| 1. |
- Karlsson, Mikael, et al.
(författare)
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"Distributed proton radiation therapy"--a new concept for advanced competence support.
- 2006
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 45:8, s. 1094-101
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Tidskriftsartikel (refereegranskat)abstract
- The increased interest in high precision radiation therapy is to a large extent driven by the potential of modern imaging technology. The aim of this project was to analyse how an expensive proton facility best could support a multi-centre health care system. We have developed a model for distributed expert collaboration where all clinical experts will work close to their patients in regional centres. Patients who are candidates for proton therapy will be examined and dose-planned at their regional clinic, discussed in a fully information supported video conference and digitally made available at the proton treatment facility. The proton facility itself will be placed near a communication centre easily reached by all patients where they will be treated under full responsibility of their own physician at the home clinic. This concept has been analysed in detail both with respect to the overall functionality and with respect to possible weaknesses. It was found that the concept of distributed radiation therapy, as proposed here, will offer a stable clinical solution for advanced radiation therapy. It will support the spread of knowledge, serve as a fully developed backup system and the concept will further serve as an efficient base for clinical research.
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| 2. |
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| 3. |
- Berg, Ulrika, et al.
(författare)
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Lack of sex differences in the IGF-IGFBP response to ultra endurance exercise.
- 2008
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 18:6, s. 706-714
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Tidskriftsartikel (refereegranskat)abstract
- The insulin-like growth factor (IGF)-IGF binding proteins (BP) and the pituitary-gonadal axes were investigated during ultra endurance exercise in 16 endurance-trained athletes (seven women). Median duration of the race was 6.3 days. Although food and drink were ad libitum, energy balance was negative. Blood samples were drawn before (PRE), at the end of (END) and 24 h after (POST24h) the race. Serum concentrations of total IGF-I (t-IGF-I) and free IGF-I (f-IGF-I) decreased by 33 (SD 38)% and 54 (19)%, respectively. The decrease in t-IGF-I appeared to be associated to the total energy deficit during the race. At END, the IGFBP-3 fragmentation and IGFBP-1 were increased but these changes did not predict changes in f-IGF-I. An increase in POST24h IGFBP-2 levels in women was the only sex difference. Testosterone was decreased by 67 (12)% in the men and estradiol became undetectable in the women without any detectable increase in LH and/or FSH. In conclusion ultra endurance exercise results in similar IGF-IGFBP responses in men and women reflecting a catabolic state. IGFBP-2 was the only exception, with increased levels in women after exercise. A concomitant decrease in gonadal hormones was not related to endocrine changes in the IGF-IGFBP axis but may be related to local changes in IGF-I expression.
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| 4. |
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| 5. |
- Björling, Mikael, et al.
(författare)
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Ventilation measurements combined with pollutant concentration measurements discriminates between high emission rates and insufficient ventilation
- 2007
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Ingår i: IAQVEC 2007 Indoor Air Quality Ventilation and Energy Conservation. ; , s. 393-400
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Konferensbidrag (refereegranskat)abstract
- High local concentrations of a pollutant can be the result of high local emission rates of the pollutant or insufficient ventilation. Using tracer gases to map the ventilation in multi-zone buildings combined with measurements of the local pollutant concentration provide the means to discriminate between these causes. In a similar manner, the propagation rate of pollutants from a source to a target zone and the emission rate of the pollutants at the source may be determined quantitatively.The paper presents both the theoretical framework for the techniques and experimental examples of the proposed methods.
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| 6. |
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| 7. |
- Fatahi, Nabi, 1961, et al.
(författare)
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General practitioners' views on consultations with interpreters: a triad situation with complex issues.
