| 1. |
- Arroyo, Carlos, 1977, et al.
(author)
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Experimental and Numerical Investigation of an Aggressive Intermediate Turbine Duct: Part 2−Flowfield under Off-Design Inlet Conditions
- 2008
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In: Collection of Technical Papers - AIAA Applied Aerodynamics Conference. - Reston, Virigina : American Institute of Aeronautics and Astronautics. - 1048-5953.
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Conference paper (peer-reviewed)abstract
- Intermediate turbine ducts (ITD’s) are annular S-shaped channels used in turbofan engines to guide the flow between the small-radius high-pressure turbine and the large-radius lowpressureturbine. This paper is the second part of a two-part paper presenting the results of acombined experimental and computational investigation of the flow in an aggressiveintermediate turbine duct. The first part of the paper focused on the flowfield under the ITDdesign conditions. This second part of the paper presents and analyses the flowfield andperformance under two off-design conditions (i.e. lower and higher turbine load). The focus ison the changes of the flowfield for these conditions as the inlet flow angles differ from thedesign values (e.g. flow separation occurs in the duct for the lower turbine load case) and theeffect of this change on the duct performance. Total pressure losses are seen to increase forboth off-design cases, especially for the case with flow separation (lower turbine load). Thestatic pressure recovery is also found to be lower for the case with flow separation while for thehigher turbine load tested it remains almost unchanged. In addition, differences foundbetween the measured and predicted performance parameters are discussed. The experimentalstudy was performed in a large-scale, low-speed turbine facility. The CFD computations wereperformed for the same flow conditions and used boundary conditions based on the measuredinlet plane.
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| 2. |
- Berg, Marie, 1955, et al.
(author)
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Early random capillary glucose level screening and multidisciplinary antenatal teamwork to improve outcome in gestational diabetes mellitus
- 2007
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In: Acta Obstet Gynecol Scand. ; 86:3, s. 283-90
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Journal article (peer-reviewed)abstract
- BACKGROUND: This study describes maternal and neonatal characteristics and delivery outcome in women with gestational diabetes mellitus [GDM], compared to a control group. METHODS: A retrospective observational study of 719 women with GDM was undertaken in a Swedish urban district. All other parturients at the same hospital served as the control group. GDM was diagnosed using random capillary glucose levels at fixed intervals, beginning early in pregnancy. An oral glucose tolerance test was performed at glucose levels>or=7.0 mmol/l (127.8 mg/dl). Data was analysed according to glucose levels at diagnosis, ie, mild or severe GDM. RESULTS: GDM was diagnosed in 2.28% of the women who were older and had higher Body Mass Index [BMI]. A high proportion was of non-Nordic origin (44.5%); they had severe GDM more often (49.1%) than the Nordic group (33.1%). The GDM-mild group had less complications and abnormalities, compared to the GDM-severe group, although both groups differed from the control group in this respect. Delivery was spontaneous in 70.2% of GDM-mild, 65.7% of GDM-severe and 81.0% of the control group. LGA (+2 SD) was found in 4.8, 10.5 and 3.2%, respectively. CONCLUSION: Early non-fasting random universal screening and multidisciplinary antenatal teamwork intervention seems to be favourable, with low rates of excessive fetal growth, instrumental vaginal delivery and caesarean section.
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| 3. |
- Brown, Rachael, et al.
(author)
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Assessing the integrity of sympathetic pathways in spinal cord injury.
- 2007
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In: Autonomic neuroscience : basic & clinical. - : Elsevier BV. - 1566-0702. ; 134:1-2, s. 61-8
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Journal article (peer-reviewed)abstract
- STUDY DESIGN: Measurement of cutaneous sympathetic reflexes and hemodynamic responses to brief electrical stimuli applied above (forehead) and below (abdominal wall) a spinal lesion. OBJECTIVE: To assess the validity of using cutaneous vasoconstriction as a sensitive indicator of increases in sympathetic activity in spinal cord injury. SETTING: Prince of Wales Medical Research Institute, Australia. SUBJECTS: Twenty spinal cord injured subjects with injuries ranging from C3-T11 and nine able-bodied controls. METHOD: Cutaneous electrical stimulation was applied to the forehead and abdominal wall to subjects at unexpected times. Sudomotor and vasomotor responses, as well as continuous arterial pressure, heart rate and respiration were monitored. RESULTS: Sudomotor (electrodermal) responses to forehead stimulation were scarce in spinal cord injured subjects, whereas cutaneous vasoconstrictor responses (photoelectric pulse plethysmography) provided a sensitive indicator of any remaining central control of sympathetic function below the lesion. Electrical stimulation applied to the abdominal wall evoked vasoconstrictor reflexes below the lesion in the majority of spinal cord injured subjects, whereas only a limited number of electrodermal responses were observed. That these cutaneous vasoconstrictor responses could reflect parallel increases in muscle and splanchnic vasoconstrictor activity was indicated by the increases in blood pressure; patients lacking vasoconstrictor responses rarely showed stimulus-induced blood pressure increases. CONCLUSION: Our findings show that skin vasomotor responses to somatosensory stimulation provide a more sensitive tool than electrodermal responses for evaluation of sympathetic function below a spinal cord lesion. STATEMENT OF ETHICS: We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research, and all experiments were conducted with the understanding and consent of each subject.
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| 4. |
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| 5. |
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| 6. |
- Charkoudian, N., et al.
