Biomedical subjects

S I Mellgren

Publications and source records attributed to S I Mellgren.

At least 55 records · Page 3Linked to original sources

PubMed1996

MRI of anatomical variants of the wrist in women.

In the analysis of magnetic resonance (MR) images of the wrist joint, some structural variations may lead to misinterpretation. Our aim was to search for different anatomical variants and their MR characteristics on axial images. Two groups of patients with rheumatoid arthritis (thirty one) and carpal tunnel syndrome (sixty two), and a group of asymptomatic controls (fifty four) underwent bilateral MR axial wrist imaging from the metacarpal bases to the distal radiocarpal joint. The imaging techniques included spin echo (SE), turbo spin echo (TSE) and fast field echo (FFE) sequences, using 3 mm-slice thickness. Different anatomical variants including hypoplasia of the hamulus or hook of the hamate bone (4 cases), anomalous muscles (lumbricals) inside the carpal tunnel (2 cases), unusual location (5 cases) and double branching of the median nerve (14 cases), and aberrant median artery (one case) were detected. These variants, if unfamiliar to MR readers, may be misinterpreted as pathological features.

Adolescent↗

PubMed1996

Quantified neurological examination with emphasis on motor and sensory functions in patients with rheumatoid arthritis and controls.

A controlled study of quantified clinical neurological examination, including psychophysical assessment of sensory thresholds, in patients with rheumatoid arthritis (RA) was carried out. Fifty-five women with seropositive RA living in North Norway and 83 healthy controls underwent clinical neurological examination quantified by neurological symptom score (NSS) and neurological deficit score (NDS). Vibration threshold (VT), warm-cold detection threshold (limen) as well as heat pain detection threshold (HPDT) were performed to evaluate afferent myelinated and unmyelinated fibre functions. Higher scores on NSS and NDS were seen in RA patients compared with the controls. Higher index finger and big toe VT was demonstrated in the patients, while results from warm-cold limen and HPDT were not significantly different in the two groups. Among the disease-related variables, the most prominent finding was a positive association of index finger VT with disease duration in the patients (P = 0.01). Maximum walking time (15 m) was a significant predictor of big toe VT in the patient group (P = 0.0001). This study suggests impaired peripheral nerve function in afferent myelinated fibres. However, involvement of dorsal column fibres cannot be excluded, although patients with radiological atlantoaxial subluxation were not included in this study.

Adolescent↗

PubMed1996

Quantitative cerebral MRI in epileptic patients.

OBJECTIVES: To determine cerebral atrophy parameters on MRI images of epileptic patients. MATERIAL AND METHODS: Examination of the brain was performed in a 0.5 Tesla magnet in 32 women with epilepsy and 36 female healthy controls. Fifteen patients were classified to have generalised epilepsy and 17 had partial seizure onset. Epileptic patients with structural brain changes were excluded. At midsagittal level the area of corpus callosum, cerebrum and cerebellum were selected as atrophy parameters. At transverse level the ventricle-brain ratio (VBR) as a measure of overall cerebral atrophy, bifrontal ratio (BFR) reflecting atrophy in the area of the frontal horns, bicaudate ratio (BCR) and bioccipital ratio (BOR) were calculated to evaluate atrophy in the region of nucleus caudatus as well as in the occipital area. RESULTS: The mean values of VBR were significantly larger in the two epileptic groups than in controls, p = 0.0003. No significant difference in mean VBR were found between focal and generalised seizure onset epilepsy. Also significant decreased cerebellar area on midsagittal section was detected in epileptic patients with partial onset epilepsy compared with controls, p = 0.037. Atrophy was not associated with type and duration of epilepsy, but VBR and age were positively associated in patients with generalised onset seizures. CONCLUSION: These findings suggest general brain atrophy to be present in epileptic patients including those with partial epilepsy. Whether atrophy in epileptic patients occurs as a consequence of disease-related factors like hypoxia or treatment with antiepileptic drugs has to be investigated in a prospectively designed study.

Adult↗

PubMed1996

Recovery of sensory function after surgical decompression in carpal tunnel syndrome.

The function of thick and thin sensory nerve fibers after surgical decompression in carpal tunnel syndrome were evaluated using quantitative sensory testing (QST). The thin nerve fibers were studied using tests for thermal thresholds, and the thick myelinated fibers by vibrametry. The tests were performed before surgery and at 6 weeks, 4 and 10 months after surgery. The improvement of function in thin nerve fibers came within 6 weeks (P = 0.001). The improvement of function in thick myelinated fibers continued to improve until 4 months after the operation (P = 0.0001). This difference in the time course of the recovery indicates that the thick myelinated nerve fibers were more affected than the thin nerve fibers. The function of both type sensory nerve fibers did also improve in the fifth finger (P = 0.05). The function in thin nerve fibers worsened somewhat between 6 weeks and 4 months after surgery, possibly due to postoperative scar tissue.