- 2008
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Ingår i: Scandinavian journal of primary health care. - : Informa UK Limited. - 1502-7724 .- 0281-3432. ; 26:1, s. 40-5
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study a group of general practitioners' (GPs) views on cross-cultural consultations through interpreters in primary healthcare in Sweden. DESIGN: Two group interviews and three personal interviews with experienced GPs regarding clinical consultation through interpreters were carried out. The interviews were transcribed and analysed and the text was categorized according to content analysis. SETTING: Primary healthcare. SUBJECTS: Eight GPs were interviewed. MAIN OUTCOME MEASURES: The response and opinions of the GPs. RESULTS: In the analysis it appeared that an optimal clinical encounter demands an active role by all participants involved in the consultation. The interpreter has to strive after being a stable neutral information bridge, and has a balancing role between the GP and the patient. The GP has to be open to cultural inequalities and recognize consultation through an interpreter as a part of her/his job. The patient needs to be an active and visible participant, not hiding behind the interpreter. Common obstacles and imperfections to reach the best possible triad were discussed. Additionally, practical assets in the encounter were delineated. Accurate physical placing of the persons in the room, adequate length of consultation time, and using the same interpreter from one visit to another were mentioned as factors influencing the outcome of the consultation. CONCLUSION: Barriers in cross-cultural communications could originate from all persons involved, the interpreter, the GP, and the patient, as well as from tangible factors. Ways to reduce misunderstandings in GP-patient encounters through interpreters are suggested.
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| 8. |
- Fatahi, Nabi, 1961, et al.
(författare)
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Nurse radiographers’ experiences of communication with patients who do not speak the native language
- 2009
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Ingår i: Australian Journal of Advanced Nursing. - 0813-0531 .- 1447-4328. ; 66:4, s. 774-783
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Tidskriftsartikel (refereegranskat)abstract
- Improvements are needed in order to give satisfactory healthcare to patients with limited language abilities. These include improved education of interpreters, especially about cultural diversity, medical terminology and radiology methods. Early identification of the need for an interpreter, preferably stated on the radiology request form, and sufficient on-site time for radiological examinations are needed. Employment by the healthcare system of professional interpreters in the most frequent foreign languages seems warranted. Finally, inter-cultural communication skills and issues should be emphasized in nurse radiographers’ and other healthcare professionals’ educational programmes
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| 9. |
- Fernström, Maria, et al.
(författare)
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Reduced efficiency, but increased fat oxidation, in mitochondria from human skeletal muscle after 24-h ultraendurance exercise.
- 2007
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Ingår i: Journal of applied physiology. - : American Physiological Society. - 8750-7587 .- 1522-1601. ; 102:5, s. 1844-1849
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Tidskriftsartikel (refereegranskat)abstract
- The hypothesis that ultraendurance exercise influences muscle mitochondrial function has been investigated. Athletes in ultraendurance performance performed running, kayaking, and cycling at 60% of their peak O(2) consumption for 24 h. Muscle biopsies were taken preexercise (Pre-Ex), postexercise (Post-Ex), and after 28 h of recovery (Rec). Respiration was analyzed in isolated mitochondria during state 3 (coupled to ATP synthesis) and state 4 (noncoupled respiration), with fatty acids alone [palmitoyl carnitine (PC)] or together with pyruvate (Pyr). Electron transport chain activity was measured with NADH in permeabilized mitochondria. State 3 respiration with PC increased Post-Ex by 39 and 41% (P < 0.05) when related to mitochondrial protein and to electron transport chain activity, respectively. State 3 respiration with Pyr was not changed (P > 0.05). State 4 respiration with PC increased Post-Ex but was lower than Pre-Ex at Rec (P < 0.05 vs. Pre-Ex). Mitochondrial efficiency [amount of added ADP divided by oxygen consumed during state 3 (P/O ratio)] decreased Post-Ex by 9 and 6% (P < 0.05) with PC and PC + Pyr, respectively. P/O ratio remained reduced at Rec. Muscle uncoupling protein 3, measured with Western blotting, was not changed Post-Ex but tended to decrease at Rec (P = 0.07 vs. Pre-Ex). In conclusion, extreme endurance exercise decreases mitochondrial efficiency. This will increase oxygen demand and may partly explain the observed elevation in whole body oxygen consumption during standardized exercise (+13%). The increased mitochondrial capacity for PC oxidation indicates plasticity in substrate oxidation at the mitochondrial level, which may be of advantage during prolonged exercise.
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| 10. |
- Fernström, Maria, et al.
(författare)
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Skeletal muscle mitochondrial function and ROS production in response to extreme endurance exercise in athletes.
