| 1. |
- Hammarberg, Karin M., et al.
(författare)
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Facial clefts involving the midline in combination with intracranial anomalies : Case studies illustrating surgical treatment and medical substitution
- 2012
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X .- 2000-6764. ; 46:3-4, s. 200-203
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Tidskriftsartikel (refereegranskat)abstract
- Malmö and Uppsala have been regional centres for the treatment of cleft lip and palate since the beginning of the 1950s. We have about 80 new cases every year and most patients have conventional oronasal clefts, either cleft lip and palate or isolated cleft palate. During a 10-year period we have come across four patients who have had varying degrees of midface dysplasia combined with intracranial anomalies. One child died at an early age, but the other three children were given medical substitution of hypopituitarism and have had their clefts reconstructed.
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| 2. |
- Klasson, Stina, et al.
(författare)
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Blood flow dynamics and sensitivity in breasts after reconstruction with DIEP-flap
- 2014
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 48:6, s. 407-411
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Tidskriftsartikel (refereegranskat)abstract
- A method of breast reconstruction is based on the Deep Inferior Epigastric Perforator (DIEP) technique. Skin and fat are transplanted from the abdomen to the chest; blood vessels are reconnected through microsurgery. Nerves are, however, left unconnected. This study aims to evaluate the blood flow and reinnervation of blood vessels and skin in breasts reconstructed by DIEP flaps without neural repair. In all, DIEP flaps of 10 patients were tested at an average of 16.3 months postoperatively. Blood flow was assessed by PeriScan PIM II System, both before and after indirect heating. Tactile perception threshold was assessed by Semmes-Weinstein monofilament and thermal sensibility by SENSELab MSA Thermotest. The patients' contralateral breasts were used as controls. The blood flow of the flaps was statistically significantly lower than in the control breasts, both before and after indirect heating. The change in blood flow after indirect heating did, however, not significantly differ when comparing the breasts. All flaps regained deep pressure sensibility in all four quadrants. Five patients regained even better sensibility in one of their quadrants. Seven patients regained perception of cold stimuli, five perceived warmth. This study has shown that skin blood flow regulation is present in DIEP flaps 1 year after reconstruction. Blood flow dynamics are very similar to those in the normal breast. There is also a recovery of tactile and thermal sensibility, but this study has not shown any clear parallels between recovery blood flow, tactile sensibility and thermal sensibility.
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| 3. |
- Luu, Henrik, et al.
(författare)
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Curettage and electrodessication combined with photodynamic therapy in the treatment of large squamous cell carcinomas in unfit and frail patients
- 2022
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Ingår i: BMJ Case Reports. - : BMJ. - 1757-790X. ; 15:6
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Tidskriftsartikel (refereegranskat)abstract
- A Caucasian female patient in her 90s was referred to the department of plastic and reconstructive surgery for surgical removal of a large invasive squamous cell carcinoma on the anterior chest wall. A skin biopsy prior to the referral indicated that the tumour was moderately differentiated. The patient suffered from severe congestive heart failure with a mechanical valve prosthesis and atrial fibrillation, and was therefore treated with anticoagulants. Hence, a surgical procedure would be hazardous. Therefore, other treatment options were considered. The principal aim was to reduce the amount of tumour tissue to an appropriate size suitable for later excision with primary wound closure. After interdisciplinary discussions, curettage and electrodessication combined with photodynamic therapy was judged the best alternative treatment in this case. At the 1.5 years follow-up after the intervention there was no indication for further surgery. The patient was at that stage content with the treatment and its outcome.
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| 4. |
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| 5. |
- Zamora, Juan Carlos, et al.
(författare)
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Considerations and consequences of allowing DNA sequence data as types of fungal taxa
- 2018
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Ingår i: IMA Fungus. - : INT MYCOLOGICAL ASSOC. - 2210-6340 .- 2210-6359. ; 9:1, s. 167-185
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Tidskriftsartikel (refereegranskat)abstract
- Nomenclatural type definitions are one of the most important concepts in biological nomenclature. Being physical objects that can be re-studied by other researchers, types permanently link taxonomy (an artificial agreement to classify biological diversity) with nomenclature (an artificial agreement to name biological diversity). Two proposals to amend the International Code of Nomenclature for algae, fungi, and plants (ICN), allowing DNA sequences alone (of any region and extent) to serve as types of taxon names for voucherless fungi (mainly putative taxa from environmental DNA sequences), have been submitted to be voted on at the 11th International Mycological Congress (Puerto Rico, July 2018). We consider various genetic processes affecting the distribution of alleles among taxa and find that alleles may not consistently and uniquely represent the species within which they are contained. Should the proposals be accepted, the meaning of nomenclatural types would change in a fundamental way from physical objects as sources of data to the data themselves. Such changes are conducive to irreproducible science, the potential typification on artefactual data, and massive creation of names with low information content, ultimately causing nomenclatural instability and unnecessary work for future researchers that would stall future explorations of fungal diversity. We conclude that the acceptance of DNA sequences alone as types of names of taxa, under the terms used in the current proposals, is unnecessary and would not solve the problem of naming putative taxa known only from DNA sequences in a scientifically defensible way. As an alternative, we highlight the use of formulas for naming putative taxa (candidate taxa) that do not require any modification of the ICN.
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| 6. |
- Aleynick, Mark, et al.
(författare)
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Pattern recognition receptor agonists in pathogen vaccines mediate antitumor T-cell cross-priming
- 2023
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Ingår i: Journal for ImmunoTherapy of Cancer. - : BMJ Publishing Group Ltd. - 2051-1426. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- Background Cancer immunotherapies are generallyeffective in patients whose tumors contain a prioriprimed T-cells reactive to tumor antigens (TA). Oneapproach to prime TA-reactive T-cells is to administerimmunostimulatory molecules, cells, or pathogens directlyto the tumor site, that is, in situ vaccination (ISV). Werecently described an ISV using Flt3L to expand and recruitdendritic cells (DC), radiotherapy to load DC with TA, andpattern recognition receptor agonists (PRRa) to activateTA-loaded DC. While ISV trials using synthetic PRRa haveyielded systemic tumor regressions, the optimal method toactivate DCs is unknown.Methods To discover optimal DC activators and increaseaccess to clinical grade reagents, we assessed whetherviral or bacterial components found in common pathogenvaccines are an effective source of natural PRRa(naPRRa). Using deep profiling (155-metric) of naPRRaimmunomodulatory effects and gene editing of specificPRR, we defined specific signatures and molecularmechanisms by which naPRRa potentiate T-cell priming.Results We observed that vaccine naPRRa can be evenmore potent in activating Flt3L-expanded murine andhuman DCs than synthetic PRRa, promoting cross-primingof TA-reactive T-cells. We developed a mechanisticallydiverse naPRRa combination (BCG, PedvaxHIB, Rabies)and noted more potent T-cell cross-priming than withany single naPRRa. The naPRRa triplet—as part of Flt3Lprimed ISV—induced greater intratumoral CD8 T-cellinfiltration, T-cells reactive to a newly defined tumorousneoantigen, durable tumor regressions.Conclusions This work provides rationale for thetranslation of pathogen vaccines as FDA-approved clinicalgrade DC activators which could be exploited as immunestimulants for early phase trials.
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| 7. |
- Anand, Aseem, et al.
