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Biomedical subjects

J Isacson

Publications and source records attributed to J Isacson.

At least 19 recordsLinked to original sources
PubMed2000

The Wagner revision prosthesis consistently restores femoral bone structure.

The short-term results are reported for 43 hip revision operations with the long-stemmed Wagner prosthesis. The patients were followed-up for an average of 25 months. The Charnley scores were; pain 5.2, movement 4.0 and walking 4.0. All patients except one showed abundant new bone formation. The stem subsided more than 20 mm in 5 patients and in 22 the subsidence was less than 5 mm. The major complication was dislocation, which occurred in 9 patients; 8 of these were reoperated and from then on remained stable.

Aged↗
PubMed1999

Surgical hemostasis after tourniquet release does not reduce blood loss in knee replacement. A prospective randomized study of 81 patients.

We studied the effect of timing of tourniquet release on blood loss in 81 patients (85 knees) who were operated on for total knee replacement. The patients were randomly allocated to one of two groups. In one group, the tourniquet was released for hemostasis before wound closure and in the other group, the tourniquet was not released until the wound was closed and a compressive dressing applied. We found no difference in total blood loss between the two groups and conclude that intraoperative release of the tourniquet for hemostasis is not effective for reducing blood loss in total knee replacement.

Aged↗
PubMed1999

Diathermy knife does not reduce bleeding in surgery for primary hip arthroplasty. A prospective randomized study of 67 patients.

We evaluated bleeding in a prospective randomized study of 67 patients undergoing primary hip arthroplasty. In group A, all dissections were made with the diathermy knife and in group B, we used the scalpel. In both groups, bleeding points were coagulated with diathermy. The surgical approach, use of anti-coagulants and method of anesthesia were similar in the two groups. We found that use of a diathermy knife does not significantly reduce bleeding.

Adult↗
PubMed1995

Acquisition of IgG serum antibodies against two Bordetella antigens (filamentous hemagglutinin and pertactin) in children with no symptoms of pertussis.

To study the specificity of serum antibodies against filamentous hemagglutinin (FHA) and pertactin for infection with Bordetella pertussis, we followed the acquisition of IgG serum antibodies against these 2 surface proteins of the organism in children who had been vaccinated with a monocomponent pertussis toxoid vaccine and who had experienced no symptoms of pertussis. Antibodies were estimated with enzyme-linked immunosorbent assay. In Part 1 of our study 5 consecutive samples obtained between 3 and 36 months of age from 71 children were available. Most had maternally derived antibodies to FHA (70 of 71) and pertactin (51 of 71) in the 3-month sera which declined in the subsequent sera. From about 1 year of age there were small but significant increases in antibodies against both antigens. At 3 years of age 71 of 71 had antibodies to FHA and 58 of 71 had antibodies to pertactin. In Part 2 of our study sera from 109 three-year old children were available. The 12 children with a history of family exposure to pertussis had significantly higher geometric mean titers of FHA antibodies than the 97 children with no history of family exposure. The geometric mean titers of pertactin antibodies did not differ. We suggest 3 explanations for the acquisition of FHA and pertactin antibodies in children with no history of pertussis: (1) asymptomatic B. pertussis infection in vaccinated children; (2) infection with Bordetella parapertussis; (3) infection with cross-reacting antigens from other organisms, e.g., nonencapsulated Haemophilus influenzae.

Adhesins, Bacterial↗
PubMed1995

Response and decline of serum IgG antibodies to pertussis toxin, filamentous hemagglutinin and pertactin in children with pertussis.

