| 1. |
- Fengsrud, Espen, 1970-, et al.
(författare)
-
Total endoscopic ablation of patients with long-standing persistent atrial fibrillation : a randomized controlled study
- 2016
-
Ingår i: Interactive Cardiovascular and Thoracic Surgery. - Oxford, United Kingdom : Oxford University Press. - 1569-9293 .- 1569-9285. ; 23:2, s. 292-298
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Total endoscopic ablation of atrial fibrillation is an alternative to catheter ablation, but its clinical role needs further evaluation. The aim of this study was to compare total endoscopic ablation with rate control in patients with long-standing persistent atrial fibrillation and to examine the effect of endoscopic ablation on heart rhythm, symptoms, physical working capacity and myocardial function during 1 year of follow-up.Methods: In a prospective controlled study, 36 patients aged >50 years with symptomatic long-standing persistent atrial fibrillation were randomized to either total endoscopic ablation (n = 17, after two drop-outs before ablation n = 15) or rate control therapy (n = 19). In the ablation group, a box lesion encircling the pulmonary veins was performed, using temperature-controlled radiofrequency energy. Loop recorders were implanted in all patients. Echocardiography and quality-of-life assessment were performed at 6 and 12 months, and physical working capacity assessment at 6 months.Results: There was no mortality or thromboembolic event. In the control group, all patients were in permanent atrial fibrillation during 12 months of follow-up. In the ablation group, the proportion of patients in sinus rhythm without antiarrhythmic drugs was 12/15 (80%) at 12 months. The median freedom of atrial fibrillation at 3-12 months was 95% in the ablation group and the proportion of patients with an atrial fibrillation burden of <5% at 3-12 months was 8/15 (53%). The left ventricular ejection fraction increased during follow-up in the ablation group compared with the control group (from 53.7 ± 8.6 to 58.8 ± 6.5%, P = 0.003), combined with a reduction in the left atrial area (from 29.2 ± 5.5 to 27.2 ± 6.3 cm(2), P = 0.002). The physical working capacity increased in the ablation group compared with the control group (from 94 ± 21.4 to 102.9 ± 14.4%, P = 0.011). The subjective physical and mental capacity scale also improved during follow-up in the ablation group, but not in the control group (P =0.003 and 0.018, respectively).Conclusions: Total endoscopic ablation in patients with long-standing persistent atrial fibrillation significantly reduced atrial fibrillation burden 12 months after intervention compared with controls. The left ventricular function, physical working capacity and subjective physical and mental health were improved. These results need to be confirmed in larger randomized trials.
|
|
| 2. |
- Fengsrud, Espen, 1970-
(författare)
-
Atrial fibrillation : endoscopic ablation and postoperative studies
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Atrial fibrillation (AF) is associated with an increased risk of stroke, heart failure and cardiovascular death. Initial treatment focuses on rhythm or rate control and anticoagulation after risk assessment. Catheter abla-tion (CA) is an option in highly symptomatic patients but is less effective in long-standing persistent AF(LSPAF). Total endoscopic ablation is an alternative, but its clinical role needs further evaluation. In patients undergoing aortocoronary bypass graft (CABG) surgery, up to 9 % present with preoperative AF. One-third experience postoperative AF, which is associated with increased hospital stay, risk of stroke and decreased long-term survival. The long-term effects on heart rhythm have not been studied.Methods and Results: 571 patients undergoing CABG from 1999 to 2000 were followed for six years. Postoperative AF was the strongest independent risk factor for late AF and an age-independent risk factor for late mortality. 615 pa-tients from the same cohort, including patients with preoperative AF, were fol-lowed up at 15 years. Death due to cerebral ischaemia, heart failure and sudden death were most common in the pre- and postoperative AF groups. The presence of pre- or postoperative AF was an independent risk factor for late mortality.In our first ten patients, total endoscopic ablation of AF using a right-sided unilateral approach was feasible and safe with acceptable results. 36 patients with symptomatic LSPAF were then randomized to total endoscopic ablation or rate control. Loop recorders were implanted in all patients. In the control group, all patients were in permanent AF for 12 months. In the ablation group, 12/15 patients (80%) were in SR without antiarrhythmic drugs at 12 months. Median freedom of AF at 3–12 months was 95%, and 8/15 (53%) had an AF burden of < 5%. Myocardial function, physical working capacity(PWC) and subjective physical and mental health improved.Conclusions: Postoperative AF patients have an eightfold increased risk of future AF and a doubled long-term cardiovascular mortality. Both pre- or post-operative AF in CABG patients is a major risk factor for late cardiovascular morbidity and mortality. Total endoscopic ablation of AF is feasible and safe. In patients with LSPAF, it significantly reduced AF burden at 12 months compared with controls. Myocardial function, PWC and subjective physical and mental health improved.
