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  • 1.
    Brandström, Per
    et al.
    Pediatric Uro-Nephrologic Center, Queen Silvia Children's Hospital, University of Gothenburg, Göteborg, Sweden.
    Esbjörner, Elisabeth
    Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Herthelius, Maria
    Department for Clinical Science, Intervention and Technology, Karolinska University Hospital, Huddinge, Sweden.
    Holmdahl, Gundela
    Pediatric Uro-Nephrologic Center, Queen Silvia Children's Hospital, University of Gothenburg, Göteborg, Sweden.
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sillén, Ulla
    Pediatric Uro-Nephrologic Center, Queen Silvia Children's Hospital, University of Gothenburg, Göteborg, Sweden.
    Sixt, Rune
    Pediatric Uro-Nephrologic Center, Queen Silvia Children's Hospital, University of Gothenburg, Göteborg, Sweden.
    Sjöberg, Ingrid
    Department of Pediatrics, Children's University Hospital, Lund, Sweden.
    Stokland, Eira
    Pediatric Uro-Nephrologic Center, Queen Silvia Children's Hospital, University of Gothenburg, Göteborg, Sweden.
    Jodal, Ulf
    Pediatric Uro-Nephrologic Center, Queen Silvia Children's Hospital, University of Gothenburg, Göteborg, Sweden.
    Hansson, Sverker
    Pediatric Uro-Nephrologic Center, Queen Silvia Children's Hospital, University of Gothenburg, Göteborg, Sweden.
    The Swedish reflux trial in children: I. Study design and study population characteristics2010In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 184, no 1, p. 274-279Article in journal (Refereed)
    Abstract [en]

    PURPOSE: We compared the rates of febrile urinary tract infection, kidney damage and reflux resolution in children with vesicoureteral reflux treated in 3 ways, including antibiotic prophylaxis, endoscopic therapy and surveillance with antibiotics only for symptomatic urinary tract infection. MATERIALS AND METHODS: Children 1 to younger than 2 years with grade III-IV reflux were recruited into this prospective, open, randomized, controlled, multicenter study and followed for 2 years after randomization. The main study end points were recurrent febrile urinary tract infection, renal status on dimercapto-succinic acid scintigraphy and reflux status. Outcomes were analyzed by the intent to treat principle. RESULTS: During a 6-year period 128 girls and 75 boys entered the study. In 96% of cases reflux was detected after urinary tract infection. The randomization procedure was successful and resulted in 3 groups matched for relevant factors. Recruitment was slower than anticipated but after patients were entered adherence to the protocol was good. Of the children 93% were followed for the intended 2 years without a treatment arm change. All except 2 patients completed 2-year followup scintigraphy. CONCLUSIONS: Recruitment was difficult but a substantial number of children were entered and randomly assigned to 3 groups with similar basic characteristics. Good adherence to the protocol made it possible to address the central study questions.

  • 2.
    Christofferson, Rolf
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Stenberg, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Grottes barnkirurgi och barnurologi2015 (ed. 1)Book (Other academic)
  • 3. Clementsson Kockum, Christina
    et al.
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Blåsextrofi, epispadi och kloakexstrofi2015In: Grottes Barnkirurgi och Barnurologi / [ed] Christofferson R, Läckgren S, Stenberg A, Lund: Studentlitteratur AB, 2015, 1, p. 225-230Chapter in book (Other academic)
  • 4.
    Draaken, Markus
    et al.
    Institute of Human Genetics, University of Bonn, Germany.
    Baudisch, Friederike
    Timmermann, Bernd
    Kuhl, Heiner
    Kerick, Martin
    Proske, Judith
    Wittler, Lars
    Pennimpede, Tracie
    Ebert, Anne-Karoline
    Rösch, Wolfgang
    Stein, Raimund
    Bartels, Enrika
    von Lowtzow, Catharina
    Boemers, Thomas M
    Herms, Stefan
    Gearhart, John P
    Lakshmanan, Yegappan
    Kockum, Christina Clementsson
    Holmdahl, Gundela
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Nordenskjöld, Agnetha
    Boyadjiev, Simeon A
    Herrmann, Bernhard G
    Nöthen, Markus M
    Ludwig, Michael
    Reutter, Heiko
    Institute of Human Genetics, University of Bonn, Germany.
    Classic bladder exstrophy: Frequent 22q11.21 duplications and definition of a 414 kb phenocritical region2014In: Birth defects research. Clinical and molecular teratology, ISSN 1542-0752, E-ISSN 1542-0760, Vol. 100, no 6, p. 512-517Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Classic bladder exstrophy (CBE) is the most common form of the bladder exstrophy and epispadias complex. Previously, we and others have identified four patients with a duplication of 22q11.21 among a total of 96 unrelated CBE patients.