(författare)
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Assessing Radiographic Response to 223Ra with an Automated Bone Scan Index in Metastatic Castration-Resistant Prostate Cancer Patients
- 2020
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Ingår i: Journal of Nuclear Medicine. - : Society of Nuclear Medicine. - 0161-5505 .- 2159-662X .- 1535-5667. ; 61:5, s. 671-675
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Tidskriftsartikel (refereegranskat)abstract
- For effective clinical management of patients being treated with 223Ra, there is a need for radiographic response biomarkers to minimize disease progression and to stratify patients for subsequent treatment options. The objective of this study was to evaluate an automated bone scan index (aBSI) as a quantitative assessment of bone scans for radiographic response in patients with metastatic castration-resistant prostate cancer (mCRPC). Methods: In a multicenter retrospective study, bone scans from patients with mCRPC treated with monthly injections of 223Ra were collected from 7 hospitals in Sweden. Patients with available bone scans before treatment with 223Ra and at treatment discontinuation were eligible for the study. The aBSI was generated at baseline and at treatment discontinuation. The Spearman rank correlation was used to correlate aBSI with the baseline covariates: alkaline phosphatase (ALP) and prostate-specific antigen (PSA). The Cox proportional-hazards model and Kaplan-Meier curve were used to evaluate the association of covariates at baseline and their change at treatment discontinuation with overall survival (OS). The concordance index (C-index) was used to evaluate the discriminating strength of covariates in predicting OS. Results: Bone scan images at baseline were available from 156 patients, and 67 patients had both a baseline and a treatment discontinuation bone scan (median, 5 doses; interquartile range, 3-6 doses). Baseline aBSI (median, 4.5; interquartile range, 2.4-6.5) was moderately correlated with ALP (r = 0.60, P < 0.0001) and with PSA (r = 0.38, P = 0.003). Among baseline covariates, aBSI (P = 0.01) and ALP (P = 0.001) were significantly associated with OS, whereas PSA values were not (P = 0.059). After treatment discontinuation, 36% (24/67), 80% (54/67), and 13% (9/67) of patients demonstrated a decline in aBSI, ALP, and PSA, respectively. As a continuous variable, the relative change in aBSI after treatment, compared with baseline, was significantly associated with OS (P < 0.0001), with a C-index of 0.67. Median OS in patients with both aBSI and ALP decline (median, 134 wk) was significantly longer than in patients with ALP decline only (median, 77 wk; P = 0.029). Conclusion: Both aBSI at baseline and its change at treatment discontinuation were significant parameters associated with OS. The study warrants prospective validation of aBSI as a quantitative imaging response biomarker to predict OS in patients with mCRPC treated with 223Ra.
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| 8. |
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| 9. |
- Appelros, Frida, et al.
(författare)
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On the role of the frontal projection in videoradiography of velopharynx in decision-making for a velopharyngeal flap plasty in patients with cleft palate
- 2020
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 54:4, s. 255-259
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Tidskriftsartikel (refereegranskat)abstract
- Despite uneventful primary surgery, patients with cleft palate may experience velopharyngeal insufficiency (VPI) and hypernasal speech. Videoradiography of velopharynx is a commonly used method to visualize velopharyngeal function and a velopharyngeal flap is often used to counteract VPI. The aim of this study was to investigate whether the frontal projection on videoradiography plays a role in the decision-making about velopharyngeal flap surgery, or possibly the width and orientation of the flap. A secondary aim was to evaluate the effect of the flap in improving velopharyngeal function. Between 2007 and 2016, 75 patients had received a flap at our department. During the same period of time, 41 patients who had undergone videoradiography did not receive a flap. Medical records, particularly regarding speech assessments, videoradiography statements and operating records, were scrutinised to seek information about the factors leading up to the decision about whether or not to perform a flap. In only one instance, reduced lateral pharyngeal wall movement found on the frontal projection was clearly taken into account when deciding to refrain from performing a velopharyngeal flap. Only a slight agreement was found between pre-operative speech assessment and findings in videoradiography. Hypernasality was reduced by flap surgery in 97% of the patients. We conclude the frontal projection of the videoradiographic examination seems to have no crucial role in the decision-making on performing a velopharyngeal flap or not in patients with cleft palate. Even with reduced lateral pharyngeal wall movement, a velopharyngeal flap effectively reduces hypernasality and VPI.
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| 10. |
- Axelsson, Robert, et al.
(författare)
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Evaluation of Multi-level Social Learning for Sustainable Landscapes : Perspective of a Development Initiative in Bergslagen, Sweden
- 2013
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Ingår i: Ambio. - : Springer Netherlands. - 0044-7447 .- 1654-7209. ; 42:2, s. 241-253
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Tidskriftsartikel (refereegranskat)abstract
- To implement policies about sustainable landscapes and rural development necessitates social learning about states and trends of sustainability indicators, norms that define sustainability, and adaptive multi-level governance. We evaluate the extent to which social learning at multiple governance levels for sustainable landscapes occur in 18 local development initiatives in the network of Sustainable Bergslagen in Sweden. We mapped activities over time, and interviewed key actors in the network about social learning. While activities resulted in exchange of experiences and some local solutions, a major challenge was to secure systematic social learning and make new knowledge explicit at multiple levels. None of the development initiatives used a systematic approach to secure social learning, and sustainability assessments were not made systematically. We discuss how social learning can be improved, and how a learning network of development initiatives could be realized.
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| 11. |
- Becker, Magnus, et al.
(författare)
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Adult skeletal profile in isolated cleft palate: a comparison of the von Langenbeck and Wardill procedures for primary repair of the palate
- 2001
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 35:4, s. 387-397
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Tidskriftsartikel (refereegranskat)abstract
- Sixty-four adult patients operated on for isolated cleft palate were evaluated with regard to facial skeletal morphology using conventional radio-cephalometry. Dental occlusion was assessed clinically. Forty-two had had a von Langenbeck repair at the age of 7 months and 22 a Wardill repair at 18 months. The mean error of the method was 0.7 degree for angular, and 0.9 mm for linear, measurements. The group with clefts had less maxillary prognathism (s-n-ss), more maxillary inclination (NSL/NL), more retroclined lower incisors (ILI/ML), and shorter total and upper facial heights (n-gn, n-sp) compared with the reference group. Multiple regression analysis was used to evaluate differences between the two treatment regimens. Explanatory variables in addition to surgical technique were sex, severity of cleft, and presence of a velopharyngeal flap. Only one variable, lower incisor inclination (ILI/ML), was different for the two regimens. Ten (24%) in the von Langenbeck group had a lateral cross-bite compared with one (5%) in the Wardill group. Other variables in a multivariate regression analysis were affected by sex and severity of cleft to various degrees. This study showed no obvious differences in facial skeletal morphology that could be attributed to surgical technique. Factors other than technique, including sex, age, and severity of cleft merit attention.
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| 12. |
- Becker, Magnus, et al.
(författare)
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Birth weight, body length, and cranial circumference in newborns with cleft lip or palate
- 1998
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Ingår i: Cleft Palate Journal. - 0009-8701. ; 35:3, s. 255-261
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This paper reports on birth weight, body length, body mass index, and cranial circumference at birth of infants with cleft lip and/or palate born between 1973 and 1992. METHODS: Data were obtained from two nationwide Swedish health registries. Infants with syndromes, twins, and infants with immigrant parentage were excluded from the study. Comparisons were made with all singleton births with the same exclusion criteria (n = 2,031,140). RESULTS: The body dimensions of infants with isolated cleft lip (n = 865) were found not to differ from those of control subjects, but infants with isolated cleft palate (n = 811) or cleft lip and palate (n = 1139) were found to be lighter and shorter than control subjects. Also, infants with the Pierre Robin sequence (n = 121) had a tendency to be lighter and shorter than control subjects, but these differences did not reach statistical significance despite the large study population.
