| 1. |
- Bobjer, Johannes, et al.
(author)
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Location of retroperitoneal lymph node metastases in upper tract urothelial carcinoma : results from a prospective lymph node mapping study
- 2023
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In: European Urology Open Science. - : Elsevier. - 2666-1691 .- 2666-1683. ; 57, s. 37-44
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Journal article (peer-reviewed)abstract
- Background: There is limited information on the distribution of retroperitoneal lymph node metastases (LNMs) in upper tract urothelial carcinoma (UTUC).Objective: To investigate the location of LNMs in UTUC of the renal pelvis or proximal ureter and short-term complications after radical nephroureterectomy (RNU) with lymph node dissection (LND).Design, setting, and participants: This was a prospective Nordic multicenter study (four university hospitals, two county hospitals). Patients with clinically suspected locally advanced UTUC (stage >T1) and/or clinical lymph node–positive (cN+) disease were invited to participate. Participants underwent RNU and fractionated retroperitoneal LND using predefined side-specific templates.Outcome measurements and statistical analysis: The location of LNMs in the LND specimen and retroperitoneal lymph node recurrences during follow-up was recorded. Postoperative complications within 90 d of surgery were ascertained from patient charts. Descriptive statistics were used.Results and limitations: LNMs were present in the LND specimen in 23/100 patients, and nine of 100 patients experienced a retroperitoneal recurrence. Distribution per side revealed LNMs in the LND specimen in 11/38 (29%) patients with right-sided tumors, for whom the anatomically larger, right-sided template was used, in comparison to 12/62 (19%) patients with left-sided tumors, for whom a more limited template was used. High-grade complications (Clavien grade ≥3) within 90 d of surgery were registered for 13/100 patients. The study is limited in size and not powered to assess survival estimates.Conclusions: The suggested templates that we prospectively applied for right-sided and left-sided LND in patients with advanced UTUC included the majority of LNMs. High-grade complications directly related to the LND part of the surgery were limited.Patient summary: This study describes the location of lymph node metastases in patients with cancer in the upper urinary tract who underwent surgery to remove the affected kidney and ureter. The results show that most metastases occur within the template maps for lymph node surgery that we investigated, and that this surgery can be performed with few severe complications.
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| 2. |
- Brändstedt, Johan, et al.
(author)
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Urosymphyseal fistula after pelvic radiotherapy in a tertial referral centre : a rare entity with significant comorbidity requiring multidisciplinary management
- 2023
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In: Scandinavian journal of urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 58, s. 4-10
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Journal article (peer-reviewed)abstract
- Objective: To report population-based clinical presentation and outcomes in patients with urosymphyseal fistula (USF) after pelvic radiotherapy (RT).Patients and methods: A retrospective chart review was performed in 33 consecutive patients diagnosed with suspicion of USF in a tertial referral center from 2014–2022 to ascertain information about diagnostic delay, clinical presentation, precipitating causes, treatments received and outcomes during the median 22 months follow-up. Out of 33 consecutive patients with suspicion of USF, one female with vesicovaginal fistula, one patient developing RT-associated bladder angiosarcoma, four patients with short follow-up (<3 months), and three patients that during chart review not were considered to have a USF were excluded.Results: In all, 24 males with a median age of 77 years were diagnosed with USF. Local pain was the predominating symptom in 17/24 (71%) patients. Endourologic manipulations preceded the diagnosis of USF in 16 patients. Five patients had a diagnostic delay of more than 3 months. At diagnosis, 20/24 patients had radiological signs of osteomyelitis, and five had a concomitant rectourethral fistula. Due to comorbidity, five patients were not amenable to any other interventions than urinary catheter or suprapubic tube in conjunction with long-term antibiotics, of which three died from infections related to the USF. Out of the remaining 19 patients receiving some form of urinary diversion, five had recurrent osteomyelitis, of which four did not undergo cystectomy in conjunction with surgery for the USF.Conclusions: Urethral endourologic interventions in patients previously subjected to pelvic RT should be performed cautiously.
