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  • 51.
    Edin, Fredrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Liu, Wei
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Boström, Marja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Magnusson, Peetra U.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Klinisk immunologi.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Differentiation of human neural progenitor cell-derived spiral ganglion-like neurons: a time-lapse video study2014Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, nr 5, s. 441-447Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusions: Human neural progenitor cells can differentiate into spiral ganglion-like cells when exposed to inner ear-associated growth factors. The phenotype bears resemblance to human sphere-derived neurons. Objective: To establish an in vitro model for the human auditory nerve to replace and complement in vivo animal experiments and ultimately human in vivo transplantation. Methods: Human neural progenitors were differentiated under conditions developed for in vitro survival of human primary spiral ganglion culture with media containing growth factors associated with inner ear development. Differentiation was documented using time-lapse video microscopy. Time-dependent marker expression was evaluated using immunocytochemistry with fluorescence and laser confocal microscopy. Results: Within 14 days of differentiation, neural progenitors adopted neural phenotype and expressed spiral ganglion-associated markers.

  • 52.
    Edin, Fredrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Liu, Wei
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Li, Hao
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Atturo, Francesca
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Magnusson, Peetra U
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Klinisk immunologi.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    3-D gel culture and time-lapse video microscopy of the human vestibular nerve2014Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, nr 12, s. 1211-1218Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    UNLABELLED: Abstract Conclusions: Human inner ear neurons have an innate regenerative capacity and can be cultured in vitro in a 3-D gel. The culture technique is valuable for experimental investigations of human inner ear neuron signaling and regeneration.

    OBJECTIVES: To establish a new in vitro model to study human inner ear nerve signaling and regeneration.

    METHODS: Human superior vestibular ganglion (SVG) was harvested during translabyrinthine surgery for removal of vestibular schwannoma. After dissection tissue explants were embedded and cultured in a laminin-based 3-D matrix (Matrigel™). 3-D growth cone (GC) expansion was analyzed using time-lapse video microscopy (TLVM). Neural marker expression was appraised using immunocytochemistry with fluorescence and laser confocal microscopy.

    RESULTS: Tissue explants from adult human SVG could be cultured in 3-D in a gel, indicating an innate potential for regeneration. Cultured GCs were found to expand dynamically in the gel. Growth cone expansion and axonal Schwann cell alignment were documented using TLVM. Neurons were identified morphologically and through immunohistochemical staining.

  • 53.
    Edvardsson Rasmussen, Jesper
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Bergquist, Jonas
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för kemi - BMC, Analytisk kemi.
    Eriksson, Per Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    The proteome of perilymph in patients with vestibular schwannoma: A possibility to identify biomarkers for tumor associated hearing loss?2018Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, nr 6, artikkel-id e0198442Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Due to the surrounding bone, the human inner ear is relatively inaccessible and difficult to reach for cellular and molecular analyses. However, these types of investigations are needed to better understand the etiology, pathophysiology and progression of several inner ear disorders. Moreover, the fluid from the inner ear cannot be sampled for micro-chemical analyses from healthy individuals in vivo. Therefore, in the present paper, we studied patients with vestibular schwannoma (VS) undergoing trans-labyrinthine surgery (TLS). Our primary aim was to identify perilymph proteins in patients with VS on an individual level. Our second aim was to investigate the proteins identified at a functional level and our final aim was to search for biological markers for tumor-associated hearing loss and tumor diameter. Methods and findings Sixteen patients underwent TLS for sporadic VS. Perilymph was aspirated through the round window before opening the labyrinth. One sample was contaminated and excluded resulting in 15 usable samples. Perilymph samples were analyzed with an online tandem LTQ-Orbitrap mass spectrometer. Data were analyzed with MaxQuant software to identify the total number of proteins and to quantify proteins in individual samples. Protein function was analyzed using the PANTHER Overrepresentation tool. Associations between perilymph protein content, clinical parameters, tumor-associated hearing loss and tumor diameter were assessed using Random Forest and Boruta. In total, 314 proteins were identified; 60 in all 15 patients and 130 proteins only once in 15 patients. Ninety-one proteins were detected in at least 12 out of 15 patients. Random Forest followed by Boruta analysis confirmed that alpha-2-HS-glycoprotein (P02765) was an independent variable for tumor-associated hearing loss. In addition, functional analysis showed that numerous processes were significantly increased in the perilymph. The top three enriched biological processes were: 1) secondary metabolic processes; 2) complement activation and 3) cell recognition. Conclusions The proteome of perilymph in patients with vestibular schwannoma has an inter-individual stable section. However, even in a cohort with homogenous disease, the variation between individuals represented the majority of the detected proteins. Alpha-2-HS-glycoprotein, P02765, was shown to be an independent variable for tumor-associated hearing loss, a finding that needs to be verified in other studies. In pathway analysis perilymph had highly enriched functions, particularly in terms of increased immune and metabolic processes.

  • 54.
    Ehnhage, Anders
    et al.
    Karolinska Inst, Div Otorhinolaryngol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Johnsson, Pernilla Sahlstrand
    Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Lund, Sweden.;Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Malmo, Sweden..
    Ahlström-Emanuelsson, Cecilia
    Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Lund, Sweden.;Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Malmo, Sweden..
    Andersson, Morgan
    Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Lund, Sweden.;Skane Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Malmo, Sweden..
    Knutsson, Johan
    Vastmanland Hosp, Clin Res Ctr, Dept Otorhinolaryngol, Vasteras, Sweden..
    Lien, Jacob
    Karolinska Inst, Div Otorhinolaryngol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Norlander, Tomas
    Aleris Sabbatsbergs Hosp, Stockholm, Sweden..
    Olsson, Petter
    Karolinska Inst, Div Otorhinolaryngol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Friis-Liby, Jan-Eric
    Friis Liby & Ronndahl ENT Practice, Gothenburg, Sweden..
    Holmstrom, Mats
    Karolinska Inst, Div Otorhinolaryngol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Treatment of idiopathic rhinitis with kinetic oscillations - a multi-centre randomized controlled study2016Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, nr 8, s. 852-859Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusions: The potential effects of KOS are still uncertain regarding the most effective air pressure to be used as well as the physiological effects on the nasal mucosa. The results of the study do not support a convincing treatment effect by KOS on IR. Objectives: Idiopathic rhinitis (IR) is a common disorder, affecting approximate to 10-20% of the population. A new method for treating IR, Kinetic Oscillation Stimulation (KOS), has been reported to have beneficial effects on total vasomotor symptom scores (TVRSS). The primary objective with this study was to evaluate if a mean pressure of 65 mbar, pressure amplitude of 100 mbar, and 68Hz treatment with KOS had a positive effect on total vasomotor symptom scores (TVRSS), as compared with a mean pressure of 65 mbar, pressure amplitude of 4 mbar, and 68Hz treatment in patients with idiopathic rhinitis. Methods: Two hundred and seven patients were randomized (Full Analysis Set, FAS) in the study, including five visits and lasting for approximate to 25 weeks. All patients had two treatment episodes, and all patients had at least one treatment, meant as active, with high amplitude pressure for 10min in each nostril. Group 1 had two such treatments, and Group 2 had one treatment with low amplitude pressure, initially meant as placebo, on one occasion. Because of numerical improvements in these two groups, a new control group, Group 3, was introduced. They had one new control treatment where the balloon was inserted into the nose, without any air inflation and without oscillations. Results: KOS treatment with high amplitude pressure did not have significant beneficial effects as compared to low amplitude pressure on TVRSS. Numerical improvements in TVRSS and SNOT 22 were found when comparing high and low amplitude pressure treatments with uninflated balloon treatment. However, this part of the study was initially single-blinded, and these results were secondary objectives.

  • 55.
    Ek, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Does training with the PhonicStick improve phonological awareness?: A meta study including one new pilot study2011Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [en]

    The PhonicStick is a joystick which has been developed as a communicative device to be used by people with severe physical disabilities. During the developmental phase the possibility of using this device in order to train the phonological awareness of 6 – 8 year old children was examined. The studies conducted did not show any statistical difference in phonological awareness when this was tested with current tests after the children had trained with the PhonicStick. One explanation for this could be that the children had already begun to read and write in school. Therefore, a part of the present study was aimed at investigating if a difference in results on the norm referenced tests could be obtained if the children were 4-5 years old instead of 6-8. Parts of a norm referenced test for phonological awareness and an adapted test material for the PhonicStick were used for this evaluation. The 10 examined children were equally divided into a test and a control group.In addition, a meta study was performed, where all the studies relevant to phonological awareness and the PhonicStick were evaluated. Data from these studies were summarized, and processed statistically. Only two statistically significant (p<0.05) differences could be shown after the training with the PhonicStick: both the test group and the control group obtained better results in the posttest in the test of “phoneme identification” and the test group performed better at the test “word production” then the control group. A possible interpretation of the results could be that there might be an intuitive phonological awareness that can not be tested with the current tests for phonological awareness.

  • 56.
    Eklinder, Jeanette
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Svensson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Reparationer i AKK-samtal med Tellusdator: En samtalsanalytisk fallstudie om hur ett barn löser kommunikativa problem i interaktion med sin omgivning2009Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Huvudsyftet med denna studie är att beskriva hur ett barn, som använder ett datorbase­rat grafiskt kommunikationshjälpmedel (Tellus), med hjälp av reparationer löser lokala kommunikativa problem i samarbete med människor i sin omgivning. Barnet har video­filmats i vardagliga naturligt förekommande aktiviteter – skola och hem. Som analys­metod har Conversation Analysis (CA) använts. Resultaten visar att reparationer är en typ av resurser för deltagarna att, bland annat, skapa samförstånd genom att förtydliga oklarheter och missförstånd i samtalet. Reparationssekvenserna är ofta långa, och leder till inskottssekvenser i samtalet, men har en viktig interaktionell betydelse för att uppnå samförstånd. Analysen visar även att kommunikation med datorbaserad AKK är mul­timodal, trots att datorn är barnets primära kommunikationshjälpmedel. Exempelvis används tecken, gester och ljud för att markera fel och för att visa upp känslor. Aktivi­teten och datorns placering påverkar också interaktionen. I skolan används datorn oftare som en traditionell kommunikationskarta. Detta beror till stor del på att samtalspartnern sitter på ett sådant sätt att det barnet gör med datorn blir synligt för båda. Forskning som belyser reparationer i denna typ av AKK-samtal saknas. Denna studie kommer förhopp­ningsvis att skapa intresse för fortsatt forskning som, med ett interaktionellt synsätt, identifierar och beskriver fungerande kommunikativa praktiker i AKK-samtal.