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| 13. |
- Becker, Magnus, et al.
(författare)
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Clinical examination compared with morphometry of digital photographs for evaluation of repaired cleft lips
- 1998
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 32:3, s. 301-306
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-four adult patients who had been operated on as infants for isolated cleft lip underwent clinical examination combined with photographic documentation using a digital camera. The same predetermined protocol comprising 20 variables describing nasolabial appearance was used for both the clinical examination and the computerised evaluation of the images. The correlation between the two methods is described in the present study. The results obtained with the two methods agreed closely. For metric variables the mean coefficient of correlation was 0.73 and when all measurements were combined, it reached 0.98. Likewise, discrete variables showed a close correlation, with a mean kappa value of 0.72. Variables related to muscular dynamics of the lip can for obvious reasons not be judged from photographs. However, the computerised photographic evaluation was able to detect more precisely even minor angular deviations of the nose and to measure areas such as the areas of the nostrils. We conclude that morphometry of digital photographs is a new valuable clinical tool for the assessment of the nasolabial appearance in patients with cleft lip and palate.
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| 14. |
- Becker, Magnus, et al.
(författare)
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Computing data about patients with cleft lip and palate
- 1999
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 33:2, s. 203-208
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Tidskriftsartikel (refereegranskat)abstract
- For clinical research and quality control in the treatment of patients with cleft lip and palate (CLP) we created a register based on commercially available computer components. In this report we present the logical organisation of the system and give some representative examples of its applicability. There is great potential for easy access to data, and presentation.
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| 15. |
- Becker, Magnus, et al.
(författare)
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Millard repair of unilateral isolated cleft lip: a 25-year follow-up
- 1998
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 32:4, s. 387-394
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-five patients with isolated unilateral cleft lip took part in a follow-up study at a mean age of 28.6 years. All had had a primary, Millard lip repair, at a mean age of 4.6 months. In 20 patients, at least one secondary correction had been undertaken during adolescence. The overall long-term outcome was thought to be good, leaving a fairly inconspicuous fine lip scar and acceptable nose configuration. In half the patients, however, the lip was slightly elongated and the nostrils were still asymmetrical. These findings concurred with the patients' subjective assessments, which showed that appearance of the lip and nose were rated good by 20 (80%) and 16 (64%), respectively. The findings of this study provide a baseline for future evaluation of the results achieved with lip closure by Johanson's technique.
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| 16. |
- Becker, Magnus, et al.
(författare)
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Morphometry in digital photographs: a promising technique for assessing patients with cleft lip and palate
- 1998
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 32:3, s. 295-299
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Tidskriftsartikel (refereegranskat)abstract
- As digital photography is being increasingly used in clinical medicine, we devised a software program for 'on screen' image analysis, which allows distance, angle, and area to be measured. In this study, 30 photos were evaluated by 10 observers, so 3000 observations were used to test the reproducibility of the measurements. The results showed excellent reproducibility within observer, between observers, and between photographs. The coefficient of variation (CV) ranged from 0 to 1.3% for distance, from 0.6 to 2.3% for angle, and from 1.5 to 7.7% for area. The system could be particularly useful for assessing patients with cleft lip and palate.
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| 17. |
- Becker, Magnus, et al.
(författare)
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Von Langenbeck or Wardill procedures for primary palatal repair in patients with isolated cleft palate--speech results
- 2000
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 34:1, s. 27-32
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Tidskriftsartikel (refereegranskat)abstract
- Sixty-six patients operated on for isolated cleft palate were evaluated as adults, and their speech was assessed clinically. Forty-four had undergone a von Langenbeck repair at the age of 7 months and 22 a Wardill repair at the age of 18 months. Speech was judged subjectively by the patients themselves, and perceptual assessment was made by three speech pathologists. The remaining speech problems, mainly hypernasality, were moderate or severe in 7 (16%) of the patients in the von Langenbeck group, and in 7 (32%) in the Wardill group. On the other hand, the patients in the Wardill group had fewer fistulas closed, and fewer velopharyngoplasties. There were no significant differences between the two methods regarding speech in adulthood. The Wardill method produced significantly more scar tissue clinically, which carries the potential risk of inhibition of facial growth. The present speech results will therefore be weighed against the outcome of maxillofacial growth for these patients.
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| 18. |
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| 19. |
- Berggren, Helena, et al.
(författare)
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Prenatal compared with postnatal cleft diagnosis: What do the parents think?
- 2012
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 46:3-4, s. 235-241
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Tidskriftsartikel (refereegranskat)abstract
- Since the 1980s, prenatal detection of cleft lip with or without cleft palate (CLP) is possible with a transabdominal ultrasound. The improvement of prenatal detection has resulted in an increased demand for prenatal information and counselling. The aim of this study was to, by means of a questionnaire, evaluate how families, who received the diagnosis prenatally and postnatally, respectively, think about the prenatal and postnatal consultation. Patients referred prenatally or postnatally to the department, due to CLP, between January 2006 and September 2010 were included in the study. Thirty-six of the families (95%) answered the questionnaire concerning prenatal counselling. A total of 46 parents (82%) answered the questionnaire concerning postnatal counselling. In the prenatal group, half of the patients were first informed by the ultrasound unit, whereas 16% were initially informed by the cleft team. More of the families that were informed by the cleft team were content with the information received than the families who were informed by the ultrasound unit. The majority of the families were satisfied with the structure of the consultation. Most of the patients in the postnatal group were happy with the postnatal consultation. Most of the parents in the postnatal group would have wanted to know about the diagnosis prenatally. The great majority of the parents was happy with the consultation with the cleft team and thought that they received enough information. However, the information received at the referring units could be improved. Parents seem to want information on the cleft diagnosis and its treatment as soon as possible.
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| 20. |
- Berggren, Helena, et al.
(författare)
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Prenatal ultrasound detection of cleft lip, or cleft palate, or both, in southern Sweden, 2006-2010.
- 2012
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 46:2, s. 69-74
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Tidskriftsartikel (refereegranskat)abstract
- It has been possible to detect cleft lip (CL), with or without cleft palate (CLP), using ultrasound (US) since the beginning of the 1980s. The aim of this study was to assess the accuracy of prenatal diagnosis of cleft lip with or without cleft palate, and isolated cleft palate (ICP), in our catchment area. Screening protocols in the different US clinics in southern Sweden were also compared, as regards evaluation of the fetal face and prenatal diagnosis of CLP. Forty-four (31%) of the patients were diagnosed by prenatal US and 97/144 (67%) were diagnosed at birth. The detection rate was 44/102 (43%) if the ICP are excluded. The specificity was 100%. Among the prenatally diagnosed clefts, 25/44 (57%) were diagnosed before the gestational age of 20 weeks. In 19/44 (43%) of the cases the US diagnosis of cleft was accurate in the light of the postnatal outcome. All US departments in our catchment area follow the Swedish guidelines and offer one routine US examination during the second trimester between 18 and 20 weeks of pregnancy. In addition, many of the clinics offer an additional US examination during the third trimester. Our detection rate is similar to previous findings. The detection rates and the accuracy of the prenatal diagnosis can be improved. To achieve this, an increased focus on detecting clefts, standardising scanning plans, and rescans in case of incomplete facial views, are essential.
