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Browsing Artikler, rapporter og annet (klinisk medisin) by Author
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Engeseth, Kjersti H.; Obstfelder, Aud; Wynn, Rolf (Journal article; Tidsskriftartikkel; Peer reviewed, 27-Jul-2007)[+][-]
Abstract: Background: There has been an increased interest in the use of telemedical applications in clinical practice in recent years. Considerable effort has been invested in trials and experimental services. Yet, surprisingly few applications have continued beyond the research and development phase. The aim of this study is to explore characteristics of successfully implemented telemedical applications. Methods: An extensive search of telemedicine literature was conducted in order to identify relevant articles. Following a defined selection process, a small number of articles were identified that described characteristics of successfully implemented telemedical applications. These articles were analysed qualitatively, drawing on central procedures from Grounded Theory (GT), including condensation and categorisation. The analysis resulted in a description of features found to be of importance for a successful implementation of telemedicine. Subsequently, these features were discussed in light of Science and Technology studies (STS) and the concept of 'social negotiation'. Results: Telemedical applications introduced into routine practice are typically characterised by the following six features: 1) local service delivery problems have been clearly stated, 2) telemedicine has been seen as a benefit, 3) telemedicine has been seen as a solution to political and medical issues, 4) there was collaboration between promoters and users, 5) issues regarding organizational and technological arrangements have been addressed, and 6) the future operation of the service has been considered. Conclusions: Our findings support research arguing that technologies are not fixed entities moving from invention through diffusion and into routine use. Rather, it is the interplay between technical and social factors that produces a particular outcome. The success of a technology depends on how this interplay is managed during the process of implementation. URI: http://hdl.handle.net/10037/1153 File(s) in this item: 1
article.pdf (247.4Kb) -
Okeke, Malachy Ifeanyi; Tryland, Morten; Nilssen, Øivind; Moens, Ugo; Traavik, Terje (Journal article; Tidsskriftartikkel; Peer reviewed, 12-May-2009)[+][-]
Abstract: Background: Poxvirus-vectored vaccines against infectious diseases and cancer are currently under development. We hypothesized that the extensive use of poxvirus-vectored vaccine in future might result in co-infection and recombination between the vaccine virus and naturally occurring poxviruses, resulting in hybrid viruses with unpredictable characteristics. Previously, we confirmed that co-infecting in vitro a Modified vaccinia virus Ankara (MVA) strain engineered to express influenza virus haemagglutinin (HA) and nucleoprotein (NP) genes with a naturally occurring cowpox virus (CPXV-NOH1) resulted in recombinant progeny viruses (H Hansen, MI Okeke, Ø Nilssen, T Traavik, Vaccine 23: 499–506, 2004). In this study we analyzed the biological properties of parental and progeny hybrid viruses.
Results: Five CPXV/MVA progeny viruses were isolated based on plaque phenotype and the expression of influenza virus HA protein. Progeny hybrid viruses displayed in vitro cell line tropism of CPXV-NOH1, but not that of MVA. The HA transgene or its expression was lost on serial passage of transgenic viruses and the speed at which HA expression was lost varied with cell lines. The HA transgene in the progeny viruses or its expression was stable in African Green Monkey derived Vero cells but became unstable in rat derived IEC-6 cells. Hybrid viruses lacking the HA transgene have higher levels of virus multiplication in mammalian cell lines and produced more enveloped virions than the transgene positive progenitor virus strain. Analysis of the subcellular localization of the transgenic HA protein showed that neither virus strain nor cell line have effect on the subcellular targets of the HA protein. The influenza virus HA protein was targeted to enveloped virions, plasma membrane, Golgi apparatus and cytoplasmic vesicles.
