| 1. |
- Cengiz, Y, et al.
(author)
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Randomized trial of traditional dissection with electrocautery versus ultrasonic fundus-first dissection in patients undergoing laparoscopic cholecystectomy.
- 2005
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In: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 92:7, s. 810-3
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Journal article (peer-reviewed)abstract
- BACKGROUND: In laparoscopic cholecystectomy dissection can be with monopolar electrocautery or with ultrasonic shears, and can start at the triangle of Calot or at the fundus of the gallbladder. METHODS: Thirty-seven patients undergoing laparoscopic cholecystectomy were randomized to electrocautery dissection from the triangle of Calot and 43 to fundus-first dissection with ultrasonic shears. All procedures were strictly standardized, and patients and their postoperative carers were blinded to the operation performed. RESULTS: Ultrasonic fundus-first dissection was associated with a shorter duration of operation (mean 46 versus 61 min), fewer overnight hospital stays (two versus eight), lower pain scores 4 and 24 h after surgery, less nausea at 2, 4 and 24 h, and a shorter period of sick leave (mean 5.5 versus 9.3 days) compared with electrocautery from the triangle of Calot. CONCLUSION: Ultrasonic fundus-first dissection during laparoscopic cholecystectomy was quicker and associated with less nausea and pain than electrocautery dissection from the triangle of Calot.
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| 2. |
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| 3. |
- Israelsson, Elisabeth, et al.
(author)
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Marked differences in CRP genotype frequencies between the Fulani and sympatric ethnic groups in Africa
- 2009
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In: Malaria Journal. - : Springer Science and Business Media LLC. - 1475-2875. ; 8:136
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Journal article (peer-reviewed)abstract
- Background C-reactive protein (CRP) is an acute phase protein that can activate various immune cells and bind to certain Fcγ receptors. The latter may compete with the binding of IgG antibodies to these receptors and could thereby interfere with the antigen-specific immune response. Polymorphisms in the promoter region of the CRP gene have been strongly associated with the plasma concentration of CRP. The known lower susceptibility to malaria in the Fulani ethnic group, as compared to their sympatric neighbours in Africa, has been linked to different genetic backgrounds. The present study was performed to investigate if polymorphisms in the CRP gene could contribute to the lower susceptibility to malaria seen in the Fulani ethnic group. Methods The CRP -717 T>C, -286 C>T>A, and +1444 C>T polymorphisms were analysed in asymptomatic Fulani and non-Fulani individuals from Mali and Sudan using Pyrosequencing T and TaqMan r MGB probes. Results The rare -286 A allele, previously shown to be associated with increased CRP expression and plasma levels, was shown to be more frequent in the non-Fulani ethnic groups as compared to the sympatric Fulani ethnic group both in Mali and Sudan. The common -717 T allele was more prevalent in the non-Fulani ethnic group compared to the sympatric Fulani ethnic group, but only in Mali. The parasite prevalence was increased for the -286 A allele, but not for the -717 T allele. No differences regarding genotype frequency or parasite prevalence were seen for +1444 C>T. Conclusion This study indicate that CRP may play an important role in the immune responses to malaria, and that the -286 C/T/A CRP polymorphism may be a contributing factor to the lower susceptibility to malaria seen in the Fulani.
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| 4. |
- Israelsson, Leif A, et al.
(author)
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Incisional hernia repair in Sweden 2002
- 2006
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In: Hernia. - : Springer. - 1265-4906 .- 1248-9204. ; 10:3, s. 258-261
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Journal article (peer-reviewed)abstract
- Incisional hernia is a common problem after abdominal surgery. The complication and recurrence rates following the different repair techniques are a matter of great concern. Our aim was to study the results of incisional hernia repair in Sweden. A questionnaire was sent to all surgical departments in Sweden requesting data concerning incisional hernia repair performed during the year 2002. Eight hundred and sixty-nine incisional hernia repairs were reported from 40 hospitals. Specialist surgeons performed the repair in 782 (83.8%) patients. The incisional hernia was a recurrence in 148 (17.0%) patients. Thirty-three per cent of the hernias were subsequent to transverse, subcostal or muscle-splitting incisions or laparoscopic procedures. Suture repair was performed in 349 (40.2%) hernias. Onlay mesh repair was more common than a sublay technique. The rate of wound infection was 9.6% after suture repair and 8.1% after mesh repair. The recurrence rate was 29.1% with suture repair, 19.3% with onlay mesh repair, and 7.3% with sublay mesh repair. This survey revealed that there is room for improvement regarding the incisional hernia surgery in Sweden. Suture repair, with its unacceptable results, is common and mesh techniques employed may not be optimal. This study has led to the instigation of a national incisional hernia register.
