Complications following subcutaneous mastectomy with Immediate Breast Reconstruction

Background: Breast cancer is the most frequent cancer among Norwegian women, and one of the surgical treatments involves subcutaneous mastectomy with immediate breast reconstruction. A master thesis published in 2017 reported that 56% of the breasts that underwent this type of surgery at UNN Tromsø, developed one or more postoperative complications. Based on the complication rate and new research on the field, changes were made in the surgical technique. The purpose of this study is to investigate if changes made in the surgical technique at UNN Tromsø has led to a reduction in postoperative complications. The changes include implementation of vertical incision, hydrodissection and prepectoral breast reconstruction. Materials and method: The study was conducted as a retrospective observational study for quality assurance at the Department of Urology, Breast and Endocrine- and Plastic and Reconstructive Surgery at UNN Tromsø. All patients having undergone subcutaneous mastectomy with immediate reconstruction during 2017-2021 were included. Results: A total of 87 patients (138 breast) were included in the study. The postoperative complication rate was reduced from 56% in the previous thesis to 32% in this study. Breasts operated without the HD technique had a significantly higher rate of skin flap necrosis (p = 0.004). Vertical incision was the most frequent used incision and was used in 50% of the breasts. No significant difference in complication rates were found when comparing prepectoral and subpectoral reconstruction. Reoperation was needed in 42% of the breasts because of complications and 31% of the breast needed one or more additional surgeries to obtain a cosmetic favorable result. Conclusion: A reduction in postoperative complications was found after the changes were made in the surgical technique. Vertical incision was used most frequent, and breasts operated without the HD technique had a significantly higher rate of skin flap necrosis, indicating that HD and vertical incision may have had a contributing factor to the reduction

How to start a Focus Group: Using cartoons in adult focus groups to discuss consumers feedback expectations in food service settings.

This article tests a novel method for starting focus groups quickly while ensuring that respondents understand the topic of interest for the study. To kick start the focus groups, a cartoon style illustration was developed. The cartoons depicted various food service experience from start to finish. Respondents first task was to indicate when it was natural for them to give feedback on the food service experience. The results show that the cartoons allowed respondents to quickly understand the topic, which in turn gave them confidence to contribute with relevant information from the start. In addition, respondents used the framework of the illustrations to keep the discussion focused on the topic throughout. We generally find that it is getting harder to find people who are willing to commit to 2 h focus groups after work. For us to find participants who are willing to take part, we are having to be much more time conscious, this method allows for shorter groups without losing valuable information. The method has a potential when it comes to testing food products as well as in the development of dishes for gastronomic experiences. It may also be a good tool to use in sensory focus groups. The use of comics to start off the focus group worked well in the context of a non-sensitive topic, in this case food service experiences. Further research could explore using this method for more sensitive topics.publishedVersio

Barnehagens arbeid med bærekraft i måltider

Tidlig i studieåret skjønte jeg at jeg ville fokusere på bærekraft på et eller annet vis i mitt bachelorprosjekt. Til slutt falt valget på at temaet for oppgaven skulle være “Bærekraftige måltider i barnehagen”. Grunnen til dette er at jeg selv vet hvor mange gode samtaler og stunder som ligger i måltidene i barnehagen. Her har man tid til å roe ned, prate sammen og lære av hverandre. På bakgrunn av dette ble jeg nysgjerrig på om barnehager griper denne stunden til å snakke med barna om bærekraft, om de selv ser hva som er bærekraft i måltidene og hvilket fokus dette har i planleggingen og gjennomføringen av måltidene. «Måltidene har ikke bare en ernæringsmessig verdi, men utgjør en helhetlig ramme med tanke på å utvikle barnas sosiale kompetanse, kulturforståelse og kunnskaper og holdninger til mat og drikke.» (Meld. St. 19, (2015-2016), 2016, s.41). Ut fra refleksjonene jeg har gjort meg om temaet jeg ønsket å skrive om og disse to utdragene fra Rammeplanen og Stortingsmeldingen “Tid for lek og læring - bedre innhold i barnehagen” har jeg kommet frem til min problemstilling: Hvilket fokus har barnehager på bærekraft i mat - og måltidsituasjoner?publishedVersio