(author)
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Relationship between muscle sympathetic nerve activity and systemic hemodynamics during nitric oxide synthase inhibition in humans
- 2006
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In: AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY. - : American Physiological Society. - 0363-6135 .- 1522-1539. ; 291:3
-
Journal article (peer-reviewed)abstract
- Large interindividual differences exist in resting sympathetic nerve activity (SNA) among normotensive humans with similar arterial pressure (AP). We recently showed inverse relationships of resting SNA with cardiac output (CO) and vascular adrenergic responsiveness that appear to balance the influence of differences in SNA on blood pressure. In the present study, we tested whether nitric oxide (NO)-mediated vasodilation has a role in this balance by evaluating hemodynamic responses to systemic NO synthase (NOS) inhibition in individuals with low and high resting muscle SNA (MSNA). We measured MSNA via peroneal microneurography, CO via acetylene uptake and AP directly, at baseline and during increasing systemic doses of the NOS inhibitor NG-monomethyl-l-arginine (l-NMMA). Baseline MSNA ranged from 9 to 38 bursts/min (13 to 68 bursts/100 heartbeats). l-NMMA caused dose-dependent increases in AP and total peripheral resistance and reflex decreases in CO and MSNA. Increases in AP with l-NMMA were greater in individuals with high baseline MSNA ( PANOVA < 0.05). For example, after 8.5 mg/kg of l-NMMA, in the low MSNA subgroup ( n = 6, 28 ± 4 bursts/100 heartbeats), AP increased 9 ± 1 mmHg, whereas in the high-MSNA subgroup ( n = 6, 58 ± 3 bursts/100 heartbeats), AP increased 15 ± 2 mmHg ( P < 0.01). The high-MSNA subgroup had lower baseline CO and smaller decreases in CO with l-NMMA, but changes in total peripheral resistance were not different between groups. We conclude that differences in CO among individuals with varying sympathetic traffic have important hemodynamic implications during disruption of NO-mediated vasodilation.
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| 7. |
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| 8. |
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| 9. |
- Donadio, Vincenzo, et al.
(author)
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Arousal elicits exaggerated inhibition of sympathetic nerve activity in phobic syncope patients.
- 2007
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In: Brain : a journal of neurology. - : Oxford University Press (OUP). - 1460-2156. ; 130:Pt 6, s. 1653-62
-
Journal article (peer-reviewed)abstract
- Alerting stimuli causing arousal have been shown to elicit a reproducible transient inhibition of muscle sympathetic nerve activity (MSNA) in healthy subjects. The aim of the present study was to test whether this inhibitory response to arousal is exaggerated in patients with a history of vasovagal syncope. We studied 24 untreated syncope patients, 12 of whom met the DSM-IV-TR diagnostic criteria for blood/injury phobia and 18 age-matched healthy subjects. MSNA was recorded from the peroneal nerve at the fibular head. Arousal was induced by randomly presented trains of five electrical pulses delivered to a finger. The pulses were triggered on five consecutive R waves of the ECG, with a delay of 200 ms. Patients also underwent cardiological and neurological examinations, tilt test and a structured interview to investigate diagnostic criteria for specific phobia. The syncope patients had significantly lower resting MSNA (29 +/- 2 bursts/min) and diastolic blood pressure (BP, 78 +/- 2 mmHg) compared to controls (36 +/- 2 bursts/min and 84 +/- 3 mmHg; P < 0.05), whereas no significant differences were found for resting heart rate and systolic BP. The phobic patient group exhibited prolonged sympathetic inhibitions to arousal stimuli compared to controls and non-phobic patients, whereas no difference was found between tilt-positive and tilt-negative patients or between controls and non-phobic patients. The findings suggest that the degree of inhibition in response to arousal stimuli is related to a subjective factor coupled to fear of blood/injury. The exaggerated inhibition in patients with phobia to blood/injury may be a factor predisposing to syncope in those patients.
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| 10. |
- Donadio, Vincenzo, et al.
(author)
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Daytime sympathetic hyperactivity in OSAS is related to excessive daytime sleepiness.
- 2007
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In: Journal of sleep research. - : Wiley. - 0962-1105 .- 1365-2869. ; 16:3, s. 327-32
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate the relationships among sympathetic hyperactivity, excessive daytime sleepiness (EDS) and hypertension in obstructive sleep apnoea syndrome (OSAS). Ten newly diagnosed OSAS patients with untreated EDS and daytime hypertension underwent polysomnography (PSG) and daytime measurements of plasma noradrenaline (NA), ambulatory blood pressure (BP), muscle sympathetic nerve activity (MSNA) by microneurography and objective assessment of EDS before and during 6 months of compliance-monitored continuous positive airway pressure (CPAP) treatment. One month after the start of CPAP, BP, MSNA and NA were significantly lowered, remaining lower than baseline also after 3 and 6 months of treatment. CPAP use caused a significant improvement of sleep structures, and reduced EDS. A statistical correlation analysis demonstrated that EDS was not correlated with sleep measures obtained from baseline PSG (% sleep stages, apnoea and arousal index, mean oxygen saturation value), whereas daytime sleepiness was significantly correlated with MSNA. Furthermore, MSNA and BP showed no correlation. Our data obtained from selected patients suggest that the mechanisms inducing EDS in OSAS are related to the degree of daytime sympathetic hyperactivity. Additionally, resting MSNA was unrelated to BP suggesting that factors other than adrenergic neural tone make a major contribution to OSAS-related hypertension. The results obtained in this pilot study need, however, to be confirmed in a larger study involving more patients.
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| 11. |
- Eder, Derek, 1959, et al.
(author)
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Sympathetic nerve and cardiovascular responses to auditory startle and prepulse inhibition.
- 2009
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In: International Journal of Psychophysiology. - : Elsevier BV. - 0167-8760. ; 71:2, s. 149-155
-
Journal article (peer-reviewed)abstract
- While sudden (startling) sensory stimuli are generally thought of as inducing sympathetic excitation, in humans there is a short-lasting inhibition of limb muscle sympathetic nerve activity (MSNA). This study is the first to examine and contrast the effects of acoustic startle and the prepulse inhibition of startle (PPI) on MSNA, blood pressure, heart rate, and eye blinks. Startle elicited a two-component withdrawal of MSNA: an early inhibition of one sympathetic burst followed by a second inhibition. PPI abolished the early, but not the late MSNA inhibition. Prepulse stimuli alone had no early inhibitory effects on MSNA. Early MSNA inhibition, which may occur at latencies of approximately 100 ms, appears to be part of a CNS-generated startle reflex which subserves automatic defensive responses to potential threats. The late MSNA inhibition coincided with the stimulus-induced blood pressure increase and is probably an inhibitory reflex response.
