| 1. |
- Lindblom, Rickard P F, et al.
(författare)
-
Even small aneurysms can bleed : a ruptured small idiopathic aneurysm of the internal thoracic artery
- 2013
-
Ingår i: Interactive Cardiovascular and Thoracic Surgery. - : Oxford University Press (OUP). - 1569-9293 .- 1569-9285. ; 17:3, s. 583-585
-
Tidskriftsartikel (refereegranskat)abstract
- Internal thoracic artery (ITA) aneurysms are rare, but a rupture is potentially fatal. Most cases of ITA aneurysms are iatrogenic, caused by, for instance, previous sternotomy or pacemaker implantation. Other known aetiologies are vasculopathies, either of inflammatory origin or as part of connective tissue disorders like Marfan's syndrome, Ehler-Dahnlos syndrome or neurofibromatosis Type 1. Idiopathic ITA aneurysms are exceedingly scarce. The present case illustrates an unusual scenario, which posed diagnostic challenges, where spontaneous rupture of an idiopathic or possibly very late post-traumatic aneurysm of the left ITA led to a life-threatening bleeding, successfully treated by endovascular coiling with standby preparation for conversion to open surgery. This case demonstrates the importance of the careful interpretation of radiological findings and the significance of multidisciplinary collaboration between radiologist and clinician.
|
|
| 2. |
- Sennefelt Nyman, Sofi, et al.
(författare)
-
Study protocol for locoregional precision treatment of hepatocellular carcinoma with transarterial chemoembolisation (TACTida), a clinical study : idarubicin dose selection, tissue response and survival
- 2022
-
Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:11
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Hepatocellular carcinoma (HCC) is a common cause of cancer-related death, often detected in the intermediate stage. The standard of care for intermediate-stage HCC is transarterial chemoembolisation (TACE), where idarubicin (IDA) is a promising drug. Despite the fact that TACE has been used for several decades, treatment success is unpredictable. This clinical trial has been designed believing that further improvement might be achieved by increasing the understanding of interactions between local pharmacology, tumour targeting, HCC pathophysiology, metabolomics and molecular mechanisms of drug resistance.METHODS AND ANALYSIS: The study population of this single-centre clinical trial consists of adults with intermediate-stage HCC. Each tumour site will receive TACE with two different IDA doses, 10 and 15 mg, on separate occasions. Before and after each patient's first TACE blood samples, tissue and liquid biopsies, and positron emission tomography (PET)/MRI will be performed. Blood samples will be used for pharmacokinetics (PK) and liver function evaluation. Tissue biopsies will be used for histopathology analyses, and culturing of primary organoids of tumour and non-tumour tissue to measure cell viability, drug response, multiomics and gene expression. Multiomics analyses will also be performed on liquid biopsies. PET/MRI will be used to evaluate tumour viability and liver metabolism. The two doses of IDA will be compared regarding PK, antitumour effects and safety. Imaging, molecular biology and multiomics data will be used to identify HCC phenotypes and their relation to drug uptake and metabolism, treatment response and survival.ETHICS AND DISSEMINATION: Participants give informed consent. Personal data are deidentified. A patient will be withdrawn from the study if considered medically necessary, or if it is the wish of the patient. The study has been approved by the Swedish Ethical Review Authority (Dnr. 2021-01928) and by the Medical Product Agency, Uppsala, Sweden.TRIAL REGISTRATION NUMBER: EudraCT number: 2021-001257-31.
|
|
| 3. |
|
|
| 4. |
- Ahlström, Håkan, et al.
(författare)
-
Magnetic resonance imaging of sacroiliac joint inflammation
- 1990
-
Ingår i: Arthritis and Rheumatism. - 0004-3591 .- 1529-0131. ; 33:12, s. 1763-1769
-
Tidskriftsartikel (refereegranskat)abstract
- A consecutive series of 27 patients with symptoms compatible with sacroiliitis underwent magnetic resonance imaging (MRI) of the sacroiliac joints. The diagnostic sensitivity of MRI was similar to that of computed tomography or conventional radiography. However, MRI seems to have the potential of providing unique information about the disease process in sacroiliitis by demonstrating abnormalities in subchondral bone and periarticular bone marrow. The results of this study suggest that early inflammatory changes in sacroiliitis occur in the subchondral structures of the sacroiliac joints.
|
|
| 5. |
- Baranto, Adad, 1966, et al.
(författare)
-
Back pain and degenerative abnormalities in the spine of young elite divers: a 5-year follow-up magnetic resonance imaging study
- 2006
-
Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:9, s. 907-14
-
Tidskriftsartikel (refereegranskat)abstract
- Several studies have been published on disc degeneration among young athletes in sports with great demands on the back, but few on competitive divers; however, there are no long-term follow-up studies. Twenty elite divers between 10 and 21 years of age, with the highest possible national ranking, were selected at random without knowledge of previous or present back injuries or symptoms for an MRI study of the thoraco-lumbar spine in a 5-year longitudinal study. The occurrence of MRI abnormalities and their correlation with back pain were evaluated. Eighty-nine percent of the divers had a history of back pain and the median age at the first episode of back pain was 15 years. Sixty-five percent of the divers had MRI abnormalities in the thoraco-lumbar spine already at baseline. Only one diver without abnormalities at baseline had developed abnormalities at follow-up. Deterioration of any type of abnormality was found in 9 of 17 (53%) divers. Including all disc levels in all divers, the total number of abnormalities increased by 29% at follow-up, as compared to baseline. The most common abnormalities were reduced disc signal, Schmorl's nodes, and disc height reduction. Since almost all divers had previous or present back pain, a differentiated analysis of the relationship between pain and MRI findings was not possible. However, the high frequency of both back pain and MRI changes suggests a causal relationship. In conclusion, elite divers had high frequency of back pain at young ages and they run a high risk of developing degenerative abnormalities of the thoraco-lumbar spine, probably due to injuries to the spine during the growth spurt.
|
|
| 6. |
- Baranto, Adad, 1966, et al.
(författare)
-
Back pain and MRI changes in the thoraco-lumbar spine of top athletes in four different sports: a 15-year follow-up study
- 2009
-
Ingår i: Knee surgery, Sports traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 17:9, s. 1125-1134
-
Tidskriftsartikel (refereegranskat)abstract
- A total 71 male athletes (weight lifters, wrestlers, orienteers, and ice-hockey players) and 21 non-athletes were randomly selected, for a baseline MRI study. After 15 years all the participants at baseline were invited to take part in a follow-up examination, including a questionnaire on back pain and a follow-up MRI examination. Thirty-two athletes and all non-athletes had disc height reduction at one or several disc levels. Disc degeneration was found in more than 90% of the athletes and deterioration had occurred in 88% of the athletes, with the highest frequency in weight lifters and ice-hockey players. 78% of the athletes and 38% of the non-athletes reported previous or present history of back pain at baseline and 71 and 75%, respectively at follow-up. There was no statistically significant correlation between back pain and MRI changes. In conclusion, athletes in sports with severe or moderate demands on the back run a high risk of developing disc degeneration and other abnormalities of the spine on MRI and they report high frequency of back pain. The study confirmed our hypothesis, i.e. that most of the spinal abnormalities in athletes seem to occur during the growth spurt, since the majority of the abnormalities demonstrated at follow-up MRI after the sports career were present already at baseline. The abnormalities found at young age deteriorated to a varying degree during the 15-year follow-up, probably due to a combination of continued high load sporting activities and normal ageing. Preventive measures should be considered to avoid the development of these injuries in young athletes.
|
|
| 7. |
|
|
| 8. |
- Bergqvist, David, et al.
