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Biomedical subjects

N Egund

Publications and source records attributed to N Egund.

At least 91 records · Page 5Linked to original sources

Roentgen stereophotogrammetry in high tibial osteotomy for gonarthrosis.

In three cases operated with high tibial osteotomy for medial gonarthrosis the exact method of roentgen stereophotogrammetry with tantalum balls as bone markers (Selvik 1974) was used to study angular and translational movement in three dimensions at the operation and during the healing period. Tibial osteotomy caused angular and translational movements even in planes where correction was not intended, and the stereo technique revealed that stability was not present when knee mobilisation started. Correlation between the stereo values and conventional radiographic measurements were best in the frontal plane (root mean square value of discrepancies 1.3 degrees). Roentgen stereophotogrammetry gives superior information compared with the conventional radiographic technique, but it is concluded that the latter has sufficient accuracy for the clinical assessment of corrections in the frontal plane.

Aged↗

Tibial osteotomy in medial gonarthrosis. The importance of over-correction of varus deformity.

In a prospective series of 52 knees selected for high tibial osteotomy because of early medial arthrosis, special care was taken to obtain a final over-correction in valgus. The operative procedure and the pre- and post-operative radiographic examinations were standardized and the follow up was 1-3 years. 49 of the 52 knees had obtained a normal or over-corrected mechanical axis. 45 of these had improved painfree walking distance, and 31 were painfree. In 45 knees the arthrotic condition had not progressed, and in 5 of these there were signs of cartilage restitution. It is concluded that precise correction of medial gonarthrosis can be achieved, and this provides a rational basis for definitive treatment of early stages of this condition: for the majority an endoprosthesis operation should not be needed in the future.

Adult↗

Growth disturbance after physial injury of distal femur and proximal tibia studied by roentgen stereophotogrammetry.

Longitudinal growth determined by roentgen stereophotogrammetry was registered in three patients with physial injuries in distal femur and in two patients with physial injuries in proximal tibia during 18 months. The injuries in distal femur were classified as Type I, Type I kII and Type IV and in proximal tibia as Type I kII and Type IV in the different cases according to Salter and Harris. Markers of tantalum balls were implanted into the metaphysis and bony epiphysis of distal femur and proximal tibia permitting regular determination of longitudinal growth. Significant growth disturbances was registered in four patients. The Salter-Harris classification was difficult to use to predict growth disturbance after physial injuries around the knee. The roentgen stereophotogrammetric method was found useful to determine normal growth rate and after physial injuries to reveal growth disturbance leading to complete or partial growth arrest resulting in leg length discrepancy or angular deformity. This method facilitates preoperative planning if surgery is needed.

Adolescent↗

CT of soft-tissue tumors.

Computed tomography was performed on 52 patients with soft-tissue tumors, 36 malignant and 16 benign. Major advantages with CT include the possibility of differentiating between lipoma and other tumors and the ability to demonstrate the transverse location of a lesion (intra- or extracompartmental). It was not possible to relate attenuation values to histologic type or grade of malignancy. CT was found superior to conventional radiography in demonstrating additional bony destruction of the pelvis and spine. The risk of overestimating the size of high grade malignant tumors because of accompanying edema is discussed. CT should precede angiography in the investigation of soft-tissue tumors, and angiography may primarily be reserved for those lesions where vascular relationships are not adequately demonstrated by CT.

Adolescent↗

High tibial osteotomy: a seven-year clinical and radiographic follow-up.

A series of 107 knees were evaluated for mobility, stability and pain relief two and seven years after high tibial osteotomy for correction of deformity secondary to arthrosis; patients with rheumatoid arthritis were excluded from this series. Eighteen knees had lateral femorotibial arthrosis, or which only six had good results at seven year follow-up. As many as six knees required further surgery. Of the 89 knees with medial arthrosis, 45 had good results, 36 did not and the remaining eight required further surgery. Lasting pain relief was clearly associated with correction of the mechanical axis of the knee which was more difficult to achieve in severe stages of the disease. In 22 of the 24 corrected knees, the disease had not progressed further. Six of these showed radiographic signs of cartilage repair. By contrast, two-thirds of the undercorrected knees had further progress of the disease. The opposite compartment did not suffer from the increased load on the articular cartilage; only three overcorrected knees showed cartilage narrowing, and they were painless. High tibial osteotomy is a reliable method for definitive treatment of early medial type gonarthrosis provided that the radiographically defined mechanical axis is adequately corrected.

Aged↗

Dynamics of Technetium-99m methylenediphosphonate imaging of the femoral head after hip fracture.

A prospective study of the development of necrosis of the femoral head was performed in 34 patients with fractures of the femoral neck. Technetium-99m MDP images of the hip regions were obtained immediately after nailing of the hip and at four, eight and 12 months. There was a good correlation between qualitative and numeric evaluation of isotope uptake in the femoral heads. Comparison of the activity level in the femoral head on the fracture side with that in the contralateral control site showed activity ratios to vary between < 1.0 for those heads showing a general reduction in activity on conventional images to > 1.4 with a mean of 2.0 for those showing increased activity. The initial postoperative images in 2/7 undislocated fractures showed a marked depression in femoral head activity on the fracture side; 13/21 dislocated fractures showed a similar defect suggesting a significant loss of bone remodeling. Normal Tc-99m activity in the femoral head (category 2) was observed in two fracture cases imaged within 24 hours of fracture, just prior to nailing. Repeat studies within one week of fracture and nailing demonstrated a marked depression in activity (category 0). Radiographic evidence of collapse later developed in both patients. The perfusion and blood pool images were useful for identifying femoral heads with deficient circulation. This investigation has demonstrated that the nailing procedure may threaten the vascular condition of the femoral head in hip fracture, that a dead head may be radiographically normal and clinically asymptomatic, and that the metabolic condition of the femoral head may be expressed in numeric terms suitable for statistical analysis.