- 2006
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Ingår i: 14 European bioenergetic conference, Moscow, Russia, 22-27 July, 2006.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Although it is well known that endurance exercise induces oxidative stress (1) there is no evidence of deteriorated mitochondrial function after 1-2 hours intensive exercise (2). However, the effects of extreme endurance exercise on mitochondrial function and mitochondrial ROS production have not been investigated previously. Nine healthy well-trained men (age 27.1 ± 0.87 (mean ± SE), BMI 24.2 ± 0.64 and VO2 peak 62.5 ± 1.78 ml/kg. min) performed 24 hours exercise, consisting of equal parts running, cycling and paddling. Muscle biopsies were taken from vastus lateralis pre-exercise (PreEx), immediately post-exercise (PostEx) and after 28 hours of recovery (PostEx-28). Mitochondria were isolated and mitochondrial respiration was analyzed with palmitoyl-carnitine (PC) and pyruvate (Pyr). Mitochondrial H2O2 release was measured with the Amplex Red-horseradish peroxide method. The reaction was initiated by addition of succinate with following addition of antimycin A (reversed electron flow). UCP3 protein expression, evaluated with western blot technique, was not changed by exercise. Both state 3 (Pyr and PC) and state 4 (PC) rates of oxygen consumption (estimated per maximal ETC-activity) were increased PostEx (+29%, +11% and +18%). State 3 remained elevated PostEx-28, whereas state 4 (Pyr) decreased below that at PreEx (-18%). Mitochondrial efficiency (P/O) decreased PostEx (Pyr -8.9%, PC -6.1%) and remained reduced PostEx-28. The relative substrate oxidation (state 3 PC/Pyr) increased after exercise PreEx: (0.71 ± 0.06 vs. PostEx (0.90 ±0.04) and (0.77 ±0.06) PostEx-28. Mitochondrial H2O2 release (succinate) increased dramatically after exercise (+189 ± 64%). Treatment with Antimycin A resulted in a twofold-increased rate of mitochondrial H2O2 release PreEx but a decreased rate in PostEx samples. The exercise-induced changes in mitochondrial ROS production was totally abolished PostEx-28. In conclusion extreme endurance exercise decreases mitochondrial efficiency and increases mitochondrial ROS production. Both of these changes would increase the oxygen demand during exercise. Relative fatty acid oxidation as measured in isolated mitochondria increased after exercise indicating that the capacity to oxidize fat is improved during prolonged exercise.1. Mastaloudis, A., S.W. Leonard, and M.G. Traber, Oxidative stress in athletes during extreme endurance exercise. Free Radic Biol Med, 2001. 31(7): p. 911-22.2. Tonkonogi, M., et al., Mitochondrial function and antioxidative defence in human muscle: effects of endurance training and oxidative stress. J Physiol, 2000. 528 Pt 2: p. 379-88.
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| 11. |
- Gunnarsson, Mikael, et al.
(författare)
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Long-term biokinetics and radiation exposure of patients undergoing 14C-glycocholic acid and 14C-xylose breath tests.
- 2007
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Ingår i: Cancer Biotherapy & Radiopharmaceuticals. - : Mary Ann Liebert Inc. - 1557-8852 .- 1084-9785. ; 22:6, s. 762-771
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Tidskriftsartikel (refereegranskat)abstract
- The (14)C-glycocholic acid and (14)C-xylose breath tests are clinically used for the diagnosis of intestinal diseases, such as bacterial overgrowth in the small intestine. The two tests have in earlier studies been thoroughly evaluated regarding their clinical value, but due to the long physical half-life of (14)C and the limited biokinetic and dosimetric data, which are available for humans, several hospitals have been restrictive in their use. The aim of this study was to investigate the long-term biokinetics and dosimetry of the two (14)C compounds in patients and volunteers, using the highly sensitive accelerator mass spectrometry (AMS) technique. Eighteen (18) subjects were included, 9 for each compound. The (14)C content in samples from exhaled air, urine, and, for some subjects, also feces were analyzed with both liquid scintillation counting (LSC) and AMS. The results from the glycocholic acid study showed that, up to 1 year after the administration, 67%+/-6% (mean+/-standard deviation) of the administered activity was recovered in exhaled air, 2.4%+/-0.4% was found in urine, and 7.6% (1 subject) in feces. In the xylose study, the major part was found in the urine (66%+/-2%). A significant part was exhaled (28%+/-5%), and the result from an initial 72-hour stool collection from 2 of the subjects showed that the excretion by feces was insignificant. The absorbed dose to various organs and tissues and the effective dose were calculated by using biokinetic models, based on a combination of experimental data from the present study and from earlier reports. In the glycocholic acid study, the highest absorbed dose was received by the colon (1.2 mGy/MBq). In the xylose study, the adipose tissue received 0.8 mGy/MBq. The effective dose was estimated to 0.5 (glycocholic acid) and 0.07 mSv/MBq (xylose). Thus, from a radiation protection point of view, we see no need for restrictions in using the two (14)C-labeled radiopharmaceuticals on adults with the activities normally administered (0.07-0.4 MBq).
