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Biomedical subjects

J Gillquist

Publications and source records attributed to J Gillquist.

At least 127 records · Page 7Linked to original sources
PubMed1981

Arthralgia and crystal deposits in Crohn's disease.

Ten patients with Crohn's disease and recurrent pain in the knee joints were subjected to arthroscopy. Biopsies obtained from the synovial membrane were examined under polarizing light microscopy. The arthroscopy revealed crystalline deposits in 7 patients and the microscopic examination of the synovial membrane demonstrated positively birefringent crystals in 4 patients. The crystals with positive birefringence had the rod or rhomboid shape typical of pyrophosphate crystals. As arthroscopy crystals in 7 patients and polarizing microscopy revealed crystals in one further patient, crystal deposits were thus found in 8 patients altogether. All patients had normal serum uric acid values. The crystal deposits were interpreted as pyrophosphate and their possible connection with the recurrent arthralgia in Crohn's disease is discussed.

Adult↗
PubMed1981

Arthroscopy in the early diagnosis of injuries to the knee joint.

In a series of 192 patients with acute knee injuries the diagnosis at arthroscopy was compared with the clinical diagnosis with or without confirmation at arthrotomy. Arthroscopy was used in 117 cases, clinical examination in 72 cases, and arthrography in 3 cases. All patients presented for diagnosis and treatment within 4 weeks of injury, and most within 1 week. The anterior cruciate ligament (ACL) was torn in 100 cases, and in 92 this was the main injury. The incidence of complete, isolated ACL tear was 1.5 per cent. ACL tear occurred in a higher proportion of cases in the arthroscopy group compared with diagnosis by other methods. An ACL tear was usually combined with injury to the medial ligament complex. Twenty-five patients showed tear of the posterior cruciate ligament (PCL), and in one-third of these there was also injury to the ACL. The medial ligaments were injured in 77 per cent of the whole series and this was the predominant lesion in 57 cases. Tear of the postero-medial capsular ligament (PMCL) was found in more than half of our patients. The ratio lateral/medial meniscus tear was 1:1.6 in the arthroscopy group and 1:27 in the group where arthroscopy was not undertaken. Arthroscopy resulted in an increase in the number of components of injury identified owing to improved diagnosis of tears of the ACL, the PMCL, the lateral meniscus, and possibly also of the PCL. There were no complication or side-effects of arthroscopy. In 93 per cent of cases primary suture was done. Reconstruction was rarely necessary if operation was undertaken within 2 weeks of injury.

Adolescent↗
PubMed1981

Different techniques for diagnostic arthroscopy. A randomized comparative study.

A randomized comparison between the anterolateral approach and the Needlescope technique for knee joint arthroscopy in 121 consecutive patients is presented. The central approach was used a reference, and the results of the other two techniques were compared with the results of this technique in the same patient. It is shown that the Needlescope necessitates a multiple puncture technique to give reliable information. When so used the results were comparable with those obtained with Storz arthroscopes and the central approach. On the other hand, the anterolateral approach gave less accurate results, mainly because of the difficulties encountered in examining the posterior compartments.

Arthroscopy↗
PubMed1981

Arthroscopic examination of the posterior cruciate ligament.

Of a series of 484 arthroscopies done with a special technique, we were able to inspect the posterior cruciate ligament satisfactorily in 96 per cent. The arthroscopic findings were checked at arthrotomy in 203 knees and the incidence of injury to the ligament in this group was 13.8 per cent. The over-all incidence of the injury in the series was 8 per cent. We made only one major diagnostic error: in this patient the ligament could not be fully visualized.

Diagnostic Errors↗
PubMed1981

Complications to subtotal parathyroidectomy.

Seventy-three patients were operated on for confirmed hyperparathyroidism. Identification of all glands was done by 1/3 biopsies for histopathologic examination on frozen section during the operation. In cases of adenoma only, the adenoma was removed except for the biopsies. In cases of hyperplasia, subtotal resection was made, leaving between a half-gland and a whole gland. The frequency of complications was analysed. Temporary hypocalcemia occurred in a similar frequency in both adenoma and hyperplasia groups. Permanent hypocalcemia was present in only one patient. At follow-up 3-5 years after operation, 98.6% of the patients were normocalcemic. Ionized and total serum calcium were normalized 3 months after operation and remained so for the rest of the follow-up period. Serum phosphate, serum magnesium and serum parathormone also remained normal. Thus identification of parathyroid glands with biopsies or subtotal parathyroidectomy in cases with hyperplasia did not increase the risk of postoperative complications.

