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| 2. |
- Andersson, Jonny K, 1972, et al.
(författare)
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Patients with triangular fibrocartilage complex injuries and distal radioulnar joint instability have reduced rotational torque in the forearm.
- 2016
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Ingår i: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 41:7, s. 732-8
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Tidskriftsartikel (refereegranskat)abstract
- A total of 20 patients scheduled for wrist arthroscopy, all with clinical signs of rupture to the triangular fibrocartilage complex and distal radioulnar joint instability, were tested pre-operatively by an independent observer for strength of forearm rotation. During surgery, the intra-articular pathology was documented by photography and also subsequently individually analysed by another independent hand surgeon. Arthroscopy revealed a type 1-B injury to the triangular fibrocartilage complex in 18 of 20 patients. Inter-rater reliability between the operating surgeon and the independent reviewer showed absolute agreement in all but one patient (95%) in terms of the injury to the triangular fibrocartilage complex and its classification. The average pre-operative torque strength was 71% of the strength of the non-injured contralateral side in pronation and supination. Distal radioulnar joint instability with an arthroscopically verified injury to the triangular fibrocartilage complex is associated with a significant loss of both pronation and supination torque.
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| 4. |
- Bunketorp Käll, Lina, 1975, et al.
(författare)
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Adaptive motor cortex plasticity following grip reconstruction in individuals with tetraplegia
- 2018
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Ingår i: Restorative Neurology and Neuroscience. - : IOS Press. - 0922-6028 .- 1878-3627. ; 36:1, s. 73-82
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Tidskriftsartikel (refereegranskat)abstract
- Background: Tendon transfer is a surgical technique for restoring upper limb motor control in patients with cervical spinal cord injuries (SCI), and offers a rare window into cortical neuroplasticity following regained arm and hand function. Objective: Here, we aimed to examine neuroplasticity mechanisms related to re-established voluntary motor control of thumb flexion following tendon transfer. Methods: We used functional Magnetic Resonance Imaging (fMRI) to test the hypothesis that restored limb control following tendon transfer is mediated by activation of that limb's area of the primary motor cortex. We examined six individuals with tetraplegia who underwent right-sided surgical grip reconstruction at Sahlgrenska University Hospital, Sweden. All were right-handed males, with a SCI at the C6 or C7 level, and a mean age of 40 years (range = 31-48). The average number of years elapsed since the SCI was 13 (range = 6-26). Six right-handed gender-and age-matched control subjects were included (mean age 39 years, range = 29-46). Restoration of active thumb flexion in patients was achieved by surgical transfer of one of the functioning elbow flexors (brachioradialis), to the paralyzed thumb flexor (flexor pollicis longus). We studied fMRI responses to isometric right-sided elbow flexion and key pinch, and examined the cortical representations within the left hemisphere somatomotor cortex a minimum of one year after surgery. Results: Cortical activations elicited by elbow flexion did not differ in topography between patients and control participants. However, in contrast to control participants, patients' cortical thumb flexion activations were not topographically distinct from their elbow flexion activations. Conclusion: This result speaks against a topographic reorganization in which the thumb region regains thumb control following surgical tendon transfer. Instead, our findings suggest a neuroplastic mechanism in which motor cortex resources previously dedicated to elbow flexion adapt to control the thumb.
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| 5. |
- Bäckström, Erica, et al.
(författare)
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Uncovering the regional localization of inhaled salmeterol retention in the lung
- 2018
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Ingår i: Drug Delivery. - : Taylor & Francis Group. - 1071-7544 .- 1521-0464. ; 25:1, s. 838-845
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Tidskriftsartikel (refereegranskat)abstract
- Treatment of respiratory disease with a drug delivered via inhalation is generally held as being beneficial as it provides direct access to the lung target site with a minimum systemic exposure. There is however only limited information of the regional localization of drug retention following inhalation. The aim of this study was to investigate the regional and histological localization of salmeterol retention in the lungs after inhalation and to compare it to systemic administration. Lung distribution of salmeterol delivered to rats via nebulization or intravenous (IV) injection was analyzed with high-resolution mass spectrometry imaging (MSI). Salmeterol was widely distributed in the entire section at 5 min after inhalation, by 15 min it was preferentially retained in bronchial tissue. Via a novel dual-isotope study, where salmeterol was delivered via inhalation and d(3)-salmeterol via IV to the same rat, could the effective gain in drug concentration associated with inhaled delivery relative to IV, expressed as a site-specific lung targeting factor, was 5-, 31-, and 45-fold for the alveolar region, bronchial sub-epithelium and epithelium, respectively. We anticipate that this MSI-based framework for quantifying regional and histological lung targeting by inhalation will accelerate discovery and development of local and more precise treatments of respiratory disease.
