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Biomedical subjects

K Jonsson

Publications and source records attributed to K Jonsson.

At least 91 records · Page 5Linked to original sources
PubMed1994

The topography of the vascular systems in the periodontal and peri-implant tissues in the dog.

The present investigation reports an animal experiment the objective of which was to study the vascular topography of the periodontium and the peri-implant soft and hard tissues in the beagle dog. 2 beagle dogs were used. The right mandibular premolars were extracted and healing allowed for 3 months. 2 titanium fixtures a.m. Brånemark were installed in the right premolar region. Abutment connection was performed 3 months later. The contra-lateral mandibular sites were used as tooth harboring control units. A 4-month period of meticulous plaque control was initiated. A clinical and radiographical examination was performed towards the end of this period and revealed that the gingiva and peri-implant mucosa were clinically healthy and that the bone tissue at teeth and implants had a normal height. The carotid arteries were perfused with a mixture of carbon and calf serum. 2 bucco-lingual sections, about 100-150 microns thick, and one mesio-distal section comprising the junctional epithelium and underlying connective tissue were sampled. The sections were treated, cleared and examined in a microscope. The results of the present investigation demonstrated that the vasculature of the gingiva and the supracrestal connective tissue at teeth is derived from two sources, namely the supraperiosteal vessels lateral of the alveolar process and the vessels of the periodontal ligament. The blood vessels of the peri-implant mucosa were found to be terminal branches of larger vessels originating from the periosteum of the bone of the implant site.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

The diagnostic efficacy of magnetic resonance imaging and ultrasonography in Morton's neuroma: a radiological-surgical correlation.

All patients operated upon for Morton's neuroma during 1991 who were examined with both magnetic resonance imaging and ultrasonography were included in this prospective study. The object of the study was to evaluate the diagnostic value of these two modalities. The preoperative diagnosis was purely clinical. Histology confirmed surgical findings. A 0.3 T scanner was used for the magnetic resonance imaging, and a 7.5 MHz linear transducer was used for the ultrasonography. The study includes nine patients. Eight neuromas were found at surgery. Of these, only five were diagnosed with magnetic resonance imaging and three with ultrasonography. This indicates that false negative diagnoses are common. At present we find these modalities of little or no value, but, with improved equipment and experience, they may become valuable.

Adult↗
PubMed1994

Detection of infection in loosened hip prostheses: efficacy of sonography.

OBJECTIVE: The purpose of this study was to determine the efficacy of sonography in the detection of infection in loosened hip prostheses. MATERIALS AND METHODS: The normal capsular morphology in 15 asymptomatic patients with total hip replacements was studied sonographically. Sonograms were then obtained in 33 patients who had pain in the hip after arthroplasty and radiologic findings of loosening of the prosthesis. These patients subsequently underwent aspiration and arthrography of the hip. Six of the 33 symptomatic patients proved to have prosthetic joint infection. RESULTS: On sonograms, the normal pseudocapsule is adherent to the proximal part of the anterior femoral cortex, and the capsule-to-bone distance is less than 3.2 mm (average, 2.6 mm). No hips with a capsule-to-bone distance less than 3.2 mm were infected. Sonograms in the six patients with infection showed marked intraarticular effusion with a mean capsule-to-bone distance of 10.2 mm. Five of these six had extracapsular fluid collections. Two patients with hip dislocations and four with aseptic loosening of the prosthesis had capsular distension on sonograms and cultures of aspirated material that showed no growth. CONCLUSION: Sonography can be used to diagnose infection around loosened hip prostheses. All patients who had an intraarticular effusion with extraarticular extension seen on sonograms had infection.

Aged↗
PubMed1994

Chevron osteotomy for hallux valgus not improved by additional adductor tenotomy. A prospective, randomized study of 84 patients.

