uu.seUppsala University Publications
Change search
Link to record
Permanent link

Direct link
BETA
Christofferson, R
Alternative names
Publications (10 of 19) Show all publications
Georgantzi, K., Sköldenberg, E., Tiensuu Janson, E., Jakobson, Å. & Christofferson, R. (2019). Diagnostic Ultrasound-Guided Cutting Needle Biopsies in Neuroblastoma: a safe and efficient procedure. Journal of Pediatric Surgery, 54(6), 1253-1256
Open this publication in new window or tab >>Diagnostic Ultrasound-Guided Cutting Needle Biopsies in Neuroblastoma: a safe and efficient procedure
Show others...
2019 (English)In: Journal of Pediatric Surgery, ISSN 0022-3468, E-ISSN 1531-5037, Vol. 54, no 6, p. 1253-1256Article in journal (Refereed) Published
Abstract [en]

Background

Neuroblastoma (NB) is the most common extracranial solid tumor of childhood and accounts for 15% of deaths in pediatric oncology. Apart from the clinical stage at diagnosis, molecular factors are important for the characterization of the tumor and for decision on adequate treatment. Pretreatment diagnosis and molecular profiling are based on analysis of a tumor sample, obtained either by fine needle aspiration cytology (FNAC), cutting needle biopsy or open surgical biopsy. The method used depends on local tradition and routines. Ultrasound-guided cutting needle biopsy (UCNB) has been used at the Uppsala University Hospital since 1988 for diagnosis of pediatric solid tumors.

Procedures

Medical records of 29 patients with NB who underwent pretreatment, diagnostic, ultrasound-guided needle biopsy were reviewed. Information extracted from the patients’ records included: age at diagnosis, gender, tumor site, clinical stage, molecular profiling made on biopsies (e.g. MYCN status, ploidy and chromosomal aberrations), and UCNB complications (i.e. bleeding, pain, or anesthesiologic complications).

Results

A total of 34 UCNBs were performed in the 29 patients. Repeated biopsies were done in three patients. UCNB was diagnostic in 90% (26/29). A complete molecular profiling was obtained in all UCNBs after 2008. Two patients (7%) developed a significant bleeding and two (7%) needed analgesics following UCNB. Neither infection nor tumor growth in the needle tract was observed. There were no anesthesiologic complications.

Conclusions

UCNB is reasonably safe in patients with NB and usually gives a sufficient amount of tumor tissue for a histological diagnosis, molecular profiling, and biobank storage.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
ultrasound, biopsy, neuroblastoma, complications, child
National Category
Pediatrics Surgery
Identifiers
urn:nbn:se:uu:diva-364673 (URN)10.1016/j.jpedsurg.2018.12.023 (DOI)000469332500030 ()30700386 (PubMedID)
Funder
Swedish Childhood Cancer Foundation, TJ2017-0094
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-06-26Bibliographically approved
Georgantzi, K., Tsolakis, A. V., Jakobson, Å., Christofferson, R., Tiensuu Janson, E. & Grimelius, L. (2019). Synaptic Vesicle Protein 2 and Vesicular Monoamine Transporter 1 and 2 Are Expressed in Neuroblastoma. Endocrine pathology, 30(3), 173-179
Open this publication in new window or tab >>Synaptic Vesicle Protein 2 and Vesicular Monoamine Transporter 1 and 2 Are Expressed in Neuroblastoma
Show others...
2019 (English)In: Endocrine pathology, ISSN 1046-3976, E-ISSN 1559-0097, Vol. 30, no 3, p. 173-179Article in journal (Refereed) Published
Abstract [en]

