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Biomedical subjects

C Lindqvist

Publications and source records attributed to C Lindqvist.

At least 37 records · Page 2Linked to original sources

Disodium clodronate in the treatment of diffuse sclerosing osteomyelitis (DSO) of the mandible.

Diffuse sclerosing osteomyelitis (DSO) of the mandible is a chronic condition, the cause of which is not known. Jaw pain, occurring irregularly, is a typical symptom. The aim of the study was to assess the effectiveness of disodium clodronate for relieving pain in patients with DSO. Disodium clodronate is a bisphosphonate used to treat diseases of bone and calcium metabolism. Ten DSO patients experiencing pain received disodium clodronate or placebo intravenously on a randomized double-blind basis. Both minimum (300 mg) and maximum (900 mg) doses were well tolerated. Disodium clodronate administration did not result in better immediate pain relief than placebo administration. However, 6 months after treatment there was a statistically significant difference in pain intensity between the groups, with the disodium clodronate group experiencing significantly less pain.

Adult↗

Effectiveness of operative treatment of internal orbital wall fracture with polydioxanone implant.

Many implants, some made from teflon or silicone, have been used for internal orbital wall reconstruction. Late complications relating to use of such implants have been reported. In this prospective study a polydioxanone (PDS) implant absorbable in vivo was used for internal orbital wall reconstruction. Follow-up involved clinical examination, magnetic resonance imaging (MRI) and computerized tomography (CT). Clinical examinations were undertaken before operation and up to 36 weeks postoperatively. Sixteen consecutive patients (10 pure blow-out fractures, six with associated zygomatic fracture) took part in the study. Prevalences of diplopia, proptosis and enophthalmus were recorded during each follow-up examination. This study revealed no muscle entrapment within the fracture line. Although CT results confirmed bone growth in the internal orbital wall, shape was unsatisfactory, and orbital volume was not reduced. MRI revealed thick scar formations in six cases (37.5%), fibrotic sinuses filled with air or gas in three cases (19%) and a fibrotic sinus with fluid around the PDS in one case (6%). Our results suggest that use of PDS in reconstructing the internal orbital wall is inadvisable.

Absorbable Implants↗

Oral symptoms at menopause--the role of hormone replacement therapy.

OBJECTIVE: A questionnaire was used to investigate the prevalence of self-assessed sensations of painful mouth (PM) and dry mouth (DM) in menopause-aged women. Special attention was paid to the association of the use of hormone replacement therapy (HRT) with oral symptoms. Our hypothesis was that women using HRT have fewer oral symptoms than those who do not use HRT. STUDY DESIGN: Patients were selected from among 50- to 58-year-old women attending a communal mammography screening program in Helsinki, Finland. Every fifth woman was offered a structured questionnaire. RESULTS: Completed questionnaires were received from 3173 women (response rate, 65%). Of the total sample, 46.8% (n = 1486) used HRT. The occurrence of PM was 8.2% (n = 259) and DM, 19.9% (n = 631). Climacteric symptoms were reported by 24% (n = 761) of the total sample and by 19.2% (n = 285) of the HRT users. According to logistic regression analyses, climacteric symptoms were found to be predictive of PM (P =.000) and DM (P =.000). The use of HRT also increased the occurrence of PM (P =.03). However, as a single covariate in our statistical model, the use of HRT was not a predictor of PM. The use of HRT also did not correlate with the occurrence of DM. CONCLUSIONS: The occurrence of PM and of DM seemed to be associated with climacteric symptoms in general, and the use of HRT did not prevent the oral symptoms studied.

Age Factors↗

Focal sialadenitis in patients with ankylosing spondylitis and spondyloarthropathy: a comparison with patients with rheumatoid arthritis or mixed connective tissue disease.

