Biomedical subjects

K Osterman

Publications and source records attributed to K Osterman.

At least 19 recordsLinked to original sources

PubMed2001

At what age do children learn to discriminate between act and actor?

Children's ability to make moral judgements about an act on the basis of aspects of the act rather than on liking and preconceived ideas about the actor was investigated. 85 children of 4 age groups (preschool, Grades 1, 2, and 3, age range 5-9 years) participated. Act/Actor discrimination was investigated with a test consisting of 8 cartoons. In 4, a rabbit was behaving aggressively against a wolf; the other 4 portrayed identical acts with the wolf as aggressor and the rabbit as victim. Participants made moral evaluations of each cartoon. IQ was measured with Raven's Standard Progressive Matrices, and the general level of moral development was measured in accord with Piaget's (1932) criteria. Age, IQ, and general moral development correlated with discriminative ability for Act and Actor. In Piagetian terms, children at the heteronomous level were not capable of such discrimination, while children at the autonomous level (above 7 years of age) in general were.

Age Factors↗

PubMed2000

The long-term effects of rally driving on spinal pathology.

OBJECTIVES: To investigate the consequences of rally driving on lumbar degenerative changes. BACKGROUND: Vehicular driving is suspected to accelerate disc degeneration through whole-body vibration, leading to back problems. However, in an earlier well-controlled study of lumbar MRI findings in monozygotic twins, significant effects of lifetime driving on disc degeneration were not demonstrated. Another study of machine operators found only long-term exposure to vibration on unsprung seats led to a reduction in disc height. DESIGN: Case-control study comparing rally drivers with population sample. METHODS: Eighteen top rally drivers and co-drivers, mean age 43 yrs (SD, 10), volunteered for the study. The subjects were interviewed and imaged with a MR scanning and lumbar images were analyzed for degenerative findings using a standard scoring protocol previously published. The reference group was composed of 14 men, mean age 55 yrs (SD, 10), selected from a population sample. RESULTS: Overall results showed no significant differences in lumbar degenerative findings as assessed from MR images between the rally drivers and the reference group; age-adjusted differences were not statistically significant for disc heights, bulges, herniations, end-plate irregularities, or osteophytes. CONCLUSION: Even extreme vehicular vibration as experienced in rally driving does not appear to have significant effects on disc generation. RELEVANCE: The study results do not support driving, and its associated whole body vibration, as a significant cause of disc degeneration and question the theory that the higher incidence of back pain among drivers is due to accelerated disc degeneration. Other driving-related factors, such as postural stress, may deserve more attention.

Adult↗

PubMed1997

Instrumented measurement of anterior-posterior translation in knees with chronic anterior cruciate ligament tear.

Anteroposterior translation of the knee joint was measured with a Knee Signature System device on 12 women and 14 men with a unilateral, chronic, isolated, anterior cruciate ligament (ACL) tear. A control group with stable knees consisted of 10 women and 10 men. Anterior translation at 178 N load of the uninjured knees was 8.0 mm (+/-2.2 mm) and in knees with an ACL tear, 14.2 mm (+/-4.2 mm). Corresponding values for anteroposterior translation were 12.1 mm (+/-2.5 mm) and 19.3 mm (+/-4.9 mm), respectively. A difference of 3 mm or more in anteroposterior translation at 178 N load between injured and uninjured knees indicated an ACL tear with 85% specificity and 88% sensitivity.

Adult↗

PubMed1997

Disc degeneration in young patients with isthmic spondylolisthesis treated operatively or conservatively: a long-term follow-up.