Conclusion: Our results suggest that homologous recombination between poxvirus-vectored vaccine and naturally circulating poxviruses, genetic instability of the transgene, accumulation of non-transgene expressing vectors or hybrid virus progenies, as well as cell line/type specific selection against the transgene are potential complications that may result if poxvirus vectored vaccines are extensively used in animals and man.URI: http://hdl.handle.net/10037/2191 File(s) in this item: 1
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Bjorbekkmo, Svein; Olstad, Reidun; Sørgaard, Knut; Myklebust, Lars H.; Molvik, Stian; Nymann, Asle (Journal article; Tidsskriftartikkel; Peer reviewed, 18-May-2009)[+][-]
Abstract: Background: The VELO study is a comparative study of two Community Mental Health Centres (CMHC) in Northern Norway. The CMHCs are organized differently: one has no local inpatient unit, the other has three. Both CMHCs use the Central Mental Hospital situated rather far away for compulsory and other admissions, but one uses mainly local beds while the other uses only central hospital beds. In this part of the study the ward staffs level of competence and treatment philosophy in the CMHCs bed units are compared to Central Mental Hospital units. Differences may influence health service given, resulting in different treatment for similar patients from the two CMHCs.
Methods: 167 ward staff at Vesterålen CMHCs bed units and the Nordland Central Mental Hospital bed units answered two questionnaires on clinical practice: one with questions about education, work experience and clinical orientation; the other with questions about the philosophy and practice at the unit. An extended version of Community Program Philosophy Scale (CPPS) was used. Data were analyzed with descriptive statistics, non-parametric test and logistic regression.
Results: We found significant differences in several aspects of competence and treatment philosophy between local bed units and central bed units. CMHC staff are younger, have shorter work experience and a more generalised postgraduate education. CMHC emphasises family therapy and cooperation with GP, while Hospital staff emphasise diagnostic assessment, medication, long term treatment and handling aggression.
Conclusion: The implications of the differences found, and the possibility that these differences influence the treatment mode for patients with similar psychiatric problems from the two catchment areas, are discussed.URI: http://hdl.handle.net/10037/2192 File(s) in this item: 1
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Rezvyy, Grigory; Olstad, Reidun; Parniakov, Alexander; Fedulova, Elena (Journal article; Tidsskriftartikkel; Peer reviewed, 04-Apr-2008)[+][-]
Abstract: Background: A general education in psychiatry does not necessary lead to good diagnostic skills. Specific training programs in diagnostic coding are established to facilitate implementation of ICD-10 coding practices. However, studies comparing the impact of these two different educational approaches on diagnostic skills are lacking. The aim of the current study was to find out if a specific training program in diagnostic coding improves the diagnostic skills better than a general education program, and if a national bias in diagnostic patterns can be minimised by a specific training in diagnostic coding.
Methods: A pre post design study with two groups was carried in the county of Archangels, Russia. The control group (39 psychiatrists) took the required course (general educational program), while the intervention group (45 psychiatrists) were given a specific training in diagnostic coding. Their diagnostic skills before and after education were assessed using 12 written case-vignettes selected from the entire spectrum of psychiatric disorders.
Results: There was a significant improvement in diagnostic skills in both the intervention group and the control group. However, the intervention group improved significantly more than did the control group. The national bias was partly corrected in the intervention group but not to the same degree in the control group. When analyzing both groups together, among the background factors only the current working place impacted the outcome of the intervention.
Conclusion: Establishing an internationally accepted diagnosis seems to be a special skill that requires specific training and needs to be an explicit part of the professional educational activities of psychiatrists. It does not appear that that skill is honed without specific training. The issue of national diagnostic biases should be taken into account in comparative cross-cultural studies of almost any character. The mechanisms of such biases are complex and need further consideration in future research. Future research should also address the question as to whether the observed improvement in diagnostic skills after specific training actually leads to changes in routine diagnostic practice.URI: http://hdl.handle.net/10037/2100 File(s) in this item: 1
article.pdf (280.6Kb) -
Bjorbekkmo, Svein; Olstad, Reidun E.; Myklebust, Lars Henrik Ryther; Sørgaard, Knut; Molvik, Stian; Nymann, Asle (Journal article; Tidsskriftartikkel; Peer reviewed, 2009)[+][-]