Adult↗

PubMed1996

C-fibre function in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) frequently involves the central nervous system (CNS), but to a considerably lesser degree leads to peripheral neuropathy as measured by conventional nerve conduction velocity studies. Neuropathic symptoms are, however, frequently reported. Abnormalities of other nerve fibers than the large myelinated nerves might thus be responsible for such phenomena. Three age matched groups of 44 patients with SLE, 50 patients with rheumatoid arthritis (RA) and 45 healthy controls were investigated with quantitative sensory thermotesting. Warm detection thresholds (WDT) and heat pain detection thresholds (HPDT) were found significantly higher in SLE compared to RA and controls. There were no differences between the RA and the control group. In the SLE group no association to disease duration, medication or CNS abnormalities were found. Neuropathic symptoms and vibration thresholds showed weak associations to WDT. These findings imply that there is an impairment of C-fibre function in SLE. This small fibre neuropathy is probably not part of a generalized diffuse polyneuropathy also affecting large fibres, although this can not be ruled out completely by this study.

Adult↗

PubMed1996

Nerve conduction studies in rheumatoid arthritis.

We performed a controlled study in search of possible differences in nerve conduction parameters in 52 patients with rheumatoid arthritis (RA) and 77 healthy controls. Nerve conduction studies (NCS) including recordings of motor and sensory amplitudes, the nerve conduction velocities and the distal latencies were investigated in both groups. The mean summed amplitude of compound muscle action potentials was 30.3 mV (SD = 7.9) in the patients compared with 35.9 mV (SD = 6.8) in the controls (p = 0.0001). Contrary to this, the mean values for motor distal latency was 14.3 msec (SD = 2.0) in the patients and 15.9 msec (SD = 1.8) in the controls (p = 0.0001). Decreased values for nerve conduction studies found in the patients may indicate impaired nerve functions in RA. However, the summed motor and sensory distal conduction were in fact better in the patient group.

Adolescent↗

PubMed1996

Quantitative magnetic resonance imaging and the electrophysiology of the carpal tunnel region in floor cleaners.

OBJECTIVES: The purpose of this study was to evaluate possible structural changes of the wrist and subclinical damage in the median nerves of healthy floor cleaners. METHODS: Twenty-four cleaners and 19 referents (noncleaners), all women, underwent bilateral magnetic resonance (MR) wrist examination and nerve conduction studies. They were all randomly selected from an occupational health service. From MR images the volumes of the wrist, carpal tunnel, and thenar and hypothenar muscles were calculated, as well as the signal intensity of the median nerve, bilaterally. RESULTS: No significant difference in the volume of the carpal tunnel was found in the two groups. The relative signal intensity of the median nerve was 0.55 for the cleaners and 0.48 for the referents (P = 0.05). The mean nerve conduction velocity values were 55.2 m.s-1 for the right median nerve of the cleaners and 57.4 m.s-1 for the right median nerve of the referents (P = 0.03). The median nerve of the cleaners had a mean sensory amplitude of 128.2 microV compared with 162.8 microV for the referents (P = 0.01). There was a tendency towards a longer distal latency of the median nerve in the cleaner group. CONCLUSIONS: This study revealed subclinical intrinsic damage to the median nerve, as demonstrated by MR, and poorer electrophysiological nerve function among workers at high risk (cleaners) compared with workers at lower risk (noncleaners).

Adult↗

PubMed1996

Autonomic nervous system function in rheumatoid arthritis. A controlled study.

OBJECTIVE: To study cardiovascular autonomic nervous functions in patients with rheumatoid arthritis (RA) compared with controls and to investigate fasting and meal stimulated pancreatic polypeptide (PP) in RA and its possible associations with autonomic functions and disease activity. METHODS: Forty-three women meeting the American Rheumatism Association 1987 diagnostic criteria for RA and 61 healthy controls were studied. Blood pressure recordings and cardiovascular heart rate studies were performed. PP was measured by radioimmunoassay. RESULTS: Cardiovascular reflexes were equal in the 2 groups, but the patients had significantly higher fasting plasma PP level with mean log10 value of 0.94 pmol/l (SD = 0.38) compared with 0.68 pmol/l (SD = 0.35) in the controls (p = 0.0006). Mean log10 plasma PP increase 30 min after the meal was 1.80 pmol/l (SD = 0.42) for the patient group and 1.47 pmol/l (SD = 0.40) in the controls (p = 0.0001). Feeding caused a mean PP increase of 1.85 (SD = 0.42) for the patients and 1.44 (SD = 0.42) in the controls 60 min postprandially (p = 0.0001). Multiple regression and correlation analysis showed no association between PP and disease activity. CONCLUSION: The higher basal and postprandial PP in the RA group indicates a relationship between the disease and PP by unknown mechanisms.

