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Biomedical subjects

T Holmström

Publications and source records attributed to T Holmström.

At least 55 records · Page 3Linked to original sources
PubMed1983

Long-term controlled trial with diphosphonate in patients with osteolytic bone metastases.

Thirty-four normocalcaemic women with multiple osteolytic bone metastases from breast cancer were randomly allocated to treatment with disodium dichloromethylene diphosphonate (Cl2MDP) 1600 mg/day orally (17) or placebo (17) for 3-9 months. Fasting urinary hydroxyproline/creatinine and calcium/creatinine ratios declined in the Cl2MDP group but not in the placebo group. Four patients in the placebo group died from hypercalcaemia. New bone metastases were more common in patients on placebo and these patients also required more analgesic drugs than those on Cl2MDP. Cl2MDP seemed to reduce bone pain and bone resorption and prevent the development of hypercalcaemia caused by osteolytic metastases. The formation of new bone metastases and the growth of old ones seemed to be retarded by Cl2MDP.

Adult↗
PubMed1983

Long-term 1,25-dihydroxycholecalciferol treatment in renal failure.

1,25-Dihydroxycholecalciferol (1,25-DHCC) was administered to four patients on maintenance hemodialysis and to four patients with renal failure not requiring hemodialysis. Secondary hyperparathyroidism was found in both groups of patients. Before initiation of 1,25-DHCC treatment both groups had serum 1,25-DHCC levels below the normal range (33.1 +/- 15.3 pg/ml). During the treatment period, serum 1,25-DHCC concentrations were normalized. Parathormone concentration in serum decreased in both groups during the observation period. Serum calcium concentration was normalized in patients with renal failure and within the upper normal range in patients on maintenance hemodialysis. Bone biopsy and densitometry, of the radius showed a trend towards normalization of bone during the treatment period, while X-ray studies showed no clear effect of 1,25-DHCC treatment. This study shows that changes in bone mineralization can be reversed by normalization of 1,25-DHCC.

Adolescent↗
PubMed1982

Histological changes in clinical half-joint allograft replacements.

Fourteen biopsies of cartilage and subchondral bone were taken from nine half-joint knee allografts 10 weeks to 8 years after the transplantation. Deep-frozen cadaver grafts were used to replace the defective half-joint after resection for bone tumour. The biopsies revealed a slow substitution of the dead grafted bone and cartilage. Subchondrally, signs of incorporation could be seen from 12 months on. The dead cartilage matrix degraded gradually and slow simultaneous regeneration was observed. Thus, fibrocartilage was seen on the articular surface of the graft at 12 months, chondrocytes were present at 18 months, but islands of hyaline cartilage were not seen earlier than 7 years after the transplantation. In accordance with the earlier clinical findings, the histological signs of rejection were minimal. The long-term result of half-joint allograft transplantation is obviously dependent on the cartilage component.

Adolescent↗
PubMed1981

Replacement of the femoral head by ceramic endoprosthesis. An experimental study on rabbits.

In 31 rabbits the femoral head was replaced by a ceramic endoprosthesis. For 11 of the experimental animals the endoprostheses were made by the Arabia China Factory in Helsinki, and for 20 by Staatliche Porzellan Manufaktur in Berlin. The operation was performed under fully sterile conditions and the follow-up time was between 6 and 34 weeks. The hip joint was examined clinically, roentgenologically, macroscopically and histologically. The bending tolerance of the ceramic endoprosthesis was not adequate. Mechanical loosening of the proximal part of the prosthesis occurred in 68 per cent and was combined with fracture of the prosthetic stem. This created a pseudarthrosis-like reaction in the acetabular area and limited the movement of the hip joint. The distal fragment of the stem was always surrounded by a thin layer of dense bone. In the nonfractured cases (32 per cent), however, the reaction was only moderate and the movement of the hip joint was well preserved. The tissue reactions to the ceramic material were slight, but the great number of secondary reactions following stem fractures make the use of the ceramic endoprosthesis questionable in experiments with rabbits.

Animals↗
PubMed1981

Severe gastrointestinal bleeding due to carcinoid tumour of the ileum.

Repeated episodes of severe intestinal bleeding in a 55-year-old male were found to originate from multiple small carcinoid tumours of the ileum. Laparatomy was performed after extensive negative endoscopic and radiological investigation of the bleeding site, and five tumours, 6 to 15 mm in diameter, were found within a 40 cm bowel segment. The most distal tumour was situated 50 cm from the ileocaecal valve. The site of bleeding was erosion of the bowel mucosa at the largest tumour. The affected bowel was excised, including its mesentery with two lymph nodes containing small islands of metastatic carcinoid tumour. Otherwise no metastases were found.

Carcinoid Tumor↗
PubMed1981

Connective tissue changes in autogenous vein graft used as a mesocaval shunt.

Autogenous jugular vein was used as a mesocaval shunt in dogs with ligated portal vein. Nine out of fifteen animals survived the operation and could be used for further studies one month postoperatively. Immediately after the shunt procedure an increased portosystemic pressure gradient was observed. However, this returned to normal at one month after the operation. At this time the graft was patient in seven out of nine dogs. Histological studies of the graft showed a smooth neointima and an increased number of elastin fibers in the media. The collagen concentration of the vein wall was significantly reduced and the glucosaminoglycans were significantly increased. It was however, not possible to assess the relative role of the operative trauma and the new haemodynamic and anatomical environment.