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| 6. |
- Fridén, Mikael E, 1984-
(författare)
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Development of Methods for Analysis of Valuable Compounds in By-products from Agricultural and Forestry Industrial Sectors
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A growing interest in sustainable development has made efficient utilisation of starting materials and, if they occur, by-products become increasingly important. Vast amounts of by-products are generated by the forestry and food industry. Incineration for energy production is one way to make use of these by-products but some of them contain compounds that would have an increased value if they were extracted, so called “high value species”. The by-products are often very complex, so reliable methods for analysis of the high value species are required in the development of processes to utilise them. A wide range of compounds can be analysed using chromatographic separation coupled to mass spectrometry, making it a powerful tool in the evaluation of methods for extracting high value species from industry by-products.This thesis is based on four studies of potential high value species. In the first study, methods were developed to differentiate isobaric flavonoids and then use this knowledge to determine the identity of the flavonoids in three different plant extracts. In the second study, three different methods to extract betulin from birch bark were evaluated regarding extracted amount and purity of betulin. One of the methods was then investigated in industrial scale using a model approach. In the third study, the flavonoid contents of lovage were determined and other major extracted compounds were investigated by high performance liquid chromatography coupled to electrospray ionisation mass spectrometry. Gas chromatography and supercritical fluid chromatography were used to obtain complementary information about major components. In the fourth study, high resolution mass spectrometry utilising two different types of fragmentation was used with the purpose of overcoming the shortcomings of the methods developed in the first study. The results indicated that it would be possible to develop methods compatible with chromatographic separation for differentiating different types of isobaric substituents. The ability of performing sequential fragmentation was used to investigate some isobaric aglycones by creating spectral trees, and unique pathways were found for each of them.
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| 7. |
- Fridén, Mikael E, 1984-, et al.
(författare)
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Evaluation and analysis of environmentally sustainable methodologies for extraction of betulin from birch bark with a focus on industrial feasibility
- 2016
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Ingår i: Green Chemistry. - : Royal Society of Chemistry (RSC). - 1463-9262 .- 1463-9270. ; 18:2, s. 516-523
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Tidskriftsartikel (refereegranskat)abstract
- Betulin from birch bark was extracted using two principally different extraction methodologies - classical Reflux Boiling (RB) and Pressurized Liquid Extraction (PLE). The extraction methods were analyzed based on both recovery and purity as well as for RB industrial feasibility. The purity and recovery for the different extraction methods were analyzed using High Performance Liquid Chromatography (HPLC) coupled with three different detection principles: Diode Array Detection (DAD), Mass Spectrometry (MS) and Charged Aerosol Detection (CAD). The chromatographic purity was determined by all detections whereas the DAD was used also for complementary gravimetric calculations of the purity of the extracts. The MS detection (in MS and MS/MS modes) was mainly used to characterize the impurities. Two steps to increase the purity of RB extracts were evaluated - pre-boiling the bark in water and precipitation by adding water to the extract. Finally, the methods were compared in terms of amounts of betulin produced and solvent consumed. The RB method including a precipitation step produced the highest purity of betulin. However, results indicate that PLE using three cycles with the precipitation step gives similar purities as for RB. The PLE method produced up to 1.6 times higher amount of extract compared to the RB method. However, the solvent consumption (liter solvent per gram product) for PLE was around 4.5 times higher as compared to the classical RB. PLE performed with only one extraction cycle gave results more similar to RB with 1.2 times higher yield and 1.4 times higher solvent consumption. The RB process was investigated on an industrial scale using a model approach and several important key-factors could be identified. The most energy demanding step was the recycling of extraction solvent which motivates that solvent consumption should be kept low and calculations show a great putative energy reduction by decreasing the ethanol concentration used in the RB process to lower than 90%.
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| 8. |
- Koch-Borner, S., et al.
