| 1. |
- Arver, Brita, et al.
(författare)
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Bilateral Prophylactic Mastectomy in Swedish Women at High Risk of Breast Cancer: A National Survey.
- 2011
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Ingår i: Annals of surgery. - : Lippincott Williams and Wilkins; 1999. - 1528-1140 .- 0003-4932. ; 253:6, s. 1147-1154
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/OBJECTIVE:: This study attempted a national inventory of all bilateral prophylactic mastectomies performed in Sweden between 1995 and 2005 in high-risk women without a previous breast malignancy. The primary aim was to investigate the breast cancer incidence after surgery. Secondary aims were to describe the preoperative risk assessment, operation techniques, complications, histopathological findings, and regional differences. METHODS:: Geneticists, oncologists and surgeons performing prophylactic breast surgery were asked to identify all women eligible for inclusion in their region. The medical records were reviewed in each region and the data were analyzed centrally. The BOADICEA risk assessment model was used to calculate the number of expected/prevented breast cancers during the follow-up period. RESULTS:: A total of 223 women operated on in 8 hospitals were identified. During a mean follow-up of 6.6 years, no primary breast cancer was observed compared with 12 expected cases. However, 1 woman succumbed 9 years post mastectomy to widespread adenocarcinoma of uncertain origin. Median age at operation was 40 years. A total of 58% were BRCA1/2 mutation carriers. All but 3 women underwent breast reconstruction, 208 with implants and 12 with autologous tissue. Four small, unifocal, invasive cancers and 4 ductal carcinoma in situ were found in the mastectomy specimens. The incidence of nonbreast related complications was low (3%). Implant loss due to infection/necrosis occurred in 21 women (10%) but a majority received a new implant later. In total, 64% of the women underwent at least 1unanticipated secondary operation. CONCLUSIONS:: Bilateral prophylactic mastectomy is safe and efficacious in reducing future breast cancer in asymptomatic women at high risk. Unanticipated reoperations are common. Given the small number of patients centralization seems justified.
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| 2. |
- Bergh, Jonas, et al.
(författare)
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FACT : An Open-Label Randomized Phase III Study of Fulvestrant and Anastrozole in Combination Compared With Anastrozole Alone as First-Line Therapy for Patients With Receptor-Positive Postmenopausal Breast Cancer
- 2012
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Ingår i: Journal of Clinical Oncology. - Alexandria, VA : American Society of Clinical Oncology. - 0732-183X .- 1527-7755. ; 30:16, s. 1919-1925
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the effect of therapy with anastrozole versus a combination of fulvestrant and anastrozole in women in first relapse of endocrine-responsive breast cancer. Patients and Methods: Postmenopausal women, or premenopausal women receiving a gonadotropin-releasing hormone agonist, with estrogen receptor– and/or progesterone receptor–positive disease at first relapse after primary treatment of localized disease were open-label randomly assigned to a fulvestrant loading dose (LD) regimen followed by monthly injection plus 1 mg of anastrozole daily or to 1 mg of anastrozole daily alone. The primary end point was time to progression (TTP). Results: In all, 514 women were randomly assigned to fulvestrant plus anastrozole (experimental arm; n = 258) or anastrozole (standard arm; n = 256). Approximately two thirds had received adjuvant antiestrogens, but only eight individuals had received an aromatase inhibitor. Median TTP was 10.8 and 10.2 months in the experimental versus standard arm, respectively (hazard ratio [HR] = 0.99; 95% CI, 0.81 to 1.20; P = .91); median overall survival was 37.8 and 38.2 months, respectively (HR = 1.0; 95% CI, 0.76 to 1.32; P = 1.00). Incidences of prespecified adverse events (AEs) were similar. Hot flashes were more common in the experimental arm: 63 patients (24.6%) versus 35 patients (13.8%) in the standard arm (P = .0023). Death owing to AEs was reported in 11 (4.3%) and five patients (2.0%) in the experimental versus standard arm, respectively. Conclusion: Fulvestrant (250 mg + LD regimen) in combination with anastrozole offered no clinical efficacy advantage over anastrozole monotherapy in this population of individuals with a relatively high proportion of previous adjuvant antiestrogen exposure.
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| 3. |
- Bing, Vibeke, et al.