|
|
| 3. |
- Fengsrud, Espen, 1970-, et al.
(författare)
-
Pre- and postoperative atrial fibrillation in CABG patients have similar prognostic impact
- 2017
-
Ingår i: Scandinavian Cardiovascular Journal. - : Taylor & Francis. - 1401-7431 .- 1651-2006. ; 51:1, s. 21-27
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study pre- and postoperative atrial fibrillation and its long-term effects in a cohort of aortocoronary bypass surgery patients.Design: Altogether 615 patients undergoing aortocoronary bypass graft surgery in 1999-2000 were studied. Forty-four (7%) had preoperative atrial fibrillation. Postoperative atrial fibrillation occurred in 165/615 patients (27%) while 406/615 patients (66%) had no atrial fibrillation. After a median follow-up of 15 years, symptoms and medication in survivors were recorded, and cause of death in the deceased was obtained.Results: Death due to cerebral ischaemia was most common in the pre- and postoperative atrial fibrillation groups (7% and 5%, respectively, v. 2% among those without atrial fibrillation, p = 0.038), as were death due to heart failure (18% and 14%, v. 7%, p = 0.007) and sudden death (9% and 5%, v. 2%, p = 0.029). The presence of pre- or postoperative atrial fibrillation was an independent risk factor for late mortality (hazard ratios 1.47 (1.02-2.12) and 1.28 (1.01-1.63), respectively).Conclusions: Patients with pre- or postoperative atrial fibrillation undergoing aortocoronary bypass surgery have increased long-term mortality and risk of cerebral ischemic and cardiovascular death compared with patients in sinus rhythm.
|
|
| 4. |
- Holmqvist, Fredrik, et al.
(författare)
-
A decade of catheter ablation of cardiac arrhythmias in Sweden : ablation practices and outcomes
- 2019
-
Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 40:10, s. 820-830
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing 'real-world' data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported.Methods and Results: Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff-Parkinson-White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7-7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P < 0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3 years). The rate of reported adverse events was low (n = 595, 1.7%). Death in the immediate period following ablation was rare (n = 116, 0.34%).Conclusion: Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.
|
|
| 5. |
- Holmqvist, Fredrik, et al.