    METHODS: Here, we investigated whether this chromosomal aberration was commonly associated with CBE/bladder exstrophy and epispadias complex in an extended case-control sample. Multiplex ligation-dependent probe amplification and microarray-based analysis were used to identify 22q11.21 duplications in 244 unrelated bladder exstrophy and epispadias complex patients (including 217 CBE patients) and 665 healthy controls.

    RESULTS: New duplications of variable size were identified in four CBE patients and one control. Pooling of our previous and present data (eight duplications in 313 CBE patients) yielded a combined odds ratio of 31.86 (95% confidence interval, 4.24-1407.97). Array-based sequence capture and high-throughput targeted re-sequencing established that all breakpoints resided within the low-copy repeats 22A to 22D. Comparison of the eight duplications revealed a 414 kb phenocritical region harboring 12 validated RefSeq genes. Characterization of these 12 candidate genes through whole-mount in situ hybridization of mouse embryos at embryonic day 9.5 suggested that CRKL, THAP7, and LZTR1 are CBE candidate genes.

    CONCLUSION: Our data suggest that duplication of 22q11.21 increases CBE risk and implicate a phenocritical region in disease formation.

  • 5.
    Kirsch, Andrew J.
    et al.
    Department of Pediatric Urology, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA.
    Arlen, Angela M.
    Department of Pediatric Urology, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA.
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Current Trends in Dextranomer Hyaluronic Acid Copolymer (Deflux) Injection Technique for Endoscopic Treatment of Vesicoureteral Reflux2014In: Urology, ISSN 0090-4295, E-ISSN 1527-9995, Vol. 84, no 2, p. 462-468Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE To determine the current preferred injection technique(s) for endoscopic management of pediatric vesicoureteral reflux (VUR). Since the approval of dextranomer hyaluronic acid copolymer (Dx/HA) in 2001, injection methods have evolved and now include the hydrodistention implantation technique (HIT) and double HIT as well as subureteral transurethral injection (STING) method. METHODS In July 2012, 278 pediatric urologists in the United States were contacted to complete a 15-question survey regarding Dx/HA injection technique(s) currently used in their practice. RESULTS Fifty board-certified pediatric urologists completed the survey for a response rate of 18%. Most respondents (60%) were in a single-specialty group practice, and 12% were affiliated with an academic-or university-based practice. Respondents reported seeing a mean of 159 pediatric patients (range, 40-400 patients) with VUR annually, and 94% used Dx/HA >= 4 times in the past year. Forty-seven respondents (94%) reported using double HIT over the course of their career compared with 36 (72%) for STING and 30 (60%) for HIT (P < .05). Double HIT gained widespread acceptance between 2007 and 2008, paralleled by a decline in use of other injection techniques. A significantly higher percentage currently perform double HIT (92%) compared with either STING (24%) or HIT (34%; P < .001). Respondents reported the use of double HIT 15 times more often than STING technique and 5 times more often than HIT during the past 12 months (P < .001). CONCLUSION The double HIT method is currently the most commonly performed technique for endoscopic correction of VUR by pediatric urologists in the United States.

  • 6. Lundin, Johanna
    et al.
    Söderhäll, Cilla
    Lundén, Lina
    Hammarsjö, Anna
    White, Iréne
    Schoumans, Jacqueline
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
    Kockum, Christina Clementson
    Nordenskjöld, Agneta
    22q11.2 microduplication in two patients with bladder exstrophy and hearing impairment2010In: European Journal of Medical Genetics, ISSN 1769-7212, E-ISSN 1878-0849, Vol. 53, no 2, p. 61-65Article in journal (Refereed)
    Abstract [en]