(författare)
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Rehabilitation After Posterior Deltoid to Triceps Transfer in Tetraplegia
- 2016
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993. ; 97:6
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe and evaluate the rehabilitation concept after posterior deltoid to triceps transfer in patients with tetraplegia. Participants: Patients with tetraplegia who had posterior deltoid to triceps tendon transfer and had muscle strength measurements 1 year postsurgery from 2009 to 2013 (N=44). Interventions: Posterior deltoid to triceps tendon transfer to restore elbow extension and postoperative rehabilitation. Main Outcome Measures: Elbow extension range of motion and muscle strength and the modified Canadian Occupational Performance Measure (COPM). Results: Surgery was performed on 53 arms. No major complications (eg tendon rupture, lengthening) were reported. Muscle strength measured 1 year after surgery was on average grade 3 (out of 5) in the 53 operated arms. The ability to extend the elbow against gravity was achieved in 62% of the arms (muscle strength of grade >= 3). In patients with a preoperative elbow extension deficit (n=14), the deficit was reduced on average from 16 degrees to 9 degrees. The performance of the prioritized activities as measured with the COPM improved on average 2.6 scale steps, from 3.3 to 5.9. Satisfaction with the performance improved on average 3.2 scale steps, from 2.8 to 6.0. Conclusions: The posterior deltoid to triceps tendon transfer with the applied rehabilitation protocol is a safe and effective procedure. There were no tendon ruptures, and all patients were able to complete the rehabilitation protocol. The shorter restriction time after surgery allows the patient to be independent at an earlier stage of the rehabilitation and reduces hospitalization or care burden. (C) 2016 by the American Congress of Rehabilitation Medicine
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| 9. |
- Stener-Victorin, E, et al.
(författare)
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Acupuncture or metformin to improve insulin resistance in women with polycystic ovary syndrome: study protocol of a combined multinational cross sectional case-control study and a randomised controlled trial
- 2019
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 9:1, s. e024733-
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Tidskriftsartikel (refereegranskat)abstract
- Polycystic ovary syndrome (PCOS) is linked to hyperinsulinemia and insulin resistance with dysfunctional glucose metabolism. Pilot studies suggests that acupuncture treatment with combined manual and low-frequency electrical stimulation (electroacupuncture (EA)) of the needles decrease circulating glycated haemoglobulin (HbA1c) and homeostatic model assessment-insulin resistance. Therefore, we here aim to investigate if acupuncture treatment or metformin together with lifestyle or lifestyle management alone improves insulin sensitivity and related symptoms in overweight/obese women with PCOS.Methods and analysisThis is a two-centre multinational (Sweden and China), cross-sectional case–control study combined with an open-labelled randomised controlled trial (RCT). Participants are randomised to one of three groups: (1) EA 2–3 times/week during 4 months+lifestyle management; (2) metformin, 500 mg, three/day during 4 months+lifestyle management; or (3) lifestyle management alone. The primary outcome measure in the RCT is changes in HbA1C. A total of 123 obese overweight women with PCOS will be enrolled and randomised into one of the three groups with a target power of at least 80% and 5% significance level based on two-sided tests.Ethics and disseminationThe study has been approved by the Regional Ethical Review Board of Stockholm and of Peking University Third Hospital, China. Primary outcome data of the RCT will be published in a relevant journal together with supporting secondary outcome measurements. Further, outcome measurements will be published in separate papers as well as case–control data.Expected resultsWe anticipate that EA and metformin, both with lifestyle management, are equally effective and superior to lifestyle management alone for improvement of glycaemic control.Trial registration numbersNCT02647827and EudraCT2015-004250-18.
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| 10. |
- Varadharajan, S., et al.
(författare)
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Exploring In Silico Prediction of the Unbound Brain-to-Plasma Drug Concentration Ratio: Model Validation, Renewal, and Interpretation
- 2015
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Ingår i: Journal of Pharmaceutical Sciences. - : Elsevier BV. - 0022-3549. ; 104:3, s. 1197-1206
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Tidskriftsartikel (refereegranskat)abstract
- Recently, we built an in silico model to predict the unbound brain-to-plasma concentration ratio (K-p,K-uu,K-brain), a measure of the distribution of a compound between the blood plasma and the brain. Here, we validate the previous model with new additional data points expanding the chemical space and use that data also to renew the model. The model building process was similar to our previous approach; however, a new set of descriptors, molecular signatures, was included to facilitate the model interpretation from a structure perspective. The best consensus model shows better predictive power than the previous model (R-2 = 0.6 vs. R-2 = 0.53, when the same 99 compounds were used as test set). The two-class classification accuracy increased from 76% using the previous model to 81%. Furthermore, the atom-summarized gradient based on molecular signature descriptors was proposed as an interesting new approach to interpret the K-p,K-uu,K-brain machine learning model and scrutinize structure K-p,K-uu,K-brain relationships for investigated compounds. (c) 2014 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 104:1197-1206, 2015
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| 11. |
- Yamada, Takashi, et al.
(författare)
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Nitrosative modifications of the Ca2+ release complex and actin underlie arthritis-induced muscle weakness.
- 2015
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 74:10, s. 1907-1914
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Tidskriftsartikel (refereegranskat)abstract
- Skeletal muscle weakness is a prominent clinical feature in patients with rheumatoid arthritis (RA), but the underlying mechanism(s) is unknown. Here we investigate the mechanisms behind arthritis-induced skeletal muscle weakness with special focus on the role of nitrosative stress on intracellular Ca(2+) handling and specific force production.
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