Biomarker research is of great interest in the field of traumatic brain injury (TBI), since there are numerous potential markers that may indicate central nervous system damage, yet the brain is normally well isolated and discovery is at its infancy. Traditional methods for biomarker discovery include time consuming multi step chromatographic mass spectrometery (MS) techniques or pre-defined serial probing using traditional assays, making the identification of biomarker panels limiting and expensive. These shortfalls have motivated the development of a MS based probe that can be embedded into 3D neural cultures and obtain temporal and spatial information about the release of biomarkers. Using the high sensitivity MS ionization method of nano-electrospray ionization (nano-ESI) with an in-line microdialysis (MD) unit allows us to use MS to analyze low concentrations of TBI biomarkers from within cell cultures with no need for off-line sample manipulation. This thesis goes through the development of the probe by studying the theoretical principles, simulations and experimental results of the probe's capability to sample small local concentrations of a marker within cell culture matrix, the MD unit's sample manipulation capabilities, and the ability to detect markers using in-line MD-nano-ESI MS.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Liver transplantation is the best therapy for patients with end-stage liver diseases and unresectable early hepatocellular carcinoma (HCC). Living donor liver transplantation (LDLT) has been successfully implemented as an alternative to deceased donor liver transplantation (DDLT) and likewise offers comparable excellent survival rate. However, the inferior post-transplant oncological outcomes are found in LDLT recipients with HCC. The liver grafts used in LDLT are usually small-for-size and less effective in coping with shear stress from transient portal hypertension, which results in small-for-size liver graft injury. Acute phase small-for-size liver graft injury may promote late phase tumor recurrence, whereas the underlying mechanism remains unclear. CXCL10, an inflammatory chemokine, initiates liver inflammatory response during hepatic ischemia-reperfusion (IR) injury and may link acute phase small-for-size liver graft injury and late phase tumor recurrence, yet the precise mechanisms remain elusive. Endothelial progenitor cells (EPCs) participate in tissue repair for graft recovery and also provide an angiogenic environment for tumor growth. Myeloid derived suppressor cells (MDSCs) and regulatory T cells (Tregs) can suppress the activation of the immune system and play a critical role in graft rejection and cancer development. We here established the rat orthotopic liver transplantation with whole graft or small-for-size graft model to study the impact of acute phase small-for-size liver graft injury on the mobilization of EPCs, MDSCs and Tregs, and intragraft CXCL10 and its receptor, CXCR3,gene expressions. We further subjected CXCL10-/-mice and CXCR3-/-mice to hepatic IR injury and major hepatectomy to study the role of CXCL10/CXCR3 signaling on the mobilization of EPCs, MDSCs and Tregs. We also investigated the effect of CXCL10 on EPC migration and tube formation in vitroas well as intratumoral microvessel density (MVD) in the rat liver transplantation with tumor growth model and EPCs on tumor growth in nude mice. Key findings: 1. Liver transplantation with small-for-size graft resulted in severe intragraft vascular injury and higher CXCL10 andCXCR3 gene expressions as well as more EPC, MDSC and Treg cell mobilizationin circulation than whole graft. 2. CXCL10-/-mice and CXCR3-/-mice had less circulating EPCs, MDSCs and Tregs than WT mice after hepatic IR injury and major hepatectomy. 3. CXCL10 recruited EPCs in dose-dependent and CXCR3-dependent manners and promoted EPC tube formation in vitro. 4. Higher intratumoral MVD was observed in small-for-size graft than in whole graft in liver transplantation with tumor growth model. 5. Tumor grew more quickly by combining EPC infusionin nude mouse orthotopic liver tumor model. In conclusion, acute phase small-for-size liver graft injury significantly mobilizes EPCs, MDSCs and Tregs after transplantation through CXCL10/CXCR3 signaling. More EPC mobilization and intragraft differentiation after transplantation with small-for-size liver graft may be related to higher intratumoral MVD in small-for-size liver graft after transplantation with tumor development. Therefore, targeting at post-transplant CXCL10/CXCR3 signaling may not only attenuate early phase liver graft injury but also prevent late phase tumor recurrence. / published_or_final_version / Surgery / Doctoral / Doctor of Philosophy

