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Biomedical subjects

A Nyström

Publications and source records attributed to A Nyström.

At least 37 records · Page 2Linked to original sources
PubMed1993

Arterial spasticity and cold intolerance in relation to time after digital replantation.

Cold induced arterial vasospasm was studied in ten patients with single digit replantation, by measuring finger systolic pressure at different finger temperatures. Each patient was examined three times; within 2 weeks of surgery, after 1 year and after 3 years. The replantations were performed using long arterial and venous grafts. Cold-related vasospasm is established during the first year after trauma, and thereafter seems to be persistent. It is concluded that the subjective cold tolerance, which affects all patients after digital amputation regardless of whether replantation is performed or not, is partly due to vasospasm. It is less pronounced in patients without pathological vasospasm in the replanted digit. Cold intolerance is likely to decrease during the first 2 years after replantation, but not to disappear completely.

Adult↗
PubMed1993

IGF2 is parentally imprinted during human embryogenesis and in the Beckwith-Wiedemann syndrome.

The phenomenon of parental imprinting involves the preferential expression of one parental allele of a subset of chromosomal genes and has so far only been documented in the mouse. We show here, by exploiting sequence polymorphisms in exon nine of the human insulin-like growth factor 2 (IGF2) gene, that only the paternally-inherited allele is active in embryonic and extra-embryonic cells from first trimester pregnancies. In addition, only the paternal allele is expressed in tissues from a patient who suffered from Beckwith-Wiedemann syndrome. Thus the parental imprinting of IGF2 appears to be evolutionarily conserved from mouse to man and has implications for the generation of the Beckwith-Wiedemann syndrome.

Alleles↗
PubMed1992

Molecular analysis of patients with Wiedemann-Beckwith syndrome. I. Gene dosage on the short arm of chromosome 11.

Wiedemann-Beckwith syndrome (WBS) is characterised by a specific group of congenital malformations associated with an increased concurrent risk for development of a defined group of childhood neoplasms. The mode of inheritance is complex, but recently compiled family data suggest that it is an autosomal dominant trait of varying expression. It has previously been suggested that major rearrangements on the short arm of chromosome 11 may be involved in the aetiology of the disease, particularly in the region of the insulin like growth factor II (IGF-II) gene (11p15.5). This gene is thought to be parentally imprinted in the mouse and it has been suggested that in the human, duplication of the non-imprinted locus in WBS patient might lead to diploid expression of the gene and consequent general hyperplasia. This model predicts that there should be both frequent and parental origin specific duplication of the IGF-II gene in the patients. It was the aim of this study to examine the IGF-II locus and its surrounding chromosomal environment for such lesions in a large number of WBS patients. Using restriction fragment length polymorphism analysis for four linked markers on 11p and genomic clones internal to the IGF-II locus we could find no evidence of alteration or amplification of this area in any of the 11 patients investigated. In one patient who developed a Wilms tumour we could find no evidence for loss of any material on the short arm of chromosome 11 as reported previously.(ABSTRACT TRUNCATED AT 250 WORDS)

Beckwith-Wiedemann Syndrome↗
PubMed1992

Molecular analysis of patients with Wiedemann-Beckwith syndrome. II. Paternally derived disomies of chromosome 11.

In Wiedemann-Beckwith syndrome (WBS) a putative disease gene resides at the tip of the short arm of chromosome 11 in the region of the insulin growth like factor II (IGF-II) gene. Whilst changes in gene dosage in this area do not appear to be common in the syndrome, in familial cases the lesion appears to be dominant only when inherited through the female line. We undertook to examine the parental origin of the copies of chromosome 11 in a large group of WBS patients using a series of restriction fragment length polymorphisms (RFLPs) on 11p, and report here that in one sporadic case of WBS out of 14 both copies of chromosome 11 are derived from the father and are present in a normal dosage. This suggests that at least one mode of expression of the lesion is modified by genomic imprinting.

Beckwith-Wiedemann Syndrome↗
PubMed1992

Natural history of scaphoid non-union, with special reference to "asymptomatic" cases.

33 patients with non-union of the carpal scaphoid were diagnosed by X-ray examination two to 37 years following the original trauma. All of the patients could be contacted and summoned for a re-examination ten to 17 years later. X-rays revealed a 100% incidence of progressive radio-carpal osteoarthritis. It is concluded that freedom of pain is not a reliable prognostic indicator, and that all patients with non-union of the carpal scaphoid are likely to benefit from surgical treatment of the pseudarthrosis. The only exception to this rule might be the patient in whom the radio-carpal joint is already deteriorated by an advanced degenerative arthritis.

Adolescent↗
PubMed1992

Segmental metacarpal replacement with bone cement and a silicone joint prosthesis: a case report.

The replacement of the distal half of the third metacarpal and the metacarpophalangeal joint with bone cement and a silicone implant is reported. Eight years after surgery, x-ray and clinical examination revealed no evidence of instability or material failure. The active and passive range of motion in the reconstructed metacarpophalangeal joint was 35 degrees, and the hand was free of pain.