OBJECTIVES: To investigate the occurrence of and risk factors for focal sialadenitis in patients with rheumatoid arthritis (RA), mixed connective tissue disease (MCTD), ankylosing spondylitis (AS), and spondyloarthropathy (SpA). METHODS: A total of 85 patients (25 with RA, 19 with MCTD, 19 with AS, 22 with SpA) participated in the study. Each patient filled out a questionnaire for eye and oral symptoms and for the use of medication, and was interviewed; other tests included Schirmer's test, laboratory tests, collection of unstimulated and stimulated whole saliva, and minor salivary gland biopsy. A focus score of > or =1 was regarded as an indicator of focal sialadenitis. RESULTS: Focal sialadenitis was observed in 68% (57/84) of all patients. It affected 80% (20/25) of the patients with RA, 94% (17/18) of those with MCTD, 58% (11/19) of those with AS, and 41% (9/22) of those with SpA (chi(2) test, p=0.0013). Salivary secretion correlated negatively with the focus scores-that is, severity of focal sialadenitis. Patients with focal sialadenitis had both decreased salivary secretion and decreased tear secretion significantly more often than did patients without (chi(2) test, p=0.0074 and p=0.048 respectively). Patients with positive rheumatoid factor (RF), antinuclear antibodies (ANA), or SSA or SSB antibodies had sialadenitis significantly more often than did patients with negative antibodies. In the subgroup of patients with AS or SpA, no associations were found between focal sialadenitis and the presence of these antibodies. CONCLUSION: In addition to patients with RA or MCTD, focal sialadenitis also affects a very high proportion of patients with AS or SpA. Focus scores are significantly higher in patients with RA or MCTD than in those with AS or SpA. A significant association exists between focal sialadenitis and RF, ANA, SSA and SSB. However, in the subgroup of patients with AS or SpA, no associations were found between focal sialadenitis and serological markers or clinical symptoms.

Adult↗

Oral health of patients scheduled for elective abdominal aortic correction with prosthesis.

OBJECTIVE: to evaluate the frequency of potential oral foci of infection in patients scheduled for elective abdominal aortic surgery. DESIGN: prospective clinical study. MATERIALS: oral health and dentures of 50 patients (33 males and 17 females, mean age 65 years) were examined before aortic surgery. CHIEF OUTCOME MEASURES: radiographic and clinical examination with special emphasis on identifying acute and chronic oral and ontogenic conditions which may contribute to aortic prosthesis infection. RESULTS: eighty-two per cent of the patients had some oral infection foci. The mean number of remaining teeth in the cohort was 9.3, and 21% of these were potential infectious foci (62% in the patients). Twenty-six per cent of the patients suffered from oral Candida infection. Seventy-four per cent of the patients had total or partial dentures, 45% of which were ill-fitting and needed repair. CONCLUSIONS: oral infectious foci occur frequently in patients needing aortic surgery. Untreated foci may contribute to aortic prosthesis infection. Preoperative oral evaluation and elimination of intraoral infection is recommended for patients scheduled for abdominal aortic repair.

Acute Disease↗

Increased salivary acetaldehyde levels in heavy drinkers and smokers: a microbiological approach to oral cavity cancer.

The pathogenetic mechanisms behind alcohol-associated carcinogenesis in the upper digestive tract remain unclear, as alcohol is not carcinogenic. However, there is increasing evidence that a major part of the tumour-promoting action of alcohol might be mediated via its first, toxic and carcinogenic metabolite acetaldehyde. Acetaldehyde is produced from ethanol in the epithelia by mucosal alcohol dehydrogenases, but much higher levels derive from microbial oxidation of ethanol by the oral microflora. In this study we investigated factors that might alter the composition and quantities of the oral microflora and, consequently, influence microbial acetaldehyde production. Information about dental health, smoking habits, alcohol consumption and other factors was obtained by a questionnaire from 326 volunteers with varying social backgrounds and health status, e.g. oral cavity malignancy. Paraffin-induced saliva was collected and the microbial production of acetaldehyde from ethanol was measured. Smoking and heavy drinking were the strongest factors increasing microbial acetaldehyde production. Whether poor dental status may alter local acetaldehyde production from ethanol remained unanswered. Bacterial analysis revealed that mainly gram-positive aerobic bacteria and yeasts were associated with higher acetaldehyde production. Increased local microbial salivary acetaldehyde production due to ethanol among smokers and heavy drinkers could be a biological explanation for the observed synergistic carcinogenic action of alcohol and smoking on upper gastrointestinal tract cancer. It offers a new microbiological approach to ethanol-associated carcinogenesis at these anatomic sites.