We investigated 106 feet in 84 patients in a prospective randomized series where the clinical and radiographic results of the original chevron osteotomy were compared to the same procedure with the addition of an adductor tenotomy in patients averaging 47 years of age and with a mean follow-up of 3 years. Clinically there was no difference in the satisfaction rate of the two groups, with 58 satisfied and partially satisfied in the 62 operated by chevron osteotomy alone, and 42 of 44 in the group where adductor tenotomy was added. The hallux valgus angle decreased by 7.5 degrees in the group operated with chevron osteotomy and by 9.8 degrees (P 0.04) when an adductor tenotomy was added. The major objective factor affecting satisfaction was the attainment of a decreased ball circumference, shown by the fact that dissatisfied patients had a greater postoperative ball circumference than both satisfied and partially satisfied patients, whereas there were no radiographic correlations to satisfaction. We cannot recommend adding adductor tenotomy to the chevron osteotomy.

Adolescent↗
PubMed1994

Femoral head shape in Legg-Calvé-Perthes disease. Correlation between conventional radiography, arthrography and MR imaging.

Twenty-three children with Legg-Calvé-Perthes disease were examined to determine the femoral head shape. We evaluated and correlated conventional radiography, arthrography and MR imaging. In the a.p. view, measurements were obtained from the center of the femoral head along the bony or cartilaginous outline at 30 degrees intervals. Maximum flattening of the cartilaginous outline appeared laterally, 60 degrees from the center of the baseline of the epiphyseal index and the caput index. Maximum flattening of the bony outline was found at 75 degrees. Arthrography and MR imaging gave the same information about the shape of the femoral head cartilage. The bony femoral head shape on conventional radiographs in the a.p. view did not reflect the cartilage shape obtained by MR and arthrography.

Arthrography↗
PubMed1994

Film-screen vs. digital radiography in rheumatoid arthritis of the hand. An ROC analysis.

In a prospective investigation the diagnostic accuracy of film-screen and digital radiography in rheumatoid arthritis of hands was compared. Seventy hands of 36 patients with established rheumatoid arthritis were included in the study. Each of 11 joints in every hand was evaluated regarding the following radiologic parameters: soft tissue swelling, joint space narrowing, erosions and periarticular osteopenia. The digital images were obtained with storage phosphor image plates and evaluated in 2 forms; as digital hard-copy on film and on a monitor of an interactive workstation. The digital images had a resolution of either 3.33 or 5.0 lp/mm. ROC curves were constructed and comparing the area under the curves no significant difference was found between the 3 different imaging forms in either resolution group for soft tissue swelling, joint space narrowing and erosions. The film-screen image evaluation of periarticular osteopenia was significantly better than the digital hard-copy one in the 3.33 lp/mm resolution group, but no significant difference was found in the 5.0 lp/mm group. These results support the view that currently available digital systems are capable of adequate diagnostic performance.

Adult↗
PubMed1993

Percutaneous transluminal renal angioplasty versus surgical reconstruction of atherosclerotic renal artery stenosis: a prospective randomized study.

PURPOSE: The purpose of this prospective randomized study was to compare percutaneous transluminal renal angioplasty (PTRA) and operation as initial therapy with regard to technical results, primary and secondary patency, and effects on blood pressure and renal function in patients with atherosclerotic unilateral renal artery stenosis. METHODS: Fifty-eight patients who did not have diabetes, who were less than 70 years of age, and who had severe hypertension and significant stenosis were randomized to receive PTRA or operation. Angiography was performed 10 days, 1 year, and 2 years after treatment to verify patency, and blood pressure and renal function were simultaneously evaluated. RESULTS: Technically, PTRA was successful in 83% and operation in 97% of patients. The primary patency rate after 24 months was 75% in the PTRA group and 96% in the operative group in technically successful cases. The secondary patency rate in the PTRA group was 90% and in the surgical group 97%. To achieve these results four patients in the PTRA group required operation, and one patient in the surgical group required PTRA. Hypertension was cured or improved after additional treatment in 90% of the patients after PTRA and 86% after operation. The corresponding figures for improved or unchanged renal function were 83% and 72%, respectively. After additional treatment, effects on blood pressure and renal function did not differ. Seventeen percent of the patients treated with PTRA required surgical intervention. CONCLUSIONS: PTRA is recommended as first choice of therapy for atherosclerotic renal artery stenosis causing renovascular hypertension if combined with intensive follow-up and aggressive reintervention.