Bakgrund: Distriktssköterskor har en viktig och ansvarsfull roll i omvårdnaden gällande sårvård, och en betydande del av det självständiga arbetet går åt till att behandla patienter med svårläkta sår. Syfte: Att studera hur distriktssköterskor arbetar med svårläkta sår genom att ta del av deras erfarenheter och upplevelser. Vidare var syftet att undersöka varför de handlar som de gör vid olika situationer och vad grundar de sina beslut på. Metod: Studien har en kvalitativ deskriptiv ansats. Ett strategiskt urval gjordes med inklusionskriteriet att informanterna arbetade som distriktssköterskor i primärvården/vårdcentraler i Norduppland. Tio informanter intervjuades och en strukturerad fråge guide användes. Studien analyserades med en kvalitativ manifest innehållsanalys. Resultat: Resultatet i denna studie visar att informanterna anser att praktisk erfarenhet väger tyngre än formell erfarenhet. Den formella erfarenheten anses vara bristfällig när det gäller sårvård, men lång praktisk erfarenhet anses ge högre sårvårdskompetens. Beslut och bedömningar bygger på ”oskrivna riktlinjer”. Alla informanter arbetar på liknande sätt, men utan att lokala riktlinjer finns nedskrivna på vårdcentralerna. Även den centrala upphandlingen av sårvårdsmaterial påverkar beslutet då bedömningen kan leda till att de vill använda ett annat material än de som är upphandlat. Det framkom i studien att informanterna anser att sårläkning främjas allra bäst genom att få patienter delaktig i sin vård. Slutsats: Då distriktssköterskan i sin profession har ett egenansvar samt en skyldighet att hålla sig uppdaterad med ny evidens, så är slutsatsen att behovet och ansvaret behöver belysas. Förslag till vidare forskning är att efter implementerade riktlinjer studera hur de följs. / Background: Nurses have an important and responsible role in the care regarding wound care, and a significant part of the independent work is used to treat patients with chronic wounds. Purpuse: Study how nurse is working with chronic wounds by taking part of their experiences. A further aim was to examine why they act as they do in different situations and what they based their decisions on. Method: The study was a qualitative descriptive approach. A strategic choice was made with that the informants worked as nurses in primary care / medical centers in Northern Uppland. Ten informants interviewed and a structured query guide used. The study was analyzed with a qualitative manifest content analysis. Results: The results of this study show that the practical experience outweighs formal qualification. The formal experience is considered deficient when it comes to wound care, but long practical experience is considered to provide a higher wound care expertise. Decisions and judgments based on "unwritten guidelines". All informants working in a similar way, but without the local guidelines. Although the central procurement of wound care materials affect the decision on which assessment to use. The informants believe that healing is promoted at its best by getting patients involved in their care. Conclusion:The nurse has own responsibility in their profession to keep themselves updated with new evidence. The conclusion is that the need and responsibility has to be clarified. Suggestions for further research are that after the guidelines implemented, study how this are followed.

published_or_final_version / Anatomy / Master / Master of Philosophy

published_or_final_version / Orthopaedic Surgery / Master / Master of Philosophy

published_or_final_version / Anatomy / Doctoral / Doctor of Philosophy

No description available.

No description available.

The overall aim of this study is to explore the subjective experiences of psychotherapeutic interventions and the sense-making process in a group of persons paralysed as a consequence of violence-related gunshot injury. An available and purposive sample of ten participants was selected from public and private hospitals in and around Johannesburg, and from the Association for the Physically Disabled in South Africa. Three females and seven males, between the ages of 26 and 43 years, took part in the research. The participants had all suffered penetrative damage to the spinal cord in the thoracic region as a result of violence related gunshot injury, and are therefore classified as having paraplegia The participants' gunshot injuries had been sustained in incidents ranging from attempted hijacking and armed robbery, to being caught in crime-related crossfire. In-depth interviews were conducted with the participants. A narrative approach was used to examine participants' unique stories, utilising a systematic form of narrative analysis. The thesis consists of three articles, namely 1) The subjective experience of psychotherapeutic interventions in the rehabilitation of persons paralysed as a result of violence-related gunshot injuries; 2) Making sense of paraplegia caused by violence-related gunshot injury; and 3) Therapeutic guidelines for the management of persons paralysed as a result of violence-related gunshot injuries. The findings of article 1 reveal that paraplegic persons had both positive and negative experiences during their hospital rehabilitation. Ultimately, however, positive experiences compensated for negative experiences. This suggests that in the absence of psychotherapeutic interventions, psychosocial adjustment may possibly not be facilitated. The second article indicates that although several barriers prevented participants from making sense of their trauma, meaningful relationships, spiritual growth and a greater appreciation of the value of life were still possible. in the final article guidelines were put forward that include meeting the holistic and adjustment needs of paraplegic persons. Future research is suggested and limitations acknowledged. / Thesis (Ph.D. (Psychology))--North-West University, Potchefstroom Campus, 2006.