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| 3. |
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| 4. |
- Abrahamsson, Johan, et al.
(author)
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Complete metabolic response with [18F]fluorodeoxyglucose-positron emission tomography/computed tomography predicts survival following induction chemotherapy and radical cystectomy in clinically lymph node positive bladder cancer
- 2022
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In: BJU International. - : Wiley. - 1464-4096 .- 1464-410X. ; 129:2, s. 174-181
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Journal article (peer-reviewed)abstract
- Objective: To determine whether repeated [18F]fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET-CT) scans can predict increased cancer-specific survival (CSS) after induction chemotherapy followed by radical cystectomy (RC). Patients and Methods: Between 2007 and 2018, 86 patients with clinically lymph node (LN)-positive bladder cancer (T1–T4, N1–N3, M0–M1a) were included and underwent a repeated FDG-PET-CT during cisplatin-based induction chemotherapy. The 71 patients that had a response to chemotherapy underwent RC. Response to chemotherapy was evaluated in LNs through repeated FDG-PET-CT and stratified as partial response or complete response using three different methods: maximum standardised uptake value (SUVmax), adapted Deauville criteria, and total lesion glycolysis (TLG). Progression-free survival (PFS) and CSS were analysed for all three methods by Cox regression analysis. Results: After a median follow-up of 40 months, 15 of the 71 patients who underwent RC had died from bladder cancer. Using SUVmax and the adapted Deauville criteria, multivariable Cox regression analyses adjusting for age, clinical tumour stage and LN stage showed that complete response was associated with increased PFS (hazard ratio [HR] 3.42, 95% confidence interval [CI] 1.20–9.77) and CSS (HR 3.30, 95% CI 1.02–10.65). Using TLG, a complete response was also associated with increased PFS (HR 5.17, 95% CI 1.90–14.04) and CSS (HR 6.32, 95% CI 2.06–19.41). Conclusions: Complete metabolic response with FDG-PET-CT predicts survival after induction chemotherapy followed by RC in patients with LN-positive bladder cancer and comprises a novel tool in evaluating response to chemotherapy before surgery. This strategy has the potential to tailor treatment in individual patients by identifying significant response to chemotherapy, which motivates the administration of a full course of induction chemotherapy with a higher threshold for suspending treatment due to toxicity and side-effects.
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| 5. |
- Abrahamsson, Johan, et al.
(author)
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On the Efficiency of a Two-Power-Level Flywheel-Based All-Electric Driveline
- 2012
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In: Energies. - : MDPI AG. - 1996-1073. ; 5:8, s. 2794-2817
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Journal article (peer-reviewed)abstract
- This paper presents experimental results on an innovative electric driveline employing a kinetic energy storage device as energy buffer. A conceptual division of losses in the system was created, separating the complete system into three parts according to their function. This conceptualization of the system yielded a meaningful definition of the concept of efficiency. Additionally, a thorough theoretical framework for the prediction of losses associated with energy storage and transfer in the system was developed. A large number of spin-down tests at varying pressure levels were performed. A separation of the measured data into the different physical processes responsible for power loss was achieved from the corresponding dependence on rotational velocity. This comparison yielded an estimate of the perpendicular resistivity of the stranded copper conductor of 2.5 x 10(-8) +/- 3.5 x 10(-9). Further, power and energy were measured system-wide during operation, and an analysis of the losses was performed. The analytical solution was able to reproduce the measured distribution of losses in the system to an accuracy of 4.7% (95% CI). It was found that the losses attributed to the function of kinetic energy storage in the system amounted to between 45% and 65%, depending on usage.
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| 6. |
- Abrahamsson, Johan, et al.
(author)
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Prototype of electric driveline with magnetically levitated double wound motor
- 2010
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In: Electrical Machines (ICEM), 2010 XIX International Conference on.