The purpose of this long-term follow-up was (1) to investigate disc changes in the olisthetic segment in patients treated conservatively, (2) to compare disc changes above the slipped vertebra in conservatively treated patients with those in operatively treated patients, and (3) to establish possible relations of disc changes to the degree of the slip and to subjective back pain symptoms of the patients. The subjects were 227 patients with isthmic L5 olisthesis diagnosed under 20 years of age (mean 13.8 years) with a mean follow-up of 15.4 (range 5-30) years. Of these, 145 patients had been treated with segmental fusion and 82 had been treated conservatively. At follow-up, standing anteroposterior and lateral radiographs as well as flexion/extension views of the lumbar spine were taken. Disc degeneration was graded semiquantitatively: 0 = normal disc height, 1 = decrease of disc height < 50%, 2 = decrease > or = 50%, and 3 = obliteration of the disc. In the conservatively treated patients degeneration of the olisthetic disc was distributed by grade as follows: O: n = 38, 1: n = 24, 2: n = 14, 3: n = 6. No motion at all was observed in the olisthetic segment in 40 patients (48%) with a mean slip of 30%, segmental motion of 4 degrees-18 degrees was found in 42 patients with a mean slip of 14%. There was a statistically significant association of the degree of slip to the severity of disc degeneration and non-mobility of the segment. Grade 1 degeneration of the L4/5 disc occurred in 25.6% of the conservatively treated patients and in 32% of 48 patients treated with L5-S1 fusion. This correlated with the severity of the slip, but not with pain symptoms or pathologic segmental mobility at the time of follow-up. Out of 84 patients with L4-S1 fusion, in 17% grade 1 degeneration of the L3/4 disc was observed, and 3 out of 13 patients (23%) with L3-S1 fusion had grade 1 degeneration of the disc above the fusion. The disc changes had no correlation with subjective pain symptoms. It is concluded that the natural course of isthmic spondylolisthesis is associated with disc degeneration and spontaneous stabilization of the olisthetic segment. Fusion operations do not significantly increase the rate of disc degeneration in the adjacent disc above the fusion after a mean postoperative follow-up of 13.8 years. No correlation between the number of degenerated discs or the degree of degeneration and subjective low back pain symptoms was found.

Adolescent↗

PubMed1997

Effect of 1 year daily treatment with 400 microg budesonide (Pulmicort Turbuhaler) in newly diagnosed asthmatics.

The aim of this study was to investigate whether treatment with a low daily dose of 400 microg inhaled budesonide (Pulmicort Turbuhaler) in newly diagnosed asthmatics could influence the course of asthma. Seventy five adult patients, mostly with mild asthma, diagnosed during the previous year and bronchial hyperresponsiveness, participated in a double-blind, randomized, parallel-group multicentre study. They were treated with budesonide 200 microg b.i.d. or placebo, delivered via Turbuhaler for 12 months and followed-up for another 6 months without inhaled steroid treatment. Airway function, symptom scores, reactivity to histamine and inflammatory indices in blood were assessed. The mean increase in morning peak expiratory flow (PEF) was 28 L x min(-1) after budesonide treatment compared with no increase in the placebo group (p=0.011). The provocative dose of histamine causing a 20% fall in forced expiratory volume in one second (PD20) (geometric mean) increased in the budesonide group by approximately two doubling dose steps, but not in the placebo group (p=0.0003). The difference between groups with regard to improvement in asthma symptom scores and inflammatory indices did not reach statistical significance. During the 6 month follow-up, the PEF values of the patients who had previously been treated with budesonide decreased by 18 L x min(-1) while the PD20 decreased by approximately one doubling dose step. In conclusion, early treatment with a low dose of budesonide improves airway function and decreases bronchial responsiveness, but the improvements are short-lasting without continued treatment.

Administration, Inhalation↗

PubMed1996

Functional and clinical results after anterior interbody lumbar fusion.

The functional and clinical results of anterior interbody lumbar fusion were assessed in 134 patients. Functional tests included spinal mobility and isokinetic trunk muscle strength measurements. The score rating system of the Japanese Orthopaedic association (JOA) and the Oswestry disability index were used for clinical evaluation. Functional results revealed decreased spinal flexibility when compared with normal values. A reduction in physical ability was also seen in the isokinetic trunk muscle measurements. Non-union seemed to have only little effect on the functional results. Patients under 20 years at operation had the best results, but beyond this threshold results did not vary with age. The JOA rating score was 25 or more in 50% of patients. The mean Oswestry disability index was 47.8 (range 1-82) preoperatively and 20 (range 0-68) at follow-up (P < 0.001), indicating a clear decrease in subjective disability. Solid fusion was seen in 107 patients (80%) at follow-up.

