| 1. |
- Johansson, Arne G., et al.
(författare)
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A four-year clinical and sonographic longitudinal follow-up of clubfeet treated according to Ponseti with normal references
- 2023
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Ingår i: Journal of Childrens Orthopaedics. - 1863-2521. ; 17:3, s. 212-223
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Tidskriftsartikel (refereegranskat)abstract
- Purpose:To follow children with a clubfoot by ultrasonography during the entire treatment period up to 4 years and compare with controls. Method:Thirty clubfeet in 20 children treated using the Ponseti method and 29 controls were followed by repeated ultrasonography investigations from neonates to the age of 4 years. The previously established coronal medial and lateral, sagittal dorsal and posterior projections were used. Changes over time, correlations to the Dimeglio score, and the course of treatment were studied. Results:The medial malleolus-navicular distance was shorter, while the talar tangent-navicular distance and the talo-navicular angle were larger in clubfeet than in controls even after the initial correction. The healthy feet in unilateral cases did not differ significantly from the controls. The range of motion in the talo-navicular joint was approximately 20 degrees less in clubfeet than in controls during the first four years of life. The medial malleolus-navicular distance (r = -0.58) and the talo-navicular angle (r = 0.66) at the first ultrasonography showed the highest correlation to the number of casts needed to correct the deformities. Conclusion:Ultrasonography can be used to evaluate the initial degree of deformities in clubfeet and to follow the progress of the treatment and growth. Ultrasonography showed a clear difference between clubfeet and controls during the first four years of life. Although it was not possible to define specific limit values as benchmarks in the treatment, dynamic ultrasonography can provide valuable support in the decision-making process when complementary treatment may be needed.
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| 2. |
- Johansson, Arne G., et al.
(författare)
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Range of motion in the talo-navicular and the calcaneo-cuboid joints evaluated by ultrasound during clubfoot treatment with normal references up to the age of four years
- 2018
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Ingår i: Journal of Childrens Orthopaedics. - : SAGE Publications. - 1863-2521 .- 1863-2548. ; 12:5, s. 526-538
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Previous ultrasound studies of clubfeet have mainly focused on the first year of life. The purpose of this study was to improve the evaluation of the talo-navicular and calcaneo-cuboid joints by adding new variables, evaluating the repeatability of ultrasound measurements for normal feet and clubfeet and establishing values for normal feet up to four years of age. Methods A control group of 105 children divided into ten age groups, and 71 clubfeet in 46 children were examined. Four new variables were introduced: medial malleolus-Talar head-Navicular distance, medial tangent of the talus to the medial border of the navicular distance, the angle between the longitudinal axis of the talus and a line from the centre of the talar head to the medial corner of the navicular, the angle between the lateral borders of the calcaneus and the cuboid. The mobility in the talo-navicular and the calcaneo-cuboid joints was assessed by comparing measurements with the foot in adduction and abduction. Results The variables could be assessed with fair to very good intra- and inter-observer repeatability (intraclass correlation coefficient > 0.8 and >= 0.6, respectively), with a few exceptions. There was less movement in talo-navicular and calcaneo-cu boid joints in clubfeet than in controls. Conclusion Morphology of normal feet and clubfeet, as well as mobility in the talo-navicular and calcaneo-cuboid joints, can be assessed by ultrasound with a fair to very good reliability from birth to the age of four years.
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| 3. |
- Nannmark, Ulf, 1958, et al.
(författare)
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Indomethacin, (-)-terbutaline (beta 2 agonist), and (+)-terbutaline in acute inflammation induced by repeated ischemia in hamster cheek pouch.
