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Acute lung injury and ARDS in acute pancreatitis: Mechanisms and potential intervention

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World Journal of gastroenterology 2010年第17期16卷 2094-2099页

作者： Roland andersson Department of Surgery Clinical Sciences LundLund University Lund University Hospital SE-221 85 LundSweden

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in acute pancreatitis still represents a substantial problem,with a mortality rate in the range of 30%-40%.The present review evaluates underlying pathophysiological mechanisms in both ALI and ARDS and potential clinical *** mediators and pathophysiological pathways are involved during the different phases of ALI and *** initial exudative phase is characterized by diffuse alveolar damage,microvascular injury and influx of inflammatory *** phase is followed by a fibro-proliferative phase with lung repair,type Ⅱ pneumocyte hypoplasia and proliferation of *** derived from polymorphonuclear neutrophils,various pro-inflammatory mediators,and phospholipases are all involved,among *** factors that promote pancreatitis-associated ALI may be found in the gut and mesenteric *** is a lack of complete understanding of the underlying mechanisms,and by improving our knowledge,novel tools for prevention and intervention may be developed,thus contributing to improved outcome.

关键词： Acute lung injury Acute respiratory distress syndrome Acute pancreatitis Etiology Pathophysiology

Pancreatic function,quality of life and costs at long-term follow-up after acute pancreatitis

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World Journal of gastroenterology 2010年第39期16卷 4944-4951页

作者： Bodil andersson Marie-Louise Pendse Roland andersson Department of Surgery Clinical Siences LundLund University Lund University Hospital

AIM:To evaluate long-term endocrine and exocrine pancreatic function,quality of life and health care costs after mild acute pancreatitis and severe acute pancreatitis(SAP).METHODS:Patients prospectively included in 2001-2005 were followed-up after 42(36-53)*** function was evaluated with laboratory tests,the oral glucose tolerance test(OgTT),fecal elastase-1 and a *** Form(SF)-36,was ***:Fourteen patients with a history of SAP and 26 with mild acute pancreatitis were *** glucose after OgTT was higher after SAP(9.2 mmol/L vs 7.0 mmol/L,P=0.044).Diabetes mellitus or impaired glucose tolerance in fasting plasma glucose and/or 120 min plasma glucose were more common in SAP patients(11/14 vs 11/25,P=0.037).Sick leave,time until the patients could take up recreational activities and time until they had recovered were all longer after SAP(P gnificant differences in SF-36 were seen between the groups,or when comparing with age and gender matched reference *** hospital costs,including primary care,follow-up and treatment of complications,were higher after SAP(median€16572 vs €5000,Pgreater resource use with long recovery,but most patients regained a good quality of life.

关键词： Acute pancreatitis Endocrine function Exocrine function Quality of life Cost

Tissue factor in predicted severe acute pancreatitis

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World Journal of gastroenterology 2010年第48期16卷 6128-6134页

作者： Ellen andersson Jakob Axelsson gunilla Eckerwall Daniel Ansari Roland andersson Department of Surgery Clinical Sciences LundLund University Lund University Hospital

AIM: To study tissue factor (TF) in acute pancreatitis and evaluate the role of TF as a predictive marker of severity. METHODS: Forty-nine consecutive patients admitted to Lund University Hospital, fulfilling the criteria of predicted severe acute pancreatitis (AP), were recruited prospectively between 2002 and 2004. Blood samples for TF analyses were drawn at inclusion in the study and 12 h, 1 d and 3 d later. RESULTS: Twenty-seven patients developed mild AP, and 22 patients severe AP. At inclusion in the study, the groups were comparable with respect to gender, aetiology, Acute Physiology and Chronic Health Evaluation Ⅱ score, and duration of pain. At inclusion in the study and at 12 h, TF was higher in the severe AP group (P = 0.035 and P = 0.049, respectively). After 1 and 3 d, no differences in TF levels were noted. Interleukin (IL)-6 was significantly higher in the severe AP group at all of the studied time points. C-reactive protein (CRP) was significantly higher in the AP group at 1 and 3 d. In receiver operating characteristic-curves, the area under the curve (AUC) for TF was 0.679 (P = 0.035) at inclusion in the study, and a cut off level for TF of 40 pg/mL showed a sensitivity of 71% and a specificity of 67%, whereas corresponding AUC for IL-6 was 0.775, P = 0.001, and for CRP was 0.653. IL-6 showed better AUC-values than TF at all time points studied. CONCLUSION: TF-levels are raised early in severe AP. TF as an early predictive marker of severe AP is superior to CRP, but inferior to IL-6.