Adolescent↗

PubMed1996

Anterior interbody lumbar fusion in severe low back pain.

Clinical, functional, and radiographic results of 83 patients treated by anterior interbody lumbar fusion are presented. Seventy-two percent of patients previously had undergone 1 or more spine operations. In 54% of patients, the main indication for anterior fusion was failed back surgery. There were 52 women and 29 men. The mean age of patients at operation was 43.6 years (range, 21-60 years). The mean followup time was 5 years (range, 2-10 years). Solid fusion was achieved in 104 (81%) of 129 levels on 59 (71%) of 83 patients. The clinical results were estimated 3 ways: the patient's own opinion, the change of Oswestry disability index, and the score rating system of the Japanese Orthopaedic Association. Patient opinions of the benefit of the procedure were the following: 74% very much improved, 12% little improved, 10% no improvement, and 4% worse. The mean Oswestry index before operation was very high at 48.8 points (range, 22-82 points), reflecting the severity of dysfunction in these patients. The mean Oswestry index at the followup study was 30.5 points (range, 0-68 points). In the score rating system of the Japanese Orthopaedic Association, the final rating of 25 points or more (regarded as satisfactory) was achieved in 22 (26.5 %) patients. The decision regarding indications for the operation and the operation itself should be made by experienced surgeons.

Activities of Daily Living↗

PubMed1996

Critical aspects of neonatal surgery in clubfoot.

Good results after early operative treatment of clubfoot has been reported by some investigators. Most have recommended early conservative treatment and later surgical procedures in resistant cases. Operation immediately after birth is demanding, and the operative team must master all problems of neonatal surgery, anesthesiology, and postoperative care. Conservative treatment in experienced hands may lead to a satisfactory result in one third of cases. We recommend primarily conservative treatment, but patients with resistant cases must undergo operation at age 2-5 months. We need more prospective studies and generally accepted grading systems of results.

Clubfoot↗

PubMed1996

Results of a trial of anterior or circumferential lumbar fusion in the treatment of severe isthmic spondylolisthesis in young patients.

The radiological and clinical results in 27 patients operated on for severe isthmic spondylolisthesis at age < 20 years with uninstrumented anterior interbody fusion alone in 11 or combined anterior and posterolateral (circumferential) fusion in 16 are reported. The mean follow-up time was 5.9 +/- 2.4 years. The two groups were comparable with regard to age at operation, sex, preoperative symptoms, mean preoperative slip and sagittal rotation angle. The follow-up assessment, made by an independent observer, included interview, Oswestry disability index, physical examination, functional tests, and plain radiographs. At follow-up, there were no statistical differences between the groups in subjective, clinical, and functional outcomes. Follow-up radiographs showed no progression of slip in either group. The sagittal rotation angle worsened slightly in the anterior fusion group but improved by 5.8 degrees (p < 0.001) on the average in the combined fusion group. There were no instances of pseudarthrosis. Two patients, one in each group, were reoperated on early for postoperative peroneal weakness; both recovered. The clinical and functional results were satisfactory in most cases. The radiological results concerning the sagittal rotation angle were superior in the combined fusion group, but whether this will affect the long-term clinical result is not known.

Adolescent↗

PubMed1996

Experimental lumbar spondylolisthesis in growing rabbits.

Lumbosacral spondylolisthesis was provoked experimentally in growing rabbits by means of a bilateral facet joint resection at the L7-S1 segment. The effects of additional immobilization of the L6-L7 segment with bone cement and of severing the lumbosacral disc on the development of the olisthesis were tested. A mean ventral slip of 21% was seen after the facet joint resection. The slip resembled the spondylolisthesis seen in humans in wedging of the olisthetic vertebra, sacral rounding, and increased sagittal rotation. Combining the facet joint resection with immobilization of the L6-L7 segment resulted in a mean slip of 15%. Morphologic features of the slip were like those seen after a plain facet joint resection. A different result was seen after facet joint resection was combined with severing of the lumbosacral disc. The mean slip was only 6%, and sacral rounding was a prominent feature. This experiment shows that an upright posture of the spine is not a prerequisite for the development of spondylolisthesis. A bilateral facet joint resection in a growing rabbit results in a human like spondylolisthesis. This model may help further experimental studies concerning the changes in the olisthetic disc.