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| 12. |
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| 13. |
- Ekborn, Andreas, et al.
(author)
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High-dose cisplatin with amifostine : ototoxicity and pharmacokinetics
- 2004
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In: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 114:9, s. 1660-1667
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Journal article (peer-reviewed)abstract
- OBJECTIVES/HYPOTHESIS: Ototoxicity is a common side effect of high-dose cisplatin treatment. Thiol-containing chemoprotectors ameliorate cisplatin ototoxicity under experimental conditions. The trial was initiated to test the efficacy of amifostine protection in high-dose cisplatin treatment (125-150 mg/m) for metastatic malignant melanoma, to correlate the ototoxic outcome with cisplatin pharmacokinetics, and to evaluate the importance of using a selective analytical method for the quantification of cisplatin. STUDY DESIGN: Prospective study of 15 patients with stage IV malignant melanoma. METHODS: Clinical follow-up of therapeutic response, pure-tone audiometry, and analysis of cisplatin and its monohydrated complex in blood ultrafiltrate by liquid chromatography with postcolumn derivatization were performed. Ultrafiltered blood platinum was analyzed by inductively coupled plasma mass spectrometry. RESULTS: Ototoxicity and gastrointestinal toxicity were the most prominent side effects. Three patients ultimately required hearing aids. All patients had audiometric changes at one or more frequencies after the second treatment course, and all but one patient reported auditory symptoms. No correlation was found between hearing loss and blood cisplatin pharmacokinetics. Platinum levels determined by inductively coupled plasma mass spectrometry were higher than total platinum levels calculated from cisplatin and monohydrated complex concentrations obtained by liquid chromatography analysis. CONCLUSION: Ototoxicity was unacceptable despite amifostine treatment. Cisplatin pharmacokinetics during the first treatment course were not predictive of hearing loss. Amifostine caused a lowering of dose-normalized area under the concentration-time curve for cisplatin and monohydrated complex. Use of the unselective inductively coupled plasma mass spectrometry analysis leads to an overestimation of active drug. Selective analysis of cisplatin is especially important when evaluating cisplatin pharmacokinetics during chemoprotector treatment.
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| 14. |
- Emterling, A, et al.
(author)
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Clinicopathological significance of microsatellite instability and mutated RIZ in colorectal cancer
- 2004
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In: Annals of Oncology. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 15:2, s. 242-246
-
Journal article (peer-reviewed)abstract
- Background: Several studies have shown that microsatellite instability (MSI) is related to favourable survival in colorectal cancer patients but there are controversial results. Tumour suppressor gene RIZ is a susceptible mutational target of MSI. However, its clinicopathological significance has not been investigated. We investigated the prognostic significance of MSI in Swedish colorectal cancer patients and the clinicopathological significance of RIZ mutations. Patients and methods: We analysed 438 colorectal adenocarcinomas for MSI by microsatellite analysis. Among them, 29 MSI and 28 microsatellite stable (MSS) tumours were examined for RIZ mutations by DNA sequencing. Results: MSI (13% of 438 cases) was not associated with survival (rate ratio=0.97, 95% confidence interval =0.57-1.64, P=0.90), although it was related to proximal tumour (P <0.001), poor differentiation and mucinous carcinomas (P <0.001), multiple tumours (P=0.01) and negative/weak expression of hMLH1 (P=0.03). RIZ mutations were detected in 31% of 29 MSI tumours but in none of the 28 MSS tumours. The mutations were related to female (P=0.01), proximal tumour (P=0.01), stage B (P=0.01) and poor differentiation (P=0.047). Conclusions: MSI was not a prognostic factor in the Swedish patients included in this study. Clinicopathological variables associated with RIZ mutations might be a consequence of the MSI characteristics.
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| 15. |
- Evertsson, Sofia, 1972-, et al.
(author)
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Microsatellite instability and MBD4 mutation in unselected colorectal cancer
- 2003
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 23:4, s. 3569-3574
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Journal article (peer-reviewed)abstract
- BACKGROUND: We investigated the prognostic significance of microsatellite instability (MSI) and the association with clinicopathological factors in colorectal cancer, and further identified MBD4 mutations and their clinicopathological significance.PATIENTS AND METHODS: MSI was analyzed in 201 colorectal cancers. Sequencing analysis of MBD4 was performed in 26 MSI and 28 microsatellite stable (MSS) tumors.RESULTS: Twenty-seven tumors (13.4%) were MSI but did not correlate with improved survival. MSI was significantly correlated with proximal colon tumors (p < 0.001), poor differentiation or mucinous type (p = 0.005) and multiple tumors (p = 0.04). MBD4 mutations were found in 15% MSI but not in MSS tumors. The mutated cases showed female overrepresentation, proximal site and poorly-differentiated/mucinous type.CONCLUSION: MSI was not correlated with survival, but shared other features associated with MSI in colorectal cancer as demonstrated by others. The clinicopathological variables associated with the MBD4 mutations were probably the reflection of MSI features.
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| 16. |
- Gray, Marcus A, et al.
(author)
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Following one's heart: cardiac rhythms gate central initiation of sympathetic reflexes.