Adult↗
PubMed1981

The importance of elevated TSH in serum after subtotal thyroidectomy for hyperthyroidism. A five-year follow-up study.

68 patients operated on for hyperthyroidism were observed regularly for 5 years after operation as regards the concentration of TSH in serum and the incidence of hypothyroidism and recurrent hyperthyroidism. 20 patients had elevated TSH 6 weeks after operation. 5 years later 9 of them had developed hypothyroidism, 6 had elevated TSH without clinical symptoms of hypothyroidism, while 5 were normal in all measured thyroid variables. 48 patients had normal TSH 6 weeks after operation. 5 years later 5 of them had developed a recurrence of hyperthyroidism, 4 had elevated TSH with no clinical symptoms of hypothyroidism, while the remaining 39 patients were euthyroid with normal thyroid variables. A scheme for follow-up of patients operated on for hyperthyroidism is proposed, with close follow-up of patients with elevated TSH soon after operation.

Adult↗
PubMed1980

Operative arthroscopy.

Today operative arthroscopy has become increasingly accepted as the method of choice for many knee disorders. Extraction of loose or foreign bodies, division of the medial plica, shaving the patella or fixation of osteochondritis are examples of procedures suitable for the arthroscope. However, arthroscopy has had the largest impact on therapeutic principles in the field of meniscus surgery. It is now technically possible to operate all meniscus lesions endoscopically. The technique developed in Linköping, Sweden, involves the use of a special knife. The principles for removal of flap tears, bucket handles and for subtotal meniscectomy is described. Selection of type of operation can be done according to the need of the particular patient with this technique. The equipment is fairly inexpensive and no operating arthroscopy is needed. The results in the first 200 cases were good or excellent in the majority of patients. The off-work period is very short.

Endoscopes↗
PubMed1980

Protein composition of the thyroid colloid in patients with hyperthyroidism.

Analysis of the protein composition of the thyroid colloid was performed in 28 patients operated on for hyperthyroidism. Fifteen of the patients were treated before the operation with carbimazole combined with thyroxine and 13 were treated with propranolol alone. Colloid was collected by micropuncture of single follicles in peroperative thyroid biopsies. The protein composition was analysed by microgel electrophoresis and densitometry, both in the colloid samples and in the supernatant fraction of homogenates of microbiopsies from the thyroid specimens. The analyses showed that, during treatment with carbimazole and thyroxine, the relative amount of the larger thyroglobulin aggregates (S-TG) was decreased compared with the relative amount observed in the colloid from normal thyroid tissue. In the hyperfunctioning thyroid tissue from the propranolol-treated patients the protein composition of the colloid was similar to that observed in normal tissue and the relative amount of the S-TG fractions was significantly higher than in the carbimazole- and thryoxine-treated group. It may be concluded that the increased release of thyroid hormones in hyperthyroidism is not combined with changes in the protein composition of the thryoid colloid. The decreased relative amount of the S-TG fractions in the thyroid colloid from patients treated with carbomazole and thryoxine was probably due to an insufficient capacity to iodinate thyroglobulin.

Carbimazole↗
PubMed1980

Protein synthesis in hyperfunctioning human thyroid tissue.

The rate of protein synthesis was examined in vitro in thyroid tissue slices. The material was obtained from euthyroid patients operated on for hyperparathyroidism and from hyperthyroid patients with Graves' disease pre-operatively treated with propranolol alone. The rate of protein synthesis was calculated from the incorporation of [3H]leucine radioactivity in the soluble thyroid proteins (mainly the colloid proteins), the amount of soluble protein per mg tissue and amount of DNA. Based on these figures it was observed that the rate of protein synthesis was 3.2 times higher in the hyperfunctioning thyroid tissue than in the normal tissue. A significant correlation was observed between this activity factor and the serum concentrating of thyroxine. It is concluded that the increased hormone formation in hyperthyroid Graves' disease at least partly depends on an increased rate of protein synthesis in the follicular epithelium. This could be due to stimulation by thyroid immunoglobulins, but other pathogenetic mechanisms may be responsible.

Humans↗
PubMed1979

Arthroscopic examination of the posteromedial compartment of the knee joint.