The serum IgG antibody response and decrease to 3 Bordetella pertussis antigens was compared in children with pertussis. Sera were obtained at the first clinical visit and 1, 3 and 12 months later from 89 children with > or = 3 weeks of paroxysmal cough. IgG antibodies to pertussis toxin (PT), to filamentous hemagglutinin (FHA) and to pertactin were determined with ELISA. Of 54 children with culture-confirmed pertussis or culture-confirmed familial exposure, 45 (83%) had a significant (> or = 3 fold) increase in PT IgG and 40 (74%) in FHA IgG antibodies, while only 29 (54%) had a significant increase in pertactin IgG antibodies. Significant decreases in PT, FHA and pertactin IgG antibodies were found in 34 (63%), 9 (17%) and 28 (52%) children, respectively. In the remaining 35 who did not have culture-confirmed disease, significant PT and/or FHA IgG antibody increases (criteria for pertussis according to the WHO definition) were found in 17 (49%). Only 6 of these 17 children had a significant pertactin IgG antibody increase. Of the remaining 18 children (who did not fulfil WHO criteria for pertussis), significant decreases in PT and/or FHA IgG antibodies were found in 13. We conclude that a serum IgG reaction to PT and FHA occurs in almost all children with pertussis. An increase in pertactin IgG antibodies occurs less frequently than against PT and FHA. Significant decreases in PT or FHA IgG antibodies in children with clinical pertussis might be of use as a diagnostic criterion in children brought late for examination.

Adhesins, Bacterial↗
PubMed1994

Gadolinium-enhanced magnetic resonance imaging of 36 patients one year after lumbar disc resection.

A prospective study of 36 patients with radicular leg pain and lumbar herniation who underwent single-level disc resection is presented. Clinical follow-up was combined with a gadolinium-DPTA MRI examination, 1 year after surgery. Disc herniation was still present in eight patients and four of these did not have any significant radicular pain. Another 15 patients had a small protrusion at the site of the former herniation. Twenty-three patients showed evidence of scar tissue. The nerve root was displaced in 12 patients and was thickened in 16 patients, respectively. Clinically, 19 patients recovered from leg pain, 14 patients improved, and 3 patients remained unchanged compared with preoperative symptoms. There was no consistent correlation between postoperative back pain or radicular leg pain and MR findings.

Adolescent↗
PubMed1994

Comparison of contrast-enhanced computed tomography and gadolinium-enhanced magnetic resonance imaging one year after lumbar discectomy.

Computed tomography (CT) and magnetic resonance imaging (MRI) with intravenous contrast were performed on a prospective group of 35 consecutive patients 1 year after surgery for disc herniation. The aim of the study was to compare the two methods in the analysis of postoperative changes. Computed tomography showed, compared with MRI, more extensive scar tissue in 12 patients and increased deformation of the dural sac in 5 patients. However, the nerve root was better delineated by MRI, and this facilitated the assessment of root thickening in 13 patients and root displacement, which could not be seen by CT in seven patients. MRI revealed four small protrusions that were not visible with CT. The two methods were found to be of equal value in regard to findings such as disc herniations and foraminal stenosis, which might influence the surgeons decision to perform repeat surgery.

Adolescent↗
PubMed1994

Safety, immunogenicity and an open, retrospective study of efficacy of a monocomponent pertussis toxoid vaccine in infants.

One hundred forty-five infants were vaccinated with 25 micrograms of pertussis toxoid (NICHD-Ptxd) at 3, 5 and 7 or at 3, 5 and 12 months of age. One month after the third vaccination all had high serum IgG and neutralizing antibodies (antitoxin) against pertussis toxin. Vaccination at 3, 5 and 12 months resulted in higher antibody titers than vaccination at 3, 5 and 7 months. Sera obtained from 109 children at 3 years of age showed a decline of antibodies, but all had detectable antibodies. Adverse reactions were confined to local redness and swelling, which exceeded 2 cm after 17% of all injections. When the children were 3 years old, a comparison was made of the incidence of clinical pertussis in 142 of the 145 vaccinated children and in 284 age-matched controls living in the same areas. Information on symptoms of pertussis was obtained from the parents during telephone interviews. None of the vaccinated children had clinical pertussis, defined as a 6-week course of paroxysmal cough with whooping attacks or vomiting, whereas 57 controls (20%) had experienced these symptoms. Sixteen vaccinated children were exposed to pertussis in the household. Two of them had laboratory-verified Bordetella pertussis infections with cough of 2 and 4 weeks, respectively, without whooping attacks or vomiting, whereas 14 did not develop a cough. The study shows that NICHD-Ptxd is immunogenic in infants and that it most likely confers a high degree of protection against pertussis.

