| 11. |
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| 12. |
- Holmberg, Lars, et al.
(author)
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A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer
- 2002
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In: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 347:11, s. 781-789
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Journal article (peer-reviewed)abstract
- BACKGROUND: Radical prostatectomy is widely used in the treatment of early prostate cancer. The possible survival benefit of this treatment, however, is unclear. We conducted a randomized trial to address this question. METHODS: From October 1989 through February 1999, 695 men with newly diagnosed prostate cancer in International Union against Cancer clinical stage T1b, T1c, or T2 were randomly assigned to watchful waiting or radical prostatectomy. We achieved complete follow-up through the year 2000 with blinded evaluation of causes of death. The primary end point was death due to prostate cancer, and the secondary end points were overall mortality, metastasis-free survival, and local progression. RESULTS: During a median of 6.2 years of follow-up, 62 men in the watchful-waiting group and 53 in the radical-prostatectomy group died (P=0.31). Death due to prostate cancer occurred in 31 of 348 of those assigned to watchful waiting (8.9 percent) and in 16 of 347 of those assigned to radical prostatectomy (4.6 percent) (relative hazard, 0.50; 95 percent confidence interval, 0.27 to 0.91; P=0.02). Death due to other causes occurred in 31 of 348 men in the watchful-waiting group (8.9 percent) and in 37 of 347 men in the radical-prostatectomy group (10.6 percent). The men assigned to surgery had a lower relative risk of distant metastases than the men assigned to watchful waiting (relative hazard, 0.63; 95 percent confidence interval, 0.41 to 0.96). CONCLUSIONS: In this randomized trial, radical prostatectomy significantly reduced disease-specific mortality, but there was no significant difference between surgery and watchful waiting in terms of overall survival.
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| 13. |
- Ivarsson, Pia-Maria, 1957-
(author)
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Barns gemenskap i förskolan
- 2003
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Doctoral thesis (other academic/artistic)abstract
- This study is about children’s communities. It is also about children’s everyday interaction in a pre-school setting and how they utilise interactional and institutional resources to construct peer communities and to group themselves within them. The peer communities discussed in this study are embedded in an institutional context, namely the pre-school setting.To capture this phenomenon an ethnographic approach was used. Included in the benefits of choosing this approach are the opportunities to study everyday practices and children’s activities in a pre-school setting. Participant observations, child interviews and video recordings were used when the data were subsequently constructed and analysed.One feature underlying the pre-school setting as a social context is the organisation of time and space. Time and space structure children’s activities and their material and immaterial resources and social relations. This is shown in an example related to a little boy’s (Mattias) story of everyday practices in pre-school. Another illustrative example of how time and space form the structure for routines and social relations is when the children play a game called ‘the ting-a-ling train’. Still another example of an interesting finding was discovered when the children swung together in the pre-school playground.The preschool conditions allow children to construct their own strategies to gain access to the interactive space, where their negotiations and the organisation of time and space are of vital importance. Another important finding is that activity and talk about activity are functions that are inter-related and that children use as interactional resources.When the children become members of a pre-school group they are at the same time constructed as pre-schoolers. They are ‘doing-being’ pre-schoolers and at a same time constructing the everyday practice called pre-school. Interaction and social context are entwined, which means that a study of children’s peer communities in a pre-school setting offers valuable knowledge about the world of children and about the pre-school as a social context.
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| 14. |
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| 15. |
- Johansson, Jan-Erik, 1963
(author)
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Gastro-intestinal toxicity related to haemopoietic stem cell transplantation with a special focus on the intestinal barrier function
- 2000
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Doctoral thesis (other academic/artistic)abstract
- The myeloablative, cytotoxic therapy (conditioning treatment) prior to haemopoietic stem cell transplantation (HSCT) has the combined purpose of eliminating leukaemic or cancer cells located in the bone marrow or elsewhere in the body and, in the allogeneic setting, of suppressing the immune response of the recipient to prevent marrow rejection. The unwanted effect is the inevitable elimination of normal, haemopoietic stem cells, a lethal effect which is circumvented by the following administration of haemopoietic stem cells from the patient (autologous HSCT) or from a related or an unrelated donor (allogeneic HSCT). However, normal tissues with a high cell-turnover rate, primarily the gastro-intestinal (GI) tract, will likewise be affected. Besides causing significant GI symptoms, this injury includes a disruption of the intestinal barrier, facilitating the permeation of bacteria and endotoxin through the bowel wall, with subsequent septicaemia and release of cytokines, known to be important mediators of graft-versus-host disease (GVHD), the primary complication of allogeneic HSCT. Accordingly, murine HSCT-models have suggested that after intensification of the conditioning treatment, GVHD has been amplified as a result of aggravated GI toxicity.Using a 51Cr-EDTA resorption test, the present study investigates the intestinal-barrier function in HSCT patients receiving myeloablative or reduced intensity conditioning (RIC). It also investigates whether the strengthening of the GI immune system by the oral administration of an immunoglobulin preparation would modify intestinal barrier integrity during autologous HSCT. Finally, on the basis of the observation that the impairment of intestinal barrier integrity by non-steroidal anti-inflammatory drugs (NSAID) is due to an early disturbance of energy metabolism in enterocytes, the existence of a similar mechanism in chemotherapy was searched for. Using high-performance liquid chromatography (HPLC) technique and 51Cr-EDTA resorption, the purine-nucleotide content in enterocytes and intestinal permeability was determined in rats after chemotherapy.It was found that the intestinal barrier was disrupted preceding clinical symptoms with myeloablative conditioning, but preserved with RIC. The oral administration of an immunoglobulin preparation revealed ameliorated intestinal barrier integrity during autologous HSCT. In rats, an early-detectable disruption of the intestinal barrier was found which parallels a decrease in purine-nucleotide content in enterocytes, reflecting a metabolic disturbance.A hypothesis may be formed containing an early intestinal-barrier disruption with chemotherapy, initiated by a metabolic disturbance in enterocytes. Since murine data revealed aggravated GVHD with increased intestinal injury, the preserved intestinal integrity with RIC should have the potential of reducing GVHD severity. These observations suggest that the intestinal barrier function has a central role to play in the intestinal damage induced by cytotoxic therapy as well as in GVHD.
