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Biomedical subjects

C Lindqvist

Publications and source records attributed to C Lindqvist.

At least 163 records · Page 9Linked to original sources

Primary reconstruction of the mandible in cancer surgery. A report of 13 reconstructions according to the principles of rigid internal fixation.

This study comprises 30 patients with extensive oral cancer invading the mandibular bone. In each case, large segmental composite resections were performed and the mandibles primarily reconstructed, according to the principles of rigid internal fixation. All but one of the reconstructions were successful and the functional and cosmetic results were excellent or good in 12 patients. The results indicate that primary reconstruction can be performed without major complications. Bone transplantation may be omitted or postponed to a later date. The fact that tracheostomy and intermaxillary fixation can be avoided, is a major advantage for these patients.

Adult↗

Sports-related maxillofacial fractures in a hospital material.

Sports-related maxillofacial fractures were analysed in 80 patients, accounting for 5.6% of all patients with facial bone fractures, treated during the 5-year period 1981-1985. 55% of the patients had 1 or more mandibular fractures and 45% had midface fractures. 6% of the patients had multiple injuries. The most common causes of injury were collision and fall. Soccer and ice hockey turned out to be the most hazardous sports, although sports-related maxillofacial fractures were less severe than those related to other causes. The need for oral and facial protection among athletes involved in contact sports is discussed.

Adolescent↗

Bone resection in patients with mandibular sarcoma.

Thirty-nine cases of mandibular sarcoma were reported to the Finnish Cancer Registry during the period 1953-1985. In 11 of these (nine osteosarcomas, one chondrosarcoma, one leiomyosarcoma), the pre- and postoperative radiographs were still available, and they were analyzed in order to evaluate the radicality of the primary surgical procedure in relation to recurrences during the follow-up. On the basis of several radiological details, the resection was considered inadequate in seven cases. One operation was probably inadequate because of rather scanty margins. In only three cases had an adequate primary resection with proper safety margins been performed. All of the seven patients with inadequate primary surgery had recurrence and five of them died of local disease or metastases, whereas only one of the three patients with adequate resection had recurrence in adjacent soft tissues. It is concluded, that radiological findings of mandibular sarcoma that often are missed include widening of the mandibular canal and disappearance of the lamina dura. Proper preoperative radiological examination resulting in more radical primary surgery would certainly decrease the recurrence and mortality rates in patients with mandibular sarcoma.

Adult↗

A simple method for establishing the position of the condylar segment in sagittal split osteotomy of the mandible.

When a rigid fixation of the mandibular sagittal split osteotomy is performed, the exact position of the condyle has to be maintained. We report a simple method for determining the preoperative position of the proximal segment. The method is fast and does not require additional technical equipment. Preliminary results indicate that a decrease in postoperative temporomandibular joint problems can be achieved by using this method. A follow-up will show whether the method also can decrease the incidence of skeletal relapse.

Bone Plates↗

Atlanto-axial subluxation in patients with seronegative spondylarthritis.

Two patients with seronegative HLA-B27-connected spondylarthropathy, associated in one case with psoriasis and in the other with Reiter's disease, who had atlanto-axial subluxation (AAS) are reported. The AAS caused muscle weakness and intractable occipito-cervical pain. Both patients were treated operatively with a Gallie type C1-C2 fusion. The symptoms subsided following surgery and the patients remained free of cervical spine discomfort. The report also indicates that the rarer variants of the HLA-B27 associated chronic seronegative spondylarthropathies may cause AAS complicated by neurological symptoms and that the disorder is amenable to surgical intervention.

Adult↗

Paraesthesia of the infraorbital nerve following fracture of the zygomatic complex.

68 patients with fractures of the zygomatic complex were studied. Of these, 56 had sensory disturbances of the infraorbital nerve. 50 patients were operated on and in 42% (21) some degree of persisting hypesthesia was found. No significant difference in outcome was found between the different methods of indirect reduction used. However, in 10 out of 12 patients in which direct fixation with transosseous wiring of the infraorbital margin was performed, persisting hypesthesia was encountered. In 3 out of 4 patients where the nerve was also explored primarily, the sensation returned totally. A secondary nerve deliberation was also found to be beneficial in 4 out of 5 patients with persisting total loss of sensation.

Adolescent↗

Effect of adenosine on human cerebral blood flow as determined by positron emission tomography.