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| 5. |
- Israelsson, Leif A
(author)
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Parastomal hernias
- 2008
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In: Surgical Clinics of North America. - : W.B. Saunders Co.. - 0039-6109 .- 1558-3171. ; 88:1, s. 113-125
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Journal article (peer-reviewed)abstract
- The incidence of parastomal hernias is probably 30% to 50%. Suture repair of a parastomal hernia or relocation of the stoma results in a high recurrence rate, whereas with mesh repair recurrence rates are lower. Several mesh repair techniques are used in open and laparoscopic surgery, but randomized trials comparing various techniques and with long-term follow-up are needed for better evidence.
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| 6. |
- Israelsson, Leif A
(author)
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Preventing and treating parastomal hernia
- 2005
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In: World Journal of Surgery. - : Springer. - 0364-2313 .- 1432-2323. ; 29:8, s. 1086-1089
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Journal article (peer-reviewed)abstract
- Parastomal hernia represents a major surgical challenge. There is no uniform definition of parastomal hernia, and the true rate is therefore difficult to establish, although it is probably higher than 30%. Many surgical techniques have been tried to prevent and treat parastomal hernia; but despite these efforts, herniation continues to be a problem. The only method that has reduced the rate of parastomal hernia in a randomized trial is the use of a prophylactic prosthetic mesh. A large-pore low-weight mesh with reduced polypropylene content and a high proportion of absorbable material placed in a sublay position at the primary operation significantly reduces the rate of parastomal hernia. Recurrence rates after surgical treatment of parastomal hernia are high unless mesh is used. Relocation of the stoma, with prophylactic mesh in a sublay position at the new site and sublay mesh repairing the incisional hernia at the primary site, is the standard method for treating parastomal hernia in our department.
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| 7. |
- Johannesson, Per, et al.
(author)
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A novel and rapid method to quantify cytolytic replication of picornaviruses in cell culture
- 2005
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In: Journal of virological methods. - : Elsevier BV. - 0166-0934. ; 130, s. 117-123
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Journal article (peer-reviewed)abstract
- Determining viral titers is a key issue in a wide variety of studies regarding different aspects of virology. The standard methods used for determining picornavirus titers are endpoint titration assay and plaque assay, both time consuming and laborious. The method described uses the tetrazolium salt MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium-bromide) that is reduced to formazane by cellular dehydrogenase, genes shown to be down-regulated during picornavirus infection. The amount formazane produced correlates with the viral titers obtained and can easily be measured using an ELISA plate reader. The colorimetric method has been evaluated using virus types from different genera of the Picornaviridae family. The MTT method reduces the time spent on determining the viral titers and still maintains a reliable accuracy.
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| 8. |
- Jonsson, Nina, et al.