- 2009
-
In: The Journal of neuroscience : the official journal of the Society for Neuroscience. - 1529-2401. ; 29:6, s. 1817-25
-
Journal article (peer-reviewed)abstract
- Central nervous processing of environmental stimuli requires integration of sensory information with ongoing autonomic control of cardiovascular function. Rhythmic feedback of cardiac and baroreceptor activity contributes dynamically to homeostatic autonomic control. We examined how the processing of brief somatosensory stimuli is altered across the cardiac cycle to evoke differential changes in bodily state. Using functional magnetic resonance imaging of brain and noninvasive beat-to-beat cardiovascular monitoring, we show that stimuli presented before and during early cardiac systole elicited differential changes in neural activity within amygdala, anterior insula and pons, and engendered different effects on blood pressure. Stimulation delivered during early systole inhibited blood pressure increases. Individual differences in heart rate variability predicted magnitude of differential cardiac timing responses within periaqueductal gray, amygdala and insula. Our findings highlight integration of somatosensory and phasic baroreceptor information at cortical, limbic and brainstem levels, with relevance to mechanisms underlying pain control, hypertension and anxiety.
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| 17. |
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| 18. |
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| 19. |
- Krogstad, Anne-Lene, 1956, et al.
(author)
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Evaluation of objective methods to diagnose palmar hyperhidrosis and monitor effects of botulinum toxin treatment.
- 2004
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In: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology. - : Elsevier BV. - 1388-2457. ; 115:8, s. 1909-16
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate (1) if laboratory tests may be a useful complement in diagnosing palmar hyperhidrosis and (2) if such tests can be used in the follow up examination of treatment effects. METHODS: Repeated measurements of evaporation and conductance were made in glabrous skin on hands and compared with subjective estimates of the degree of sweating in 20 control subjects and 20 patients with a history of palmar hyperhidrosis. In addition, 17 patients were monitored for up to 6 months after treatment of the hands with botulinum toxin A. RESULTS: Before treatment, evaporation in the palms was higher in the patients than in the control subjects but skin conductance did not differ between the groups. After treatment both evaporation and skin conductance decreased markedly in the patients and then slowly returned towards pretreatment values. CONCLUSIONS: Measurements of evaporation, but not skin conductance, may be a useful objective adjunct when diagnosing palmar hyperhidrosis. Both methods can, however, be used to monitor intraindividual changes of sweating over time.
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| 20. |
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| 21. |
- Lin, Cindy Shin-Yi, et al.
(author)
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Axonal changes in spinal cord injured patients distal to the site of injury.
- 2007
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In: Brain : a journal of neurology. - : Oxford University Press (OUP). - 1460-2156. ; 130:Pt 4, s. 985-94
-
Journal article (peer-reviewed)abstract
- It is generally assumed that the peripheral nervous system remains intact following a spinal injury. Accordingly, the electrical thresholds of motor axons in a peripheral nerve below the lesion should be similar to those in intact subjects. Yet in attempts to enter the common peroneal nerve with microelectrodes in 24 quadriplegic or paraplegic individuals it was often found that electrical stimulation over or within the nerve failed to elicit contractions in the pre-tibial flexors. To investigate whether consistent changes in axonal physiology occurred distal to the site of injury in patients with spinal cord injury (SCI), motor nerve excitability was formally tested in 15 of these patients. Threshold tracking techniques were used to measure axonal excitability parameters (stimulus-response curves, strength-duration properties, threshold electrotonus, a current-threshold relationship and the recovery cycle) of motor axons in the median and common peroneal nerves. In these patients motor axons were uniformly of high threshold and consequently, stimulus-response curves were shifted to the right. In some SCI patients, axons were completely inexcitable. Amplitudes of compound motor action potentials were reduced, consistent with axonal loss and strength-duration time constant was significantly reduced in SCI patients (SCI 0.13 +/- 0.02 ms, controls 0.43 +/- 0.02 ms, mean +/- SE, P < 0.0001). Excitability changes were more prominent the more clinically severe the injury, with progressive deterioration over time since the original injury. While compression and traction sustained during the original injury or subsequent hospital rehabilitation may contribute in part to some of these changes, it is difficult to attribute these findings solely to such processes. Changes in axonal structure and ion channel function, but perhaps more critically decentralization and consequent inactivity, are likely to underlie the complex changes observed in axonal excitability in SCI patients.
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| 22. |
- Löfgren, N., et al.
(author)
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Remote sessions and frequency analysis for improved insight into cerebral function during pediatric and neonatal intensive care.
- 2003
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In: IEEE transactions on information technology in biomedicine. - 1089-7771 .- 1558-0032. ; 7:4, s. 283-90
-
Journal article (peer-reviewed)abstract
- A project involving recording and analysing EEG together with cardiovascular signals and temperature has been initiated. The aim of this project is to establish difficulties and possibilities involved with implementing a system for remote sessions and analysing EEG in correlation with other physiological signals. One objective is to find indicators of cerebral function during postasphyxia neonatal intensive care and pediatric cardiopulmonary bypass surgery with hypothermia. Remote sessions for joint interpretation have been carried out between pediatricians and clinical neurophysiologists, and EEG has been analyzed using frequency analyzing tools. One result is the discovery of reversible spectral changes coinciding with blood pressure falls, which may indicate loss of autoregulation function. This finding is one outcome from initial use of a system, developed during the project to facilitate communication about, and analysis of the recorded signals. Thus, already from a limited number of remote sessions and the use of basic signal processing techniques, important results have been achieved and better insight has been gained of how cerebral function is affected by cardiopulmonary bypass surgery. In this paper, we present our experiences from introducing a system for remote consultations, and evaluate the use for such a system in the current applications.
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| 23. |
- Moparhti, Satish Babu, et al.
