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Biomedical subjects

T Gustafson

Publications and source records attributed to T Gustafson.

At least 37 records · Page 2Linked to original sources
PubMed1985

Gastrointestinal function in patients with progressive systemic sclerosis.

In 24 patients with progressive systemic sclerosis (PSS) the pentagastrin-stimulated gastric acid secretion was determined to investigate if acid hypersecretion is associated with reflux-oesophagitis--the most common complication to oesophageal involvement in PSS. Gastro-oesophageal reflux was observed in 12, reflux-oesophagitis in 9 and oesophageal mycosis in 8 patients. Gastric acid secretion was increased in 13 (54%) patients and tended to be higher in patients with oesophagitis. Patients with reflux and increased acid secretion seemed to be free from oesophageal mycosis. Bacterial overgrowth and malabsorption are known complications to intestinal scleroderma and these items were investigated using non-invasive methods. Four patients had increased bile acid deconjugation, 3 had increased (14C)xylose degradation indicating bacterial overgrowth and 7 patients had decreased fat absorption in the triolein breath test. Nutritional status with respect to selenium, folate, cobalamin and fat-soluble vitamins was essentially normal.

Adult↗
PubMed1985

Traumatic hip joint tamponade. Two cases with femoral head ischaemia.

Two elderly patients had pain after hip trauma with no radiographic evidence of fracture. Computed tomography demonstrated capsular haematoma. Scintimetry revealed femoral head ischaemia. Intracapsular hip joint pressure in extension was 240 and 176 mm Hg, respectively, in neutral position and 280 and 360 mm Hg in internal rotation. The hip joints were aspirated for 8 ml and 5 ml of blood, respectively, leading to pain relief and regained radiotracer uptake in the femoral head. It is concluded that traumatic hip joint tamponade may cause femoral head ischaemia which may be reversed by aspiration.

Accidents, Home↗
PubMed1985

Intracapsular pressure in transient synovitis of the hip.

Fourteen consecutive children with symptoms of transient synovitis of the hip were examined with sonography regarding intracapsular effusion, with scintimetry regarding blood-flow in the proximal femoral epiphysis (PFE) and with intracapsular pressure recording and aspiration. All patients had an intracapsular effusion. Intracapsular pressure was found to depend on the position of the hip. The mean pressure with hips in extension and inward rotation was 22.6 kPa (170 mm Hg) whereas in 45 degrees of flexion it was 2.3 kPa. In two cases scintimetry demonstrated reduced blood flow to the PFE; after aspiration, isotope uptake returned to normal, indicating that increased intracapsular pressure has a harmful effect on circulation to the PFE. Children with transient synovitis should be treated with the hips in 45 degrees of flexion to reduce intracapsular pressure. Forcing the hip in extension causes a risk of ischaemia of the PFE.

Adolescent↗
PubMed1985

Preoperative herniography in clinically manifest groin hernias.

Herniography was performed in 88 patients (7 females, 81 males) clinically judged to have a groin hernia. The preoperative herniography demonstrated the exact type of hernia in 62 out of 94 hernias operated on (66%), and the hernias found at operation were predicted by the herniography in 69 out of 94 hernias operated on (73%). A contralateral asymptomatic hernia was revealed by herniography in 17 out of 88 patients. The majority (11) of these hernias were small and lateral. One patient with an asymptomatic femoral hernia underwent hernioplasty. The remaining 16 patients have not been operated on and have remained symptom-free. According to our experience, preoperative herniography does not appreciably alter the operative management of patients with clinically manifest groin hernias. Although the examination reveals a significant number of additional asymptomatic hernias, this diagnostic knowledge is probably of minimal clinical significance, especially when considering the discomforts and cost of the examination.

Adult↗
PubMed1984

Herniography--a useful diagnostic method in patients with obscure groin pain.

118 adult patients (45 females, 73 males) with obscure inguinal pain but without clinical signs of hernia were investigated with herniography. The examination revealed inguinal hernia in 37 instances (15 females, 22 males; 31.3%). Thirty out of these 37 patients (12 females, 18 males) have been operated on. Two false positive cases of the herniography examination have been encountered, giving a diagnostic specificity of herniography of 93.3% (95% confidence interval 78-99%). Six patients (5 females, 1 male) with a negative result of herniography have been operated on. One hernia was detected among these, i.e. one false negative result of herniography. The remaining 75 patients (25 females, 50 males) with a negative result of herniography have not yet developed any hernia. We conclude that herniography is a valuable radiological investigation for demonstration of adult preclinical hernia.