    Bladder exstrophy is a congenital malformation of the bladder and urethra. The genetic basis of this malformation is unknown however it is well known that chromosomal aberrations can lead to defects in organ development. A few bladder exstrophy patients have been described to carry chromosomal aberrations. Chromosomal rearrangements of 22q11.2 are implicated in several genomic disorders i.e. DiGeorge/velocardiofacial- and cat-eye syndrome. Deletions within this chromosomal region are relatively common while duplications of 22q11.2 are much less frequently observed. An increasing number of reports of microduplications of this region describe a highly variable phenotype. We have performed array-CGH analysis of 36 Swedish bladder exstrophy patients. The analysis revealed a similar and approximately 3 Mb duplication, consistent with the recently described 22q11.2 microduplication syndrome, in two unrelated cases with bladder exstrophy and hearing impairment. This finding was confirmed by multiplex ligation-dependent probe amplification (MLPA) and FISH analysis. Subsequent MLPA analysis of this chromosomal region in 33 bladder exstrophy patients did not reveal any deletion/duplication within this region. MLPA analysis of 171 anonymous control individuals revealed one individual carrying this microduplication. This is the first report of 22q11.2 microduplication associated with bladder exstrophy and hearing impairment. Furthermore the finding of one carrier among a cohort of normal controls further highlights the variable phenotype linked to this microduplication syndrome.

  • 7.
    Läckgren, Göran
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
    Kirsch, Andrew J
    Dept.of Pediatric Urology, Childrens Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
    Surgery Illustrated - Surgical Atlas: Endoscopic treatment of vesicoureteral2010In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 105, no 9, p. 1332-1347Article in journal (Refereed)
  • 8.
    Läckgren, Göran
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
    Stenberg, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
    Endoscopic treatment of vesicoureteral reflux: current practice and the need formultifactorial assessment2009In: Therapeutic Advances in Urology, ISSN 1756-2880, Vol. 1, no 3, p. 131-141Article in journal (Refereed)
    Abstract [en]

    Vesicoureteral reflux (VUR) affects around 1% of all children. It carries an increased risk of febrile urinary-tract infections (UTIs) and is associated with impaired renal function. Antibiotic prophylaxis is an established approach to managing the condition, but it does not protect against UTI and encourages bacterial resistance. Ureteral re-implantation (open surgery) is a relatively traumatic procedure typically requiring hospitalization, and there is a risk of significant post-treatment complications. Endoscopic treatment with NASHA/Dx gel (Deflux) is minimally invasive, well tolerated and provides cure rates approaching those of open surgery: 8090% in several studies. It has also been shown to be effective in a variety of ‘complicated’ cases. Thus, endoscopic treatment is generally preferable to open surgery and long-term antibiotic prophylaxis. Non-treatment of VUR is being discussed as an alternative option, although this mainly appears suitable for children with low-grade reflux and normal kidneys. A new approach to managing VUR may be considered, with treatment decisions based not only on the grade of reflux but also on factors such as age, sex, renal scarring and bladder dysfunction. Open surgery would be reserved only for use in the 1015% of children notresponding to endoscopic treatment and those with severe ureteral anomalies.

  • 9.
    Nevéus, Tryggve
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Läckgren, G
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Stenberg, A
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Norgaard, JP
    Anticholinergic treatment for nocturnal enuresis: Current understanding and future expectations2005In: Dialogues in Pediatric Urology, Vol. 26, no 6, p. 9-11Article in journal (Refereed)
  • 10. Nevéus, Tryggve
    et al.
    Stenberg, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Lilja, B
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
    Diurnal and nocturnal arginine profiles in enuretics and controls1995In: Proceedings of the third International Children's Continence Symposium, 1995, Vol. 65Conference paper (Refereed)
  • 11.
    Reutter, Heiko
    et al.
    Institute of Human Genetics Department of Neonatology, University of Bonn, Germany.
    Draaken, Markus
    Pennimpede, Tracie
    Wittler, Lars
    Brockschmidt, Felix F.
    Ebert, Anne-Karolin
    Bartels, Enrika
    Roesch, Wolfgang
    Boemers, Thomas M.
    Hirsch, Karin
    Schmiedeke, Eberhard
    Meesters, Christian
    Becker, Tim
    Stein, Raimund
    Utsch, Boris
    Mangold, Elisabeth
    Nordenskjoeld, Agneta
    Barker, Gillian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
    Kockum, Christina Clementsson
    Zwink, Nadine
    Holmdahl, Gundula
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Jenetzky, Ekkehart
    Feitz, Wouter F. J.
    Marcelis, Carlo
    Wijers, Charlotte H. W.
    Van Rooij, Iris A. L. M.
    Gearhart, John P.
    Herrmann, Bernhard G.
    Ludwig, Michael
    Boyadjiev, Simeon A.
    Noethen, Markus M.
    Mattheisen, Manuel
    Genome-wide association study and mouse expression data identify a highly conserved 32 kb intergenic region between WNT3 and WNT9b as possible susceptibility locus for isolated classic exstrophy of the bladder2014In: Human Molecular Genetics, ISSN 0964-6906, E-ISSN 1460-2083, Vol. 23, no 20, p. 5536-5544Article in journal (Refereed)
    Abstract [en]