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Ozolina, A.; Strike, E.; Jaunalksne, I.; Krumina, A.; Bjertnaes, Lars J.; Vanags, I. (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Enhanced bleeding remains a serious problem after cardiac surgery, and fibrinolysis is often involved. We speculate that lower plasma concentrations of plasminogen activator inhibitor – 1 (PAI-1) preoperatively and tissue plasminogen activator/PAI-1 (t-PA/PAI-1) complex postoperatively might predispose for enhanced fibrinolysis and increased postoperative bleeding. Totally 88 adult patients (mean age 66 ± 10 years) scheduled for cardiac surgery, were enrolled into a prospective study. Blood samples were collected pre-operatively, on admission to the recovery and at 6 and 24 hours postoperatively. Patients with a surgical bleeding that was diagnosed during reoperation were discarded from the study. The patients were allocated to two groups depending on the 24-hour postoperative chest tube drainage (CTD): Group I > 500ml, Group II ≤ 500ml. Associations between CTD, PAI-1, t-PA/PAI-1 complex and D-dimer were analyzed with SPSS. Nine patients were excluded because of surgical bleeding. Of the 79 remaining patients, 38 were allocated to Group I and 41 to Group II. The CTD volumes correlated with the preoperative plasma levels of PAI-1 (r = − 0.3, P = 0.009). Plasma concentrations of preoperative PAI-1 and postoperative t-PA/PAI-1 complex differed significantly between the groups (P < 0.001 and P = 0.012, respectively). Group I displayed significantly lower plasma concentrations of fibrinogen and higher levels of D-dimer from immediately after the operation and throughout the first 24 hours postoperatively. Lower plasma concentrations of PAI-1 preoperatively and t-PA/PAI-1 complex postoperatively leads to higher plasma levels of D-dimer in association with more postoperative bleeding after cardiac surgery. URI: http://hdl.handle.net/10037/4887 File(s) in this item: 1
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Rannestad, Toril; Skjeldestad, Finn Egil (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Women in deprived socioeconomic situations run a high pain risk. Although number of pain sites (NPS) is considered highly relevant in pain assessment, little is known regarding the relationship between socioeconomic conditions and NPS. The study population comprised 653 women; 160 recurrence-free long-term gynecological cancer survivors, and 493 women selected at random from the general population. Demographic characteristics and co-morbidity over the past 12 months were assessed. Socioeconomic conditions were measured by Socioeconomic Condition Index (SCI), comprising education, employment status, income, ability to pay bills, self-perceived health, and satisfaction with number of close friends. Main outcome measure NPS was recorded using a body outline diagram indicating where the respondents had experienced pain during the past week. Chi-square test and forward stepwise logistic regression were applied. There were only minor differences in SCI scores between women with 0, 1-2 or 3 NPS. Four or more NPS was associated with younger age, higher BMI and low SCI. After adjustment for age, BMI and co-morbidity, we found a strong association between low SCI scores and four or more NPS, indicating that there is a threshold in the NPS count for when socioeconomic determinants are associated to NPS in women. URI: http://hdl.handle.net/10037/4422 File(s) in this item: 1
article.pdf (213.2Kb) -
Rasmussen, Knut; Bratlid, Dag (Journal article; Tidsskriftartikkel; Peer reviewed, 15-Feb-2007)[+][-]
Abstract: Background: In order to maintain both quality and efficiency of health services in a small country with a scattered population, Norway established a monopoly system for 38 highly specialized medical services. The geographical distributions of these services, which are provided by one or two university hospitals only, were analysed. Methods: The counties of residence for 2 711 patients admitted for the first time in 2001 to these 31 monopolies and 7 duopolies were identified. Results: The general tendency observed was that with increasing distance from residential home to monopoly hospitals there was a declining coverage of these health services. The same pattern was found even with regard to explicit diagnoses or treatments such as organ transplantations (except renal transplantations). Duopolies seemed to yield a more even geographical distribution of the services. Conclusion: Monopolies may serve as a useful means for maintaining quality in highly specialized medical services, but seem to have an inherent tendency to do this at the expense of geographical equality. URI: http://hdl.handle.net/10037/1260 File(s) in this item: 1
article.pdf (253.7Kb) -
Augestad, Knut Magne; Revhaug, Arthur; Vonen, Barthold; Johnsen, Roar; Lindsetmo, Rolv-Ole (Journal article; Tidsskriftartikkel, 11-Aug-2008)[+][-]
Abstract: Background: Waiting time and costs from referral to day case outpatient surgery are at an unacceptably high level. The waiting time in Norway averages 240 days for common surgical conditions. Furthermore, in North Norway the population is scattered throughout a large geographic area, making the cost of travel to a specialist examination before surgery considerable. Electronic standardised referrals and booking of day case outpatient surgery by GPs are possible through the National Health Network, which links all health care providers in an electronic network. New ways of using this network might reduce the waiting time and cost of outpatient day case surgery.