Neuroblastoma (NB), the most common extracranial cancer in childhood, exhibits neuroendocrine (NE) differentiation. Two well-established NE markers, chromogranin A (CgA) and synaptophysin (syn), are used in the histopathological diagnostics. Our aims were to explore if the NE markers synaptic vesicle protein 2 (SV2) and vesicular monoamine transporter 1 (VMAT1) and 2 (VMAT2) also are expressed in human NB and if so, evaluate their usefulness in NB histopathological diagnostics. Tumor specimens from 21 NB patients, before and/or after chemotherapy, were immunostained for CgA, syn, SV2, VMAT1, and VMAT2. Clinical data was extracted from patients' records. SV2 was highly expressed in NB, as was CgA while syn was less frequently expressed compared to the other two. Both VMATs were expressed in several NB, VMAT2 in more cases than VMAT1 and its expression was similar to syn. Chemotherapy did not affect the immunoreactivity in an obvious way. SV2 was highly expressed in NB and can thus be useful marker in NB diagnostics. VMAT1 and VMAT2 were also expressed in NB but similar to syn less reliable as tumor markers.

Keywords
neuroblastoma, neuroendocrine, immunohistochemistry, urine-dopamine, urine-HVA, urine-VMA, markers
National Category
Surgery Pediatrics Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-364674 (URN)10.1007/s12022-019-09584-3 (DOI)000481425400001 ()31317476 (PubMedID)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-09-25Bibliographically approved
Georgantzi, K., Sköldenberg, E., Stridsberg, M., Kogner, P., Jakobson, Å., Tiensuu Janson, E. & Christofferson, R. H. H. (2018). Chromogranin A and neuron-specific enolase in neuroblastoma: Correlation to stage and prognostic factors.. Pediatric Hematology & Oncology, 35(2), 156-165
Open this publication in new window or tab >>Chromogranin A and neuron-specific enolase in neuroblastoma: Correlation to stage and prognostic factors.
Show others...
2018 (English)In: Pediatric Hematology & Oncology, ISSN 0888-0018, E-ISSN 1521-0669, Vol. 35, no 2, p. 156-165Article in journal (Refereed) Published
Abstract [en]

Chromogranin A (CgA) and neuron specific enolase (NSE) are important markers in adult neuroendocrine tumors (NET). Neuroblastoma (NB) has certain neuroendocrine properties. The aim of this study was to correlate blood concentrations of CgA, chromogranin B (CgB), and NSE to prognostic factors and outcome in children with NB. Blood samples from 92 patients with NB, 12 patients with benign ganglioneuroma (GN), 21 patients with non-NB solid tumors, 10 patients with acute leukemias, and 69 healthy children, were analyzed. CgA concentrations were higher in neonates vs. children older than one month in the control group (p < 0.0001), and in neonates with NB vs. the control group (p < 0.01). CgA and NSE concentrations were higher in patients with stages 3 and 4 disease (p < 0.05 and p < 0.05), in patients having tumors with amplification of MYCN (p < 0.05 and p < 0.001), or chromosome 1 p deletion (p < 0.05 and p < 0.05). NSE correlated to the tumor size at diagnosis (p < 0.001) and to tumor related death (p < 0.01) in NB. CgA and NSE concentrations were elevated in patients with NB and especially in those with advanced disease. Both CgA and NSE correlated to genetic markers, while only NSE correlated to primary tumor size and outcome in NB. We found that CgA and NSE are clinically valuable tumor markers in NB and they merit prospective clinical evaluations as such.

Keywords
Chromogranin A, neuroblastoma, neuron-specific enolase, prognosis, tumor markers
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-360970 (URN)10.1080/08880018.2018.1464087 (DOI)000446356300007 ()29737901 (PubMedID)
Funder
Swedish Childhood Cancer Foundation
Available from: 2018-09-20 Created: 2018-09-20 Last updated: 2018-12-07Bibliographically approved
Angsten, G., Gustafson, E., Dahl, N. & Christofferson, R. H. (2017). Resolution of infantile intestinal pseudo-obstruction in a boy. Journal of Osteoporosis and Physical Activity, 24, 28-34
Open this publication in new window or tab >>Resolution of infantile intestinal pseudo-obstruction in a boy
2017 (English)In: Journal of Osteoporosis and Physical Activity, ISSN 2052-3211, E-ISSN 2213-5766, Vol. 24, p. 28-34Article in journal (Refereed) Published
Abstract [en]