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| 21. |
- Brorson, Håkan, et al.
(författare)
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Complete reduction of lymphoedema of the arm by liposuction after breast cancer
- 1997
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - 0284-4311. ; 31:2, s. 137-143
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of lymphoedema of the arm after mastectomy ranges between 8% and 38%, and it is an appreciable problem from both functional and social aspects. Conservative and previous surgical regimens have not been completely successful. In the light of these experiences, liposuction clearly constitutes an interesting new surgical approach, which is potentially capable of effecting predictable and reliable improvements in patients with lymphoedema. Twenty eight women with lymphoedema of the arm after breast cancer were consecutively treated by liposuction. Limb compression with a compression garment was instituted immediately after operation. All patients had been given radiotherapy after the operation for breast cancer. Mean preoperative volume of oedema was 1845 ml (range 570-3915), and mean volume of aspirate was 2250 ml (range 1000-3850); volume of aspirate correlated linearly with the volume of preoperative oedema. There were no major surgical complications, but blood transfusion was necessary in eight patients whose volume of aspirate exceeded 2000 ml. After 12 months (n = 24), an average reduction in volume of oedema of 106% was found. Such a normalisation can be expected in patients with oedema that amounts to about 2500 ml. Although the oedema cannot be completely removed in more severe cases, substantial reduction is beneficial from both functional and cosmetic aspects. We conclude that liposuction is safe and effective for reducing lymphoedema of the arm after operations for breast cancer. In a one-stage procedure, oedematous and hypertrophic fat tissue can be removed with an excellent clinical outcome.
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| 22. |
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| 23. |
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| 24. |
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| 25. |
- Chaudhry, Mahwash, et al.
(författare)
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The 5-year-olds' index, the GOSLON Yardstick index, and the modified Huddart/Bodenham index among children with complete unilateral cleft lip and palate : A methodological study
- 2018
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Ingår i: International Journal of Orthodontic Rehabilitation. - : MM Publishers. - 2542-5579 .- 2349-5243. ; 9:3, s. 101-106
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Tidskriftsartikel (refereegranskat)abstract
- Background: The function of many orthodontic indices is to assess occlusion in patients born with a cleft. The aim of this study was to assess the intra- and interexaminer reliability for the 5-year-olds' (5YO) index, the GOSLON Yardstick index, and the modified Huddart/Bodenham (MHB) index in dental casts of children with complete unilateral cleft lip and palate (UCLP); a further aim is to compare the indices to each other.Methods: Forty dental casts from 5-year-old nonsyndromic patients with complete UCLP who had undergone primary surgery at Skåne University Hospital in Malmö, Sweden, were examined by two examiners: one orthodontic specialist and one general dentist.Results: Intraexaminer reliability for 5YO and MHB had a substantial (κ: 0.61–0.80) to almost perfect agreement ( κ: 0.81–1.00) and GOSLON Yardstick moderate (κ: 0.41–0.60) to almost perfect agreement. Grouped teeth or single-tooth MHB had an almost perfect agreement for both examiners. Interexaminer reliability for 5YO had a moderate agreement, whereas GOSLON Yardstick and MHB had a fair agreement (κ: 0.21–0.40). Grouped teeth or single-tooth MHB had an almost perfect agreement.Conclusions: The 5YO index illustrates the occlusion and has a high degree of reliability for an experienced orthodontist. The GOSLON Yardstick also illustrates the occlusion, but reliability between assessments is lower. MHB index can be used with a high degree of reliability when categorized as grouped or single tooth, but the judgment of total occlusion is more uncertain.
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| 26. |
- Christensen, JS, et al.
(författare)
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Diffusion of phosphorus in relaxed Si1-xGex films and strained Si/Si1-xGex heterostructures
- 2003
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Ingår i: Journal of Applied Physics. - : AIP Publishing. - 0021-8979 .- 1089-7550. ; 94:10, s. 6533-6540
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Tidskriftsartikel (refereegranskat)abstract
- Phosphorus diffusion has been studied in relaxed Si1-xGex samples (x=0.11 and 0.19) and strained Si/Si1-xGex/Si heterostructures (x=0.08, 0.13, and 0.18). The diffusivity of P is found to increase with increasing Ge content, while the influence of compressive strain results in a decrease in diffusivity as compared to that in relaxed material. The effect of strain is found to be equivalent to an apparent activation energy of -13 eV per unit strain, where the negative sign indicates that the P diffusion is mediated by interstitials in Si1-xGex (x<0.20). This conclusion is also supported by an experiment utilizing injection of Si self-interstitials, which results in an enhanced P diffusion in strained Si1-xGex. Further, P is found to segregate into Si across Si/Si1-xGex interfaces and the segregation coefficient increases with increasing Ge concentration.
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| 27. |
- Christensen, JS, et al.
(författare)
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Phosphorus and boron diffusion in silicon under equilibrium conditions
- 2003
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Ingår i: Applied Physics Letters. - : AIP Publishing. - 0003-6951 .- 1077-3118. ; 82:14, s. 2254-2256
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Tidskriftsartikel (refereegranskat)abstract
- The intrinsic diffusion of phosphorus and boron in high-purity epitaxial silicon films has been studied. Phosphorus diffusion in a wide temperature range (810 to 1100 degreesC) revealed diffusion coefficients with an Arrhenius behavior exhibiting an activation energy of 2.74+/-0.07 eV and a pre-exponential factor of (8+/-5)x10(-4) cm(2)/s. In the temperature range of 810 to 1050 degreesC, boron was found to diffuse with an activation energy of 3.12+/-0.04 eV and a pre-exponential factor of 0.06+/-0.02 cm(2)/s. These results differ from those of many previous studies, but this deviation may to a large extent be attributed to slow transients before equilibrium concentrations of point defects are established at temperatures below similar to1000 degreesC. Despite a similar diffusion mechanism mediated by Si self-interstitials, P exhibits a lower activation energy than B because of stronger bonding to the Si self-interstitial.
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| 28. |
- Christensen, J. S., et al.
(författare)
-
Phosphorus diffusion in the presence of threading dislocations in strain relaxed SiGe films
- 2006
-
Ingår i: Materials Science in Semiconductor Processing. - : Elsevier BV. - 1369-8001 .- 1873-4081. ; 9:4-5, s. 650-654
-
Tidskriftsartikel (refereegranskat)abstract
- We have studied phosphorus diffusion in strain relaxed Si1-xGex films (x = 0.1 and 0.2) by secondary ion mass spectrometry (SIMS). The relaxed films were grown with low-pressure chemical vapor deposition (LPCVD) on a Si substrate followed by a graded SiGe layer. Two sets of samples were prepared under different growth conditions, and by transmission electron microscopy (TEM) it was shown that these conditions resulted in one set of samples containing a high density of threading dislocations in the relaxed films, and one set with a low dislocation density. The SIMS profiles of the phosphorus distributions in the samples, after annealing in N-2-ambient in the temperature range of 700-950 degrees C, show that the phosphorus diffusion is significantly faster in the films with the high dislocation density. Furthermore, the data suggests that the fast diffusion is due to a higher mobility of the diffusing complex rather than an increase in the point defect concentration mediating the diffusion, a result which indicates that the threading dislocations may act as channels for the rapid dopant diffusion in SiGe.