  • 57.
    Elinder, Karolina
    et al.
    Vasteras Hosp, Dept Otorhinolaryngol, Vasteras, Sweden..
    Soderman, Anne-Charlotte Hessen
    Karolinska Inst, Div Clin Sci Intervent & Technol, Dept Otorhinolaryngol Aleris Sabbatsberg, Stockholm, Sweden..
    Stalfors, Joacim
    Univ Gothenburg, Sahlgrenska Univ Hosp, Dept Otorhinolaryngol, Gothenburg, Sweden.;Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Gothenburg, Sweden..
    Knutsson, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Vasteras Hosp, Dept Otorhinolaryngol, Vasteras, Sweden..
    Factors influencing morbidity after paediatric tonsillectomy: a study of 18,712 patients in the National Tonsil Surgery Register in Sweden2016Inngår i: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 273, nr 8, s. 2249-2256Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective of this study was to examine factors affecting morbidity after tonsillectomy in children. Data from the National Tonsil Surgery Register in Sweden on 18,712 patients who underwent tonsillectomy with or without simultaneous adenoidectomy between 1 and 18 years of age were analysed. This register includes data on sex, gender, surgical indication, and the surgical and haemostasis techniques used for each patient, as well as patient-reported outcomes for haemorrhage, analgesic use and antibiotic use. Comparison of patients who underwent surgery for infection versus upper airway obstruction revealed a significant increase in haemorrhage complications in the infection group. However, no significant difference remained after the adjustments for confounders in multivariable regression analysis. Instead, the increased risk among patients who underwent surgery for infection was mainly attributable to the use of bipolar diathermy and increased patient age. Patients who received surgery for infection reported more days of analgesic use, as well as more unplanned contacts with a health care service provider due to pain, compared with those who underwent surgery for upper airway obstruction. These results remained significant in multivariate analysis. The use of bipolar diathermy for haemostasis resulted in an increased risk, while the use of cold steel surgical instruments, a younger patient age and female sex led to a decreased risk. The surgical and haemostasis techniques used are the most important factors that affect morbidity after tonsillectomy in the paediatric age group. The choice of surgical techniques is of utmost importance for decreasing morbidity in these patients.

  • 58.
    Eriksson, Ann-Sofie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Bremer Zerpe, Linnéa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Logopedi i Öppna Vårdformer: utvärdering av pågående projekt2008Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    I Uppsala har det inte funnits tillräckliga resurser för att personer med ät- och kommunikationssvårigheter ska få fortsatta logopedinsatser efter att de har skrivits ut från den geriatriska vården. Ett projekt startades därför 2007 med målet att utveckla modeller för logopediskt arbete så att vårdkedjan blir komplett och rehabilitering kan fortsätta så länge vårdtagaren har behov av det. Projektet har riktat sig till personer över 65 år som har ät- och/eller kommunikationssvårigheter på grund av stroke eller progredierande kognitiv/neurologisk sjukdom. Syftet med den här studien har varit att utvärdera projektet efter att halva projekttiden har gått. En processutvärdering baserad på dokumentation om projektet har gjorts. Statistiska analyser har gjorts på data som projektet har samlat in om vårdtagarnas svälj- och kommunikationsförmåga. Där har bland annat förmågorna före och efter logopedinsatser jämförts med varandra. Slutligen har intervjuer med åtta anhöriga till projektdeltagare gjorts för att se hur projektet har påverkat dem. Studien har visat att det finns ett behov av logopeder i öppna vårdformer men också ett behov av att synliggöra och informera om logopedens arbete. Det har visat sig att både kommunikation och ät- och sväljförmåga har förbättrats efter insatser av logoped. Intervjuer med anhöriga har visat att projektet inte haft någon särskild betydelse för dem. I framtiden vore det också intressant att ta reda på hur boendepersonal påverkats av projektet.

  • 59.
    Erixon, Elsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Hearing Preservation CI Surgery and Hybrid Hearing: From Anatomical Aspects to Patient Satisfaction2014Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    A common cause of profound deafness is hair cell dysfunction in the cochlea. Cochlear implants (CI) bypass the hair cells via an electrode and stimulate the cochlear nerve directly. Nowadays, it is possible to preserve residual hair cell function and hearing through flexible electrodes and a-traumatic CI surgery techniques; called hearing preservation CI surgery. This may suit partially deaf patients who can use natural low frequency hearing in combination with electric high frequency hearing; so-called hybrid hearing. The aim of this thesis was to elucidate the effectiveness of hearing preservation CI surgery. The thesis demonstrates human cochlear anatomy in relation to CI and evaluates hearing and patient satisfaction after hearing preservation CI surgery.

    Analyses of human cochlear moulds belonging to the Uppsala collection showed large variations in dimensions and coiling characteristics of the cochlea. Each cochlea was individually shaped. The size and shape of the cochlea influences the position of the electrode. The diameter of the basal cochlear turn could predict insertion depth of the electrode, which is crucial for hearing preservation. The first 21 patients operated with hearing preservation CI surgery in Uppsala, showed preserved hearing.

    Nine-teen partially deaf patients receiving implants intended for hybrid hearing, were evaluated concerning pure tone audiometry, monosyllables (MS) and hearing in noise test (HINT). They also responded to a questionnaire, consisting of the IOI-HA, EQ-5D VAS and nine questions about residual hearing. The questionnaire results indicated a high degree of patient satisfaction with improved speech perception in silence and noise. This was also reflected by improved results in MS and HINT. Hearing was preserved in all patients, but there was an on-going deterioration of the residual hearing in the operated ear which surpassed the contralateral ear. There were no correlations between the amount of residual hearing and patient satisfaction or speech perception results. Electric stimulation provides a major contribution to speech comprehension in partially deaf patients. All the patients showed a high degree of satisfaction with their CI, regardless of varying hearing preservation.

    Delarbeid
    1. Variational anatomy of the human cochlea: implications for cochlear implantation
    Åpne denne publikasjonen i ny fane eller vindu >>Variational anatomy of the human cochlea: implications for cochlear implantation
    2009 (engelsk)Inngår i: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 30, nr 1, s. 14-22Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    HYPOTHESIS: To study variations in human cochlea anatomy with potential implications for cochlear implantation surgery. BACKGROUND: A comprehension of the anatomic variations of the human cochlea is essential for understanding the degree of surgical trauma induced by inserting various electrode arrays in cochlear implantation surgery. Variations in anatomy may also limit the potential for performing hearing preservation. METHODS: We studied 73 archival, nonselected, adult, corrosion casts of human inner ears. Anatomic reference points were constructed from photographic reproductions taken at different angles, and various dimensions were assessed using planimetry. Anatomic variants with particular clinical/surgical interests were pinpointed. RESULTS: Results showed that the human cochlea is individually shaped, varying greatly in dimensions ("fingerprint"). The outer cochlear wall length ranged from 38.6 to 45.6 mm with a mean length of 42.0 mm. The first turn represented 53% of the total length and ranged from 20.3 to 24.3 mm. The number of quadrants varied from slightly more than 8 to 12. The facial nerve canal ran in close proximity to the upper first turn explaining facial nerve excitement during stimulation of electrodes in this region in some instances. The internal diameter (height) of the cochlear tube in the first turn varied broadly (1.6-2.6 mm), occasionally with limited space for conventional implants. CONCLUSION: The human cochlea exhibits extensive anatomic variations. These variations will influence the location of cochlear implant arrays and affect the potential of hearing preservation surgery. Our results may explain the surgeon's difficulties sometimes to insert electrode arrays even in so-called "normal" cochleae.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-113210 (URN)10.1097/MAO.0b013e31818a08e8 (DOI)000276925300003 ()18833017 (PubMedID)
    Tilgjengelig fra: 2010-01-26 Laget: 2010-01-26 Sist oppdatert: 2017-12-12bibliografisk kontrollert
    2. How to predict cochlear length before cochlear implantation surgery
    Åpne denne publikasjonen i ny fane eller vindu >>How to predict cochlear length before cochlear implantation surgery
    2013 (engelsk)Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 133, nr 12, s. 1258-1265Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Conclusions: The basal turn diameter of the human cochlea predicts the outer wall length of the basal and two first turns relatively well but there was less correlation for the total cochlear length. The linear regression graph defines the length of the basal turn within an error of +/- 1 mm and could be used clinically to distinguish small and large cochleae. Objective: The human cochlea varies in size. The preoperative assessment of cochlear length can be crucial for non-traumatic electrode insertion and hearing preservation. In this study, we estimated the external cochlear wall length by assessing the basal turn diameter. Methods: A total of 51 non-selected, human inner ear moulds were analysed. A line was drawn from the midpoint of the round window through the cochlear mid-portion to the opposite side (A) and correlated to the cochlear turn lengths. Linear regression analyses were carried out. Results: Mean diameter A was 9.3 mm. The mean basal turn length was 22.8 mm, the two first turns were 35.1 mm and the total length was 41.2 mm. Linear regression analyses indicated a coefficient of determination (R-2) of 0.74 for diameter A and the basal turn length, R-2 = 0.70 for the two-turn length and R-2 = 0.39 for the total length.

    Emneord
    Human cochlea, electro-acoustic-stimulation, EAS, partial deafness, cochlear implant, hearing preservation
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-213453 (URN)10.3109/00016489.2013.831475 (DOI)000327419700004 ()
    Tilgjengelig fra: 2013-12-30 Laget: 2013-12-23 Sist oppdatert: 2017-12-06bibliografisk kontrollert
    3. Cochlear implantation and hearing preservation: results in 21 consecutively operated patients using the round window approach
    Åpne denne publikasjonen i ny fane eller vindu >>Cochlear implantation and hearing preservation: results in 21 consecutively operated patients using the round window approach
    2012 (engelsk)Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 132, nr 9, s. 923-931Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Conclusion:

    Prevalent hearing conservation may be achieved after round window (RW) cochlear implantation using soft and flexible electrode arrays if variations of RW anatomy, topography, and facial nerve position are considered. The most favorable electrode insertion depth remains to be established.

    Objectives:

    We assessed the incidence of cochlear function after cochlear implant (CI) electrode insertion through the RW in our first 21 consecutively operated patients aimed at hearing conservation.

    Methods:

    Eleven patients had a preoperative low frequency hearing suitable for electro-acoustic stimulation. Hearing was preserved in an additional nine patients at their request with the intention to use full frequency CI stimulation. Anatomic variations of the RW were carefully considered using our temporal bone collection of micro-dissected ears. Electrode extension was assessed on X-ray by measuring the insertion angle of the first electrode and intra-cochlear length and correlated with audiometric data.

    Results:

    There was no incidence of total loss of residual hearing in any of the patients. A slight deterioration of low frequency thresholds occurred in some patients. Mean hearing loss at 125-500 Hz was 14.4 dB at 1 month following surgery and 15.6 dB after 1 year. Insertion angle (300-540°) and depth (17.5-28.5 mm) were not statistically correlated to hearing loss.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-181696 (URN)10.3109/00016489.2012.680198 (DOI)000307995600003 ()22667762 (PubMedID)
    Tilgjengelig fra: 2012-09-27 Laget: 2012-09-27 Sist oppdatert: 2017-12-07bibliografisk kontrollert
    4. Hearing and patient satisfaction in 19 patients receiving implants intended for hybrid hearing: A two-year follow-up
    Åpne denne publikasjonen i ny fane eller vindu >>Hearing and patient satisfaction in 19 patients receiving implants intended for hybrid hearing: A two-year follow-up
    (engelsk)Inngår i: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186Artikkel i tidsskrift (Fagfellevurdert) Accepted
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-221532 (URN)
    Tilgjengelig fra: 2014-04-01 Laget: 2014-04-01 Sist oppdatert: 2017-12-05bibliografisk kontrollert
  • 60.
    Erixon, Elsa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Hearing and Patient Satisfaction Among 19 Patients Who Received Implants Intended for Hybrid Hearing: A Two-Year Follow-Up2015Inngår i: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, nr 5, s. E271-E278Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To measure patient satisfaction and correlate to hearing results in partially deaf patients, after hearing preservation cochlear implant surgery with hybrid hearing strategy, and to evaluate the stability of residual low-frequency hearing (LFH) over time. Design: A patient satisfaction survey and a retrospective, 2-year follow-up journal study. Nineteen partially deaf patients intended for hybrid hearing responded to a questionnaire when they had used their cochlear implants for at least a year. The questionnaire consisted of the International Outcome Inventory for Hearing Aids, EuroQol Group visual analogue scale and nine questions about hybrid hearing. Pure-tone audiometry, monosyllables, and hearing in noise test results from the patients' medical records were evaluated and compared with the results from the patient satisfaction survey. Results: All of the patients were satisfied with their CIs. The mean International Outcome Inventory for Hearing Aids score was 29. The CIs provided a major contribution to the speech comprehension of these partially deaf patients. Two years after surgery, the patients' mean binaural score on tests of monosyllables was 58%, and the mean signal to noise ratio was 4.6 dB. We observed ongoing deteriorations in the residual hearing of the operated ears that surpassed the deteriorations observed in the contralateral ears. One month after surgery, the LFH loss (125-500 Hz) was 17 dB, and after 2 years, this loss was 24 dB compared with 5 dB in the nonoperated ear. There were no significant correlations between preserved LFH and patient satisfaction or speech perception results. Conclusions: Electric stimulation provided a major contribution to speech comprehension of partially deaf patients. The gain reached in speech understanding widely exceeded the downside in losing some residual hearing. All the patients showed a high degree of satisfaction with their CIs regardless of varying hearing preservation.