(författare)
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Det har både blivit lättare och svårare - om det nya i att arbeta på familjecentraler
- 2011
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 88:2, s. 133-143
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Den här artikeln utgår ifrån personalens perspektiv. Första delen är resultat från en enkätstudie som fokuserar på hur personal förändrat sitt sätt att arbeta sedan de började arbeta på familjecentral. De flesta upplever att eftersom de har andra professioner i samma hus lättare upptäcker familjer med extra behov av stöd och bättre kan fokusera på sina egna arbetsuppgifter. Som fördjupning av svaren i enkäten har olika personalkategorier ombetts skriva en kortfattad berättelse om sitt eget arbete på familjecentral. Sjuksköterskor, barnmorska, psykolog, socionom, förskollärare, bibliotekarie och samordnare berättar hur de arbetar. Slutsatserna från artikeln är att familjecentraler kan ses som ett svar på att stödet till blivande och småbarnsföräldrar har utökats på de områden som den traditionella mödra- och barnhälsovården har sett som problematisk att möta. Sannolikt ökar förutsättningarna för att de som behöver extra stöd också kan få möjlighet till detta under förutsättning att extra stöd finns när familjecentralens resurser inte räcker till.
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| 4. |
- Bing, Vibeke, et al.
(författare)
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Det har både blivit lättare och svårare - om det nya i att arbeta på familjecentraler
- 2011
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 88:2, s. 133-143
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Den här artikeln utgår ifrån personalens perspektiv. Första delen är resultat från en enkätstudie som fokuserar på hur personal förändrat sitt sätt att arbeta sedan de började arbeta på familjecentral. De flesta upplever att eftersom de har andra professioner i samma hus lättare upptäcker familjer med extra behov av stöd och bättre kan fokusera på sina egna arbetsuppgifter. Som fördjupning av svaren i enkäten har olika personalkategorier ombetts skriva en kortfattad berättelse om sitt eget arbete på familjecentral. Sjuksköterskor, barnmorska, psykolog, socionom, förskollärare, bibliotekarie och samordnare berättar hur de arbetar. Slutsatserna från artikeln är att familjecentraler kan ses som ett svar på att stödet till blivande och småbarnsföräldrar har utökats på de områden som den traditionella mödra- och barnhälsovården har sett som problematisk att möta. Sannolikt ökar förutsättningarna för att de som behöver extra stöd också kan få möjlighet till detta under förutsättning att extra stöd finns när familjecentralens resurser inte räcker till.
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| 5. |
- Hamrin, Kerstin, et al.
(författare)
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Prolonged Exercise-Induced Stimulation of Skeletal Muscle Glucose Uptake Is due to Sustained Increases in Tissue Perfusion and Fractional Glucose Extraction
- 2011
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 96:4, s. 1085-1092
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Tidskriftsartikel (refereegranskat)abstract
- Context: The mechanisms behind the positive effects of physical activity on glucose metabolism in skeletal muscle and the time course of the effects need to be more elucidated. Objective: The aim was to examine the prolonged effects of an acute bout of one-legged exercise on local skeletal muscle glucose utilization and tissue perfusion. Design and Setting: Interstitial glucose concentration, local tissue perfusion, glucose uptake, and effects of insulin infusion were studied 12 h after an acute bout of exercise and without prior exercise. Participants: Ten healthy subjects, five women and five men, participated in the study. Intervention: Microdialysis measurements, (133)Xe clearance, and a 2-h hyperinsulinemic euglycemic clamp were performed on two occasions. Main Outcome Measures: We measured interstitial glucose concentration and tissue perfusion in the quadriceps femoris muscle of both legs. Results: Tissue perfusion (3.3 +/- 0.6 ml x 100 g(-1) x min(-1) vs. 1.4 +/- 0.2 ml x 100 g(-1) x min(-1); P = 0.007) and basal glucose uptake (2.3 +/- 0.5 mu mol x 100 g(-1) x min(-1) vs. 0.9 +/- 0.2 mu mol x 100 g(-1) x min(-1); P = 0.006) were increased in the leg that had exercised compared to the resting leg; the findings in the resting leg were comparable to those in the control experiment without prior exercise. The relative effect of insulin on fractional skeletal muscle glucose uptake was the same in all experimental settings, and insulin did not affect tissue perfusion. Conclusions: The prolonged stimulatory effect of physical exercise on skeletal muscle glucose uptake was mediated via vascular effects combined with an increase in basal glucose transport independent of enhancement of insulin responses.
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| 6. |
- Henriksson, Fredrik, 1988-, et al.
