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Biomedical subjects

J Wiberg

Publications and source records attributed to J Wiberg.

At least 19 recordsLinked to original sources
PubMed2006

[Clinical experience and results of using the V.A.C. instill therapy in infected hip- and knee prosthetics].

Since September 2005 our patients with acute endoprosthetic infection are treated, next to the normal wound debridement, with a full automatic vacuum drain system (V.A.C. instill system). This therapy unit entail a three step program. Based on the well known vacuum therapy, the new system contains an additional fluid drain and affecting period with an antibiotic or antiseptic instillation therapy. In the last half year we were able to treat five patients with endoprosthetic infection by using this therapy unit. In our opinion, we have a successfull method of treating patients with acute, infected big joints after endoprosthetic implantation. The therapy unit of V.A.C. instill is quickly available and easy to learn. Next to much better comfort for the patients the most advantage is to leave the prosthetic inside during the infection management with the new therapy unit. Further results in treating acute joint infections after endoprosthetic implantation must been shown, if this new method is to be the new standard in daily clinical routine.

Acute Disease↗
PubMed2001

Small bowel perforation as a complication of microsurgical lumbar diskectomy. A case report and brief review of the literature.

Ventral perforation is a rare complication of lumbar diskectomy. Injury to retroperitoneal vessels is the most common serious complication to such perforation. Ventral perforation with damage to the bowel is rarely reported. The authors present the first case report of injury to the small bowel during a microsurgical lumbar diskectomy. The case illustrates the importance of awareness of bowel injury as a possible complication of diskectomy. Possible pre- and postoperative considerations are also discussed. A brief review of the literature on bowel injuries after this common surgical procedure is also given.

Autopsy↗
PubMed1995

Reliability and concurrent validity of the BROM II for measuring lumbar mobility.

OBJECTIVE: To establish the reliability of the BROM II device for measuring lumbar mobility in the sagittal, coronal and transverse planes and its validity against the double inclinometer method. DESIGN: Blind intra- and interexaminer reliability and concurrent validity. Interexaminer reliability was determined between two examiners. SETTING: Chiropractice teaching college. SUBJECTS: Forty-seven asymptomatic chiropractic students (27 men and 20 women, age range 18 to 38 yr). MAIN OUTCOME MEASURE: Lumbar mobility measurement in degrees using the BROM II and double inclinometer techniques. RESULTS: Intraclass correlation coefficients (ICC) showed good intra- and interexaminer reliability of the BROM II for flexion (0.91 and 0.77, respectively) and lateral flexion (0.91 and 0.85 respectively). Less support was given to the reliability of the instrument in extension (0.63 and 0.35, respectively) and rotation (0.57 and 0.36 respectively). Concurrent validity of the BROM II and double inclinometer methods was partially supported (ICC in all planes range from 0.27 to 0.75). CONCLUSION: The BROM II was found to be a reliable instrument in the measurement of lumbar mobility in the sagittal (flexion) and coronal planes. However, before this device can be recommended as an assessment tool in clinical practice or clinical trials, further investigation into its reliability in a symptomatic group of patients is required. (J Manipulative Physiol Ther 1995; 18:497-502).

Adolescent↗
PubMed1993

[Thoracolumbar injuries. Surgical treatment of patients with neurological damage].

This article presents the neurological outcome after surgery of a series of 54 patients with damage to the spinal cord and/or cauda equina caused by thoracolumbar injuries. The fractures, dislocations or fracture-dislocations were all reduced and stabilized by a Harrington distraction device or transpedicular fixation system (posterior segment fixator). Peroperative inspection revealed that correction and distraction alone may be inadequate to achieve intraspinal decompression. Additional anterior decompression by posterolateral approach was necessary in 31 patients (57%). In this series there was an unexpected high rate of dural rents. Tears were found in 11 patients (20%) and nerve roots (cauda equina) appeared to have herniated through the tear in eight. Significant improvement of the neurological deficits was obtained in 81%. The improvement rate was much better in patients with incomplete lesions than among those with complete lesions. We are convinced that surgery improves the neurological outcome if carried out at the proper time, after sufficient decompression of the spinal cord and nerve roots, and repair of dural rents.

Adolescent↗
PubMed1992

[Cervical disk defects. Results of surgical treatment of cervical vertebral radiculopathy].

The article presents a retrospective study of a series of 213 patients treated for cervical spondylotic radiculopathy by anterior surgery. The follow-up period ranged from 2-8 years. The overall functional outcome of surgery showed a rate of improvement of 91.5% at late follow-up. In 8.5% of the patients there was no change, and none considered themselves as being worse than before surgery. The various selective symptoms and signs were analyzed. Improvement of root pain was obtained in 93.4% of the patients, of sensory deficits in 90.7% and of motor deficits in 81.8%. The rate of improvement for neck pain was 44.6%. In this series, mortality was zero and there was no peroperative neurological deterioration. 3.3% of the patients were re-operated at the previous level. A second operation at another level or levels was necessary in 5.2% of the patients. Early surgical treatment, and possibly the degree of neurological deficits, were the only factors found to influence overall functional recovery. In contrast to the overall results, and in spite of large individual variations, neither sensory nor motor deficits, nor root pain, were statistically influenced by degree of root deficits or duration of symptoms.