(författare)
-
Secondary aortoenteric fistula after endovascular aortic interventions : a systematic literature review
- 2008
-
Ingår i: Journal of Vascular and Interventional Radiology. - : Elsevier BV. - 1051-0443 .- 1535-7732. ; 19:2, s. 163-165
-
Forskningsöversikt (refereegranskat)abstract
- PURPOSE: To evaluate the collective incidence of, and experience with, aortoenteric fistula after endovascular aortoiliac therapy. MATERIALS AND METHODS: A systematic literature research was performed to identify cases of aortoenteric fistulation after aortic stent-graft procedures or stent implantation. RESULTS: The review revealed 16 cases of aortoenteric fistulation after aortic stent-grafting (n = 15) or stent placement (n = 1), in 14 patients with abdominal aortic aneurysm. Six had undergone endovascular aneurysm repair because of what was considered a "hostile abdomen." The symptoms did not differ from those in patients with arterioenteric fistulation after open aortic repair. A defect in the stent-graft or its function was the predominant cause of fistulation. One fistula was diagnosed at autopsy, two patients died perioperatively, and 13 survived with in situ repair or an axillobifemoral graft, all after removal of the stent-graft or stent. However, the follow-up time was short, longer than 1 year in only five of the 13 survivors. CONCLUSIONS: Aortoenteric fistulation does occur after endovascular implantation of stents and stent-grafts. The incidence is unknown but is probably low. Follow-up time in most publications was less than 1 year, which is considered short to assess potential graft infection.
|
|
| 9. |
- Bergqvist, David, et al.
(författare)
-
Svårkontrollerad blödning vid kirurgi - praktiska åtgärder
- 2007
-
Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 104:6, s. 407-411
-
Tidskriftsartikel (refereegranskat)abstract
- Difficult-to-control intraoperative bleeding--practical measures Bleeding with difficulties obtaining haemostasis can be a catastrophe. This paper summarizes a symposium with the above title. A short introduction gives the background of normal haemostasis as well as iatrogenic vascular injuries as reflected in the Swedish vascular registry (Swedvasc). Practical guidelines are given on how to manage situations of severe haemorrhage with the help of pharmacological substances, local haemostatics, endovascular methodology and open surgery.
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
- Björkman, Henrik, et al.
(författare)
-
Split renal function in patients with suspected renal artery stenosis : a comparison between gamma camera renography and two methods of measurements with computed tomography
- 2006
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 47:1, s. 107-113
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To validate a method for calculating split renal function from computed tomography (CT) compared with gamma camera renography, and to test a new method for the measurement based on a volume-rendering technique. MATERIAL AND METHODS: Thirty-eight patients, aged 65.7 +/- 11.6 (range 37.8-82.1) years, who had undergone both CT angiography and gamma camera renography for a suspected renal artery stenosis were included in this study. Split renal function was calculated from the CT examinations by measuring area and mean attenuation in the image slices of the kidneys, and also by measuring volume and mean attenuation from a 3D reconstruction of the kidneys. Gamma camera renography with 99mTc-MAG3 with or without captopril enhancement was used as a reference. RESULTS: The 2D CT method had good correlation with renography (r=0.93). Mean difference was 4.7 +/- 3.6 (0-12) percentage points per kidney. There was also excellent correlation between the two CT methods (r=1.00). CONCLUSION: CT is equivalent to renography in determining split renal function, and the measurement from the CT examination can be made more quickly and equally accurately with a 3D technique.
|
|
| 13. |
|
|
| 14. |
- Carlson, K, et al.
(författare)
-
MR imaging of multiple myeloma in tumour mass measurement at diagnosis and during treatment
- 1995
-
Ingår i: Acta Radiologica. - 0284-1851 .- 1600-0455. ; 36:1, s. 9-14
-
Tidskriftsartikel (refereegranskat)abstract
- The bone marrow of the spine, pelvis and proximal femora was examined with MR imaging at diagnosis in 30 cases of multiple myeloma (MM), and during treatment on 69 occasions. The MR pattern was normal, focal or diffuse and correlated to stage. A tumour mass index (TMI) was calculated by estimating the total myeloma mass visualised at MR imaging. The TMI correlated significantly with stage, lytic bone lesions, serum calcium, serum beta-2-microglobulin and survival. No abnormalities were seen at MR investigation in 4 of 6 patients classified as stage II because of osteoporosis only. Therapy efficacy evaluation with MR imaging corresponded to clinical evaluation on 54 of the 69 occasions. MR examination of bone marrow in MM patients can be used for tumour mass assessment, both at diagnosis and during follow-up. Valuable information can be obtained when the tumour mass is difficult to estimate using clinical criteria, e.g. in non-secretory MM or when osteoporosis is the only variable indicating an increase in the tumour mass.
|
|
| 15. |
- Carlsson, Rickard, et al.
(författare)
-
Neuropsychological functions predict 1-and 3-year outcome in first-episode psychosis
- 2006
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 113:2, s. 102-111
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine neuropsychological performance as a possible predictor of course and outcome in first-episode psychotic (FEP) patients. Method: A group of consecutive FEP patients (n = 120) tested with Wechsler Adult Intelligence Scales-Revised (WAIS-R) at baseline was compared with a healthy group (n = 30) matched for age, education and gender. Relationship between WAIS-R and both Brief Psychiatric Rating Scale and Global Assessment of Function (GAF) ratings were studied at baseline and at 1- and 3-year follow-ups. Results: The performance of FEP patients was significantly lower (P < 0.001) than that of healthy comparison subjects on all WAIS-R subtests except for Information and Comprehension. The WAIS-R scores of patients with schizophrenia syndromes (DSM-IV) were lower than those of patients with non-schizophrenia syndromes on Block Design. Low WAIS-R Full-Scale IQ scores in FEP patients predicted the presence of negative symptoms at 1-year follow-up and of low GAF ratings at 3-year follow-up. Conclusion: Neurocognitive performance at admission appears to predict various aspects of functional outcome in FEP.
|
|
| 16. |
- Dahlstrand, Ursula, et al.
(författare)
-
Primary patency of percutaneously inserted self-expanding metallic stents in patients with malignant biliary obstruction
- 2009
-
Ingår i: HPB : the official journal of the International Hepato Pancreato Biliary Association. - : Elsevier BV. - 1365-182X. ; 11:4, s. 358-63
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Effective bile duct drainage is crucial to the health-related quality of life of patients with jaundice caused by obstruction of the bile duct by inoperable malignant tumours. METHODS: All patients who were treated at Uppsala University Hospital, Sweden with percutaneous stenting between 2000 and 2005 were identified retrospectively. Data on the location of the obstruction and type of stent used, date and cause of death and date of stent failure were abstracted from the patients' notes. Stent patency was defined as the duration from the insertion of the stent to the date of failure. In cases in which the cause of death was directly related to failure of the stent, the date of death was defined as the patency endpoint. RESULTS: A total of 64 patients (34 women, 30 men) were identified. Their mean age was 71 years (standard deviation 11 years). The median length of patency was 11.4 months. Stent diameter >10 mm and distal stricture were found to be associated with significantly longer patency time in univariate Cox proportional hazard analysis. In multivariate Cox proportional hazard analysis, only location of the stricture was found to be independently and significantly associated with patency time. DISCUSSION: Percutaneous stenting is a good alternative for patients with obstructive jaundice and a life expectancy /=10 mm. However, patency time was found to be lower for hilar tumours.
|
|
| 17. |
|
|
| 18. |
- Ebeling Barbier, Charlotte, et al.
