The frequency and causes of reversal from negative to positive bacteriological tests in root canal therapy.
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Biomedical subjects
Publications and source records attributed to B Engström.
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In Sweden, competitive exclusion (CE) treatment has been used since 1981 as a part of the national control programme for Salmonella. According to the programme all broiler flocks are tested for Salmonella before slaughter thus providing an evaluation of CE treatment. The CE culture used is mainly for the two consecutive flocks raised in a unit after a Salmonella-infected flock has been identified. During the period 1981-1990 Ce culture has been given to 179 flocks, involving 3.82 million chickens. Only one of the treated flocks was found to be Salmonella-positive. A special study during a period when Salmonella was spread by contaminated feed demonstrated that CE treatment was effective in controlling Salmonella under field conditions. A likely contributory factor is that the hatcheries in Sweden can be claimed to be Salmonella-free. In addition, the control programme and related action, have led to a very low incidence of Salmonella in broiler chickens. A nationwide study carried out in 1990 demonstrated that less than 1% of broiler chickens was contaminated with Salmonella after slaughter.
Performing arthroscopic anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone autograft normally includes placing sutures in the femoral bone plug to be able to pull the graft through the joint, and in the tibial bone plug to be able to apply tension to the graft as you insert the distal interference screw. We have used one No. 5 Ethibond suture (Ethicon, Somerville, NJ) for the femoral bone plug, and normally place two similar sutures into the tibial bone plug. This is to reduce the risk of loosing tension if one of the sutures is cut while inserting the tibial fixation screw. This article suggests a solution to the problems that will arise in cases of accidentally cutting both of the sutures in the tibial bone plug.
Nivalenol has been analysed in Swedish cereals between 1987 and 1990 and it was found in oats (35% of all samples), barley (13%) and wheat (4%), with a high yearly variation. The highest concentration was 4700 micrograms/kg. Nivalenol-producing strains of Fusarium poae were isolated from contaminated samples. Feeding nivalenol to chicks produced no toxic effects at concentrations below 5 mg/kg and only small effects at 6 and 12 mg/kg.
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Injuries occurring in three Swedish elite soccer teams were analyzed during 1 year. A total of 49 of 64 players (75%) sustained 85 injuries. The incidence of injury during games was 13 injuries per 1000 hours, while the incidence during training was 3 injuries per 1000 hours. Twenty percent of the injuries required hospital facilities. The majority of the traumatic injuries (93%) were to the lower extremities, with one third of the total injuries occurring in the knee. Overuse injuries accounted for 35% of all injuries and occurred mainly during preseason training and at the end of each season. Conversely, the majority of traumatic injuries occurred during games, equally distributed between the first and second halves with a predominance toward the end of each half. The position of the player within the team did not influence injury rate. The referee considered 28% of the traumatic injuries to be caused by violation of existing rules. Thirty-four percent of the injuries were major, causing more than 1 month of absence from training and/or games. Eleven knee injuries required surgical intervention revealing seven ruptured ACLs, of which three were chronic. At followup, 9 to 18.5 months after injury, 4 of 12 players with major knee injuries had returned to play at the elite level. The others had either been transferred to lower divisions or were still in rehabilitation.
Injuries occurring in two female elite soccer teams were recorded during 1 year. Of 41 players, 33 (80%) sustained 78 injuries. The incidence of injury during games was 24/1000 hours, while the incidence during training was 7/1000 hours. The majority (88%) of injuries were localized to the lower extremities, with equal occurrence in the left and right legs. Forty-nine percent of the injuries occurred in the knee or ankle. Most of the injuries were minor (49%), while 36% were moderate and 15% were major. Of the major injuries (N = 12), 10 were due to trauma and 7 (58%) were knee ligament or meniscal tears. Overuse injuries constituted 28% of all injuries and occurred mainly during preseason training and at the beginning and end of the competitive season. Traumatic injuries (72%) occurred mainly during games with a predominance at the beginning of the competitive season. Almost 80% of the traumatic injuries occurred during physical contact with an opponent. Extrinsic factors such as weather, playing surface, temperature, or the position of the player within the team did not influence the injury rate. We conclude that female elite soccer players sustain a high incidence of injury. Few injuries were major, but 17% of the players sustained a major knee injury during the year.
A functional analysis, including Rowe score and measurements of isokinetic peak torque and range of motion of the shoulder, and a subjective assessment were performed in 26 consecutive patients (23 males and 3 females) with unoperated anterior shoulder instability. Patients experienced the initial dislocation at an average age of 23 +/- 8 years and 58% occurred during sports activity. No patient had gone through any controlled rehabilitation program. In this study, an average of 7 years (range, 1 to 28) had passed since the initial dislocation. Fifty-nine percent of the patients complained of markedly reduced ability to perform in sports because of instability, impaired strength, decreased range of motion, and pain induced by activity. The majority (65%) of the patients reported instability only during physical activity. The average Rowe score was 68 +/- 14 on a scale of 100. In comparison with the healthy side, the injured shoulder had a significantly lower isokinetic peak torque during abduction and internal rotation, as well as a reduced range of motion in extension, abduction, and external rotation, but not in flexion. The severity of impairment (Rowe score, deficit in range of motion, and peak torque) was not related to the number of dislocations sustained or to the duration of instability.
