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Biomedical subjects

J Heerfordt

Publications and source records attributed to J Heerfordt.

At least 19 recordsLinked to original sources
PubMed1979

Scintigraphic skeletal changes in non-dialyzed patients with advanced renal failure.

Technetium-99m-polyphosphate (Tc-PP) bone scintigraphy was performed in 51 patients with advanced renal failure in order to evaluate the applicability of this method in detection of metabolic bone changes in these patients. The creatinine clearance varied from 2 to 40 ml/min and none of the patients had previously been on dialysis treatment. The scintigrams were graded according to the focal and the generalized abnormal uptake of the tracer in the skeleton. 34 patients showed generalized scintigraphic changes and among these the changes in 18 patients were classified as severe. An inverse correlation was found between the kidney function and the generalized scintigraphic classification. Focal bone changes were found in 11 patients. In order to evaluate the influence of the lack of kidney function on the scintigraphic results, 3 patients with acute oliguric renal failure were examined. All had normal scintigrams. It is concluded that Tc-PP bone scintigraphy is a sensitive method in revealing renal osteodystrophy in non-dialyzed patients with advanced renal failure in agreement with previous reports on patients on chronic hemodialysis and after kidney transplantation.

Adolescent↗
PubMed1978

Spontaneous regression of a malignant primary bone tumour.

A histologically confirmed malignant, primary bone tumour in the pelvis, presumably an osteosarcoma, underwent spontaneous regression. The large tumour was inoperable and gave rise to severe pain as well as difficulty in walking. After 2 years of progression, with increasing desition improved spontaneously, and at present the patient is alive, almost symptom-free, after 6 years follow-up.

Adult↗
PubMed1978

Hemipelvectomy. Postoperative rehabilitation assessed on the basis of 41 cases.

Rehabilitation was evaluated on the basis of 41 consecutive hemipelvectomies for malignant tumours. Owing to early metastasization and death, 11 patients were not supplied with prostheses, while prosthetic fitting was attempted in the remaining 30. Of this number 27 completed prosthetic training, with the result that 15 used their prosthesis, while 12 discarded it after some time, six because of poor general health owing to recurrence of the tumours and six because they felt that the prosthesis was too heavy and difficult to wear. Twenty-three returned to work. After elimination of the most severely tumour-affected patients, there were 19 one-year survivors without recurrence. Thirteen of them were using their prosthesis every day, and thirteen had gone back to work. Serious mental sequelae were found in five patients, including four with long-lasting exogenous depressions and one with anxiety neurosis.

Adult↗
PubMed1978

Osteosarcoma of the metatarsal bones. Review of the literature and report of a case.

A case of osteosarcoma affecting the third metatarsal bone is submitted. Below-knee amputation was performed, but the patient developed pulmonary metastases and died 1 year after the operation. The six cases of osteosarcoma in the metarsal bones published so far are reviewed. The prognosis for cases with this localization does not appear to differ from that for osteosarcoma in general.

Adult↗
PubMed1978

Numerical assessment of bone scintigraphy in primary bone tumors and tumor-like conditions.

Fifty-four tumors or tumor-like conditions in bone were studied by numerically assessed 99m-technetium polyphosphate scintigraphy. The uptake was expressed as a ratio of the uptake in the tumor region to the uptake in a corresponding region in the contralateral part of the body. In the malignant tumors there was marked variation in the uptake within each individual tumor group, a variation that rendered a differential diagnosis impossible. In general, the uptake was fairly high in malignant tumors and lower in benign ones. A ratio below 1.5 suggested the likelihood that the lesion was benign. The ratios also varied considerably with the site of the tumor and the patients' ages. Relatively low ratios were found for tumors of the trunk and for juxta-articular tumors in children, whereas higher and more varied ratios were observed in tumors of the peripheral skeleton in adults. It is concluded that numerically assessed scintigraphy is not a useful supplement to other methods used for diagnosing bone tumors.

Adolescent↗
PubMed1977

Is renal osteodystrophy reversible?

In order to investigate the possible reversibility of renal osteodystrophy, eleven necrograft recipients were investigated six years after transplantation, when treatment with prednisone had been withdrawn for 1.5 years. Serum ionised calcium, phosphorus, alkaline phosphatases, PTH, skeletal radiography, Technetium polyphosphate (Tc-PP) bone scintigraphy and radial bone mineral content (BMC) were studied. Normal blood biochemistry, radiography and Tc-PP scintigraphy were found in nine (82%) of the patients, in contrast to the considerably higher frequency of abnormalities ordinarily found in haemodialysis patients. However, the radial BMC was significantly reduced (mean 13.5%) and identical with the BMC value in haemodialysis patients. We conclude that some regression of renal osteodystrophy may take place after a successful kidney transplantation, but that decreased mineralisation of the appendicular skeleton persists. Whether this latter finding is due to long-term steroid treatment or is an indicator of an irreversible component in renal osteodystrophy cannot be stated.