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| 29. |
- Cornefjord, Måns, et al.
(författare)
-
A systematic review of differences in outcome between one and two stage palate repair in cleft lip and palate
- 2023
-
Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 58, s. 132-141
-
Forskningsöversikt (refereegranskat)abstract
- The aim of this systematic review was to determine whether one-stage palatoplasty for children born with cleft lip and palate shows overall advantages in outcome compared with two-stage palatoplasty. The included studies were controlled studies of syndromic and non-syndromic children born with unilateral cleft lip and palate, bilateral cleft lip and palate, or isolated cleft palate. The interventions studied were one-stage palatoplasty and two-stage palatoplasty starting with the soft palate. The outcomes were facial growth, speech, hearing, presence of fistulae, other complications related to surgery, health-related quality of life, and health economics. In total, 14 original studies were included. Results were dichotomized into showing advantage for one- or two-stage palatoplasty for the respective outcome and compared with the results from six included systematic reviews. No overall advantage for either surgical strategy was found for any of the outcome measures. The certainty of evidence was highest for the presence of fistulae, followed by facial growth and speech. For several outcomes, the quality of the existing evidence was too low to allow for any conclusions to be drawn. Neither one- nor two-stage palatoplasty showed significant advantages in clinical outcomes compared with the other. Other aspects such as ethics, economics, or surgeon's preference might hence be of more importance. Homogenous choices of outcome measures and defined minimal clinically important differences would facilitate further research.
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| 30. |
- Eriksson, Annika K., et al.
(författare)
-
Influence of iron addition on the oxygen-deficient Sr0.85Bi0.15Co1-xFexO3-delta (0.0 <= x <= 1.0) perovskites
- 2008
-
Ingår i: Journal of Solid State Chemistry. - : Elsevier BV. - 0022-4596 .- 1095-726X. ; 181:8, s. 2031-2040
-
Tidskriftsartikel (refereegranskat)abstract
- A series of oxygen-deficient Sr0.85Bi0.15Co1-xFexO3-delta (0.0 <= x <= 1.0) perovskite phases were prepared using solid-state reaction. Results of neutron powder diffraction analyses show that the introduction of Fe onto the B-site severely effects the long range coherence of the oxygen vacancy ordered, 14/mmm supercell, observed for the x = 0.0 sample. For x = 0.1 a smaller, a = b approximate to a(p), c approximate to 2a(p), P4/mmm supercell gives the best agreement to the diffraction data, whilst phases in the range 0.2 <= x <= 0.6 adopt disordered cubic perovskite structures. Pseudo-cubic, a = b approximate to a(p), c approximate to a(p), structures are found for x >= 0.8. Evidence of weak superstructures, reflecting local oxygen ordering, is also obtained from electron diffraction. For all oxygen-annealed phases the average structure reverts to cubic Pm (3) over barm. The as-prepared samples show G-type antiferromagnetic order at room temperature. The oxygen annealed x = 0.10, 0.25 and 1.0 samples display low-temperature spin-glass transitions.
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| 31. |
- Farzaneh, Farokh, et al.
(författare)
-
Speech results in adult Swedish patients born with bilateral complete cleft lip and palate.
- 2009
-
Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 43:4, s. 207-213
-
Tidskriftsartikel (refereegranskat)abstract
- Thirty-six adult patients (26 men and 10 women) who had been operated on for bilateral complete cleft lip and palate (BCLP) were evaluated with regard to long-term follow-up consisting of clinical investigation, perceptual speech analysis, and self-estimation of quality of speech. Twenty-six had had a von Langenbeck repair at the age of 14 months (L-14 group), and 10 a Wardill repair at the age of 18 months (W-18 group). Statistical comparisons between the groups were made by univariate and multiple logistic regression analyses. Both groups had a large percentage of hypernasality despite a high incidence of velopharyngeal flaps in both. There were no significant differences between the groups regarding any of the analysed speech variables. The outcomes of hypernasality, nasal escape, velopharyngeal friction sounds, hyponasality, and general impression indicate, however, a slightly better result for the L-14 group.
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| 32. |
- Farzaneh, Farokh, et al.
(författare)
-
Speech results in adult Swedish patients born with unilateral complete cleft lip and palate.
- 2008
-
Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 42:1, s. 7-13
-
Tidskriftsartikel (refereegranskat)abstract
- Sixty-one adult patients (34 men and 27 women) who were operated on for unilateral complete cleft lip and palate (UCLP) were followed up from 1996-2001 by clinical investigation, perceptual speech analysis, and self-estimation of quality of speech. Thirty-four had had a von Langenbeck repair at the age of 8 months (L-8 group), and 27 a Wardill repair at the age of 18 months (W-18 group). Statistical comparisons were made by univariate and multiple logistic regression analyses. The L-8 group had a slightly better general outcome but at the expense of a greater incidence of velopharyngeal flaps. There was no significant difference in hypernasality, being 7/34 (21%) of the patients in the L-8 group, compared with 9/27 (33%) in the W-18 group. Compared with findings reported previously of patients with isolated cleft palate (CP) who were treated and investigated under the same circumstances, the speech outcome in the group with UCLP was found to be significantly better.
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| 33. |
- Farzaneh, Farokh, et al.
(författare)
-
von Langenbeck procedures at 14 months or Wardill at 18 months for primary repair of cleft palate in adult Swedish patients with bilateral complete cleft lip and palate: A study of facial growth.
- 2009
-
Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 43:4, s. 214-24
-
Tidskriftsartikel (refereegranskat)abstract
- We compared facial growth in patients with bilateral complete cleft lip and palate (BCLP) in whom the palate had been repaired by the von Langenbeck procedure at the age of 14 months (L-14), or by the Wardill procedure at 18 months (W-18). A total of 151 unaffected subjects were used as a reference group. Thirty-six adult patients, 26 in the L-14 group, and 10 in the W-18 group, were investigated clinically and with lateral skull radiography, and they also filled out a questionnaire about their dental condition. Multiple linear regression was used to analyse the effect of surgical strategy, sex, and the presence of a velopharyngeal flap on several dependent variables indicating sagittal and vertical jaw relations, and inclination of incisors. The BCLP group was characterised by a pre-normal basal relation (ss-n-sm), retroclined upper (ILs/NL) and lower (ILi/ML) incisors, maxillary retrognathism (s-n-ss) in men, larger maxillary plane angle (NSL/NL) in women, larger mandibular plane (NSL/ML) and intermaxillary vertical relation (NL/ML) in men, and smaller anterior facial height (n-gn) and upper anterior facial height (n-sp). In the BCLP group, differences in outcomes could be explained only by sex. The sagittal jaw base relation (ss-n-sm) was significantly smaller in men than in women, whereas the total anterior facial height (n-gn) was greater in men. Lateral crossbite was found in about 75% of patients. About 70% were satisfied with their dental condition. The choice of surgical strategy had no significant influence on the variables measured on facial morphology.
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| 34. |
- Farzaneh, Farokh, et al.
(författare)
-
von Langenbeck procedures at 8 months or Wardill at 18 months for primary repair of cleft palate in adult Swedish patients with unilateral complete cleft lip and palate: A study of facial growth.