(författare)
-
Percutaneous Closure in Transfemoral Aortic Valve Implantation : A Single-Centre Experience
- 2015
-
Ingår i: Cardiovascular and Interventional Radiology. - : Springer Science and Business Media LLC. - 0174-1551 .- 1432-086X. ; 38:6, s. 1438-1443
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To report the experience of a percutaneous closure device used for transfemoral transcatheter aortic valve implantation (TAVI) in an unselected patient and operator population.MATERIALS AND METHODS: Eighty-two consecutive patients (32 women, 50 men) who underwent transfemoral TAVI between September 2009 and February 2014 at our hospital were retrospectively reviewed for percutaneous closure device (PCD) failure, vascular complications, and bleeding. The diameter and calcification of the common femoral artery (CFA) and the thickness of the subcutaneous fat layer in the groin were assessed on computed tomography images.RESULTS: The incidences of PCD failure and minor and major vascular complications were 19.5 % (n = 16/82), 19.5 % (n = 16/82), and 7 % (n = 6/82) respectively. 8.5 % (n = 7/82) had a minor perioperative bleeding, 6 % (n = 5/82) had a major bleeding, and none had any life-threatening bleeding. When PCD failed, haemostasis was obtained with fascia suturing, covered stent placement, or with surgical cutdown. Thirty-day mortality and 1-year all-cause mortality were 8.5 % (n = 7/82) and 19.5 % (n = 16/82), respectively. In a multiple regression analysis, the CFA diameter and the presence of severe calcification were independently related to PCD failure (correlation coefficient = -0.24, p = 0.027 and correlation coefficient = 0.23, p = 0.036, respectively).CONCLUSION: PCD failure was related to a small CFA diameter and to a severely calcified CFA. Failure could largely be managed with minimally invasive techniques such as covered stents or fascia suturing.
|
|
| 19. |
- Ebeling Barbier, Charlotte, et al.
(författare)
-
Placement of a transjugular intrahepatic portosystemic shunt in addition to recanalization of acute and chronic portomesenteric vein occlusions : a retrospective evaluation
- 2020
-
Ingår i: Acta Radiologica, Supplement. - : SAGE PUBLICATIONS LTD. - 0365-5954 .- 2058-4601. ; 9:10
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Portomesenteric vein thrombosis may be life-threatening due to bowel ischemia caused by venous stasis, or variceal bleeding caused by portal hypertension. Purpose: To evaluate the effectiveness and safety of recanalization combined with transjugular intrahepatic portosystemic shunt in acute and chronic portomesenteric vein thrombosis in patients with and without liver cirrhosis. Material and Methods: 21 consecutive patients (5 women, 16 men; mean 48 years) with portomesenteric vein thrombosis (8 acute, 13 chronic) treated at the Interventional Radiology department between March 2014 and September 2018 were retrospectively reviewed. The main portal vein was completely obliterated and the portomesenteric vein thrombosis extended into the superior mesenteric vein in all patients. The portomesenteric vein thromboses were recanalized transhepatically, a transjugular intrahepatic portosystemic shunt was inserted, thrombectomy was performed in acute portomesenteric vein thrombosis, and angioplasty with or without additional stenting was performed in chronic portomesenteric vein thrombosis. Results: Recanalization was successful in 8/8 patients (100%) with acute portomesenteric vein thrombosis, and in 11/13 patients (85%) with chronic portomesenteric vein thrombosis. In 12 patients, blood flow was restored in one session. Several sessions were more frequently needed in patients with acute portomesenteric vein thrombosis compared to those with chronic portomesenteric vein thrombosis (p = 0.003). Re-occlusion occurred and was recanalized in 10/19 patients and was more frequent in patients with chronic (n = 8/11) than on those with acute (n = 2/8) portomesenteric vein thrombosis (p = 0.04). Adverse events occurred in five patients. There was no 30-day mortality. Conclusion: Recanalization and insertion of a transjugular intrahepatic portosystemic shunt is safe and effective in patients with acute and chronic portomesenteric vein thrombosis with or without cirrhosis. Recanalization was more likely to stay patent in acute compared with chronic portomesenteric vein thrombosis.
|
|
| 20. |
|
|
| 21. |
- Ebeling Barbier, Charlotte, et al.
(författare)
-
Selective internal radiation therapy in patients with progressive neuroendocrine liver metastases
- 2016
-
Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 43:8, s. 1425-1431
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate the safety and efficacy of selective internal radiation therapy (SIRT) in patients with unresectable liver metastases from neuroendocrine tumours (NETLMs).METHODS: This retrospective study included 40 patients with progressive NETLMs (22 women, 18 men, mean age 61.6 years) who underwent SIRT with (90)Y-labelled resin microspheres. Tumour response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) on CT or MR images. Medical records were reviewed.RESULTS: In the 40 patients, 54 evaluable SIRT procedures were performed, 33 to the right liver lobe (mean activity 1.31 GBq), 13 to the left lobe (mean activity 0.85 GBq), and 8 to both lobes (mean activity 1.61 GBq). Late follow-up imaging (mean 20 months) was performed after 44 of the treatments. Objective tumour response and disease control rates were 54 % (29 of 54 treatments) and 94 % (51 treatments), respectively, at the early follow-up examination (mean 3 months) and 34 % (15 treatments) and 57 % (25 treatments), respectively at the late follow-up examination. Mean overall survival from the first SIRT was 34,8 months and survival rates at 1, 2, 3 and 5 years were 76 %, 59 %, 52 % and 35 % respectively. Adverse effects were generally mild and easily manageable, except in one patient who died from radiation-induced liver failure. Of the 45 patients, 18 (45 %) had received peptide receptor radionuclide therapy (PRRT) prior to SIRT.CONCLUSION: SIRT with (90)Y-labelled resin microspheres is a safe and effective treatment for patients with progressive NETLM, and also for those who have received prior PRRT.
|
|
| 22. |
- Eklöf, Hampus, et al.