A term boy with spontaneous passage of meconium exhibited episodes of abdominal distension and diarrhea. Due to failure to thrive and suspicion of Hischsprung's disease he was referred to our university hospital at five months of age. Rectal biopsies were normal. Laparotomy revealed dilation of the small bowel and colon without any mechanical obstruction. Full thickness bowel biopsies were taken and a loop ileostomy was constructed. Histopathology revealed fibrosing myopathy, Cajal cell hypertrophy, and neuronal degeneration in both the large and small bowel. The small bowel showed mastocytosis without inflammation. A central venous catheter was placed for vascular access, replaced three times and later switched to a subcutaneous venous port. Catheters were locked after use with vancomycin-heparin and later taurolidine. The individually tailored home parenteral nutrition contained unsaturated fatty acid lipids to reduce cholestasis. Initial insufficient growth was improved after correction of partial parenteral nutrition based on a metabolic balance study. The ileostomy was revised once and finally taken down at 11 years of age following one year without parenteral support. At follow-up at 13 years of age he has episodes of moderate abdominal pain and has entered puberty and reports a high quality of life. (C) 2017 The Authors. Published by Elsevier Inc.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Child, Intestinal pseudo-obstruction, Home parenteral nutrition, Unsaturated fatty acid parenteral nutrition, Taurolidine, Outcome
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-335647 (URN)10.1016/j.epsc.2017.06.007 (DOI)000409098900008 ()
Available from: 2017-12-08 Created: 2017-12-08 Last updated: 2017-12-08Bibliographically approved
Fredriksson, F., Christofferson, R. H. & Lilja, H. E. (2016). Adhesive small bowel obstruction after laparotomy during infancy. British Journal of Surgery, 103(3), 284-289
Open this publication in new window or tab >>Adhesive small bowel obstruction after laparotomy during infancy
2016 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 103, no 3, p. 284-289Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Intra-abdominal adhesions can cause adhesive small bowel obstruction, chronic abdominal pain and female infertility. Reports on long-term outcomes following laparotomy during infancy are scarce. The aims of this study were to investigate the incidence of and risk factors for long-term adhesive small bowel obstruction and associated morbidity after laparotomy during infancy.

METHODS: Infants who underwent laparotomy between 1976 and 2011 were identified. Data were extracted from medical records and a questionnaire was sent to the patients.

RESULTS: Some 898 of 1185 eligible patients were included, with a median follow-up time of 14·7 (range 0·0-36·0) years. Median age at first laparotomy was 6 (range 1·0-365·0) days. There were 113 patients (12·6 per cent) with adhesive small bowel obstruction who underwent relaparotomy, 79 (69·9 per cent) occurring during the first 2 years after the initial laparotomy. The highest incidence of small bowel obstruction was found in patients with Hirschsprung's disease (19 of 65, 29 per cent), malrotation (13 of 45, 29 per cent), intestinal atresia (11 of 40, 28 per cent) and necrotizing enterocolitis (16 of 64, 25 per cent). Lengthy duration of surgery (hazard ratio (HR) 1·25, 95 per cent c.i. 1·07 to 1·45), stoma formation (HR 1·72, 1·15 to 2·56) and postoperative complications (HR 1·81, 1·12 to 2·92) were independent risk factors. Chronic abdominal pain was reported in 180 (24·0 per cent) of 750 patients, and 17 (13·8 per cent) of 123 women reported infertility.

CONCLUSION: The incidence of adhesive small bowel obstruction after laparotomy in infants is high.