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| 12. |
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| 13. |
- Hägg, Daniel, 1974, et al.
(författare)
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Oxidized LDL induces a coordinated up-regulation of the glutathione and thioredoxin systems in human macrophages.
- 2006
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Ingår i: Atherosclerosis. - : Elsevier BV. - 0021-9150 .- 1879-1484. ; 185:2, s. 282-9
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Tidskriftsartikel (refereegranskat)abstract
- Using DNA microarray analysis, we found that human macrophages respond to oxidized low-density lipoprotein (oxLDL) by activating the antioxidative glutathione and thioredoxin systems. Several genes of the glutathione and thioredoxin systems were expressed at high levels in macrophages when compared to 80 other human tissues and cell types, indicating that these systems may be of particular importance in macrophages. The up-regulation of three genes in these systems, thioredoxin (P < 0.005), thioredoxin reductase 1 (P < 0.001) and glutathione reductase (P < 0.001) was verified with real-time RT-PCR, using human macrophages from 10 healthy donors. To investigate the possible role of these antioxidative systems in the development of atherosclerosis, expression levels in macrophages from 15 subjects with atherosclerosis (12 men, 3 women) and 15 matched controls (12 men, 3 women) were analyzed using DNA microarrays. Two genes in the glutathione system Mn superoxide dismutase (P < 0.05) and catalase (P < 0.05) differed in expression between the groups. We conclude that macrophage uptake of oxidized LDL induces a coordinated up-regulation of genes of the glutathione and thioredoxin systems, suggesting that these systems may participate in the cellular defense against oxidized LDL and possibly modulate the development of atherosclerosis.
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| 14. |
- Lättman, Håkan, et al.
(författare)
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At what age becomes Cliostomum corrugatum adult?
- 2006
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The objective was to investigate at what the age specimen of Cliostomum corrugatum become fertile in order to estimate the time span between the meiosis events. The species has its main distribution in Europe but has also been found on the west coast of British Columbia and is red listed, e.g., in Sweden (nearly threatened), Denmark, Germany and England. In the province of Östergötland, southern Sweden it is most frequent on old Quercus robur trees in open oak forest or meadows. I may also be found on other deciduous trees as Ulmus and Fraxinus species. It is mainly groving on the flat terminal parts of the rough bark of the tree trunks and not on the sides of the cracks. Cliostomum corrugatum does not grow on young oak trees. The smallest tree trunk diameter with Cliostomum corrugatum was is 0.65 m, a tree of at least 100 years of age. On two localities in Östergötland all oaks were studied and the size of the trees and the size of the largest thallus of Cliostomum corrugatum were recorded. Out of this data the size of how small a tree can possibly be for hosting Cliostomum corrugatum. This estimate was compared with the size of the smallest thalli with apothecia and the size of trees on which these appeared. With knowledge of the peripheral secondary growth of oaks it was possible to estimate the age of the youngest fertile Cliostomum corrugatum to about 30 years. Thus, equal to the time span between two meiosis events.
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| 15. |
- Lättman, Håkan, et al.
(författare)
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Generation time estimated to be 25-30 years in Cliostomum cossugatum (Ach.) Fr.