Adult↗
PubMed1993

Effect of femoral condyle configuration on disability after an anterior cruciate ligament rupture. 100 patients followed for 5 years.

We measured the configuration of the femoral condyles on lateral radiographs in 100 consecutive, prospectively-studied patients with a complete rupture of the anterior cruciate ligament, with or without associated lesions of the menisci and collateral ligaments. The patients had mainly low-to-moderate activity demands, and in all the patients the cruciate tear was primarily treated non-operatively. A quotient was calculated from the measurements of sagittal depth and axial height in order to describe the geometry of the femoral condyles. Measurements were reproducible with an intra- and interobserver coefficient of correlation of 0.89-0.98. At follow-up, after 5 (3-6) years, 16 patients had developed disability leading to reconstructive surgery. The remaining 84 patients did not have any major functional limitations, but some had reduced their activity level. Individual variations in the articular geometry were found with a more spherical shape of the femoral condyles in the patients where non-operative treatment had failed. Our findings indicate that articular geometry is of importance for function after an anterior ligament lesion.

Anterior Cruciate Ligament↗
PubMed1992

Early intensive treatment of clubfoot. 75 feet followed for 6-11 years.

47 consecutive children with 28 bilateral and 19 unilateral clubfeet were treated during the neonatal period according to a strict protocol including physiotherapy and bracing from the first 2 weeks of life; further, in most of the children, an operation was performed at 3 (2-5) months of age. Physiotherapy was continued during the first year of life and bracing for 3 years. 27 feet had repeat operations. No peroperative or postoperative complications were seen. At follow-up at aged 8 (6-11) years, the cosmetic result was good in 62 feet, acceptable in 12 feet, and poor in 1 foot, whereas the functional result was excellent in 51 feet, good in 21 feet, and fair in 3 feet. The radiographs showed a higher lateral talocalcaneal angle in the control feet than in the treated feet; but in other radiographic aspects, no differences were seen. The need of a secondary or even tertiary operation did not indicate a poor result.

Age Factors↗
PubMed1992

CT of the wrist in suspected scaphoid fracture.

Bone scan and sagittal projection CT of the scaphoid was performed in 10 patients with clinically suspected scaphoid fractures. The primary and follow-up plain radiographs were negative or equivocal for fracture. CT examination demonstrated scaphoid fracture in 7 patients and normal findings in 3. It is concluded that CT of the scaphoid can replace bone scan to diagnose or rule out fracture in institutions where nuclear medicine facilities are not available.

Adolescent↗
PubMed1992

Osteochondritis dissecans of the elbow. A long-term follow-up study.

Thirty-one patients with osteochondritis dissecans of the capitellum humeri were followed for an average of 23 years. There were symptoms in about half of the elbows at the follow-up examination. Impaired motion and pain on effort were the most common complaints. Roentgenographic signs of degenerative joint disease were present in more than half of the elbows and correlated with a reduced range of motion. The diameter of the radial head increased in comparison with the contralateral elbow in two thirds of the patients.

Adolescent↗
PubMed1992

Precision of hyaline cartilage thickness measurements.

Measurement of cartilage thickness in vivo is an important indicator of the status of a joint as the various degenerative and inflammatory arthritides directly affect the condition of the cartilage. In order to assess the precision of thickness measurements of hyaline articular cartilage, we undertook a pilot study using MR imaging, plain radiography, and ultrasonography (US). We measured the cartilage of the hip and knee joints in 10 persons (4 healthy volunteers and 6 patients). The joints in each patient were examined on two separate occasions using each modality. In the hips as well as the knee joints, the most precise measuring method was plain film radiography. For radiographs of the knees obtained in the standing position, the coefficient of variation was 6.5%; in the hips this figure was 6.34%. US of the knees and MR imaging of the hips were the second best modalities in the measurement of cartilage thickness. In addition, MR imaging enabled the most complete visualization of the joint cartilage.

Adult↗
PubMed1991

Clinical outcome and health care costs in renal revascularization--percutaneous transluminal renal angioplasty versus reconstructive surgery.