Bone Cements↗
PubMed1992

Venous anatomy of the thumb and thenar area.

The venous anatomy of the thumb and the thenar area, including the first web space, was studied after injection of a polymerizing plastic resin into the vascular tree of six fresh human cadaveric specimens. As in the previously described parts of the hand and fingers, certain anatomical features were consistently present in all examined specimens. The topography of the vessels is different from that of veins in other parts of the hand, and we conclude that this reflects differences in mechanical demands upon the soft tissues in various parts of the hand and the digits.

Hand↗
PubMed1992

Factors that influence the incidence of brachial oedema after treatment of breast cancer.

Six factors that may increase the likelihood of swelling of the arm after treatment of breast cancer were investigated in 136 patients who had undergone treatment. The highest incidence of oedema was among patients who had received radiotherapy in high doses with few fractions to the axilla (60%), and in patients with a history of one or more infections in the arm on the operated side (89%). Overweight, oblique surgical incision, infection in the arm, and radiotherapy correlated with arm swelling. The age of the patient and whether the operation had been done on the dominant or non-dominant side correlated less with the incidence of oedema.

Adult↗
PubMed1991

Cold-induced arterial spasm after digital amputation.

The incidence and intensity of cold-induced digital vasospasm was investigated in 18 patients with digital amputation injuries. Nine patients had undergone replantation surgery, while in the remaining nine cases the injury had been treated by stump revision and closure. The vascularity of the injured digits and of uninjured fingers in both hands, was studied. The results confirm that cold-induced vasospasm is no more conspicuous in replanted fingers than in amputation stumps. Pathological vascular reactions to cold were also common in uninjured fingers in both hands.

Adolescent↗
PubMed1991

Replantation of the completely avulsed thumb using long arterial and venous grafts.

Long arterial and venous grafts (10-15 cm. in length) were used in the replantation of thumbs amputated by avulsion. All replanted parts survived and thrombosis requiring anastomotic revision did not occur in any of the cases. Based upon a consideration of different factors that may lead to the formation of thrombus in reconstructed vessels, a method is recommended for routine use in replantation of the thumb, with specific reference to avulsion injuries.

Adult↗
PubMed1991

Recovery from symptoms after carpal tunnel syndrome surgery in males in relation to vibration exposure.

A follow-up study was conducted in forty-one men (fifty-five hands) treated surgically for carpal tunnel syndrome. The number of hours of vibration exposure and exactly which hand tool was used were recorded and each tool was categorized according to vibration level. The patients were divided into a low exposure and a high exposure group. Age at surgery, mean distal latency in the median nerve, and the duration between onset of symptoms and surgery were similar for the two groups. Only one patient experienced nocturnal paresthesia at follow-up in the low exposure group in contrast to twelve in the high exposure group. This corresponded to an age-standardized odds ratio (relative risk) of eighteen for nocturnal paresthesia after surgery in the high exposure group, with the low exposure group as referents. Previous vibration exposure may influence the recovery after carpal tunnel surgery.

Adult↗
PubMed1991

Effects of cold exposure on the circulation of replanted fingers during the early postoperative period.

The replanted finger after a complete amputation is an excellent model for the study of many aspects of vascular physiology. In the present clinical study, 10 patients were investigated to evaluate the incidence of cold-induced vasospasm in replanted digits during the early postoperative period. The results indicate that cold-induced vasospasm is not a risk factor in the early postoperative phase after digital-replantation surgery. It is concluded that cold-induced spasm of the digital arteries is primarily a central, nerve-mediated reflex.

Adult↗
PubMed1991

Digital amputation, replantation, and cold intolerance.

In a controlled, retrospective, clinical study, the relationships between traumatic digital amputation, digital replantation, and cold intolerance were investigated. The results of the investigation indicate that cold intolerance is a major reason for disability after digital amputation. They also indicate that the cold intolerance experienced after digital replantation is due to the original injury, and that it is not aggravated by the reconstructive surgery. Cold intolerance, in and of itself, is not a contraindication to digital replantation, regardless of whether the patient lives or works in high- or low-temperature environments.

Adolescent↗
PubMed1991

Deep venous anatomy of the human palm.

The anatomy of the deep veins of the human palm was studied in a series of dissections on 12 fresh cadaver specimens after injection of a polymerizing plastic compound into the vascular tree. Using measures of function rather than position in the hand as criteria for the classification of the vessels, six venous types were identified and characterized: arborized, arches, deep axial, web space, perforating, and synovial.

Cadaver↗
PubMed1991

Importance of time in assessing arm and hand function after treatment of breast cancer.

Ninety-three patients were examined on two occasions at 24-month intervals after surgery and irradiation for breast cancer. Stiffness of the shoulder joint, brachial oedema, pain in the arm, and the patients' subjective assessment of the degree of functional disability were registered. The results indicated that both oedema and stiffness of the shoulder joint are acceptable measures of functional impairment. We conclude, however, that such measurements should not be used as indicators of prognosis, because spontaneous improvement can occur for two years or more after treatment.

Arm↗