Adult↗
PubMed1976

Scintigraphic skeletal changes in uremic patients on regular hemodialysis.

99Tcm-polyphosphate (Tc-PP) bone scintigraphy was performed in 30 consecutive uremic patients on regular hemodialysis and compared with a normal control group. 27 of the patients (90%) had pathological accumulation on the scintigrams, while roentgenographic abnormalities were present in only 10 patients (33%), indicating that scintigraphy is superior to X-ray in the early detection of skeletal changes in uremic patients. In the group with the most pronounced uptake on the scintigrams there was a preponderance of previously kidney-transplanted patients, while no correlation could be demonstrated between the severity of the scintigraphic findings and the duration of the hemodialysis period, the anephric state of the patients, the underlying kidney disease or the sex. It is suggested that intensive glucocorticoid treatment, even of short duration in the previously kidney-transplanted patients, may aggravate uremic osteodystrophy.

Adult↗
PubMed1976

Comparison of 18F and 99mTc-polyphosphate in orthopedic bone scintigraphy.

To compare 99mTc-polyphosphate and 18F for use in orthopedics, 79 patients were examined with both. Fifty cases were suitable for analysis. While the extraskeletal uptake of 18F was found to be negligible, 99mTc-polyphosphate may accumulate considerably in pathologic soft tissue, e.g., in soft-tissue tumors and in inflamed synovial tissue. This soft-tissue Tc accumulation may obscure the osseus uptake, notably in the examination of joint regions, commonly the regions of interest in orthopedics. After simultaneous administration of both agents, quantitative measurements were performed on specimens of bone and synovial tissue from diseased joints in human patients and in rabbits. The uptake of 99mTc-polyphosphate in synovial tissue was shown to be about seven times that of 18F, while their uptakes in bone were equal. In short, 99mTc-polyphosphate, a valuable tracer in general, is hardly the agent of choice in orthopedics.

Adult↗
PubMed1975

Tumours of the thymic region. Symptomatology, diagnosis, treatment, and prognosis.

Fifty-three patients operated on between 1952 and 1971 were originally diagnosed as having thymoma. Re-examination of the material shows that only half of these tumours were true thymomas. The rest were classified as malignant lymphomas, primary and secondary carcinomas, and a few haemangiomas. Half of the patients had symptoms at the time of diagnosis. However, in half of the asymptomatic cases the tumours had penetrated the capsule. Decisive in prognosis are the macroscopic findings around the capsule. Of 33 patients with infiltration of the capsule, 30 had died at the time of investigation. Twenty-five patients died within two years of operation, Twenty-five patients had thymomas, of which 14 were well defined. Twelve patients with thymomas suffered from myasthenia gravis. The treatment of choice of thymoma is total excision, if necessary enbloc, and if there is penetration of the capsule, radiotherapy should be given. None of the patients with a well-defined thymoma had died from their tumour while only two patients with infiltrating thymomas are still alive, Of eight patients with Hodgkin's disease located in the thymus, six had penetration of the capsule, and of these only one patient is still alive. Two patients with well-defined tumours are both alive. The treatment of localized Hodgkin's disease is excision and irradiation. The prognosis for patients with other malignant tumours was bad, the mean time of survival being less than six months.

Adolescent↗
PubMed1975

Femoral head necrosis in renal transplanted patients. Evidence of a haemodynamic etiological factor.

In a material of 197 consecutive renal allotransplanted patients, 15 patients developed femoral head necrosis on X-ray examination. Eleven of these patients developed the femoral head necrosis ipsilateral to the renal allograft. It is therefore suggested that the altered haemodynamics caused by the transplantation may be of pathogenic importance in the development of the femoral head necrosis.

Adolescent↗
PubMed1975

150 open fractures of the tibial shaft--the relation between necrosis of the skin and delayed union.

In 150 open fractures of the tibial shaft a close relationship between the presence of skin necrosis and delayed union was found. The incidence of skin necrosis rose with the severity of trauma. It was high (22 per cent) among the fractures that were treated conservatively, but even higher (41 per cent) among those treated with primary osteosynthesis. Neither conventional conservative treatment nor osteosynthesis seems to be satisfactory as a primary treatment of the most severe cases. It is instead suggested that external fixation by the Hoffmann-Vidal technique should be combined with transposition of viable muscle tissue across denuded fractured bone areas according to the method of Ger.

Adolescent↗