(författare)
-
Increasing Ablation Volumes And A Shift Towards More Complex Arrhythmias : Data From The Swedish National Catheter Ablation Registry
- 2018
-
Konferensbidrag (refereegranskat)abstract
- Background: Catheter ablation has become the treatment of choice for many tachyarrhythmias. The ablation techniques are continuously refined and the indications expanded, enabling treatment of more complex substrates. Hence, the spectrum of treated arrhythmias is likely to have changed over time, but compelling data on this are lacking.Objective: The present study set out to explore the changing pattern of ablations performed in the setting of a universal, single-payer healthcare system, using data from the Swedish national catheter ablation registry.Methods: The Swedish National Catheter Ablation Registry covers virtually all (>97%) catheter ablations performed in Sweden since 2005 and comprises 42,192 ablations on 32,237 individual patients. In the present analysis, all ablations performed between 2005 and 2016 were included.Results: In 2005, there were 7 ablation centers in Sweden performing a total of 1,584 ablations (226/center; 175/million). In 2016, 11 ablation centers performed 5,022 ablations (457/center; 502/million). Ablation of atrial fibrillation increased from 326 ablations (21% of all) in 2005 to 2,063 (41%) in 2016. Although, the number of ablation procedures for ventricular tachycardia and premature ventricular contractions is increasing, it is still on a relatively modest level (Figure). In contrast to other reports, there is no apparent decline in the number of accessory pathway ablations.Conclusion: In the setting of a universal, single-payer healthcare system, the number of ablations more than tripled over a 10-year period. Ablation of atrial fibrillation is the main driver behind this increase and accounted for 41% of all ablations in Sweden in 2016.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Alhede, Christina, et al.
(författare)
-
Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation
- 2017
-
Ingår i: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 244, s. 186-191
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24 months of follow-up. Methods: Patients with paroxysmal AF (N = 260) enrolled in the MANTRA PAF trial were treated with AAD (N = 132) or CA (N = 128). At baseline and 3, 6, 12, 18 and 24 months follow-up patients underwent 7-day Holter monitoring to assess SVEC and AF burden. We compared SVEC burden between treatments with Wilcoxon sum rank test. Results: Patients treated with AAD had significantly lower daily SVEC burden during follow-up as compared to CA (AAD: 19 [6-58] versus CA: 39 [14-125], p = 0.003). SVEC burden increased post-procedurally followed by a decrease after CA whereas after AAD SVEC burden decreased and stabilized after 3 months of follow-up. Patients with low SVEC burden had low AF burden after both treatments albeit this was more pronounced after CA at 24 months of follow-up. Conclusion: AAD was superior to CA in suppressing SVEC burden after treatment of paroxysmal AF. After CA SVEC burden increased immediately post-procedural followed by a decrease whereas after AAD an early decrease was observed. Lower SVEC burden was highly associated with lower AF burden during follow-up especially after CA. (C) 2017 Elsevier B.V. All rights reserved.
|
|
| 9. |
- Alhede, Christina, et al.
(författare)
-
Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation
- 2018
-
Ingår i: Europace. - : OXFORD UNIV PRESS. - 1099-5129 .- 1532-2092. ; 20:1, s. 50-57
-
Tidskriftsartikel (refereegranskat)abstract
- Aims Early identification of patients who could benefit from early re-intervention after catheter ablation is highly warranted. Our aim was to investigate the association between post-procedural burden of supraventricular ectopic complexes (SVEC) and the risk of long-term atrial fibrillation (AF) recurrence. Methods and results A total of 125 patients undergoing catheter ablation for AF were included. Patients underwent 7-day Holter recordings immediately post-procedural. The number of SVEC in post-procedural Holter recordings was categorized into quartiles: 0-72, 73-212, 213-782 and amp;gt;= 783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF amp;gt;= 1 min during follow-up Holter recordings, cardioversion or hospitalization for AF after a 3-month blanking period and within 24 months of follow-up. High post-procedural supraventricular ectopy burden was associated with an increased risk of long-term AF recurrence in a dose-dependent manner (amp;gt;= 783 SVEC: HR 4.6 [1.9-11.5], P amp;lt; 0.001) irrespective of AF recurrence during the blanking period or other risk factors. In patients with early AF recurrence amp;lt; 90 days after catheter ablation ectopy burden was also highly predictive of long-term AF recurrence (SVEC amp;gt;= 213: HR 3.0 [1.3-6.7], P = 0.007). Correspondingly, patients with early AF recurrence but low ectopy burden remained at low risk of long-term AF recurrence after the blanking period. Conclusion Our results indicate that post-procedural ectopy burden is highly associated with long-term AF recurrence and could be a potent risk marker for selection of patients for early re-ablation. Development of future ablation risk stratification and strategies should include focus on post-procedural ectopy burden.
|
|
| 10. |
- Alhede, Christina, et al.
