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Biomedical subjects

J Karlsson

Publications and source records attributed to J Karlsson.

At least 127 records · Page 7Linked to original sources
PubMed1997

Is bracing after anterior cruciate ligament reconstruction necessary? A 2-year follow-up of 78 consecutive patients rehabilitated with or without a brace.

The aim of this study was to evaluate the effect of a standard postoperative rehabilitation knee brace on function, stability and postoperative complications at the 2-year follow-up after anterior cruciate ligament (ACL) reconstructive surgery. Seventy-eight consecutive patients with a unilateral chronic ACL rupture reconstructed by the same surgeon using the endoscopic "all-inside" technique, patellar tendon autograft and interference screw fixation were included in the study. The rehabilitation followed a standard protocol. Group A included 39 patients who were supplied postoperatively with a knee brace for 4 (range 3-6) weeks. Group B included 39 patients for whom a brace was not used. The median age was 27 (range 16-48) years in group A and 26 (range 14-51) years in group B. The median time period between the injury and the index operation was 24 (range 3-150) months in group A and 18 (range 3-360) months in group B. All 78 patients were re-examined by two independent observers after a median follow-up period of 25 (range 23-28) months in group A and 24 (range 22-27) months in group B. The median KT-1000 total side-to-side difference between the reconstructed and the uninjured knees at 89 N was 3 (range -5.5-11) mm in group A and 3 (range -7-10) mm in group B (NS). When the anterior translation was tested separately at 89 N, the corresponding values were 3 (range -4-13) mm in group A and 3 (range -5-10) mm in group B (NS). The median one-leg hop quotient was 95% (range 50%-167%) of the uninjured leg in group A and 92% (range 64%-119%) in group B (NS). The median Lysholm score was 89 (range 39-100) points in group A and 85 (range 37-100) points in group B (NS). In group A, 27/39 (69%) patients and in group B 21/39 (54%) patients were classified as excellent or good (NS). The median Tegner activity level was 7 (range 3-9) in group A and 6 (range 3-9) in group B (NS). Using the IKDC scale, 27/39 (69%) in group A and 24/39 (62%) in group B were classified as normal or nearly normal (NS). The median sick leave in group A was 62 (range 0-357) days and 59 (range 0-243) days in group B (NS). No serious complications occurred during the first 6 postoperative weeks. Two serious complications were, however, registered after the 6th postoperative week. One patient in group A sustained a rupture of the reconstructed ACL 8 weeks postoperatively (3 weeks after removing the brace), and one patient in group B sustained an undislocated patellar fracture during the 7th postoperative week after a fall. This study indicates that the use of a postoperative rehabilitation brace after an arthroscopic ACL reconstruction did not appear to influence either objective stability or subjective function by the 2-year follow-up.

Adolescent↗
PubMed1997

Factors affecting donor-site morbidity after anterior cruciate ligament reconstruction using bone-patellar tendon-bone autografts.

The objective of this study was to assess knee function after anterior cruciate ligament reconstruction focusing on residual donor-site problems. Ninety consecutive patients with chronic unilateral anterior cruciate ligament rupture were operated on by the same surgeon using patellar tendon autografts, the all-inside arthroscopic technique, and interference screw fixation. At the follow-up examination 24 (range 22-32) months after the index operation, the median total anterior-posterior KT-1000 side-to-side difference was 2.5 (-7 to 11) mm. The median Lysholm score was 86 (range 37-100) points and the median Tegner activity level was 6 (range 1-9). Using the IKDC evaluation system, 62 of 90 (69%) were classified as normal or nearly normal. The median one-leg-hop quotient was 93 (range 0-167)% of the uninjured leg. Of 90 patients, 44 (49%) had minor or no discomfort when asked to walk on their knees (kneewalkers) and 46 of 90 (51%) patients had severe problems or found it impossible to perform the test (non-kneewalkers). The 'kneewalkers' had a median loss of anterior knee sensitivity of 10 (range 0-120) cm2. The corresponding value for the 'non-kneewalkers' was 25 (range 0-200) cm2 (P = 0.0001). Palpatory donor-site tenderness was registered in 19 of 44 (43%) of the 'kneewalkers' and 37 of 46 (80%) of the 'non-kneewalkers' (P < 0.001). Full hyperextension was not regained by 9 of 44 (20%) of the 'kneewalkers' and 19 of 46 (41%) of the 'non-kneewalkers' (P < 0.05). Additional surgery during the follow-up period was required by 6 of 44 (14%) of the 'kneewalkers' and 19 of 46 (41%) of the 'non-kneewalkers' (P < 0.01). Magnetic resonance imaging focusing on the donor site was performed on 31 randomly selected patients and revealed no difference between the 'kneewalkers' and the 'non-kneewalkers' in terms of patellar tendon width, thickness, length, and residual donor-site gap size. The kneewalking test was found to be a functional and reliable test for detecting donor-site morbidity. It appears that donor-site morbidity was related to problems requiring additional surgery during the follow-up period, such as extension deficit and pain near the metal implant on the tibial side, as well as the loss of anterior knee sensitivity. It appears to be important to attempt to preserve the sensitivity in the operated area during surgery and to regain full hyperextension in the postoperative period to minimize donor-site morbidity.