Acetaldehyde↗

Collagenases in different categories of peri-implant vertical bone loss.

The loosening of dental implants is associated with peri-implant vertical bone loss. The mechanisms and mediators of this bone destruction are not known. To test the hypothesis that collagenase-2 and collagenase-3 might be markers or maybe even mediators in this process, we measured collagenase-2 (time-resolved immunofluorometric assay) and collagenase-3 (quantitative immunoblot) in peri-implant sulcus fluid in 49 implant sites in 13 patients. Vertical bone loss was graded as being < 1 mm, from 1 to 3 mm, or > 3 mm. The severity of inflammation, as rated according to Gingival Index, did not correlate with the category of bone loss (p > 0.05). Collagenase-2 and collagenase-3 were higher (p < 0.05) in the group which had lost > 3 mm of bone than in the two other groups. Gingival Index is not a clinically important marker for bone loss, but collagenase-2 and collagenase-3 in peri-implant sulcus fluid are. They might participate in peri-implant osteolysis.

Adult↗

Bioabsorbable plates and screws: Current state of the art in facial fracture repair.

BACKGROUND AND OBJECTIVES: The use of bioabsorbable materials in craniomaxillofacial surgery began a new era in fracture fixation. The purpose of this paper is to review the historical perspectives and the current concept of bioresorbable materials in fracture fixation. METHODS AND MATERIALS: The authors review the biochemistry and clinical characteristics of bioabsorbable polymers--polylactic acid (PLA), polyglycolic acid (PGA), polydioxanone (PDS), and their copolymers. Their use and clinical perspectives by the Helsinki (authors') group and other study groups are presented. RESULTS AND CONCLUSIONS: These materials have proven to be safe in clinical applications. When manufactured with current technology, they are easy to handle. Economically, they are nearly equal to similar metal devices. The materials have met clinical success throughout the world, first in orthognathic surgery, followed by treatment of fractures of the upper facial skeleton and the mandible. Today, most maxillofacial fractures and osteotomies may be adequately fixed with bioabsorbable materials.

Absorbable Implants↗

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Acquired Hyperostosis Syndrome↗

Detection of baculovirus-infected insect cells by flow cytometric side-scatter analyses.

BACKGROUND: The baculovirus expression vector system (BEVS), utilizing the Autographa californica nuclear polyhedrosis virus (AcNPV), has turned out to be an attractive alternative for high-level expression (<600 mg/l) of recombinant proteins. However, there is a shortage of reliable methods for monitoring the infection process in situations where marker proteins cannot be used. METHODS: Three recombinant baculoviruses, FastBac1-wtGFP, VTBac-GFP, and VL1392-hIL-2Ralpha, all having the genes inserted under the transcriptional control of the polyhedrin gene promoter of the Autographa californica nuclear polyhedrosis virus (AcNPV), were used to infect Spodoptera frugiperda (Sf9) and Mamestra brassicae (IZD-MB-0503) insect cells. The infection process of the recombinant baculoviruses was monitored by flow cytometric side-scatter and fluorescence intensity analyses over a period of 6-96 h. RESULTS: A clear correlation between the side-scatter (SSC) signal and the relative fluorescence was observed for both of the infected cell lines, compared to noninfected cells. Comparison of SSC histograms from noninfected insect cells with cells infected with the nonfluorescent recombinant baculovirus VL1392-hIL-2Ralpha showed a clear increase of SSC for the infected cells. CONCLUSIONS: The SSC parameter can therefore be utilized for flow cytometric monitoring of a baculovirus infection process in situations where suitable markers are not available.

Animals↗

Generation of a new protein purification matrix by loading ceramic hydroxyapatite with metal ions--demonstration with poly-histidine tagged green fluorescent protein.