(författare)
-
The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation
- 2018
-
Ingår i: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 250, s. 122-127
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Supraventricular ectopic complexes (SVEC) are known risk factors of recurrent atrial fibrillation (AF). However, the impact of SVEC in different age groups is unknown. We aimed to investigate the risk of AF recurrence with higher SVEC burden in patients +/- 57 years, respectively, after treatment with antiarrhythmic medication (AAD) or catheter ablation (CA). Methods: In total, 260 patients with LVEF amp;gt;40% and age amp;lt;= 70 years were randomized to AAD (N = 132) or CA (N = 128) as first-line treatment for paroxysmal AF. All patients underwent 7-day Holter monitoring at baseline, and after 3, 6, 12, 18 and 24 months and were categorized according to median age +/- 57 years. We used multi-variate Cox regression analyses and we defined high SVEC burden at 3 months of follow-up as the upper 75th percentile amp;gt;195 SVEC/day. AF recurrence was defined as AF amp;gt;= 1 min, AF-related cardioversion or hospitalization. Results: Age amp;gt;57 years were significantly associated with higher AF recurrence rate after CA (58% vs 36%, p = 0.02). After CA, we observed a higher SVEC burden during follow-up in patients amp;gt;57 years which was not observed in the younger age group treatedwith CA (p = 0.006). High SVEC burden at 3 months after CA was associated with AF recurrence in older patients but not in younger patients (amp;gt;57 years: HR 3.4 [1.4-7.9], p = 0.005). We did not find any age-related differences after AAD. Conclusion: We found that younger and older patients respond differently to CA and that SVEC burden was only associated with AF recurrence in older patients. (C) 2017 Elsevier B.V. All rights reserved.
|
|
| 11. |
- Aronsson, Mattias, et al.
(författare)
-
The cost-effectiveness of radiofrequency catheter ablation as first-line treatment for paroxysmal atrial fibrillation : results from a MANTRA-PAF substudy.
- 2015
-
Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 17:1, s. 48-55
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this prospective substudy was to estimate the cost-effectiveness of treating paroxysmal atrial fibrillation (AF) with radiofrequency catheter ablation (RFA) compared with antiarrhythmic drugs (AADs) as first-line treatment.METHODS AND RESULTS: A decision-analytic Markov model, based on MANTRA-PAF (Medical Antiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation) study data, was developed to study long-term effects and costs of RFA compared with AADs as first-line treatment. Positive clinical effects were found in the overall population, a gain of an average 0.06 quality-adjusted life years (QALYs) to an incremental cost of €3033, resulting in an incremental cost-effectiveness ratio of €50 570/QALY. However, the result of the subgroup analyses showed that RFA was less costly and more effective in younger patients. This implied an incremental cost-effectiveness ratio of €3434/QALY in ≤50-year-old patients respectively €108 937/QALY in >50-year-old patients.CONCLUSION: Radiofrequency catheter ablation as first-line treatment is a cost-effective strategy for younger patients with paroxysmal AF. However, the cost-effectiveness of using RFA as first-line therapy in older patients is uncertain, and in most of these AADs should be attempted before RFA (MANTRA-PAF ClinicalTrials.gov number; NCT00133211).
|
|
| 12. |
- Chen, Lei, et al.
(författare)
-
Coordinating dangerous goods vehicles : C-ITS applications for safe road tunnels
- 2015
-
Ingår i: 2015 IEEE Intelligent Vehicles Symposium (IV). - Piscataway, NJ : IEEE. - 9781467372664 - 9781467372657 ; , s. 156-161
-
Konferensbidrag (refereegranskat)abstract
- Despite the existing regulation efforts and measures, vehicles with dangerous goods still pose significant risks on public safety, especially in road tunnels. Solutions based on cooperative intelligent transportation system (C-ITS) are promising measures, however, they have received limited attention. We propose C-ITS applications that coordinate dangerous goods vehicles to minimize the risk by maintaining safe distances between them in road tunnels. Different mechanisms, including global centralized coordination, global distributed coordination, and local coordination, are proposed and investigated. A preliminary simulation is performed and demonstrates their effectiveness. © 2015 IEEE.
|
|
| 13. |
|
|
| 14. |
- Englund, Anders, et al.
