| 21. |
- Wessberg, Per, 1954, et al.
(författare)
-
The effect of surgery and remodelling on spinal canal measurements after thoracolumbar burst fractures.
- 2001
-
Ingår i: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. - 0940-6719. ; 10:1, s. 55-63
-
Tidskriftsartikel (refereegranskat)abstract
- Bone fragments in the spinal canal after thoracolumbar spine injuries causing spinal canal narrowing is a frequent phenomenon. Efforts to remove such fragments are often considered. The purpose of the present study was to evaluate the effects of surgery on spinal canal dimensions, as well as the subsequent effect of natural remodelling, previously described by other authors. A base material of 157 patients operated consecutively for unstable thoracolumbar spine fractures at Sahlgrenska University Hospital in Gothenburg during the years 1980-1988 were evaluated, with a minimum of 5-years follow-up. Of these, 115 had suffered burst fractures. Usually the Harrington distraction rod system was employed. Patients underwent computed tomography (CT) preoperatively, postoperatively and at follow-up. From digitized CT scans, cross-sectional area (CSA) and mid-sagittal diameter (MSD) of the spinal canal at the level of injury were determined. The results showed that the preoperative CSA of the spinal canal was reduced to 1.4 cm2 or 49% of normal, after injury. Postoperatively it was widened to 2.0 cm2 or 72% of normal. At the time of follow-up, the CSA had improved further, to 2.6 cm2 or 87%. The extent of widening by surgery depended on the extent of initial narrowing, but not on fragment removal. Remodelling was dependent on the amount of bone left after surgery. The study shows that canal enlargement during surgery is caused by indirect effects when the spine is distracted and put into lordosis. Remodelling will occur if there is residual narrowing. Acute intervention into the spinal canal, as well as subsequent surgery because of residual bone, should be avoided.
|
|
| 22. |
- Christensson, Anders, et al.
(författare)
-
Serum cystatin C advantageous compared with serum creatinine in the detection of mild but not severe diabetic nephropathy.
- 2004
-
Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 256:6, s. 510-518
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine whether serum cystatin C is more accurate than serum creatinine in the detection of diabetic nephropathy, also after adjustment for age.METHODS: Forty-one patients with type 1 and 82 patients with type 2 diabetes were evaluated with serum creatinine, serum cystatin C, and (51)Cr-EDTA clearance (reference method). Cystatin C was measured by a particle-enhanced turbidimetric method and creatinine by an enzymatic method. Statistical estimations were performed both without and with age adjustment created by z-scores for (51)Cr-EDTA clearance, creatinine, and cystatin C. The cut-off levels for glomerular filtration rate (GFR) ((51)Cr-EDTA clearance) were 60 and 80 mL min(-1) 1.73 m(-2), respectively, in absolute values and 80, 90 and 95% CIs, respectively, in age-adjusted values (z-scores).RESULTS: Estimations without age adjustment showed significantly (P = 0.0132) closer correlation for cystatin C (r = 0.817) versus (51)Cr-EDTA clearance as compared with creatinine (r = 0.678). However, when using age-adjusted values, the correlation for cystatin C and creatinine, respectively, versus (51)Cr-EDTA clearance did not differ. When comparing the diagnostic utilities for serum cystatin C versus serum creatinine in manifest renal impairment (GFR < 60 mL min(-1) 1.73 m(-2) or z-scores <-1.28 SD), there were no significant differences between the two markers whether age adjusted or not. However, for diagnosing mild nephropathy (GFR < 80 mL min(-1) 1.73 m(-2) or z-score -0.84 SD), serum cystatin C is significantly more useful.CONCLUSIONS: Serum cystatin C performed better compared with serum creatinine even when measured enzymatically, to detect mild diabetic nephropathy. However, serum creatinine was as efficient as serum cystatin C to detect advanced diabetic nephropathy.
|
|
| 23. |
|
|
| 24. |
|
|
| 25. |
- Bornmyr, S, et al.
(författare)
-
Effect of local cold provocation on systolic blood pressure and skin blood flow in the finger
- 2001
-
Ingår i: Clinical Physiology. - : Wiley. - 1365-2281 .- 0144-5979. ; 21:5, s. 570-575
-
Tidskriftsartikel (refereegranskat)abstract
- Demonstration of increased vascular cold reactivity in patients with Raynaud's syndrome is difficult. For medico-legal reasons, it is important to get objective measures of vasospasm in these patients. Evaluation of the degree of vasospasm also provides prognostic information which is useful for patient management. In this study, we compare two methods of arterial circulation measurement. The laser Doppler scanning is a new method, which uses the recently developed laser Doppler perfusion imaging (LDPI) instrument. The aim of the present study was to compare the effect on finger skin blood flow measured with LDPI with changes in finger systolic blood pressure during local cold provocation. The effect of such provocation, skin blood flow and systolic blood pressure, were studied in 15 healthy controls. Six patients with known traumatic vasospastic disease (TVD) were also tested with both methods. Finger skin blood flow was measured with LDPI on the distal phalanx of the index finger of the left hand, every minutes during 6 min of local heating at 40 degrees C followed by local cooling for 3 min at 15 degrees C and then for 3 min at 10 degrees C. Finger systolic blood pressure was measured with strain-gauge method before and after local cooling to 10 degrees C with a cuff perfused with water of desired temperature. The test was performed in the same finger within a week of the laser Doppler scanning. Local finger cooling to 15 degrees C and 10 degrees C caused a significant decrease in blood flow, most marked at 10 degrees C. There was, however, no correlation between the decrease in blood flow and blood pressure. In the TVD-patients decreases in skin blood flow were similar compared with the healthy controls. In contrast, the changes in systolic blood pressure, were outside normal range (systolic quotient <0.65) in five of the six patients (83%), and also in 11 of the 15 healthy controls (73%). In conclusion, there is no correlation between the decrease in finger skin blood flow and systolic blood pressure during local cold provocation. For diagnosis of traumatic vasospastic disease (TVD), local cold-induced changes in finger systolic blood pressure seems superior to changes in skin blood flow, but the ideal clinical method for demonstrating increased cold-induced vasospasm is, however, still lacking.
|
|
| 26. |
- Dahlin, Lars, et al.