Adolescent↗
PubMed1997

Quality of life in patients with prostatic cancer: results from a Swedish population study.

PURPOSE: We evaluated a prostate cancer-specific module in an unselected patient population. MATERIALS AND METHODS: A population study design was used to confirm the psychometric properties and clinical relevance of a prostate cancer-specific module, supplementing the standardized EORTC QLQ-C30 in Sweden. The study sample comprised 1,138 patients (81% response rate) examined by a mailout/mailback procedure 1.5 to 3.5 years after diagnosis. The standardized multitrait analysis method estimated the internal consistency and convergent and discriminant validity of 3 multi-item scales on sexuality, urinary symptoms and bowel symptoms. Confirmation of prostate-specific scales by disease stage and treatment used principal components analysis. The clinical relevance was tested by correlation analysis including disease and treatment-related parameters. RESULTS: Convergent and discriminant validity of all 3 prostate-specific scales was confirmed. The internal consistency was satisfactory for the sexuality and urinary scales (alpha 0.92 and 0.76, respectively), while the bowel scale failed to reach the alpha level of 0.70 required for group comparisons. The former scales showed invariance over all principal components analyses of subgroups (disease stage and treatment). The latter scale comprised differing numbers of items in the subgroup analyses, suggesting the use of single items at present. Descriptive data of the core and module questionnaires by disease and treatment-related parameters confirmed their interpretability and thus their clinical usefulness. CONCLUSIONS: The presented self-report questionnaire technique has great potential to inform clinicians about the quality of life in patients suffering from prostate cancer.

Aged↗
PubMed1997

Vitamins Q and E, extracorporal circulation and hemolysis.

Whole blood vitamin Q (ubiquinone), plasma vitamins Q and E (alpha-(alpha-)tocopherol) and free cholesterol (FC) were studied before (control or base-line value, sample I) and during open chest surgery and extracorporal circulation (samples II-IV) in 10 male IHD patients. Identity existed between control whole blood and plasma ubiquinone. During surgery an increased discrepancy with lower plasma vitamin Q levels were seen. Control plasma vitamins Q, E and FC averaged 0.88 +/- 0.16 (SE), 12.1 +/- 2.2 mg x l(-1) and 0.75 +/- 0.15 g x l(-1). Corresponding molar values were 1.02 +/- 0.17, 28.1 +/- 5.1 micromol x l(-1) and 1.94 +/- 0.74 mmol x l(-1). Vitamin Q and E decreased continuously and averaged 0.64 mg x l(-1) in sample IV (0.74 micromol x l(-1), p < 0.001) and 9.4 mg x l(-1) in sample III (21.8 micromol x l(-1), p < 0.001). Hemolysis in all sample IV vials, ruined all vitamin E determinations. When normalized for FC (NQ and NE), decreases were found to be 17 (IV) and 12% (III), respectively. Large interindividual variations existed. High control NQ and NE values allowed a larger antioxidant vitamin depletion. High NQ seemed also to be a prerequisite for NE depletion. In addition, signs indicated an active liver vitamin Q release for patients rich in control antioxidant values. It was suggested that the antioxidant vitamin depletion did not prevent from radical trauma to membrane structural lipids (especially omega-3 fatty acids or vitamin F1), less membrane fluidity, erythrocyte fragility and hemolysis.

Aged↗
PubMed1997

Long-term results after surgical management of partial Achilles tendon ruptures.