(författare)
-
Kateterburen ablation - bättre än läkemedel.
- 2015
-
Ingår i: Läkartidningen. - : Läkartidningen Förlag. - 0023-7205 .- 1652-7518. ; 112
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Randomiserade studier har visat att ablation av förmaksflimmer har bättre effekt än antiarytmisk medicinering. Enligt europeiska och amerikanska riktlinjer kan alla typer av förmaksflimmer komma ifråga för ablation. Hos patienter med paroxysmalt förmaksflimmer är lyckandefrekvensen ca 70–80 procent, medan den är något lägre vid persisterande och långvarigt flimmer. Risken för allvarliga komplikationer är låg, <1,0 procent.
|
|
| 15. |
|
|
| 16. |
- Englund, Claire, 1954-
(författare)
-
Teaching in an age of complexity : exploring academic change and development in higher education
- 2018
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Higher education (HE) has expanded and diversified at an unprecedented rate over the last two decades in response to a rapidly changing educational and political climate. Change and development are omnipresent, a constant part of university teachers’ sociocultural and organisational practice at multiple levels; the micro-level, the meso-level and the macro-level Against this background, the aim of this thesis is to gain a deeper understanding of the factors that influence academic change. A further aim of the thesis is to provide insight into factors that may be relevant in the design of academic development activities to support teachers and managers in the enhancement of teaching and learning. A twelve-year longitudinal study of teachers on an online pharmacy programme forms the basis for the research, where a multilevel approach is used to investigate academic change and development in a teaching and learning environment supported by educational technology (Edtech). The approach captures the influence of factors such as conceptions and approaches to teaching at the micro-level of the individual teacher, as well as the influence of systemic factors such as the sociocultural context at the meso-level of the department or programme and the structural context at the macro-level of the institution.To explore and understand the complexity of change and development in academic practice at micro-, meso- and macro-level two theoretical frameworks are used: conceptions of and approaches to teaching (CAT), and Cultural-Historical Activity Theory (CHAT). An interventionist method based on the tenets of CHAT was also employed. Data analysed in the thesis includes interviews with teachers (n=57), observations (n=27 hours), student evaluation surveys (n=30) and document analysis (n=11) collected over a 12-year timespan (2004-2016). The analysis indicated that at the micro-level a critical factor in the choice and use of Edtech is the underlying conception of and approach to teaching and learning of the teacher. Opportunities for change and development were found to be facilitated by the sociocultural context at the meso-level of the department, where support from the community and mediating tools for communication were present, but could also be hindered when this was lacking. At macro-level, institutional policy and strategy documents were seen to impede change and development, where research is consistently prioritised over teaching. At the meso-level of the department or programme, the opportunity to work together as a team to collaboratively construct and develop practice was found to be of significance in the development of agency and academic practice.Taking into account a combined analysis of the five papers included, it can be concluded that if a deeper understanding of academic change and development is to be achieved, it is necessary to adopt a holistic approach, considering factors at micro-, meso- and macro-level and the interrelationships between these factors. This thesis discusses the consequences of the research for the facilitation of academic change and development. A multilevel, holistic approach is suggested, building on the principles of the Scholarship of Teaching and Learning (SoTL) model. SoTL initiatives at all levels should be aligned to promote academic change and development through: the development of teachers’ individual practice at micro-level, the collaborative development of scholarly practice at the meso-level of the department and a strategic institutional approach at macro-level linking SoTL to employment and promotion frameworks and the recognition of teaching quality.The main contribution of this thesis lies in the adoption of a holistic approach to understanding academic practice in higher education, taking into consideration factors at micro-, meso- and macro-level and the interrelationships between these factors.
|
|
| 17. |
- Englund, Claire, et al.