Clinical outcome and health care costs related to investigation, treatment with either percutaneous transluminal renal angioplasty (PTRA) or reconstructive surgery, and follow-up of patients with renovascular hypertension with or without uraemia were analysed in 21 PTRA-treated and 16 operated patients. Most renal artery stenoses were atherosclerotic. Nineteen PTRAs were successful or partly successful and two failed; the patients were operated on without delay. All surgical reconstructions were successful. In the PTRA group six restenoses occurred after 4-24 months. Four were treated with re-PTRA and two were operated on. No recurrence occurred in the operated group. At the end of follow-up (median 48, range 9-84 months) primary patency in the PTRA group was 69 per cent and in the operated group 100 per cent. Secondary patency in the PTRA group was 100 per cent. With regard to hypertension, including primary and secondary results, 19 out of 21 (90 per cent) patients were improved in the PTRA group and 13 out of 16 (81 per cent) in the operated group. The diagnostic and preprocedure costs were the same in both groups, whereas the procedure and postprocedure costs were lower in the PTRA group. However, the follow-up costs were considerably higher because of recurrences and their treatment in the PTRA group. The total median cost of reconstructive surgery was 12 per cent higher than for PTRA, a non-significant difference.

Adolescent↗
PubMed1991

Avulsion of the cervical spinal ring apophyses: acute and chronic appearance.

Avulsion of the superior or inferior ring apophyses of the cervical spine was found in 12 of 1922 patients aged 10-20 years. Clinical and radiological follow-up of 9 of these patients was undertaken 3-25 years after trauma. Avulsion of the superior apophysis occurs after flexion, while extension trauma causes avulsion of the inferior ring apophysis. The follow-up appearance is characteristic in both instances. In superior ring apophysis avulsion, there is a bow shape of the superior aspect of the involved vertebral body. In inferior avulsion, the avulsed apophysis fuses with the vertebral body and forms an "osteophyte", whose shape and size depend on the degree of displacement.

Adolescent↗
PubMed1991

Radiologic changes in temporomandibular, hand, and foot joints of patients with rheumatoid arthritis.

Radiologic changes in the temporomandibular joint (TMJ) and in the joints of the hand and foot were recorded for 90 adult patients with rheumatoid arthritis. The severity of the changes was graded according to the Larsen classification of six grades (O to V), and mainly erosive changes were recorded. The assessment of the radiographs was performed with the aid of reference films. The radiologic changes in the TMJs corresponded to grade II (definite early abnormality) and paralleled those of most of the metacarpophalangeal and metatarsophalangeal joints. The most severe changes were localized to the wrists, with a median grade of III (moderate destructive abnormality). The severity of the changes was similar on the right and left sides of the TMJ. We conclude that TMJ involvement in patients with rheumatoid arthritis is severe and warrants a thorough initial clinical examination. Such a strategy will facilitate the diagnosis and treatment of TMJ changes in the early stages of the disease.

Adolescent↗
PubMed1991

A method for the accurate measurement of opsonic activity in uterine secretions of the mare.

This study was undertaken to develop a method for accurately measuring opsonic activity in the uterine secretions of the mare. Ten mares were used in the study. They ranged in ages from 6 to 19 years and were of various genital health status. Undiluted uterine secretions were collected by inserting a tampon into the uterus during estrus; serum samples were collected simultaneously Opsonic activity in the secretions and serum was analyzed in a chemiluminescence assay, in which zymosan particles were opsonized. Opsonic activity was determined as peak chemiluminescence, time to peak chemiluminescence, and total chemiluminescence (area under curve). The peak chemiluminescence was 16 to 17 times higher when uterine secretions were used for opsonization rather than when buffer was used. Compared to the opsonic activity in serum, the peak chemiluminescence was 21% (P</=0.05) lower, the time to peak chemiluminescence was 117% (P</=0.05) longer, and the total chemiluminescence over 60 minutes was 7% (P</=0.05) greater in the uterine secretions. These data show that opsonic activity in the uterus is approximately of the same magnitude as that in the circulation.

Journal Article↗