- 2008
-
Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 42:2, s. 67-76
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to compare facial growth in patients with unilateral complete cleft lip and palate (UCLP) in whom the palate was repaired with the von Langenbeck procedure at 8 months (L-8), or the Wardill procedure at 18 months (W-18). A total of 151 unaffected subjects were used as a reference series. Sixty-one adult patients, 34 in the L-8 group and 27 in the W-18 group, were investigated clinically and with lateral skull radiography and also filled out a questionnaire about their dental condition. Multiple linear regression was used to analyse the effects of the surgical strategy, sex, and the presence of a velopharyngeal flap on several dependent variables indicating sagittal jaw relations, vertical jaw relations, and inclination of incisors. The UCLP group was characterised by a short (n-sp) and retrusive maxilla (s-n-ss) and a retrusive mandible for women (s-n-sm), larger maxillary inclination (NSL/NL), more retroclined lower incisors (IL(I)/ML), shorter upper facial heights (n-sp) and normal total face height (n-gn) than the reference group. In the UCLP group there were significant differences between men and women in mandibular prognathism (s-n-sm), maxillary/mandibular relations (ss-n-sm), maxillary inclination (NSL/NL), total anterior facial height (n-gn), and upper anterior facial height (n-sp). Lateral crossbite was found in 20% of the UCLP group. The prevalence was similar in the L-8 and W-18 groups. Almost 80% of the patients in the UCLP group considered that their dental condition was good. The choice of surgical strategy had no significant influence on the variables measured on facial morphology.
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| 35. |
- Fernandez-Mateos, P, et al.
(författare)
-
Point mutations and deletion responsible for the Bombay H null and the Reunion H weak blood groups.
- 1998
-
Ingår i: Vox sanguinis. - 0042-9007. ; 75:1, s. 37-46
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Definition of the molecular basis of the Reunion and the Bombay red cell and salivary H-deficient phenotypes. METHODS: Sequence and expression of FUT1 and FUT2 genes from H-deficient individuals. Family segregation analysis of the mutations responsible for the fucosyltransferase defects of H, secretor and Lewis systems. RESULTS: The Indian red cell H null Bombay phenotype depends on a new mutation of the FUT1 gene. T725-->G changing Leu242-->Arg. Their salivary nonsecretor phenotype is secondary to a complete deletion of the FUT2 gene. The red cell H weak Reunion phenotype depends on another new mutation of FUT1, C349-->T which induces a change of His117-->Tyr. Their salivary nonsecretor phenotype is due to the known Caucasian inactivating mutation G428-->A. CONCLUSION: Single prevalent FUT1 and FUT2 point mutations and a deletion are responsible for the Indian Bombay H null and the Reunion H weak phenotypes found on Reunion island. This is in contrast with other H-deficient phenotypes where sporadic nonprevalent inactivating mutations are the rule.
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| 36. |
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| 37. |
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| 38. |
- Freccero, Carolin, et al.
(författare)
-
Sympathetic and parasympathetic neuropathy are frequent in both type 1 and type 2 diabetic patients.
- 2004
-
Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 27:12, s. 2936-2941
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE—The aim of this study was to evaluate the frequency of sympathetic versus parasympathetic neuropathy among type 1 and type 2 diabetic patients. RESEARCH DESIGN AND METHODS—There were 43 patients with type 1 and 17 with type 2 diabetes who were investigated. Sympathetic nerve function was assessed by measurement of the vasoconstriction (VAC) index by laser Doppler perfusion imaging of a locally heated finger followed by indirect cooling. Parasympathetic nerve function was assessed by R-R interval variation during deep breathing as measured by the expiration/inspiration (E/I) ratio. Results were expressed as age-corrected z scores in SD; VAC index >1.64 SD and E/I ratio <−1.64 SD were considered abnormal. RESULTS—VAC index was abnormal in 40% with type 1 and 41% with type 2 diabetes, whereas the E/I ratio was abnormal in 42% with type 1 and 65% with type 2 diabetes. There was a clear association between VAC index and E/I ratio among type 1 (rs = 0.525; P = 0.0002) but not among type 2 (rs = 0.10) diabetic patients. Among type 2 diabetic patients, the degree of dysfunction was most severe regarding parasympathetic function (P = 0.0167). CONCLUSIONS—Sympathetic and parasympathetic neuropathy were frequent in both type 1 and type 2 diabetic patients. However, there was a difference between the two types of diabetes. Sympathetic and parasympathetic nerve functions correlated in type 1 but not in type 2 diabetic patients. The explanation for this discrepancy might be that parasympathetic nerve function was most severely affected among type 2 diabetic patients.
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| 39. |
- Freccero, Carolin, et al.
(författare)
-
The influence of wavelength and probe configuration on findings of a skin vasoconstriction test when using laser Doppler perfusion devices.
- 2006
-
Ingår i: Microvascular Research. - : Elsevier BV. - 1095-9319 .- 0026-2862. ; 71:Jan 3, s. 64-67
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to establish the degree to which a standardized test based on laser Doppler blood flow measurement is dependent on the particular equipment set-up being used. For this purpose, we examined finger skin blood flow with laser Doppler instruments in 20 healthy subjects. In laser Doppler perfusion monitoring (LDPM), we used a custom-made probe with two detecting fibers placed 0.25 and 1.2 min from the illuminating fiber, respectively, and two laser Doppler perfusion imagers (LDPI) with a wavelength of 632.8 nm and 780 rim, respectively. Warming of the hand was achieved with a Peltier element, and reflex vasoconstriction was induced by immersing the other hand for 3 min into a water bath kept at 15 degrees C. As a measure for the change in skin blood flow, a vasoconstriction index (VAC: cooling/before cooling) was calculated and used for the comparison of the different devices. VAC values gathered around 0.6 for all devices. However, LDPI with a wavelength of 632.9 nm showed a slightly higher VAC index, and the difference was significant. We conclude that using a standardized test is the most appropriate for monitoring changes in blood flow rather than recording and comparing discrete values in intermittent recordings. Although a difference was noted when comparing the devices, different fiber separations and wavelengths seem then to be of little consequence. (c) 2005 Published by Elsevier Inc.
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| 40. |
- Grayson, Samuel, et al.
(författare)
-
Blood flow dynamics in reconstructed auricles
- 2013
-
Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 47:4, s. 313-316
-
Tidskriftsartikel (refereegranskat)abstract
- Ear reconstruction with autologous rib cartilage is performed in stages. Restitution of blood flow between the separate stages is crucial to obtain a good result. Laser Doppler perfusion imaging (LDPI) and local temperature were measured in reconstructed and normal ears in response to indirect heating. Ten persons who had had a unilateral ear reconstruction were included in the study. At a minimum, 157 days had passed since the last operation. LDPI showed no difference in blood flow between the reconstructed ear and the normal ear, neither before nor after indirect heating. The upper part of the normal ear was slightly cooler than the corresponding part in the reconstructed ear. Indirect heating caused an increase of LDPI-values and temperatures in the upper, middle, and lower part of the ear both in the reconstructed ear and the normal one. Skin blood flow recovers after 3-stage ear reconstruction and shows normal dynamic response upon indirect heating.
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| 41. |
- Hammerich, Linda, et al.
