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Biomedical subjects

T K Pedersen

Publications and source records attributed to T K Pedersen.

14 recordsLinked to original sources

Le Fort I miniplate osteosynthesis: a randomized, prospective study comparing resorbable PLLA/PGA with titanium.

The aim of this study was to compare the use of resorbable osteosynthesis material (LactoSorb) with titanium osteosynthesis for the fixation of Le Fort I osteotomies with respect to long-term stability and morbidity. To achieve exact cephalometric measures, five tantalum micro implants were inserted in the maxilla during surgery. A total of 60 patients undergoing a non-segmented Le Fort I osteotomy were randomized to one of the treatments and were followed for 1 year postoperatively. For the osteotomies fixated with LactoSorb, the lateral cephalometric analysis demonstrated a statistically significant difference in the vertical position of the maxilla after 6 weeks as the position became more superior compared with the postoperative situation (mean change of 0.6 mm). In the titanium group no significant changes in position were observed. There were no statistically significant changes in the position of the maxilla from 6 weeks to 12 months in either of the treatment groups. The changes in maxillary postion were not clinically noticeable in either of the treatment groups, and all treatments were completed with satisfactory results. There were two cases of infection and wound dehiscence in the LactoSorb group, whereas titanium osteosynthesis was more often palpable after 6-12 months and required surgical removal in three cases.

Absorbable Implants↗

Spontaneous resolution of amniotic bands.

The amniotic band syndrome comprises a group of sporadic congenital anomalies characterized by amputations, constriction bands, pseudosyndactylism and multiple craniofacial, visceral and body wall defects. It occurs in approximately 1 in 1200 to 1 in 15 000 live births. Some of the cases present with congenital anomalies that are incompatible with life, but a selected group shows isolated limb constrictions. Repeated sonographic examinations afforded us the opportunity of observing the in utero process of limb strangulation and subsequent spontaneous lysis of an amniotic band attached to a fetal elbow. Surgical fetal therapy with lysis of the constriction ring in utero is an option, but intervention is probably not always warranted. Spontaneous resolution does occur.

Adult↗

Resorption of the temporomandibular condylar bone according to subtypes of juvenile chronic arthritis.

OBJECTIVE: To evaluate the relative impact of sex, type of onset, course of disease, age at onset, duration of disease and status of HLA-B27, antinuclear antibodies (ANA), and rheumatoid factor on the risk of developing a condylar erosion. METHODS: Condylar changes of the temporomandibular joint (TMJ) were diagnosed on orthopantomograms from 169 consecutive patients with juvenile chronic arthritis (JCA). A multiple regression analysis was applied to establish the relative weight of the independent variables affecting the severity of the condylar erosion. RESULTS: It was found that 62.1% of the patients exhibited condylar resorption. The highest prevalence was seen in children with a polyarticular onset or course of disease and early age at onset and severe resorption was also frequent in these groups. Patients with positive ANA also had a high prevalence but with a mild degree of resorption. In contrast, HLA-B27 positive patients had a lower risk of TMJ involvement and resorptive changes of the condyle. CONCLUSION: Polyarticular and early onset arthritis are associated with a high risk for TMJ involvement and a severe condylar bone loss can be expected. ANA positive patients have a high prevalence, and B27 positive patients have a low prevalence of TMJ arthritis but in both subgroups, the outcome of the bone resorptive process is mild.

Adolescent↗

Clinical aspects of orthodontic treatment for children with juvenile chronic arthritis.

Growth abnormalities as a consequence of temporomandibular joint arthritis in children with juvenile chronic arthritis are difficult and complicated problems to treat. The diagnosis of the inflammatory condition in the joint is difficult but important to the success of the interceptive treatment. The diagnostic problems, treatment objectives, and treatment suggestions are discussed in this article.

Activator Appliances↗

Contrast enhanced magnetic resonance imaging as a method to diagnose early inflammatory changes in the temporomandibular joint in children with juvenile chronic arthritis.

OBJECTIVE: Recent studies have stressed early diagnosis of temporomandibular joint (TMJ) involvement in children with juvenile chronic arthritis (JCA) to initiate treatment before destruction of the condylar head and growth alterations take place. TMJ involvement is often asymptomatic, but studies with contrast enhanced magnetic resonance imaging (MRI) in other joints have shown that it is possible to detect the early inflammatory changes. METHODS: Thirty TMJ in 15 children with newly diagnosed JCA (mean age 12.0 years) were examined clinically, with radiographs and with MRI enhanced with gadolinium diethylene thiamine pentaacetic acid (Gd-DTPA). A control group of 10 healthy children (mean age 11.5 yrs) were examined clinically and with MRI. The MRI variables included T1 weighted images before and after administration of Gd-DTPA with and without fat suppression. RESULTS: MRI enhanced with Gd-DTPA indicated inflammatory activity in 87% of the patients. Conventional MRI without contrast medium proved to be insignificant in diagnosing early inflammatory changes. CONCLUSION: Enhanced MRI is very efficient in diagnosing early inflammatory changes of the TMJ and is a more sensitive method than the clinical examination and radiographs.