- 2009
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Ingår i: The Lichenologist. - : Britich Lichen Society. - 0024-2829 .- 1096-1135. ; 41:5, s. 557-559
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Knowledge of spore to spore generation time is extremely important for several reasons. As it is the shortest generation time, it indicates the maximum nucleotide substitution rate over time and provides a rate limit for the evolution of a species. In population genetics most calculations involving time use ‘generations’ as the unit of measurement and in order to convert these ‘generations’ into ‘years’, knowledge of generation time is needed but rarely available. Knowledge of generation time may also be essential for conservation purposes and assessments of migration history. This knowledge also makes it possible to estimate both the age of a population and also to determine to what extent a population represents the genetic diversity of a species (Rosenberg & Nordborg 2002). In this paper we present a method for assessing generation length for lichens using Cliostomum corrugatum (Ach.) Fr. as an example. This lichen was selected for investigation because it is restricted to forests with long temporal continuity (Lättman et al. 2009) and information on generation time is essential to estimate the rate of dispersal at the landscape level.
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| 16. |
- Mattsson, Claes, 1978-
(författare)
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Fabrication and Characterization of Photon Radiation Detectors
- 2007
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis involves a study the fabrication and characterization of photon radiation detectors. The focus has been to develop and improve the performance of optical measurement systems, but also to reduce their cost. The work is based on the study of two types of detectors, the position sensitive detector and the thermal detector. Infrared detectors are usually subcategorized into photonic detectors and thermal detectors. In the thermal detectors, heat generated from the incident infrared radiation is converted into an electrical output by some sensitive element. The basic structure of these detectors consists of a temperature sensitive element connected to a heat sink through a thermally isolating structure. Thin membranes of Silicon and Silicon nitride have been commonly used as thermally insulation between the heat sink and the sensitive elements. However, these materials suffer from relatively high thermal conductivity, which lowers the response of the detector. The fabrication of these membranes also requires rather advanced processing techniques and equipment. SU-8 is an epoxy based photoresist, which has low thermal conductivity and requires only standard photolithography. A new application of SU-8 as a self-supported membrane in a thermal detector is presented. This application is demonstrated by the fabrication and characterization of both an infrared sensitive thermopile and a bolometer detector. The bolometer consists of nickel resistances connected in a Wheatstone bridge configuration, whereas the thermopile uses serially interconnected Ti/Ni thermocouple junctions. The position sensitive detectors include the lateral effect photodiodes and the quadrant detectors. Typical applications for these detectors are distance measurements and as centering devices. In the quadrant detectors, the active region consists of four pn-junctions separated by a narrow gap. The size of the active region in these detectors depends on the size of the light spot. In outdoor application, this spot size dependence degrades the performance of the four-quadrant detectors. In this thesis, a modified four-quadrant detector having the pn-junctions separated by a larger distance has been fabricated and characterized. By separating the pn-junctions the horizontal electric filed in the active region is removed, making the detector spot size insensitive. Linearity of the lateral effect photodiodes depends on the uniformity of the resistive layer in the active region. The introduction of mechanical stress in an LPSD results in a resistance change mainly due to resistivity changes, and this affects the linearity of the detector. Measurements and simulations, where mechanical stress is applied to LPSDs are presented, and support this conclusion.
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| 17. |
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| 18. |
- Mattsson, C. Mikael
(författare)
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Mysteriet plötslig hjärtdöd
- 2009. - 1
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Ingår i: Idrottens olösta gåtor. - Stockholm : SISU Idrottsböcker. - 9789185433797 ; , s. 54-65
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Bokkapitel (populärvet., debatt m.m.)
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| 19. |
- Mattsson, C. Mikael
(författare)
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När hjärtat slutar slå : Plötslig hjärtdöd
- 2009
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Ingår i: Idrott & Kunskap. - 1652-6961. ; :4, s. 26-30
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Det är alltid tragiskt och ofta ett mysterium när en till synes helt frisk idrottsutövare faller död ned på planen mitt under pågående match. I den här artikeln ska vi försöka bena ut begreppet ”plötslig hjärtdöd inom idrotten”: Vad är det? Vad beror det på? Och vad kan man göra för att förhindra det? I början av juli hölls en konferens vid Stanford Universitetet i USA där världsledande experter i ämnet var samlade.