National Category
Surgery Pediatrics
Identifiers
urn:nbn:se:uu:diva-273906 (URN)10.1002/bjs.10072 (DOI)000368804700016 ()26667204 (PubMedID)
Available from: 2016-01-19 Created: 2016-01-19 Last updated: 2017-11-30Bibliographically approved
Christofferson, R., Läckgren, G. & Stenberg, A. (2015). Grottes barnkirurgi och barnurologi (1ed.). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Grottes barnkirurgi och barnurologi
2015 (Swedish)Book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2015. p. 268 Edition: 1
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-279325 (URN)978-91-44-07151-0 (ISBN)
Available from: 2016-02-29 Created: 2016-02-29 Last updated: 2017-09-15Bibliographically approved
Fredriksson, F., Christofferson, R. H., Carlsson, P.-O. & Lilja, H. E. (2014). Locally increased concentrations of inflammatory cytokines in an experimental intraabdominal adhesion model. Journal of Pediatric Surgery, 49(10), 1480-1484
Open this publication in new window or tab >>Locally increased concentrations of inflammatory cytokines in an experimental intraabdominal adhesion model
2014 (English)In: Journal of Pediatric Surgery, ISSN 0022-3468, E-ISSN 1531-5037, Vol. 49, no 10, p. 1480-1484Article in journal (Refereed) Published
Abstract [en]

Background: Peritoneal adhesions may cause bowel obstruction, infertility, and pain. This study investigated cytokines, proteins and growth factors thought to promote formation of adhesions in an experimental intraabdominal adhesion model. Methods: Male Sprague-Dawley rats were subjected to laparotomy, cecal abrasion, and construction of a small bowel anastomosis and examined at various time points after surgery. Concentrations of cytokines and growth factors in plasma and peritoneal fluid were analyzed using electrochemoluminescence and quantitative sandwich enzyme immunoassay technique. Results: Concentrations of interleukin-6 (IL-6), interleukin-1beta (IL-1 beta), and tumor necrosis factor alpha (TNF-alpha) increased in peritoneal fluid from 6 h after incision. Plasma concentrations of IL-6 increased at 6 h, but plasma concentrations of IL-1 beta and TNF-alpha remained low. Peritoneal fluid concentrations of platelet-derived growth factor-BB (PDGF- BB), transforming growth factor beta1 (TGF-beta 1), vascular endothelial growth factor (VEGF), tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) were below detection levels at all time points. Conclusion: Early elevations of IL-6, IL-1 beta, and TNF-alpha concentrations in peritoneal fluid correlated to adhesion formation in this rodent model. Our model is relevant and reproducible, suitable for intervention, and indicates that antiadhesion strategies should be early, local and not systemic.

Keywords
Peritoneal adhesions, Rat, Inflammatory cytokines
National Category
Pediatrics Surgery
Identifiers
urn:nbn:se:uu:diva-236557 (URN)10.1016/j.jpedsurg.2014.03.010 (DOI)000343140200008 ()25280650 (Scopus ID)
Available from: 2014-11-24 Created: 2014-11-19 Last updated: 2017-12-05Bibliographically approved
Georgantzi, C., Sköldenberg, E., Stridsberg, M., Jakobson, A. & Christofferson, R. (2013). Chromogranin A In Neuroblastoma: Correlation To Stage And Prognostic Factors. Paper presented at 45th Congress of the International Society of Paediatric Oncology (SIOP) 2013, 25th-28th, 2013, Hong Kong, China. Pediatric Blood & Cancer, 60(S3), 228-228
Open this publication in new window or tab >>Chromogranin A In Neuroblastoma: Correlation To Stage And Prognostic Factors
Show others...
2013 (English)In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 60, no S3, p. 228-228Article in journal, Meeting abstract (Refereed) Published
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-211140 (URN)000324735501445 ()
Conference
45th Congress of the International Society of Paediatric Oncology (SIOP) 2013, 25th-28th, 2013, Hong Kong, China
Available from: 2013-11-20 Created: 2013-11-20 Last updated: 2017-12-06Bibliographically approved
Hermansson, O., George, M., Wester, T. & Christofferson, R. (2013). Local delivery of bupivacaine in the wound reduces opioid requirements after intraabdominal surgery in children. Pediatric surgery international (Print), 29(5), 451-454
Open this publication in new window or tab >>Local delivery of bupivacaine in the wound reduces opioid requirements after intraabdominal surgery in children
2013 (English)In: Pediatric surgery international (Print), ISSN 0179-0358, E-ISSN 1437-9813, Vol. 29, no 5, p. 451-454Article in journal (Refereed) Published
Abstract [en]