    Bladder exstrophy-epispadias complex (BEEC), the severe end of the urorectal malformation spectrum, has a profound impact on continence as well as sexual and renal functions. It is widely accepted that for the majority of cases the genetic basis appears to be multifactorial. Here, we report the first study which utilizes genome-wide association methods to analyze a cohort comprising patients presenting the most common BEEC form, classic bladder exstrophy (CBE), to identify common variation associated with risk for isolated CBE. We employed discovery and follow-up samples comprising 218 cases/865 controls and 78 trios in total, all of European descent. Our discovery sample identified a marker near SALL1, showing genome-wide significant association with CBE. However, analyses performed on follow-up samples did not add further support to these findings. We were also able to identify an association with CBE across our study samples (discovery: P = 8.88 x 10(-5); follow-up: P = 0.0025; combined: 1.09 x 10(-6)) in a highly conserved 32 kb intergenic region containing regulatory elements between WNT3 and WNT9B. Subsequent analyses in mice revealed expression for both genes in the genital region during stages relevant to the development of CBE in humans. Unfortunately, we were not able to replicate the suggestive signal for WNT3 and WNT9B in a sample that was enriched for non-CBE BEEC cases (P = 0.51). Our suggestive findings support the hypothesis that larger samples are warranted to identify association of common variation with CBE.

  • 12. Ritzén, E Martin
    et al.
    Bergh, A
    Bjerknes, R
    Christiansen, P
    Cortes, D
    Haugen, S E
    Jörgensen, N
    Kollin, C
    Lindahl, S
    Läckgren, G
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Main, K M
    Nordenskjöld, A
    Rajpert-De Meyts, E
    Söder, O
    Taskinen, S
    Thorsson, A
    Thorup, J
    Toppari, J
    Virtanen, H
    Nordic consensus on treatment of undescended testes.2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 5, p. 638-643Article in journal (Refereed)
    Abstract [en]

    Aim: To reach consensus among specialists from the Nordic countries on the present state-of-the-art in treatment of undescended testicles.

    Methods: A group of specialists in testicular physiology, paediatric surgery/urology, endocrinology, andrology, pathology and anaesthesiology from all the Nordic countries met for two days. Before the meeting, reviews of the literature had been prepared by the participants.

    Recommendations: The group came to the following unanimous conclusions: (1) In general, hormonal treatment is not recommended, considering the poor immediate results and the possible long term adverse effects on spermatogenesis. Thus, surgery is to be preferred. (2) Orchiopexy should be done between 6 and 12 months of age, or upon diagnosis, if that occurs later. (3) Orchiopexy before age one year should only be done at centres with both paediatric surgeons/urologists and paediatric anaesthesiologists. (4) If a testis is found to be undescended at any age after 6 months, the patient should be referred for surgery—to paediatric rather than general surgeons/urologists if the boy is less than one year old or if he has bilateral or non-palpable testes, or if he has got relapse of cryptorchidism.

  • 13. Siegmund, Werner
    et al.
    Sillén, Ulla
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Schnabel, Frieder
    Mürtz, Gerd
    Feustel, Cornelia
    Pharmacokinetics and pharmacodynamics of propiverine in children aged between 5 and 10 years with symptoms of overactive bladder2010In: Clinical Pharmacokinetics, ISSN 0312-5963, E-ISSN 1179-1926, Vol. 49, no 5, p. 335-342Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVES: Pharmacokinetic studies in children are particularly required for drugs with intensive hepatic and regioselective intestinal elimination and pharmacological effects that may be critical for absorption at therapeutic doses, such as a delay in intestinal transit. One example is the antimuscarinic drug propiverine, the pharmacokinetics of which were evaluated in the present study in children with symptoms of overactive bladder.

