Department of Surgical Sciences

Department of Surgical Sciences Annual Report 2015 Avsändare/Fastställd av Olle Nilsson 2016-05-12 Introduction Chairman’s annual address/comments The year 2015 was another good and memorable year with numerous achievements in the areas of teaching and research by the teachers and staff of the Department of Surgical Sciences. Our vision for the department is that it should provide a platform for the researchers and teachers by reducing their administrative duties and enabling them to focus on their main duties; research and teaching. We can do so by the contributions of our highly proficient and qualitative administrative staff. It is my firm belief that decisions concerning strategic research questions are best handled by the researchers themselves, while the department has an important role in providing technical and administrative support. The department should also provide research students, graduate students and staff with favorable stimulating and creative working conditions. We feel fortunate to work within a very successful university in a well-organized institution in good economic standing. Although the work with assembling this Annual Report is tedious, it also is highly rewarding by giving an interesting perspective on the impressive accomplishments by the teachers, researchers and staff of the Department of Surgical Sciences. It is impressing to note how our researchers have managed to combine top quality research evidenced by publications in the most highly-ranked scientific journals with an impressing width covering a wide range of subjects. In addition, the scientific output in numbers is highly impressive. The attraction of external grants has gradually increased during the last decade, this year being no exception. In addition, a vast number of scientific papers many in high-ranking journals were produced and an impressive number of PhD theses defended. One of the most important achievements during this year had been the successful collaboration of the teachers, researchers and personnel from the department of Radiology and PET as an important and integral part of our Department starting 2015. We are certain that this new collaboration proven of great value to us all. In addition it is a privilege to welcome the new Professor in urology Pär Stattin to our department. Throughout 2015, our teachers have made outstanding contributions in clinical education. The department has the main responsibility for several specialist education programmes in nursing within the surgical field. These programmes are of profound importance for both the University Hospital and for the nursing profession, i.e. intensive care, anesthesiology, surgical care and ambulance care. The new curriculum in our medicine programme is now running reasonably smoothly, but improvements are continuously implemented in order to promote the scientific and academic career of our young and capable scholars. Teachers from the department play an essential role in this development. The department is now involved in teaching during semester 1, 3, 5, 6, 7 and 11, with main responsibility for the curriculum taking place during semester 6, 7 and part of semester 11. This pedagogic involvement is an important contribution to both teaching and to medicine. Other contributions within the pedagogic field include teaching in biomedicine, physiotherapy and nursing. Looking forward to 2016, we can anticipate an exceptionally interesting year with numerous challenges, hard work but also a rewarding and enjoyable time to look forward to. I want to thank everyone at the Department, including all teachers, researchers, administrators, students and laboratory personnel for their dedication and excellent work in 2015. With great thankfulness to all staff colleagues and friends at the Department of Surgical Sciences I will now hand over the exciting task of leading the Department into the future to Per Hellman, the Department could not be in better hands. Olle Nilsson Professor and Chairman 2 Table of contents Introduction _________________________________________________________________ 2 Table of contents ____________________________________________________________ 3 Organization _______________________________________________________________ 12 Scientific Reports ___________________________________________________________ 14 1) Anesthesiology and intensive care medicine ________________________________ 14 Research group 1: Cardiac arrest-neuroprotection ________________________ 14 Mechanical chest compressions during cardiac arrest ________________ 14 DISCO-trial: Direct or Subacute Coronary angiography for Out-of-hospital cardiac arrest ___________________________________________ 15 INTOx-A prospective measurement of serum concentrations of routine drugs in patients treated in the intensive care unit-A quality measurement/ improvement for clinical treatment and forensic assessment ______ 17 Research group 2: Injury and critical care epidemiology ____________________ 18 Research group 3: Lung function in anesthesia and intensive care ___________ 19 Inflammation induced by mechanical ventilation _____________________ 19 Spontaneous breathing in ARF __________________________________ 20 Apneic oxygenation or low tidal volume ventilation in combination with/without extracorporeal carbon dioxide removal (ECCO2R) or a proton acceptor (THAM) in ARF ____________________________ 20 Lung function measurements using optoelectronic plethysmography during anesthesia _____________________________________________ 20 Research group 4: Pain research group ________________________________ 22 Search for candidate biomarkers markers relevant to pain pathophysiology22 Visualization of peripheral pain mechanisms using PET ligands relevant to inflammation ___________________________________________ 22 Persistent postoperative pain ___________________________________ 22 Strong opioids for long term treatment of pain ______________________ 23 Effect of anesthetic drugs on the developing brain ___________________ 23 Clinical and biochemical characterization of very complex chronic pain patients _______________________________________________ 23 Research group 5: Sepsis and intensive care research group _______________ 24 3 Experimental septic shock ______________________________________ 24 Steroids and endotoxemic shock ________________________________ 24 Renal function during endotoxemia _______________________________ 25 Renal function in critical illness __________________________________ 25 Blood sampling and drug administration through intraosseous needles ___ 25 Intraosseous needles and administration of antibiotics ________________ 26 Intraosseous needles and thromboelastography ____________________ 26 Intraosseous needles and administration of adrenaline _______________ 27 The impact of rapid bolus administration vs. slow infusion on the extravasation of albumin __________________________________ 27 Model of living bacteria and bacterial clearance by splanchnic mononuclear phagocyte system _______________________________________ 28 Microcirculation and mitochondrial dysfunction ______________________ 28 Antibiotic concentration in critical illness (ACCIS study) _______________ 28 The epidemiology of sepsis in Sweden ____________________________ 29 2) Endocrine Surgery ____________________________________________________ 54 Genetics and treatment of endocrine tumors ____________________________ 54 Parathyroid _______________________________________________________ 54 Carcinoids _______________________________________________________ 54 Endocrine pancreatic tumors _________________________________________ 54 Adrenocortical tumors ______________________________________________ 55 Graves’ disease ___________________________________________________ 55 Clinical studies ____________________________________________________ 55 Experimental Surgery ____________________________________________________ 56 Personalized medicine, Precision Medicine _____________________________ 56 Adrenal tumors; genetics, epigenetics and new therapeutic strategies ________ 57 Complicated Graves’ disease ________________________________________ 57 Rare Mendelian inherited conditions ___________________________________ 57 Endocrine disrupting chemicals and adrenal disorders _____________________ 57 Clinical studies ____________________________________________________ 57 Computational Medicine ____________________________________________ 57 4 Agencies that support the work/Funding ___________________________ 58 Clinical cancer epidemiology _________________________________________ 67 Clinical trials_________________________________________________ 67 Translational research _________________________________________ 67 Register-based research _______________________________________ 68 Methodological developments ___________________________________ 68 3) Gastrointestinal Surgery _______________________________________________ 73 Upper Abdominal Surgery ___________________________________________ 73 Bariatric surgery _____________________________________________ 73 Esophageal- and gastric cancer _________________________________ 73 Liver surgery _____________________________________________________ 74 MRI studies _________________________________________________ 74 Local registry of liver surgery ____________________________________ 74 Liver tissue and cultured cells ___________________________________ 74 Ablative methods with IRE ______________________________________ 75 Biliary surgery ____________________________________________________

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