Antibodies, Bacterial↗
PubMed1993

How common is whooping cough in a nonvaccinating country?

In Sweden general vaccination with a whole cell pertussis vaccine was recommended from 1953. In 1979 the recommendation was withdrawn because the Swedish-made vaccine had become ineffective. In order to determine the incidence of the disease in a nonvaccinating country, 400 children born in 1980 were randomly selected from the population register of Göteborg, Sweden. The parents of the children were interviewed in 1990, when the children were 10 years old. The parents of 377 children could be reached, and of those 372 were not vaccinated against pertussis. Of the nonvaccinated children 61% had experienced clinically typical whooping cough; 195 (119 with and 76 without a history of whooping cough) agreed to donate a serum sample for determination of antibodies against pertussis toxin, filamentous hemagglutinin and pertactin. Of the children with a history of whooping cough, 91% had antibodies against pertussis toxin, as had 64% of the children without a history of disease. All but 3 children had antibodies against filamentous hemagglutinin and all 195 children had antibodies against pertactin. The antibody titers against the 2 last mentioned proteins did not differ between children with and without a history of whooping cough or between children with and without antibodies against pertussis toxin.

Antibodies, Bacterial↗
PubMed1993

Does microscopic removal of lumbar disc herniation lead to better results than the standard procedure? Results of a one-year randomized study.

Sixty patients with single-level lumbar disc herniation confirmed by computerized tomography were studied in a randomized prospective study. The aim was to see if there was any difference between the microscopic removal of a disc herniation and the standard procedure. All patients were operated on by the same surgeon by either method. They were all followed up by an impartial observer at 3 weeks, 2 months, 6 months, and 1 year. There were no differences between the groups regarding perioperative bleeding, complications, inpatient stay, time off work, or end result. The authors concluded that the decision to use the operating microscope may be left to the surgeon, because it had no effect on the short-term results or those at 1 year.

Adolescent↗
PubMed1989

Cauda equina syndrome with normal lumbar myelography.

The consequences of signs of emergency compression of cauda equina in combination with a normal lumbar myelography are reported in 19 patients. Two of them had a tumor and a herniated disc, respectively, in the thoracic spine discovered by a second myelography. One patient was considered to have a hysterical paresis. In 3 patients the symptoms were attributed to diseases not related to the spine. Thirteen patients recovered spontaneously. We conclude that the prognosis for patients with signs of compression of the cauda equina is favorable provided the myelography is normal; surgical exploration is then not indicated. However, if severe unexplained symptoms persist and computed tomography is normal, myelography of the thoracic spine should be considered.

Acute Disease↗
PubMed1988

Gait in rheumatoid arthritis: an electrogoniometric investigation.

For the purpose of detecting early aberrations of gait in rheumatoid arthritis 17 women suffering from that disease were examined. They were all under 50 years of age and had an essentially normal range of motility in the hips, knees and ankles. Eleven healthy women walking at voluntary speed and 6 healthy women walking at the same slow speed as the RA patients were included as controls. The recordings were made while the subject walked on a treadmill with a computerized electrogoniometer measuring the angular excursions of the hip, knee and ankle in three planes simultaneously. The patients with RA walked at a slower speed than did the healthy subjects (0.6 vs 1.2 ms-1). The angular excursions, i.e. inward and outward rotation, abduction and adduction, flexion and extension, were significantly less in the RA patients than in the healthy subjects who walked at voluntary speed. As compared to the healthy subjects walking at a slow speed, the differences in range of motility were much smaller. The major aberrations of the gait pattern were found in the ankles and feet, which showed reduced internal rotation (7 vs 10 degrees), adduction (6 vs 12 degrees) and a less pronounced plantar flexion at toe off (1 vs 8 degrees).

Adult↗
PubMed1988

17-year follow-up of symptoms and signs in the knee joint in rheumatoid arthritis.

