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Biomedical subjects

E Eriksson

Publications and source records attributed to E Eriksson.

430 records · Page 24Linked to original sources

Cylinder or mobile cast brace after knee ligament surgery. A clinical analysis and morphologic and enzymatic studies of changes in the quadriceps muscle.

Sixteen patients participated in a prospective randomized trial in which a standard cylinder cast was compared with a mobile cast brace. Both were worn for 4 weeks, beginning at 1 week after reconstruction of the anterior cruciate ligament. The athletes that had used a cast brace could return to sports activities in about one-half the time it took for the athletes with a standard cast. The patients with a standard cast showed a significant atrophy of Type I (slow twitch) muscle fibers in the vastus lateralis. The cast brace patients did not show any significant changes in cross-sectional areas of Type I or Type II (fast twitch) muscle fibers. The standard cast patients had a significant reduction of succinate dehydrogenase (SDH) activity in the vastus lateralis whereas the patients with the cast brace did not show any significant changes. No difference in surgical end result was found. A cast brace with a limited range of motion between 20 and 60 degrees of flexion is recommended as the standard postoperative treatment after knee ligament surgery.

Adult↗

Hypotrophy of the soleus muscle in man after achilles tendon rupture. Discussion of findings obtained by computed tomography and morphologic studies.

Seven athletes (age range, 35 to 43 years), who sustained total subcutaneous ruptures of the Achilles tendon 2 to 5 cm above its distal insertion, were treated surgically with suturing of the tendon, immobilization of the leg and foot for 6 weeks, and cast changes so as to increase the dorsiflexion of the foot. Needle biopsies were obtained several times from the soleus muscles of both the injured and uninjured legs at a depth of about 5 cm. The cross-sectional area was measured by computed tomography at the same level the tissue was obtained by biopsy. Results of morphologic studies revealed a selective Type I fiber atrophy of the soleus muscle. Computed tomography revealed a 23% decrease in the area of the calf muscles and a 11% total reduction in the cross-sectional area of the calf (about the middle, where the gastrocnemius muscle is transformed into a tendon and where the soleus lies superficially). Mere measurement of the circumference of the calf is judged to be a poor criterion of muscle atrophy when compared with these other means of evaluation of atrophy. The evidence compiled during this study suggests that prompt surgical treatment of Achilles tendon ruptures, with cast changes several times during the period of immobilization and with tension maintained on the muscle, is the most effective treatment regimen we have found for this injury.

Achilles Tendon↗

Comparison of isometric muscle training and electrical stimulation supplementing isometric muscle training in the recovery after major knee ligament surgery. A preliminary report.

Eight patients undergoing reconstruction of the anterior cruciate ligament were randomly allocated into two groups. The control group received a standard plaster cast and isometric muscle training. The stimulated group received a standard plaster cast, isometric training, and percutaneous electrical stimulation during the recovery period. The patients were examined clinically and with repeated muscle biopsies before surgery, 1 week after surgery, and 5 weeks after surgery at the time of removal of the cast. The electrically stimulated group had better muscle function from a clinical point of view and their succinate dehydrogenase activities were significantly higher than those in the control group. Electrical stimulation thus could prevent the fall in oxidative enzyme activity which was noted in the control group. The results suggest that percutaneous electrical stimulation may be a way of preventing muscle atrophy after major knee ligament surgery in athletes.

Adult↗

A comparison between the transpatellar tendon and the lateral approach to the knee joint during arthroscopy. A cadaver study.

The cental transpatellar tendon arthroscopic approach and the standard lateral approach were compared in 200 unselected cadaver knees. A 5-mm arthroscopic dummy was used in the investigation. In 198 knees, using the transpatellar tendon approach, the dummy passed through the infrapatellar fat pad. In 7 cases with the transpatellar approach and in 22 cases with the lateral approach, we were unable to reach the medial posterior compartment of the knee joint. It was usually easier to insert the arthroscopic dummy into the posterior fossa if the knee joint was held at 35 to 40 degrees of flexion of the knee than at 90 degress of flexion. In 88 of 100 knees, the dummy could be passed from the transpatellar approach into the lateral posterior fossa and in 77 of 100 knees from the lateral approach. Patella baja was found in 16 knees (8%). Since the transpatellar tendon approach should not be used in these cases, it means that this technique cannot be used in all cases. From an anatomical point of view, the transpatellar tendon method thus does not offer any major advantages compared to the standard lateral one.

Aged↗

Breaststroke swimmer's knee. A biomechanical and arthroscopic study.