  • 61.
    Farnebo, Lovisa
    et al.
    Linkoping Univ, Dept Otorhinolaryngol, Dept Clin & Expt Med, SE-58185 Linkoping, Sweden..
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Makitie, Antti
    Univ Helsinki, Dept Otorhinolaryngol, Helsinki, Finland.;Helsinki Univ Hosp, Helsinki, Finland.;Karolinska Inst, Div Ear Nose & Throat Dis, Dept Clin Sci Intervent & Technol, Karolinska Univ Hosp, Stockholm, Sweden..
    A Nordic survey on the management of head and neck CUP2016Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, nr 11, s. 1159-1163Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion: The management of Head and Neck Cancer of Unknown Primary (HNCUP) patients varies both between centres within and also between the Nordic countries. This study contributes to a continuing discussion of how to improve the accuracy of diagnosis and quality of treatment of HNCUP patients.Objectives: The initiative for this study was based on the lack of common guidelines for diagnostic procedures and for treatment of HNCUP patients in the Nordic countries constituting a region having a rather homogeneous population.Method: A structured questionnaire was sent to all university hospitals in the five Nordic countries.Results: Four of the five Nordic countries use either national guidelines or specific protocols when handling HNCUP. The main diagnostic tools are PET-CT, fine needle aspiration, endoscopic evaluation with biopsies, and most often bilateral tonsillectomy. At 21 of 22 university hospitals the treatment decision is made at a multidisciplinary conference. Three of seven Swedish centres use only radiotherapy or chemoradiotherapy to treat N+ HNCUP patients. Robotic surgery for biopsy of the tongue base is beginning to become an alternative to targeted biopsies in Sweden and Finland. Narrow Band Imaging is used only in Finland.

  • 62.
    Farnebo, Lovisa
    et al.
    Linkoping Univ, Dept Clin & Expt Med, Dept Otorhinolaryngol, Linkoping, Sweden..
    Malila, Nea
    Finnish Canc Registry, FIN-00170 Helsinki, Finland..
    Makitie, Antti
    Karolinska Inst, Div Ear Nose & Throat Dis Intervent & Technol, Dept Clin Sci, Stockholm, Sweden.;Karolinska Hosp, S-10401 Stockholm, Sweden.;Univ Helsinki, Dept Otorhinolaryngol Head & Neck Surg, Helsinki, Finland.;Helsinki Univ Hosp, FI-00029 Helsinki, Hus, Finland..
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Early death among head and neck cancer patients2016Inngår i: Current Opinion in Otolaryngology & Head and Neck Surgery, ISSN 1068-9508, E-ISSN 1531-6998, Vol. 24, nr 2, s. 115-120Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Purpose of reviewManagement of advanced head and neck cancer (HNC) is characterized by high mortality. Furthermore, the treatment involves significant burden to patients and high costs to healthcare systems. Recognizing the risks of early death in patients with a high probability of noncurable disease is important for each individual treatment decision-making. It is thus critical to consider the benefits and side-effects of the planned treatment in relation to the expected survival and to discuss these factors with the patient. However, only few studies have documented early death in HNC patients, that is, during the first posttreatment 6 months. We performed a systematic literature review to find the incidence of this phenomenon and to outline the probable cause.Recent findingsEarly mortality in patients with HNC can be explained either by direct effect of malignant disease, may be related to comorbidities, or secondary to the treatment. These factors act together resulting in expected or unexpected early death.SummaryThe present review provides information on the mechanisms leading to early phase mortality (<6 months) after management of HNC. It also reports the incidence of this phenomenon among Finnish and Swedish patient populations.

  • 63. Fehrm, Johan
    et al.
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Bring, Johan
    Browaldh, Nanna
    Blood pressure after modified uvulopalatopharyngoplasty: results from the SKUP3 randomized controlled trial.2017Inngår i: Sleep medicine, Vol. 34, s. 156-161Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    Obstructive sleep apnea (OSA) is a risk factor for hypertension. The SKUP3 study showed that modified uvulopalatopharyngoplasty (UPPP) significantly improved nocturnal respiration, sleepiness, and quality of life. The aim of this study was to evaluate the impact of surgery on blood pressure in patients with OSA.

    Methods

    We used a single-center randomized controlled trial to compare modified UPPP with controls at baseline and after six months. The controls received delayed surgery with an additional six-month follow-up. All operated patients also had a follow-up after 24 months. Polysomnography was performed at each follow-up, with systolic and diastolic blood pressure (SBP, DBP) measured the morning after.

    Results

    A total of 65 patients were randomized to intervention (n = 32) or control (n = 33). At follow-up (n = 61/65, 94%), there were significant differences between the groups in both mean SBP (−9.4 mmHg [95% CI: −17.9, −0.83], p < 0.05) and mean DBP (−6.4 mmHg [95% CI: −12.8, −0.04], p < 0.05), in favor of UPPP. Blood pressure and respiratory parameters at follow-up correlated. The analyses of all operated patients showed a significant decrease in mean (SD) blood pressure after six months (n = 49/65, 75%; SBP: −4.5 [9.0], p = 0.001; DBP: −2.2 [6.6], p = 0.030) as well as after 24 months (n = 35/65, 54%; SBP: −8.9 [11.5], p < 0.0001; DBP: −4.2 [9.4], p = 0.012).

    Conclusions

    Blood pressure was significantly decreased after surgery, indicating that modified UPPP decreases the blood pressure, in a selected group of patients with moderate to severe OSA. The long-term effect was also significant, but these results are uncertain due to a high proportion of missing values.

  • 64.
    Fehrm, Johan
    et al.
    Karolinska Univ Hosp, Dept Otorhinolaryngol, Stockholm, Sweden;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Nerfeldt, Pia
    Karolinska Univ Hosp, Dept Otorhinolaryngol, Stockholm, Sweden;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Sundman, Joar
    Karolinska Univ Hosp, Dept Otorhinolaryngol, Stockholm, Sweden;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar. Kirurgiska Vetenskaper, Uppsala Universitet.
    Adenopharyngoplasty vs Adenotonsillectomy in Children With Severe Obstructive Sleep Apnea A Randomized Clinical Trial2018Inngår i: JAMA Otolaryngology - Head and Neck Surgery, ISSN 2168-6181, E-ISSN 2168-619X, Vol. 144, nr 7, s. 580-586Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    IMPORTANCE Adenotonsillectomy (ATE) is the primary surgical method for treating obstructive sleep apnea (OSA) in children. However, children with severe OSA have an increased risk for residual OSA after ATE. Previous studies indicate that adenopharyngoplasty (APP), a modified ATE with closure of the tonsillar pillars, might improve the surgical outcome, but the overall evidence is weak. OBJECTIVE To determine whether APP is more effective than ATE for treating severe OSA in otherwise healthy children. DESIGN, SETTING. AND PARTICIPANTS A blinded randomized clinical trial was conducted at the otorhinolaryngology department at Karolinska University Hospital, Stockholm, Sweden. Eighty-three children, aged 2 to 4 years, with an obstructive apnea-hypopnea index (OAHI) score of 10 or higher, were randomized to APP (n = 36) or ATE (n = 47). Participants were recruited from December 1, 2014, through November 31, 2016. INTERVENTIONS Adenotonsillectomy was performed in all 83 patients in both groups by the cold steel technique. The APP group also underwent closure of the tonsillar pillars with 2 inverted sutures on each side. MAIN OUTCOMES AND MEASURES The primary outcome was the difference between the groups in OAHI score change before and after surgery. A higher score indicates worse problems and a score of 10 or higher is defined as severe OSA. The outcome was evaluated per protocol and with intention-to-treat analysis. Secondary outcomes were other polysomnography variables and the Obstructive Sleep Apnea-18 (OSA-18) questionnaire (possible total symptom score range, 18-126; higher scores indicate worse quality of life). Polysomnography was performed and the OSA-18 questionnaire was completed preoperatively and 6 months postoperatively. RESULTS A total of 83 children (49 [59%] boys; mean [SD] age, 36.6 [9.2] months) were included in the study. Of these, 74(89%) (APP, n = 30; ATE, n = 44) completed the study. The mean (SD) preoperative OAHI score was 23.8 (11.8) for APP and 23.8 (11.5) for ATE. Both the APP and ATE groups had a significant decrease in mean OAHI score after surgery (-21.7; 95% CI, -26.3 to -17.2; and -21.1; 95% CI, -24.5 to -17.7, respectively), but there was no significant difference between the groups (0.7; 95% CI, -4.8 to 6.1). Furthermore, no significant differences between the groups were seen regarding other polysomnography variables (eg, respiratory distress index: mean, 0.6; 95% CI, -5.0 to 6.3) or the OSA-18 questionnaire (eg, total symptom score: -0.5; 95% CI, -13 to12). One patient from each group was readmitted owing to postoperative bleeding, but no other complications were seen. CONCLUSIONS AND RELEVANCE This trial did not show that APP was more effective than ATE alone to treat otherwise healthy children with severe OSA. This finding suggests that ATE should continue to be the primary treatment for OSA in children.

  • 65.
    Fransson, Anette E
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Kisiel, Marta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Pirttilä, Kristian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för läkemedelskemi, Avdelningen för analytisk farmaceutisk kemi.
    Pettersson, Curt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för läkemedelskemi, Avdelningen för analytisk farmaceutisk kemi.
    Videhult Pierre, Pernilla
    Division of Audiology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Hydrogen Inhalation Protects against Ototoxicity Induced by Intravenous Cisplatin in the Guinea Pig2017Inngår i: Frontiers in Cellular Neuroscience, ISSN 1662-5102, E-ISSN 1662-5102, Vol. 11, artikkel-id 280Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Permanent hearing loss and tinnitus as side-effects from treatment with the anticancer drug cisplatin is a clinical problem. Ototoxicity may be reduced by co-administration of an otoprotective agent, but the results in humans have so far been modest.

    Aim: The present preclinical in vivo study aimed to explore the protective efficacy of hydrogen (H2) inhalation on ototoxicity induced by intravenous cisplatin.

    Materials and Methods: Albino guinea pigs were divided into four groups. The Cispt (n = 11) and Cispt+H2 (n = 11) groups were given intravenous cisplatin (8 mg/kg b.w., injection rate 0.2 ml/min). Immediately after, the Cispt+H2 group also received gaseous H2 (2% in air, 60 min). The H2 group (n = 5) received only H2 and the Control group (n = 7) received neither cisplatin nor H2. Ototoxicity was assessed by measuring frequency specific ABR thresholds before and 96 h after treatment, loss of inner (IHCs) and outer (OHCs) hair cells, and by performing densitometry-based immunohistochemistry analysis of cochlear synaptophysin, organic transporter 2 (OCT2), and copper transporter 1 (CTR1) at 12 and 7 mm from the round window. By utilizing metabolomics analysis of perilymph the change of metabolites in the perilymph was assessed.