(author)
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Expression of MAC30 protein is related to survival and biological variables in primary and metastatic colorectal cancers
- 2007
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In: International Journal of Oncology. - 1019-6439 .- 1791-2423. ; 30:1, s. 91-95
-
Journal article (peer-reviewed)abstract
- MAC30 is highly expressed in several types of tumors including colorectal cancers, however, its clinicopathological and biological significance in colorectal cancers is currently not known. The aim of our study was to investigate MAC30 expression in distant normal mucosa, adjacent normal mucosa, primary tumors and metastases of colorectal cancer, and to determine the relationship between MAC30 expression and clinicopathological and biological variables. MAC30 expression was immunohistochemically examined in distant normal mucosa (n = 54), adjacent normal mucosa (n = 123), primary tumors (n = 217) and lymph node metastases (n = 56) from colorectal cancer patients. MAC30 cytoplasmic expression was increased from distant normal mucosa to primary tumor and to metastasis (p < 0.0001-0.04). Furthermore, 40% primary and 37% metastatic tumors showed stronger cytoplasmic expression of MAC30 at the tumor invasive margins compared to inner tumor areas. Strong cytoplasmic expression of MAC30 in the metastasis was related to a poor prognosis (p = 0.04). MAC30 cytoplasmic expression was positively related to expression of proliferating cell nuclear antigen (p = 0.04), p53 (p = 0.04), nucleoporin 88 (p = 0.001), legumain (p = 0.004) and particularly interesting new cysteine-histidine rich protein (p = 0.004). However, MAC30 expression in the nucleus and stroma did not have any clinicopathological and biological significance (p > 0.05). In conclusion, MAC30 protein may play a role in development of colorectal cancer, and can be considered as a prognostic factor.
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| 24. |
- Mårtensson, Lena, 1958, et al.
(author)
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Acupuncture versus subcutaneous injections of sterile water as treatment for labour pain
- 2008
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In: Acta Obstetricia et Gynecologica. - : Wiley. - 0001-6349 .- 1600-0412. ; 87, s. 171-177
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Journal article (peer-reviewed)abstract
- Background. Two methods for pain relief and relaxation during labour are sterile water injections and acupuncture. In several studies, sterile water injections have been shown to provide good pain relief, particularly for low back pain during labour. The acupuncture studies for pain relief during labour are not as concordant. Therefore, the aim of this study was to explore if there were any differences between acupuncture and sterile water injections regarding pain relief and relaxation during labour. Methods. A randomised controlled trial. Some 128 pregnant women at term were randomly assigned to receive acupuncture (no 62) sterile water injections (no. 66). The primary endpoint was to compare the differences between pre-treatment pain levels and maximum pain in the 2 groups. Results. The main results of this study were that sterile water injections yielded greater pain relief (pB0.001) during childbirth compared to acupuncture. The secondary outcome showed that women in the sterile water group had a higher degree of relaxation (pB0.001) compared to the acupuncture group. The women’s own assessment of the effects also favoured sterile water injections (pB0.001). There were no significant differences regarding requirements for additional pain relief after treatment between the 2 groups. Conclusions. Women given sterile water injection experience less labour pain compared to women given acupuncture.
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| 25. |
- Mårtensson, Lena, et al.
(author)
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Sterile water injections as treatment for low-back pain during labour : A review
- 2008
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In: Australian and New Zealand journal of obstetrics and gynaecology. - : Blackwell Publishing. - 0004-8666 .- 1479-828X. ; 48:4, s. 369-374
-
Research review (peer-reviewed)abstract
- Background: Some women have severe low-back pain during childbirth. It has been shown that sterile water injections reduce this pain. This method, which is easy to learn and very cheap can be a good pain relief alternative primarily in countries with limited available pain relief options. Aims: The aim of this article was to describe published research concerning sterile water injections for treatment of low-back pain during labour. Methods: Three databases were searched from their inception until February, 2008. The inclusion criteria were trials elucidating the pain relief effect of sterile water injections during childbirth. The search terms were labour, birth, obstetrics, parturient, pregnancy, pain relief, analgesia, injection, papules, blocks and sterile water. The computerised literature searches yielded 64 trials, 55 of which failed to meet our inclusion criteria. We used the Jadad Score Instrument to assess the quality of the remaining nine articles, of which six were of adequate quality. Results: All studies in this review had similar alms, designs and measurement instruments and they reported good pain relief particularly, for low-back pain during childbirth. In all studies the pain score reduction is approximately, 60% and the effect remains up to two hours. Conclusions: Sterile water injections seem to be a good alternative for low-back pain during childbirth.
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| 26. |
- Mårtensson, Lena, et al.
(author)
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Subcutaneous versus intracutaneous injections of sterile water for labour analgesia : a comparison of perceived pain during administration
- 2000
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In: British Journal of Obstetrics and Gynecology. - : Wiley-Blackwell. - 1470-0328 .- 1471-0528. ; 107:10, s. 1248-1251
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Journal article (peer-reviewed)abstract
- Objective To investigate whether, during injections of sterile water, there is any difference in perceived pain between intracutaneous and subcutaneous injections.Design Blind controlled trial with cross-over design.Setting Göteborg and Skövde, Sweden.Participants One hundred healthy female volunteers.Methods The women were randomised into two groups and subjected to two trials, within one week of each other. During the first trial one group ( n= 50 ) received the intracutaneous injection first, followed by the subcutaneous injection. The second group ( n= 50 ) was given the subcutaneous injection first, followed by intracutaneous injection. In both groups all the injections were given in reverse order during the second trial.Main outcome measures Experienced pain during the administration of sterile water injections, measured by visual analogue scale.Results The analysis showed intracutaneous injections to be significantly more painful than subcutaneous injections, even after adjusting for injection day and for left/right site of injection (mean 60.8 vs 41.3, P < 0.001 ).Conclusions The findings suggest that the less painful subcutaneous injection technique should be used.
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| 27. |
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| 28. |
- Norrsell, Ulf, 1937, et al.
(author)
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Tactile directional sensibility and diabetic neuropathy.