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| 20. |
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| 21. |
- Mattsson, C. Mikael
(författare)
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Så styrketränar du hjärtat
- 2009
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Ingår i: Idrott & kunskap. - 1652-6961. ; 6:3, s. 38-42
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 22. |
- Mattsson, C. Mikael, et al.
(författare)
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Träning för långdistans : De senaste rönen
- 2007
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Ingår i: Outside. - 1652-4624. ; :3, s. 44-48
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Många tidskrifter skriver om optimala metoder för att öka sin prestationsförmåga, gå ner i vikt, eller helt enkelt se snyggare ut. Följande artikel är ett försök att ge dig verktygen för att själv kunna optimera din träning.
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| 23. |
- Mattsson, C. Mikael, et al.
(författare)
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Unexpected cardiovascular response during ultra-endurance exercise.
- 2008
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Ingår i: 13th Annual Congress of the European College of Sport Science (ECSS), Estoril, Lissabon, Portugal.. - 9789727351565 ; , s. 142-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- During prolonged exercise at fixed work rate heart rate (HR) increases slowly with concomitant decrease in stroke volume (SV) in order to maintain cardiac output. Simultaneously, an increased oxygen uptake (VO2) occurs. In this paper we report an unexpected and previously not observed cardiovascular response to ultra-endurance exercise. Nine well-trained male athletes performed 24-h exercise in a controlled laboratory setting, with altering blocks of kayaking, running and cycling. Each block consisted of 110 min of exercise and 10 min of rest. Measurements (HR, VO2 and blood samples) were conducted during cycling at fixed work rate every 6th hour. The average work intensity was approximately 55 % of respective VO2peak. HR was increased at 6 h with 15 beats/min (13 %) compared to pre-exercise (Pre-Ex), but thereafter unexpectedly returned towards initial values. VO2 on the other hand was increased with 0.22 l/min (10 %) at 6 h and 0.37 l/min (17 %) at 12 h compared to Pre-Ex, and thereafter remained stable. This implies an increased oxygen pulse (VO2/HR) with approximately 10 % compared to Pre-Ex at the later half of the exercise. The cardiovascular drift did not progress continuously, but instead changed drastically when duration exceeded 6 hours. The changes in HR and VO2 might have different and complex explanations. HR drift might be explained mainly by central circulatory adaptation (e.g. desensitisation of cardiac adrenergic receptors) whereas drift in VO2 may depend upon peripheral changes (e.g. decreased mitochondrial efficiency). Consequently, using solely HR for determining exercise intensity and energy expenditure becomes invalid during ultra-endurance exercise, if the cardiovascular drift is not measured and taken into account.
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| 24. |
- Mattsson, Jan-Eric, 1949-, et al.
(författare)
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Macrolichen diversity in relation to diversity of woody plants
- 2006
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In studies concerning nature conservation issues common lichen species have usually been neglected although collecting of these results gives comparatively small disturbance of the populations and is easily done. Instead rare or threatened species or species usually have been used as indicators of sites with high biodiversity. Here, the macrolichen diversity is compared with the diversity of woody plants and other characteristics of different sites in Estonia, Finland and Sweden as a part of a larger project including comparative studies on habitats with presumably high species diversity The site selection was based on the occurrence of Daphne mezereum which usually occurs in semi-open habitats in transitions zones containing species from the surrounding biotopes. One of the main objectives with the study was to develop a fairly rapid method of evaluation of biodiversity using easily identified species. As total inventories are time consuming and reflects snapshots of a certain occasion it is beneficial to use other methods which may give a little less but sufficient information for many purposes, e.g., estimations on biodiversity. The ecological and evolutionary processes that shape diversity and distributions are general and results are assumed to be translatable from the target species to other species. The combination of data from a small number of species may constitute a useful monitoring protocol for lichens and higher plants. In total about 50 lichen species and 25 substrates are included and analyzed in the study. Most of the most common lichens are sorediate or isidiate and asexually reproducing and occur on several substrates. The relation between the diversity of lichen and woody plants is presented.