    Results: Cisplatin induced electrophysiological threshold shifts, hair cell loss, and reduced synaptophysin immunoreactivity in the synapse area around the IHCs and OHCs. H2 inhalation mitigated all these effects. Cisplatin also reduced the OCT2 intensity in the inner and outer pillar cells and in the stria vascularis as well as the CTR1 intensity in the synapse area around the IHCs, the Deiters' cells, and the stria vascularis. H2 prevented the majority of these effects.

    Conclusion: H2 inhalation can reduce cisplatin-induced ototoxicity on functional, cellular, and subcellular levels. It is proposed that synaptopathy may serve as a marker for cisplatin ototoxicity. The effect of H2 on the antineoplastic activity of cisplatin needs to be further explored.

  • 66.
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Heavy snorer’s disease: a progressive local neuropathy.1999Inngår i: Acta oto-laryngologicaArtikkel i tidsskrift (Fagfellevurdert)
  • 67.
    Friberg, Danielle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    B, Carlsson-Nordlander
    H, Larsson
    E, Svanborg
    UPPP for habitual snoring: a 5-year follow-up with respiratory sleep recordings.1995Inngår i: The LaryngoscopeArtikkel i tidsskrift (Fagfellevurdert)
  • 68.
    Friberg, Danielle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    B, Gazelius
    Evaluation of the vascular reaction in pharyngeal mucosa.1998Inngår i: Acta oto-laryngologicaArtikkel i tidsskrift (Fagfellevurdert)
  • 69.
    Friberg, Danielle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    B, Gazelius
    LE, Lindblad
    B, Nordlander
    Habitual snorers and sleep apnoics have abnormal vascular reactions of the soft palatal mucosa on afferent nerve stimulation.1998Inngår i: The LaryngoscopeArtikkel i tidsskrift (Fagfellevurdert)
  • 70.
    Friberg, Danielle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    B, Gazelius
    T, Hökfelt
    B, Nordlander
    Abnormal afferent nerve endings in the soft palatal mucosa of sleep apnoics and habitual snorers.1997Inngår i: Regulatory peptidesArtikkel i tidsskrift (Fagfellevurdert)
  • 71.
    Friberg, Danielle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    C, Lundberg
    Antibiotic prophylaxis in major head and neck surgery when clean-contaminated wounds are established.1990Inngår i: Scandinavian journal of infectious diseases. SupplementumArtikkel i tidsskrift (Fagfellevurdert)
  • 72.
    Friberg, Danielle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    J, Sundquist
    X, Li
    K, Hemminki
    K, Sundquist
    Sibling risk of pediatric obstructive sleep apnea syndrome and adenotonsillar hypertrophy.2009Inngår i: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 32, nr 8, s. 1077-1083Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives:

    To estimate sibling risk of hospitalization for children with sleep disordered breathing (SDB), diagnosed with (1) obstructive sleep apnea syndrome (OSAS), or (2) adenotonsillar hypertrophy in the total Swedish population.

    Design, Setting, and Participants:

    Using the MigMed database at the Karolinska Institute, we divided the population of Sweden aged 0–18 years into sibling groups based on a shared mother and father and presence of a primary hospital diagnosis of OSAS or adenotonsillar hypertrophy for each individual born between 1978 and 1986, during the follow-up period 1997–2004. Individuals with at least one affected sibling were identified and the incidence rates were computed, using standardized incidence ratios (SIRs) with 95% confidence intervals (CIs). Reference groups were boys and girls with unaffected siblings of 2 or more.

    Results:

    After accounting for socioeconomic status, age, and geographic region, boys with at least one sibling with OSAS had an increased risk of having OSAS (SIR, 33.2; 95% CI, 16.5–64.8), and in girls the SIR was 40.5 (19.4–81.4). For hypertrophy of the tonsils or hypertrophy of the adenoids and tonsils the corresponding SIRs were 4.53 (3.0–6.8) for boys and 4.94 (3.3–7.4) for girls.

    Conclusions:

    The study indicate an increased sibling risk of sleep disordered breathing in children, which may be due to heritable genes and/or shared environment such as increased awareness among family members or referring doctors. Caregivers should ask parents if siblings have similar symptoms, and thus offer them early treatment.

  • 73.
    Friberg, Danielle
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    K, Lundkvist
    X, Li
    K, Sundquist
    Parental poverty and occupation as risk factors for pediatric sleep-disordered breathing2015Inngår i: Sleep medicine, Vol. 16, nr 9, s. 1169-1175Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives/Background

    Previous studies have found associations between pediatric sleep-disordered breathing (SDB) and socioeconomic status (SES), as well as a neighborhood-related disadvantage. This study analyzes the association among familial SES, parental occupation, and SDB in Swedish offspring.

    Methods

    A nationwide dataset was constructed by linking Swedish census data to hospital discharge register data on all first hospitalizations of children and adolescents aged 0–18 years during the study period 1997–2007. The outcome was SDB, defined as diagnostic codes for obstructive sleep apnea (OSA), adenotonsillar hypertrophy, or tonsillar hypertrophy. Familial SES was defined as family income and maternal education. The odds ratio (OR) was calculated with a 95% confidence interval (CI).

    Results

    34,933 of three million children had a first hospital diagnosis of SDB. The OR was significantly increased in offspring in families with a low income (1.79) and maternal education (1.21). Significantly increased ORs were found in 14 of 38 maternal (37%) and 13 of 48 paternal (27%) occupations, and six of them involved both parents: drivers, welders, and workers in mechanics and iron metalware, chemical processing, and manufacture of food and glass. A significantly decreased OR was found in 12 (25%) of the paternal occupations, e.g., scientists, physicians, teachers, artists, administrators, and farmers, as well as in maternal occupations, such as artists and farmers, with offspring aged 0–6 years.

    Conclusion

    This study indicates that low familial SES and parental occupations associated with a low educational level increased, whereas academic parental occupations and farmers decreased the risk of SDB in offspring.

  • 74.
    Friberg, Danielle
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    T, Ansved
    K, Borg
    B, Carlsson-Nordlander
    H, Larsson
    E, Svanborg
    Histological indications of a progressive snorers disease in an upper airway muscle.1998Inngår i: American journal of respiratory and critical care medicineArtikkel i tidsskrift (Fagfellevurdert)
  • 75.
    Frick, Claudia
    et al.
    Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, Eberhard Karls University Tübingen, DE-72076 Tübingen, Germany.
    Müller, Marcus
    Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, Eberhard Karls University Tübingen, DE-72076 Tübingen, Germany.
    Wank, Ute
    EMC Microcollect GmbH, DE-72070 Tubingen, Germany.
    Tropitzsch, Anke
    Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, Eberhard Karls University Tübingen, DE-72076 Tübingen, Germany.
    Kramer, Benedikt
    Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, Eberhard Karls University Tübingen, DE-72076 Tübingen, Germany.
    Senn, Pascal
    Univ Hosp Geneva, HUG, Serv Otorhinolaryngol Head & Neck Surg, Dept Clin Neurosci, CH-1211 Geneva 14, Switzerland.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Wiesmüller, Karl-Heinz
    Löwenheim, Hubert
    Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, Eberhard Karls University Tübingen, DE-72076 Tübingen, Germany.
    Biofunctionalized peptide-based hydrogels provide permissive scaffolds to attract neurite outgrowth from spiral ganglion neurons2017Inngår i: Colloids and Surfaces B: Biointerfaces, ISSN 0927-7765, E-ISSN 1873-4367, Vol. 149, s. 105-114Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cochlear implants (CI) allow for hearing rehabilitation in patients with sensorineural hearing loss or deafness. Restricted CI performance results from the spatial gap between spiral ganglion neurons and the CI, causing current spread that limits spatially restricted stimulation and impairs frequency resolution. This may be substantially improved by guiding peripheral processes of spiral ganglion neurons towards and onto the CI electrode contacts. An injectable, peptide-based hydrogel was developed which may provide a permissive scaffold to facilitate neurite growth towards the CI. To test hydrogel capacity to attract spiral ganglion neurites, neurite outgrowth was quantified in an in vitro model using a custom-designed hydrogel scaffold and PuraMatrix(®). Neurite attachment to native hydrogels is poor, but significantly improved by incorporation of brain-derived neurotrophic factor (BDNF), covalent coupling of the bioactive laminin epitope IKVAV and the incorporation a full length laminin to hydrogel scaffolds. Incorporation of full length laminin protein into a novel custom-designed biofunctionalized hydrogel (IKVAV-GGG-SIINFEKL) allows for neurite outgrowth into the hydrogel scaffold. The study demonstrates that peptide-based hydrogels can be specifically biofunctionalized to provide a permissive scaffold to attract neurite outgrowth from spiral ganglion neurons. Such biomaterials appear suitable to bridge the spatial gap between neurons and the CI.

  • 76.
    Frykholm, Carina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Klar, Joakim
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Tomanovic, Tatjana
    Karolinska Hosp, Dept Hearing & Balance Disorders, Solna, Sweden.
    Ameur, Adam
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Dahl, Niklas
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Stereocilin gene variants associated with episodic vertigo: expansion of the DFNB16 phenotype2018Inngår i: European Journal of Human Genetics, ISSN 1018-4813, E-ISSN 1476-5438, Vol. 26, nr 12, s. 1871-1874Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Vestibular disorders comprise a heterogeneous group of diseases with transient or permanent loss of vestibular function. Vestibulopathy is in most cases associated with migraine, Meniere disease, hereditary ataxias, or sensorineural hearing loss. We identified two brothers and their first cousin affected by hearing loss and episodic vertigo. The brothers were homozygous STRC nonsense variant [c.4027 C> T, p.(Q1343*)], whereas their first cousin was compound heterozygous for the STRC nonsense variant and a 97 kb deletion spanning the entire STRC gene. Clinical investigations confirmed pathological vestibular responses in addition to a characteristic DFNB16 hearing loss. The STRC gene encodes Stereocilin in the cochlea and in the vestibular organ where it ensheathes the kinocilium of the otolithic membranes. Stereocilin is associated with the gel overlaying the vestibular kinocilia, suggesting a role for the protein in sensing balance and spatial orientation. Our findings support such a function for Stereocilin in the vestibular organ and expand the phenotype associated with DFNB16.