关键词： Acute pancreatitis Coagulation Prediction of severity Tissue factor

Deformation,fragmentation and acceleration of a controlled fragmentation charge casing

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Defence Technology（防务技术） 2019年第5期15卷 786-795页

作者： Andreas Helte Olof andersson Patrik Lundberg FOI Defence and SecuritySystems and Technology

Two different finite element software,LS-DYNA and Impetus,have been evaluated to test their ability to predict the deformation,fragmentation and acceleration of a controlled fragmentation charge *** general-purpose program LS-DYNA was used with a multi-material ALE formulation and a masspreserving erosion criterion coupled to a Johnson-Cook fracture *** the Impetus simulations,a third order Lagrangian element formulation was used for the casing and a node-splitting element erosion treatment coupled to a Cockcroft-Latham failure criterion was used to describe casing *** high-explosive gases were described by a discrete particle *** order to acquire data to validate our computational tools and constitutive models,a series of experiments have been performed using a laboratory charge with an internal grooved *** the test series,the charge geometry was fixed except that the groove depth were varied from very shallow to very deep resulting in different deformation patterns,fracture modes and terminal *** diagnostic tools captured the different stages of the expansion and fragmentation of the casing.A high-speed framing camera depicted the deformation pattern before fragmentation and was used to determine the moment when the casing *** different complementary techniques were used to follow the acceleration of the fragments;a Photon Doppler velocimetry to determine the initial acceleration of the casing,double exposed radiographs to estimate the fragment velocity after break-up and a high-speed video to determine the terminal velocity of the fragment after leaving the *** addition,the fragments were soft recovered in a set of sawdust pit tests and their final shape and weight were measured.A SEM was used to characterise the fracture surfaces and to determine the modus of fracture(tensile or shear failure).Comparisons to experiments show that both software can predict the change in deformation behaviour

关键词： Controlled fragmentation Fracture mechanics LS-DYNA Impetus

Micromechanical modeling of polycrystalline high manganese austenitic steel subjected to abrasive contact

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Friction 2020年第3期8卷 626-642页

作者： Matti LINDROOS Anssi LA UKK ANEN Tom andersson VTT Lifecycle Solutions Tampere 33720Finland

This study focuses on microstructural and micromechanical modeling of abrasive sliding contacts of wear-resistant Hadfield steel.3 D finite element representation of the microstructure was employed with a crystal plasticity model including dislocation slip,deformation twinning,and their *** results showed that deformation twinning interacting with dislocations had a key role in the surface hardening of the material,and it was also important for the early hardening process of the sub-surface grains beyond the heavily distorted surface *** effects of grain orientation and microstructural features were discussed and analyzed according to the micromechanical model to give a perspective to the anisotropy of the material and the feasibility of using micromechanics in virtual material design.

关键词： crystal plasticity micromechanical modeling of abrasion austenitic manganese steel deformation twinning

Review of current methods of acousto-optical tomography for biomedical applications

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Frontiers of Optoelectronics 2017年第3期10卷 211-238页

作者： Jacqueline gUNTHER Stefan andersson-ENgELS Tyndall National Institute Lee Maltings Dyke Parade Cork T12 R5CP Ireland Department of Physics University College Cork Cork T12 YN60 Ireland

The field of acousto-optical tomography （AOT） for medical applications began in the 1990s and has since developed multiple techniques for the detection of ultrasound-modulated light. Light becomes frequency shifted as it travels through an ultrasound beam. This ＂tagged＂ light can be detected and used for focused optical imaging. Here, we present a comprehensive overview of the techniques that have developed since around 2011 in the field of biomedical AOT. This includes how AOT has advanced by taken advantage of the research conducted in the ultrasound, as well as, the optical fields. Also, simulations and reconstruction algorithms have been formulated specifically for AOT imaging over this time period. Future progression of AOT relies on its ability to provide significant contributions to in vivo imaging for biomedical applications. We outline the challenges that AOT still faces to make in vivo imaging possible and what has been accomplished thus far, as well as possible future directions.