(författare)
-
Granular cell tumour of the ulnar nerve in a young adult.
- 2002
-
Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 36:1, s. 46-49
-
Tidskriftsartikel (refereegranskat)
|
|
| 27. |
|
|
| 28. |
- Guerin, S, et al.
(författare)
-
Radiation dose as a risk factor for malignant melanoma following childhood cancer
- 2003
-
Ingår i: European Journal of Cancer. - 1879-0852. ; 39:16, s. 2379-2386
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine therapy-related risk factors for the development of melanoma after childhood cancer. Among 4401 3-year survivors of a childhood cancer in eight French and British centres and 25 120 patients younger than 20 years old at first malignant neoplasm (FMN) extracted from the Nordic Cancer Registries, 16 patients developed a melanoma as a second malignant neoplasm (SMN). A cohort study of the French and British cohorts was performed. In a nested case-control study, the 16 patients who developed a melanoma as a SMN (cases) were matched with 3-5 controls in their respective cohort according to gender, age at the first cancer, the calendar year of occurrence of the first cancer and follow-up. Radiotherapy appeared to increase the risk of melanoma for local doses > 15 Gy, Odds Ratio (OR)= 13 (95% Confidence Interval (CI): 0.94-174). Regarding chemotherapy, we observed an increased OR for both alkylating agents and spindle inhibitors, OR 2.7 (95% CI: 0.5-14). Children treated for a gonadal tumour as a FMN were found to be at a higher risk of melanoma, OR 8.7 (95% CI: 0.9-86). The adjusted OR for the local radiation dose was 1.07 (95% CI: 1.00-1.15). In conclusion, radiotherapy may contribute to an increased risk of melanoma as a SMN, but only at very high doses of low linear energy transfer radiation. Common genetic origins between gonadal tumours and malignant melanomas are likely. (C) 2003 Elsevier Ltd. All rights reserved.
|
|
| 29. |
- Holmlund, F, et al.
(författare)
-
Sympathetic skin vasoconstriction--further evaluation using laser Doppler techniques
- 2001
-
Ingår i: Clinical Physiology. - : Wiley. - 1365-2281 .- 0144-5979. ; 21:3, s. 287-291
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to quantify the reflex sympathetic vasoconstriction in skin at different depths. Twenty healthy subjects were studied. Finger skin blood flow was measured using laser Doppler perfusion imaging (LDPI) and laser Doppler perfusion monitoring (LDPM). In LDPM, a probe with fibres separated 0.25 mm (deep) and 0.14 mm (superficial) from the illuminating fibre was used. Local heating (40 degrees C) was achieved with a Peltier element, and reflex vasoconstriction induced by immersion of the contra-lateral hand and forearm for 3 min in water at 15 degrees C. The change in skin blood flow was measured and a vasoconstriction index (VAC: cooling/before cooling) calculated. VAC indices of LDPI, LDPM-0.25 and LDPM-0.14 were 0.60, 0.59 and 0.60, respectively. The two components of the LDPM perfusion value, blood cell velocity and concentration, were studied separately. Their contributions in LDPM-0.25 were roughly the same, whereas the velocity component dominated in LDPM-0.14, although their relative responses in the two channels were similar. We conclude that sympathetic skin vasoconstriction does not significantly differ in two compartments, as probed with fibres separated by 0.25 and 0.14 mm. Blood cell velocity is influenced in a proportional way, as is concentration.
|
|
| 30. |
- Liu, Jin-Ming, et al.
(författare)
-
Alveolar albumin leakage during large tidal volume ventilation and surfactant dysfunction
- 2001
-
Ingår i: Clinical Physiology. - : Wiley. - 1365-2281 .- 0144-5979. ; 21:4, s. 421-427
-
Tidskriftsartikel (refereegranskat)abstract
- Detergent given as an aerosol and large tidal volume ventilation (LTVV) have been observed, by us, to promote lung injury by an additive effect on alveolocapillary barrier function. The surfactant system may be further damaged if protein leakage occurs into the alveoli. The aim was to study the effect of detergent and LTVV on the alveolar leakage of albumin and also the effect of detergent on surface activity of lung washings and lung tissue extracts. Technetium-99m-labelled human serum albumin was given intravenously. The alveolar leakage of albumin was measured after perturbing the surfactant system with the detergent dioctyl sodium sulfosuccinate either singly or in combination with LTVV. Four groups of rabbits were studied after 3 h of experimental ventilation. Surface tension measurements of tissue extracts, lung mechanics and gas exchange did not show any differences between groups. Wet lung weight and albumin leakage were significantly increased in the two groups subjected to LTVV compared with groups given normal tidal volume ventilation. Low doses of detergent did not affect surface activity of lung tissue extracts or alveolar leakage of albumin. LTVV increased alveolar leakage of albumin and produced oedema. No additive effect was seen when detergent and LTVV were combined.
|
|