Adolescent↗
PubMed1982

Intestinal circulation in coeliac disease: an angiographic study.

Selective angiography of the superior mesenteric artery (SMA) was performed in 14 patients with coeliac disease and in 20 sex- and age-matched patients without malabsorption. In coeliac disease there was a significant increase in the SMA diameter and a significantly shortened intestinal circulation time as compared to controls, reflecting an increased blood flow and/or a reduced blood volume in the diseased intestine.

Adolescent↗
PubMedDate not supplied

Circulatory disturbance of the first metatarsal head after Chevron osteotomy as shown by bone scintigraphy.

Distal osteotomies, such as Chevron osteotomies, have a potentially high risk for circulatory disturbance, since they transect part of the circulatory apparatus. An increased risk of up to 40% of avascular necrosis diagnosed radiographically has been reported when the osteotomy is combined with adductor tenotomy. On the other hand, new circulatory studies indicate that the circulation does not go in direct proximity to the adductor tendon. In this prospective study, 38 consecutive patients (41 feet) were randomized to Chevron osteotomy alone or Chevron osteotomy with adductor tenotomy. They were investigated 2 to 9 days postoperatively with 99mTc-methylene diphosphonate scintigraphy as well as x-rays and clinical examination. The average follow up was 19 months (range 12-48 months). Three defects were found in those operated with Chevron osteotomy alone, and one defect was found in a patient operated with Chevron osteotomy and adductor tenotomy. None of the patients had symptoms attributable to reduced circulation of the metatarsal head. Repeat scans showed healing in all four cases. Radiographs failed to show any signs of necrosis. Thus, Chevron osteotomy is a safe method in the treatment of hallux valgus which can be combined with adductor tenotomy without increasing the risk for circulatory disturbance.

Adult↗
PubMedDate not supplied

Cineradiography identifies esophageal candidiasis in progressive systemic sclerosis.

Cineradiography of the esophagus showed signs of esophageal candidiasis in 11 out of 71 patients with progressive systemic sclerosis (PSS) - both in diffuse scleroderma and the CREST syndrome. Culture of esophageal brushings confirmed the presence of Candida albicans in eight of these 11 patients. Antimycotic treatment decreased the cineradiographic signs of candidiasis and the degree of dysphagia. Since impaired esophageal motility and treatment with immunosuppressive drugs may predispose to candida esophagitis, and since dysphagia will decrease after antimycotic treatment esophageal mycosis should always be sought in patients with PSS.

Candidiasis↗
PubMedDate not supplied

Bone scintigraphy in staging of bladder carcinoma.

The role of bone scintigraphy in the staging of bladder carcinoma before attempted radical therapy was evaluated from a personal series of 71 consecutive cases. The results from this were correlated to previous reports--accumulated data from a total of 458 staging bone scans were thus obtained. In this accumulated material metastases were diagnosed in 4.6 per cent--in 2.8 per cent true positive and in 1.7 per cent false positive findings. The effect of the bone scanning results on therapy was minimal: cystectomy was performed in spite of the diagnosis of metastases in 16 out of 21 patients. In only 4 patients (0.9%) surgery was avoided because of scintigraphy results. Scintigraphy thus has no place in the routine preoperative staging of bladder carcinoma.

Aged↗
PubMedDate not supplied

Radiography and scintigraphy in the assessment of early gonarthrosis.

The radiographic and scintigraphic appearances in early gonarthrosis were compared in 62 knees. Early femorotibial osteoarthrosis was found to be confined to one compartment (medial or lateral) of the joint. However, concomitant patellofemoral osteoarthrosis was common. 99Tcm-MDP scintigraphy was consistently positive when the joint space (femorotibial and patello-femoral) was reduced by 75 per cent or more. Joint space narrowing by as much as 50 per cent could be observed in a scintigraphically normal knee. The inconsistency between the radiologic and scintigraphic findings in the earliest stages of gonarthrosis points to the importance of appropriate radiographic technique.

Aged↗