    METHODS: The pharmacokinetics of immediate-release propiverine were studied in a dose-escalating, parallel-group study (propiverine 5, 10 and 15 mg twice daily for 14 days) in 25 subjects (11 females and 14 males aged 5-10 years; bodyweight 17-44 kg; body mass index 14-21 kg/m2) with symptoms of overactive bladder during waking hours. Serum concentration-time curves of propiverine and its major metabolite propiverine N-oxide (M-5) were evaluated up to 3 hours and 8 hours after the first and last administration, respectively, using liquid chromatography with tandem mass spectrometry. The voiding frequency, number of incontinence and urgency episodes, single voided volume and urine flow variables were measured before and after treatment.

    RESULTS: Significant dose-related increases in the serum exposure (the area under the concentration-time curve, the maximum concentration and the minimum concentration) with propiverine and M-5 in the dose groups < or =0.3 mg/kg and 0.3 to < or =0.45 mg/kg after both single-dose and repeated-dose administration were found. The elimination half-lives of propiverine and M-5 at steady state were no different (mean +/- SD 12.2 +/- 11.2 and 14.5 +/- 9.94 hours, respectively). Higher doses did not result in additional dose-proportional increases in the respective pharmacokinetic parameters, particularly not after repeated-dose treatment. The voiding frequency, voided volume and urge symptoms were beneficially changed from baseline; significant dose-dependent changes were not observed. Most of the adverse events that were probably or possibly drug related were reported for patients in the high-dose group (>0.45 mg/kg).

    CONCLUSIONS: The disposition of propiverine is dose related after repeated administration of the recommended doses below 0.45 mg/kg (0.3-0.45 mg/kg) twice daily in children aged 5-10 years with symptoms of overactive bladder and urinary incontinence. (Trial registration numbers: [clinicaltrials.gov] NCT00795925; [EudraCT] 2004-001243-30).

  • 14.
    Soderhall, Cilla
    et al.
    Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.
    Lundin, Johanna
    Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lagerstedt-Robinson, Kristina
    Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
    Grigelioniene, Giedre
    Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Kockum, Christina Clementson
    Department of Pediatric Surgery, University Hospital, Lund, Sweden.
    Nordenskjold, Agneta
    Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
    A Case with Bladder Exstrophy and Unbalanced X Chromosome Rearrangement2014In: European journal of pediatric surgery, ISSN 0939-7248, E-ISSN 1439-359X, Vol. 24, no 4, p. 353-359Article in journal (Refereed)
    Abstract [en]

    Introduction Bladder exstrophy is a rare congenital malformation of the bladder and is believed to be a complex disorder with genetic and environmental background. We describe a young adult female with an isolated bladder exstrophy and with an X chromosome aberration. Patients and Methods Karyotyping identified an X chromosome rearrangement that was further characterized with array comparative genomic hybridization (CGH) and confirmed by multiplex ligation-dependent probe amplification and fluorescence in situ hybridization (FISH) analysis. Results The identified X chromosome rearrangement in our index patient consists of a gain of chromosomal material in region Xq26.3-> qter and loss in region Xp22.12->pter. This aberration was also carried by her mother and sister, none with bladder exstrophy. All three have a disproportionate short stature, as expected due to the deletion of one of the copies of the SHOX gene on Xp22.3. X-inactivation studies revealed a complete skewed inactivation pattern in carriers. Crossover events in the maternal germline furthermore resulted in different genetic material on the rearranged X chromosome between the index patient and her sister. Conclusion Our findings suggest an X-linked genetic risk factor for bladder exstrophy.