(författare)
-
A prospective comparison of duplex ultrasonography, Captopril renography, MRA and CTA in assessing renal artery stenosis
- 2006
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 47:8, s. 764-774
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To prospectively compare the diagnostic accuracy of duplex ultrasonography, captopril renography, computed tomography angiography (CTA), and 3D Gd magnetic resonance angiography (MRA) in diagnosing hemodynamically significant renal artery stenosis (RAS). Material and Methods: The standard of reference was measurement of transstenotic pressure gradient. Fifty-eight hypertensive patients with suspicion of RAS were evaluated, when possible, by all five techniques. Sensitivity and specificity to detect RAS were compared for each technique on both a patient and kidney basis. Discrepancies were evaluated separately and classified as borderline, method dependent, or operator dependent. Results: The prevalence of RAS was 77%. The sensitivity/specificity of ultrasonography, captopril renography, CTA, and MRA in detecting kidneys with RAS was 73/71%, 52/63%, 94/62%, and 93/91%, respectively. Ultrasonography had a significantly lower sensitivity than CTA and MRA (P < 0.001) but higher than captopril renography (P = 0.013). Borderline RAS was the main cause for discrepancies. Conclusion: MRA and CTA were significantly better than duplex ultrasonography and captopril renography in detecting hemodynamically significant RAS. The ultrasonography criteria for RAS based on the evaluation of renal peak systolic velocity and renal/aortic ratio are questionable. Captopril renography cannot be recommended for assessing RAS.
|
|
| 23. |
|
|
| 24. |
- Eklöf, Hampus, 1960-
(författare)
-
On Renal Artery Stenosis
- 2005
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Renal artery stenosis (RAS) is a potentially curable cause of hypertension and azotemia. Besides intra-arterial renal angiography there are several non-invasive techniques utilized to diagnose patients with suspicion of renal artery stenosis. Removing the stenosis by revascularization to restore unobstructed blood flow to the kidney is known to improve and even cure hypertension/azotemia, but is associated with a significant complication rate. To visualize renal arteries with x-ray techniques a contrast medium must be used. In a randomized, prospective study the complications of two types of contrast media (CO2 and ioxaglate) were compared. CO2 was not associated with acute nephropathy, but induced nausea and had lower attenuation differences compared to Ioxaglate. Acute nephropathy was related to the ioxaglate dose and the risk was evident even at very low doses if the patients were azotemic with creatinine clearance <40 ml/min. Evaluating patients for clinically relevant renal artery stenosis can be done utilizing several non-invasive techniques. MRA was retrospectively evaluated and shown to be accurate in detecting hemodynamically significant RAS. In a prospective study of 58 patients, evaluated with four methods for renal artery stenosis, it was shown that MRA and CTA were significantly better than ultrasonography and captopril renography in detecting hemodynamically significant RAS. The standard of reference was trans-stenotic pressure gradient measurement, defining a stenosis as significant at a gradient of ≥15 mmHg. The discrepancies were mainly found in the presence of borderline stenosis.The outcome of percutaneous revascularization procedures showed a technical success rate of 95%, clinical benefit in 63% of treated patients, 30-day mortality 1.5% and major complication rate of 13%. The major complication rate for patients with baseline serum creatinine >300µmol/l was 32%. Our results compare favorably with published studies and guidelines.
|
|
| 25. |
- Eklöf, Hampus, et al.
(författare)
-
Outcome after endovascular revascularization of atherosclerotic renal artery stenosis
- 2009
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 50:3, s. 256-64
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: With an aging population, more patients might be treated for atherosclerotic renal artery stenosis (ARAS). The goal of this treatment is to achieve a dialysis-free life or a well-controlled blood pressure with reduced risks of cardiovascular complications. PURPOSE: To analyze the clinical outcome of percutaneous transluminal renal artery angioplasty without stenting (PTRA) or with stenting (PTRS) for ARAS at one center. MATERIAL AND METHODS: The study group comprised 152 patients who underwent 203 PTRA/PTRS. All had hypertension, and 45% had azotemia. A retrospective collection of baseline and postprocedural number of antihypertensive drugs, blood pressure, and serum creatinine were analyzed during a follow-up of 3-18 months. RESULTS: Technical success rate was 95%, and clinical benefit was seen in 63% of patients. Complications included a 30-day mortality rate of 1.5%, a total complication rate of 35%, and major adverse events in 13%. The major adverse events were highly related to azotemia. Major adverse events within 30 days, with permanent disability, were seen in 5% and almost exclusively in patients with moderate or severe renal impairment. A subgroup analysis of 28 patients with renal duplex resistive index (RI) pre-PTRA/S and 6 months' follow-up showed a benefit of PTRA/PTRS in 17 (68%) of the 25 patients with RI <80 and in all three (100%) of the patients with RI >or=80. CONCLUSION: Endovascular treatment of ARAS has an excellent technical success rate, with a clinical improvement rate of >60%. However, it is associated with a considerable complication rate. Serious complications are seen mainly in azotemic patients. Predictors of clinical response could not be identified. Renal duplex RI is questioned as a predictor of clinical outcome.
|
|
| 26. |
- Eklöf, Hampus, et al.
(författare)
-
Renal artery stenosis evaluated with magnetic resonance angiography using intraarterial pressure gradient as the standard of reference : A multireader study
- 2005
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 46:8, s. 802-809
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate 3D-Gd-magnetic resonance angiography (MRA) in detecting hemodynamically significant renal artery stenosis (RAS). MATERIAL AND METHODS: Thirty patients evaluated for atherosclerotic RAS by MRA and digital subtraction angiography (DSA) were retrospectively included. Standard of reference for hemodynamically significant RAS was a transstenotic gradient of 15 mmHg. DSA visualized 60 main renal arteries and 9 accessory arteries. Pressure gradient measurement (PGM) was available from 61 arteries. Three radiologists evaluated all examinations independently in a blinded fashion. RESULTS: RAS was present in 26 arteries. On MRA, each reader identified 4 of 9 accessory renal arteries, a detection rate of 44%. The three readers correctly classified 22/25/22 of the 26 vessels with a significant gradient as > or =60% RAS and 31/25/32 of the 35 with no significant gradient as < 60% RAS on MRA. Interobserver agreement was substantial. MRA image quality was adequate for RAS evaluations in all patients. ROC curves indicated that MRA is an adequate method for evaluating RAS. When screening for RAS, a 50% diameter reduction cut-off is better than 60%. RAS with 40-80% diameter reductions accounted for 65% of discrepancies. CONCLUSION: MRA is an adequate method for evaluating RAS limited mainly by poor detection rate for accessory renal arteries.
|
|
| 27. |
- Eriksson, Lars-Gunnar, et al.
(författare)
-
Endoscopic marking with metallic clip facilitates transcatheter arterial embolization in upper peptic ulcer bleeding.
- 2006
-
Ingår i: Journal of Vascular and Interventional Radiology. - 1051-0443 .- 1535-7732. ; 17:6, s. 959-964
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To enable accurate transcatheter arterial embolization (TAE) of the target vessel, a new technique to localize the exact position of a bleeding ulcer was tested that involves endoscopic marking of the ulcer with a metallic clip. MATERIALS AND METHODS: In 13 patients (mean age, 75 years) with acute bleeding ulcers (11 duodenal ulcers, two malignant ulcers), a metallic clip was placed at gastroscopy followed or preceded by routine endoscopic treatment. The metallic clip was placed in the fibrous edge of the ulcer adjacent to the bleeding point. In 10 patients, TAE was indicated as a result of continued or recurrent bleeding. The artery was embolized with microcoils as close as possible to the clip. In three patients, there was no indication for TAE, so plain abdominal radiography was performed to determine whether the marking clip was still in place. RESULTS: In 11 patients, the clip was still in place on radiography; in two, it had disappeared. Hemostasis was achieved in eight of 10 patients after TAE. In six patients, the clip was essential to identify the bleeding vessel. CONCLUSION: Marking of the bleeding ulcer with a clip before TAE enhances the possibility that the correct vessel is embolized. This will most likely minimize the risk of recurrent bleeding after embolization, especially in patients who do not show contrast medium extravasation.
|
|
| 28. |
- Eriksson, Lars-Gunnar, et al.