Materials and Methods: In a randomised controlled trial, selected patients (inguinal hernia, gallstone disease and pilonidal sinus) referred to the university hospital are either randomised to direct electronic referral and booking for outpatient surgery (one stop), or to the traditional patient pathway where all patients are seen at the outpatient clinic several weeks ahead of surgery. Consultants in gastrointestinal surgery designed standardised referral forms and guidelines. New software has been designed making it possible to implement referral forms, guidelines and patient information in the GP's electronic health record. For "one-stop" referral, GPs must provide mandatory information about the specific condition. Referrals were linked to a booking system, enabling the GPs to book the hospital, day and time for outpatient surgery. The primary endpoints are waiting time and costs. The sample size calculation was based on waiting time. A reduction in waiting time of 60 days (effect size), 25%, is significant, resulting in a sample size of 120 patients in total.
Discussion: Poor communication between primary and secondary care often results in inefficiencies and unsatisfactory outcomes. We hypothesised that standardised referrals would improve the quality of information, making it feasible to use a one-stop approach for all patients undergoing surgery on an outpatient basis for inguinal hernia, pilonidal sinus and gallstones. In this study we wanted to investigate the waiting time and cost-effectiveness of direct electronic referral and booking of outpatient surgery compared to the traditional patient pathway, where the patient is seen at the outpatient clinic prior to surgery.
Trial registration: This trial has been registered at ClinicalTrials.gov. The trial registration number is: NCT00692497URI: http://hdl.handle.net/10037/2142 File(s) in this item: 1
article.pdf (603.1Kb) -
Ringen, Amund Hovengen; Hjortdahl, Magnus; Wisborg, Torben (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: The treatment of trauma victims is a complex multi-professional task in a stressful environment. We previously found that trauma team members perceive leadership as the most important human factor. The aim of the present study was to assess the experience and education of Norwegian trauma team leaders, and allow them to describe their perceived educational needs. We conducted an anonymous descriptive study using a point prevalence methodology based on written questionnaires. All 45 hospitals in Norway receiving severely injured trauma victims were contacted on a randomly selected weeknight during November 2009. Team leaders were asked to specify what trauma related training programs they had participated in, how much experience they had, and what further training they wished, if any. Response rate was 82%. Slightly more than half of the team leaders were residents. The median working experience as a surgeon among team leaders was 7.5 years. Sixty-eight percent had participated in multiprofessional training in non-technical skills, while 54% had passed the advanced trauma life support(ATLS) course. Fifty-one percent were trained in damage control surgery. A median of one course per team leader was needed to comply with the new proposed national standards. Team leaders considered training in damage control surgery the most needed educational objective. Level of experience among team leaders was highly variable and their educational background insufficient according to international and proposed national standards. Proposed national standards should be urgently implemented to ensure equal access to high quality trauma care. URI: http://hdl.handle.net/10037/3968 File(s) in this item: 1
article.pdf (235.9Kb) -
Risberg, Terje; Chrisanthar, Ranjan; Knappskog, Stian; Løkkevik, Erik; Anker, Gun; Østenstad, Bjørn; Lundgren, Steinar; Mjaaland, I; Engebretsen, L; Lillehaug, Johan Richard; Lønning, Per Eystein; Mæhle, L; Berge, Elisabet (Journal article; Tidsskriftartikkel; Peer reviewed, 2008)[+][-]
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Romner, Bertil; Heskestad, Ben; Baardsen, Roald; Ingebrigtsen, Tor; Helseth, Eirik; Waterloo, Knut (Journal article; Tidsskriftartikkel; Peer reviewed, 20-Feb-2009)[+][-]
Abstract: Background: In three previous Norwegian studies conducted between 1974 and 1993, the annual incidence rates of hospital admitted head injuries were 236, 200 and 169 per 100,000 population. The aim of this study was to describe the incidence of head injury in the Stavanger region and to compare it with previous Norwegian studies.