(författare)
-
Teaching with technology in higher education : understanding conceptual change and development in practice
- 2017
-
Ingår i: Higher Education Research and Development. - : Routledge. - 0729-4360 .- 1469-8366. ; 36:1, s. 73-87
-
Tidskriftsartikel (refereegranskat)abstract
- Research indicates that teachers’ conceptions of and approaches to teaching with technology are central for the successful implementation of educational technologies in higher education. This study advances this premise. We present a 10-year longitudinal study examining teachers’ conceptions of and approaches to teaching and learning with technology. Nine teachers on an online Bachelor of Science in Pharmacy and a Master of Pharmacy programme at a Swedish university were studied using a phenomenographic approach. Results showed clear differences between novice and experienced teachers. Although novice teachers initially held more teacher-focused conceptions, they demonstrated greater and more rapid change than experienced colleagues. Experienced teachers tended to exhibit little to no change in conceptions. Supporting conceptual change should, therefore, be a central component of professional development activities if a more effective use of educational technology is to be achieved.
|
|
| 18. |
- Englund, Claire, et al.
(författare)
-
The influence of sociocultural and structural contexts in academic change and development in higher education
- 2018
-
Ingår i: Higher Education. - : Springer. - 0018-1560 .- 1573-174X. ; 76:6, s. 1051-1069
-
Tidskriftsartikel (refereegranskat)abstract
- Teaching quality improvements frequently focus upon the ‘development’ of individual academics in higher education. However, research also shows that the academics’ context has considerable influence upon their practices. This study examines the working environments of teachers on an online pharmacy programme, investigating contextual conditions that facilitate or impede academic change and development. Interview data and institutional policy documents are examined within a Cultural-Historical Activity Theory framework. Distinct differences in the teachers’ sociocultural context were identified as influencing change and development. Departmental teaching cultures and patterns of communication influenced practice both positively, by offering collegial support, and negatively by impeding change. The findings have significance for academic development strategies. They suggest that departmental-level support should include communicative pathways that promote reflection upon and development of conceptions of teaching and learning.
|
|
| 19. |
- Englund, Emelie, et al.
(författare)
-
Cartilage oligomeric matrix protein promotes prostate cancer progression by enhancing invasion and disrupting intracellular calcium homeostasis
- 2017
-
Ingår i: Oncotarget. - : Impact Journals, LLC. - 1949-2553. ; 8:58, s. 98298-98311
-
Tidskriftsartikel (refereegranskat)abstract
- Cartilage oligomeric matrix protein (COMP) was recently implicated in the progression of breast cancer. Immunostaining of 342 prostate cancer specimens in tissue microarrays showed that COMP expression is not breast cancer-specific but also occurs in prostate cancer. The expression of COMP in prostate cancer cells correlated with a more aggressive disease with faster recurrence. Subcutaneous xenografts in immunodeficient mice showed that the prostate cancer cell line DU145 overexpressing COMP formed larger tumors in vivo as compared to mock-transfected cells. Purified COMP bound to and enhanced the invasion of DU145 cells in vitro in an integrin-dependent manner. In addition, intracellular COMP expression interfered with cellular metabolism by causing a decreased level of oxidative phosphorylation with a concurrent upregulation of lactate production (Warburg effect). Further, expression of COMP protected cells from induction of apoptosis via several pathways. The effect of COMP on metabolism and apoptosis induction was dependent on the ability of COMP to disrupt intracellular Ca2+ signalling by preventing Ca2+ release from the endoplasmic reticulum. In conclusion, COMP is a potent driver of the progression of prostate cancer, acting in an anti-apoptotic fashion by interfering with the Ca2+ homeostasis of cancer cells.
|
|
| 20. |
|
|
| 21. |
- Englund Flodström, I, et al.
