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Biomedical subjects

H Forssell

Publications and source records attributed to H Forssell.

At least 19 recordsLinked to original sources
PubMed1992

Immunohistochemical detection of androgen receptors in human oral mucosa.

Oral mucosal biopsies from 11 healthy volunteers, 7 women and 4 men, were analysed for the localization of androgen, oestrogen and progesterone receptors. The samples were dissected as quickly as possible and immediately frozen in liquid nitrogen to be stored at -70 degrees C. Only androgen receptors could be detected by the methods used. These were mainly located in the nuclei of basal epithelial cells, and to some extent in the nuclei of fibroblasts and endothelial cells. Failure in the localization of oestrogen and progesterone receptors might have been due either to low numbers of receptors or to the insensitivity of antibodies used. The method is thus suitable only for detecting androgen receptors.

Adult↗
PubMed1992

Resolution of oral lichenoid lesions after replacement of amalgam restorations in patients allergic to mercury compounds.

The significance of contact allergy in patients with various oral symptoms was studied. Positive patch-test reactions to mercury compounds were found in 21/91 patients. Of these, 18 had lichenoid lesions in oral mucosa in close contact to amalgam fillings, and three patients with contact allergy had neither amalgam fillings in their teeth nor visible oral lesions. Amalgam replacement was carried out in 15/18 symptomatic patients. The fillings were replaced with gold in three cases, composite resin fillings in six, glass ionomer in three and both gold and composite materials in three cases. In 10 patients there was complete replacement and in five it was restricted to the fillings adjacent to the mucosal lesions. After a mean follow-up period of 3.2 years a complete cure was seen in seven patients, each of whom had had all their fillings changed. A marked improvement occurred in six patients, and there was no change in two.

Adult↗
PubMed1990

Medetomidine premedication in dental surgery--a double-blind cross-over study with a new alpha 2-adrenoceptor agonist.

A single 50-micrograms dose of medetomidine, a highly selective alpha 2-adrenoceptor agonist, was administered intravenously as premedication 30 min before surgical third molar extraction under local anaesthesia to ten healthy male subjects in a double-blind, placebo-controlled, cross-over study. Blood pressure, heart rate, plasma catecholamines and cortisol were measured as indicators of operation-related stress. Apprehension and pain were assessed with repeated Visual Analogue Scales. The dental surgeon rated the overall effectiveness of the premedications, and the patients reported their subjective preference. Drug-induced sedation was determined with the Critical Flicker Frequency (CFF) test. The dental surgeon rated medetomidine as significantly more effective premedication than saline placebo. Apprehension was significantly reduced by medetomidine. The patients clearly preferred medetomidine premedication. Blood pressure was lower in the medetomidine session, whereas no significant differences were seen in heart rate. Plasma noradrenaline was lower after medetomidine, but adrenaline and cortisol levels were not affected. In conclusion, medetomidine may offer a useful alternative to traditional premedications in out-patient surgery, and its clinical usefulness should also be studied in other anaesthetic paradigms.

Adrenergic alpha-Agonists↗
PubMed1990

Attenuation of gastric sham feeding response during reflex sympathetic activation in man.

In six human volunteers we studied the effects of hypovolemia on the secretory activity of the gastric mucosa. The secretion of acid and HCO3 from the stomach was calculated from continuous measurements of pH and Pco2 in gastric effluent. Gastric secretion was stimulated by sham feeding (SF), and cardiac filling pressure was decreased by pooling blood in the lower extremities (lower body negative pressure (LBNP]. LBNP at -20 mmHg had no significant effects on systemic arterial pressure or heart rate but increased plasma norepinephrine concentration by 48 +/- 6% (p less than 0.001). Both the acid and the alkaline responses to SF were significantly attenuated during LBNP (-38 +/- 8%, p less than 0.01, and -55 +/- 14%, p less than 0.05, respectively). Analysis of the relationship between acid and HCO3 secretion in individual experiments suggested a relatively more pronounced inhibition of HCO3 secretion. The results imply that a decreased responsiveness of the gastric mucosa may be one component of the cardiovascular reflex adaptation to hypovolemia. A downregulation of active secretion will lead to smaller metabolic demands from the secreting cells and may thereby help to maintain a vasoconstriction in the gastric mucosa.

Adult↗
PubMed1989

A comparison of two sedative premedications for minor oral surgery under local anaesthesia.