In a series of 356 arthroscopies of the knee joint 127 patients were explored by arthrotomy. A Storz arthroscope was introduced through the patellar tendon, and we alternated between the 30 degrees and 70 degrees optical systems in the same trocar sheath. The 30 degrees system was used for inspection of the superior, anterior, medial and lateral compartments, and to lead the tip of the instrument to the posterior part of the joint. The 70 degrees telescope was then used, providing a good view of the posterior cruciate ligament and the posterior horn of the menisci and their attachments. It also allowed direct inspection of the posterolateral and posteromedial compartments. No major diagnostic error was made by the arthroscopist in the 127 patients operated on as a result of the findings of endoscopic examination. Arthroscopy with the use of both 30 degrees and 70 degrees telescopes at the same session gives high diagnostic accuracy and detailed, exact pre-operative diagnosis.

Endoscopes↗
PubMed1979

Transcutaneous meniscectomy under arthroscopic control.

A technique of arthroscopic excision of a torn meniscus has evolved during two years' experience of therapeutic arthroscopy of the knee joint. The same method is used for both medial and lateral meniscus lesions under full visual control throughout the procedure, with a standard arthroscope inserted centrally through the patellar tendon. The first 18 consecutive patients thus treated have been followed up. Endoscopic operation was complemented by arthrotomy in three; in 15 no other treatment was given. The time in hospital, convalescence, sick leave, and knee function at follow-up were compared in these 15 patients with matched controls treated in the ordinary way by arthrotomy. Knee function did not differ between the groups, whereas all other variables showed better results after arthroscopic excision.

Endoscopes↗
PubMed1979

Long term results of surgery for non-acute anteromedial rotatory instability of the knee.

Seventy-eight patients treated by extraarticular reconstruction including pes anserinus transfer for anteromedial rotatory instability of the knee were reinvestigated 16--47 months (mean 28) after operation. Function before and after operation was assessed by means of a knee rating score. Of these patients, 94 per cent showed a higher score after operation. Twenty per cent showed full recovery with no limitation of knee function whatsoever. The follow-up score was higher with preserved medial meniscus function than when this structure had been removed. When not initially torn, the medial meniscus tended to become involved with time. Mild laxity in extension, possibly indicative of a posterior cruciate injury previously underestimated or not observed, was found in 15 per cent of the patients. No correlation was found between late knee function and the interval between injury and operation or the interval between operation and follow-up examination. The long term results were good. Extraarticular reconstruction is thus indicated in cases of chronic rotatory instability of the anteromedial type. Routine meniscectomy is not recommended in these patients, however. Signs possibly indicating posterior cruciate ligament involvement should be carefully looked for, as even minor posterior cruciate injury, easily overlooked, may influence the late results.

Adolescent↗
PubMed1979

Arthroscopic visualization of the posteromedial compartment of the knee joint.

Introduction of the arthroscope in the midline through the patellar tendon about 1 cm. below the apex of the patella is described. The posterior compartments of the knee joint can be examined from this single entry. The technique has been used in 1232 patients without any complications. In 127 patients subjected also to arthrotomy the arthroscopic diagnosis proved to be correct in all instances except for one missed rupture of the posterior cruciate liagment. In that case a bucket handle rupture of the medial meniscus prevented the entry into the posteromedial compartment.

Endoscopy↗
PubMed1979

Calcium infusion in suspected hyperparathyroidism: changes in parathyroid hormone concentration related to histopathological findings.

Changes in parathormone, total and free calcium concentrations in serum were studied in 27 patients with suspected hyperparathyroidism (25 with normocalcemia judged from CaT). Six patients were classified as normals. In 21 patients neck explorations was performed. Patients with definite pathology in the parathyroid glands had higher parathormone, total and free calcium levels than patients with borderline pathology or normal glands. The mean parathormone concentration fell significantly during calcium infusion in patients with histologically normal parathyroid glands. In patients with definitely pathological glands the parathormone concentration remained unchanged during the calcium infusion.

Adenoma↗
PubMed1979

Peroperative estimation of the size of the thyroid remnant.

A new method for estimation of the size of the remaining tissue after thyroid resection is described. The method has been tested on cadavers and during lobectomy in a series of patients. It is shown that intraoperative quantification of the thyroid remnant can be performed mostly with +/- 0.5 g for an individual thyroid lobe with a coefficient of variation of +/- 7.6%. In patients with toxic nodular goiter and calcifications, however, the error might be larger due to the varying homogeneity of the thyroid tissue. In 73 patients with negative antibody titers operated on for hyperthyroidism it was shown that the size of the thyroid remnant was negatively correlated to the delta TSH, determined 6 weeks after the operation.

Cadaver↗