关键词： acousto-optic ultrasound modulation optical imaging biomedical imaging

Framework for assessing quality of care for inflammatory bowel disease in Sweden

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World Journal of gastroenterology 2012年第10期18卷 1085-1092页

作者： Martin Rejler Jrgen Tholstrup Mattias Elg Anna Spngéus Boel andersson gre Department of Medicine Highland Hospital S 57533 Eksj Sweden Division of Quality Management and Technology and HELIX Vinn Excellence Centre Linkping University S 58183 Sweden Department of Medical and Health Sciences Faculty of Health Sciences Linkping University S 58183 Sweden Jnkping Academy for Improvement of Health and Welfare The School of Health Sciences Jnkping University Jnkping Academy Box 1026 S 55111 Jnkping Sweden

AIM: To create and apply a framework for quality assessment and improvement in care for inflammatory bowel disease (IBD) patients. METHODS A framework for quality assessment and improvement was created for IBD based on two generally acknowledged quality models. The model of Donabedian (Df) offers a logistical and productive perspective and the Clinical Value Compass (CVC) model adds a management and service perspective. The framework creates a pedagogical tool to understand the balance between the dimensions of clinical care (CVC) and the components of clinical outcome (Df). The merged models create a framework of the care process dimensions as a whole, reflecting important parts of the IBD care delivery system in a local setting. Clinical and organizational quality measures were adopted from clinical experience and the literature and were integrated into the framework. Data were collected at the yearly check-up for 481 IBD patients during 2008. The application of the quality assessment framework was tested and evaluated in a local clinical IBD care setting in Jnkping County, Sweden. RESULTS: The main outcome was the presentation of how locally-selected clinical quality measures, integrated into two complementary models to develop a frame-work, could be instrumental in assessing the quality of care delivered to patients with IBD. The selected quality measures of the framework noted less anemia in the population than previously reported, provided information about hospitalization rates and the few surgical procedures reported, and noted good access to the clinic. CONCLUSION: The applied local quality framework was feasible and useful for assessing the quality of care delivered to IBD patients in a local setting.

关键词： Quality measures Inflammatory bowel disease Value compass Donabedian Quality improvement

Radiofrequency ablation or percutaneous ethanol injection for the treatment of liver tumors

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World Journal of gastroenterology 2012年第10期18卷 1003-1008页

作者： Daniel Ansari Roland andersson Department of Surgery Clinical Sciences Lund Skane University Hospital and Lund University

The liver is a common location of both primary and secondary malignancies. For unresectable liver cancer, many local ablative therapies have been developed. These include e.g., percutaneous ethanol injection (PEI), percutaneous acetic acid injection, radiofrequency ablation (RFA), cryoablation, microwave ablation, laserinduced thermotherapy, and high-intensity focused ultrasound. RFA has recently gained interest and is the most widely applied thermoablative technique. RFA allows more effective tumor control in fewer treatment sessions compared with PEI, but with a higher rate of complications. However, there are certain circumstances where PEI therapy represents a better strategy to control liver tumors than RFA, especially in situations where RFA is difficult, for example when large vessels surround the tumor. In the context of hepatocellular carcinoma (HCC), both RFA and PEI are feasible and of benefit in non-operable patients. RFA seems superior to PEI in HCC > 2 cm, and the combination of interventions may be of benefit in selected patients. Liver resection is superior to RFA for patients with HCC meeting the Milan criteria, but RFA can be employed in tumors ≤ 3 cm and where there is an increased expected operative mortality. In addition, some lines of evidence indicate that RFA and PEI can be employed as a bridge to liver transplantation. The use of RFA in colorectal liver metastases is currently limited to unresectable disease and for patients unfit for surgery. The aim of this article is to summarize the current status of RFA in the management of liver tumors and compare it to the cheap and readily available technique of PEI.

关键词： Colorectal liver metastases Hepatocellular cancer Liver resection Percutaneous ethanol injection Radiofrequency ablation

Effective and Sustainable Flood and Landslide Risk Reduction Measures:An Investigation of Two Assessment Frameworks

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International Journal of Disaster Risk Science 2016年第4期7卷 374-392页

作者： Yvonne andersson-Skld Lars Nyberg Swedish National Road and Transport Research Institute(VTI) Centre for Climate and Safety Karlstad University

Natural events such as floods and landslides can have severe *** risks are expected to increase,both as a consequence of climate change and due to increased vulnerabilities,especially in urban *** preventive measures are often cost-effective,some measures are beneficial to certain values,while some may have negative impacts on other *** aim of the study presented here was to investigate two frameworks used for assessing the effectiveness and sustainability of physical and nonphysical flood and landslide risk reduction *** study is based on literature,available information from authorities and municipalities,expert knowledge and experience,and stakeholder views and *** results indicate that the risks for suboptimization or maladaptation are reduced if many aspects are included and a broad spectrum of stakeholders are *** sustamability assessment tools applied here can contribute to a more transparent and sustainable risk management process by assessing strategies and interventions with respect to both short- and long-term perspectives,including local impacts and wider environmental impacts caused by climate change,for *** tools can also cover social and economic *** assessment tools provide checklists that can support decision processes,thus allowing for more transparent decisions.

关键词： Flood risk Landslide risk Risk reduction measures Sustainability assessment tools Sweden