Biomedical subjects

E Karaharju

Publications and source records attributed to E Karaharju.

At least 19 recordsLinked to original sources

PubMed1992

Treatment of solitary plasmacytoma of the femur. A case report.

In radical tumour surgery the inevitable bone loss is considerable. If in addition the local tissues at the tumour site have been damaged by radiation therapy, massive endoprosthesis or even amputation should be considered. In cases with large bone loss, a vascularized fibular graft is one possibility to bridge the resected region. A case of a young man with a solitary plasmacytoma of the upper femoral diaphysis is presented. The lesion was reoperated 3 years after the primary diagnosis with resection of the non-ossified tumour site and reconstruction with a vascularized fibular graft.

Adult↗

PubMed1990

Collagen synthesis and mineralization in the early phase of distraction bone healing.

Corticotomy of the distal radius followed by gradual distraction by external fixation was performed on three sheep. Collagen synthesis and mineral deposition were analysed from sequential biopsies obtained from the center of the distraction area during the first 4 weeks of distraction. The whole distraction area was rapidly filled with organic matrix the amount of which, due to fluctuation in its nonprotein component, initially decreased from 88 to 66% of the level in control bone but gained its initial level in 4 weeks. Total protein in the matrix represented 70% of that in the control bone during the 4-week follow up period while the proportion of collagen of the total protein increased from 53 to 88%, a level comparable with the unoperated bone. Determination of the type of fibrillar collagen by characterization of their cyanogen bromide peptides showed that in the distraction area production of type II collagen does not occur but the heteropolymer type I (alpha 1(I)2 alpha 2(I)1) collagen represents almost totally the collagen synthesized. Deposition of mineral into the distraction gap was detectable already after 2 weeks and increased rapidly after 3 weeks of distraction. The results suggest that unlike in other processes, e.g., direct osteonal and callus-type bone repair, in distraction bone healing gradual distraction of osteotomized bone leads directly to synthesis of mature fibrous organic matrix of bone followed by its rapid mineralization.

Animals↗

PubMed1990

Ten years' experience in patients with osteogenic sarcoma in Finland.

Ten years' results of 56 patients with high grade osteogenic sarcoma are reported. Fifty-two patients had M0 disease. Immediately after open biopsy the patients were treated with chemotherapy using modified Rosen's protocols T4, T7 and T10. The primary tumor was adequately removed in most patients. Six children were treated with limb saving. The actuarial and disease-free survival was 80% after 1 year, and 73% to 8 years. Two patients died because of toxic side effects of chemotherapy, one of septicemia, the other of late cardiac failure secondary to doxorubicin.

Actuarial Analysis↗

PubMed1989

External fixation of Colles' fracture.

Radiographic and functional results of external fixation of 32 Colles' fractures were compared with the results of plaster fixation of 189 Colles' fractures. Despite the fact that the fractures treated with the external device were more unstable and comminuted, the final results were equal in both groups, and the radiographic outcome of external fixation was superior. Pin loosening decreased with predrilling rather than self-tapping. We recommend external fixation for unstable fractures of the distal forearm.

Adolescent↗

PubMed1988

Experimental lengthening of tibial diaphysis: gap healing with or without gradual distraction.

Stepwise distraction of the rabbit tibia after a transverse diaphyseal osteotomy was performed in an external fixator. The goal was to clarify the fine-structural parameters of long-bone lengthening. The tibias were vertically cut and studied 5 weeks after the osteotomy, and the specimens with an initial gap without further lengthening were compared with those with a gap and stepwise distraction. The role of periosteal bone induction was essential for the ossification of a growing gap, whereas the ossification of a simple gap proceeded equally by the endosteal and periosteal routes. The distraction resulted in vertical organization of the premature callus tissue at the proximal pole of the distracted gap, while the distal part of the gap area was deficiently filled by endosteal bone but preliminary fixed by a bridge of periosteal callus tissue.

