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Biomedical subjects

H Kofoed

Publications and source records attributed to H Kofoed.

At least 37 records · Page 2Linked to original sources
PubMed1987

External fixation of displaced fractures of the proximal humerus. Technique and preliminary results.

A new technique for the treatment of displaced fractures of the proximal humerus is described. Twelve fractures in 11 patients were managed by transcutaneous reduction using a Steinmann pin, and external fixation with a Hoffmann-type neutralising bar connected to two half-pins in the humeral head and three half-pins in the shaft. The pins were removed after four weeks. Two patients sustained redisplacement after a further injury, but in the others reduction was maintained. Two cases of pin-track infection resolved after antibiotics, but delayed union resulted. There were no neurovascular injuries and at follow-up of 6 to 12 months no refractures had been seen. The early functional results were excellent or satisfactory in nine cases.

Adult↗
PubMed1987

Respiratory gas pressures in the spine. Measurements in goats.

Normal values of pO2, pCO2, pH, and intraosseous pressure were measured in situ in the lumbar spine of goats. In the lumbar bodies and discs no difference existed between values found cranially and caudally. pO2 was lower and pCO2 higher in the nucleus pulposus than in the adjacent lumbar bodies. This emphasizes the nutritional route to the disc via the vertebral end plate. Intraosseous pressures in the cranial and caudal levels of the lumbar spine did not differ, and the pressures were the same as otherwise found in cancellous bone. These are the first combined in situ measurements of several basic metabolic parameters in the normal spine using recordings with continuous mass spectrometry. They may constitute a basis for further investigation of metabolism in the structures of the spine.

Animals↗
PubMed1987

Arterial hypoxia does not affect subchondral pressure and regional blood flow.

The influence of arterial hypoxia on bone marrow pressure, regional blood flow and oxygen and carbon dioxide tensions was investigated by simultaneous and continuous measurements in the femoral condyles of 8 rabbits. Arterial hypoxia was obtained by hypoventilation. The subchondral gas tensions and regional blood flow were measured by a previously described technique based on mass spectrometry. Arterial hypoxia caused a significant decrease in subchondral oxygen tension and an increase in subchondral carbon dioxide tension. There was no significant change in bone marrow pressure and regional blood flow.

Animals↗
PubMed1986

Aggressive fibromatosis. Report of two cases with rare clinicopathological manifestations.

Two cases of aggressive fibromatosis are described, one with tricentric origin and with the first tumor originating in the hand, the other with malignant transformation into a myxoid fibrosarcoma, grade III. The primary treatment of aggressive fibromatosis should be wide excision, and the follow-up should be long, taking into account the possibility of multicentricity and the risk of malignant transformation.

Adolescent↗
PubMed1986

Synovitis causes hypoxia and acidity in synovial fluid and subchondral bone.

The purpose of the present study was to evaluate the environmental changes in synovial fluid and subchondral bone during synovitis in rabbits in which the knee joint on one side was subjected to a procedure causing instability; a traumatic synovitis rapidly developed. Three weeks following the procedure, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2) and hydrogen ion concentration (pH) were measured in vivo in the juxta-articular bone and in the synovial fluid of both the normal and the affected sides. Mass spectrometry was used for simultaneous registration of PO2 and PCO2, while a monocrystalline antimony pH electrode was used for simultaneous measurement of pH in vivo. Hypoxia, hypercapnia and relative acidity were found in synovial fluid and subchondral bone of knees with synovitis. The metabolic environment of synovial fluid and subchondral bone was considerably changed at the 3-week stage of experimental osteoarthritis and this was probably secondary to regional venous congestion.

Animals↗
PubMed1986

Effect of simulated joint effusion on subchondral haemodynamics and metabolism.