The assessment of qualitative olfactory dysfunction in COVID-19 patients: a systematic review of tools and their content validity

Background: There is a lack of overview of the tools used to assess qualitative olfactory dysfunction, including parosmia and phantosmia, following COVID-19 illness. This could have an impact on the diagnosis and treatment offered to patients. Additionally, the formulations of symptoms are inconsistent and often unclear, and consensus around the wording of questions and responses is needed. Aim of study: The aim of this systematic review is to provide an overview of tools used to assess qualitative olfactory dysfunction after COVID-19, in addition to addressing the content validity (i.e., item and response formulations) of these tools. Methods: MEDLINE, Web of Science, and EMBASE were searched 5th of August 2022 and updated on the 25th of April 2023 to identify studies that assess qualitative olfactory dysfunction in COVID-19 patients. Primary outcomes were the tool used (i.e., questionnaire or objective test) and item and response formulations. Secondary outcomes included psychometric properties, study design, and demographic variables. Results: The assessment of qualitative olfactory dysfunction is characterized by heterogeneity, inconsistency, and lack of validated tools to determine the presence and degree of symptoms. Several tools with overlapping and distinct features were identified in this review, of which some were thorough and detailed, while others were merely assessing the presence of symptoms as a binary measure. Item and response formulations are also inconsistent and often used interchangeably, which may lead to confusion, incorrect diagnoses, and inappropriate methods for solving the problem. Conclusions: There is an unmet need for a reliable and validated tool for assessing qualitative olfactory dysfunction, preferably one that also captures quantitative olfactory issues (i.e., loss of smell), to ensure time-effective and specific assessment of the ability to smell. A consensus around the formulation of items and response options is also important to increase the understanding of the problem, both for clinicians, researchers, and the patient, and ultimately to provide the appropriate diagnosis and treatment.publishedVersio

Tolkning av avtaler på formuerettens område

Avhandlingen tar for seg utvalgt høyesterettspraksis fra perioden 2000 til 2020, med siktemål om å fastlegge hva som er gjeldende avtalerettslig tolkningslære

Protein purification and gene isolation of chlamysin, a cold-active lysozyme-like enzyme with antibacterial activity

AbstractAn antibacterial ∼11 kDa protein designated chlamysin was isolated from viscera of the marine bivalve Chlamys islandica. Chlamysin inhibited the growth of all Gram-positive and Gram-negative bacteria tested. The isolated protein was highly efficient in hydrolyzing Micrococcus luteus cells only at low pH (4.5–6.2) and at low temperature (4–35°C). No significant loss of enzyme activity was observed after 30 days storage at room temperature or after heating to 70°C for 15 min, suggesting relatively high protein structure stability. Sequence-analyzed fragments of the protein revealed data which guided the isolation of the cDNA gene, encoding a 137 amino acid chlamysin precursor in scallops. The deduced protein contains a high portion of cysteine, serine and histidine residues and has a predicted isoelectric point below 7. The chlamysin protein was found to have sequence homology to an isopeptidase and to a recently published bivalve lysozyme

NUDT16 and ITPA play a dual protective role in maintaining chromosome stability and cell growth by eliminating dIDP/IDP and dITP/ITP from nucleotide pools in mammals