(författare)
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Towards Applying The Boothroyd, Dewhurst and Knight Methodology for Cost Estimation on Fibre Composite Manufacturing - A Theoretical Approach
- 2014
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Ingår i: Proceedings of The 6th International Swedish Production Symposium 2014. - Gothenburg. - 9789198097412
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Konferensbidrag (refereegranskat)abstract
- Increased usage of carbon fibre composite poses challenges for the automotive industry; one is to manage carbon fibre composites within the product development process. This paper combines knowledge in design engineering, material science and production technology, aiming to bridge these domains. The study indicates that mass production methods suitable for carbon fibre have several factors in common with traditional polymer production methods. Thus, it is possible that DfMA methods for traditional polymer production can be adjusted for carbon fibre composite production. The result is summarised in a table aiming to facilitate engineering decisions related to cost estimations for composite moulding.
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| 7. |
- Jedvert, Kerstin, 1984, et al.
(författare)
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Mild steam explosion: A way to activate wood for enzymatic treatment, chemical pulping and biorefinery processes
- 2012
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Ingår i: Nordic Pulp and Paper Research Journal. - 2000-0669 .- 0283-2631. ; 27:5, s. 828-835
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Tidskriftsartikel (refereegranskat)abstract
- Industrially chipped wood chips of Norway spruce (Picea abies) were subjected to mild steam explosion (115 - 160 degrees C) in a small-scale steam explosion reactor. This was followed by kraft cooking or extraction in alkali at 130 degrees C for two hours, or by an enzymatic treatment with a culture filtrate in order to investigate the efficiency of the process in opening wood structure. The results demonstrated that mild explosion has an effect on opening wood structure, shown by increased release of glucomannans during alkaline extraction and faster delignification in kraft cooks for steam-exploded samples. The effect was also shown by analysis of the released reducing sugars of enzymatic treated wood chips, which showed that the wood structure became accessible for enzymes even at very modest mild steam explosion conditions. This was not observed in untreated wood chips, used as reference. The enzyme activity increased with increased temperature during mild steam explosion, and the effect did not seem to be linear. The mechanical effect of steam explosion seems to be of great importance at lower temperatures, and both chemical and mechanical effects are important at higher steam explosion temperatures. Samples for enzymatic treatment were taken both from the edges of wood chips as well as from the middle part of the chips, and the effect of steam explosion was somewhat greater in samples from the middle parts.
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| 8. |
- Shi, Hong, et al.
(författare)
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Prognostic impact of polymorphisms in the MYBL2 interacting genes in breast cancer
- 2012
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Ingår i: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 1573-7217 .- 0167-6806. ; 131:3, s. 1039-1047
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Tidskriftsartikel (refereegranskat)abstract
- MYBL2 is a transcription factor, which regulates the expression of genes involved in cancer progression. In this study, we investigated whether putative functional variants in genes regulating MYBL2 (E2F1, E2F3 and E2F4) or in genes, which are regulated by MYBL2 (BCL2, BIRC5, COL1A1, COL1A2, COL5A2, ERBB2, CLU, LIN9 and TOP2A) affect breast cancer (BC) susceptibility and clinical outcome. Twenty-eight SNPs were genotyped in a population-based series of 782 Swedish BC cases and 1,559 matched controls. BC-specific survival analysis of BIRC5 suggested that carriers of the minor allele of rs8073069 and rs1042489 have a worse survival compared with the major homozygotes (HR 2.46, 95% CI 1.39-4.36 and HR 1.81, 95% CI 1.01-3.25, respectively). The poor survival was observed especially in women with aggressive tumours. Multivariate analysis supported the role of rs8073069 as an independent prognostic marker. For BCL2, minor allele carriers of rs1564483 were more likely to have hormone receptor-positive tumours than the major homozygotes. Another SNP in BCL2, rs4987852, was associated with tumour stages II-IV and histologic grade 3. In CLU, the minor allele carriers of rs9331888 were more likely to have tumours with regional lymph node metastasis and stages II-IV than the major homozygotes. In conclusion, our study suggests a role of genetic variation in BIRC5, BCL2 and CLU as progression and prognostic markers for BC, supporting previous studies based on the expression of the genes.
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| 9. |
- Shi, Hong, et al.