  • 77.
    Fröman, Charlotta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Henricson, Berit
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Förberedande läpprundning hos personer som stammar: EMG-studier av stamning och flytande tal2010Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
  • 78.
    Gadeborg, Jennie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Lundgren, Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Hur barn i åldern 4;0-5;11 år presterar på taluppfattningstestet HöraTal: En analys av resultaten från en talperceptions- och entalproduktionsuppgift2008Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Talperceptionstest har skapats för att få information om hur en person kan uppfatta ochdiskriminera mellan språkljud. HöraTal Test 1.1 är ett omfattande analytiskt datorbaserattalperceptionstest. Testet är anpassat för icke läskunniga barn från fyra års ålder. Det ärframtaget för barn med hörselnedsättning och/eller cochleaimplantat men kan ävenanvändas för barn med neurologisk skada, specifik språkstörning och/eller annatförstaspråk än svenska. Huvudsyftet med studien är att ta fram ett referensmaterial för hurnormalhörande barn med normal språkutveckling i åldern 4;0 till och med 5;11 årpresterar på HöraTal Test. Därutöver undersöks om det finns ett samband mellantalperceptionssvårigheter och talproduktionssvårigheter. Detta prövas genom att resultatenpå vissa delar av talperceptionstestet jämförs med resultatet på ett talproduktionstest. Istudien ingick 16 fyraåringar och 19 femåringar. Studien visade att de flesta fyraåringarinte klarar av att genomföra testet. Femåringarna hade ett högt medelresultat vilketindikerar att femåringar med normal hörsel bör få ett högt resultat, många rätt, på HöraTalTest och att testet är lämpligt för att testa talperception. Det krävs dock ett större antalförsökspersoner för att man säkert ska kunna uttala sig om förväntade resultat på HöraTalTest i populationen. Studien visade inget samband mellan perceptions- ochproduktionssvårigheter men det var för få försökspersoner som hade uttalsavvikelser iproduktionsuppgiften för att bekräfta eller förkasta ett samband mellan perceptions- ochproduktionssvårigheter i populationen.

  • 79. Gao, Chaobing
    et al.
    Li, Xiaohong
    Tong, Busheng
    Wu, Kaile
    Liu, Yehai
    Anniko, Matti
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Duan, Maoli
    Up-regulated expression of Dicer reveals poor prognosis in laryngeal squamous cell carcinoma2014Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, nr 9, s. 959-963Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusions: Increased expression of Dicer may be a prognostic biomarker for patients with laryngeal squamous cell carcinoma (LSCC). Objectives: Recent studies have shown that many microRNAs (miRNAs) play an important role in the development and progression of human cancers. Dicer, one of the most important enzymes of the miRNA machinery, performs the final step of biogenesis of miRNAs. This study aimed to investigate the impact of Dicer expression on patient survival in human LSCC. Methods: We detected the expression of Dicer in larynx tissue specimens from 76 LSCC samples and 26 polyps by immunohistochemistry. The clinicopathological and prognostic significance of Dicer expression was investigated in LSCC. Results: Our data showed that the expression of Dicer was significantly higher in the LSCC than in the polyp tissue specimens. Moreover, the expression level of Dicer was significantly associated with the pTNM stage and tumor lymph node metastasis. Kaplan-Meier survival analyses revealed a strong association between tumor Dicer expression and the survival of the patients with LSCC.

  • 80.
    Giese, Dina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Carotid Artery Compression Caused by the Cochlea2015Inngår i: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 36, nr 7, s. 1275-1278Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hypothesis We investigated the possible interference between the human internal carotid artery and the cochlea. Background The cochlea and the internal carotid artery (ICA) are anatomically closely related in the human temporal bone. The intimacy may even result in functional interferences. Methods Here, we analyzed 324 human plastic inner ear corrosion casts including the ICA canal and jugular bulb. Results Results showed that in 23% (14 cases), the cochlea caused physical impression in the carotid canal (CA) with luminal restriction. In one case, there was no separation between the CC and the basal turn of the cochlea. The distance between the CC and the cochlea varied between 0 and 1 mm among these 14 specimens. The lumen restriction of the CC in the pyramid-axial projection varied between 39% and 79%. Conclusion We speculate that the reduction in ICA canal lumen size caused by the cochlea may form a predilection site for intratemporal ICA plaque formation and therefore be clinically relevant.

  • 81. Gisselsson-Solen, Marie
    et al.
    Henriksson, Gunnel
    Hermansson, Ann
    Melhus, Åsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin, Klinisk bakteriologi.
    Effect of pneumococcal conjugate vaccination on nasopharyngeal carriage in children with early onset of acute otitis media - a randomized controlled trial2015Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, nr 1, s. 7-13Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion: Although children vaccinated with heptavalent pneumococcal conjugate vaccine (PCV) had fewer episodes of acute otitis media (AOM), this trial was unable to prove a simultaneous decrease in nasopharyngeal carriage. Objective: Carriage rates of AOM pathogens in the nasopharynx are high among children, and colonization is the first step towards infection. The possible impact of PCV on carriage is therefore of interest, particularly in children with recurrent AOM. The aims of this study were to examine the effect of heptavalent PCV on carriage of AOM pathogens in children at high risk of developing recurrent disease, and to monitor carriage of resistant pathogens in vaccinated and unvaccinated children. Methods: A total of 109 children with an onset of AOM before 6 months of age, 89 of whom developed recurrent disease, were enrolled in a trial. Fifty-two children were vaccinated and all were closely monitored for 3 years. Results: There was no difference statistically between vaccinated children and controls concerning the carriage of any of the major AOM pathogens. There was evidence of within-child clustering for S. pneumoniae (p = 0.002) and H. influenzae (p < 0.001), indicating that children continued to carry either species over time. Resistance rates were generally low and comparable with national levels.

  • 82. Gisselsson-Solen, Marie
    et al.
    Henriksson, Gunnel
    Hermansson, Ann
    Melhus, Åsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin.
    Risk factors for carriage of AOM pathogens during the first 3 years of life in children with early onset of acute otitis media2014Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, nr 7, s. 684-690Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion: Risk factors associated with increased carriage rates are the same in children with recurrent acute otitis media (rAOM) as in healthy children. These are also known to be risk factors for the development of AOM itself. Objectives: The aim of this study was to describe risk factors for nasopharyngeal carriage in a cohort of young children at high risk of developing rAOM. Methods: Children with an onset of AOM before 6 months of age, indicating an 80% risk of developing rAOM, were enrolled in a vaccination trial on heptavalent PCV. These children were monitored for 3 years during healthy and AOM periods with nasopharyngeal cultures, physical examinations, and questionnaires. Results: A total of 109 children were included at a mean age of 5 months; 105 were followed for 3 years, 89 (82%) of whom developed rAOM. Risk factors associated with increased carriage of all major AOM pathogens were age < 2 years, concurrent AOM, and fulfilment of rAOM criteria. Having siblings in day care was associated with increased carriage of Streptococcus pneumoniae and Haemophilus influenzae, recent antibiotic treatment was associated with H. influenzae and Moraxella catarrhalis carriage, and winter season was associated with M. catarrhalis carriage alone.

  • 83.
    Gisselsson-Solen, Marie
    et al.
    Univ Lund Hosp, Dept Otorhinolaryngol Head & Neck Surg, S-22185 Lund, Sweden..
    Hermansson, Ann
    Univ Lund Hosp, Dept Otorhinolaryngol Head & Neck Surg, S-22185 Lund, Sweden..
    Melhus, Åsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionsmedicin.
    Individual-level effects of antibiotics on colonizing otitis pathogens in the nasopharynx2016Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 88, s. 17-21Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Although there is evidence of an association between antibiotic consumption and resistant bacteria on a population level, the relationship on an individual level has been less well studied, particularly in terms of nasopharyngeal colonization. We have therefore analysed this association, using data from a closely followed cohort of children taking part in a vaccination trial. Methods: 109 children with early onset of acute otitis media (AOM) were randomised to heptavalent pneumococcal conjugate vaccine (PCV7) or no vaccination. They were followed for three years with scheduled appointments as well as sick visits. Nasopharyngeal cultures were obtained at all visits. Antibiotic treatments were recorded, as were risk factors for AOM, including siblings, short breast-feeding and parental smoking. Data were entered into a Cox regression model, and the findings of Streptococcus pneumoniae and Haemophilus influenzae with reduced susceptibility to the penicillin group were related to the number of previous courses of antibiotics. Results: There was evidence of an association between the amount of previously consumed betalactams and colonization with beta-lactamasenegative ampicillin-resistant (BLNAR) H. influenzae (RR 1.21; 95% CI 1.03-1.43; p = 0.03), and also with the most commonly prescribed drug; amoxicillin (RR 1.39; 95% CI 1.09-1.76; p = 0.01). There was no evidence for an association between antibiotic consumption and betalactamase producing H. influenzae or S. pneumoniae with reduced susceptibility to penicillin. Furthermore, there was no evidence of an association between resistant bacteria and AOM risk factors or PCV7. Conclusion: In this subgroup of children, most of whom were given several courses of antibiotics in early childhood, there was evidence of an association between betalactam/amoxicillin consumption and nasopharyngeal colonization with BLNAR strains, bacteria that have increased in prevalence during the last 10-15 years, and that are notoriously difficult to treat with oral antibiotics.

  • 84. Gisselsson-Solen, Marie
    et al.
    Hermansson, Ann
    Melhus, Åsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin.
    Brodszki, Nicholas
    Immunologic findings in young children with early onset of acute otitis media2014Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, nr 10, s. 1022-1028Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion: No significant differences in the number of immune aberrations were seen between children with or without severe recurrent acute otitis media (rAOM); however, subnormal values of immunological markers were found more often than expected, and 4 of the 60 children had treatment-requiring immune deficiencies. Objective: Minor immunologic aberrations have been reported to be more frequent in children with rAOM. Immune investigation is recommended in children with severe rAOM, defined as six or more AOM episodes per year. The purpose of this study was to describe immunological findings in young children at high risk of developing rAOM, and to relate these to the number of expected aberrations and to the presence of severe rAOM. Methods: A total of 109 children at risk of developing rAOM were offered immune investigation including complement function, immunoglobulins with subclasses and cellular immunity. Results: Sixty patients were tested, 31 of whom had severe rAOM and 12 of whom did not develop rAOM. Low levels of IgG2 (27%), C1q (31%) and mannan-binding lectin (21%) were found up to eight times as often as expected. Although subnormal values were more frequent among children with severe rAOM, the study was too small to provide reliable evidence of any difference. Four children were diagnosed with immune deficiencies that required treatment.

  • 85.
    Glueckert, R.
    et al.
    Med Univ Innsbruck, Dept Otolaryngol, Innsbruck, Austria;Univ Clin Ear Nose & Throat Med Innsbruck, Univ Clin Innsbruck, Tirol Kliniken, Innsbruck, Austria.
    Chacko, L. Johnson
    Med Univ Innsbruck, Dept Otolaryngol, Innsbruck, Austria.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Liu, Wei
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Handschuh, S.
    Univ Vet Med, VetImaging, VetCore Facil Res, Vienna, Austria.
    Schrott-Fischer, A.
    Med Univ Innsbruck, Dept Otolaryngol, Innsbruck, Austria.
    Anatomical basis of drug delivery to the inner ear2018Inngår i: Hearing Research, ISSN 0378-5955, E-ISSN 1878-5891, Vol. 368, s. 10-27Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    The isolated anatomical position and blood-labyrinth barrier hampers systemic drug delivery to the mammalian inner ear. Intratympanic placement of drugs and permeation via the round-and oval window are established methods for local pharmaceutical treatment. Mechanisms of drug uptake and pathways for distribution within the inner ear are hard to predict. The complex microanatomy with fluid filled spaces separated by tight-and leaky barriers compose various compartments that connect via active and passive transport mechanisms. Here we provide a review on the inner ear architecture at light-and electron microscopy level, relevant for drug delivery. Focus is laid on the human inner ear architecture. Some new data add information on the human inner ear fluid spaces generated with high resolution microcomputed tomography at 15 urn resolution. Perilymphatic spaces are connected with the central modiolus by active transport mechanisms of mesothelial cells that provide access to spiral ganglion neurons. Reports on leaky barriers between scala tympani and the so-called cortilymph compartment likely open the best path for hair cell targeting. The complex barrier system of tight junction proteins such as occludins, claudins and tricellulin isolates the endolymphatic space for most drugs. Comparison of relevant differences of barriers, target cells and cell types involved in drug spread between main animal models and humans shall provide some translational aspects for inner ear drug applications. (C) 2018 The Authors. Published by Elsevier B.V.