The effect of intravenous infusion of adenosine on CBF was studied in seven patients with cerebral arteriovenous malformation. The patients were examined with positron emission tomography with controlled ventilation using [15O] water and [11C] fluoromethane as tracers. Total and regional CBF were determined before and during infusion of adenosine at rates producing a reduction of the MABP by approximately 10-40%. Six patients were normoventilated, and one was hyperventilated. Mean CBF in areas with normal brain tissue was 54 ml/100 g/min before adenosine infusion under normoventilation. Adenosine infusion increased mean CBF with 23-85%. Mean CVR was decreased with 43-65% and exceeded the percentage reduction of MABP in all normoventilated subjects. In the hyperventilated patient, the reduction of CVR was similar to the reduction of MABP, and CBF was unaffected, except for the 30% increase in the thalamus. It is concluded that intravenous administration of adenosine produces marked cerebral vasodilation in normoventilated subjects and that this response can be counteracted by hyperventilation.

Adenosine↗

A monoclonal antibody inhibiting leucocyte adhesion blocks induction of IL-2 production but not IL-2 receptor expression.

Monoclonal antibody 60.3 defines the leucocyte antigen CD 18 and recognizes a cell surface glycoprotein with an apparent molecular weight (MW) of 90,000 expressed by most human peripheral blood and bone marrow cells. This antibody can, among other things, block phorbol ester-induced adhesion among human mononuclear leucocytes. We show in this study that phorbol esters alone can induce peripheral blood mononuclear cells (PBL) to secrete interleukin-2 (IL-2) and that the IL-2-dependent cell line CTLL can be used for measuring this lymphokine without influence of the phorbol esters themselves. These findings make it possible to analyse the capacity of antibody 60.3 to interfere with IL-2 production and receptor expression by phorbol ester or phytohaemagglutinin (PHA)-treated human PBL. A significant positive correlation between blockage of induced cell aggregation by antibody 60.3 and reduction in IL-2 release was observed. The addition of interleukin-1 (IL-1) restored IL-2 secretion in PHA-treated, but not in 4-beta-phorbol 12, 13-dibutyrate [P(Bu)2]-treated, cells in the presence of this antibody. In parallel, IL-2 receptor expression was determined by immunofluorescence using biotinylated anti-IL-2 receptor (Tac) antibodies. FACS analysis showed that IL-2 receptor expression was unaffected by antibody 60.3, whereas DNA synthesis of the same P(Bu)2-treated PBL was inhibited. However, addition of external recombinant IL-2 overcame this proliferation blockade. These results indicate that a cell-to-cell adhesion step is necessary for the production of IL-2, but not for the expression of its receptor on both PHA- and P(Bu)2-treated human PBL.

Antibodies, Monoclonal↗

[Chronic cephalalgia as a sequela of rheumatic spondylarthritis of the cervical spine].

Deformity and instability of the cervical spine is quite frequently recordable from patients with chronic rheumatoid arthritis. More than 70 per cent of patients who had been suffering this rheumatoid disease for more than ten years with mutilating peripheral joint lesions exhibited radiologically visible and clinically recordable cervical spine disorders. Anterior atlanto-axial subluxation has proved to be the most common rheumatic deformity of the cervical spine and was found to cause severe, even intolerable occipito-cervical headache. The authors have obtained good results from posterior C1-C2 fusion operation on patients in whom headache had been invalidising and resistant to conservative treatment.

Arthritis, Rheumatoid↗

Dysphagia and micrognathia in a patient with juvenile rheumatoid arthritis.

This report describes the case of a 35-year-old man with juvenile rheumatoid arthritis. The patient experienced swallowing difficulties that were initially thought to be a result of the disease affecting the cervical spine. A maxillofacial examination, however, showed a total loss of the mandibular condyles, short rami and bodies, and a retrusion of the jaw. This was considered to be the main cause of the dysphagia, and not a glossopharyngeal nerve compression. The surgical-orthodontic management of these difficult cases is discussed.

Adult↗

Fatal cervical spinal injuries in road traffic accidents.

The present study analyses fatal road traffic accidents involving private cars and vans in Finland during the period 1972-1982, in which an injury to the cervical spine was the main cause of death. The material consists of 289 victims; this being 10.5 per cent of all the fatalities in this category of road traffic accidents. Front seat and rear seat passengers seem to have an equal risk of sustaining a fatal cervical spinal injury. However, front seat passengers have a significantly greater chance (P less than 0.001) of having fatal cervical spinal injuries than the drivers. Of the victims 21.1 per cent had worn safety belts but there was no statistical difference between those who did and those who did not wear safety belts. Increasing age seems to increase the risk of fatal cervical spinal injuries. Patients between 16 and 25 years of age had the lowest risk and patients over the age of 60 had the highest risk of sustaining a fatal cervical spinal injury (P less than 0.001). In 48.1 per cent of the cases, the victims were multiply injured and this is similar to other main causes of death in road traffic accidents. Wearers of safety belts had significantly (P less than 0.001) more multiple injuries. Of the patients who died of cervical injury, only 8.8 per cent survived transportation to hospital and 1.4 per cent survived longer than 24 hours. A direct blow was the most common mechanism of the cervical injury (47.1 per cent) and deceleration was found in 13.1 per cent of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Traffic↗

Maxillofacial trauma in fatally injured victims of motor vehicle accidents.