  • 15.
    Stenberg, Arne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Treatment of vesicoureteral reflux in children using stabilized non-animal hyaluronic acid/dextranomer gel (NASHA/DX): A long-term observational study2007In: Journal of Pediatric Urology, ISSN 1477-5131, Vol. 3, no 2, p. 80-85Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Vesicoureteral reflux (VUR) can be treated with open surgery, antibiotic therapy or endoscopic injection. A goal in children is to reduce the incidence of febrile urinary tract infections (UTIs). The present long-term observational study investigated outcomes and experiences of endoscopic treatment with stabilized non-animal hyaluronic acid/dextranomer, NASHAtrade mark/Dx. PATIENTS AND METHODS: Children treated with NASHA/Dx between 1993 and 1998 were sent a questionnaire by mail in 2005. Patients included in the study (n=231) had VUR grade III-V before treatment and grade 0-II afterwards. Patients completed 21 questions, with parental assistance if required. The questionnaire assessed clinical outcome, and the attitudes of both patients and their parents to their experiences of treatment with NASHA/Dx gel. Patients reporting UTI after treatment were contacted and their records analyzed. RESULTS: Questionnaires were completed by 179 eligible patients. Most (72%) received a single injection of NASHA/Dx gel, and all experienced febrile UTI before treatment. After treatment, 45 patients (25%) experienced UTI; 25 of these reported fever. Patient records and telephone interviews revealed no evidence of febrile UTI in 19 cases; febrile UTI was confirmed in six cases, an incidence of 3.4%. When asked about the worst aspect of VUR treatment, 9% indicated treatment with NASHA/Dx compared to 19% for medication and 72% for voiding cystourethrogram (VCUG); parent-rated responses were 19%, 24% and 57%, respectively. CONCLUSIONS: Endoscopic treatment with NASHA/Dx gel was associated with a low number of febrile UTIs following treatment, viewed positively and considered less bothersome than medication or VCUG. These findings support this treatment as a primary intervention for VUR.

  • 16. Stenberg, Å M
    et al.
    Sundin, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
    Larsson, B S
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
    Stenberg, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
    Lack of distant migration after injection of a 125iodine labeled dextranomer based implant into the rabbit bladder1997In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 158, no 5, p. 1937-1941Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    In recent years endoscopic treatment of stress incontinence and vesicoureteral reflux has been introduced. Reports of possible particle migration of the injected material to distant organs in humans and experimental animals have led to a search for biological nonmigration products. An implant found to have a good clinical effect in these conditions is dextranomer in hyaluronan. We performed this study in rabbits to investigate the possible migration of dextranomer particles.

    MATERIALS AND METHODS:

    125Iodine labeled dextranomer particles were injected into the submucosal space of rabbit bladders, and samples of blood and various tissues were examined for radioactivity at scheduled intervals during a 28-day period. Furthermore, whole body autoradiography was performed 1 day, and 1 and 4 weeks after injection.

    RESULTS:

    Radioactivity was found in blood samples and in all tissues but it remained at the background activity level except in the thyroid, where uptake representing free 125iodine was detected. In the bladder 41 and 45% of the injected dose remained within the bladder wall 1 day and 4 weeks, respectively, after injection. The remainder of the dose probably disappeared from the bladder wall by leakage into the urine shortly after deposition, as indicated by the finding of 10-fold higher urine radioactivity levels at day 1 than at day 28 after injection.

    CONCLUSIONS:

    No distant migration of dextranomer particles occurs after submucosal injection of such an implant in the rabbit bladder wall.

  • 17.
    Stenbäck, A
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Akut Skrotum2015In: Grottes Barnkirurgi och Barnurologi / [ed] Christoffersson R, Läckgren G, Stenberg A, Lund: Studentlitteratur AB, 2015, 1, p. 247-250Chapter in book (Other academic)
  • 18.
    Stenbäck, A
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Fimos2015In: Grottes Barnkirurgi och Barnurologi / [ed] Christoffersson R, Läckgren G, Stenberg A, Lund: Studentlitteratur AB, 2015, p. 251-252Chapter in book (Other academic)
  • 19.
    Stenbäck, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Retentio Testis2015In: Grottes barnkirurgi och barnurologi / [ed] Christoffersson R, Läckgren G, Stenberg A, Lund: Studentlitteratur AB, 2015, p. 241-246Chapter in book (Other academic)
  • 20. Thorup, J
    et al.
    Haugen, S
    Kollin, C
    Lindahl, S
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
    Nordenskjold, A
    Taskinen, S
    Surgical treatment of undescended testes2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 5, p. 631-637Article, review/survey (Refereed)
    Abstract [en]

    The mainstay of therapy for undescended testes is operative treatment within the first years of life in order to avoid ongoing testicular degenerative changes. The surgical therapy for the palpable undescended testis is orchiopexy and when the testis is non-palpable, a supplementary laparoscopic approach. Success of orchiopexy for inguinal testes has been >95% and for abdominal testes >85–90% in most series.