- 2001
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In: Muscle & nerve. - 0148-639X. ; 24:11, s. 1496-502
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Journal article (peer-reviewed)abstract
- Five different procedures used to diagnose neuropathy were compared in a "blind" study with diabetic patients. The aim was to evaluate tests of tactile directional sensibility. Three matched groups were examined, two groups with type I diabetes, either with or without suspected neuropathy, and one of healthy controls. Testing consisted of: (1) examination by a specialist in neurology, (2) electrophysiologic measurement of nerve conduction velocity and determination of cool sensitivity, and (3) determination of directional sensibility in two stages, with categorical and quantitative techniques. Abnormal test results were obtained for both groups of diabetic patients. Quantitatively measured directional sensibility had the highest sensitivity (89%) and specificity (85%) when calculated for patients who had received a diagnosis of neuropathy from the neurologist, despite one case of abnormal directional sensibility among the healthy controls. Conduction velocity testing was almost comparably sensitive (80%) and cool sensitivity, comparably specific (85%) when calculated in the same manner.
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| 29. |
- Olausson, Håkan, 1965, et al.
(author)
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Functional role of unmyelinated tactile afferents in human hairy skin: sympathetic response and perceptual localization.
- 2008
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In: Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale. - : Springer Science and Business Media LLC. - 1432-1106. ; 184:1, s. 135-40
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Journal article (peer-reviewed)abstract
- In addition to A-beta fibres the human hairy skin has unmyelinated (C) fibres responsive to light touch. Previous functional magnetic resonance imaging (fMRI) studies in a subject with a neuronopathy who specifically lacks A-beta afferents indicated that tactile C afferents (CT) activate insular cortex, whereas no response was seen in somatosensory areas 1 and 2. Psychophysical tests suggested that CT afferents give rise to an inconsistent perception of weak and pleasant touch. By examining two neuronopathy subjects as well as control subjects we have now demonstrated that CT stimulation can elicit a sympathetic skin response. Further, the neuronopathy subjects' ability to localize stimuli which activate CT afferents was very poor but above chance level. The findings support the interpretation that the CT system is well suited to underpin affective rather than discriminative functions of tactile sensations.
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| 30. |
- Portelius, Erik, 1977, et al.
(author)
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An Alzheimer's disease-specific beta-amyloid fragment signature in cerebrospinal fluid.
- 2006
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In: Neuroscience letters. - : Elsevier BV. - 0304-3940. ; 409:3, s. 215-9
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Journal article (peer-reviewed)abstract
- Pathogenic events in Alzheimer's disease (AD) involve an imbalance between the production and clearance of the neurotoxic beta-amyloid peptide (Abeta), especially the 42 amino acid peptide Abeta1-42. While much is known about the production of Abeta1-42, many questions remain about how the peptide is degraded. To investigate the degradation pattern, we developed a method based on immunoprecipitation combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry that determines the Abeta degradation fragment pattern in cerebrospinal fluid (CSF). We found in total 18 C-terminally and 2 N-terminally truncated Abeta peptides and preliminary data indicated that there were differences in the detected Abeta relative abundance pattern between AD and healthy controls. Here, we provide direct evidence that an Abeta fragment signature consisting of Abeta1-16, Abeta1-33, Abeta1-39, and Abeta1-42 in CSF distinguishes sporadic AD patients from non-demented controls with an overall accuracy of 86%.
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| 31. |
- Sandén, Helena, et al.
(author)
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Bicycle ergometer test to obtain adequate skin temperature when measuring nerve conduction velocity.
- 2005
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In: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology. - : Elsevier BV. - 1388-2457. ; 116:1, s. 25-7
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To achieve optimal diagnostic accuracy, measurements of nerve conduction velocity require standardised tissue temperatures. To warm an extremity to a desired temperature that remains constant during the measurement may be difficult, especially in subjects with low finger temperatures. The aim of this study was to investigate if a submaximal bicycle ergometer test before the examination would be a useful method of obtaining high and stable finger temperatures during nerve conduction studies in the hand. METHODS: 114 women aged 25-65 (median 44) performed a bicycle ergometer test on an electrically braked bicycle ergometer (Siemens-Elema) before they underwent a nerve conduction test. RESULTS: Before cycling, the mean finger temperature was 28.1 degrees C (range 20.5-35.4 degrees C) and 15 min after the test 35.1 degrees C (range 30.3-36.9 degrees C). The levels remained almost constant throughout the nerve conduction examination, which had a duration of approximately 25 min. CONCLUSIONS: A bicycle ergometer test proved to be a simple and effective method of raising hand temperature.
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| 32. |
- Sandén, Helena, et al.
(author)
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Normal nerve conduction velocity and vibrotactile perception thresholds in computer users.
- 2005
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In: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 78:3, s. 239-42
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Journal article (peer-reviewed)abstract
- OBJECTIVES: A literature report described significantly raised vibration threshold within the territory of the median nerve in a group of office workers and concluded that the results indicated a change in the function of large sensory fibres. The aim of the present cross-sectional study was to compare vibrotactile perception thresholds and nerve conduction measurements in the upper extremity between female computer users (secretaries) and female non-users (nurses). METHODS: Eighty-two secretaries, aged 25-65 (median 44) years and 35 nurses, aged 24-57 (median 46) years went through nerve conduction measurements on the dominant hand and also a vibration threshold test with readings over the hand at five sites which tested cutaneous innervation of the median, ulnar, and radial nerves. RESULTS: There was no significant difference in any parameter of the nerve conduction testing and there was no significant difference in any parameter of the vibration threshold test between secretaries and nurses. The numerical differences between groups were small and in both directions and thus do not indicate a power problem. CONCLUSIONS: We saw no signs of early neural deficits of large sensory fibres in subjects who intensively use computer keyboard equipment.
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| 33. |
- Selin, Lotta, et al.