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Conference paper (peer-reviewed)abstract
- This paper presents the ongoing work of constructing a complete driveline for an electric road vehicle, using a flywheel as auxiliary energy storage. The flywheel energy storage system (FESS) is connected in series between the main energy storage (batteries) and the wheel motor of the vehicle, allowing the batteries to deliver power to the system in an optimized way, while at the same time making efficient use of regenerative braking. A double wound permanent magnet electric machine is used to electrically separate the two sides. In order to minimize losses, the machine has a double rotor configuration and is suspended with magnetic bearings. A bench test set-up is being constructed to investigate the properties of this system in detail. This set-up will achieve a level of power and energy close to that of a full scale system. This will allow measurements of complete drive cycles to be performed, improving the understanding of the constituting components and optimization of the complete system.
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| 7. |
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| 8. |
- de Santiago Ochoa, Juan, et al.
(author)
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Design Parameters Calculation of a Novel Driveline for Electric Vehicles
- 2009
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In: World Electric Vehicle Journal. - 2032-6653. ; 3
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Journal article (peer-reviewed)abstract
- A driveline for electric vehicles is presented. The propulsion system is operated at a higher voltage than the primary energy source. The batteries selected as the primary energy source deliver power to the vehicle through a motor-generator wounded with two electrically isolated sets of windings, named Two Voltage Level Machine (TVLM). The dynamic behaviour of a vehicle operating according to a standard drive cycle is studied. Parameters of the driveline such as power rates and size of the flywheel are obtained by optimization. A description of the performance of a TVLM is also presented through its equivalent circuit and the control of the machine. Special attention to the system losses is presented. A scale prototype has been constructed and tested under a drive cycle, demonstrating the system performance of the system.
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| 9. |
- Eliasson, Charlotte, 1973, et al.
(author)
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Multivariate methodology for surface enhanced Raman chemical imaging of lymphocytes
- 2006
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In: Chemometrics and Intelligent Laboratory Systems. - : Elsevier BV. - 0169-7439 .- 1873-3239. ; 81:1, s. 13-20
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Journal article (peer-reviewed)abstract
- Surface enhanced Raman spectroscopy (SERS) was used to study the uptake of rhodamine 6G in human lymphocytes. In total four Raman images of lymphocytes were used. The aim was to find a multivariate methodology capable of separating spectra with chemical information from those that mainly contained the surface enhanced background, in order to create chemical images. The standard PCA procedure was compared with PCA of standard normal variate (SNV) corrected spectra, spectra baseline corrected in the wavelet domain, and variable trimming before PCA, to isolate unique spectra. It was not straightforward to perform a standard PCA for overview, since the small background variation in many variables dominated over the Raman band variation that only occur in few variables. It was shown that wavelet filtering could remove background variations and that variable trimming followed by PCA modelling left the unique Raman spectra as outliers, which facilitated interpretation of the Raman score images.
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| 10. |
- Eliasson, Charlotte, 1973, et al.
(author)
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Surface-enhanced Raman scattering imaging of single living lymphocytes with multivariate evaluation
- 2005
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In: Spectrochimica Acta Part A-Molecular and Biomolecular Spectroscopy. - : Elsevier BV. - 1386-1425. ; 61:4, s. 755-760
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Journal article (peer-reviewed)abstract
- This paper is aimed to show the possibility to determine individual organic compounds introduced into single living cells with surface-enhanced Raman spectroscopy (SERS). Surface enhancement was achieved with gold colloids that were allowed to diffuse into lymphocytes. An introduced analyte, rhodamine 6G, could be imaged together with for example nucleotides and amino acids of the cell. Multivariate evaluation of surface-enhanced Raman images proved to be a powerful tool for the separation of spectral information of various intracellular components. The principal component analysis (PCA) enabled identification of spectra containing different chemical information and separation of the spectral contribution of rhodamine 6G from the complex cellular matrix.
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