(author)
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A rapid and efficient method for studies of virus interaction at the host cell surface using enteroviruses and real-time PCR
- 2009
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In: Virology Journal. - 1743-422X. ; 6:Article ID: 217
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Journal article (peer-reviewed)abstract
- Background: Measuring virus attachment to host cells is of great importance when trying to identify novel receptors. The presence of a usable receptor is a major determinant of viral host range and cell tropism. Furthermore, identification of appropriate receptors is central for the understanding of viral pathogenesis and gives possibilities to develop antiviral drugs. Attachment is presently measured using radiolabeled and subsequently gradient purified viruses. Traditional methods are expensive and time-consuming and not all viruses are stable during a purification procedure; hence there is room for improvement. Real-time PCR (RT-PCR) has become the standard method to detect and quantify virus infections, including enteroviruses, in clinical samples. For instance, primers directed to the highly conserved 5' untranslated region (5'UTR) of the enterovirus genome enable detection of a wide spectrum of enteroviruses. Here, we evaluate the capacity of the RT-PCR technology to study enterovirus host cell interactions at the cell surface and compare this novel implementation with an established assay using radiolabeled viruses. Results: Both purified and crude viral extracts of CVB5 generated comparable results in attachment studies when analyzed with RT-PCR. In addition, receptor binding studies regarding viruses with coxsackie- nd adenovirus receptor (CAR) and/or decay accelerating factor (DAF) affinity, further demonstrated the possibility to use RT-PCR to measure virus attachment to host cells. Furthermore, the RT-PCR technology and crude viral extracts was used to study attachment with low multiplicity of infection (0.05 x 10(-4)TCID(50)/cell) and low cell numbers (250), which implies the range of potential implementations of the presented technique. Conclusion: We have implemented the well-established RT-PCR technique to measure viral attachment to host cells with high accuracy and reproducibility, at low cost and with less effort than traditional methods. Furthermore, replacing traditional methods with RT-PCR offers the opportunity to use crude virus containing extracts to investigate attachment, which could be considered as a step towards viral attachment studies in a more natural state.
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| 9. |
- Jänes, Arthur, 1970-, et al.
(author)
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Preventing parastomal hernia with a prosthetic mesh : a 5-year follow-up of a randomized study
- 2009
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In: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 33:1, s. 118-121
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Journal article (peer-reviewed)abstract
- BACKGROUND: Parastomal hernia is a major clinical problem. In a randomized, clinical trial, a prosthetic mesh in a sublay position at the index operation reduced the rate of parastomal hernia at 12-month follow-up, without any increase in the rate of complications. This study was designed to evaluate the rate of complications after 5 years. METHODS: Between January 2001 and April 2003, 54 patients who had a permanent ostomy were randomized to a conventional stoma or to a stoma with the addition of a mesh in a sublay position. A large-pore, lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material was used. RESULTS: After 5 years, 21 patients with a conventional stoma were alive and parastomal herniation was recorded in 17 patients, of whom repair had been demanded in 5. In 15 patients operated on with the addition of a mesh herniation, that did not require repair, was present in 2 (P<0.001). No fistulas or strictures developed. No mesh infection was noted and no mesh was removed during the study period. CONCLUSIONS: At stoma formation, a prophylactic low-weight mesh in a sublay position is a safe procedure that reduces the rate of parastomal hernia.
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| 10. |
- Millbourn, Daniel, et al.
(author)
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Effect of stitch length on wound complications after closure of midline incisions : a randomized controlled trial
- 2009
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In: Archives of surgery (Chicago. 1960). - : American Medical Association. - 0004-0010 .- 1538-3644. ; 144:11, s. 1056-1059
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Journal article (peer-reviewed)abstract
- HYPOTHESIS: In midline incisions closed with a single-layer running suture, the rate of wound complications is lower when a suture length to wound length ratio of at least 4 is accomplished with a short stitch length rather than with a long one. DESIGN: Prospective randomized controlled trial. SETTING: Surgical department. PATIENTS: Patients operated on through a midline incision. INTERVENTION: Wound closure with a short stitch length (ie, placing stitches <10 mm from the wound edge) or a long stitch length. MAIN OUTCOME MEASURES: Wound dehiscence, surgical site infection, and incisional hernia. RESULTS: In all, 737 patients were randomized: 381 were allocated to a long stitch length and 356, to a short stitch length. Wound dehiscence occurred in 1 patient whose wound was closed with a long stitch length. Surgical site infection occurred in 35 of 343 patients (10.2%) in the long stitch group and in 17 of 326 (5.2%) in the short stitch group (P = .02). Incisional hernia was present in 49 of 272 patients (18.0%) in the long stitch group and in 14 of 250 (5.6%) in the short stitch group (P < .001). In multivariate analysis, a long stitch length was an independent risk factor for both surgical site infection and incisional hernia. CONCLUSION: In midline incisions closed with a running suture and having a suture length to wound length ratio of at least 4, current recommendations of placing stitches at least 10 mm from the wound edge should be changed to avoid patient suffering and costly wound complications.