(författare)
-
Massive Postpartum Hemorrhage Treated with Transcatheter Arterial Embolization : Technical aspects and long-term effects on fertility and menstrual cycle
- 2007
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 48:6, s. 635-642
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Transcatheter arterial embolization (TAE) is considered a safe, life-saving procedure in postpartum hemorrhage (PPH), but its long-term effect on menstruation and fertility is unclear. Purpose: To investigate technical aspects and the evaluation of complications, focused on menstrual cycle and fertility, using TAE in patients with PPH. Material and Methods: A retrospective study including 20 patients (seven with vaginal and 13 with cesarean delivery) with severe PPH treated with bilateral TAE of the uterine artery was carried out. All patients were asked to answer a questionnaire regarding their post-embolization history. In six patients, the radiation dose was measured. Results: All 20 cases underwent bilateral TAE of the uterine artery. Gelfoam was used as the embolic agent. However, after cesarean delivery in six patients who had clear contrast medium extravasation and/or pseudoaneurysm-like lesion, metallic coils had to be used in order to achieve hemostasis. No major short- or long-term complications were registered. Normal menses resumed in all patients. Four patients had a total of five full-term and two preterm pregnancies, and all delivered healthy infants by cesarean section with no recurrence of PPH. The mean radiation dose to the ovaries was 586 mGy (range 204-729 mGy). Conclusion: TAE in patients with PPH is safe and has no major short- or long-term side effects. A patient managed with TAE can expect return of normal menses and preservation of future fertility and successful pregnancies. PPH after cesarean section might need to be embolized with metallic coils in addition to Gelfoam in order to achieve secure hemostasis.
|
|
| 29. |
- Eriksson, Lars-Gunnar, 1956-
(författare)
-
Transcatheter Arterial Embolization in the Management of Life Threatening Bleeding Applied in Upper Gastrointestinal and Post Partum Bleedings.
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Transcatheter Arterial Embolization (TAE) is a method in which a catheter is inserted into an artery under fluoroscopy guidance. By using material that creates a thrombus, inserted through the catheter, the artery can be occluded and the bleeding stopped.Endoscopy is the treatment of choice in upper gastrointestinal (GI) bleeding, but 10% to 30% of patients rebleed and needs other treatment options. Post Partum Hemorrhage (PPH) may evolve rapidly and can become life threatening. Obstetrical treatment will manage most cases, but in some cases emergency surgery is needed and in the worst case hysterectomy.The primary aim of this thesis was to evaluate the clinical usefulness, improve the TAE technique and compare the outcome of TAE with surgery used as “salvage therapy” in patients with upper GI bleeding. Evaluate TAE technique and the long-term effect on the menstrual cycle and fertility in severe PPH.To evaluate the clinical usefulness 13 patients were treated with TAE after endoscopic treatment failure and 5 were treated for recurrent hemorrhage after emergency surgery. The clinical outcome and mortality rate of 40 patients treated with TAE was compared with 51 patients treated with surgery of upper GI bleedings. In 13 patients the ulcer was marked with placement of a metallic clip at endoscopy to be able to locate the exact site of the bleeding ulcer during the TAE procedure.A retrospective study of 20 patients with severe PPH treated with bilateral TAE of the uterine artery was performed. TAE was found to be effective and an alternative to emergency surgery for control of massive upper GI bleeding. The 30-day mortality was lower in the TAE group (3%) compared to the surgical group (14%). By marking the bleeding ulcer at endoscopy using a metallic clip the site of bleeding could be identified on angiography without extravasation of contrast media.No major impact on fertility or menstruation cycle was found in patients treated with TAE in PPH. TAE in PPH is safe and have no major long-term side effect. By using TAE in PPH hysterectomy can be avoided.
|
|
| 30. |
- Eriksson, Lars-Gunnar, 1956-, et al.
(författare)
-
Transcatheter arterial embolization versus surgery in the treatment of upper gastrointestinal bleeding after therapeutic endoscopy failure
- 2008
-
Ingår i: Journal of Vascular and Interventional Radiology. - : Elsevier BV. - 1051-0443 .- 1535-7732. ; 19:10, s. 1413-8
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To retrospectively compare the outcome of transcatheter arterial embolization (TAE) and surgery as salvage therapy of upper gastrointestinal bleeding after failed endoscopic treatment. MATERIALS AND METHODS: From January 1998 to December 2005, 658 patients were referred to diagnostic/therapeutic emergency endoscopy and diagnosed with upper gastrointestinal bleeding. Ninety-one of these 658 patients (14%) had repeat bleeding or continued to bleed. Forty of those 91 patients were treated with TAE and 51 were treated with surgery. From the medical records, the following variables were recorded: demographic data, endoscopic diagnoses, comorbidities, lowest hemoglobin levels, total transfusion requirements, lengths of hospitalization stays, postprocedure complications, and mortality rates. The relative survival rate was calculated, and survival probability was calculated with the Kaplan-Meier technique. RESULTS: Patients treated with TAE were older (mean age, 76 years; age range, 40-94 years) and had slightly more comorbidities compared to patients who underwent surgery (mean age, 71 years; age range, 45-89 years). The 30-day mortality rate in patients treated with TAE was one of 40 (3%) compared to seven of 51 (14%) in patients treated with surgery (P < .07). Most repeat bleeding could be effectively treated with TAE, both in the surgical and TAE groups. CONCLUSIONS: The results of this study suggest that, after failure of therapeutic endoscopy for upper gastrointestinal bleeding, TAE should be the treatment of choice before surgery and that TAE can also be used to effectively control bleeding after failed surgery or TAE. There was a clear trend to lower 30-day mortality with use of TAE instead of surgery.
|
|
| 31. |
|
|
| 32. |
- Eriksson, Mats-Ola
(författare)
-
Aspects on Imaging and Endovascular Treatment of Aortic Dissection and Aneurysm
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aortic aneurysm and dissections are potentially life threatening conditions. The advent of endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) has reduced perioperative mortality and morbidity and are now established therapy methods for treatment of aortic disease. Adequate pre- and intraoperative imaging is important for optimal results in endovascular procedures. However, the standard use of CT and angiography may not always be sufficient to provide necessary information required for treatment, and complementary techniques are warranted in selected cases.TEVAR in acute complicated type B aortic dissections is proven effective in several reports, but long-term clinical outcome and aortic remodelling are still not fully evaluated.Intravascular phased array imaging (IPAI) was used in patients undergoing EVAR and TEVAR for aortic aneurysm and dissection. The combined information from IPAI and fluoroscopy allowed exact positioning of the stent graft. The colour Doppler function facilitated detection of blood-flow in relevant arteries during and after the procedures, and it also facilitated control of ceased flow in excluded false lumens or aneurysms.Clinical early and long-term results after TEVAR for acute complicated type B aortic dissection were investigated in all patients treated between 1999 and 2009 at UppsalaUniversityHospital. Results were favourable regarding survival and permanent neurological complications. Long-term follow-up of aortic morphological changes in the same patient group showed overall significant reduction of aortic and false lumen diameters, and an increase of true lumen diameter. Total thrombosis of the false lumen occured more often in patients with DeBakey IIIa aortic dissection, than in IIIb.In conclusion, IPAI may be a complementary tool to traditional imaging modalities in EVAR and TEVAR in selected cases. Long-term clinical outcome is excellent with favourable aortic remodeling after TEVAR in patients with acute complicated type B aortic dissection.
|
|
| 33. |
- Eriksson, Mats-Ola, et al.