Local anaesthetic infusions into the surgical wound have been shown to reduce postoperative pain and the need for opioids in adults. In children, it was found to be safe and efficacious following sternotomy and orthopaedic surgery. The aim of this study was to evaluate the need for opioids postoperatively in children receiving wound catheters delivering either bupivacaine or saline following one of three defined abdominal or bladder procedures. Prospective, randomized, double-blind, placebo controlled study. Thirty-three children, 6 months of age to 13 years of age, undergoing elective surgery for enterostomy closure, open gastrostomy or ureteral reimplantation were randomized to receive bupivacaine or saline wound infusions for 72 h postoperatively. All patients received acetaminophen orally or rectally for every 6 h. Breakthrough pain was treated with morphine bolus doses of 0.05 mg/kg or infusions if more than three morphine doses were required. Pain scores were assessed every 3 h. Outcome measures were morphine dosages, return to full oral intake and length of hospital stay. On the first postoperative day, patients with bupivacaine infusions had significantly less need for morphine (1.3 +/- A 1.3 SD doses) compared to those receiving saline infusions (3.1+/2.5 SD doses, p < 0.05). No difference was seen during postoperative day two or three. There was no significant difference between the groups regarding time to full oral intake and time to discharge. Continuous infusion of bupivacaine in the abdominal wound was effective in reducing postoperative pain in children. It significantly reduced the need for additional opioids and can be considered for postoperative pain management in children.

Keywords
Pain, Children, Postoperative
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-200344 (URN)10.1007/s00383-013-3296-6 (DOI)000317929300007 ()
Available from: 2013-05-28 Created: 2013-05-27 Last updated: 2017-12-06Bibliographically approved
Georgantzi, K., Tsolakis, A. V., Stridsberg, M., Jakobson, Å., Christofferson, R. & Janson, E. T. (2011). Differentiated expression of somatostatin receptor subtypes in experimental models and clinical neuroblastoma. Pediatric Blood & Cancer, 56(4), 584-589
Open this publication in new window or tab >>Differentiated expression of somatostatin receptor subtypes in experimental models and clinical neuroblastoma
Show others...
2011 (English)In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 56, no 4, p. 584-589Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Neuroblastoma (NB) is a solid tumor of childhood originating from the adrenal medulla or sympathetic nervous system. Somatostatin (SS) is an important regulator of neural and neuroendocrine function, its actions being mediated through five specific membrane receptors. The aim of this study was to investigate the expression of the different somatostatin receptors (SSTRs) in NB tumor cells that may form targets for future therapeutic development.

PROCEDURE:

Tumor specimens from 11 children with stage II-IV disease were collected before and/or after chemotherapy. Experimental tumors derived from five human NB cell lines were grown subcutaneously in nude mice. Expression of SSRTs, the neuroendocrine marker chromogranin A (CgA) and SS was detected by immunohistochemistry using specific antibodies.

RESULTS:

SSTR2 was detected in 90%, SSTR5 in 79%, SSTR1 in 74%, SSTR3 in 68% whereas SSTR4 was expressed in 21% of the clinical tumors. The experimental tumors expressed SSTRs in a high but variable frequency. All clinical tumors showed immunoreactivity for CgA but not for SS.

CONCLUSION:

The frequent expression of SSTRs indicates that treatment with unlabeled or radiolabeled SS analogs should be further explored in NB.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-140509 (URN)10.1002/pbc.22913 (DOI)000287986700013 ()21120894 (PubMedID)
Available from: 2011-01-05 Created: 2011-01-05 Last updated: 2018-10-31
Organisations

Search in DiVA

Show all publications