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| 25. |
- Rubio, Carlos A., et al.
(författare)
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Reliability of the reported size of removed colorectal polyps
- 2006
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Ingår i: Anticancer Research. - 0250-7005 .- 1791-7530. ; 26:6C, s. 4895-4899
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Tidskriftsartikel (refereegranskat)abstract
- Background: The size of colorectal polyps is important in the clinical management of these lesions. Aim: To audit the accuracy in calculating the size of polyps by various specialists. Materials and Methods: Eighteen pathologists and four surgeons measured, with a conventional millimetre ruler, the largest diameter of 12 polyp phantoms. The results of two independent measurements (two weeks apart) were compared with the gold standard-size assessed at The Royal Institute of Technology, Sweden. Results: Thirty-one percent (83/264-trial 1) and 33% (88/264-trial 2) of the measurements underestimated or overestimated the gold standard size by > 1 mm. Of the 22 experienced participants, 95% (21/22-trial 1) and 91% (20/22-trial 2) misjudged by > 1 mm the size of one or more polyps. Values given by 13 participants (4.9%) in trial I and by 15 participants (5.7%) in trial 2, differed by ! 4 mm from the gold standard size. In addition, a big difference between the highest and the lowest values was recorded in some polyps (up to 11.4 mm). Those disparate values were regarded as a human error in reading the scale on the ruler. Conclusion: Using a conventional ruler (the tool of pathologists worldwide) unacceptably high intra-observer and inter-observer variations in assessing the size of polyp-phantoms was found. The volume and the shape of devices, as well as human error in reading the scale of the ruler were confounding factors in size assessment. In praxis, the size is crucial in the management of colorectal polyps. Considering the clinical implications of the results obtained, the possibility of developing a method that will allow assessment of the true size of removed clinical polyps is being explored.
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| 26. |
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| 27. |
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| 28. |
- Svensson, Johan, 1964, et al.
(författare)
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Growth hormone (GH) replacement therapy in GH deficient adults: predictors of one-year metabolic and clinical response.
- 2007
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Ingår i: Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society. - : Elsevier BV. - 1096-6374 .- 1532-2238. ; 17:1, s. 67-76
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study investigated whether baseline status could predict the responsiveness to one-year growth hormone (GH) replacement therapy in adult GH deficient (GHD) patients. DESIGN: A total of 380 European patients with adult onset GHD due to non-functioning pituitary adenoma that had been enrolled in Pfizer International Metabolic Database (KIMS), and that had completed one year of GH replacement therapy within KIMS, were studied. RESULTS: The mean initial dose of GH was 0.22 (SEM 0.01) mg/day and after one year, the mean dose was 0.36 (0.01) mg/day. The mean insulin-like growth factor-I (IGF-I) SD score increased from -1.75 (0.08) at baseline to 0.47 (0.05) after one year. Quality of life (QoL)-Assessment of GHD in Adults (QoL-AGHDA), waist circumference, waist:hip ratio, and serum lipid pattern improved. Women received a higher dose of GH than men after one year, and demonstrated similar treatment response. In multiple stepwise forward regression analyses, the one-year changes in QoL-AGHDA score, waist:hip ratio, and serum low density lipoprotein-cholesterol (LDL-C) level correlated inversely with the baseline values of the same variable. In addition, the change after one year in QoL-AGHDA score correlated inversely with duration of hypopituitarism and baseline serum high density lipoprotein-cholesterol (HDL-C) level, and the change in waist:hip ratio correlated inversely, although more weakly, with baseline serum HDL-C level and UK citizenship and positively with baseline waist circumference and the initial GH dose. The change in serum LDL-C level additionally correlated inversely with the mean GH dose and duration of hypopituitarism and positively with UK citizenship. CONCLUSIONS: Baseline status could, with moderate strength, predict the responsiveness in the same variable whereas it could not, or only weakly, predict the response in other variables. Therefore, when the decision to start GH replacement is undertaken, as many outcome variables as possible should be evaluated in order to adequately evaluate the likelihood of clinical benefit. Finally, women have a similar response to GH replacement as men when individualised GH dosing schedules are employed and should therefore be selected for GH therapy to a similar extent.