(författare)
-
Intravascular Ultrasound with a Vector Phased-Array Probe (AcuNav) Is Feasible in Endovascular Abdominal Aortic Aneurysm Repair
- 2009
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 50:8, s. 870-875
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The ideal imaging method for endovascular aneurysm repair (EVAR) should provide all data regarding diagnosis, measurements, and guiding of stent-graft deployment. Contrast-enhanced computed tomography (CT) is used for preoperative EVAR planning, together with intraoperative angiography. However, the administered contrast volume might result in contrast-induced nephropathy (CIN). Purpose: To develop a technique for aortic measurements, vessel wall evaluation, and stent-graft positioning by using a vector phased-array intravascular ultrasound probe with color Doppler function (AcuNav) in elective EVAR. Material and Methods: Thirteen elective EVAR patients were included. AcuNav was compared to pre- and postoperative CT examinations, perioperative angiography, and postoperative duplex. Results: Measurements for stent-graft sizing were easily obtained and facilitated by the color Doppler function and corresponded well with CT and angiography. The combined information from AcuNav and fluoroscopy provided exact positioning of the stent graft. An aortic placement of the probe provided superior imaging results compared to an inferior vena cava approach. Detection of endoleak was found to be difficult. No complications were registered. Conclusion: The use of AcuNav combined with fluoroscopy in EVAR was found to be safe, effective, and feasible in planning and guiding EVAR procedures. Best results were seen with the probe placed in the artery. AcuNav might be used to replace contrast-enhanced CT and angiography, hence reducing the risk of CIN, especially in high-risk patients.
|
|
| 34. |
- Eriksson, Mats-Ola, et al.
(författare)
-
Morphologic Outcome after Endovascular Treatment of Complicated Type B Aortic Dissection
- 2013
-
Ingår i: Journal of Vascular and Interventional Radiology. - : Elsevier BV. - 1051-0443 .- 1535-7732. ; 24:12, s. 1826-1833
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:To investigate the long-term morphologic changes of the aorta after thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection and to analyze whether these changes differed between DeBakey class IIIa and IIIb dissections.MATERIALS AND METHODS:During the period 1999-2009, 58 patients with acute complicated type B aortic dissection were treated with TEVAR. Seven patients lacked follow-up data, leaving 51 patients-17 patients with DeBakey IIIa aortic dissection and 34 patients with DeBakey IIIa aortic dissection IIIb-for inclusion in the study. Computed tomography scans performed before and after TEVAR were evaluated. Maximum thoracic and abdominal aortic diameters and diameters of the true lumen and false lumen at the level of the maximum aortic diameter in the thorax and abdomen were analyzed as well as degree of thrombosis of the false lumen.RESULTS:There was an overall significant reduction of the thoracic aortic diameter, increased true lumen diameter, and reduced false lumen diameter (P < .05). Total thrombosis of the false lumen, with or without reintervention, was seen in 53% of all patients, in 41% primarily and in 12% after reintervention. The IIIa group had a higher degree of total false lumen thrombosis. All patients in the IIIb group had total thrombosis of the false lumen along the stent graft.CONCLUSIONS:Long-term follow-up showed favorable aortic remodeling after TEVAR for acute complicated type B aortic dissection. Total thrombosis of the false lumen occurred more often in patients with DeBakey IIIa aortic dissection compared with patients with DeBakey IIIb aortic dissection.
|
|
| 35. |
|
|
| 36. |
- Eriksson, Mats-Ola, et al.
(författare)
-
The value of intravascular phased-array imaging in endovascular treatment of thoracic aortic pathology
- 2011
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 52:3, s. 285-290
-
Tidskriftsartikel (refereegranskat)abstract
- Background Careful pre-, intra- and postoperative diagnostics in endovascular treatment of thoracic aortic pathology is crucial for a favourable outcome. Computer tomography (CT) and digitally subtracted angiography (DSA) do not always provide sufficient diagnostic information. Purpose To report our primary experiences of using intraluminal phased-array imaging (IPAI) as an additive tool for diagnostics and endovascular treatment of thoracic aortic pathology. Material and Methods Eleven patients, nine men and two women (mean age 60, range 45) were examined intraoperatively with IPAI in stentgraft procedures of thoracic aortic pathology. Results IPAI could detect and visualize the entries and re-entries in the intima. Aortic branch vessels could be visualized for patency both during and immediately after stentgraft deployment. It was also possible to detect ceased blood flow in the false lumen or aneurysmal sac after stentgraft deployment. Conclusion IPAI is a helpful tool for diagnostics and for guiding stentgraft placing in the treatment of thoracic aortic pathology.
|
|
| 37. |
- Fahlström, Markus, et al.
(författare)
-
Aortastentgraft ingen kontraindikation för undersökning med MR : Men undersökningskvaliteten kan påverkas, visar litteraturstudie
- 2014
-
Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 111:27-28, s. 1184-1187
-
Tidskriftsartikel (refereegranskat)abstract
- Endovascular implantation of stent grafts is currently considered the preferred treatment for many aortic pathologies. In Sweden, approximately 900 patients are treated with an aortic stent graft. Stent grafts consists of a metal stent which is manufactured in stainless steel or nitinol covered by a prosthetic graft material. The possibility to perform successful magnetic resonance imaging (MRI) of a patient depends on the metal composition of and the localisation of the stent graft. This article presents the most common types of stent grafts and how they affect patients’ possibility to undergo an MRI examination successfully.
|
|
| 38. |
- Granberg, Dan, et al.
(författare)
-
Liver embolization with trisacryl gelatin microspheres (embosphere) in patients with neuroendocrine tumors
- 2007
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 48:2, s. 180-185
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To report our experience of liver embolization with trisacryl gelatin microspheres (Embospheretrade mark) in patients with metastatic neuroendocrine tumors. MATERIAL AND METHODS: Fifteen patients underwent selective embolization of the right or left hepatic artery with Embosphere. One lobe was embolized in seven patients and both lobes, on separate occasions, in eight patients. Seven patients had midgut carcinoids, two had lung carcinoids, one suffered from a thymic carcinoid, and five had endocrine pancreatic tumors. Eight patients suffered from endocrine symptoms, seven of whom had carcinoid syndrome and one WDHA (watery diarrhea, hypokalemia, achlorhydria) syndrome. RESULTS: Partial radiological response was seen after eight embolizations (in six different patients), stable disease was observed after 13 embolizations (after three of these, necroses occurred), while radiological progression was noted after only two embolizations. Only two patients experienced a biochemical response. Clinical improvement of carcinoid syndrome was observed after five embolizations. There were no major complications. Fever >38 degrees C was seen after all but four embolizations, and urinary tract infections were diagnosed after eight embolizations. CONCLUSION: Selective hepatic artery embolization with Embosphere particles is a safe treatment for patients with metastatic neuroendocrine tumors and may lead to partial radiological response as well as symptomatic improvement of disabling endocrine symptoms.
|
|
| 39. |
|
|
| 40. |
- Haller, Olle, et al.