(author)
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Dystocia in labour - risk factors, management and outcome: a retrospective observational study in a Swedish setting
- 2008
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 87:2, s. 216-221
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Journal article (peer-reviewed)abstract
- Background. Labour dystocia (LD) is associated with adverse maternal and child outcomes. This study investigated obstetric risk factors, frequency of interventions and delivery outcomes for LD. Methods. A retrospective, observational, study of 1,480 deliveries was undertaken in a Swedish district hospital during 2000 and 2001. Results. LD was identified in 21% of deliveries, 16.7% of which ended in caesarean section (CS) compared to 1.7% of deliveries without LD. Multiparity with no previous vaginal delivery (OR = 6.0), epidural analgesia (EDA) at cervical dilation ≤5 cm (OR = 4.6), primiparity (OR = 4.5), gestational age ≥42 weeks (OR = 3.1), birth weight >4,000 g (OR = 2.7) and EDA at cervical dilation >5 cm (OR = 2.0) were major independent risk factors for LD. Conclusions. In delivery management, special attention should be directed to primiparous women and multiparous women with no previous vaginal delivery. Women given EDA, especially at cervical dilation ≤5 cm are also of particular interest. Furthermore, rigorous routines for LD diagnosis and oxytocin augmentation are important.
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| 34. |
- Selin, Lotta, et al.
(author)
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Use and abuse of oxytocin for augmentation of labor.
- 2009
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In: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 88:12, s. 1352-7
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the use of oxytocin for augmentation of labor and its relation to labor progress and delivery outcome. DESIGN AND SETTING: A retrospective observational study undertaken in a Swedish hospital during 2000-2001. SAMPLE: Singleton pregnancies at > or = 37 weeks of gestation with cephalic presentation and spontaneous onset of labor. METHODS: Data were collected from 1,263 clinical records. The partogram was used to diagnose labor dystocia (LD). MAIN OUTCOME MEASURES: Prevalence of oxytocin administration, LD and operative delivery. RESULTS: Oxytocin was administered to 55% of the women (75% of primiparas and 38.1% of multiparas); a majority did not meet LD criteria. LD frequency was 19.8% (32.7% in primiparas and 7.4% in multiparas). Oxytocin was started both 'too early' and 'too late' in relation to the diagnosis of LD. Cesarean section (CS) was performed on 17.1% of primiparous and 2.4% of multiparous oxytocin recipients with LD, compared to 2.3 and 1.5%, respectively, of oxytocin recipients without diagnosed LD. CONCLUSIONS: Oxytocin augmentation was undertaken in an unstructured manner; some women were inadequately treated and others were treated unnecessarily. Oxytocin recipients with LD underwent operative delivery to a higher extent than oxytocin recipients without LD, suggesting that the main reason for CS was the underlying problem of LD rather than the oxytocin augmentation itself.
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| 35. |
- Sun, Xiao-Feng, 1959-, et al.
(author)
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Polymorphisms in sulfotransferase 1A1 and glutathione S-transferase P1 genes in relation to colorectal cancer risk and patients' survival
- 2005
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In: World Journal of Gastroenterology. - 1007-9327 .- 2219-2840. ; 11:43, s. 6875-6879
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Journal article (peer-reviewed)abstract
- Aim: To examine whether polymorphisms in SULT1A1 and GSTP1 genes contribute to colorectal cancer development and whether they are associated with clinicopathological variables are not well identified. Methods: We examined the genotypes of 125 colorectal cancer patients and 666 healthy controls in a Swedish population by using PCR restriction fragment length polymorphism (RFLP). Results: SULT1A1 *2/*2 genotype (OR = 2.49, 95%CI = 1.48-4.19, P = 0.0002) and *2 allele (OR = 1.56, 95%CI = 1.16-2.10, P = 0.002) had an effect on colorectal cancer susceptibility, while GSTP1 genotype was without effect. However, GSTP1 G-type predicted a worse prognosis in the patients independently of gender, age, Dukes' stage, growth pattern, and differentiation (P = 0.03). Conclusion: Polymorphism in SULT1A1 may predispose to colorectal cancer and GSTP1 may be a biological indicator of prognosis in the patients. © 2005 The WJG Press and Elsevier Inc. All rights reserved.
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| 36. |
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| 37. |
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| 38. |
- Wallin, Fredrik, 1978, et al.
(author)
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Experimental and Numerical Investigation of an Aggressive Intermediate Turbine Duct: Part 1−Flowfield at Design Inlet Conditions
- 2008
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In: Paper AIAA-2008-7055, 26th AIAA Applied Aerodynamics Conference, Honolulu, August 18-21, 2008. - Reston, Virigina : American Institute of Aeronautics and Astronautics. - 1048-5953.
-
Conference paper (peer-reviewed)abstract
- Demands on lower emissions and reduced noise levels drive the design of modern turbofan engines toward high by-pass ratios. The design of the intermediate turbine ducts, connecting the high- and low-pressure turbines, will become more important as the turbofan engine by-pass ratios are increased. In order to introduce more aggressive designs there is a need to understand the flow features of high aspect ratio and high diffusion ducts. This is part one of a two-part paper, presenting a comparison between an experimental study and a CFD analysis of the flowfield of an aggressive intermediate turbine duct for design inlet conditions. Part one focuses on the on-design conditions and the second part will focus on off-design conditions. The experimental study was performed in a large-scale, low-speed turbine facility. The work presented highlights some of the challenges associated with more aggressive intermediate ducts for the next generation of turbofan engines. The main flow features are successfully reproduced by the CFD, but there are discrepancies found in the predicted local velocity and loss levels. An explanation of the discrepancies between the experimental data and the CFD results is provided and an attempt to track the origin of these differences is made.
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| 39. |
- Wallin, Gunnar B, 1936
(author)
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Interindividual differences in muscle sympathetic nerve activity: a key to new insight into cardiovascular regulation?