Methods: All head injured patients referred to Stavanger University Hospital during a one-year period (2003) were registered in a partly prospective and partly retrospective study. The catchment area for the hospital is strictly defined to a local population of 283,317 inhabitants (2003).
Results: The annual incidence rate was 207/100,000 population for hospital referred head injury and 157/100,000 population for hospital admitted head injury. High age- and sex specific incidence rates were observed among the oldest, and the highest rate (882/100,000) among men above 90 years. More than 50% of the injuries were caused by falls.
Conclusion: Comparison with previous Norwegian studies indicates decreasing annual incidence rates for hospital admitted head injury during the last 30 years.URI: http://hdl.handle.net/10037/2194 File(s) in this item: 1
article.pdf (257.6Kb) -
Røe, Oluf Dimitri; Szulkin, Adam; Anderssen, Endre; Flatberg, Arnar; Sandeck, Helmut; Amundsen, Tore; Erlandsen, Sten Even; Dobra, Katalin; Sundstrøm, Stein Harald (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Pemetrexed, a multi-folate inhibitor combined with a platinum compound is the first-line treatment of malignant mesothelioma, but median survival is still one year. Intrinsic and acquired resistance to pemetrexed is common, but its biological basis is obscure. Here we report for the first time a genome-wide profile of acquired resistance in the tumour from an exceptional case with advanced pleural mesothelioma and almost six years survival after 39 cycles of second-line pemetrexed/carboplatin treatment. Genome-wide analysis with Illumina BeadChip Kit of 25,000 genes was performed on mRNA from pre-treatment and post-resistance biopsies from this individual as well on case and control samples from our previously published study (in total 17 samples). Cell specific expression of proteins encoded by selected genes were analysed by immunohistochemistry. Serial serum levels of CA125, CYFRA21-1 and SMRP levels were examined. TS protein, the main target of pemetrexed was overexpressed. Proteins and genes related to DNA damage response, elongation and telomere extension and repair related directly and indirectly to platinum resistance were overexpressed, as the CHK1 protein and the genes CHEK2, LIG3, POLD1, POLA2, FANCD2, PRPF19, RECQ5 respectively, the last two not previously described in mesothelioma. We observed a down-regulation of leukocyte transendothelial migration and cell adhesion molecules pathways. Silencing of NT5C in two mesothelioma cell lines did not sensitize the cells to Pemetrexed. Proposed resistance markers are TS, KRT7/ CK7, TYMP/ thymidine phosphorylase and down-regulated SPARCL1 and CDKN1B. Moreover, comparison of the primary expression of the sensitive versus a primary resistant case showed multi-fold overexpressed DNA repair, cell cycle, cytokinesis, and spindle formation in the latter. Serum CA125 and SMRP reflected the clinical and radiological course and tumour burden. Genome-wide microarray of mesothelioma pre- and post-resistance biopsies indicated a novel resistance signature to pemetrexed/carboplatin that deserve validation in a larger cohort. URI: http://hdl.handle.net/10037/4926 File(s) in this item: 1
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Salvesen, Rolf (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: The aim of this study was to evaluate the longterm outcome in 61 patients with medication-overuse headache (MOH) who 4 years previously had been included in a randomized open-label prospective multicentre study. Sixty patients still alive after 4 years were invited to a follow-up investigation. Fifty patients (83%) participated. Sixteen visited a neurologist, 22 were interviewed through telephone, 2 gave response by a letter, and 10 were evaluated through hospital records. The influence of baseline characteristics on outcome 4 years later was evaluated by non-parametric tests. p values below 0.01 were considered significant. At follow-up, the 50 persons had a mean reduction of 6.5 headache days/month (p\0.001) and 9.5 acute headache medication days/month (p\0.001) compared to baseline. Headache index/month was reduced from 449 to 321 (p\0.001). Sixteen persons (32%) were considered as responders due to a C50% reduction in headache frequency from baseline, whereas 17 (34%) persons met the criteria for MOH. None of the baseline characteristics consistently influenced all five outcome measures. Total Hospital Anxiety and Depression Scale (HADS) score at baseline was predictors (p\0.005) for being a responder after 4 years. At 4 years’ follow-up, onethird of the 50 MOH patients had C50% reduction in headache frequency from baseline. A low total HADS score at baseline was associated with the most favorable outcome. URI: http://hdl.handle.net/10037/3854 File(s) in this item: 1