Animals↗

PubMed1988

Heavy drinking and accidents--a prospective study among men of working age.

The injuries of 438 consecutive men of working age (20-64 years) were investigated. These patients were admitted to the Department of Orthopaedics and Traumatology of the Helsinki University Central Hospital. The MAST interview was used as the criterion for heavy drinking. Of the whole series 27.4 per cent met the heavy drinking criterion and in 36.4 per cent alcohol intoxication (AI) was present on admission. AI was more common in heavy drinkers (62 per cent) compared with the controls (23 per cent) (chi 2 test, P less than 0.001). S-GGT was elevated in 34 per cent of the heavy drinkers. Elevated levels of S-GGT among heavy drinkers also correlated with postoperative complications. The hospital stay of the heavy drinkers compared with the controls was statistically significantly longer (10.7 days versus 7.3 days). Although the proportion of alcohol intoxication among heavy drinkers was high, of the heavy drinkers almost 40 per cent were sober on admission. Interviews, such as MAST are recommended for use routinely with injured patients to assess alcohol abuse 'through accidents'.

Accidents↗

PubMed1988

Regeneration after physeal distraction of the radius in sheep.

In 18 sheep, gradual physeal distraction of the distal radius was performed by external fixation. Separation of the physis from the metaphysis occurred in all the sheep. Prior to bone formation, collagen fibers were organized according to the direction of the distraction, and lamellar bone was formed if the collagen bundles were lineally organized. In the area where the collagen was disorganized, and also near the periosteum, woven bone was first formed, which was then remodeled into lamellar bone. In some sheep separate groups of chondrocytes were isolated in the metaphyseal area after the distraction. In 2 animals a double physis was formed in the metaphyseal area. This was obviously due to the separation of proliferative chondrocytes in the metaphysis as a result of distraction. After consolidation of the distraction area, this zone of chondrocytes, located in the metaphysis, was still producing new bone 20 weeks postoperatively.

Animals↗

PubMed1988

Anatomical results after distal forearm fractures.

A radiological evaluation of 207 fractures of the distal forearm was performed. 91.5% of the fractures were of Colles' type. Almost 60% of them were intra-articular. A practical classification of Colles' fractures according to intra-articular fracture lines was shown to be useful in assessing the severity of these fractures. It correlated well with the shortening of the radius and the amount of dorsal tilt of the fractured wrist. It also seemed to predict the tendency for worsening of the position during treatment. An impairment of the position was noticed in more than 60% of cases. The anatomical result was evaluated as good or excellent in 60% of cases. Women seemed to have slightly better results. In age groups 35-44 and 45-54 years, the outcome was somewhat worse.

Adolescent↗

PubMed1988

Intervention of heavy drinking--a prospective and controlled study of 438 consecutive injured male patients.

We studied 120 injured male patients of working age who were heavy drinkers or alcoholics, obtaining seven points or more in the Michigan Alcoholism Screening Test (MAST). They were randomly allocated either to an intervention group (IG) or to a control group (CG). In addition to the MAST interview, the consumption of alcohol during the previous week prior to hospital admission was calculated and laboratory measures (serum GGT, ASAT and ALAT) were obtained. Counselling of the patients in the IG was carried out by a trained assistant nurse and a physician. Forty-nine patients in IG and 40 patients in CG were re-examined after 6 months. In the IG 45% and in the CG 20% of the patients were improved (Chi square test, P less than 0.05). Improvement criteria were a decrease in alcohol consumption by at least one-third and decrease of S-GGT by at least 20% during the follow-up period. In respect to the laboratory measures the groups were identical at the beginning of the study and after 6 months' follow-up. Our results are encouraging and suggest that the assessment of heavy drinking should be a routine in the treatment of alcohol-related injuries and that education and counselling must be intensive to be effective.

Accidents, Traffic↗

PubMed1987

Chordoma with a massive spindle-cell sarcomatous transformation. A light- and electron-microscopic and immunohistological study.