(författare)
-
Can low-dose abdominal CT replace abdominal plain film in evaluation of acute abdominal pain?
- 2010
-
Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 115:2, s. 113-120
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Non-contrast computed tomography (NCT) has become an important diagnostic tool in acute abdominal pain, but the drawback is the increased radiation dose compared to abdominal plain film (APF). PURPOSE: To evaluate whether NCT, including low-dose computed tomography (LDCT, using 50 mAs), provides more diagnostic information than APF in patients presenting with acute non-traumatic abdominal pain and if the use of CT can reduce the total number of additional radiograms. A second aim was to compare the diagnostic outcome between standard-dose computed tomography (SDCT) and LDCT. MATERIAL AND METHODS: During 2000, 2002, and 2004 a total of 222 patients were retrospectively reviewed, and 86 patients had APF, 60 had SDCT, and 76 had LDCT. The radiological report of each patient was compared with the final diagnosis obtained from the medical record within 30 days. Additional radiograms were registered, and a total radiation dose excluding or including APF or NCT was calculated. RESULTS: NCT gave a correct diagnosis in 50%, compared to 20% with APF (P < 0.001). The total number of additional radiograms was substantially lower in the computed tomography (CT) group compared to the APF group (P < 0.001), and the average sum of radiation dose was similar for APF and LDCT. CONCLUSION: NCT was found to be significantly better at providing diagnostic information than APF in patients presenting with acute abdominal pain. It reduced the number of additional radiograms, but the total patient dose remained somewhat higher in the CT group even when using LDCT with 50 mAs.
|
|
| 41. |
- Immerstrand, Tina, et al.
(författare)
-
Effects of oat bran, processed to different molecular weights of beta-glucan, on plasma lipids and caecal formation of SCFA in mice.
- 2010
-
Ingår i: British Journal of Nutrition. - 1475-2662. ; 104:3, s. 364-373
-
Tidskriftsartikel (refereegranskat)abstract
- In the present study, we evaluated the cholesterol-lowering effects of different oat bran (OB) preparations, differing regarding their peak molecular weight (MWp) of beta-glucans (2348, 1311, 241, 56, 21 or < 10 kDa), in C57BL/6NCrl mice. The diets were designed to be atherogenic (0.8 % cholesterol and 0.1 % cholic acid), and they reflected the Western diet pattern (41 % energy fat). All OB preparations that were investigated significantly reduced plasma cholesterol when compared with a cellulose-containing control diet, regardless of the molecular weight of beta-glucan. Moreover, the difference in viscous properties between the processed OB (from 0.11 to 17.7 l/g) did not appear to play a major role in the cholesterol-lowering properties. In addition, there was no correlation between the molecular weight of beta-glucan and the amount of propionic acid formed in caecum. Interestingly, however, there was a significant correlation between the ratio of (propionic acid+butyric acid)/acetic acid and the MWp of beta-glucans: the ratio increased with increasing molecular weight. The results of the present study suggest that the molecular weights and viscous properties of beta-glucan in oat products may not be crucial parameters for their cholesterol-lowering effects.
|
|
| 42. |
- Immerstrand, Tina, et al.
(författare)
-
Extraction of beta-Glucan from Oat Bran in Laboratory Scale
- 2009
-
Ingår i: Cereal Chemistry. - 0009-0352. ; 86:6, s. 601-608
-
Tidskriftsartikel (refereegranskat)abstract
- Effects of various enzymes and extraction conditions on yield and molecular weight of beta-glucans extracted from two batches of commercial oat bran produced in Sweden are reported. Hot-water extraction with a thermostable alpha-amylase resulted in an extraction yield of approximate to 76% of the beta-glucans, while the high peak molecular weight was maintained (1.6 x 10(6)). A subsequent protein hydrolysis significantly reduced the peak molecular weight of beta-glucans (by pancreatin to 908 x 10(3) and by papain to 56 x 10(3)). These results suggest that the protein hydrolyzing enzymes may not be pure enough for purifying beta-glucans. The isolation scheme consisted of removal of lipids with ethanol extraction, enzymatic digestion of starch with alpha-amylase, enzymatic digestion of protein using protease, centrifugation to remove insoluble material, removal of low molecular weight components using dialysis, precipitation of beta-glucans with ethanol, and air-drying.
|
|
| 43. |
- Ingason, Haukur, et al.
(författare)
-
Koncept för skydd mot brand och brandgasspridning i gruvor : Slutrapport
- 2010
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Målsättningen med projektet var att ta fram information om brandutveckling och rökspridning igruvor. Resultaten skulle användas för att ta fram rekommendationer för de deltagandegruvföretagen. Resultaten skulle också användas som underlag i framtida riskanalyser och i detsystematiska brandskyddsarbetet. Metoder och verktyg för att bestämma brandutveckling ifordon och rökspridning skulle valideras och utvärderas. Kunskapen skulle kunna användas inomgruvindustrin, men även för andra områden så som bränder i tunnlar under byggnation. Projektetska förstärka forskningsprofilen inom högskolan när det gäller brandsäkerhet iundermarksanläggningar och resultaten skall implementeras i grundutbildningen.Projektarbetet har varit delvis fokuserat mot gruvföretag och delvis mot konsultföretag somarbetar inom området. Bra samarbete och diskussioner med de företag i projektet som ansvararför gruv- eller besöksdrift har varit viktigt. Gruvföretagens behov av att få ordning på sinbrandskyddsdokumentation, förståelse för säkerhetsutrustning och insatsplanering samt sittsystematiska brandskyddsarbete, har haft stor betydelse för detaljutformningen av projektet ochpå vilket sätt det har slutligen genomförts. Samarbetet med konsultföretagen har haft en annaninriktning, där fokus istället varit erfarenhetsöverföring när det gäller scenariospel, brandtekniskdimensionering och ventilationsteknik. Deras stöd och hjälp har haft stor betydelse förgenomförandet av projektet.
|
|
| 44. |
- Ingason, Haukur, et al.
(författare)
-
The Metro Project : Final report
- 2012
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report compiles the results from the METRO project. The different parts of theproject – design fires, evacuation, integrated fire control, smoke control, extraordinarystrain onconstructions and fire- and rescue operations – are presented separately.The most complicated and expensive part of the project was the performance of thelarge scale fire and explosion tests in the Brunsberg tunnel, where the maximum heatrelease rates measured from the metro wagon was 77 MW.The main results from the project are new recommendations regarding design firesin mass transport systems, identification of key factors for fire and smoke spread in tunnelsand at stations as well as regarding the difficulties for disabled persons to evacuatefrom trains in tunnels, new recommended types of way guiding systems, safer design incase of explosions in trains and evaluation of the fire and rescue services’ possibilitiesand limitations in underground mass transport systems.
|
|
| 45. |
|
|
| 46. |
- Ingason, Haukur, et al.