(författare)
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Single nucleotide polymorphisms in the 20q13 amplicon genes in relation to breast cancer risk and clinical outcome
- 2011
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Ingår i: Breast Cancer Research and Treatment. - New York : Springer-Verlag New York. - 0167-6806 .- 1573-7217. ; 130:3, s. 905-916
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Tidskriftsartikel (refereegranskat)abstract
- The 20q13 region is frequently amplified/overexpressed in breast tumours. However, the nature of this amplification/overexpression is unknown. Here, we investigated genetic variation in five 20q13 amplicon genes (MYBL2, AURKA, ZNF217, STK4 and PTPN1) and its impact on breast cancer (BC) susceptibility and clinical outcome. As a novel finding, four polymorphisms in STK4 (rs6017452, rs7271519) and AURKA (rs2273535, rs8173) associated with steroid hormone receptor status both in a Swedish population-based cohort of 783 BC cases and in a Polish familial/early onset cohort of 506 BC cases. In the joint analysis, the minor allele carriers of rs6017452 had more often hormone receptor positive tumours (OR 0.57, 95% CI 0.40-0.81), while homozygotes for the minor allele of rs7271519, rs2273535 and rs8173 had more often hormone receptor negative tumours (2.26, 1.30-3.39; 2.39, 1.14-5.01; 2.39, 1.19-4.80, respectively) than homozygotes for the common allele. BC-specific survival analysis of AURKA suggested that the Swedish carriers of the minor allele of rs16979877, rs2273535 and rs8173 might have a worse survival compared with the major homozygotes. The survival probabilities associated with the AURKA genotypes depended on the tumour phenotype. In the Swedish case-control study, associations with BC susceptibility were observed in a dominant model for three MYBL2 promoter polymorphisms (rs619289, P = 0.02; rs826943, P = 0.03 and rs826944, P = 0.02), two AURKA promoter polymorphisms (rs6064389, P = 0.04 and rs16979877, P = 0.02) and one 3'UTR polymorphism in ZNF217 (rs1056948, P = 0.01). In conclusion, our data confirmed the impact of the previously identified susceptibility locus and provided preliminary evidence for novel susceptibility variants in BC. We provided evidence for the first time that genetic variants at 20q13 may affect hormone receptor status in breast tumours and influence tumour aggressiveness and survival of the patients. Future studies are needed to confirm the prognostic value of our findings in the clinic.
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| 10. |
- Stacey, Simon N, et al.
(författare)
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Ancestry-shift refinement mapping of the C6orf97-ESR1 breast cancer susceptibility locus.
- 2010
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Ingår i: PLoS genetics. - : Public Library of Science. - 1553-7404. ; 6:7, s. e1001029-
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Tidskriftsartikel (refereegranskat)abstract
- We used an approach that we term ancestry-shift refinement mapping to investigate an association, originally discovered in a GWAS of a Chinese population, between rs2046210[T] and breast cancer susceptibility. The locus is on 6q25.1 in proximity to the C6orf97 and estrogen receptor alpha (ESR1) genes. We identified a panel of SNPs that are correlated with rs2046210 in Chinese, but not necessarily so in other ancestral populations, and genotyped them in breast cancer case:control samples of Asian, European, and African origin, a total of 10,176 cases and 13,286 controls. We found that rs2046210[T] does not confer substantial risk of breast cancer in Europeans and Africans (OR = 1.04, P = 0.099, and OR = 0.98, P = 0.77, respectively). Rather, in those ancestries, an association signal arises from a group of less common SNPs typified by rs9397435. The rs9397435[G] allele was found to confer risk of breast cancer in European (OR = 1.15, P = 1.2 x 10(-3)), African (OR = 1.35, P = 0.014), and Asian (OR = 1.23, P = 2.9 x 10(-4)) population samples. Combined over all ancestries, the OR was 1.19 (P = 3.9 x 10(-7)), was without significant heterogeneity between ancestries (P(het) = 0.36) and the SNP fully accounted for the association signal in each ancestry. Haplotypes bearing rs9397435[G] are well tagged by rs2046210[T] only in Asians. The rs9397435[G] allele showed associations with both estrogen receptor positive and estrogen receptor negative breast cancer. Using early-draft data from the 1,000 Genomes project, we found that the risk allele of a novel SNP (rs77275268), which is closely correlated with rs9397435, disrupts a partially methylated CpG sequence within a known CTCF binding site. These studies demonstrate that shifting the analysis among ancestral populations can provide valuable resolution in association mapping.
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