Four patients suffering from Meniere's disease were labyrinthectomized. Maculae utriculi were removed and studied by electron microscopy. The neuro-epithelia from all four patients appeared fairly normal, considering the age of the patients. However, two types of degenerative change, which could be related to the inner ear disorder, could be distinguished. One was vacuolation of the sensory cell cytoplasm, followed by pycnosis of the nucleus and cell death. The other was cystic degeneration. This started with localized separations between the sensory cell and the nerve chalice. These separations developed into a single cystic cavity. A few large intra-epithelial cysts were found, probably representing the final stage of the cystic degenerative process.
Thresholds of audibility were determined in rabbits with a behavioral 'conditioned suppression' technique and with brain stem evoked response to band-pass (1/3 and 1/1 octave) filtered sine waves. Both techniques yield threshold curves with the same shape, the ABR threshold being 10-20 dB less sensitive. In rabbits with cochlear lesions (noise or kanamycin), hearing losses obtained with the two methods are very similar. It is concluded that the hearing threshold in rabbits can be obtained both electrophysiologically and behaviorally with techniques suitable for experimental auditory research.
Shipyard noise is a variable noise which induces permanent threshold shift (PTS) in exposed workers. In humans, the stapedius reflex has been found to be very stable in this type of exposure. Temporary threshold shift (TTS) in the absence of stapedius reflex has been found to extend downwards through the speech-frequencies instead of showing a high frequency dip as when the stapedius reflex is normal. The features of PTS produced by the same type of noise was investigated in rabbits with and without functioning middle ear muscles. The auditory sensitivity was measured by auditory brain stem response (ABR) and by the stapedius reflex response. Middle ear muscle function was blocked by denervation of the stapedius muscle or by general anesthesia. With normal middle ear reflex very little PTS was found. When the muscles were inactivated during the noise exposure the PTS was very extensive and covered the mid frequency range. On the basis of previous findings in humans and the present animal study it is suggested that the features of the stapedius reflex should be considered both in assessment of individual susceptibility and design of optimal acoustic environments.
Cochlear blood flow was studied with the microsphere method in young and old normotensive and spontaneously hypertensive rats. The young animals were 3-6 months old and the old ones 18-24 months. The cochlear blood flow in young rats was 1.64 microliter/min/cochlea for the normotensive and 1.51 for the spontaneously hypertensive rats. In the old rats, the cochlear blood flow rates were 1.40 and 1.29 microliter/min/cochlea, respectively. The differences were not significant between the age groups, nor between the normotensive and spontaneously hypertensive rats. However, there was a tendency towards lower cochlear blood flow with increasing age, especially among the spontaneously hypertensive rats. The difference between young normotensive and old spontaneously hypertensive rats was significant (p less than 0.05). The group of old hypertensive rats was also the only one with evident morphological changes in the organ of Corti.
Cochlear blood flow was measured in rats with a known noise-induced hearing loss, using the microsphere technique. The animals were exposed to simulated industrial noise for 3 months. The rats were divided into four groups: young and old; normotensive (N) and spontaneously hypertensive (SH). The mean values of the cochlear blood flows were compared with those of rats from matched groups not exposed to noise. The mean cochlear blood flow in the noise-exposed groups was lower than in the non-exposed groups. The decrease in cochlear blood flow was significant for all groups except young SH rats and was more pronounced in the older age group. Cochleas from the groups of old N and SH rats were investigated in the scanning electron microscope. Extensive changes were far more common in SH than in N rats.
The stria vascularis is an important functional element in the mammalian cochlea. This special tissue is considered to be the source of the endocochlear potential and thus the driving force for the production of a receptor response to the auditory stimulus. In order to maintain its function, the stria vascularis needs to be separated from the endolymphatic space by a tight seal. This seal is comprised of tight junctions in the marginal cell layer. The junctional arrangement in the stria vascularis is described, utilizing the freeze-fracturing technique which allows the visualization of large expansions of plasma membrane. The marginal cells are generally separated by tight junctions of the moderately tight to tight type. In places, however, even so-called leaky junctions with only a few sealing strands are present. Whereas the intermediate cell layer seems to lack tight junctions, the basal cells are connected by extensive tight junctions more or less covering the entire cell. These junctions seem to form an extremely tight barrier against the spiral ligament. Gap junctions are also present in the tissue. Intermediate cells as well as the basal cells are coupled by gap junctions. In the basal cell layer, gap junctional elements may also be found inside the large tight junctions comprising so-called mixed junctions.