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- Danielsson, D., et al.
(author)
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Osteoradionecrosis, an increasing indication for microvascular head and neck reconstruction
- 2020
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In: International Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0901-5027 .- 1399-0020. ; 49:1, s. 1-6
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Journal article (peer-reviewed)abstract
- Better cancer treatment has led to a steadily growing population of cancer survivors suffering from late adverse effects after cancer treatment. The aim of this study was to investigate whether there has been an increase in free flap reconstruction due to osteoradionecrosis (ORN). A retrospective review was conducted to identify all consecutive head and neck free flap reconstructions performed over an 18-year period (1995-2012) at Karolinska University Hospital. A total of 235 free flaps were identified. Cases were divided into two groups: head and neck cancer reconstructions and ORN reconstructions. A comparison between the two groups showed longer survival (P < 0.001) and higher rates of late complications (P < 0.001) among ORN cases. ORN as an indication for reconstruction increased over time, from 7.0% of the total number of free flaps performed in 1995-2000, to 15.2% during the period 2001-2006, and to 27.3% in 2007-2012 (P < 0.001). This, in accordance with the results of other studies, highlights the importance of the appropriate allocation of resources within the healthcare system to treat this patient group within the steadily increasing population of cancer survivors.
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- de Val-Borro, M., et al.
(author)
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Modelling circumbinary gas flows in close T Tauri binaries star
- 2011
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In: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 413:4, s. 2679-2688
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Journal article (peer-reviewed)abstract
- Young close binaries open central gaps in the surrounding circumbinary accretion disc, but the stellar components may still gain mass from gas crossing through the gap. It is not well understood how this process operates and how the stellar components are affected by such inflows. Our main goal is to investigate how gas accretion takes place and evolves in close T Tauri binary systems. In particular, we model the accretion flows around two close T Tauri binaries, V4046 Sgr and DQ Tau, both showing periodic changes in emission lines, although their orbital characteristics are very different. In order to derive the density and velocity maps of the circumbinary material, we employ two-dimensional hydrodynamic simulations with a locally isothermal equation of state. The flow patterns become quasi-stable after a few orbits in the frame corotating with the system. Gas flows across the circumbinary gap through the corotating Lagrangian points, and local circumstellar discs develop around both components. Spiral density patterns develop in the circumbinary disc that transport angular momentum efficiently. Mass is preferentially channelled towards the primary and its circumstellar disc is more massive than the disc around the secondary. We also compare the derived density distribution to observed line profile variability. The line profile variability tracing the gas flows in the central cavity shows clear similarities with the corresponding observed line profile variability in V4046 Sgr, but only when the local circumstellar disc emission was excluded. Closer to the stars normal magnetospheric accretion may dominate, while further out the dynamic accretion process outlined here dominates. Periodic changes in the accretion rates on to the stars can explain the outbursts of line emission observed in eccentric systems such as DQ Tau.
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- Eriksson, BO, et al.
(author)
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Upregulation of Plasminogen Activator Inhibitor-1 in Irradiated Recipient Arteries and Veins from Free Tissue Transfer Reconstruction in Cancer Patients
- 2018
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In: Mediators of inflammation. - : Hindawi Limited. - 1466-1861 .- 0962-9351. ; 2018, s. 4058986-
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Journal article (peer-reviewed)abstract
- Background. Clinical studies have shown that radiotherapy can induce vascular disease at the site of exposure but is usually not clinically evident until years after treatment. We have studied irradiated human arteries and veins to better understand the underlying biology in search of future treatments. The aim was to investigate whether radiotherapy contributed to a sustained expression of plasminogen activator inhibitor-1 (PAI-1) in human arteries and veins. Methods. Irradiated arteries and veins were harvested, together with unirradiated control vessels, from patients undergoing free tissue transfer reconstruction at a median time of 90 weeks [5–650] following radiation exposure. Differential gene expression of PAI-1 was analysed, together with immunohistochemistry (IHC) and immunofluorescence (IF). Results. PAI-1 gene expression was increased in both arteries (p=0.012) and veins (p<0.001) in irradiated compared to unirradiated control vessels. IHC and IF indicated that cells expressing PAI-1 were located in the adventitia of both arteries and veins and colocalized with cells positive for CD68, CD45, and α-SMA in arteries and with CD45 and α-SMA in veins. Conclusion. The current study shows a sustained upregulation of PAI-1 in both arteries and veins after exposure to ionizing radiation, indicating a chronic inflammation mainly in the adventitia. We believe that the results contribute to further understanding of radiation-induced vascular disease, where targeting PAI-1 may be a potential treatment.
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