(författare)
-
The Effect of Thyroid Dysfunction on Plasma Creatinine Levels
- 2016
-
Ingår i: Annals of Thyroid Research. ; 2:2, s. 82-86
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: There are conflicting reports on how kidney function isaffected in patients with thyroid dysfunction. This study was designed toinvestigate how hypothyroidism and hyperthyroidism affect the concentration ofplasma creatinine in a large patient material.Methods: Patient results with simultaneous determinations of FT4, FT3,TSH and creatinine were extracted from the laboratory information system. Overan eight year period this yielded more than thousand cases with results fromthyroid function tests combined with plasma creatinine concentrations.Results: Median plasma levels of creatinine differed significantly inhypothyroid and hyperthyroid patients as compared to euthyroid controls.An approximate 20% increase and decrease in median plasma creatinineconcentration was found for hypothyroid and hyperthyroid patients, respectively.The differences were statistically significant (p<0.001) for both groups and stillso when divided according to gender. A correlation analysis showed a significantnegative correlation between the biologically active freeT3 and creatinine.Conclusion: Thyroid hormone correlates significantly to plasma creatinine.It is important to be aware of the relationship between thyroid function andkidney function when interpreting plasma creatinine results and to considerhypothyroidism or hyperthyroidism as a possible cause of an abnormal plasmacreatinine level.Further research is needed in order to uncover the mechanisms behi
|
|
| 22. |
- Englund, Johanna, 1988, et al.
(författare)
-
Deactivation of a Pd/Pt Bimetallic Oxidation Catalyst Used in a Biogas-Powered Euro VI Heavy-Duty Engine Installation
- 2019
-
Ingår i: Catalysts. - : MDPI. - 2073-4344. ; 9:12
-
Tidskriftsartikel (refereegranskat)abstract
- The reduction of anthropogenic greenhouse gas emissions is crucial to avoid further warming of the planet. We investigated how effluent gases from a biogas powered Euro VI heavy-duty engine impact the performance of a bimetallic (palladium and platinum) oxidation catalyst. Using synthetic gas mixtures, the oxidation of NO, CO, and CH4 before and after exposure to biogas exhaust for 900 h was studied. The catalyst lost most of its activity for methane oxidation, and the activity loss was most severe for the inlet part of the aged catalyst. Here, a clear sintering of Pt and Pd was observed, and higher concentrations of catalyst poisons such as sulfur and phosphorus were detected. The sintering and poisoning resulted in less available active sites and hence lower activity for methane oxidation.
|
|
| 23. |
- Englund, Johanna, 1988, et al.
(författare)
-
Impact of palladium distribution in alumina on low-temperature oxidation of carbon monoxide
- 2016
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- When emission standards for vehicles are becoming more stringent, catalysts that efficiently oxidize CO and HC (hydrocarbons) are a necessity. One of the important aspects here is to improve efficiency at low temperatures. This is emphasized by the change in technology towards more fuel-efficient engines which results in colder emissions and the need for reducing cold-start emissions [1]. Low-temperature oxidation can be enhanced using different strategies [2]. New materials and combinations of materials could be one solution and in that context the distribution of the active phase in the support material is crucial [3]. The distribution of the active phase will influence mass and heat transfer and thereby control the conversion of the reactants. Previously, it has been shown that heterogeneous distribution of the active phase (Pt) in the support material can improve the oxidation of CO at low temperatures [3]. The idea was that concentrate the active phase locally in the support material would result in a better utilization of generated reaction heat leading to higher temperatures of the active sites and, therefore, promote higher activity. The study showed an increase in activity for the samples with heterogeneous distribution of the active phase but it was also concluded that the enhancement in activity most likely arises from mass transfer effects.
|
|
| 24. |
|
|
| 25. |
|
|