Adult↗

Adrenergic and cholinergic responses in the uteroplacental vascular bed of the guinea pig.

The effects on uterine and maternal placental circulation of adrenergic and cholinergic drugs, injected selectively in the ovarian and uterine arteries of guinea pigs, were analysed by serial angiography. Noradrenaline, 0.5 nmol/kg, was found to cause a reduction in both ovarian and uterine blood flow, associated with arterial vasoconstriction and impairment of the placental circulation. This response could be prevented by alpha-adrenergic blockade with 25 nmol/kg phenoxybenzamine. At injection into the ovarian artery, phenoxybenzamine alone increased ovarian blood flow and elicited arterial vasodilatation. At injection into the uterine artery the response was more variable, but vasodilatation was observed in four animals of six. Acetylcholine, 0.5 to 5.0 nmol/kg, evoked an increase in both ovarian and uterine blood flow and arterial vasodilatation. When the dose was increased to 50 nmol/kg, dilatation of the extrinsic uterine arteries was maintained, but the placental circulation was reduced due to concomitant contraction of the myometrium. All the effects of acetylcholine could be blocked by prior administration of 10 nmol/kg atropine. This dose of atropine did not affect uterine or placental circulation when given alone.

Acetylcholine↗

Instability and wear of total hip prostheses determined with roentgen stereophotogrammetry.

A roentgen stereophotogrammetric analysis of hip prostheses was made in four patients with rheumatoid arthritis during a postoperative period of 2 years. Implanted tantalum balls, prosthetic femoral head, and ends of the wire in the acetabular socket were used as measurement points. The migration of the prosthetic head and the acetabular socket in relation to the pelvic bone was determined. The difference between the cranial migration of the head and the socket is a measure of the postoperative instability of the hip joint and deformation of the prosthetic components. This deformation occurs in the plastic acetabular socket and is mainly due to wear. The roentgen stereophotogrammetric method can be applied to standard hip orostheses with a metal femoral head and a plastic or metal acetabular socket to study migration or loosening of the prosthesis in relation to the supporting bone, prosthesis instability, and deformation of the prosthetic components.

Adult↗

Movements in the sacroiliac joints demonstrated with roentgen stereophotogrammetry.

Using a roentgen stereophotogrammetric method, the three-dimensional movements in the sacroiliac joints were quantified in 4 patients. To provoke motion of the sacrum, changes between body positions and a test with manual pressure were used. In tests with symmetric forces on the sacrum, it in most cases rotated mainly about a transverse axis and at most approximately 2 degrees. The axis of rotation passed through the iliac bones mainly in the lower part of the iliac tuberosity. The rotations between the iliac bones and the sacrum about any of the three main axes were determined with a precision in the mean of 0.2 degrees. The distance between the two superior posterior iliac spines varied at most 0.4 mm between seven different body positions.

Adult↗

Catheterization and angiography of the abdominal arteries in the guinea-pig.

The abdominal arterial anatomy of the guinea-pig was investigated by angiography and dissection. Normally, a coeliacomesenteric trunk was found, although various forms transitional to the hepatolienogastric trunk were found. Multiple renal arteries were common in comparison to other laboratory animals and to man. A technique for selective catheterization of the abdominal arteries is described.

Abdomen↗

Reduced noradrenaline uptake and retention in cerebrovascular nerves associated with angiographically visible vasoconstriction following experimental subarachnoid hemorrhage in rabbits.

Rabbits were injected with 1-2 ml autologous blood into the chiasmatic and basal cisterns to stimulate subarachnoid hemorrhage. Selective vertebral angiography performed at various time-periods following blood injection showed a 27 per cent reduction in basilar artery diameter within 3-5 days, followed by normalization so that pre-injection size was regained within 26 days after the treatment. Formaldehyde histofluorescence of the major basal pial arteries showed almost 75 per cent reduction in number and fluorescence intensity of visible perivascular adrenergic nerves at 3-7 days following blood injection. The noradrenaline fluorescence in a normal number of nerves returned to control values at 26 days after treatment. The noradrenaline reduction in the perivascular nerves was confirmed in fluorometric determinations. The presence of cisternal blood markedly impaired the neuronal uptake of 3H-noradrenaline at 3 days following the injection. The transmitter uptake had normalized 2 weeks later. The impaired neuronal uptake of noradrenaline in the presence of cisternal blood is in accordance with the net reduction in transmitter of the perivascular nerves, and may provide one pathophysiological factor in the development of angiographically visible vasoconstriction, having a time-course resembling that of the functional changes in the perivascular adrenergic nerves.

Adrenergic Fibers↗

The effect of arthrocentesis in transient synovitis of the hip in the child: a longitudinal sonographic study.

Twenty-one children with transient synovitis of the hip were treated in two consecutive groups. In 12 patients aspiration of the synovial effusion was performed within 24 h of admission. In a second group of nine patients no aspiration was performed. There was no other difference in treatment. Joint effusion was studied sonographically in comparison with the nonsymptomatic contralateral hip. Sonography was performed immediately after admission, within 12 h after aspiration, and repeatedly during a follow-up period of up to 15 days. Following aspiration the capsular distention decreased to 49% but recurred within 24 h to 72% of the preoperative value. However, during the first 4 days of follow-up the capsular distention in the aspirated cases was significantly and permanently lower than in the nonaspirated cases. We conclude that arthrocentesis in the acute stage of transient synovitis of the hip in the child permanently reduces the intracapsular effusion.

Child↗