- 1985
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Ingår i: Inflammation. - : Springer Science and Business Media LLC. - 0360-3997 .- 1573-2576. ; 9:2, s. 173-81
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Tidskriftsartikel (refereegranskat)abstract
- A mild and controlled acute inflammatory reaction in hamster cheek pouch was created without any exogenous, but rather by locally activated and liberated, mediators. A pressure of 60 mm Hg was applied to part of the everted cheek pouch eight times with a 10-min recovery period in between. The microvascular response was followed by intravital microscopy and the permeability changes were monitored with intravital fluoroscopy and intravenous FITC dextran (mol wt 150,000). The number of extravasated polymorphonuclear leukocytes (PMNLs) was calculated by a new, whole tissue, histological technique. In three experimental groups (-)-terbutaline (beta 2-receptor agonist) 0.05 mg/100 g body wt., (+)-terbutaline 0.05 mg/100 g body wt., and indomethacin 2 mg/100 g body wt. was given intravenously before pressure was applied. A fourth group, with no drug given, served as control. There was a rapid increase in the number of FITC dextran leakages and extravasated PMNLs in the control group. Indomethacin almost completely inhibited FITC dextran permeability and extravasation of PMNLs. The beta 2 agonist markedly diminished the number of FITC dextran leakages for 75 min. The number of extravasated PMNLs was also reduced. Treatment with (+)-terbutaline, which is supposed to have no beta 2-receptor effect, gave a slight reduction in number of FITC dextran leakages and almost a complete inhibition of PMNL extravasation. Thus we conclude that indomethacin is a very potent antiinflammatory agent even in the early phase of inflammation. (-)-Terbutaline diminished the inflammatory response, probably by preventing endothelial gap formation. (+)-Terbutaline prevented PMNL extravasation either by interaction with the PMNL itself or with the endothelium.
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| 4. |
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| 5. |
- Vujic, Mihailo, 1945, et al.
(författare)
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Hereditary multiple and isolated sporadic exostoses in the same kindred : identification of the causative gene (EXT2) and detection of a new mutation, nt112delAT, that distinguishes the two phenotypes.
- 2004
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Ingår i: International Journal of Molecular Medicine. - : Spandidos Publications. - 1107-3756 .- 1791-244X. ; 13:1, s. 47-52
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Tidskriftsartikel (refereegranskat)abstract
- Hereditary multiple exostoses (HME) is a well known autosomal dominant hereditary orthopedic disorder. Isolated exostoses, on the other hand, occur as sporadic events or as secondary post-traumatic sequel. The occurrence of solitary exostoses in individuals from pedigrees affected with HME may distort conclusions about carrier status and/or diagnosis. Both conditions are potentially malignant and both are associated with genetic alterations in either EXT1 or EXT2 genes. In this study, we present a seven-generation family from western Sweden consisting of 170 blood relatives, 38 of whom had multiple cartilaginous exostoses, while 8 had isolated exostoses. Linkage analysis aimed to discern one of the known EXT genes demonstrated linkage of the HME phenotype to the EXT2 gene. Subsequent mutation analysis revealed a novel mutation, nt112delAT, in this gene. All carriers of the detected mutation had multiple exostoses, indicating full penetrance. None of the pedigree members with isolated exostoses were carriers of the detected mutation. Two of the mutation carriers developed chondrosarcoma yielding a 5.2% risk of malignant development for this mutation. The detection of this mutation has enabled us to provide appropriate genetic counseling concerning this complex situation.
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| 6. |
- Zügner, Roland, 1958, et al.
(författare)
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Stable Fixation but Unpredictable Bone Remodelling Around the Lord Stem: Minimum 23-Year Follow-Up of 66 Total Hip Arthroplasties.
- 2013
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Ingår i: The Journal of arthroplasty. - : Elsevier BV. - 1532-8406 .- 0883-5403. ; 28:4, s. 644-649
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Tidskriftsartikel (refereegranskat)abstract
- Early designs of uncemented hip implants turned out to be failures mainly because the prerequisites for durable implant fixation were unknown. One exception was the chrome-cobalt stem of the Madreporic Lord prosthesis. We prospectively studied this prosthetic design in 107 hips that underwent surgery in 1979-1986. At the last follow-up, five stems and 54 cups had been revised, corresponding to stem and cup survival rates of 92%±3% and 45%±5% at 26years. In all, 66 hips with remaining Lord stems were available for clinical follow-up 26years (24-29) after the index operation. The mean total Harris hip and pain scores were 81 (SD 14) and 41 (SD 5).
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