  • 86.
    Gronseth, Torstein
    et al.
    Univ Oslo, Oslo, Norway.;Oslo Univ Hosp, Dept Otolaryngol Head & Neck Surg, Oslo, Norway..
    Vestby, Lene K.
    Norwegian Vet Inst, Oslo, Norway..
    Nesse, Live L.
    Norwegian Vet Inst, Oslo, Norway..
    Thoen, Even
    Norwegian Vet Inst, Oslo, Norway..
    Habimana, Olivier
    Univ Hong Kong, Sch Biol Sci, Pok Fu Lam Rd, Hong Kong, Hong Kong, Peoples R China..
    von Unge, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Akershus Univ Hosp, Dept Otolaryngol Head & Neck Surg, Lorenskog, Norway.;Univ Oslo, Campus Ahus, Oslo, Norway..
    Silvola, Juha T.
    Univ Oslo, Oslo, Norway.;Akershus Univ Hosp, Dept Otolaryngol Head & Neck Surg, Lorenskog, Norway.;Univ Oslo, Campus Ahus, Oslo, Norway..
    Lugol's solution eradicates Staphylococcus aureus biofilm in vitro2017Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 103, s. 58-64Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The aim of the study was to evaluate the antibacterial efficacy of Lugol's solution, acetic acid, and boric acid against Staphylococcus aureus biofilm. Methods: The efficacy of Lugol's solution 1%, 0.1%, and 0.05%, acetic acid 5% or boric acid 4.7% for treatment of Staphylococcus aureus biofilm in vitro was tested using 30 clinical strains. Susceptibility in the planktonic state was assessed by disk diffusion test. Antiseptic effect on bacteria in biofilm was evaluated by using a,Biofilm-oriented antiseptic test (BOAT) based on metabolic activity, a biofilm bactericidal test based on culturing of surviving bacteria and confocal laser scanning microscopy combined with LIVE/DEAD staining. Results: In the planktonic state, all tested S. aureus strains were susceptible to Lugol's solution and acetic acid, while 27 out of 30 tested strains were susceptible to boric acid. In biofilm the metabolic activity was significantly reduced following exposure to Lugol's solution and 5% acetic acid, while boric acid exposure led to no significant changes in metabolic activities. In biofilm, biocidal activity was observed for Lugol's solution 1% (30/30), 0.1% (30/30), and 0.05% (26/30). Acetic acid and boric acid showed no bactericidal activity in this test. Confocal laser scanning microscopy, assessed in 4/30 strains, revealed significantly fewer viable biofilm bacteria with Lugol's solution (1% p < 0.001, 0.1% p = 0.001 or 0.05% p = 0.001), acetic acid 5% for 10 min (p = 0.001) or 30 min (p = 0.015), but not for acetic acid for 1 min or boric acid. Conclusion: Lugol's solution 1.0% and 0.1% effectively eradicated S. aureus in biofilm and could be an alternative to conventional topical antibiotics where S. aureus biofilm is suspected such as external otitis, pharyngitis and wounds. (C) 2017 Elsevier B.V. All rights reserved.

  • 87.
    Gullberg, Jenny
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Granholm, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    A PhonicStick Study: Investigating the Effectiveness of a Phonological Awareness Intervention in Children with Down Syndrome.2010Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Phonological awareness is a set of language manipulation skills such as blending, rhyme, alliteration production and detection. There are disagreements among researchers how phonological awareness is connected to literacy learning and also how and if children with Down syndrome acquire phonological awareness. The specific phenotype of Down syndrome shows deficits in both short term memory and language development. It is therefore of great concern to investigate how children with Down syndrome acquire phonological awareness and later on literacy. The PhonicStick is a joystick that generates speech sounds. In this study, the PhonicStick was used in phonological awareness intervention in children with Down syndrome. It was compared to intervention with Praxis cards – an already existing picture material in Swedish speech and language therapy. The aim of the study was to investigate if children with Down syndrome can improve phonological awareness during a six week period, and if this was the case, was there a difference in effectiveness between the materials. Six children with Down syndrome participated in this cross-over study. The results indicated that some children can acquire phonological awareness during a six week period. However, it was not possible to address the effectiveness to a certain material. The preference among the children to play with PhonicStick, showed that this is a material that motivates the children to participate in intervention. If the PhonicStick is adapted to this population of children with Down syndrome, this material can be used for phonological awareness intervention in children with Down syndrome.

  • 88. Guo, Rui
    et al.
    Zhang, HongLei
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Chen, Wei
    Zhu, XiaoQuan
    Liu, Wei
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    The inferior cochlear vein: surgical aspects in cochlear implantation2016Inngår i: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 273, nr 2, s. 355-361Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The patency of the inferior cochlear vein (ICV) may be challenged in cochlear implantation (CI) due to its location near the round window (RW). This may be essential to consider during selection of different trajectories for electrode insertion aiming at preserving residual hearing. Venous blood from the human cochlea is drained through the ICV. The vein also drains blood from the modiolus containing the spiral ganglion neurons. Surgical interference with this vein could cause neural damage influencing CI outcome. We analyzed the topographical relationship between the RW and ICV bony channel and cochlear aqueduct (CA) from a surgical standpoint. Archival human temporal bones were further microdissected to visualize the CA and its accessory canals (AC1 and AC2). This was combined with examinations of plastic and silicone molds of the human labyrinth. Metric analyses were made using photo stereomicroscopy documenting the proximal portion of the AC1, the internal aperture of the CA and the RW. The mean distance between the AC1 and the anterior rim of the RW was 0.81 mm in bone specimens and 0.67 mm assessed in corrosion casts. The AC1 runs from the floor of the scala tympani through the otic capsule passing parallel to the CA to the posterior cranial fossa. The mean distance between the CA and AC1 canal was 0.31 and 0.25 mm, respectively.

  • 89.
    Hagglund, Patricia
    et al.
    Umea Univ, Dept Odontol, Oral & Maxillofacial Radiol, Fac Med, Umea, Sweden.
    Hägg, Mary
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Hudiksvall Hosp, Speech & Swallowing Ctr, Dept Otorhinolaryngol, Hudiksvall, Region Gavlebor, Sweden.
    Wester, Per
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden;Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden.
    Jaghagen, Eva Levring
    Umea Univ, Dept Odontol, Oral & Maxillofacial Radiol, Fac Med, Umea, Sweden.
    Effects of oral neuromuscular training on swallowing dysfunction among older people in intermediate care-a cluster randomised, controlled trial2019Inngår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 48, nr 4, s. 533-540Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: this prospective, cluster randomised, controlled trial investigated the effect of oral neuromuscular training among older people in intermediate care with impaired swallowing. Methods: older people (>= 65 years) with swallowing dysfunction were cluster randomised according to care units for 5 weeks of neuromuscular training of the orofacial and pharyngeal muscles or usual care. The primary endpoint was the change in swallowing rate (assessed with a timed water swallow test) from baseline to the end-of-treatment and 6 months post-treatment. The secondary endpoints were changes in signs of aspiration during the water swallow test, and swallowing-related quality of life (QOL). An intention-to-treat principle was followed, and mixed-effects models were used for data analysis with the clustered study design as a random factor. Results: in total, 385 participants from 36 intermediate care units were screened, and 116 participants were randomly assigned to oral neuromuscular training (intervention; n = 49) or usual care (controls; n = 67). At the end of treatment, the geometric mean of the swallowing rate in the intervention group had significantly improved 60% more than that of controls (P = 0.007). At 6 months post-treatment, the swallowing rate of the intervention group remained significantly better (P = 0.031). Signs of aspiration also significantly reduced in the intervention group compared with controls (P = 0.01). No significant between-group differences were found for swallowing-related QOL. Conclusions: oral neuromuscular training is a new promising swallowing rehabilitation method among older people in intermediate care with impaired swallowing.

  • 90.
    Haylock, Anna-Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Targeting molecules for diagnostics of Head and Neck squamous cell carcinoma2017Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    To personalize treatment for cancer, correct staging of the primary tumor, nodal disease and metastatic disease is of essence. By targeting tumor specific receptors with radiolabeled antibodies, specificity and accuracy of imaging may be improved. Radio-immunodiagnostics can potentially detect small volume disease, occult metastasis and recurrent cancer in treated tissue. This thesis focuses on evaluation of radio-immunoconjugates directed towards CD44v6, which is a surface receptor overexpressed in many head and neck squamous cell carcinomas. At the outset, the monoclonal chimeric antibody cMab U36 and its cleavage products Fab’ and F(ab’)2 were labeled with 125I and assessed in vitro and in vivo (paper I). The best distribution pattern and tumor to organ ratio was achieved with F(ab’)2. Due to the immunological responses humans can develop towards chimeric antibodies, they are not optimal for clinical use, and subsequently fully human antibody fragments were developed. AbD15179, which is a monovalent fragment, was labeled with 111In and 125I and evaluated in vitro and in mice bearing CD44v6-expressing tumors. Tumor to organ ratios were improved compared to cMab U36 derived fragments, and 111In-AbD15179 displayed a more favorable distribution compared to 125I-AbD15179 (Paper II). A bivalent Fab-dHXL, AbD19384 derived from AbD15179, was then constructed and labeled with 125I and evaluated in cell- and biodistribution studies. Furthermore, an imaging study in a small animal PET was performed with 124I-AbD19384 (Paper III). Uptake in kidneys was reduced and liver uptake increased compared to AbD15179 reflecting the larger molecule. The high CD44v6 expressing tumor was clearly visualized with maximum uptake at 48 hours post injection.In paper IV human single chain fragments towards CD44v6v were selected, and the top candidates A11 and H12 were further evaluated in vitro and in vivo. Single chain fragments are small molecules exhibiting fast clearance and high affinity to the target. The study proved this by demonstrating superior tumor to blood ratios of radiolabeled A11 and H12 compared to previously studied molecules. 

    Delarbeid
    1. A novel CD44v6 targeting antibody fragment with improved tumor-to-blood ratio
    Åpne denne publikasjonen i ny fane eller vindu >>A novel CD44v6 targeting antibody fragment with improved tumor-to-blood ratio
    Vise andre…
    2012 (engelsk)Inngår i: International Journal of Oncology, ISSN 1019-6439, Vol. 40, nr 5, s. 1525-1532Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    The chimeric monoclonal antibody U36 (cMAb U36) recognizes the CD44v6 antigen. Its potential as a radioimmunotargeting agent, as well as its safety, has been shown in previous studies in head and neck cancer patients. However, intact MAbs have long circulation time in the blood and tumor targeting may also be hampered due to the slow and incomplete diffusion into solid tumors. In comparison, smaller monovalent Fab' and divalent F(ab')2 fragments are expected to exhibit shorter circulating half-lives, better tumor penetration and are thus more likely to yield better imaging results. In this study, novel F(ab')2 and Fab' fragments from cMAb U36 were radiolabeled with 125I and the characteristics of the conjugates in vitro were examined. The biodistribution of the conjugates were then evaluated in nude mice bearing CD44v6-expressing xenograft tumors. Furthermore, the penetration depth and distribution in tumor tissue was assessed by autoradiography in selected tumor samples. The in vitro experiments showed that the conjugates were stable and had intact affinity to CD44v6. The biodistribution study demonstrated superior tumor-to-blood ratio for the novel cMAb U36 fragment 125I-F(ab')2 compared with both the intact MAb and the monovalent fragment form. Autoradiography also revealed better tumor penetration for 125I-F(ab')2. This study demonstrates that the use of antibody fragments may improve radioimmunotargeting and possibly improve the management of head and neck malignancies.