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| 11. |
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| 12. |
- Piekarek, Kristoffer, et al.
(author)
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Perforated colonic diverticular disease : the importance of NSAIDs, opioids, corticosteroids, and calcium channel blockers
- 2008
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In: International Journal of Colorectal Disease. - : Springer Science and Business Media LLC. - 0179-1958 .- 1432-1262. ; 23:12, s. 1193-1197
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Journal article (peer-reviewed)abstract
- PURPOSE: Perforated colonic diverticular disease is associated with a high rate of late sequel and mortality. The risk of colonic perforation may relate to intracolonic pressure and mucosal barrier function in the wall of diverticula. The use of substances affecting these parameters may therefore be associated with the risk of developing a perforation. The aim was to study the effect of nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, corticosteroids, calcium channel blockers, and antimuscarinics on perforation in diverticular disease.MATERIALS AND METHODS: A review of 54 patients with colonic diverticular perforation-forming the case group-and 183 patients with verified colonic diverticular disease-forming the control group-was done. Patient characteristics and drug use was registered.RESULTS: Case group and control group were comparable with respect to sex, age, and comorbidity. In multivariate analysis, the use of NSAIDs (OR 3.56; 95% CI 1.50-8.43), opioids (OR 4.51; 95% CI 1.67-12.18), and corticosteroids (OR 28.28; 95% CI 4.83-165.7) were significantly associated with perforated diverticular disease. Acetylsalicylic acid in cardiologic dose did not affect the rate of perforation (OR 0.66; 95% CI 0.27-1.61). The use of calcium channel blockers was associated with a reduced rate of diverticular complications (OR 0.14; 95% CI 0.02-0.95).CONCLUSIONS: The administration of NSAIDs, opioids, and corticosteroids are associated with an increased risk of colonic diverticular perforation. Acetylsalicylic acid in cardiologic dose does not affect the risk of perforation. Calcium channel blockers are associated with a reduced risk of perforation.
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| 13. |
- Wagner, K, et al.
(author)
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Association of polymorphisms and haplotypes in the human growth hormone 1 (GH1) gene with breast cancer
- 2005
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In: Endocrine-related cancer. - : Bioscientifica. - 1351-0088 .- 1479-6821. ; 12:4, s. 917-928
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Journal article (peer-reviewed)abstract
- The growth hormone 1 (GH1)/insulin-like growth factor I (IGF-I) axis plays an important role in the development of breast cancer. By binding to its receptor, GH1 stimulates the production of IGF-I and its binding protein IGFBP3, resulting in the regulation of cell proliferation, differentiation and apoptosis. The GH1 gene expression is regulated by a highly polymorphic proximal promoter and a distal locus control region (LCR) 14.5 kb upstream of the gene. We investigated the effect of single nucleotide polymorphisms (SNPs) in the LCR and in the promoter region and an intron 4 SNP (IVS4+90 T/A) on breast cancer risk in a large cohort of Polish and German familial breast cancer cases and controls. SNPs in the LCR did not show an influence on breast cancer risk, either alone or in haplotypes. Three SNPs in the promoter region (G-340T, A-68G/C and A-63T/C) showed an increased and four SNPs (A-137G, G-119T, G-93delG and T-4G) a decreased allele frequency in the cases compared with the controls. Two of the SNPs (A-137G and G-93delG) lead to a decreased breast cancer risk among the minor allele carriers in the joint analysis of the two populations (odds ratio (OR) 0.62, 95% confidence interval (95% CI) 0.44–0.89, P=0.01 and OR 0.65, 95% CI 0.47–0.90, P=0.01, respectively). Haplotype analysis with these seven promoter SNPs revealed a protective association (OR 0.61, 95% CI 0.37–1.00, P=0.04) for the haplotype GAGdAAT, containing the G-93delG variant allele, which in the single analysis already showed a protective effect. The effect was marginally stronger in combination with the LCR GC haplotype (OR 0.49, 95% CI 0.23–1.01, P=0.04).
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