Adolescent↗

PubMed1995

[Peripheral neuropathies].

Some new aspects of peripheral nerve disease are reviewed. Hereditary motor and sensory neuropathy (HSMN) constitutes a genetically heterogeneous group of chronic polyneuropathies with loci mapping to chromosome 17 (type Ia), chromosome 1 (type Ib), and the X chromosome (X-linked HSMN). Although peripheral nerve abnormalities occur in approximately 50% of diabetic patients, the frequency of severe diabetic neuropathy even in insulin-dependent persons is rather modest (6%). Intensified insulin treatment seems more important for preserving peripheral nerve function than treatment with aldose reductase inhibitors. Acute inflammatory demyelinating polyradiculoneuropathy (Guillain-Barré syndrome) and chronic inflammatory demyelinating polyneuropathy may both be beneficially influenced by plasma exchange or intravenous immunoglobulin. In acute inflammatory demyelinating polyradiculoneuropathy, campylobacter jejuni infection is a common preceding event. There is some evidence of cross reactivity between this infectious agent and the ganglioside GM1 in peripheral nerve myelin.

Female↗

PubMed1995

Mental health status in systemic lupus erythematosus.

Mental health status was assessed in 43 SLE patients and 32 healthy controls applying the GHQ-30 version of The General Health Questionnaire. A 46.5% prevalence of non-psychotic psychiatric disturbance was found in SLE patients compared to 15.6% in the control group (p = 0.01). Factor analysis displayed that SLE patients reported far more depression and difficulty in coping compared to controls. In SLE patients, impaired mental health showed significant associations to several disease associated neurological manifestations, as well as to disease activity. The results indicate that the disease itself influences the psychological well being in a substantial number of patients with SLE.

Adult↗

PubMed1995

Quantitative cerebral MR in rheumatoid arthritis.

PURPOSE: To determine the presence of hyperintense white matter lesions and atrophy reflecting cerebral vasculitis in rheumatoid arthritis. METHODS: Thirty-three patients with rheumatoid arthritis and 48 control subjects were examined with MR. Mean age was 45.1 years (range, 26 to 55 years) for the patients and 42.2 years (range, 25 to 55 years) in the control group. To determine atrophy we measured the area of corpus callosum, the cerebrum, and the cerebellum on midline sagittal sections. On transverse images, the ventricle-to-brain ratio, the bifrontal ratio, and the bicaudate ratio were selected as atrophy parameters. Area and signal intensity were measured for the biggest and the smallest lesions in both groups. RESULTS: Nine patients (27%) had hyperintense lesions compared with 15 (31%) of the control subjects. Mean numbers of hyperintense lesions were 1.3 in patients and 2.1 in control subjects. Mean area of the largest lesion in each patient was 27.4 mm2 for the patients and 29.8 mm2 in the control group. In patients with long disease duration (> 15 years) the mean ventricle-to-brain ratio was 0.09 compared with 0.08 in the control subjects. The midsagittal area of the cerebellum was 1349.8 mm2 in the patients with long disease duration and 1573.3 mm2 in the control group. No difference in number of hyperintense white matter lesions was detected between patients with long disease duration and the control subjects. Comparing the total group of patients with the control subjects, no significant differences in atrophy parameters or hyperintense white matter lesions were found. Also, there were no significant differences in relative signal intensity of the hyperintense lesions and corpus callosum between the two groups. We were not able to detect differences between treated versus untreated patients. CONCLUSION: This study indicates a tendency of more cerebral and cerebellar atrophy in patients with severe rheumatoid arthritis. The number and size of the white matter lesions were not significantly different in the two groups and do not support a higher frequency of even clinically silent infarcts caused by vasculitis in the patients with rheumatoid arthritis compared with control subjects.

Adult↗

PubMed1994

Autonomic function in systemic lupus erythematosus.

A controlled study with paired analysis of data was performed in 34 patients with systemic lupus erythematosus (SLE) and 34 age and sex-matched healthy controls. Autonomic function was not affected significantly in SLE patients as judged by standardised cardiovascular tests. Pancreatic polypeptide (PP) response to meal stimulation, which is impaired in parasympathetic failure, was for unknown reasons found to be significantly increased in SLE patients both in unstimulated and stimulated states. Neither cardiovascular nor serological tests could thus reveal significant autonomic dysfunction in SLE. Drugs with cardiovascular effects highly influenced autonomic function and could thus be misinterpreted as autonomic dysfunction caused by SLE itself.

Adolescent↗

PubMed1993

A controlled study of peripheral neuropathy in systemic lupus erythematosus.