    Conclusion: Operation within the first year of life is a safe therapy for undescended testes.

  • 21.
    Vivier, Pierre-Hugues
    et al.
    Hop Prive Estuaire, Serv Radiol, Ramsay Gen Sante, Radiol, 505 Rue Irene Joliot Curie, F-76620 Le Havre, France.;Univ Hosp Charles Nicolle, Pediat Radiol, Rouen, France..
    Augdal, Thomas A.
    Univ Hosp North Norway, Pediat Radiol, Tromso, Norway..
    Avni, Fred E.
    Lille Univ Hosp, Jeanne de Flandre Hosp, Pediat Radiol, Lille, France..
    Bacchetta, Justine
    Hop Femme Mere Enfant, Pediat Nephrol, Bron, France..
    Beetz, Rolf
    Univ Med Clin, Ctr Paediat & Adolescent Med, Pediat Nephrol, Mainz, Germany..
    Bjerre, Anna K.
    Natl Hosp Norway, Oslo Univ Hosp, Pediat Nephrol, Oslo, Norway..
    Blickman, Johan
    Golisano Childrens Hosp, Pediat Radiol, Rochester, NY USA..
    Cochat, Pierre
    Hop Femme Mere Enfant, Pediat Nephrol, Bron, France..
    Coppo, Rosana
    Regina Margherita Hosp, Pediat Nephrol, Turin, Italy..
    Damasio, Beatrice
    Ist Giannina Gaslini, Pediat Radiol, Genoa, Italy..
    Darge, Kassa
    Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Pediat Radiol, Philadelphia, PA 19104 USA..
    El-Ghoneimi, Alaa
    Univ Paris Diderot, Univ Hosp Robert Debre, APHP, Pediat Surg & Urol, Paris, France..
    Hoebeke, Piet
    Ghent Univ Hosp, Urol, Ghent, Belgium..
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Pediatric Surgery.
    Leclair, Marc-David
    Children Univ Hosp, Pediat Surg & Urol, Nantes, France..
    Lobo, Maria-Luisa
    Univ Hosp, Hosp Santa Maria, Radiol, Lisbon, Portugal..
    Manzoni, Gianantonio
    Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Pediat Urol, Milan, Italy..
    Marks, Stephen D.
    Great Ormond St Hosp Children NHS Fdn Trust, Paediat Nephrol, London, England..
    Mattioli, Girolamo
    Dinogmi Univ Genova, Gaslini Inst, Pediat Surg & Urol, Genoa, Italy..
    Mentzel, Hans-Joachim
    Univ Hosp Jena, Pediat Radiol Diagnost & Intervent Radiol, Jena, Germany..
    Mouriquand, Pierre
    Hosp Civils Lyon, Hop Mere Enfant, Pediat Urol, Lyon 1, France.;Claude Bernard Univ, Lyon 1, France..
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Ntoulia, Aikaterini
    Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Pediat Radiol, Philadelphia, PA 19104 USA.;Kings Coll Hosp London, Paediat Radiol, London, England..
    Ording-Muller, Lil-Sofie
    Oslo Univ Hosp, Paediat Radiol, Oslo, Norway..
    Oswald, Josef
    Hosp Sisters Char, Pediat Urol, Linz, Austria..
    Papadopoulou, Frederica
    Ioannina Univ, Radiol, Ioannina, Greece..
    Porcellini, Gabriella
    Regina Margherita Hosp, Pediat Nephrol, Turin, Italy..
    Ring, Ekkehard
    Univ Hosp LKH Graz, Dept Pediat, Graz, Austria..
    Rösch, Wolfgang
    Univ Med Ctr Regensburg, Pediat Urol, Regensburg, Germany..
    Teixeira, Ana F.
    Ctr Hosp Sao Joao, Pediat Nephrol, Oporto, Portugal..
    Riccabona, Michael
    Univ Hosp LKH Graz, Pediat Radiol, Graz, Austria..
    Standardization of pediatric uroradiological terms: a multidisciplinary European glossary2018In: Pediatric Radiology, ISSN 0301-0449, E-ISSN 1432-1998, Vol. 48, no 2, p. 291-303Article in journal (Refereed)
    Abstract [en]

    To promote the standardization of nephro-uroradiological terms used in children, the European Society of Paediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication between different clinicians involved in pediatric urology and nephrology.