Adult↗
PubMed1990

Patency and flow velocity profiles in the internal carotid artery assessed by digital subtraction angiography and Doppler studies two years after endarterectomy.

A follow-up of 55 patients 2 years after a total of 60 carotid endarterectomies. Fifty-two patients who had a total of 57 endarterectomies survived the first 2 post-operative years and were re-examined using pulsed Doppler spectral analysis and intravenous digital subtraction angiography (IVDSA). One patient had died following a stroke and 2 after a cardiac infarction. The Doppler and IVDSA examinations revealed a non-symptomatic restenosis of the relevant internal carotid artery in 2 patients. There were no relevant occlusions and no symptomatic re-stenoses were detected. Spectral spreading of the Doppler signal at the site of the endarterectomy was found in 18% of the internal carotid arteries, whereas wall irregularities (diameter reduction less than 10%) were demonstrated in 25% by IVDSA. A stenosis or occlusion was found in 14 (25%) of the 57 ipsilateral external carotid arteries.

Blood Flow Velocity↗
PubMed1990

Cerebral vasoreactivity and blood flow before and 3 months after carotid endarterectomy.

We measured regional cerebral blood flow and cerebral vasoreactivity before and 3 months after carotid endarterectomy using xenon-133 inhalation with single-photon emission computed tomography and the acetazolamide test in 14 selected patients who had suffered cerebral transient ischemic attacks due to an ipsilateral internal carotid artery stenosis. The patients had neither clinical nor cerebral computed tomographic evidence of infarction. Baseline regional cerebral blood flow was symmetrical before and unchanged after endarterectomy. Before endarterectomy, vasoreactivity in the middle and anterior cerebral artery territories of the symptomatic side was significantly reduced (p less than 0.05); however, vasoreactivity was normalized 3 months after surgery. Our findings strongly suggest that the stenoses caused a reduction in perfusion reserve that was improved by carotid endarterectomy.

Acetazolamide↗
PubMed1989

MRI in cervical disk herniation.

Eleven operated herniated disks in 10 patients were evaluated preoperatively with plain films, myelography and magnetic resonance imaging. Plain X-ray was a valuable supplement to MRI for studying the bony changes. Myelography showed 7 of 11 herniated disks while MRI gave correct diagnosis in all. It is concluded that MRI can replace myelography and computerized tomography in the preoperative evaluation of cervical herniated disk. The other examinations may be supplementary in some cases.

Adult↗
PubMed1988

Trigeminal alveolar nerve of the lower jaw in the cichlid Tilapia mariae: evidence for continual axon generation and presence of exceptionally small myelinated axons.

Cross sections from the trigeminal alveolar nerve of the lower jaw in the cichlid Tilapia mariae were examined by electron microscopy. The nerve fibers are arranged in groups with a core of unmyelinated and small myelinated axons, surrounded by myelinated axons of varying sizes. The core contains large bundles of unmyelinated axons collectively ensheathed by circumferentially located Schwann cells, as well as smaller bundles of unmyelinated axons partly separated from each other by Schwann cell processes. Among the unmyelinated axons, occasional scattered profiles resembling growth cones are seen. The total number of axons in this tooth-related nerve increases from approximately 1,500 to 5,000, as the animals grow in length from 4.5 to 21.5 cm. Some 24-49% of the axons are unmyelinated. The myelinated axons have maximum diameters of 1.0-3.0 micron, depending on body size. Most myelinated axons have diameters less than 1.0 micron and the smallest ones reach down to 0.3 micron. These results show that there is a continual addition of axons to the alveolar nerve of the lower jaw in Tilapia mariae and that the critical diameter for myelination in this peripheral nerve is similar to that typically found in the mammalian CNS.

Animals↗
PubMed1988

Neurological outcome after surgery for thoracic and lumbar spine injuries.

New techniques for internal fixation, employed by neurosurgeons and orthopaedic surgeons, provide reduction and stabilization with early mobilization of patients after injuries of the thoracolumbar spine. It has, however, appeared difficult to prove that the neurological outcome after surgery may be superior to conservative treatment. In this study the neurological results after surgery are evaluated in 30 patients with injuries of the spinal cord and/or cauda equina. Canal encroachment was found on tomograms or CT in all patients. The unstable fractures, dislocations or fracture-dislocations were all reduced and stabilized by the Harrington distraction device. However, peroperative inspection revealed that the Harrington instrumentation alone may be inadequate in achieving intraspinal decompression. Additional anterior decompression by posterolateral approach was necessary in 13 of the 30 patients (43%). In this series there was an unexpectedly high rate of dural tears. These were found in 8 patients (27%) and nerve roots (cauda equina) appeared to have herniated through the tear in 6 of the 8 patients. Significant improvement of the neurological deficit was obtained in 22 of the 30 patients (73%), and the improvement rate in patients with incomplete lesions of the spinal cord was 83% (25 of 30 patients). In this series there was a definite trend toward greater neurological recovery when compared to the results obtained in patients treated conservatively. The importance of a neurosurgical approach in diagnosis and treatment of these patients is stressed.