(författare)
-
Systemic clinical tumor regressions and potentiation of PD1 blockade with in situ vaccination
- 2019
-
Ingår i: Nature Medicine. - : Nature Publishing Group. - 1078-8956 .- 1546-170X. ; 25:5, s. 814-824
-
Tidskriftsartikel (refereegranskat)abstract
- Indolent non-Hodgkin’s lymphomas (iNHLs) are incurable with standard therapy and are poorly responsive to checkpoint blockade. Although lymphoma cells are efficiently killed by primed T cells, in vivo priming of anti-lymphoma T cells has been elusive. Here, we demonstrate that lymphoma cells can directly prime T cells, but in vivo immunity still requires cross-presentation. To address this, we developed an in situ vaccine (ISV), combining Flt3L, radiotherapy, and a TLR3 agonist, which recruited, antigen-loaded and activated intratumoral, cross-presenting dendritic cells (DCs). ISV induced anti-tumor CD8+ T cell responses and systemic (abscopal) cancer remission in patients with advanced stage iNHL in an ongoing trial (NCT01976585). Non-responding patients developed a population of PD1+CD8+ T cells after ISV, and murine tumors became newly responsive to PD1 blockade, prompting a follow-up trial of the combined therapy. Our data substantiate that recruiting and activating intratumoral, cross-priming DCs is achievable and critical to anti-tumor T cell responses and PD1-blockade efficacy.
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| 42. |
- Hansson, Emma, et al.
(författare)
-
Adopted children with cleft lip or palate, or both, require special needs cleft surgery.
- 2012
-
Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 46:2, s. 75-79
-
Tidskriftsartikel (refereegranskat)abstract
- In recent years adoption of children with cleft lip, with or without cleft palate (CLP), and other birth defects has become more common. The aim of the present study was to describe the characteristics and initial care and treatment of adopted children with CLP. A total of 25 children were referred to our department between 2008 and 2010, 7 (28%) of whom had bilateral CLP and 16 (64%) had unilateral CLP. Two children had atypical clefts. Twenty of the patients (80%) had been operated on with a lip plasty in China before adoption. Most patients (n = 14) was seen by the cleft team within two months of arrival, and 13 were operated on within a month of the first visit at our department. In total, 22 primary palatoplasties, 6 lip plasties, and 1 lip adhesion were done. There were 5 fistulas (14%) three months after the palatoplasty. On arrival, 11 (44%) of the children were carriers of methicillin-resistant Staphylococcus aureus (MRSA). Adoption of children with CLP creates new challenges for the cleft teams, as we no longer have control over the overall treatment plan as regards preoperative and surgical treatment and timing of the operations. The patients are also often carriers of resistant bacteria, which create nursing challenges. In cases where the child is older than a year and has not been operated on, we advocate that the palatoplasty, or combined lip plasty and palatoplasty, is always given priority so that speech development is not compromised.
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| 43. |
- Hansson, Emma, et al.
(författare)
-
Analysis of complications after repair of hypospadias
- 2007
-
Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 41:3, s. 120-124
-
Tidskriftsartikel (refereegranskat)abstract
- We have reviewed 184 patients after repair of primary hypospadias. They were operated on and followed-up according to a standard protocol, and the senior author (HS) participated in all operations. The patients were reconstructed using a Byars two-stage procedure ( n = 102) or a Scuderi ( n = 29) or Mathieu ( n = 41) single-stage procedure. The rest ( n = 12) just had a removal of the chordee with realignment of the skin. Complications recorded were haematomas, postoperative infections, malfunction of catheter, urinary retention, fistulas, and strictures. Thirty-eight complications developed in 26 patients and the overall incidence of fistula was 22 in 18 patients (10%). Our findings suggest that the most decisive risk factor for complications is the severity of the primary malformation, because a severe malformation per se is difficult to treat as it requires a long reconstruction; in addition the curvature, shortage of tissue, and extensive surgery generally require a staged reconstruction in these cases. Other factors seem to be of much lesser importance.
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| 44. |
- Hansson, Emma, et al.
(författare)
-
Depression in Dercum's disease and in obesity: A case control study
- 2012
-
Ingår i: BMC Psychiatry. - 1471-244X. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Dercum's disease is characterised by pronounced pain in the adipose tissue and a number of associated symptoms. The condition is usually accompanied by generalised weight gain. Many of the associated symptoms could also be signs of depression. Depression in Dercum's disease has been reported in case reports but has never been studied using an evidence-based methodology. The aim of this study was to examine the presence of depression in patients with Dercum's disease compared to obese controls that do not experience any pain. Methods: A total of 111 women fulfilling the clinical criteria of Dercum's disease were included. As controls, 40 obese healthy women were recruited. To measure depression, the Montgomery Asberg Depression Rating Scale (MADRS) was used. Results: According to the total MADRS score, less than half of the patients were classified as having "no depression" (44%), the majority had "light" or "moderate depression" (55%) and one individual had "severe depression" in the Dercum group. In the control groups, the majority of the patients were classified as having "no depression" (85%) and a small number had "light depression" (15%). There was a statistically significant difference for the total MADRS score between the two groups (p = 0.014). Conclusion: The results indicate that the patients with Dercum's disease are more likely to suffer from depression than controls.
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| 45. |
- Hansson, Emma, et al.
(författare)
-
Evaluation of measurement of fat mass reduction after liposuction in obese patients.
- 2012
-
Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X.
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Body composition measurements are used to evaluate surgical treatment, such as bariatric surgery in over weight patients. Nowadays, there are many different methods to measure body composition available. However, none of them has been validated for use in patients after operation. The aim of the present study was to compare the amount of surgically removed fat with two different methods, bioelectrical impedance analysis (BIA) and total body potassium (TBK). Amount of removed fat during liposuction was measured 1, 2, 3, 4, 14 days, and 1 year postoperatively in 27 obese patients after liposuction. The results were compared with actual removed fat during the operation. The median fat mass removed was 4020 grams (range 1954-9655). Postoperatively there was a varying reduction in fat mass, as measured with BIA and with TBK. There was a clear difference between the range of amounts removed measured with BIA and the range of amount removed measured with TBK. This study indicates that BIA, but not TBK, is an appropriate method to measure fat mass in obese subjects in a surgical setting. BIA seems to underestimate the amount of fat removed, whereas TBK seems to overestimate it.
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| 46. |
- Hansson, Emma, et al.
(författare)
-
Histology of adipose tissue inflammation in Dercum's disease, obesity and normal weight controls: a case control study.
- 2011
-
Ingår i: Journal of Inflammation. - : Springer Science and Business Media LLC. - 1476-9255. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dercum's disease (DD) is characterised by obesity and chronic pain (> 3 months) in the adipose tissue. The pathogenesis of DD is unknown, but inflammatory components have been proposed. In previous reports and studies, an inconsistent picture of the histological appearance of the adipose tissue in DD has been described. The aim of this investigation was to examine the histological appearance of adipose tissue in patients with DD, with particular focus on inflammatory signs. METHODS: Fat biopsies were sampled from painful regions from 53 patients with DD. In 28 of the patients, a control adipose tissue biopsy was taken from a location where the patient did not experience any pain. In addition, fat biopsies were sampled from 41 healthy pain-free obese control patients and 11 healthy pain-free normal weight control patients. The extent of inflammation was evaluated on histological sections stained with haematoxylin-eosin. RESULTS: There was no statistically significant difference in the extent of inflammation between the biopsies from the painful knee and the biopsies from the non-painful area (p = 0.5), nor between the biopsies from the abdomen, and the biopsies from the non-painful area (p = 0.4), in patients with DD. A statistically significant difference in extent of inflammation was observed between DD and obese control patients regarding the abdomen (p = 0.022), but not the knee (p = 0.33). There were no differences in extent of inflammation between DD patients and normal weight controls (p = 0.81). CONCLUSION: The findings suggest that there is an inflammatory response in the adipose tissue in DD. However, this response is not more pronounced than that in healthy obese controls. This contradicts inflammation as the aetiology of DD.