Animals↗

PubMed1996

The role of external transpedicular fixation in anterior interbody lumbar fusion.

The aim of this study was to see whether results of anterior interbody lumbar fusion could be improved with the help of an external transpedicular device. Anterior interbody lumbar fusion was carried out in 83 patients, using the technique described by Suzuki. Fifty-six (67%) patients were fused with the Magerl-Schläpfer external fixator device as a posterior support. Twenty-seven patients had interbody fusion and a conventional plastic brace for support. The clinical and radiological results of anterior interbody lumbar fusion were compared between these groups. The mean follow-up time was 5 (range, 2-10) years. A total of 128 levels were fused. There were no statistical differences in the clinical and radiological results between patients fused with or without the external fixator. There were many complications associated with the use of an external fixator device. We do not recommend the use of an external fixator in anterior interbody lumbar fusion.

Activities of Daily Living↗

PubMed1995

Retrograde ejaculation after anterior interbody lumbar fusion.

Retrograde ejaculation as a complication of anterior interbody lumbar fusion was investigated. The diagnosis of retrograde ejaculation was made on the basis of interviews. Patients were informed of the risk of retrograde ejaculation preoperatively. At the follow-up study the patients were asked if they had noticed retrograde ejaculation after their operation. In one case (anejaculation) testis biopsy and vasography was performed. On average, the incidence of retrograde ejaculation as a complication of anterior interbody lumbar fusion has been very low, ranging from only a few cases up to 5.9% of cases involving male patients. We studied 40 male patients with severe low back pain retrospectively after they had undergone anterior interbody lumbar fusion. The mean age at operation was 31.9 years and the mean follow-up time 5.0 years. Retrograde ejaculation occurred after anterior interbody fusion in nine patients. Permanent retrograde ejaculation developed in seven of these patients (17.5%). These patients were all operated on using a transabdominal approach. Major bleeding during the operation (over 2500 ml) was observed in two patients. Seven patients with retrograde ejaculation had undergone a two-level operation (L4-SI), and eight patients had undergone between one and three previous spine operations. Retrograde ejaculation has been underestimated as a complication of anterior interbody fusion in multioperated low back patients. The possibility of this complication should be kept in mind when planning a transabdominal approach for interbody lumbar fusion in male patients. We do not recommend the transabdominal approach in male patients because of the risk of retrograde ejaculation.

Adolescent↗

PubMed1995

Lack of effect of loratadine on moderate to severe asthma.

BACKGROUND: Antihistamines have been shown to be effective in patients with allergic asthma, but their role in chronic and more severe asthma is uncertain. OBJECTIVES: To evaluate whether loratadine, a selective H1 receptor antagonist, given as an adjunct to standard asthma medication would have any effect in patients with moderate-to-severe asthma. METHODS: Thirty-five patients with moderate-to-severe asthma, most receiving inhaled steroids, were enrolled in this double-blind, crossover study. In addition to their maintenance therapy patients received either loratadine, 20 mg once daily, or placebo for 4 weeks before crossing over to the other preparation for a further 4 weeks. Variables of efficacy were daily and nocturnal respiratory symptoms, lung function (PEF, FEV1, FVC), and bronchodilator use. RESULTS: Three subjects were withdrawn from the study because of deteriorating asthma. There was a trend in favor of loratadine treatment with regard to global assessment of drug efficacy but the difference was not statistically significant. There was no objective improvement in asthma control comparing loratadine with placebo but if each treatment week were compared with the run-in period, PEF was significantly (P < .01) improved during the initial phase of loratadine treatment. This effect gradually decreased with time, suggesting tolerance to any bronchodilatory effect of the antihistamine. CONCLUSION: Loratadine, given as an adjunct to standard asthma therapy, has little if any role to play in the treatment of moderate-to-severe asthma.

Adolescent↗

PubMed1994

Radiographic correlations in adult symptomatic spondylolisthesis: a long-term follow-up study.