The gene encoding the green fluorescent protein (GFP) from the jellyfish Aequorea victoria, was inserted under transcriptional control of the polyhedrin promoter of the Autographa californica nuclear polyhedrosis virus and expressed in the Spodoptera frugiperda insect cell line Sf9 during viral infection. The baculovirus transfervector pBlueBacHisB was used for constructing the recombinant baculovirus, so that the green fluorescent protein could be tagged with a poly-histidine tail. This fusion protein was utilized as a marker for evaluating the properties of metal ion loaded ceramic hydroxyapatite as a matrix in protein purification. Ceramic hydroxyapatite loaded with Zn(II) was the best choice for purifying this poly-histidine tagged GFP, followed by Fe(III) of the metal ions tested. Ni(II) that is superior especially in many poly-histidine purification systems did not, when loaded to hydroxyapatite, have binding properties comparable to Zn(II) or Fe(III). Elution of poly-histidine tagged GFP was best performed with phosphate buffers or EDTA that could compete with the phosphate molecules in hydroxyapatite or complexly bind the metal ions, respectively.

Animals↗

A microplate-based fluorometric assay for monitoring human cancer cell attachment to cortical bone.

A microplate-based fluorometric assay was developed for quantitation of cancer cell attachment to bone matrix. To evaluate this model system we used a panel of human cancer cell lines, including the human breast cancer cell line MDA-MB-231. For the assay, bovine cortical bone from the shaft of the femur was cut, turned, and sliced to 6-mm-diameter round 200-microm-thin disks and placed into the wells of a 96-well microplate. A fluorescent dye 2', 7'-bis(2-carboxyethyl-5(6)-carboxyfluorescein (BCECF-AM) and a microplate fluorometer equipped with a standard filter set for fluorescein isothiocyanate were used to detect the cells attached to the bone disks. The fluorescence was enhanced during the measurement step by using a K+ solution (pH 8.0) containing the H+/K+ ionophore nigericin, which equilibrates internal and external pH. By taking advantage of the pH sensitivity of BCECF, the fluorescence intensity in the assay was increased 2.5 times compared to cells loaded with calcein. The specificity of the assay was demonstrated with a specific immuneserum raised against the MDA-MB-231 cell line. The assay can be completed in 1 h and permits the use of a large number of samples and is therefore useful for screening potential drug candidates that could block cancer cell attachment to bone material. Moreover, the assay described can easily be used to characterize molecular structures involved in cell attachment to bone.

Animals↗

Histological study of tissue reactions to epsilon-caprolactone-lactide copolymer in paste form.

In previous studies, epsilon-caprolactone-lactide copolymer in solid form has been used in experimental animals as suture material, and as a biodegradable nerve guide. The aim of the study reported here was to assess tissue reactions to epsilon-caprolactone-lactide copolymer in paste form, histologically, and to compare bone healing at the sites of implantation versus that at control sites. The other purpose of the study was to evaluate the properties of the implanted material as a filling material for bone defects. Resorption time and intensity of inflammatory reaction were also evaluated. Material was implanted into the abdominal walls and femurs of 34 rats. Follow-up times were from 2 weeks to 1 year. The results showed that epsilon-caprolactone-lactide copolymer in paste form induces a severe inflammatory reaction when placed in muscle, and moderate inflammation when implanted into bone. The resorption time was more than 1 year. Bone healing at sites of implantation was slower than at control sites.

Animals↗

Lag-screw fixation of anterior mandibular fractures using biodegradable polylactide screws: a preliminary report.

PURPOSE: The purpose of this study was to evaluate the utility of biodegradable, self-reinforced poly-L-lactide screws (SR-PLLA) for lag-screw fixation of anterior mandibular fractures. PATIENTS AND METHODS: SR-PLLA lag-screws were used to stabilize anterior mandibular fractures in 11 patients. Maxillomandibular fixation was used to treat concomitant mandibular condyle fractures for 2 weeks in four patients and for 1 and 5 weeks in two patients. Clinical and radiologic follow-up lasted for 6 months in 36% of patients and for 1 year in 64%. RESULTS: Healing of all anterior fractures was uneventful, with no displacement or delay of bony union. No adverse reactions to the biodegradable screws were seen during follow-up. CONCLUSION: Biodegradable SR-PLLA screw fixation seems to be a new and promising way of treating anterior mandibular fractures.