The purpose of the present study was to investigate the effect of simulated joint effusion on pO2, pCO2, the regional blood flow and intraosseous bone marrow pressure in the subchondral bone of rabbit. Mass spectrometry was used for simultaneous and continuous registration of subchondral pO2 and pCO2, while the relative argon signal was used for qualitative estimation of regional bone blood flow. The bone marrow pressure was recorded continuously by pressure transducers. Isotonic sodium chloride infusion at a constant pressure of 75 mmHg into the knee joint cavity constituted the basis for joint effusion. An instant increase in the subchondral bone marrow pressure followed the joint effusion (P less than 0.001). This resulted in a significant (P less than 0.01) decrease in the qualitative bone blood flow, significant (P less than 0.01) hypoxia and significant (P less than 0.01) hypercapnia in the subchondral bone. Joint effusion always lasted 30 minutes. Following its release all changes were reversed to normal values within 15 minutes. Within the period of observation no nervous or humoral factors seem to be brought into action. It was concluded that regional venous stasis was responsible for all changes, and that joint effusion should not be left untreated for long periods.

Animals↗
PubMed1986

Hemodynamics and metabolism in arthrosis. Studies in the rabbit knee.

Arthrosis was induced in the rabbit knee, making it unstable by ligament resection. Acidity and hypercapnia were found in the synovial fluid of the arthrotic knees, whereas oxygen partial pressure was normal. In arthrotic subchondral bone the intraosseous pressure and oxygen partial pressure were increased; intraosseous phlebography showed venous congestion. Histologic specimens showed increased subchondral bone formation, loss of cartilage and total depletion of glycosaminoglycans. The synovial membrane was hyperplastic and fibrosis was found in the underlying tissue. We suggest that changes in environmental haemodynamics and metabolism, although secondary in nature, may play an important role in the arthrotic process.

Animals↗
PubMed1986

Positive correlation between osteoarthritic ankle pain and bone marrow pressure.

We evaluated whether intraosseous pressure correlated with osteoarthritic ankle pain. This and the swelling around the ankle joint were investigated in 12 patients with secondary osteoarthritis of the ankle joint. Significant correlations were found between indexed intraosseous pressures and the degree of pain, whereas swelling around the ankle was not correlated with pain. On the other hand, a significant correlation existed between the indexed values of intraosseous pressure in the talus and the indexed values of ankle joint swelling. It was concluded that the intraosseous pressure index may be used as an objective variable for evaluation of osteoarthritic ankle joint pain.

Adult↗
PubMed1985

On the blood supply of muscle-pedicled bone: an experimental study.

In an attempt to evaluate the vascular pathophysiology of muscle-pedicled tubular bone, continuous measurements of the intraosseous perfusion pressure together with simultaneous recording by mass spectrometry of the intramedullary partial pressures of the respiratory gases have been carried out in a series of dogs, using the femur attached to the adductor muscle as an experimental model. The data obtained are presented and commented upon.

Animals↗
PubMed1985

Serous synovitis of the sternoclavicular joint. Differential diagnostic aspects.

Ten patients with unilateral spontaneous swelling of the sternoclavicular joint are presented. Plain radiographic examination of the joints revealed no abnormalities. Technetium scintigraphy was positive. After surgical biopsy the swelling and the symptoms disappeared. Patho-anatomical examination of synovialis from these joints revealed serous synovitis as the only pathological finding. Seven other patients with clinical symptoms undistinguishable from the above-mentioned and with normal plain radiographic findings showed, patho-anatomically: osteomyelitis (2 cases), ganglion (2 cases), osteoarthritis (1 case), Friedrich's disease (1 case) and a carcinoma metastasis (1 case). In view of the differential diagnostic aspects it was concluded that diagnosis of spontaneous swelling of the sternoclavicular joint after inconclusive serological, radiographical and scintigraphical examination, always should be established on the basis of surgical biopsy and patho-anatomical evaluation.

Aged↗
PubMed1985

Bone marrow circulation after osteotomy. Blood flow, pO2, pCO2, and pressure studied in dogs.

We investigated the immediate effect of osteotomy of the femoral shaft in adult dogs on intramedullary pO2, pCO2, relative bone blood flow (RBF) and intraosseous pressure (IOP). Single osteotomy resulted in a pO2 decrease from 49 mm Hg to 30 mm Hg. Double osteotomy further reduced pO2 to 21 mm Hg. Following double osteotomy, pCO2 increased from 42 mm Hg to 55 mm Hg. IOP was decreased by single osteotomy from 29 mm Hg to 15 mm Hg, and to 4 mm Hg by the second osteotomy. Linear regression analysis showed a negative correlation between pCO2 and RBF. We concluded that osteotomy introduces immediate haemodynamic and metabolic changes in the bone marrow canal. A periosteal supply of the endosteal bone seems possible provided this system is intact.