A follow-up study was conducted on correlations of radiographic measurements of isthmic spondylolisthesis to indexes of low-back pain as well as functional and working capacity in 148 middle-aged patients treated for low-back pain an average of 17 years earlier. Posterior or posterolateral fusion in situ had been performed in 50% and decompression (Gill's procedure) in 23% of patients, whereas 27% of the patients had been treated conservatively. The mean degree of the slip was 34.4 +/- 19.7% (SD) at follow-up, and the mean progression of the slip during the observation time was 6.1% units. The level of progression of the slip, instability of the olisthetic segment, or radiological nonunion of spinal fusion did not correlate with either the pain index or the activities of daily living (ADL) index. No marked radiological differences were seen between those actively employed and those pensioned. The degree of slip correlated positively with the pain index (r = 0.31; p = 0.007) and the ADL index (r = 0.24; p = 0.026) in the joint group of nonsurgical and decompression-treated patients, whereas negative correlations (pain index, r = -0.22, p = 0.065; ADL index, r = -0.22; p = 0.066) occurred in the fusion group. We conclude that degree of slip and spinal fusion operation are slightly associated with the prognosis of isthmic spondylolisthesis, whereas the other radiological variables of our study showed no association.

Activities of Daily Living↗

PubMed1994

Glove-related skin symptoms among operating theatre and dental care unit personnel (I). Interview investigation.

233 employees in hospital and dental care participated in an interview investigation on glove-related skin complaints. 37% (87/233) reported skin symptoms related to glove use. 2% (4/233) reported localized contact urticaria provoked by latex gloves, 10% (23/233) hand eczema and 24% (56/233) unclassifiable skin intolerance reactions from gloves. Another 2% (4/233) reported facial irritation from gloves. Glove-related skin symptoms were thus reported by more than 1/3 of the personnel and the reported glove-provoked contact urticaria constituted 5% (4/87) of the intolerance reactions.

Adolescent↗

PubMed1994

Glove-related skin symptoms among operating theatre and dental care unit personnel (II). Clinical examination, tests and laboratory findings indicating latex allergy.

Following interviews on glove-related skin symptoms, 202 subjects, 56 hospital workers at an operating theatre and 146 workers at dental care centres, were skin prick tested with different latex extracts. Also, in 193 cases, blood samples were RAST-analysed, using the CAP system. Sensitization to latex diagnosed by positive skin prick test and/or by demonstration of specific antibodies in serum analyses was found in 3.5% of the subjects investigated. 4 cases (2%) showed 1 or more positive skin tests, and 4 cases (2%) had positive RAST to latex antigens. Further work on the diagnostic tools is still needed, as are prognostic studies.

Adolescent↗

PubMed1994

Efficacy and tolerance of a 12-week treatment with inhaled formoterol in patients with reversible obstructive lung disease.

Formoterol, a new beta 2-agonist, and salbutamol were given as aerosols twice and four times daily, respectively, to patients with reversible obstructive lung disease. The study was controlled and double blind, and continued for 12 weeks. Ninety-nine patients from five study centers were included and 89 patients could be properly evaluated. The formoterol-treated patients used significantly less rescue medicine (salbutamol aerosol) and had higher morning PEF values. For the other efficacy variables (daytime FEV1.0, evening PEF, patient and investigator global evaluations, night sleeping time) and tolerance (side effects noted by patients, blood and urine laboratory values, ECG, patient and investigator global evaluation), there were no significant differences between the formoterol- and the salbutamol-treated groups.

Administration, Inhalation↗

PubMed1994

Knee laxity in carpet and floor layers and painters.

The knees of 154 carpet and floor layers and 131 painters were examined clinically and the anteroposterior displacement of the knees was measured with a computer-based arthrometer. The drawer test, the pivot shift and the thigh muscle stretching tests showed greater mobility among carpet and floor layers than among painters. The arthrometric examination showed equal anteroposterior tibiofemoral displacements in the two groups. Two percent of the subjects had a right knee/left knee difference indicating a cruciate ligament insufficiency. Tightness in the rectus femoris stretching test, and among carpet and floor layers also radiographic tibiofemoral osteophytosis predicted small arthrometric changes.

Adult↗