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| 29. |
- Svensson, Per-Arne, 1969, et al.
(författare)
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Regulation and splicing of scavenger receptor class B type I in human macrophages and atherosclerotic plaques
- 2005
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Ingår i: BMC Cardiovasc Disord. - : Springer Science and Business Media LLC. - 1471-2261. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The protective role of high-density lipoprotein (HDL) in the cardiovascular system is related to its role in the reverse transport of cholesterol from the arterial wall to the liver for subsequent excretion via the bile. Scavenger receptor class B type I (SR-BI) binds HDL and mediates selective uptake of cholesterol ester and cellular efflux of cholesterol to HDL. The role of SR-BI in atherosclerosis has been well established in murine models but it remains unclear whether SR-BI plays an equally important role in atherosclerosis in humans. The aim of this study was to investigate the expression of SR-BI and its isoforms in human macrophages and atherosclerotic plaques. METHODS: The effect of hypoxia and minimally modified low-density lipoprotein (mmLDL), two proatherogenic stimuli, on SR-BI expression was studied in human monocyte-derived macrophages from healthy subjects using real-time PCR. In addition, SR-BI expression was determined in macrophages obtained from subjects with atherosclerosis (n = 15) and healthy controls (n = 15). Expression of SR-BI isoforms was characterized in human atherosclerotic plaques and macrophages using RT-PCR and DNA sequencing. RESULTS: SR-BI expression was decreased in macrophages after hypoxia (p < 0.005). In contrast, SR-BI expression was increased by exposure to mmLDL (p < 0.05). There was no difference in SR-BI expression in macrophages from patients with atherosclerosis compared to controls. In both groups, SR-BI expression was increased by exposure to mmLDL (p < 0.05). Transcripts corresponding to SR-BI and SR-BII were detected in macrophages. In addition, a third isoform, referred to as SR-BIII, was discovered. All three isoforms were also expressed in human atherosclerotic plaque. Compared to the other isoforms, the novel SR-BIII isoform was predicted to have a unique intracellular C-terminal domain containing 53 amino acids. CONCLUSION: We conclude that SR-BI is regulated by proatherogenic stimuli in humans. However, we found no differences between subjects with atherosclerosis and healthy controls. This indicates that altered SR-BI expression is not a common cause of atherosclerosis. In addition, we identified SR-BIII as a novel isoform expressed in human macrophages and in human atherosclerotic plaques.
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- Tilert, Dan, 1976-
(författare)
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Development of techniques for measurements of shock wave response and moisture content in granite
- 2005
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- For measuring small, fast deformations on a micrometre scale optical methods are common. Various forms of interferometry are available, and holography is another possibility. However, if there are complications such as limited space and hazardous environments special demands arise. In our case a granite block was subject to a detonation from a small explosive charge, sending shock waves through the block. In some cases there was risk of expulsion with flying rock shards, with possible damage to expensive optics. Therefore a robust solution with no expensive, fragile parts near the test surface was needed. A fast four-channel fibre-optic sensor for measuring dynamic surface displacements was developed. Light from an LED is sent through a plastic optic fibre and reflected from the observed surface back into the fibre. A photodetector is used to measure the intensity of the reflected light, which gives the distance to the surface. Based on simple principles, micrometre and microsecond resolution was achieved. The only parts near the test surface were the fibres, easy to replace. The sensor was used for measuring the propagation velocity of the shock wave, the surface displacement and its particle velocity. One of the most important factors for the wave transmission in granite is the water content of the rock material. The pores in the granite allow for about 0.1% of the granite’s weight to come from liquid water. This is enough to affect the aforementioned measured quantities, from a few percent in some cases to over 100% in other cases. Therefore an investigation was undertaken aiming to control the water content of the granite blocks. Several series of small blocks were both soaked in water and dried, the water content measured with a high performance balance, to ensure well-controlled blasting experiments. On a larger scale, the aim with the project of which this thesis is a part was to gain systematic knowledge on the effects of penetrating weapons on granite rock shelters. This thesis shows how the raw data was obtained, presents the data itself and exemplifies its application.
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