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| 47. |
- Hansson, Emma, et al.
(författare)
-
Liposuction May Reduce Pain in Dercum's Disease (Adiposis Dolorosa).
- 2011
-
Ingår i: Pain Medicine. - : Oxford University Press (OUP). - 1526-2375 .- 1526-4637. ; 12, s. 942-952
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. The aim of this prospective study is to assess the effect of liposuction on the pain experienced by women with Dercum's disease (adiposis dolorosa). Design. Pain was examined preoperatively and at 3 months, and 1, 2, 3, and 5 years after liposuction. The subjective pain sensation was evaluated with a visual analog scale and number of words chosen, and the objective pain sensation with the mechanical pressure pain threshold. Setting. Dercum's disease is characterized by obesity and pronounced pain in the adipose tissue. The pain is chronic and often disabling and resistant to traditional analgesics and other pain treatment. However, five reports have been published on the encouraging effect of liposuction. Patients. Pain was evaluated in 53 patients with Dercum's disease that had been operated on with liposuction. As controls, 58 nonoperated subjects with Dercum's disease and 41 obese abdominoplasty patients were followed for 5 years. Results. Both subjective and objective pain measurements revealed a statistically significant decrease in the pain experienced by the Dercum patients after surgery as compared with preoperatively. However, the pain relief diminished over time. Furthermore, a significant postoperative difference could be seen between the Dercum operated group and the Dercum controls as regards measured pain. The difference decreased over time but still lingered 5 years postoperatively. Conclusion. The results suggest that liposuction might alleviate pain in patients with Dercum's disease. However, it is difficult to determine whether the effect is due to the actual surgery or to other factors.
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| 48. |
- Hansson, Emma, et al.
(författare)
-
Neuropeptide levels in Dercum's disease (adiposis dolorosa).
- 2012
-
Ingår i: Reumatismo. - 0048-7449. ; 64:3, s. 134-141
-
Tidskriftsartikel (refereegranskat)abstract
- Dercum's disease (adiposis dolorosa) is characterised by adiposity and chronic pain in the adipose tissue. It has been proposed that conditions encompassing chronic pain have altered concentrations of neuropeptides involved in pain transmission. The aim of this investigation was to examine whether patients with Dercum's disease have abnormal concentrations of different neuropeptides. In cerebrospinal fluid (CSF) and in plasma (P) from 53 patients with Dercum's disease substance P-like immunoreactivity (SP-LI), neuropeptide Y-like immunoreactivity (NPY-LI), b-endorphin-like immunoreactivity (b-END-LI), calcitonin gene-related peptidelike immunoreactivity (CGRP-LI), met-enkephalin-like immunoreactivity (m-ENK-LI), vasoactive intestinal polypeptide-like immunoreactivity (VIP-LI), somatostatin (SOM-LI), g2-melanocyte-stimulating hormone-like immunoreactivity (g2-MSH-LI), and dynorphin-like immunoreactivity (DYN-LI) were measured. Three of the substances were also measured in a control group. The CSF concentration of SP was statistically significantly lower in the Dercum group than in the control group, whereas NPY-LI and b-END-LI were borderline statistically significantly lower and higher, respectively, in Dercum patients compared to controls. Compared with reference values, CSF-MSH-LI levels were slightly elevated and CSF-NPY-LI levels were slightly lowered in the Dercum group. The other substances in both CSF and plasma were within the reference values with a high degree of statistical significance. In conclusion, altered levels of neuropeptides that have previously been seen in different pain conditions cannot clearly be demonstrated in Dercum's disease.
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| 49. |
- Hansson, Emma, et al.
(författare)
-
Quality-of-life in patients with Dercum's disease-before and after liposuction.
- 2012
-
Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 46:3-4, s. 252-256
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Tidskriftsartikel (refereegranskat)abstract
- Dercum's disease is characterised by obesity, pronounced pain in the adipose tissue, and a number of associated symptoms. Liposuction has been suggested as a treatment. However, the effect on quality-of-life after liposuction in Dercum's disease has never been investigated. The objective of this study was to examine the quality-of-life in Dercum's disease before and after liposuction. A total of 114 women fulfilling the clinical criteria of Dercum's disease were included. Of the 114 women, 53 were operated on with liposuction and 61 were Dercum controls. In addition, 41 obese healthy women operated on with abdominoplasty were recruited as controls. Health-related quality-of-life (HRQoL) was measured with the Nottingham Health Profile (NHP) and the Psychological General Well-Being index (PGWB). The Dercum group had lower HRQoL than the abdominoplasty controls. After liposuction, a slight improvement could be seen in HRQoL in the operated patients compared with preoperatively, but it did not become as high as in the abdominoplasty patients. In conclusion, the findings could suggest that liposuction improves the quality-of-life slightly in Dercum's disease. Nonetheless, the causality is unclear and the improvement is not big enough to warrant operation.
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- Hansson, Emma, et al.
(författare)
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Review of Dercum's disease and proposal of diagnostic criteria, diagnostic methods, classification and management
- 2012
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Ingår i: Orphanet Journal of Rare Diseases. - : Springer Science and Business Media LLC. - 1750-1172. ; 7
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Forskningsöversikt (refereegranskat)abstract
- Definition and clinical picture: We propose the minimal definition of Dercum's disease to be generalised overweight or obesity in combination with painful adipose tissue. The associated symptoms in Dercum's disease include fatty deposits, easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, diabetes, bloating, constipation, fatigue, weakness and joint aches. Classification: We suggest that Dercum's disease is classified into: I. Generalised diffuse form A form with diffusely widespread painful adipose tissue without clear lipomas, II. Generalised nodular form - a form with general pain in adipose tissue and intense pain in and around multiple lipomas, and III. Localised nodular form - a form with pain in and around multiple lipomas IV. Juxtaarticular form - a form with solitary deposits of excess fat for example at the medial aspect of the knee. Epidemiology: Dercum's disease most commonly appears between the ages of 35 and 50 years and is five to thirty times more common in women than in men. The prevalence of Dercum's disease has not yet been exactly established. Aetiology: Proposed, but unconfirmed aetiologies include: nervous system dysfunction, mechanical pressure on nerves, adipose tissue dysfunction and trauma. Diagnosis and diagnostic methods: Diagnosis is based on clinical criteria and should be made by systematic physical examination and thorough exclusion of differential diagnoses. Advisably, the diagnosis should be made by a physician with a broad experience of patients with painful conditions and knowledge of family medicine, internal medicine or pain management. The diagnosis should only be made when the differential diagnoses have been excluded. Differential diagnosis: Differential diagnoses include: fibromyalgia, lipoedema, panniculitis, endocrine disorders, primary psychiatric disorders, multiple symmetric lipomatosis, familial multiple lipomatosis, and adipose tissue tumours. Genetic counselling: The majority of the cases of Dercum's disease occur sporadically. A to G mutation at position A8344 of mitochondrial DNA cannot be detected in patients with Dercum's disease. HLA (human leukocyte antigen) typing has not revealed any correlation between typical antigens and the presence of the condition.
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