Animals↗
PubMed1985

Aggressive fibromatosis.

Fifteen patients with aggressive fibromatosis are presented. The patients ranged in age from one to 64 years, an average of 26 years, and the median time of follow-up study after treatment was ten years (a range of 2.5 to 22.0). Within this period, 60 per cent (nine of 15) of the tumors recurred. In a survey of the literature, when simple excision was compared with wide extirpation, the latter was found significantly superior (p less than 0.01) in terms of limiting a recurrence of the tumor. The results of a pathoanatomic study found that the number of mast cells and the size of the primary tumor could not prognosticate the clinical course. It was concluded that aggressive fibromatosis should be evaluated and treated like a low malignant soft tissue tumor.

Adolescent↗
PubMed1984

Effect of increased knee joint pressure on oxygen tension and blood flow in subchondral bone.

We have investigated the influence of acute changes in the knee joint pressure of rabbits on the oxygen tension and the regional blood flow in the subchondral bone. The intra-articular pressure was increased by infusion of a sodium chloride solution into the joint cavity, and the associated change in the subchondral oxygen tension was measured by mass spectrometry. The mass spectrometer was also used to detect, qualitatively, changes in the regional blood flow. When the joint pressure was increased from the habitual level to 75 mmHg, the average subchondral oxygen tension was reduced from about 39 to about 30 mmHg and, at the same time, the regional blood flow was reduced significantly.

Animals↗
PubMed1984

Subchondral PO2 and PCO2 are unaffected in experimental arthrosis.

We have made comparative measurements of oxygen and carbon dioxide tensions in normal and osteoarthritic subchondral bone tissue of rabbits in the 4-month stage of unilateral experimental arthrosis of the knee. The gas tensions were measured by a mass spectrometer via a special catheter inlet system. The mean values of the oxygen tensions on the normal and the osteoarthritic side were 39.8 and 46.2 mmHg, respectively. The carbon dioxide tensions were 33.3 and 34.2 mmHg. Neither difference was significant.

Animals↗
PubMed1983

Resection alloplasty in the treatment of certain malignant bone tumors.

Resection alloplasty was performed in 13 patients as treatment for malignant bone tumors. At follow-up after 4.5 years (range, 2-6 years), three patients had died. In all these cases metastases were found. Of the surviving patients one had a local recurrence, while the rest were without recurrence. All surviving patients demonstrated good functional results. It was concluded that resection alloplasty is a favorable alternative to high amputation in patients with primary or secondary bone tumors, because a high rate of radicality was achieved in the former group (as 90% at the latest follow-up are without signs of recurrence, locally or widespread), and a functionally satisfying result for both groups was achieved.

Amputation, Surgical↗
PubMed1983

Moore prosthesis in the treatment of fresh femoral neck fractures. A critical review with special attention to secondary acetabular degeneration.

A consecutive series of 106 patients with displaced femoral neck fractures was treated initially with Moore prostheses. The patients' mean age was 82.5 years (range, 67-91). At follow-up after two years, 71 patients attended. Thirty-seven per cent of these were in need of a conversion of their one-piece device to a total hip replacement on account of hip pain. When only active patients living in their own homes were considered, 55 per cent were found to need total hip replacements. The main reason for the development of hip pain was acetabular derangement. It was concluded that active patients, disregarding their age, should not be treated with one piece prostheses of their fractures could be satisfactorily reduced and pinned. If this cannot be accomplished, a primary total hip replacement may be considered.

Acetabulum↗
PubMed1983

Myonecrotic gas gangrene of the extremities.

Twenty-three patients with proven myonecrotic gas gangrene of the extremities caused by Clostridium perfringens bacteria were treated by a combination of surgical measures, benzyl-penicillin and hyperbaric oxygen at three atmospheres. 87 per cent (20/23) of the cases were cured and half of the surviving patients (10) had to be amputated at least one level higher than on admission. No single factor could be established that influenced the course of the infection comparing age under and over 50 years, vascular insufficiency and normal vascular conditions, and toxicity and non-toxicity. Nor did the level of the infection of the limb seem to have any influence. The frequency of death in relation to the described variables could not be established when multi-variance analysis was used.

Adolescent↗