A 26-year-old woman was operated on for a bulky tumor in the sacral region; she died of massive local tumor recurrence and pulmonary metastases 3 months later. Most of the original tumor showed a highly cellular spindle-cell sarcoma compatible with a fibrosarcoma of a high grade of malignancy. In a few small areas of the tumor, a chordoma-like pattern surrounded by growth of spindle-cell sarcoma was found. The spindle-cell component exhibited vimentin positivity in all tumor cells, but many cells were also cytokeratin-positive. The chordoma-like areas showed cytokeratin in all tumor cells. The chordoma-like areas, but not the spindle-cell areas also were positive for epithelial membrane antigen and S-100 protein. This case indicates that the sarcomatous change associated with chordoma may contain keratins as a sign of epithelial differentiation, and may thus represent sarcomatous transformation of chordoma cells, rather than a coincidental soft-tissue sarcoma or collision tumor.

Adult↗

PubMed1987

Fracture repair during external fixation. Torsion tests of rabbit osteotomies.

Bone repair was studied in the rabbit tibiofibular bone after a midshaft transverse osteotomy stabilized by external fixation and heavy compression. Both subendosteal and subperiosteal callus formation with concomitant contact healing were observed within 3 weeks, and were further succeeded by subendosteal resorption and increased porosis resulting in atrophy of the cortical bone. Subjected to the torsion test, the bones exhibited restoration of strength within 3 weeks, with maximal energy absorption and elasticity at 6 weeks. The failure of the osteotomy in the torsion test, with radiographic visibility of the osteotomy, characterized the soft-tissue type of behavior of the bones. Hard-tissue like behaviour of the bones with resistance to torsion at the osteotomy site and radiographic obliteration of the osteotomy line occurred by 12 weeks, indicating complete union of the osteotomy. Our experiments demonstrate that elastic external fixation is preferable to the rigid compression plate.

Animals↗

PubMed1987

Alcohol-associated femoral head necrosis.

Fifty-seven patients with femoral head necrosis (FHN), treated since 1976 at the Orthopaedic Hospital of the Invalid Foundation, Helsinki, were studied. The incidence of alcohol-associated FHN was 29% (N = 15, 13 male) and of idiopathic FHN 11.5% (N = 10, 6 male). Nine patients with alcohol-associated FHN were heavy drinkers, four were alcoholics and two were moderate drinkers at the time of the onset of the symptoms. At follow-up 80% of the alcohol-associated cases showed increased gamma-glutamyltransferase (GGT) activity in the serum. Our findings among alcohol-associated cases support previous reports according to which disturbed liver function is an important factor in the aetiology of FHN. Because of GGT's rather high sensitivity in the detection of heavy drinking in FHN, it is recommended to be used as a diagnostic aid in suspected FHN.

Adult↗

PubMed1986

Effect of compression on fracture healing. Plate fixation studied in rabbits.

Bilateral osteotomies in rabbit tibiae were secured with six-hole rigid plates, using axial compression on the right and no compression on the left side. Histological, histomorphometric and torsiometric analysis was performed up to 24 weeks postoperatively. Histological analysis showed end-to-end primary bone healing regardless of treatment. The fracture gaps tended to be smaller in the compression osteotomies, but union was achieved within the same time on both sides, and at 6 weeks torsiometric analysis of the paired specimens revealed similar mechanical properties. By the time the fracture had united both groups of bones showed similar degrees of subendosteal resorption. As a result of this porotic transformation the strength of the cortical bone was slightly impaired from 6 weeks onward, whether or not compression had been applied. The results suggest that axial compression does not augment fracture healing of plated cortical bone.

Animals↗

PubMed1986

Alcohol and accidents. A prospective study in a casualty department.