  • 22.
    Vivier, Pierre-Hugues
    et al.
    Hop Prive Estuaire, Radiol, Ramsay Gen Sante, Le Havre, France;Univ Hosp Charles Nicolle, Pediat Radiol, Rouen, France.
    Augdal, Thomas A.
    Univ Hosp North Norway, Pediat Radiol, Tromso, Norway..
    Avni, Fred E.
    Lille Univ Hosp, Jeanne de Flandre Hosp, Pediat Radiol, Lille, France..
    Bacchetta, Justine
    Hop Femme Mere Enfant, Pediat Nephrol, Bron, France..
    Beetz, Rolf
    Univ Med Clin, Ctr Paediat & Adolescent Med, Pediat Nephrol, Mainz, Germany..
    Bjerre, Anna K.
    Natl Hosp Norway, Oslo Univ Hosp, Pediat Nephrol, Oslo, Norway..
    Blickman, Johan
    Golisano Childrens Hosp, Pediat Radiol, Rochester, NY USA..
    Cochat, Pierre
    Hop Femme Mere Enfant, Pediat Nephrol, Bron, France..
    Coppo, Rosana
    Regina Margherita Hosp, Pediat Nephrol, Turin, Italy..
    Damasio, Beatrice
    Ist Giannina Gaslini, Pediat Radiol, Genoa, Italy..
    Darge, Kassa
    Univ Penn, Perelman Sch Med, Childrens Hosp Philadelphia, Pediat Radiol, Philadelphia, PA 19104 USA..
    El-Ghoneimi, Alaa
    Univ Paris Diderot, Univ Hosp Robert Debre, AP HP, Pediat Surg & Urol, Paris, France..
    Hoebeke, Piet
    Ghent Univ Hosp, Urol, Ghent, Belgium..
    Läckgren, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Pediatric Surgery.
    Leclair, Marc-David
    Children Univ Hosp, Pediat Surg & Urol, Nantes, France..
    Lobo, Maria-Luisa
    Univ Hosp, Hosp Santa Maria, Radiol, Lisbon, Portugal..
    Manzoni, Gianantonio
    Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Pediat Urol, Milan, Italy..
    Marks, Stephen D.
    Great Ormond St Hosp Children NHS Fdn Trust, Paediat Nephrol, London, England..
    Mattioli, Girolamo
    Dinogmi Univ Genova, Pediat Surg & Urol, Gaslini Inst, Genoa, Italy..
    Mentzel, Hans-Joachim
    Univ Hosp Jena, Pediat Radiol, Diagnost & Intervent Radiol, Jena, Germany..
    Mouriquand, Pierre
    Hosp Civils Lyon, Hop Mere Enfant, Pediat Urol, Lyon 1, France.;Claude Bernard Univ, Lyon 1, France..
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Ntoulia, Aikaterini
    Univ Penn, Perelman Sch Med, Childrens Hosp Philadelphia, Pediat Radiol, Philadelphia, PA 19104 USA.;Kings Coll Hosp London, Paediat Radiol, London, England..
    Ording-Muller, Lil-Sofie
    Oslo Univ Hosp, Paediat Radiol, Oslo, Norway..
    Oswald, Josef
    Hosp Sisters Char, Pediat Urol, Linz, Austria..
    Papadopoulou, Frederica
    Ioannina Univ, Radiol, Ioannina, Greece..
    Porcellini, Gabriella
    Regina Margherita Hosp, Pediat Nephrol, Turin, Italy..
    Ring, Ekkehard
    Univ Hosp LKH Graz, Dept Pediat, Graz, Austria..
    Rösch, Wolfgang
    Univ Med Ctr Regensburg, Pediat Urol, Regensburg, Germany..
    Teixeira, Ana F.
    Ctr Hosp Sao Joao, Pediat Nephrol, Oporto, Portugal..
    Riccabona, Michael
    Univ Hosp LKH Graz, Pediat Radiol, Graz, Austria..
    Standardization of pediatric uroradiological terms: A multidisciplinary European glossary2017In: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 13, no 6, p. 641-650Article in journal (Other academic)
    Abstract [en]

    To promote the standardization of nephro-uroradiological terms used in children, the European Society of Pediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication among different clinicians involved in pediatric urology and nephrology.

1 - 22 of 22
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