Adolescent↗

[Antibiotic prophylaxis in cesarean section].

We investigated the guidelines for patient selection and drug regimens for use of antibiotic prophylaxis in relation to Caesarean section in the maternity clinics in Denmark. A questionnaire was sent to all the Danish maternity clinics that perform Caesarean section, concerning indications for use of antibiotic prophylaxis and antibiotic regimens to patients undergoing acute and elective Caesarean section. All departments (n = 48) returned the questionnaire. Twenty departments (46%) provided written guidelines for antibiotic prophylaxis. Four departments (8%) used antibiotic prophylaxis in elective Caesarean sections, 25 departments (52%) used antibiotics in all emergency sections. In the presence of rupture of the membranes or prolongation of labour (> 12 hrs) 58 and 63% of the departments used antibiotic prophylaxis, respectively. The most frequent first choice drug was cefuroxim, employed by 27 departments (56%). Concerning timing, 21 departments (44%) gave antibiotics after cord clamping and 13 departments (27%) before incision. We propose a nation-wide prospective investigation on the rate of infections associated with Caesarean section to set up rational guidelines for antibiotic prophylaxis.

Antibiotic Prophylaxis↗

Antibiotic prophylaxis in cesarean section.

BACKGROUND: To investigate the guidelines for patient selection and drug regimens for application of antibiotic prophylaxis in relation to cesarean section in the maternity clinics in Denmark. METHODS: A questionnaire to all the Danish maternity clinics that perform cesarean section, concerning indications for application of antibiotic prophylaxis and antibiotic regimens to patients undergoing acute and elective cesarean section. RESULTS: All departments (n = 48) returned the questionnaire. Twenty departments (46%) provided written guidelines for antibiotic prophylaxis. Four departments (8%) used antibiotic prophylaxis to elective cesarean sections, 25 departments (52%) applied antibiotics to all emergency sections. In the presence of the rupture of membranes or prolongation of labor (> 12 hrs) 58% and 63% of the departments applied antibiotic prophylaxis, respectively. The most infrequent first choice drug was cefuroxim, employed by 27 departments (56%). Concerning timing, 21 departments (44%) applied antibiotics after cord clamping and 13 departments (27%) before incision. CONCLUSION: We propose a nation-wide prospective investigation on the rate of infections associated with cesarean section to set up rational guidelines for antibiotic prophylaxis.

Anti-Bacterial Agents↗

[Laparoscopic sterilization. Late complications of the endocoagulation method].

The objective of this analysis was to assess the failure rate and incidence of regret of tubal sterilization performed by the endocoagulation technique. The design was a register-based retrospective study. A total of 585 sterilizations were performed from January 1986 to December 1992 in the county hospital of Sønderborg. The patients who had undergone sterilization were identified by diagnosis from the database of "Kommune-data". Forty patients were excluded due to different reasons. The frequency of hospitalization from the operation to July 94 was registered. The actual case records were examined. The failure rate following endocoagulation was 0.92% (one intrauterine and four extrauterine pregnancies) corresponding to an incidence of 1.77/1000 women/year. Two women (0.37%) developed hydrosalpinx after the operation. Ten patients (1.8%) wanted a reversal of sterilization. It was concluded, that tubal sterilization by the endocoagulation method is cheap and safe. The failure rate is similar to that of other methods. Implantation in the peritoneal space is avoided. Thermic destruction is minimized, and the risk of peroperative burning of the tissue is therefore reduced.

Denmark↗

Prefrontal cortical mediation of rats' place learning in a modified water maze.

The acquisition of a place learning task in a water maze modified from the "standard" set-up by restriction of distal cues and addition of "proximal" cues (ping-pong balls in fixed positions on the surface of the water) was tested in three groups of rats: (I) animals subjected to bilateral ablation of the anteromedial prefrontal cortex, (II) rats in which the parietal "association" cortex had been removed bilaterally, and (III) a sham operated control group. The task acquisition of the prefrontally ablated group was significantly impaired, whereas the animals in which the parietal cortex had been removed acquired the task as quickly as the control group. Upon reaching criterion level performance all animals were tested on "challenge" sessions on which the cues were manipulated. Such "challenges" demonstrated that the animals of all three groups discriminated between the distal cues and utilized such a discrimination for navigational purposes.