Adolescent↗
PubMed1988

Odontogenic keratocysts. A follow-up study of 29 cases.

This study reports the incidence and recurrence rate of odontogenic keratocysts in a series of 531 jaw cysts treated at the Department of Oral Surgery, Karolinska Institute, Stockholm, from 1977 to 1984. Each case of a histologically verified odontogenic keratocyst was analysed and registered with respect to patient's age and sex, type of cyst, location and rate of recurrence. Twenty-nine odontogenic keratocysts were found (5.4% of all cysts). The most frequent locations were in the mandibular angle, ramus and third molar regions. During the observation period (1-8 years) 7 keratocysts (24%) recurred. These findings support previous observations.

Adolescent↗
PubMed1986

Effects of surgery on cervical spondylotic myelopathy.

The results of surgery for treatment of cervical spondylotic myelopathy (CSM) were assessed 3 months (early results) and 2-8 years (late results) postoperatively in 99 patients. Extensive laminectomy as well as anterior decompression and fusion, or the two procedures at staged intervals, were used. Immediate postoperative deterioration was never seen after laminectomy performed under local anaesthesia (84 patients), while transient deterioration occurred after anterior surgery in 2 of 28 patients. Cervical spondylotic radiculopathy (CSR) was found in 73% of the patients. Operative treatment for CSM also improved root symptoms, anterior surgery to a larger extent than posterior decompression. Only 10% of the patients treated with extensive laminectomy needed a second anterior operation for radiculopathy. The progression of myelopathy was arrested in 95% of the patients after surgery. Improvement was obtained in 80% both in the early and late follow-up review when compared to the preoperative functional status. The evaluation disclosed a tendency of rapid improvement during the first 3 months, subsequently followed by slow improvement in 50% and slight deterioration in 15% of the patients. The degree of improvement was in many patients not sufficient to raise the functional capability to a higher level in the employed grading system. In our opinion it is therefore important to operate patients with CSM as early as possible before neurological deficits are too pronounced.

Adult↗
PubMed1986

Patency and flow velocity profiles in the internal carotid artery assessed by digital subtraction angiography and Doppler studies three months following endarterectomy.

Pulsed Doppler spectral analysis and intravenous digital subtraction angiography have been carried out in 55 patients, three months after a total of 60 carotid endarterectomies. Five patients were operated on both sides and there were no re-operations. There were no re-stenoses and only one of the 60 internal carotid arteries was occluded. Spectral spreading of of the Doppler signal at the site of the endarterectomy was found in 52% of the internal carotid arteries, whereas wall irregularities were demonstrated in 25% by intravenous digital subtraction angiography. A stenosis or occlusion was found in 11 (18%) of the 60 ipsilateral external carotid arteries.

Carotid Artery Diseases↗
PubMed1985

The correlation of myelographic root sleeve deformity, uncovertebral spondylosis and radiculopathy.

Myelographic root sleeve deformities, uncovertebral spondylosis and myelopathy were correlated in 56 patients. Good correlation between root sleeve deformities and uncovertebral spondylosis was found. However, in some cases with spinal canal stenosis root sleeve deformities were found without corresponding bone changes. The correlation of radiculopathy to root sleeve deformity and uncovertebral spondylosis was 61 and 67%, respectively. Radiologic changes at an adjacent root level were often seen in patients without clinically correlated radiculopathy. The myelographic changes were verified at operation in all the 46 patients operated upon.

Adult↗
PubMed1985

Cerebral perfusion during nonpulsatile cardiopulmonary bypass.

The recording of middle cerebral artery (MCA) flow velocity by the transcranial Doppler method offers a new, noninvasive, continuous technique for studies of cerebral circulation. Comparative studies of electromagnetic internal carotid artery (ICA) flowmetry and MCA flow velocity by the transcranial Doppler technique have demonstrated that observed changes in MCA flow velocities reflect concomitant changes in cerebral circulation. Eleven high-risk patients undergoing cardiopulmonary bypass (CPB) procedures were included in a pilot study. Arterial blood pressure (BP), central venous pressure, and epidural intracranial pressure (EDP) were recorded during CPB. Cerebral electrical activity was recorded by a cerebral function monitor. Flow velocity in the MCA was increased during nonpulsatile CPB in 10 of the 11 patients. This increase was related to the degree of hemodilution, and the flow velocity during steady-state CPB was 80 to 300% of the prebypass value. The MCA flow velocity changed, however, in a pressure-passive manner with the cerebral perfusion pressure (CPP = BP - EDP) in the individual patient, which indicates that cerebral autoregulation was not operative. During the first 15 minutes after termination of bypass, the MCA flow velocity was reduced, but remained higher than the prebypass level, 110 to 210% of the level during the last 5 minutes preceding CPB.

Adult↗