| 41. |
- Flygare, Lennart, et al.
(författare)
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Cartilage matrix macromolecules in lavage fluid of temporomandibular joints before and 6 months after diskectomy
- 1997
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Ingår i: European Journal of Oral Sciences. - : Wiley-Blackwell. - 0909-8836 .- 1600-0722. ; 105:4, s. 369-372
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to investigate if antigenic fragments of aggrecan and cartilage oligomeric matrix protein (COMP) are detectable by enzyme-linked immunosorbent assay in lavage fluids from the temporomandibular joint (TMJ) and to examine if the relative content of these cartilage markers changes during development of osteoarthrosis (OA) after diskectomy. Lavage fluid was obtained at surgery and 6 months postoperatively in 13 patients. Computed tomography or magnetic resonance imaging was without evidence of hard-tissue changes prior to surgery in all patients. In 9 of the patients, sufficient material for analysis was obtained at both examinations. Aggrecan and COMP were detectable in all but 2 fluids, in which the COMP levels were below detection limit. The aggrecan/COMP ratio increased in all 9 patients during the 6-month period, indicating increased release of aggrecan relative to COMP fragments. The changed aggrecan/COMP ratio possibly reflects increased cartilage turnover during development of OA. Changes compatible with OA were present on computed tomography in all cases at the 6-month follow-up. This study shows that the lavage procedure is feasible for obtaining synovial fluid from the TMJ for immunochemical analyses of tissue-derived macromolecules.
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| 42. |
- Flygare, Lennart, et al.
(författare)
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Chronic recurrent multifocal osteomyelitis involving both jaws : report of a case including magnetic resonance correlation
- 1997
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Ingår i: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. - : Elsevier. - 1079-2104 .- 1528-395X. ; 83:2, s. 300-305
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Tidskriftsartikel (refereegranskat)abstract
- A case of chronic recurrent multifocal osteomyelitis in a 14-year-old girl is presented. The disease had an initial aggressive osteolytic appearance involving both the maxilla and the mandible. Conservative treatment with minimal surgical intervention has been successful in this case during a 2-year follow-up period. The value of magnetic resonance imaging and bone scintigraphy in this case and the cause of chronic recurrent multifocal osteomyelitis is discussed.
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| 43. |
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| 44. |
- Holtås, Stig, et al.
(författare)
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Epilepsiutredning. Magnettomografi allt viktigare diagnosteknik
- 1997
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Ingår i: Läkartidningen. - 0023-7205. ; 94:23, s. 2194-2200
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Tidskriftsartikel (refereegranskat)abstract
- Electroencephalography (EEG) and neuroradiology are both indispensible techniques in cases of suspected epileptic seizure, when the aim of investigation is to determine whether the seizure was of epileptic nature, and if so whether it was the result of specific provocative factors or an expression of epileptic disease. In the latter case, the epileptic condition should be classified and its aetiology determined, if possible. Routine or sleep EEG providing interictal epileptiform discharges is a useful aid to differential diagnosis. To obtain EEG recordings during actual seizures, long-term recordings, using either ambulatory equipment or an EEG-video procedure, are usually used. The combination of EEG and video recording, using surface or surgically implanted electrodes, is a procedure of major importance in the evaluation of patients refractory to medical treatment and possible candidates for epilepsy surgery. In cases of epilepsy suspected to be caused by tumour or cerebrovascular disease, neurological investigation does not differ from that routinely used in such conditions. MRI (magnetic resonance imaging) techniques have become important aids in the preoperative work-up in cases of chronic therapy-resistant partial epilepsy. MRI has also simplified the identification of minor morphological abnormalities causing partial epilepsy, and is the method of choice in such cases. The sensitivity of MRI is improved by its combination with volumetric measurements and spectroscopy. The use of functional neuroimaging with SPECT (single photon emission computed tomography) and PET (positron emission tomography) during seizures provides further information. A promising new development is the co-registration of MRI and functional imaging (dipolar reconstruction of EEG spikes and seizure patterns, SPECT, PET). MRI is a cornerstone of the preoperative work-up, but diagnosis and the choice of therapeutic approach is always based on the clinical picture, EEG, and functional and morphological imaging.
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| 45. |
- Jonsson, B, et al.
(författare)
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Forearm fractures in Malmo, Sweden. Changes in the incidence occurring during the 1950s, 1980s and 1990s
- 1999
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 70:2, s. 129-132
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Tidskriftsartikel (refereegranskat)abstract
- Between the 1950s and the 1980s, the incidence of forearm fractures increased in the city of Malmo. We have now collected data on all forearm fractures during 1991 and 1992 and compared them with previously published data from 1953-1957 and 1980-1981. During the 1990s, 1314 individuals with wrist fractures and 125 with shaft fractures were recorded. In men, we found a twofold increase in the standardized morbidity ratio (SMR) in the 1990s, compared with the 1950s. The 1990s, compared with the 1980s, showed a reduction in SMR to 0.85. In women, a comparison between the 1990s and the 1950s revealed a slight reduction in SMR, 0.9 during the 1990s. Comparison of the 1990s with the 1980s revealed a reduction in SMR to 0.7 after the age of 70 years. In individuals 60 years and older, we found a fivefold increase in the incidence of fractures of the shaft of the forearm, when comparing the 1990s with the 1980s. In women, the increase in incidence of wrist fractures appears to have been interrupted, when comparing the years 1991-1992 and 1980-1981. Among men, the incidence of wrist fractures appears to be increasing, even after the 1980s. The reduction in incidence among women may partly be explained by warmer winters during 1991-1992.
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| 46. |
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| 47. |
- Nilsson, Håkan, et al.
