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Biomedical subjects

K Jonsson

Publications and source records attributed to K Jonsson.

At least 109 records · Page 6Linked to original sources
PubMed1991

Long-term results after percutaneous transluminal angioplasty of atherosclerotic renal artery stenosis--the importance of intensive follow-up.

The aim of this study was to investigate the long-term results of percutaneous transluminal angioplasty of atherosclerotic renal artery stenosis (PTRA) in patients with renovascular hypertension with or without impending renal insufficiency who were followed up intensively with aggressive reintervention. Diagnostic work-up was based on angiography, pressure gradient and renal venous renin measurement. Patients were scheduled for regular follow-up after the PTRA and a deterioration in blood pressure or renal function was an indication for re-evaluation, and reintervention if necessary. Sixty-five patients had 71 renal artery stenoses where PTRA was attempted. It was technically successful in 59 stenoses and two occlusions and failed in ten (14%). At the end of follow-up (median 56 months [2-99]), the primary patency rate was 55%, 27 had restenosed and four were occluded, all but two within 12 months. Seventeen were treated by a further PTRA and eight by surgical reconstruction. At the end of follow-up the secondary patency after all interventions was 90%. One patient died 1 month after PTRA, and at the end of follow-up 21 patients (32%) had died, most of them (80%) from cardiovascular disease. Multivariate analyses showed a significantly reduced survival rate in patients with multiocular atherosclerosis, renal insufficiency, contralateral renal artery stenosis and ischaemic heart disease. At the end of follow-up 90% of the patients were cured or improved with regard to blood pressure. In patients with impending renal insufficiency renal function was improved in 50% and unchanged in 39%. With this strategy 55% of the patients needed only one treatment with PTRA, 25% needed a re-PTRA and 20% had to be operated on. PTRA can be recommended as initial treatment of atherosclerotic renal artery stenosis provided intensive follow-up and aggressive reintervention are performed when indicated.

Adult↗
PubMed1991

Tissue oxygenation, anemia, and perfusion in relation to wound healing in surgical patients.

Oxygen tension and collagen deposition were measured in standardized, subcutaneous wounds in 33 postoperative surgical patients. Pertinent clinical and wound parameters were analyzed by Pearson's correlation test and sequential linear regression analysis. Collagen deposition was directly and significantly proportional to wound oxygen tension and measures of perfusion. There were no significant correlations with hematocrit, estimated blood loss, length of operation, smoking, age, weight, sex, or urine output. This study in humans confirms animal experiments showing that collagen deposition and tensile strength in wounds are limited by perfusion and tissue oxygen tension. It appears unnecessary to maintain hemoglobin at normal levels to support repair, provided that peripheral perfusion can be maintained at a high level in compensation for anemia. These circumstances reflect the fact that although oxygen is essential to many aspects of healing, and must be delivered at adequate partial pressures, reparative tissue consumes relatively little of it.

Anemia↗
PubMed1991

Overview: new methods in imaging osteoarthritis.

The new imaging modalities, namely computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography (US) provide potentially powerful tools for in vivo assessment of osteoarthritis (OA), monitoring the progress of the disease and understanding its natural course. However, to use these tools effectively, we need more prospective research focused on correlating imaging data with biochemical and gross and microscopic pathologic findings. MRI is clearly the most powerful tool for demonstrating the various articular components which may be affected in OA. CT is excellent for delineating osseous abnormalities and with US we are able to evaluate the thickness and surface characteristics of those portions of articular cartilage that are accessible. The advantages and limitations of these 3 modalities are discussed as they pertain to OA of the hip and knee.

Arthrography↗
PubMed1990

Nonunion of a fractured scaphoid tubercle.

A case of nonunion of an avulsed scaphoid tubercle fragment is reported. The fragment became surrounded with a rim of calcification and ossification. After 3 1/2 years follow-up the fragment had migrated to the carpal tunnel simulating the appearance of an accessory ossicle.

Adult↗
PubMed1990

Chyluria treated with renal autotransplantation: a case report.

We report a rare case of chyluria in a patient from an area not endemic to filariasis. Initial surgical treatment consisted of stripping of the renal pedicle, following which the patient was free of symptoms for 3 months. Recurrence was noted and renal autotransplantation was performed. Chyluria has not recurred 12 months after the second operation. The etiology and various treatments of chyluria are discussed.

Adult↗
PubMed1990

Symptoms and signs of thrombotic occlusion of atherosclerotic renal artery stenosis.