Two commonly used drug combinations were studied as premedications before surgical 3rd molar removal under local anaesthesia. The study was randomized, crossover and double-blind in 12 patients. Our routine premedication for lengthy operations, consisting of diazepam 10 mg p.o. plus i.m. scopolamine 0.006 mg/kg and morphine 0.2 mg/kg, was compared with a combination of diazepam 10 mg p.o. plus metoprolol 50 mg p.o. The latter combination was expected to cause fewer central nervous system side effects and be more suitable for out-patient surgery. Drug levels in blood, physiological and biochemical indicators of operation-related stress, CNS side effects, and the patients' subjective preferences were monitored. Both combinations were equally accepted by the patients, but the diazepam/scopolamine/morphine combination caused clearly more side effects after discharge than diazepam/metoprolol. The operation-related haemodynamic changes and plasma catecholamine responses were similar after both premedications.

Adult↗
PubMed1989

Propofol infusion for sedation in outpatient oral surgery. A comparison with diazepam.

An infusion of propofol was compared with intravenous boluses of diazepam as sedation for minor oral surgery under local anaesthesia in 12 healthy patients who had elective bilateral surgical extraction of lower third molars; the patients served as their own controls. Plasma catecholamine, vasopressin and cortisol concentrations were determined from repeated blood samples. The total administered dose of propofol was 3.93 (SD 1.34) mg/kg and of diazepam 0.28 (SD 0.07) mg/kg. No cardiovascular depression or airway problems occurred. Other side effects were also rare but some discomfort on injection was frequent with propofol. Recovery times were faster after propofol than after diazepam as assessed by the Maddox wing and visual analogue scales. Propofol also provided better amnesia compared to diazepam at the time of the extraction of the teeth. Eight of the 12 patients subjectively preferred propofol sedation. There was no hormonal stress response in either group.

Adult↗
PubMed1989

Effect of elimination of occlusal interferences on signs and symptoms of craniomandibular disorder in young adults.

Sixty-two dental students judged not to be in need of treatment for craniomandibular disorder (CMD) were randomly divided into two groups, one receiving occlusal adjustment and the other mock adjustment. A double-blind study design was applied. After 2 years of education in dentistry, including courses in stomatognathic physiology, the increase in the subjective symptoms of CMD was significantly greater in the placebo control group than in the treatment group. The difference between the groups in the increase of sites tender to palpation was less clear, showing only a trend. However, the increase was statistically significant within the placebo group but not within the treatment group. Prophylactic occlusal adjustment thus appears to be effective in reducing the occurrence of symptoms of CMD, and possibly also the occurrence of clinical signs.

Adult↗
PubMed1989

Simultaneous measurement of gastric acid and bicarbonate secretion in man.

Experiments were performed to validate the computerized pH/PCO2 technique for measurement of HCO3 secretion at a physiologic pH in the human stomach. In bench-side experiments the system detected 103 +/- 2% (mean +/- SE, n = 66) of boluses or infusions of NaHCO3. The standard curve was linear in the physiologic concentration range, and in the pH interval from 1.8 to 6.9 the recovery rate of added HCO3 was independent of the pH of the aspirate. In vivo the recovery rate of an exogenous NaHCO3 infusion (240 mumol/15 min) was 95 +/- 5% (n = 9), and there was no significant correlation between basal gastric pH and recovery rate. The results support that our computerized gastric perfusion method can be used for quantification of gastric bicarbonate secretion also at a physiologic acid pH.

Bicarbonates↗
PubMed1988

Synovial chondromatosis of the temporomandibular joint. Report of a case and review of the literature.

An illustrative case of synovial chondromatosis in the temporomandibular joint (TMJ) region is presented, and 36 cases reported earlier are reviewed. The present patient, a 35-year-old woman, had been suffering from swelling and pain in the TMJ area as well as limited mandibular movements for 7 years. The condition had been treated with various conservative methods without any relief of the symptoms. Finally, radiological examination revealed calcified nodules within the joint space and a surgical exploration was performed. In all, 27 loose particles were removed from the joint in connection with the extirpation of the perforated and deformed disk. The result of surgical therapy has been favourable during the follow-up period of 18 months. Although synovial chondromatosis is rare in the TMJ, it should be kept in mind as one possible disease when treating patients suffering from symptoms similar to those of mandibular dysfunction syndrome.

Adult↗
PubMed1988

Local dental anaesthesia with lidocaine and adrenaline. Effects on plasma catecholamines, heart rate and blood pressure.

5 volunteers took part in this double-blind, cross-over study to evaluate the role of adrenaline 1:80,000 in lidocaine used in dental local anaesthesia on haemodynamics and the concentrations of catecholamines and their metabolites in plasma. The exogenous adrenaline statistically significantly elevated the heart rate (from 66 +/- 7 to 79 +/- 9 bpm), but did not affect systolic or diastolic blood pressure. Plasma adrenaline concentrations were increased more than 10-fold (from 0.02 +/- 0.02 to 1.0 +/- 0.3 nmol/l). We conclude that the adrenaline present in the local anaesthetic is a major source of adrenergic activation during minor oral surgery.