(författare)
-
The Metro Project: Final Report
- 2012
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The report compiles the results from the METRO-project. The different parts of the project; design fires, evacuation, integrated fire control, smoke control, extraordinary strain on constructions and fire- and rescue operations are presented separately. The most complicated and expensive part of the project was the performance of the large scale fire and explosion tests in the Brunsberg tunnel. The maximum heat release rates measured from the metro carriage was 77 MW. The maximum ceiling gas temperatures was 1118 °C. These values are high, and should be put into a perspective of the situation and the type of carriages used. The project is not recommending the highest values as the design fire, but values reflected in conditions. The egress study confirm that one of the major issues related to fire evacuation in underground transportation systems is that people often are reluctant to initiate an evacuation. New data show that participants moved with an average of 0.9 meters per second in the smoke filled environment (average visibility of 1.5–3.5 meters). A way-finding installation at the emergency exit, which consisted of a loudspeaker, was found to perform particularly well in terms of attracting people to the door. Two smoke control systems were simulated for a single exit metro station. The systems consisted of a pressurizing supply air system and mechanical exhaust ventilation system with and without platform screen doors. The results show that both the pressurizing supply air system and the mechanical exhaust air system provide effective smoke control for one exit metro station. The significance of the platform screen doors was shown to be important in relation to smoke control. Experiments and simulations have provided increased confidence in ability to simulate explosion scenarios to determine the pressure inside and outside a carriage and to be able to study variations of conditions such as carriage geometry and window designs. The explosion test performed show that an explosion with a relatively minor charge can significantly change the conditions for both evacuees and the rescue service. The results show that the conditions for evacuation and rescue operations can change dramatically as a result of a relatively minor explosion. Evaluation of methods and fire and rescue tactics in metros is given. Mapping of IR imaging as a tactical resource at tunnel fires was presented.
|
|
| 47. |
- Lambo, Adele, et al.
(författare)
-
Dietary fibre in fermented oat and barley beta-glucan rich concentrates
- 2005
-
Ingår i: Food Chemistry. - : Elsevier BV. - 1873-7072 .- 0308-8146. ; 89:2, s. 283-293
-
Tidskriftsartikel (refereegranskat)abstract
- The ability of different lactic acid bacteria to influence the physicochemical characteristics (content, viscosity and molecular weight) of dietary fibre in beta-glucan-rich barley and oat concentrates was investigated. The cultures used were Lactobacillus acidophilus and the exopolysaccharide producing strain Pediococcus damnosus 2.6, together with the yoghurt culture, V2 (a mixture (1:1) of Lactobacillus delbrueckii subsp. bulgaricus and Streptocoecus salivarius subsp. thermophilus). Two methodologies, one including filtration and another centrifugation-dialysis, to quantify the dietary fibre, were compared. The centrifugation-dialysis method generally gave significantly (P < 0.05) higher values than the filtration method (for example, 79.8 g/100 g DW versus 59.6 g/100 g DW for the total fibre in the native barley fibre concentrate) with the exception of soluble barley fibres. The insoluble fibre content was found to decrease after fermentation (58.8 g/100 g DW to 39.0/37.0 g/100 g DW in barley and 26.0 g/100 g DW to 4.5/3.0 g/100 g DW in oats as analysed by the centrifugation-dialysis method). The soluble fibre in the barley fibre concentrate was apparently not affected by fermentation, while contents and maximum viscosities of the soluble fibre in oat fibre concentrates decreased after fermentation. However, the molecular weight was apparently not affected. (C) 2004 Elsevier Ltd. All rights reserved.
|
|
| 48. |
- Lambo, Adele, et al.
(författare)
-
Molar mass and rheological characterisation of an exopolysaccharide from Pediococcus damnosus 2.6
- 2007
-
Ingår i: Carbohydrate Polymers. - : Elsevier BV. - 0144-8617. ; 68:3, s. 577-586
-
Tidskriftsartikel (refereegranskat)abstract
- The molar mass and theological properties of an exopolysaccharide (EPS) from Pediococcus damnosus 2.6 were investigated. The molar mass was determined by asymmetrical flow field-flow fractionation coupled with multiangle light scattering and refractive index detection. The EPS was observed to be a flexible chain polymer with a molar mass value of 4 x 10(6) g mol(-1). Heating the sample at 80 degrees C for 10 min caused a shift to lower hydrodynamic radius. The theological behaviour of the EPS was compared to that of a commercial cereal beta-glucan (0.359 x 10(6) g mol(-1)). The maximum storage modulus, G'(max) for EPS solution was lower than that for the cereal beta-glucan at all concentrations, while the relaxation time, t(G'=G") was higher. The G'(max) was reduced on heating the EPS solution at 80 degrees C for 10 min, likely indicating some conformational changes. Three-dimensional models of the polymers revealed some differences in intramolecular hydrogen bonds. The EPS molecule had a ropy nature in solution and this could make it suitable for usage as a thickener in food systems. (c) 2006 Elsevier Ltd. All rights reserved.
|
|
| 49. |
- Lambo, Adele, et al.
(författare)
-
Short-chain fatty acid formation in the hindgut of rats fed native and fermented oat fibre concentrates
- 2006
-
Ingår i: British Journal of Nutrition. - 1475-2662. ; 96:1, s. 47-55
-
Tidskriftsartikel (refereegranskat)abstract
- The formation of SCFA in rats fed fermented oat fibre concentrates was compared with that of rats fed native oat fibre concentrate. The cultures used were lactic acid bacteria consisting of Lactobacillus bulgaricus and Streptococcus thermophilus (V2), the exopolysaccharide-producing strain Pediococcus damnosus 2.6 (Pd) and L. reuteri (Lr). The materials were incorporated into test diets yielding a concentration of indigestible carbohydrates of 80 g/kg (dry weight). Rats fed the V2-fermented fibre-concentrate diet yielded higher caecal and distal concentrations of acetic acid (P < 0 center dot 01) than rats fed the native fibre concentrate. All the fermented fibre concentrates resulted in a higher propionic acid concentration in the distal colon (P < 0 center dot 05), while rats fed Pd-fermented fibre concentrate resulted in lower concentration of butyric acid (P < 0 center dot 05, P < 0 center dot 01) in all parts of the hindgut as compared with rats fed the native fibre concentrates. Butyrate concentrations ranged between 5-11 mu mol/g (distal colon) and 6-8 mu mol/g (13 d faeces). Higher proportions of acetic acid (P < 0 center dot 05; P < 0 center dot 01) were observed in the caecum of rats fed the fermented fibre concentrates. Rats fed Pd- and Lr-fermented fibre concentrates produced higher proportions of propionic acid (P < 0 center dot 05; P < 0 center dot 01) in the caecum. Changes in SCFA formation in the caecum, distal colon and faeces of rats fed the fermented samples compared with the native sample indicate that these microbes probably survive in the hindgut and that modification of the microflora composition with fermented foods is possible. This may be important for the gastrointestinal flora balance in relation to colonic diseases.
|
|
| 50. |
|
|