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Santana, Silvina; Lausen, Berthold; Bujnowska-Fedak, M; Chronaki, C; Prokosch, H.-U.; Wynn, Rolf (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: The knowledge about the relationship between health-related activities on the Internet (i.e. informed citizens) and individuals’ control over their own experiences of health or illness (i.e. empowered citizens) is valuable but scarce. In this paper, we investigate the correlation between four ways of using the Internet for information on health or illness and citizens attitudes and behaviours toward health professionals and health systems and establish the profile of empowered eHealth citizens in Europe. Data was collected during April and May 2007 (N = 7022), through computer-assisted telephone interviews (CATI). Respondents from Denmark, Germany, Greece, Latvia, Norway, Poland and Portugal participated in the survey. The profiles were generated using logistic regressions and are based on: a) socio-demographic and health information, b) the level of use of health-related online services, c) the level of use of the Internet to get health information to decide whether to consult a health professional, prepare for a medical appointment and assess its outcome, and d) the impact of online health information on citizens’ attitudes and behavior towards health professionals and health systems. Citizens using the Internet to decide whether to consult a health professional or to get a second opinion are likely to be frequent visitors of health sites, active participants of online health forums and recurrent buyers of medicines and other health related products online, while only infrequent epatients, visiting doctors they have never met face-to-face. Participation in online health communities seems to be related with more inquisitive and autonomous patients. The profiles of empowered eHealth citizens in Europe are situational and country dependent. The number of Europeans using the Internet to get health information to help them deal with a consultation is raising and having access to online health information seems to be associated with growing number of inquisitive and self-reliant patients. Doctors are increasingly likely to experience consultations with knowledgeable and empowered patients, who will challenge them in various ways. URI: http://hdl.handle.net/10037/3862 File(s) in this item: 1
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Rezvyy, Grigory; Schönfelder, Walter; Midré, Georges; Øiesvold, Terje; Olstad, Reidun (Journal article; Tidsskriftartikkel; Peer reviewed, 16-Aug-2007)[+][-]
Abstract: Background: The official statistics of persons with mental disorders who are granted disability pension (DP) in Russia and Norway indicate large differences between the countries. Methods: This qualitative explorative hypothesis-generating study is based on text analysis of the laws, regulations and guidelines, and qualitative interviews of informants representing all the organisational elements of the DP systems in both countries. Results: The DP application process is initiated much later in Norway than in Russia, where a 3 year occupational rehabilitation and adequate treatment is mandatory before DP is granted. In Russia, two instances are responsible for preparing of the medical certification for DP, a patients medical doctor (PD) and a clinical expert commission (CEC) while there is one in Norway (PD). In Russia, the Bureau of Medical-Social Expertise is responsible for evaluation and granting of DP. In Norway, the local social insurance offices (SIO) are responsible for the DP application. Decisions are taken collectively in Russia, while the Norwegian PD and SIO officer often take decisions alone. In Russia, the medical criterion is the decisive one, while rehabilitation and treatment criteria are given priority in Norway. The size of the DP in Norway is enough to cover of subsistences expenditure, while the Russian DP is less than the level required for minimum subsistence. Conclusion: There were noteworthy differences in the time frame, organisation model and process leading to a DP in the two countries. These differences may explain why so few patients with less severe mental disorders receive a DP in Russia. This fact, in combination with the size of the DP, may hamper reforms of the mental health care system in Russia. URI: http://hdl.handle.net/10037/1253 File(s) in this item: 1
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Sexton, Randall Harold; Stabbursvik, Ellen Anne Buljo (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
Description: The accepted version of this article is part of Randall H. Sexton's doctoral thesis, which is available in Munin at http://hdl.handle.net/10037/2450 URI: http://hdl.handle.net/10037/3017 File(s) in this item: 1