In 34 patients with systemic lupus erythematosus (SLE) and 34 age- and sex-matched healthy controls we performed standardized quantifiable neurological testing for neuropathic symptoms (Neuropathic Symptom Score) and deficits (Neurological Disability Score), as well as nerve conduction velocity studies (NCV) and determination of vibration thresholds (VT). SLE patients had more neuropathic symptoms and deficits than controls. Most quantitative and qualitative NCV attributes showed no difference between patients and controls. However, if categorized as NCV abnormalities of 2 or more nerves in each individual, a frequency of polyneuropathy of 21% was seen in SLE patients compared to 6% in controls. VT indicated a slight, but widespread, diffuse polyneuropathy in patients compared to controls.

Adolescent↗

PubMed1992

The clinical significance of sleep apnoea in workers exposed to organic solvents: implications for the diagnosis of organic solvent encephalopathy.

Among 51 patients referred for investigation of possible organic solvent encephalopathy 20 (39%) had pathological sleep apnoea [apnoea index (AI) greater than 5], compared with 5 of 16 house painters exposed to solvents (31%) who were screened for the disorder, and 1 of 18 (6%) age-matched controls. Twelve of the patients with AI greater than 5 were retested after 2 or more weeks without exposure to solvents, and showed a significant drop in AI. Likewise, significantly lower AI was seen in patients who were no longer exposed to solvents, compared with recently exposed patients. The implications of these findings for diagnostic evaluation of solvent encephalopathy and sleep apnoea are discussed.

Adult↗

PubMed1991

[Mitochondrial diseases. Diagnostic light and electron microscopic changes in muscle biopsies from patients with mitochondrial myopathy].

Mitochondrial myopathy can be caused by several metabolic defects in the mitochondria. Cells with high levels of oxidative metabolism, such as skeletal muscle, myocardium and brain cells, are particularly vulnerable to these defects. We describe the structural changes in muscle biopsies from 49 patients with mitochondrial myopathy. The younger patients were often symptom-free, but the possibility of a genetic defect was suggested by the family history. "Ragged-red fibres" were found in 10% of the biopsies. Typical paracrystalline inclusions were seen in the mitochondria of the oldest patients. Electron-lucent matrix and increased thickness of the inner membranes of the mitochondria in particular were found in the younger patients. Disorganization of cristae, with cristolysis and unfolding of the cristae was also found. We suggest that structural mitochondrial changes in mitochondrial myopathy constitute a stepwise process and that the mitochondrial alterations of the cristae may represent an early stage in the morphogenesis of mitochondrial disease.

Age Factors↗

PubMed1991

Mitochondrial myopathy in Marinesco-Sjögren syndrome.

Myopathy represents one of the major features of Marinesco-Sjögren syndrome (MSS). Seven patients with MSS from three different families were studied with morphological and neurophysiological methods. In two patients ragged-red fibres were found after Gomori trichrome staining. Transmission electron microscopy (EM) showed that subsarcolemmal accumulation of abnormal mitochondria regularly occurred and in one patient paracrystalline inclusion bodies were found. The EMG showed myopathic changes while the nerve condition velocities were normal. A delayed normalization of exercised-induced hyperlactatemia was noted. These findings show that mitochondrial myopathic changes are present in MSS.

Adolescent↗

PubMed1991

Peripheral neuropathy in systemic lupus erythematosus.

We studied 33 consecutive patients with systemic lupus erythematosus (SLE) for neuropathy by employing the Neuropathy Symptom Score (NSS), Neurological Disability Score (NDS), EMG and nerve conduction velocity (NCV) studies, and determinations of vibration thresholds (VT). Polyneuropathy defined as NCV abnormalities of two or more nerves occurred in seven patients (21%). Neuropathic symptoms showed a poor correlation with NCV and VT, while clinical neuropathic signs, VT, and NCV correlated with each other in most instances. When reporting frequencies of neuropathy in SLE, NCV studies should be used as a basis. NSS, NDS, and VT give additional quantifiable information and can be useful in the follow-up of patients and for evaluating the response to therapy.

Adolescent↗

PubMed1991

Muscular weakness in systemic lupus erythematosus.

We systematically evaluated muscular weakness in a series of patients with systemic lupus erythematosus (SLE) using standardized neurological scoring systems, namely Neuropathy Symptom Score for symptoms, and Neurological Disability Score for signs. Symptoms of weakness were statistically associated with clinical and electrophysiological evidence of nerve and muscle disease. Signs of weakness were statistically associated with malaise, disease activity, anemia, age, and raised erythrocyte sedimentation rate. Various disease associated variables influenced symptoms and signs differently. It is important to define a baseline characterizing muscular weakness in SLE before conclusions are drawn regarding its significance and prevalence.

Adolescent↗