The cause of the breaststroke swimmer's knee with medial pain of the knee joint has not been clearly identified. Breaststroke swimmers with knee pain were, therefore, examined arthroscopically. None showed any other disorders of their knees than medial synovitis in seven of nine swimmers. Since structural abnormalities could be ruled out, biomechanical analyses utilizing cinematographic techniques were used to study patients swimming in a special flume with the speed set at 90% of their best competitive performance. The results indicate that the extension and flexion and also in some cases the hip abduction and adduction movements of the whip kick were performed with high peak angular velocities. No significant differences in swimming technique among the six patients studied and three controls could be observed. It is concluded that a combination of high angular velocities at the hip and knee and external rotation of the tibia relative to the femur repeated in excessive amounts might be the primary cause for the medial synovitis documented in these patients. The breaststroker's knee thus seems to be an overuse syndrome.

Athletic Injuries↗

The biomechanics of anterior cruciate ligament rehabilitation and reconstruction.

The rehabilitation of knee injuries involving the anterior cruciate ligament (ACL) is controversial. This paper describes strain in the normal and reconstructed ACL during a series of passive and active tests of knee flexion with and without varus, valgus, and axial rotation torques on the tibia. Strain in the human knee ACL was significantly different depending on whether the knee flexion angle was changed passively or via simulated quadriceps contraction. The knee joint capsule was found to be important for strain protection of the ACL. Quadriceps activity did not strain the normal or reconstructed ACL when the knee was flexed beyond 60 degrees, but significantly strained the tissue from 0 to 45 degrees of knee flexion. Immobilization may not protect the ACL if isometric quadriceps contractions are allowed to occur. Properly placed reconstructions exhibited strain behavior which closely followed the anteromedial band of the ACL.

Adult↗

Stress fractures of the femoral neck in athletes. The consequence of a delay in diagnosis.

Twenty-three patients with stress fractures of the femoral neck were followed up at an average of 6.5 years after the injury. There were 16 recreational athletes and seven elite athletes. Most injuries (N = 15) occurred during running. The diagnosis was confirmed within 3 to 104 weeks (mean, 14 weeks) after the initial onset of symptoms. Sixteen of the patients were treated with internal fixation, the remaining seven were treated conservatively. Seven patients (30%) developed complications requiring major surgery. Five of these patients had Type 3 fractures (displaced) and four had been treated with internal fixation initially. The remaining two patients had Type 1 fractures (endosteal or periosteal callus without an overt fracture line); one was treated operatively and the other conservatively. Three patients developed avascular necrosis and two were treated by hip replacement. The third patient was treated with arthrodesis. Three refractures and one pseudarthrosis were treated by osteotomy. At followup, all elite athletes stated that they had to end their career as a result of the injury. Results were rated by the ability of the athlete to return to sports. There were 9 bad or fair results, 13 good, and 1 excellent result. No difference in activity level or subjective rating was observed between the surgically and conservatively treated group either preinjury or postinjury. The most important factor influencing the complication rate seems to be the type of fracture. The high incidence of displaced fractures (Type 3) could speculatively be caused by undiagnosed tension side stress fractures. If so, the delay in correct diagnosis may be disastrous. However, we could only objectively observe this in one of our cases.

Adolescent↗

Does amateur boxing lead to chronic brain damage? A review of some recent investigations.

Fifty former amateur boxers were examined and compared with two control groups of soccer players and track and field athletes. All subjects were interviewed regarding their sports career, medical history, and social variables. They underwent a physical and a neurologic examination. Personality traits were investigated and related to the platelet monoamine oxidase activity. Cerebral morphologic changes were evaluated using computed tomography and magnetic resonance imaging. Further, clinical neurophysiologic tests were made as well as neuropsychologic tests. No significant differences were found between the groups in any of the physical or neurologic examinations or in platelet monoamine oxidase activity. Socially, the boxers had a lower degree of education and had chosen less intellectual professions, but they were less impulsive and more socialized. The computed tomography images and magnetic resonance imaging studies showed no significant differences between the groups. There was a significantly higher incidence of slight or moderate electroencephalography deviations among the boxers. Neuropsychologically, the boxers had an inferior finger-tapping performance. Thus, no signs of serious chronic brain damage were found among any of the groups studied. However, the electroencephalography and finger-tapping differences between the groups might indicate slight brain dysfunction in some of the amateur boxers.

Adult↗

Hamstring injuries in sprinters. The role of concentric and eccentric hamstring muscle strength and flexibility.

Eleven sprinters with recent hamstring injuries were compared with nine uninjured runners. The flexibility of the hamstrings and the eccentric and concentric muscle torque were measured in the hamstrings and quadriceps muscles at different angular velocities. Sprinters with a previous hamstring injury had significantly tighter hamstrings than uninjured sprinters had. The uninjured sprinters had significantly higher eccentric hamstring torques at all angular velocities. They also had significantly higher concentric quadriceps and hamstring torques at 30 deg/sec but not at higher velocities. Sprinters with a history of hamstring injury thus differed from uninjured runners, being weaker in eccentric contractions and in concentric contractions at low velocities.