    HSV kategori
    Forskningsprogram
    Oto-rhino-laryngologi
    Identifikatorer
    urn:nbn:se:uu:diva-170945 (URN)10.3892/ijo.2012.1352 (DOI)000302273400023 ()22307465 (PubMedID)
    Tilgjengelig fra: 2012-03-14 Laget: 2012-03-14 Sist oppdatert: 2017-12-07bibliografisk kontrollert
    2. In vivo characterization of the novel CD44v6-targeting Fab fragment AbD15179 for molecular imaging of squamous cell carcinoma: a dual-isotope study
    Åpne denne publikasjonen i ny fane eller vindu >>In vivo characterization of the novel CD44v6-targeting Fab fragment AbD15179 for molecular imaging of squamous cell carcinoma: a dual-isotope study
    Vise andre…
    2014 (engelsk)Inngår i: EJNMMI Research, ISSN 2191-219X, E-ISSN 2191-219X, Vol. 4, artikkel-id 11Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    BACKGROUND: Patients with squamous cell carcinoma in the head and neck region (HNSCC) offer a diagnostic challenge due to difficulties to detect small tumours and metastases. Imaging methods available are not sufficient, and radio-immunodiagnostics could increase specificity and sensitivity of diagnostics. The objective of this study was to evaluate, for the first time, the in vivo properties of the radiolabelled CD44v6-targeting fragment AbD15179 and to assess its utility as a targeting agent for radio-immunodiagnostics of CD44v6-expressing tumours.

    METHODS: The fully human CD44v6-targeting Fab fragment AbD15179 was labelled with 111In or 125I, as models for radionuclides suitable for imaging with SPECT or PET. Species specificity, antigen specificity and internalization properties were first assessed in vitro. In vivo specificity and biodistribution were then evaluated in tumour-bearing mice using a dual-tumour and dual-isotope setup.

    RESULTS: Both species-specific and antigen-specific binding of the conjugates were demonstrated in vitro, with no detectable internalization. The in vivo studies demonstrated specific tumour binding and favourable tumour targeting properties for both conjugates, albeit with higher tumour uptake, slower tumour dissociation, higher tumour-to-blood ratio and higher CD44v6 sensitivity for the 111In-labelled fragment. In contrast, the 125I-Fab demonstrated more favourable tumour-to-organ ratios for liver, spleen and kidneys.

    CONCLUSIONS: We conclude that AbD15179 efficiently targets CD44v6-expressing squamous cell carcinoma xenografts, and particularly, the 111In-Fab displayed high and specific tumour uptake. CD44v6 emerges as a suitable target for radio-immunodiagnostics, and a fully human antibody fragment such as AbD15179 can enable further clinical imaging studies.

    Emneord
    Radio-immunodiagnostics, Antibody fragment, CD44v6, Molecular imaging, Fab, I-125, In-111
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-221094 (URN)10.1186/2191-219X-4-11 (DOI)000357859200001 ()24598405 (PubMedID)
    Tilgjengelig fra: 2014-03-25 Laget: 2014-03-25 Sist oppdatert: 2017-12-05bibliografisk kontrollert
    3. Evaluation of a novel type of imaging probe based on a recombinant bivalent mini-antibody construct for detection of CD44v6-expressing squamous cell carcinoma
    Åpne denne publikasjonen i ny fane eller vindu >>Evaluation of a novel type of imaging probe based on a recombinant bivalent mini-antibody construct for detection of CD44v6-expressing squamous cell carcinoma
    Vise andre…
    2015 (engelsk)Inngår i: International journal of oncology, ISSN 1791-2423, Vol. 48, nr 2, s. 461-470Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    We have developed the CD44v6-targeting human bivalent antibody fragment AbD19384, an engineered recombinant human bivalent Fab antibody formed via dimerization of dHLX (synthetic double helix loop helix motif) domains, for potential use in antibody-based molecular imaging of squamous cell carcinoma in the head and neck region. This is a unique construct that has, to the best of our knowledge, never been assessed for molecular imaging in vivo before. The objective of the present study was to evaluate for the first time the in vitro and in vivo binding properties of radio-iodinated AbD19384, and to assess its utility as a targeting agent for molecular imaging of CD44v6-expressing tumors. Antigen specificity and binding properties were assessed in vitro. In vivo specificity and biodistribution of 125I-AbD19384 were next evaluated in tumor-bearing mice using a dual-tumor setup. Finally, AbD19384 was labeled with 124I, and its imaging properties were assessed by small animal PET/CT in tumor bearing mice, and compared with 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG). In vitro studies demonstrated CD44v6-specific binding with slow off-rate for AbD19384. A favorable biodistribution profile was seen in vivo, with tumor-specific uptake. Small animal PET/CT images of 124I-AbD19384 supported the results through clearly visible high CD44v6-expressing tumors and faintly visible low expressing tumors, with superior imaging properties compared to 18F-FDG. Tumor-to-blood ratios increased with time for the conjugate (assessed up to 72 h p.i.), although 48 h p.i. proved best for imaging. Biodistribution and small-animal PET studies demonstrated that the recombinant Fab-dHLX construct AbD19384 is a promising tracer for imaging of CD44v6 antigen expression in vivo, with the future aim to be used for individualized diagnosis and early detection of squamous cell carcinomas in the head and neck region. Furthermore, this proof-of-concept research established the feasibility of using recombinant Fab-dHLX constructs for in vivo imaging of tumor biomarkers.

    Emneord
    molecular imaging, CD44v6; Fab-dHLX; F(ab')(2), recombinant antibodies, immuno-PET, head and neck squamous cell carcinoma
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-270259 (URN)10.3892/ijo.2015.3290 (DOI)000366897500003 ()26676731 (PubMedID)
    Tilgjengelig fra: 2015-12-22 Laget: 2015-12-22 Sist oppdatert: 2020-01-07bibliografisk kontrollert
    4. Generation and evaluation of antibody agents for molecular imaging of CD44v6 expressing cancers
    Åpne denne publikasjonen i ny fane eller vindu >>Generation and evaluation of antibody agents for molecular imaging of CD44v6 expressing cancers
    Vise andre…
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    Emneord
    scFv, recombinant antibody formats, CD44v6, squamous cell carcinoma, molecular imaging
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-316722 (URN)
    Tilgjengelig fra: 2017-03-14 Laget: 2017-03-14 Sist oppdatert: 2018-01-13
  • 91.
    Heimdal, John-Helge
    et al.
    Bergen Univ, Haukeland Univ Hosp, Dept Surg, Bergen, Norway;Bergen Univ, Haukeland Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Bergen, Norway.
    Maat, Robert
    Ropcke Zweers Hosp, Dept Otolaryngol, Jan Weitkamplaan 4A, NL-7772 SE Hardenberg, Netherlands.
    Nordang, Leif
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar. Uppsala Univ, Dept Surg Sci Otorhinolaryngol & Head & Neck Surg, Akad Sjukhuset Ing 78-79, S-75185 Uppsala, Sweden.
    Surgical Intervention for Exercise-Induced Laryngeal Obstruction2018Inngår i: Immunology and allergy clinics of North America, ISSN 0889-8561, E-ISSN 1557-8607, Vol. 38, nr 2, s. 317-324Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Respiratory distress during exercise can be caused by exercise-induced laryngeal obstruction (EILO). The obstruction may appear at the level of the laryngeal inlet (supraglottic), similar to supraglottic collapse observed in infants with congenital laryngomalacia (CLM). This observation has encouraged surgeons to treat supraglottic EILO with procedures proven efficient for severe CLM. This article summarizes key features of the published experience related to surgical treatment of EILO. Supraglottoplasty is an irreversible procedure with potential complications. Surgery should be restricted to cases where the supraglottic laryngeal obstruction significantly affects the quality of life in patients for whom conservative treatment modalities have failed.

  • 92.
    Hellberg, Victoria
    et al.
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Gahm, Caroline
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Ehrsson, Hans
    Karolinska Univ Hosp, Karolinska Pharm, Stockholm, Sweden..
    Liu, Wei
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    In Response to Immunohistochemical Localization of OCT2 in the Cochlea of Various Species2016Inngår i: The Laryngoscope, ISSN 0023-852X, E-ISSN 1531-4995, Vol. 126, nr 6, s. E232-E232Artikkel i tidsskrift (Fagfellevurdert)
  • 93.
    Holm, Anna
    et al.
    Umeå Univ, Dept Clin Sci, Div Otorhinolaryngol, Umeå, Sweden.
    Hellman, Urban
    Umeå Univ, Dept Publ Hlth & Clin Med, Umeå, Sweden.
    Laurent, Claude
    Umeå Univ, Dept Clin Sci, Div Otorhinolaryngol, Umeå, Sweden; Univ Pretoria, Dept Speech & Language Pathol & Audiol, Pretoria, South Africa.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Nylander, Karin
    Umeå Univ, Dept Med Biosci, Div Pathol, Umeå, Sweden.
    Olofsson, Katarina
    Umeå Univ, Dept Clin Sci, Div Otorhinolaryngol, Umeå, Sweden.
    Hyaluronan in vocal folds and false vocal folds in patients with recurrent respiratory papillomatosis2018Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 138, nr 11, s. 1020-1027Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Hyaluronan (HA) is a glycosaminoglycan with viscoelastic properties necessary for vocal fold (VF) vibration and voice production. Changes in HAs molecular mass, possibly related to human papilloma virus, could affect formation/persistence of recurrent respiratory papillomatosis (RRP).

    Aims/Objective: Describing mass and localization of HA and localization of HA receptor CD44 in VF and false vocal folds (FVF) in RRP.

    Materials and Methods: Biopsies from VF and FVF from 24 RRP patients. Twelve were studied with histo-/immunohistochemistry for HA and CD44 in epithelium, stroma and RRP lesions. Twelve samples were analyzed for HA molecular mass distribution with gas-phase-electrophoretic-molecular-mobility-analyzer (GEMMA).

    Results: Three of 23 stains (VF and FVF combined) showed faint HA staining in the epithelium; there was more extensive staining in the stroma. CD44 was present throughout all areas in FVF and VF, it did not concur with HA. GEMMA analysis revealed very high mass HA (vHMHA) with more varying amounts in VF.

    Conclusions/Significance: HA was mainly distributed in the stroma. CD44 not binding to HA might explain the non-inflammatory response described in RRP. Possibly crosslinked vHMHA was seen in VF and FVF, with more variable amounts in VF samples. Counteracting HA crosslinking could become a treatment option in RRP.