Absorption↗

Fixation of mandibular body osteotomies using biodegradable amorphous self-reinforced (70L:30DL) polylactide or metal lag screws: an experimental study in sheep.

Mandibular body osteotomies were fixed in nine sheep using new totally amorphous (70L:30DL), self-reinforced, polylactide (SR-PLA) lag screws and in nine sheep using standard stainless steel lag screws. No intermaxillary fixation was used. During follow-up, radiological, histological and microradiological studies were undertaken at 3, 6, 12 and 24 weeks. In both groups, all osteotomies consolidated at similar rates and no adverse reaction to the screws was seen. However, displacements of the fixed osteotomy fragments were common in both groups during the first 3 weeks. The biocompatibility of SR-PLA during the follow-up period was found to be good. Only initial signs of biodegradation were seen. The results of this study indicate that (70L:30DL) SR-PLA has potential for use as a fixation screw material in oral and maxillofacial surgery, and that further studies using this material are justified.

Absorbable Implants↗

Mixture of epsilon-caprolactone-lactide copolymer and tricalcium phosphate: a histological and immunohistochemical study of tissue reactions.

In cranio-maxillofacial surgery, bone transplantation is needed for treatment of bony defects. An autograft, allograft or biomaterial can be used. Autogenous bone grafts are considered to be the best materials available, but there are some disadvantages in their use including donorsite morbidity, need for a second operative site and limited graft supply. A search for new bone-graft materials therefore remains necessary. We prepared a mixture of tricalcium phosphate (TCP), which is a resorbable, non-toxic, osteoconductive ceramic material and epsilon-caprolactone-lactide copolymer P(epsilon-CL/DL-LA), a resorbable polymer, and placed it in the dermis and in mandibular bone defects in 13 rabbits. Follow-up times were two, three, seven, eight, 12, 15 and 18 weeks, tissue reactions were assessed, histologically and immunohistochemically. Times of resorption of the material from tissues were reported. We found that the mixture caused a mild inflammatory reaction when placed in bone and severe inflammation when placed in dermis. No highly fluorescent layer of tenascin or fibronectin was found surrounding the implant area. The mixture was excellent to handle and very easy to place into bone defects. The results are promising and have led us to continue development of the mixture.

Journal Article↗

Update on bioresorbable plates in maxillofacial surgery.

Biodegradable materials, mainly polymers and copolymers of polylactide and polyglycolide, are today routinely used as fixation materials in craniomaxillofacial surgery. Several research groups have shown that these materials can adequately fix osteotomies and fractures of the craniofacial skeleton. Although there are some differences between polymers, in general their biocompatibility is good. They gradually lose their strength, enabling the underlying bone to take up the stress. Secondary procedures for removal of the material causing discomfort and pain are not needed. An overview of the development of biodegradable materials, their characteristics, and illustrations of different applications in craniomaxillofacial surgery are presented. More than 200 patients have been treated successfully so far in our units, the longest follow-up time being now over 7 years. The good results indicate that the use of bioresorbable fixation can be considered routine and will be definitely state of art at the beginning of the new millennium.

Absorbable Implants↗

Osteotomy site healing following mandibular sagittal split osteotomy and rigid fixation with polylactide biodegradable screws.

Follow-up of 47 patients, treated using mandibular bilateral sagittal split osteotomy and self-reinforced poly-L-lactide acid (SR-PLLA) screws for rigid internal fixation, is presented. The focus was on clinical and radiological osteotomy healing. The average follow-up time was 2.1 years (range 0.5-5 years). Clinical recovery and radiological osteotomy healing during follow-up were uneventful. Osteolytic changes were seen around the SR-PLLA screws in 27% of cases. The majority of the screw canals remained as radiolucent shadows without bony filling.

Absorbable Implants↗