A population survey was carried out in Stockholm, Sweden, in 1967. In a sample of 15,268 individuals, 239 were found to have rheumatoid arthritis according to the New York diagnostic criteria. In 1983, i.e. 17 years later, 109 of the 127 individuals still living were reexamined. Among these, 79 complained of knee symptoms and 30 stated that the knee was the joint that presented the greatest hindrance to walking. Fifty-nine found difficulty in walking up or down stairs and 47 had to use a walking aid. These shortcomings were more often noted in the knees that had been swollen, or painful, 17 years previously. In addition, at follow-up, narrowing of the articular space was observed in the knees that were swollen and painful. Valgus deformity was associated with swelling, while varus deformity also involved, apart from the swelling, pain and restricted motility. In all, 108 operations were performed on 48 of the 109 subjects who were re-examined; 12 of these were knee operations.

Aged↗
PubMed1988

Scintigraphic findings in the rheumatoid knee joint.

An increased uptake of 99m-technetium methylenediphosphonate was found in 42 knees of 24 patients afflicted with rheumatoid arthritis. All the 23 knees which were painful and the 21 knees which had synovitis showed an increased concentration of isotope. Articular space narrowing was observed in 26 joints, all but one of which were subjected to increased isotopic accumulation and synovitis. The degree of radiologic cartilage destruction correlated significantly with the isotopic uptake. In the early stages of rheumatoid arthritis, the isotopic uptake was found to be heterogeneous within the joint in one half of the cases. In the later stages, with a narrowed articular space and valgus angulation, the isotope was concentrated to the lateral side of the joint, while joints with varus angulation had a more symmetric distribution. The degree and distribution of uptake seemed to be governed by several factors, among others, inflammatory activity and mechanical load.

Adult↗
PubMed1987

A seventeen-year follow-up of a population survey of rheumatoid arthritis.

A population survey was carried out in Stockholm during the period 1965-67 for the purpose of determining the prevalence of rheumatoid arthritis (RA). 239 subjects with RA were found in a random sample of 15,268. In 1983, 17 years later, all the 127 persons still living could be traced, 109 of whom were re-examined. In 95, all the information required to satisfy the New York diagnostic criteria was available, i.e. with radiographs of the hands and feet and a Waaler-Rose test. The number of subjects with involvement of at least 3 joints (criterion No. 2) had decreased from 72 to 36, while the persons with a positive Waaler-Rose test (criterion No. 3) had increased from 9 to 18. The total number of fulfilled criteria showed a reduction from a median of 2 criteria to 1. The Steinbrocker functional class remained unchanged for the group as a whole (median Class 2), with a significant deterioration only in the oldest age-group (from 2 to 3). The knee was most often the single joint in which the disease had started and also the joint which caused the subjects the most inconvenience at the follow-up. Medical records were traced for 85 of the 112 who had died. Among them, 44 cases of RA or polyarthritis were noted. The present study gives a conception of RA in the population, as well as of its development over a long span of time.

Adult↗
PubMed1987

Radiological findings in the rheumatoid knee joint in a seventeen-year follow-up.

In 1967 a population survey of rheumatoid arthritis (RA) was carried out in Stockholm. In a sample of 15,268 subjects, 239 were found to have RA. In 1983, i.e. 17 years later, all the 127 subjects still living could be traced, 109 of them were re-examined and 98 radiographed. Whole-leg weight-bearing radiographs of the 168 knee joints were available for determination of the HKA (Hip-knee-ankle) angle and of the articular space. In this sample, which represented the epidemiological spectrum of RA, disease activity could be associated with radiologic changes in the knee joint, e.g., erosions, cysts and sclerosis. These radiologic findings were predictable owing to the fact that New York criterion no. 3 or 4 for RA had been fulfilled 17 years earlier. In 52% of those with active RA at the follow-up, the articular space was seen to be narrowed. A certain varus angulation (2.2 degrees) was ascertained in the joints of subjects with inactive RA, while this angulation was less pronounced (0.7 degrees) in knee joints of subjects with an active disease.

Aged↗