A survey of 84 victims of maxillofacial injuries sustained in road traffic accidents is presented. The material was based on the files of the Finnish National Board of Traffic Accident Investigation of the Insurance Companies, comprised the years 1972-1983 and covered the whole country. 86% of the victims were occupants of motor cars; only 24% had worn seat belts. Similarly only two of the eight motor-cyclists had worn a helmet. The majority of all victims also had other head injuries but only 24% had brain injuries; over 50% had a chest injury. In 20 cases the facial injury was thought to be the definitive fatal trauma. In the remaining cases the other injuries could have been responsible for the fatal outcome. However, aspiration of blood from the facial wounds, unconciousness and an injured thorax probably all contributed to death which in 87% was immediate. Thirty-six of the 64 victims who had not used a seat-belt or helmet could certainly, or probably, have been saved by either the belt or the helmet. The possibilities of preventing fatal maxillofacial injuries in road traffic are discussed.

Accidents, Traffic↗

Osteosarcoma of the mandible: analysis of nine cases.

A total of 16 cases of mandibular osteosarcoma were diagnosed histologically in Finland and reported to the Finnish Cancer Registry between 1953 and 1983. Review of the histologic slides confirmed the diagnosis in only nine cases. The overall five-year survival rate was 44%. Three patients who were free of clinical disease at the end of the follow-up period (mean, 9.9 years) either had tumors of low-grade malignancy (two cases) or had undergone prompt radical surgery (one case). The importance of radiography in the diagnosis of mandibular osteosarcoma is stressed, because the widening of the periodontal membrane spaces, the sunray effect, and the widening of the mandibular canal are almost pathognomonic for osteosarcoma.

Adult↗

Maxillofacial fractures sustained in bicycle accidents.

The present report is an analysis of 93 patients (52 male; 41 female) treated in 1981-1983 for maxillofacial fractures sustained in bicycle accidents. These accidents accounted for 7.1% of all facial bone fractures treated during the same period. Most accidents were single vehicle accidents (88%) and took place during the summer months. Of the patients, 65% had mandibular fractures, 35% had midface fractures and 5% had fractures in both the middle and lower thirds of the face. Condylar fractures were by far the most common of the mandibular fractures (67%)--a result which differs from studies concerning the profile of mandibular fractures in general. The majority of the middle third fractures were zygomatic (65%). Multiple injuries were diagnosed in 38% of the cyclists and other head injuries were the most common associated injury. Mean hospitalization of the in-patients (38%) was 4.1 days and the average sick leave was 14 days. The results of the study indicate that the use of protective helmets should be strongly recommended to cyclists, although most commercially available helmets do not protect the whole facial area and especially not the chin.

Accidents↗

Rigid internal fixation of mandibular fractures--an analysis of 45 patients treated according to the ASIF method.

A report is given of 45 patients with fractures of the mandible treated by the method of rigid internal fixation. In a majority of cases, there were either absolute or relative contraindications for an IMF. Most of the fractures plated were body fractures of the mandible, followed by angular, and symphysis fractures. In 4 cases, the fractures, caused by gunshots, were compound ones. In these, extensive soft tissue reconstructions were also performed. In a majority of the patients, good primary healing was observed, and the mean hospitalization time was only 4.4 days. The infection rate of 13% was, however, relatively high, and a few disturbances were seen with respect to motor and sensory function of the lower lip. Slight occlusal dysharmonies were registered in 23%, on an average of 22 weeks postoperatively, but these could be adjusted with a minimum of grinding. It was concluded that bone plating is a useful method in the treatment of several different types of mandibular fractures including the severe compound ones. The method can be especially recommended in cases in which an IMF is contraindicated or should be avoided. The possibilities for decreasing the frequency of postoperative infections are discussed.

Adolescent↗

Primary intraosseous carcinoma of the mandible.

The case of a 58-year-old man with a large primary intraosseous carcinoma (PIOC) of the mandible is presented. The tumour is rare, and the prognosis is usually poor. There are no specific histological characteristics of PIOC. Staining for basement membrane laminin could be a valuable aid in the differential diagnosis between PIOC and tumours of ameloblastoma origin.

Carcinoma, Squamous Cell↗