  • 94.
    Holm, Anna
    et al.
    Östersunds Hosp, Div Otorhinolaryngol, Dept Clin Sci, Ostersund, Sweden.
    Schindele, Alexandra
    Östersunds Hosp, Div Otorhinolaryngol, Dept Clin Sci, Östersund, Sweden;Jämtland Hadedalen Cty Council, Östersund, Sweden.
    Allard, Annika
    Ostersunds Hosp, Div Clin Virol, Dept Clin Microbiol, Ostersund, Sweden.
    Eriksson, Irene
    Ostersunds Hosp, Div Clin Virol, Dept Clin Microbiol, Ostersund, Sweden.
    Sandström, Karl
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Nylander, Karin
    Ostersunds Hosp, Div Pathol, Dept Ear Nose & Throat, Ostersund, Sweden.
    Olofsson, Katarina
    Ostersunds Hosp, Div Otorhinolaryngol, Dept Clin Sci, Ostersund, Sweden.
    Mapping of human papilloma virus, p16, and epstein-barr virus in non-malignant tonsillar disease2019Inngår i: LARYNGOSCOPE INVESTIGATIVE OTOLARYNGOLOGY, ISSN 2378-8038, Vol. 4, nr 3, s. 285-291Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives Due to their location in the entrance of the aero-digestive tract, tonsils are steadily exposed to viruses. Human papilloma virus (HPV) and Epstein-Barr virus (EBV) are two potentially oncogenic viruses that tonsils encounter. The incidence of HPV positive tonsillar cancer is on the rise and it is unknown when infection with HPV occurs. Aim To investigate if tonsils are infected with HPV and EBV, to study the co-expression of HPV and its surrogate marker p16, and to evaluate the number of EBV positive cells in benign tonsillar disease. Materials and Methods Tonsils from 40 patients in a university hospital were removed due to hypertrophy, chronic or recurrent infection. These were analyzed for presence of HPV, its surrogate marker p16, and EBV. HPV was studied using PapilloCheck (a PCR method), while p16 was identified in epithelial and lymphoid tissue with immunohistochemistry and EBV using EBER-ISH (Epstein-Barr encoding region-in situ hybridization). Results HPV was not detected, and p16 was present at low numbers in all epithelial samples as well as in 92.5% of the lymphoid tonsillar samples. At least one EBER-positive cell was seen in 65% of cases. Larger numbers of EBER-expressing cells were only seen in two cases. Conclusion These findings demonstrate that EBV and HPV infect tonsils independently, but further studies are warranted to confirm their infectious relationship.

  • 95.
    Holtby, Josefine
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Lindlöf, Kristin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Ordförrådet hos barn med hörselskada i 7 - 9 års ålder2009Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

     

     

    I föreliggande studie undersöktes ordförrådet (ordförståelse och benämning) hos 21 barn med hörselskada och 21 normalhörande barn i åldrarna 7-9 år, matchade till ålder, kön och bostadsort. Deltagarna delades även in i undergrupper med avseende på hörselskadans typ (ledningshinder, sensorineural skada samt kombinerad skada) och grad (lätt, måttlig, grav och döva/hörselskadade barn med CI) samt typ av skolform. Ordförståelse undersöktes med Peabody Picture Vocabulary Test III och benämning undersöktes med Word Finding Vocabulary Test. Som förväntat hade gruppen med hörselskada lägre resultat på båda testen, men endast benämningstestet visade en statistiskt signifikant gruppskillnad (p = 0,002 jämfört med p = 0,054 för ordförståelse). För benämningstestet hade barn med hörselskada i 7-års ålder ett signifikant lägre resultat jämfört med åldersmatchad kontrollgrupp, medan skillnaden inte var signifikant i de äldre åldersgrupperna (8 och 9 år). Typ, grad, kön eller skolform (hörselklass kontra integrerad skolform) hade ingen signifikant effekt på något av testen, men samband kan inte uteslutas pga relativt få barn i varje undergrupp i denna studie. Explorativ analys av individuella åldersekvivalenta resultat för benämningstestet indikerade följande: (a) majoriteten av de hörselskadade barnen låg inom den nedre halvan av normalresultatet; (b) två barn med cochleaimplantat hade särskilt låga resultat; (c) deltagare med lätt hörselskada tenderade att ha sämre resultat än deltagare med grav hörselskada, vilket kan tyda på otillräckligt stöd vid lätt skada; och (d) en deltagare med måttlig hörselskada hade lika högt resultat som det högsta resultatet i kontrollgruppen.

     

     

  • 96.
    Huttunen, Kerttu
    et al.
    Univ Oulu, Fac Humanities, Logoped, Oulu, Finland;Univ Oulu, Child Language Res Ctr, Oulu, Finland;Univ Oulu, PEDEGO Res Unit, Oulu, Finland;MRC Oulu, Oulu, Finland;Oulu Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Oulu, Finland.
    Erixon, Elsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Lofkvist, Ulrika
    Univ Oslo, Dept Special Needs Educ, Oslo, Norway;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Maki-Torkko, Elina
    Orebro Univ, Sch Med Sci, Orebro, Sweden;Orebro Univ Hosp, Audiol Res Ctr, Orebro, Sweden.
    The impact of permanent early-onset unilateral hearing impairment in children - A systematic review2019Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 120, s. 173-183Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: Decision-making on treatment and (re)habilitation needs to be based on clinical expertise and scientific evidence. Research evidence for the impact of permanent unilateral hearing impairment (UHI) on children's development has been mixed and, in some of the reports, based on fairly small, heterogeneous samples. Additionally, treatment provided has been highly variable, ranging from no action taken or watchful waiting up to single-sided cochlear implantation. Published information about the effects of treatment has also been heterogeneous. Moreover, earlier reviews and meta-analyses published on the impact of UHI on children's development have generally focused on select areas of development. Objectives: This systematic review aimed to summarize the impact of children's congenital or early onset unilateral hearing impairment on listening and auditory skills, communication, speech and language development, cognitive development, educational achievements, psycho-social development, and quality of life. Methods: Literature searches were performed to identify reports published from inception to February 16th, 2018 with the main electronic bibliographic databases in medicine, psychology, education, and speech and hearing sciences as the data sources. PubMed, CINALH, ERIC, LLBA, PsychINFO, and ISI Web of Science were searched for unilateral hearing impairment with its synonyms and consequences of congenital or early onset unilateral hearing impairment. Eligible were articles written in English, German, or Swedish on permanent unilateral hearing impairments that are congenital or with onset before three years of age. Hearing impairment had to be of at least a moderate degree with PTA >= 40 dB averaged over frequencies 0.5 to 2 or 0.5-4 kHz, hearing in the contralateral ear had to have PTA(0.5-2 kHz) or PTA(0.5-4 kHz) <= 20 dB, and consequences of unilateral hearing impairment needed to be reported in an unanimously defined population in at least one of the areas the review focused on. Four researchers independently screened 1618 abstracts and 566 full-text articles for evaluation of study eligibility. Eligible full-text articles were then reviewed to summarize the results and assess the quality of evidence. Additionally, data from 13 eligible case and multi-case studies, each having less than 10 participants, were extracted to summarize their results. Quality assessment of evidence was made adapting the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) process, and reporting of the results adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Results: Three articles with the quality of evidence graded as very-low to low, fulfilled the eligibility criteria set. Due to the heterogeneity of the articles, only a descriptive summary could be generated from the results. Unilateral hearing impairment was reported to have a negative impact on preverbal vocalization of infants and on sound localization and speech perception both in quiet and in noise. Conclusions: No high-quality studies of consequences of early-onset UHI in children were found. Inconsistency in assessing and reporting outcomes, the relatively small number of participants, low directness of evidence, and the potential risk of confounding factors in the reviewed studies prevented any definite conclusions. Further well-designed prospective research using larger samples is warranted on this topic.

  • 97.
    Hägg, Mary
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Anniko, Matti
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Influence of lip force on swallowing capacity in stroke patients and in healthy subjects2010Inngår i: Acta oto-laryngologica, ISSN 1651-2251, Vol. 130, nr 11, s. 1204-1208Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Conclusion: In spite of no clinical signs of facial paresis, a pathological lip force (LF) will strongly influence swallowing capacity (SC). Stroke patients with impaired SC suffer a subclinical facial paresis. The results support earlier findings that LF training can be used to treat dysphagia. Objectives: Lip muscle training with an oral screen can improve both LF and SC in stroke patients, irrespective of the presence or absence of facial palsy. The aim was therefore to study the influence of LF on SC. Methods: This prospective study included 22 stroke patients, aged 38-90 years, with dysphagia, 12 with initial unilateral facial paresis and 45 healthy subjects, aged 25-87 years. All were investigated with a Lip Force Meter (LF100), and with an SC test. Results: A significant correlation was found between LF/SC (p = 0.012) in stroke patients but not in healthy subjects. LF/SC was not age-related in stroke patients. LF was not age-dependent in healthy subjects, but SC decreased with increasing age (p < 0.0001). However, SC did not reach a pathological value and a regression analysis showed that 73% of the variation in SC is attributable to LF and age.

  • 98.
    Hägg, Mary K D
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Tibbling, Lita I E
    Effects on facial dysfunction and swallowing capacity of intraoral stimulation early and late after stroke2015Inngår i: NeuroRehabilitation, ISSN 1878-6448, Vol. 36, nr 1, s. 101-106Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Most patients with post-stroke dysphagia are also affected by facial dysfunction in all four facial quadrants. Intraoral stimulation can successfully treat post-stroke dysphagia, but its effect on post-stroke facial dysfunction remains unknown.

    OBJECTIVE: This study aimed to investigate whether intraoral stimulation after stroke has simultaneous effects on facial dysfunction in the contralateral lower facial quadrant and in the other three facial quadrants, on lip force, and on dysphagia.

    METHODS: Thirty-one stroke patients were treated with intraoral stimulation and assessed with a facial activity test, lip force test, and swallowing capacity test at three time-points: before treatment, at the end of treatment, and at late follow-up (over one year after the end of treatment).

    RESULTS: Facial activity, lip force, and swallowing capacity scores were all improved between baseline and the end of treatment (P < 0.001 for each), with these improvements remaining at late follow-up. Baseline and treatment data did not significantly differ between patients treated short and late after stroke.

    CONCLUSIONS: Treatment with intraoral stimulation significantly improved post-stroke dysfunction in all four facial quadrants, swallowing capacity, and lip force even in cases of long-standing post-stroke dysfunction. Furthermore, such improvement remained for over one year after the end of treatment.

  • 99.
    Hägg, Mary
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Hudiksvall Hosp, Speech & Swallowing Ctr, Dept Otorhinolaryngol, Hudiksvall, Sweden.
    Tibbling, L.
    Linkoping Univ, Dept Otorhinolaryngol, Linkoping, Sweden.
    Effect of IQoro® training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke2018Inngår i: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 13, s. 60-60Artikkel i tidsskrift (Annet vitenskapelig)
  • 100.
    Hägg, Mary
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Hudiksvall Hosp, Dept Otorhinolaryngol, Speech & Swallowing Ctr, SE-82481 Hudiksvall, Sweden..
    Tibbling, Lita
    Linkoping Univ, Dept Surg, S-58183 Linkoping, Sweden..
    Effect of IQoro (R) training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke2016Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, nr 7, s. 742-748Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion All patients with dysphagia after stroke have impaired postural control. IQoro (R) screen (IQS) training gives a significant and lasting improvement of postural control running parallel with significant improvement of oropharyngeal motor dysfunction (OPMD). Objectives The present investigation aimed at studying the frequency of impaired postural control in patients with stroke-related dysphagia and if IQS training has any effect on impaired postural control in parallel with effect on OPMD. Method A prospective clinical study was carried out with 26 adult patients with stroke-related dysphagia. The training effect was compared between patients consecutively investigated at two different time periods, the first period with 15 patients included in the study more than half a year after stroke, the second period with 11 patients included within 1 month after stroke. Postural control tests and different oropharyngeal motor tests were performed before and after 3 months of oropharyngeal sensorimotor training with an IQS, and at a late follow-up (median 59 weeks after end of training). Result All patients had impaired postural control at baseline. Significant improvement in postural control and OPMD was observed after the completion of IQS training in both intervention groups. The improvements were still present at the late follow-up.

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