This study examines the incidence of alcohol-related accidents among trauma patients of working age (15-64 years). The study was made during a one-week period in the Casualty Department of Orthopaedics and Traumatology of Helsinki University Central Hospital in Finland. Patients were divided into two groups according to the time of their admission. The state of alcohol intoxication was determined in Group I using a breath alcohol analyzer (alcometer) and in Group II using both alcometer and blood alcohol concentration (BAC). The frequency of alcohol-related accidents in the whole material was 32.8% (Group I 12.4% and Group II 44.5%). Four-fifths of the patients were man. A high correlation (r = 0.93) was found between alcometer and BAC. In Group II there were intoxication levels of 3% or more (mean 3.6%) in 5.7% of all patients. This is a large number of cases of heavy alcohol intoxication and we propose to take the BAC of all patients having alcometer 3% or more in order to get as accurate a diagnosis of alcohol intoxication as possible. Fights and assaults were most frequently related to the alcohol intoxication cases.

Accidents↗

PubMed1985

Flow cytometric determination of DNA content in malignant and benign bone tumours.

The nuclear DNA content of 38 malignant and 25 benign bone tumours was measured by flow cytometry. The specimens were taken either from biopsies or from surgical specimens. Seventeen of 26 primary malignant bone tumours were aneuploid, 15 had a single aneuploid DNA content, and 2 had a biclonal abnormality. Thirteen of 15 osteosarcomas were aneuploid, but only 2 of 6 chondrosarcomas showed an aneuploid DNA content. Six of 12 metastatic malignant bone tumours were also aneuploid. All 25 benign tumours had a diploid DNA content. Cell cycle analysis showed that the proportion of cells in S- and G2M-phases was higher in the malignant compared to benign tumours, indicating a higher proliferative activity. The increase was statistically significant (p less than 0.05) both in diploid and in aneuploid tumours. Among five tumours studied after chemotherapy, four displayed a marked hyperdiploid abnormality. Aneuploidy and high proliferative activity both were highly associated with malignant bone tumours, suggesting that DNA flow cytometry may be an adjunct in the assessment of malignancy of bone tumours.

Adolescent↗

PubMed1985

Pin-hole changes after external fixation of tubular bone.

K-wire-pin-induced changes in cortical bone were studied in the intact rabbit tibiofibular bone. Using a bilateral external fixator two pairs of pins were applied under compression (10 kp), under distraction (10 kp), and in a neutralization sense. After defined intervals the pin-holes were investigated macroscopically and radiologically. Reactive and resorptive changes were present in 101 of 576 (17.5%) pin-holes, infection in 13 (2.3%) pin-holes. Changes were significantly more frequent in the distal pin-holes. The appearance of the pin-holes was not influenced by the type of external fixation used nor did the occurrence depend on the duration of metal implantation.

Animals↗

PubMed1985

The halo brace in unstable fractures of the cervical spine: a review of 14 cases.

A series of 14 patients with unstable fractures of the cervical spine, treated initially with skull traction and a few days later with a halo-thoracic brace, is described. Nine of the injuries were fractures of the odontoid process and the rest were at various levels. No patient with major neurological defects was included in the halo brace treatment. The halo brace provides significant advantages, including immediate mobilization with less time in hospital and less nursing. The results of the present series are encouraging; stable conditions were achieved in all cases.

Braces↗

PubMed1985

Immunohistochemical demonstration of nociceptors in the ligamentous structures of the lumbar spine.

Substance P, a physiologically potent neuropeptide is known to participate in the sensory, and especially nociceptive, transmission of neural impulses. On histologic grounds, the nerve terminals of the sinuvertebral nerve formerly have been suggested to be sensory in character and to mediate the low-back pain syndrome. Samples of paramedullary ligamentous structures were collected on disc operations. A positive immunoreaction as an indicator of substance P was confirmed in some nerve terminals of the posterior longitudinal ligament. Neither the yellow ligament nor the intervertebral disc showed such nociceptive-type nerves.

Humans↗