Animals↗

Condylar condition and mandibular growth during early functional treatment of children with juvenile chronic arthritis.

TMJ involvement in children with Juvenile Chronic Arthritis (JCA) will frequently cause disturbance of the growth of the mandible. Orthodontic treatment of these patients often includes orthognathic surgery, and are complicated to handle with respect to the damaged joint and impaired function. The aim of this presentation is to suggest an early treatment with a functional splint appliance, a distraction splint, with the purpose of increasing function of the joint and ensuring continuous growth of the mandible.

Arthritis, Juvenile↗

Effects of chronic imipramine on exploration, locomotion, and food/water intake in rats.

Three groups of rats were subjected to 15 daily injections of imipramine (10 or 20 mg/kg) or vehicle control injections, respectively. During the treatment period, both imipramine groups failed to grow while the control group gained weight normally. Both dosages of imipramine suppressed food intake significantly, while water intake was only reduced by 20 mg/kg of imipramine and only during the first 5 days of treatment. Twenty-four hours after the last imipramine injection, the animals were subjected to a test battery designed to demonstrate potential changes in locomotion and/or exploration. While locomotion appeared unaffected by both dosages of imipramine, the group receiving 20 mg/kg of imipramine demonstrated a significantly reduced exploration. The exploration of the group receiving imipramine in the concentration of 10 mg/kg was only marginally changed. The temporal pattern of exploration of the animals receiving 20 mg/kg of imipramine revealed that chronic imipramine treatment was associated with an initial "hyperexploration" followed by an "overhabituation," resulting in an overall reduction of exploration during a 15-min period.

Animals↗

[Spontaneous esophageal rupture during the 3rd trimester].

A 30-year-old woman, 35 weeks pregnant, developed spontaneous rupture of the oesophagus following severe vomiting, probably caused by treatment with Ritodrin (Utopar). The symptoms, diagnosis and treatment of spontaneous oesophageal rupture are discussed.

Adult↗

Prevention of postoperative deep venous thrombosis. Low-dose heparin versus graded pressure stockings.

In a prospective, controlled clinical study prevention of postoperative deep venous thrombosis by low-dose heparin (Heparin Leo 5 000 I.U. subcutaneously twice daily) was compared with graded compression stockings (TED stockings, Kendall Co.). One hundred and twelve patients, admitted during a period of one year for elective major surgery, were allocated to one of the two treatment groups. In order to detect deep venous thrombosis the 99mTc-plasmin test was performed before the operative procedure and again 5 days later. Ninety-seven patients completed the study (45 patients in the heparin group and 52 patients in the stocking group). Venous thromboembolism was detected in 4 patients (8.9%) in the heparin group and in 3 patients (5.8%) in the stocking group (p greater than 0.05). In 6 patients the plasmin test was positive and one patient in the heparin group died following pulmonary embolism. It is concluded that graded compression stockings can be used as an alternative to low-dose heparin for prophylaxis against deep venous thrombosis in elective general surgery.

Adult↗

Contrast-enhanced MRI compared to histological findings in the temporomandibular joint of antigen-induced arthritis in young rabbits.

OBJECTIVE: To study the correlation between histological findings and Magnetic Resonance Imaging (MRI) findings in experimentally induced arthritis in the temporomandibular joint (TMJ) of growing rabbits and to study the effect of intraarticular corticosteroid injections. METHODS: Arthritis was induced by ovalbumin in the left TMJ of 44 pre-sensibilized rabbits. Nine animals died during this procedure. Eight of the remaining animals with induced arthritis were treated with intraarticular corticosteroid injections one week after induction of arthritis. Twelve rabbits served as controls. MRI enhanced with Gadolinium-DTPA was performed on all animals 1 to 2 weeks after induction of arthritis and again before sacrifice and the degree of enhancement was calculated. Histology of the condyle was performed and degree of villous hyperplasia, synovial thickness, infiltration of inflammatory cells and pannus was graded. RESULTS: TMJ arthritis was successfully induced in the rabbits and was verified by enhancement of the MRI and by histological changes one week after the induction. Joints treated with intraarticular corticosteroid injections revealed complete inhibition of the inflammation. CONCLUSION: Enhancement of MRI in antigen-induced arthritis in the TMJ associated well with inflammatory changes shown histologically. An intraarticular corticosteroid injection prevents the initial inflammatory response in experimentally induced TMJ arthritis.

Adjuvants, Immunologic↗