusions: Our analysis of normal cells from healthy donors identifies a somatic mutation landscape that enhances the risk of tumor transformation in a specific cell population from the kidney proximal tubule. This unique pattern is characterized by high rate of mutation accumulation during adult life and specific targeting of expressed genes and regulatory regions.
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| 50. |
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