Adolescent↗

Proprioception in classical ballet dancers. A prospective study of the influence of an ankle sprain on proprioception in the ankle joint.

We studied prospectively the influence of ankle sprains on proprioception as measured by recording the postural sway of classical ballet dancers. Excellent balance and coordination are important for classical ballet dancers, and postural stability requires adequate proprioception from the ankle joint. Fifty-three professional dancers from the Royal Swedish Ballet, Stockholm, and 23 nonathletes, the control group, participated in the investigation. Postural sway was recorded and analyzed with a stabilimeter using a specially designed, portable, computer-assisted force plate. Six dancers sustained ankle sprains during followup. The recordings were obtained of these dancers before and after the injuries. The stabilometry results differed among the male and female dancers and the control group as follows: 1) the male dancers demonstrated a smaller total area of sway, and 2) both the male and female dancers had a smaller mean sway on the left foot than on the right (no mean difference in sway was found between the left and right foot in the control group). In comparison with the condition before injury and with the uninjured foot, the postural stability of the dancer was impaired for several weeks after the ankle sprain. Postural stability gradually improved during rehabilitation and improvement still occurred several weeks after professional dancing had resumed.

Adult↗

Electromyographic activity in expert downhill skiers using functional knee braces after anterior cruciate ligament injuries.

We studied six expert downhill skiers who had sustained anterior cruciate ligament injuries and had different degrees of knee instability. The aim was to measure possible changes in electromyographic activity recorded from lower extremity muscles during downhill skiing in a slalom course without and with a custom-made brace applied to the injured knee. Surface electrodes were used with an eight-channel telemetric electromyographic system to collect recordings from the vastus medialis, biceps femoris, semimembranosus, semitendinosus, and gastrocnemius medialis muscles from both legs. Without the brace, the electromyographic activity level of all muscles increased during knee flexion. The biceps femoris muscle was the most activated and reached 50% to 75% of the maximal peak amplitude. With the brace, the electromyographic activity increased in midphase during the upward push for the weight transfer and the peak activity occurred closer to knee flexion in midphase. Also, the uninjured knee was influenced by the brace on the injured leg, a decrease in electromyographic activity was seen in midphase. Spearman's rank correlation revealed a significant correlation between an increase in biceps femoris activity of the injured leg and increasing knee instability. We suggest that the brace caused an increased afferent input from proprioceptors, resulting in an adaptation of motor control patterns secondarily modifying electromyographic activity and timing.

Adult↗

Gene transfer in wound healing.

Gene transfer refers to the introduction of DNA or RNA molecules into target cells. The purpose of gene transfer is cellular expression of the protein encoded by the nucleic acid. This process can lead to the addition or inhibition of a cellular function. The techniques for gene transfer can generally be divided into viral, chemical, electrical, or mechanical methods. Several different viral vectors can be used for in vitro gene transfer, but in vivo adenoviral vectors are the most successful for transfection of wounds. The chemical vectors include liposomes, calcium phosphate, and diethylaminoethyl-dextran. The most important mechanical methods for gene transfer are direct single injection of DNA, particle-mediated (gene gun) transfer, and microseeding. Existing techniques currently yield expression in the physiologic or supraphysiologic range for 1 to 2 weeks. A large number of potentially useful proteins could be delivered to healing wounds with gene-transfer techniques, including stimulatory and inhibitory peptides. It has also been shown that a tetracycline switch can be used to control the beginning, as well as the end, of gene expression. Gene transfer to wounds is a powerful experimental tool for targeted, consistent, local delivery of peptides in high concentrations to the wound environment. Gene transfer shows great potential for the treatment of wounds with specific biochemical or genetic defects.

Animals↗

[Clomipramine and other serotonin reuptake inhibitors in the treatment of depressed mood, anxiety and impaired impulse control].

The antidepressive effects of substances which most likely increase the rate of monoaminergic neurotransmission by the antagonization of the serotonin and noradrenaline reuptake inhibitors has been know to exist for over thirty years. The role of both of these substances, serotonin and noradrenaline, in the function of these mechanisms is still, however, a matter of discussion. In the last ten years it has been shown that many antidepressive drugs are not only effective in the treatment of depression but also in the treatment of many other psychiatric disorders. These include for example panic anxiety attacks, compulsive-obsessive symptoms, premenstrual tension disorder etc. It appears from the treatment of these disorders that serotonin is of greater importance than noradrenaline.

Anxiety Disorders↗