Animals↗
PubMed1981

Xanthomas of the Achilles tendon.

The patients with xanthomas bilaterally in the Achilles tendons associated with type-II hyperbetalipoproteinaemia are reported. Both patients had elevated serum cholesterol, normal or slightly elevated serum triglycerides and an electrophoretic pattern of elevated beta and pre-beta lipoproteins. Subtotal resection of the tumours was found to be satisfactory in both patients with less risk of complications when compared with the earlier methods reported with total excision and reconstruction of the defect with fascial grafts. The early recognition and evaluation of the patients with hyperbetalipoproteinaemia is important because it is associated with an increased incidence of atheromatous coronary disease, often manifestated at an early age. That is why surgical interventions of tendon xanthomas must be connected with adequate medical treatment of the basic disorder in lipid metabolism

Achilles Tendon↗
PubMed1979

The healing of experimental fractures by compression osteosynthesis. I. Torsional strength.

Biomechanical properties of osteotomized rabbit tibio-fibular bones fixed with 6-hole stainless steel AO/DCP plates were investigated with torsional loading 3 to 24 weeks postoperatively. During the first 9 weeks maximum torque capacity, energy absorption and torsional rigidity increased, reflecting progressive bony union between the fractured bone ends. From 9 to 24 weeks the values of torque capacity and energy absorption decreased, whereas torsional rigidity seemed to reach a steady state without further significant changes. For the three parameters considered, the mean percentage differences between the osteotomized plated bones and their paired-sham-operated controls were 69, 64 and 80 per cent, respectively. The results suggest that internal fixation of fractured bones provides conditions for undisturbed fracture healing, but that subsequently the rigid nature of the implant has an adverse effect on the cortical bone, which slowly loses strength. Thus the optimal time for removal of the plate seems to be shortly after the fracture has healed and before the bony tissue had been weakened by secondary changes, such as cancellous transformation and spatial rearrangement of the tubular bone.

Animals↗
PubMed1978

Structural changes in intact tubular bone after application of rigid plates with and without compression.

The influence of a rigid plate on the structure of intact tubular bone was studied in forty adult rabbits using a four-hole commercial-steel DCP-ASIF plate attached to each tibiofibular bone, with and without compression. The morphological changes in the bone underlying the plate were examined and were assessed quantitatively at one day to thirty-six weeks after operation. The rigid plate induced porotic changes in the cortical bone, which were evident three weeks after the operation and increased rapidly between twelve and eighteen weeks. At thirty-six weeks, resorption cavities occupied 40.6 per cent of the cortical wall of the bones plated with compression and 41.2 per cent of the wall of those plated without compression. The changes were visible slightly earlier in the presence of compression. A rigid plate brought about a statistically significant increase both in the outer diameter of the bone and in the diameter of the medullary space as a result of subperiosteal new-bone formation and concomitant subendosteal bone resorption.

Animals↗
PubMed1978

Effect of rigid plate fixation on structure and mineral content of cortical bone.

The effect of rigid plate fixation on the structure and mineral content of cortical bone were studied by light and fluorescence microscopy and by chemical analysis of calcium and hydroxyproline content in 27 rabbits from one day to 17 weeks after the attachment of a 5 hole ASIF-plate onto intact femur. Between the second and seventeenth postoperative weeks the plated cortical bone became progressively thinner and porotically transformed. Subendosteal resorption was partly offset by the formation of new subperiosteal bone that resulted in a slightly wider than normal, thin-walled tubular bone. At 17 weeks the mean calcium content of the tubular bone under the plate was 15% less than the initial postoperative content (p less than 0.05). The corresponding decrease in calcium content in the metaphyseal and epiphyseal areas of both the operated and the control bone was highly significant. The mean values for hydroxyproline in plated and control bones remained largely unchanged.

Animals↗
PubMed1977

Fatal measles encephalopathy with retinopathy during cytotoxic chemotherapy.

A 14-year-old boy receiving post-operative cytotoxic chemotherapy for a testicular rhabdomyosarcoma developed a fatal encephalopathy associated with retinal changes 2 months after an episode of acute measles. Post-mortem histological examination showed intranuclear inclusion bodies in the neurons and glial cells, but inflammatory cell infiltrations were absent. Electron-microscopic and immunofluorescent studies revealed intracellular masses of paramyxovirus nucleocapsid-like structures, which had the morphological and antigenic properties of measles virus. Recent reports have emphasized the possibility of occurrence of a similar encephalopathy in treated childhood leukemia. It is evident, however, that this potentially fatal complication must be borne in mind when measles is contracted during any form of cytotoxic treatment or immunosuppression. Retinal changes may be of value for the diagnosis during life. We propose the designation "measles encephalopathy during immunosuppression" (MEI) for this condition.

Adolescent↗
PubMed1976

Intraosseous lipoma of the calcaneus. Report of a case and a short review of the literature.

One case of an intraosseous lipoma of the calcaneus bone is presented together with a short review of the literature. Only 20 cases of tumors in the extremities have so far been published. The typical X-ray picture shows a cystic, sharply demarcated cavity, which macroscopically at operation is filled with yellowish, adipose tissue. In the present case and one previously published a central sclerotic mass was observed. The histological picture is typical, with mature adipose tissue mixed with a few degenerated bone trabeculae.

Adult↗