- 2007
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In: Acta physiologica (Oxford, England). - : Wiley. - 1748-1708 .- 1748-1716. ; 190:4, s. 265-75
-
Research review (peer-reviewed)abstract
- The paper reviews findings in humans regarding interindividual differences in sympathetic nerve activity. Data come predominantly from microneurographic multi- or single fibre recordings of sympathetic nerve activity in healthy subjects. Findings relate to interindividual differences in muscle sympathetic nerve activity (MSNA) during resting conditions and in response to surprising sensory stimuli. At rest there are marked interindividual differences in the number of multiunit MSNA bursts. At the single fibre level the differences are because of more vasoconstrictor fibres being active in subjects with high than in subjects with low number of bursts. There are inverse relationships between (i) sympathetic burst incidence and cardiac output (CO) and (ii) between sympathetic burst incidence and vascular responsiveness to noradrenaline. Both findings contribute to explaining the absence of correlation between resting levels of MSNA and blood pressure. Surprising visual, somatosensory or auditory stimuli of sufficient strength cause a short lasting inhibition of MSNA in approx. 50-60% of healthy subjects. In subjects who display significant inhibition, the stimulus-induced blood pressure increase is smaller than in subjects without inhibition. The underlying mechanism may be related to fear of blood/injury. It is concluded that analysis of interindividual differences in sympathetic activity improves the understanding of central nervous control of the circulation.
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| 40. |
- Wallin, Gunnar B, 1936
(author)
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Regulation of sympathetic nerve traffic to skeletal muscle in resting humans.
- 2006
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In: Clinical autonomic research : official journal of the Clinical Autonomic Research Society. - : Springer Science and Business Media LLC. - 0959-9851. ; 16:4, s. 262-9
-
Research review (peer-reviewed)abstract
- An overview is given of microneurographic studies of resting vasoconstrictor traffic in human muscle nerves (muscle sympathetic nerve activity = MSNA). In multiunit recordings, the activity consists of synchronized bursts of vasoconstrictor impulses, the outflow of which is under potent arterial baroreflex control. In agreement with this, the bursts always display cardiac rhythmicity and occur during temporary reductions of blood pressure. Burst occurrence shows a close inverse correlation to variations of diastolic blood pressure whereas the correlation to the strength of the bursts is weak or absent, suggesting that the mechanisms controlling the two parameters are not identical. These dynamic characteristics are similar in all subjects despite large, reproducible, interindividual differences in number of bursts. Such interindividual differences probably have a genetic origin, and since discharge frequencies in single vasoconstrictor fibers are similar in subjects with few and many bursts, the differences in multiunit activity are likely to be due to a higher number of active fibers in subjects with many bursts. The interindividual differences in multiunit activity are not associated with differences in resting blood pressure levels. Recent studies have revealed (a) an inverse relationship between resting levels of cardiac output and MSNA and (b) evidence of reduced vascular responsiveness to noradrenaline in subject with many sympathetic bursts at rest. These findings suggest that the vasoconstriction induced by the sympathetic impulses is balanced or reduced by these factors, which thereby contribute to the poor relationship between the mean number of sympathetic bursts and the blood pressure level.
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| 41. |
- Wallin, Gunnar B, 1936, et al.
(author)
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Sympathetic neural control of integrated cardiovascular function: insights from measurement of human sympathetic nerve activity.
- 2007
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In: Muscle & nerve. - : Wiley. - 0148-639X .- 1097-4598. ; 36:5, s. 595-614
-
Research review (peer-reviewed)abstract
- Sympathetic neural control of cardiovascular function is essential for normal regulation of blood pressure and tissue perfusion. In the present review we discuss sympathetic neural mechanisms in human cardiovascular physiology and pathophysiology, with a focus on evidence from direct recordings of sympathetic nerve activity using microneurography. Measurements of sympathetic nerve activity to skeletal muscle have provided extensive information regarding reflex control of blood pressure and blood flow in conditions ranging from rest to postural changes, exercise, and mental stress in populations ranging from healthy controls to patients with hypertension and heart failure. Measurements of skin sympathetic nerve activity have also provided important insights into neural control, but are often more difficult to interpret since the activity contains several types of nerve impulses with different functions. Although most studies have focused on group mean differences, we provide evidence that individual variability in sympathetic nerve activity is important to the ultimate understanding of these integrated physiological mechanisms.
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| 42. |
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| 43. |
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| 44. |
- Wallin, Åsa R., 1976-, et al.
(author)
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Expression of PRL proteins at invasive margin of rectal cancers in relation to preoperative radiotherapy
- 2006
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In: International Journal of Radiation Oncology, Biology, Physics. - : Elsevier BV. - 0360-3016 .- 1879-355X. ; 65:2, s. 452-458
-
Journal article (peer-reviewed)abstract
- Purpose: PRL-3 (phosphatase of regenerating liver) is involved in metastasis of colorectal cancer; however, its therapeutic implication in cancer patients has not been studied. We investigated the relationships of PRL expression to radiotherapy (RT) in rectal cancer patients.Methods and Materials: Phosphatase of regenerating liver expression was immunohistochemically examined in distant (n = 36) and adjacent (n = 82) normal mucosa, primary tumor (n = 125), biopsy specimens (n = 96), and lymph node metastasis (n = 30) from rectal cancer patients participating in a clinical trial of preoperative RT.Results: Phosphatase of regenerating liver expression was increased from the distant to adjacent mucosa and to the primary tumor (p < 0.05). PRL was highly expressed at the invasive margin in 28% of the primary tumors and 26% of the metastases. In the RT group, strong PRL expression at the invasive margin was related to distant recurrence (p = 0.006) and poor survival (p = 0.01), but not in the non-RT group. The survival significance remained even after adjusting for Dukes’ stage and differentiation (p = 0.02). Additional multivariate analyses showed that the correlation with prognostic significance of PRL differed between the RT and non-RT groups (p = 0.01).Conclusion: Phosphatase of regenerating liver expression (rather than PRL-3 alone) at the invasive margin predicted resistance to RT and unfavorable survival in rectal cancer patients with preoperative RT.
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