Adult↗
PubMed1988

Simple bone cyst. Review of the literature and analysis of 23 cases.

A retrospective study of 23 simple bone cysts including analysis of clinical, radiographical, histopathological features and follow-up information was made. The age of the patients varied from 8 to 59 years (mean 21.4 years). All lesions were found in the mandible, and 2 of them were radiologically multilocular. A loose connective tissue lining was found histologically in 8 out of 17 cysts with the biopsy specimens available. At follow-up, 2 failures of the primary surgical treatment were noted. The results emphasize that a proper follow-up is required after the treatment of simple bone cyst.

Adolescent↗
PubMed1988

Recurrence of keratocysts. A long-term follow-up study.

The aim of the study was to investigate the recurrence rate of keratocysts based on a material with a follow-up of at least 5 years, and to evaluate the relationship between different features of these cysts and their recurrence. It was found that of 75 keratocysts with follow-up times ranging from 5 to 17 years (mean 8.3), 32 (43%) recurred. The cumulative recurrence rate of the 67 annually examined cysts increased from 3% after the 1st year following the operation to 37% after the 3rd year. Thereafter, no new recurrences were noted. Recurrence of keratocysts in patients with basal cell nevus syndrome occurred more frequently than that of patients without the syndrome. Keratocysts enucleated in one piece recurred significantly less often than cysts enucleated in several pieces. The recurrence rate of keratocysts with a clinically observable infection, with fistula or with a perforated bony wall was higher than that of keratocysts without these features. Recurrence was also found more frequently in cysts with multilocular radiographic appearance than in unilocular cysts. The size or the location of the keratocysts did not have an influence on the recurrence rate.

Adolescent↗
PubMed1988

Comparative potency of carbachol, sham feeding, fundic distension and 16,16-dimethyl prostaglandin E2 as stimulants of human gastric bicarbonate secretion.

Six healthy subjects in random order underwent gastric bicarbonate secretion investigations, including stimulation with increasing doses of the cholinergic agonist carbachol, sham feeding, fundic distension and gastric instillation of 16,16-dimethyl prostaglandin E2. Bicarbonate secretion was measured by a computer-based system which continuously recorded pH and PCO2 of the effluent in a high-volume gastric perfusion system. The peak 30 min gastric bicarbonate output in response to carbachol, 150 mg subcutaneously, was 114% (P less than 0.05). Vagal stimulation by sham feeding resulted in a corresponding increase of 112% (P less than 0.05), while fundic distension to a volume of 600 ml gave an increase of 114% (P less than 0.05). In comparison, the response to 80 micrograms 16,16-dimethyl prostaglandin E2 was much greater, the peak bicarbonate output being increased by 245% (P less than 0.05). Both sham feeding and fundic distension appear to be either submaximal stimuli of gastric bicarbonate secretion in man or may possess both stimulatory and inhibitory actions.

16,16-Dimethylprostaglandin E2↗
PubMed1988

Reflex sympathetic activation in humans is accompanied by inhibition of gastric HCO3- secretion.

The study was performed to determine whether the sympathetic nervous system contributes to the reflex control of gastric HCO3- secretion in humans. Gastric HCO3- secretion was registered by a computerized technique based on measurements of pH and PCO2 in gastric effluent. To minimize formation of CO2 in the stomach, subjects were pretreated with the H2-receptor blocker ranitidine. Compensations were made for HCO3- of nongastric origin. As indicators of cardiovascular sympathetic activity, we measured heart rate, forearm vascular resistance, and plasma catecholamine concentrations. In one series of experiments, peripheral sympathetic activity was enhanced by the application of a negative pressure around the lower part of the body (lower body negative pressure, LBNP), at a rate sufficient to induce a slight decrease in systemic arterial pressure. In another series of experiments, peripheral sympathetic activity was inhibited by elevation of the legs, a procedure that simulates volume loading by redistributing blood volume toward the central circulation. LBNP at -20 mmHg decreased systolic pressure and pulse pressure and significantly increased heart rate, forearm vascular resistance, and plasma catecholamine levels. All these effects were observed in the first 15-min period of LBNP and were well maintained throughout the 45-min observation period. LBNP also inhibited basal gastric HCO3- secretion rate in seven of eight individuals, but this response was slower in onset with a latency of at least 15 min. Elevation of the legs increased pulse pressure and decreased forearm vascular resistance. Catecholamines were not measured in these experiments. Gastric HCO3- secretion tended to increase, but the magnitude of the response was highly variable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