Twenty-four patients, with an occluded renal artery diagnosed at angiography or operation, in whom previous angiography had demonstrated an atherosclerotic renal artery stenosis, were compared with a group of patients with a renal artery stenosis that remained patent after a similar interval. The risk of occlusion was found to increase with age, the degree of stenosis and advanced generalised atherosclerosis. At the presumed time of occlusion few patients had symptoms which when present were vague and easily overlooked. The most suggestive sign of occlusion was a rise in serum creatinine which was seen in the majority of the patients.

Adult↗
PubMed1989

Direct coronal CT of the scaphoid bone.

A simple technique is described for the acquisition of coronal computed tomographic images of the wrist without positioning or immobilizing devices. The technique was used in four cases in which the radiographs were equivocal, to assess healing after scaphoid bone fracture or grafting. The greater resolution of the images provided more definitive information about healing.

Carpal Bones↗
PubMed1989

Computed arthrotomography of the shoulder: comparison of examinations made with internal and external rotation of the humerus.

We assessed the best positioning of the humerus for CT scans obtained after air-contrast shoulder arthrography by performing 54 examinations with both external and internal rotation of the humerus. Of the 30 abnormalities of the anterior portion of the labrum, 27 (90%) were identified on the scans obtained with the arm in internal rotation. The other three (10%) were shown best or solely on the scans obtained with the arm in external rotation. All 22 abnormalities of the anterior capsule were shown on the scans obtained with internal rotation. In no case were scans obtained in external rotation superior. Five posterior labral and capsule abnormalities were found; two of them were identified best or only on scans obtained with external rotation. The other three were shown equally well with the arm in either position. The results show that a modest (9%) increase in diagnostic yield can be expected when CT scans obtained with the arm in external rotation are added to studies performed solely with the arm internally rotated.

Adolescent↗
PubMed1988

Tissue oxygen measurements in delayed skin flaps: a reconsideration of the mechanisms of the delay phenomenon.

The delay phenomenon was studied by measuring tissue oxygen tension (PsqO2) for 3 weeks in delayed flaps and normal adjacent contralateral skin in seven mongrel dogs. The PsqO2 fell after elevation of a bipedicle flap and rose again to normal by day 14. Delivery of oxygen to this flap was improved by surgical delay, so that when the bipedicle flap was reelevated on day 14 and its distal pedicle divided, minimal changes in PsqO2 occurred. When the control area was elevated on day 14 as a random-pattern flap, it had higher PsqO2 values than measured in the bipedicle flap on day 0, and therefore, it too had participated in the delay phenomenon, even though only its midline edge had been incised. An anatomic explanation for the findings was sought in wounds made in 10 rabbit ear chambers. After injury, blood flow was seen to be rerouted parallel to the incision line and was increased first by vasodilation and then also by angiogenesis until about day 14. Rerouting of blood by injury, inflammation, and angiogenesis due to repair appears to account for a significant portion of the delay phenomenon.

Animals↗
PubMed1988

Coarctation of the abdominal aorta in elderly patients. Case report and review of the literature.

Coarctation of the abdominal aorta as a congenital disease is infrequent, the diagnosis mostly being made at an early age because of renovascular hypertension. Patients who reach the age of 40 more often tend to have the problems located distally to the renal arteries. A 66-year-old female is described, who developed an aortic occlusion, renovascular hypertension and uremia. She was cured with a bifurcation graft and a patch angioplasty of a stenotic renal artery and nephrectomy of the contralateral kidney with an occluded artery without refilling. A literature survey is made of patients older than 40 years.

Aged↗
PubMed1988

Clinical and radiological follow-up of chronic non-obstructive pyelonephritis. A retrospective study covering thirty years.

The outcome of uni- or bilateral chronic pyelonephritis was retrospectively studied in 26 patients. The material consists of all positive intravenous urographies performed at the hospital during three years in the 1950s and the follow-up time was approximately 30 years. Development of uraemia or death owing to renal disease occurred in 15% of the patients. The majority of patients with unilateral pyelonephritic changes showed unchanged scarring during the years, while progressive scarring mainly occurred in younger patients. The development of renal failure was found in patients with extensive bilateral scarring, proteinuria and hypertension.

Adolescent↗
PubMed1987

Assessment of perfusion in postoperative patients using tissue oxygen measurements.

Subcutaneous tissue oxygen tension was measured as an index of perfusion in 44 postoperative patients. Hypoperfusion was defined as suboptimal tissue oxygen tension unresponsive to increased inspired oxygen but becoming responsive after increased fluid infusion. Twelve of thirty patients who underwent major abdominal and flank operations were found to be suboptimally perfused by this definition despite adequate fluid maintenance according to standard clinical criteria including urine output. Apparently, a significant number of postoperative abdominal surgery patients are not optimally perfused, and this state is not recognized by the present clinical criteria. Tissue oximetry may be a useful objective method of assessing tissue perfusion.

Blood Gas Analysis↗