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Sitras, Vasilis; Fenton, Christopher Graham; Paulssen, Ruth H; VÅrtun, Åse; Acharya, Ganesh (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: The human placenta is a rapidly developing organ that undergoes structural and functional changes throughout the pregnancy. Our objectives were to investigate the differences in global gene expression profile, the expression of imprinted genes and the effect of smoking in first and third trimester normal human placentas. Placental samples were collected from 21 women with uncomplicated pregnancies delivered at term and 16 healthy women undergoing termination of pregnancy at 9–12 weeks gestation. Placental gene expression profile was evaluated by Human Genome Survey Microarray v.2.0 (Applied Biosystems) and real-time polymerase chain reaction. Almost 25% of the genes spotted on the array (n = 7519) were differentially expressed between first and third trimester placentas. Genes regulating biological processes involved in cell proliferation, cell differentiation and angiogenesis were up-regulated in the first trimester; whereas cell surface receptor mediated signal transduction, G-protein mediated signalling, ion transport, neuronal activities and chemosensory perception were up-regulated in the third trimester. Pathway analysis showed that brain and placenta might share common developmental routes. Principal component analysis based on the expression of 17 imprinted genes showed a clear separation of first and third trimester placentas, indicating that epigenetic modifications occur throughout pregnancy. In smokers, a set of genes encoding oxidoreductases were differentially expressed in both trimesters. Differences in global gene expression profile between first and third trimester human placenta reflect temporal changes in placental structure and function. Epigenetic rearrangements in the human placenta seem to occur across gestation, indicating the importance of environmental influence in the developing feto-placental unit. URI: http://hdl.handle.net/10037/4424 File(s) in this item: 1
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Skjelvareid, Martin Hansen; Olofsson, Tomas; Birkelund, Yngve (Conference object; Konferansebidrag, 2011)[+][-]
Abstract: The synthetic aperture focusing technique is a method for focusing ultrasonic scans used in nondestructive testing. Traditionally, the technique has mainly been used for contact testing, where the speed of sound is constant throughout the whole medium, but a number of recently proposed algorithms have extended the technique to multilayered media. One important application for such multilayer methods is immersion testing, where an object is immersed in water and the transducer is scanned within the water layer. Similarly, a multilayer technique is useful for inline ultrasound inspection of pipelines filled with liquid, for example water or oil. The multilayer methods have so far only been applied to the 2-dimensional line scan case, but in this paper we extend the the focusing procedure to the 3-dimensional surface scan case. The proposed method is based on the frequency-domain Phase Shift Migration algorithm, which is both conceptually simpler and more computationally efficient than similar time-domain methods. The performance of the focusing algorithm is tested on a three-layer structure, consisting of acrylic glass and aluminum blocks immersed in water. Several small flat-bottom holes in each block are used to simulate point scatterers, and the scatterer responses are studied using both B- and C-scan presentation. The lateral resolution of the focused image is shown to be approximately equal to half the transducer diameter, independent of both depth and layer. URI: http://hdl.handle.net/10037/3974 File(s) in this item: 1
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Smeland, Eivind; Kilvær, Thomas Karsten; Sørbye, Sveinung Wergeland; Valkov, Andrey Yurjevich; Andersen, Sigve; Bremnes, Roy M.; Busund, Lill-Tove; Dønnem, Tom (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: We aimed to explore the prognostic impact of the hypoxia-induced factors (HIFαs) 1 and 2, the metabolic HIFregulated glucose transporter GLUT-1, and carbonic anhydrase IX (CAIX) in non-gastrointestinal stromal tumor soft tissue sarcomas (non-GIST STS). Methods. Duplicate cores with viable tumor tissue from206 patients with non-GIST STS were obtained and tissue microarrays were constructed. Immunohistochemistry (IHC) was used to evaluate expression of hypoxic markers. Results. In univariate analyses, GLUT-1 (P < 0.001) and HIF-2α (P = 0.032) expression correlated significantly with a poor disease-specific survival (DSS). In the multivariate analysis, however, only high expression of GLUT-1 (HR 1.7, CI 95% 1.1–2.7, P = 0.021) was a significant independent prognostic indicator of poor DSS. Conclusion. GLUT-1 is a significant independent negative prognostic factor in non-GIST STS. URI: http://hdl.handle.net/10037/4888 File(s) in this item: 1
article.pdf (7.322Mb)
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