(författare)
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Dysphagia in stroke: a prospective study of quantitative aspects of swallowing in dysphagic patients
- 1998
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Ingår i: Dysphagia. - 1432-0460. ; 13:1, s. 32-38
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Tidskriftsartikel (refereegranskat)abstract
- This is a prospective study of 100 consecutive stroke patients. Within 24 h after stroke onset they were asked specifically about swallowing complaints and subjected to a clinical examination including neurologic examination, Mini-Mental test, and Barthel score. Dysphagic patients were examined with the repetitive oral suction swallow test (the ROSS test) for quantitative evaluation of oral and pharyngeal function at 24 h, after 1 week, and after 1 month. At 6 months, the patients were interviewed about persistent dysphagia. Seventy-two patients could respond reliably at 24 h after the stroke onset and 14 of these complained of dysphagia. Non-evaluable patients were either unconscious, aphasic, or demented. The presence of dysphagia was not influenced by age or other risk factors for stroke. Facial paresis, but no other clinical findings, were associated with dysphagia. Dysphagia 24 h after stroke increased the risk of pneumonia but did not influence the length of hospital stay, the manner of discharge from hospital, or the mortality. The initial ROSS test, during which the seated patient ingests water through a straw, was abnormal in all dysphagic stroke patients. One-third of the patients were unable to perform the test completely. Above all, dysfunction was disclosed during forced, repetitive swallow. All phases of the ingestion cycle were prolonged whereas the suction pressures, bolus volumes, and swallowing capacities were low. Abnormalities of quantitative swallowing variables decreased with time whereas the prevalences of swallowing incoordination and abnormal feeding-respiratory pattern became more frequent. After 6 months, 7 patients had persistent dysphagia. Five of these were initially non-evaluable because of unconsciousness, aphasia, or dementia.
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| 48. |
- Nilsson, Håkan, et al.
(författare)
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Oral function test for monitoring suction and swallowing in the neurologic patient
- 1995
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Ingår i: Dysphagia. - 1432-0460. ; 10:2, s. 93-100
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Tidskriftsartikel (refereegranskat)abstract
- Disturbances in swallowing are common in neurologic disease but difficult to evaluate in the clinical setting. Fundamental variables such as bolus volume, swallow capacity (volume ingested over time), and the relation between ingestion and time for important events in oral and pharyngeal swallowing have not been sufficiently studied. We therefore employed a composite method for monitoring oral and pharyngeal swallowing function: the test of Repetitive Oral Suction Swallow (the ROSS test). The technical details are described as well as preliminary results from a pilot study of 20 healthy subjects and 5 patients with neurologic swallowing impairment. The correlation with respect to time sequences for major events in bolus ingestion and oral processing as monitored by the ROSS test and by videoradiography is explained. With this simple and rapid bedside test, the immediate and long-time result of therapeutic interventions in dysphagic patients may be monitored.
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| 49. |
- Nordqvist, Anders, et al.
(författare)
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Mid-clavicle fractures in adults: end result study after conservative treatment
- 1998
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Ingår i: Journal of Orthopaedic Trauma. - 0890-5339. ; 12:8, s. 572-576
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the present study was to analyze the long-term outcome of mid-clavicle fractures in adults and to evaluate the clinical importance of displacement and fracture comminution. DESIGN: Two hundred twenty-five mid-clavicular fractures that had been nonsurgically treated at Malmo University Hospital were retrospectively evaluated, both clinically and radiographically, an average of seventeen years after injury. There were seventy-one undisplaced fractures, sixty-nine displaced two-fragment fractures, and eighty-five displaced and comminuted fractures. The average patient age at the time of trauma was thirty-three years (range 15 to 70 years). Patients were interviewed, and careful clinical and radiological examination of their shoulders was performed. Two patients had experienced transient neuritis, and another two underwent operative treatment because of progressive neuropathy. SETTING: All 225 consecutive patients were treated primarily at the Malmo University Hospital, which serves the Malmo city population (250,000). PATIENTS/PARTICIPANTS: Since the beginning of this century, all radiographs taken at the Malmo University Hospital have been classified and filed for easy retrieval. In this retrospective study, all patients treated between 1970 and 1979 were identified, and those still living were called for follow-up examination. INTERVENTION: Of the 225 fractures reviewed, 197 fractures were originally treated with a figure-of-eight splint for an average period of three weeks without any attempt to reduce the displaced fractures; twenty-four patients were allowed immediate free shoulder mobilization. MAIN OUTCOME MEASUREMENTS: Clinical rating and healing were the main outcome measurements. RESULTS: At follow-up, 185 shoulders were asymptomatic. Thirty-nine shoulders had moderate pain and were rated as fair, and one patient was rated as poor. One hundred twenty-five of the fractures had healed normally, fifty-three were malunited with persistent fracture displacement, and seven were nonunions; nonunion was significantly more prevalent in cases with displaced fractures. Forty malunited fractures and three nonunions were rated as good. CONCLUSIONS: This review demonstrates that few patients with fractures of the mid-part of the clavicle require operative treatment.
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| 50. |
- Nordqvist, Anders, et al.
(författare)
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Shortening of clavicle after fracture. Incidence and clinical significance, a 5-year follow-up of 85 patients
- 1997
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 68:4, s. 349-351
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated the incidence and clinical significance of postfracture shortening of the clavicle in 85 patients. There were 71 mid-clavicular fractures and 14 of the lateral end of the clavicle. 46 fractures were primarily undisplaced and 39 displaced. All fractures were nonoperatively treated with sling immobilization. All patients were reexamined 5 years after the fracture. 35 clavicles had healed with at least 5 mm shortening. Clavicles with originally displaced fractures were shorter and radiologically more frequently malunited. Mobility, strength and the functional Constant score were similar in the injured and normal shoulders. Our findings suggest that permanent shortening of the clavicle is common after fracture, but has no clinical significance.
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