Mammalian inosine triphosphatase encoded by ITPA gene hydrolyzes ITP and dITP to monophosphates, avoiding their deleterious effects. Itpa− mice exhibited perinatal lethality, and significantly higher levels of inosine in cellular RNA and deoxyinosine in nuclear DNA were detected in Itpa− embryos than in wild-type embryos. Therefore, we examined the effects of ITPA deficiency on mouse embryonic fibroblasts (MEFs). Itpa− primary MEFs lacking ITP-hydrolyzing activity exhibited a prolonged doubling time, increased chromosome abnormalities and accumulation of single-strand breaks in nuclear DNA, compared with primary MEFs prepared from wild-type embryos. However, immortalized Itpa− MEFs had neither of these phenotypes and had a significantly higher ITP/IDP-hydrolyzing activity than Itpa− embryos or primary MEFs. Mammalian NUDT16 proteins exhibit strong dIDP/IDP-hydrolyzing activity and similarly low levels of Nudt16 mRNA and protein were detected in primary MEFs derived from both wild-type and Itpa− embryos. However, immortalized Itpa− MEFs expressed significantly higher levels of Nudt16 than the wild type. Moreover, introduction of silencing RNAs against Nudt16 into immortalized Itpa− MEFs reproduced ITPA-deficient phenotypes. We thus conclude that NUDT16 and ITPA play a dual protective role for eliminating dIDP/IDP and dITP/ITP from nucleotide pools in mammals

NUDT16 is a (deoxy)inosine diphosphatase, and its deficiency induces accumulation of single-strand breaks in nuclear DNA and growth arrest

Nucleotides function in a variety of biological reactions; however, they can undergo various chemical modifications. Such modified nucleotides may be toxic to cells if not eliminated from the nucleotide pools. We performed a screen for modified-nucleotide binding proteins and identified human nucleoside diphosphate linked moiety X-type motif 16 (NUDT16) protein as an inosine triphosphate (ITP)/xanthosine triphosphate (XTP)/GTP-binding protein. Recombinant NUDT16 hydrolyzes purine nucleoside diphosphates to the corresponding nucleoside monophosphates. Among 29 nucleotides examined, the highest kcat/Km values were for inosine diphosphate (IDP) and deoxyinosine diphosphate (dIDP). Moreover, NUDT16 moderately hydrolyzes (deoxy)inosine triphosphate ([d]ITP). NUDT16 is mostly localized in the nucleus, and especially in the nucleolus. Knockdown of NUDT16 in HeLa MR cells caused cell cycle arrest in S-phase, reduced cell proliferation, increased accumulation of single-strand breaks in nuclear DNA as well as increased levels of inosine in RNA. We thus concluded that NUDT16 is a (deoxy)inosine diphosphatase that may function mainly in the nucleus to protect cells from deleterious effects of (d)ITP

Proteomic identification, cDNA cloning and enzymatic activity of glutathione S-transferases from the generalist marine gastropod, Cyphoma gibbosum

Author Posting. © Elsevier B.V., 2008. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Archives of Biochemistry and Biophysics 478 (2008): 7-17, doi:10.1016/j.abb.2008.07.007.Glutathione S-transferases (GST) were characterized from the digestive gland of Cyphoma gibbosum (Mollusca; Gastropoda), to investigate the possible role of these detoxification enzymes in conferring resistance to allelochemicals present in its gorgonian coral diet. We identified the collection of expressed cytosolic Cyphoma GST classes using a proteomic approach involving affinity chromatography, HPLC and nanospray liquid chromatography-tandem mass spectrometry (LC-MS/MS). Two major GST subunits were identified as putative mu-class GSTs; while one minor GST subunit was identified as a putative theta-class GST, apparently the first theta-class GST identified from a mollusc. Two Cyphoma GST cDNAs (CgGSTM1 and CgGSTM2) were isolated by RT-PCR using primers derived from peptide sequences. Phylogenetic analyses established both cDNAs as mu-class GSTs and revealed a mollusc-specific subclass of the GST-mu clade. These results provide new insights into metazoan GST diversity and the biochemical mechanisms used by marine organisms to cope with their chemically defended prey.Support was provided by the WHOI-Cole Ocean Ventures Fund (KEW), the WHOI Ocean Life Institute (KEW and MEH), a grant from Walter A. and Hope Noyes Smith (MEH), the National Science Foundation Graduate Research Fellowship (KEW), and by the National Institutes of Health (P42-ES007381 and R01-ES015912 to JVG)