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| 16. |
- Johansson, Jan-Erik, et al.
(author)
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Natural history of early, localized prostate cancer
- 2004
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In: Journal of the American Medical Association (JAMA). - : American Medical Association (AMA). - 0098-7484 .- 1538-3598. ; 291:22, s. 2713-2719
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Journal article (peer-reviewed)abstract
- CONTEXT: Among men with early prostate cancer, the natural history without initial therapy determines the potential for survival benefit following radical local treatment. However, little is known about disease progression and mortality beyond 10 to 15 years of watchful waiting. OBJECTIVE: To examine the long-term natural history of untreated, early stage prostatic cancer. DESIGN: Population-based, cohort study with a mean observation period of 21 years. SETTING: Regionally well-defined catchment area in central Sweden (recruitment March 1977 through February 1984). PATIENTS: A consecutive sample of 223 patients (98% of all eligible) with early-stage (T0-T2 NX M0 classification), initially untreated prostatic cancer. Patients with tumor progression were hormonally treated (either by orchiectomy or estrogens) if they had symptoms. MAIN OUTCOME MEASURES: Progression-free, cause-specific, and overall survival. RESULTS: After complete follow-up, 39 (17%) of all patients experienced generalized disease. Most cancers had an indolent course during the first 10 to 15 years. However, further follow-up from 15 (when 49 patients were still alive) to 20 years revealed a substantial decrease in cumulative progression-free survival (from 45.0% to 36.0%), survival without metastases (from 76.9% to 51.2%), and prostate cancer-specific survival (from 78.7% to 54.4%). The prostate cancer mortality rate increased from 15 per 1000 person-years (95% confidence interval, 10-21) during the first 15 years to 44 per 1000 person-years (95% confidence interval, 22-88) beyond 15 years of follow-up (P =.01). CONCLUSION: Although most prostate cancers diagnosed at an early stage have an indolent course, local tumor progression and aggressive metastatic disease may develop in the long term. These findings would support early radical treatment, notably among patients with an estimated life expectancy exceeding 15 years.
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| 17. |
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| 18. |
- Jonasson, Jenni, et al.
(author)
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Evidence for a common Spinocerebellar ataxia type 7 (SCA7) founder mutation in Scandinavia
- 2000
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In: European Journal of Human Genetics. - : Springer Science and Business Media LLC. - 1018-4813 .- 1476-5438. ; 8, s. 918-
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Journal article (peer-reviewed)abstract
- Spinocerebellar ataxia type 7 (SCA7) is a neuro-degenerative disorder characterised by progressive cerebellar ataxia and macular degeneration. SCA7 is one of the least common genetically verified autosomal dominant cerebellar ataxias (ADCAs) in the world (4.5 to 11.6%), but in Sweden and Finland SCA7 is the most commonly identified form of ADCA. In an inventory of hereditary ataxias in Scandinavia (Sweden, Norway, Denmark and Finland) we identified 15 SCA7 families, eight in Sweden and seven in Finland, while no cases of SCA7 could be found in Norway or Denmark. We examined whether the relatively high frequency of SCA7 families in Sweden and Finland was the result of a common founder effect. Only two out of 15 families could be connected genealogically. However, an extensive haplotype analysis over a 10.2 cM region surrounding the SCAI gene locus showed that all 15 families studied shared a common haplotype over at least 1.9 cM. This strongly suggests that all Scandinavian SCA7 families originate from a common founder pre-mutation.
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| 19. |
- Lindström, Rakel, et al.
(author)
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Corrosion of magnesium in humid air
- 2004
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In: Corrosion Science. - : Elsevier BV. - 0010-938X .- 1879-0496. ; 46:5, s. 1141-1158
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Journal article (peer-reviewed)abstract
- The influence of ambient concentrations of carbon dioxide on the atmospheric corrosion of magnesium has been studied by atomic force microscopy (AFM) and scanning electron microscopy (SEM), revealing the development and growth of corrosion products. The surfaces investigated by AFM were prepared by ultramicrotomy, using a diamond knife, to generate a smooth finish without using water or lubricant. Sputter-deposited Mg films were also studied with mechanically polished samples used to monitor the overall corrosion process. The exposures were performed at 22.0 degreesC in a synthetic environment with precise control of relative humidity (95%) and CO2 (0 or 350 ppm). Corrosion is localized in the absence of CO2 and is related to noble inclusions in the metal matrix. After corrosion product removal, relatively deep pits are evident. In contrast, pitting is inhibited in the presence of CO, with relatively uniform corrosion product development; further, the noble inclusions have no effect on the distribution of corrosion. The inhibitive effect of CO2 is also observed in the long-term exposures, showing that CO2 reduces the average corrosion rate. Mechanisms are introduced to explain the effects of CO2 and the roles of the noble inclusions on the corrosion behaviour.
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| 20. |
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