Although Achilles tendon injuries are common overuse injuries in sports, the exact incidence is unknown, primarily as a result of varying definitions and diagnoses of the underlying pathological changes. Despite numerous studies of treatment of the Achilles tendon injuries, the long-term results are not well known. The results after surgical treatment of chronic partial Achilles tendon ruptures in 64 patients with a follow-up of 6 (1.5-11) years were evaluated in a retrospective study. The ruptures were divided into three groups: (I) proximal (more than 3 cm above the calcaneus), (II) distal and (III) combined (proximal and distal). All patients underwent an operation involving the excision of the devitalized tendon tissue and, in groups (II) and (III), also the excision of the deep Achilles bursa and removal of the dorsal corner of the calcaneus. The functional results were satisfactory in 43 (67%) patients and unsatisfactory in 21 (33%). The results were better in patients with proximal ruptures than in patients with either distal or combined ruptures. Males experienced better results than females. Post-operative immobilization in a plaster cast had no significant influence on the final result. Nine (14%) patients with either a distal or a combined rupture were re-operated on and in seven of them the final result was satisfactory. The conclusion of this study is that partial Achilles tendon ruptures are often difficult to treat and only two out of three patients can be expected to obtain satisfactory results after surgical treatment.

Achilles Tendon↗
PubMed1997

Subtalar ankle instability. A review.

The aetiology of chronic functional lateral ankle instability is fairly well understood. Pathophysiological factors such as mechanical instability, proprioceptive deficit and peroneal muscle weakness have been demonstrated. Subtalar instability has been in focus during the last years as one of the possible factors behind chronic functional instability of the foot. The exact aetiology and the true incidence of subtalar ligament injuries remain unknown. Most subtalar ligamentous injuries probably occur in combination with injuries of the talo-tibial articulation. Subtalar instability can have the characteristics of chronic lateral instability or recurrent ankle sprains. Patients with chronic subtalar instability typically complain of 'giving way' symptoms and a history of recurrent sprains. Clinical examination including increased inwards rotation and forward displacement of the calcaneus may not be sufficient for the differentiation between ankle and subtalar instability. Radiographic imaging using stress radiographs may be necessary to assess subtalar instability. Subtalar instability can be defined as chronic functional instability with increased values of talar tilt and talo-calcaneal displacement as measured with standardised stress radiographs. Few authors have addressed the treatment of subtalar instability and the condition has not been clearly defined. Subtalar instability can be treated either with a tendon transfer or tenodesis procedure, such as the Chrisman-Snook or triligamentous tenodeses, or with an anatomic ligament reconstruction using the calcaneo-fibular, lateral talo-calcaneal and cervical ligaments combined with a reinforcement of the inferior extensor retinaculum. There have been no studies comparing anatomical and non-anatomical reconstructions and the long term results after ligamentous stabilisation are unknown. The focus of this article is on subtalar instability causing chronic functional ankle instability.

Chronic Disease↗
PubMed1997

Outcome after transphyseal hip fractures. 4 children followed 34-48 years.

We report long-term outcomes in 4 patients with transphyseal fractures of the hip, a rare injury. All the patients were treated without surgery. The results were good in all the patients at follow-up, 34-48 years after injury. The only complication we found was a leg-length discrepancy of 3 cm in 1 patient due to premature closure of the capital femoral physis.

Adolescent↗
PubMed1997

Heart muscle and plasma vitamin Q with heart transplantation.

OBJECTIVE: To study variations in heart muscle septum and plasma vitamin Q (Q, ubiquinone, n = 9) and plasma vitamin E (E, alpha-tocopherol, n = 4) in heart transplant patients. DESIGN: Right-sided heart septum biopsies and plasma samples were routinely saved in patients (eight males and one female, aged 48 +/- 6 years [mean +/- SEM], range 19 to 58). Observation time was one to 35 months involving one to 10 examinations. RESULTS: Average heart and plasma Q were 0.33 +/- 0.04 mg/g, range 0.06 to 0.58, and 0.65 +/- 0.10 mg/L, range 0.20 to 1.08, respectively. Corresponding values for those with only plasma E analyzed were 0.39 +/- 0.03 mg/g and 0.70 +/- 0.10 mg/L, respectively. Plasma E averaged 7.7 +/- 1.7 mg/L, range 4.6 to 11.3. There were no differences between patients in stable condition and healthy persons in heart and plasma Q, whereas plasma E corresponded to only 64% of the mean in healthy persons. On an individual level a relationship was present between heart and plasma Q. For high plasma Q, heart Q appeared to be saturated. In four patients, from whom plasma samples were taken close to a fatal complication, plasma Q averaged 0.42 mg/L (P < 0.01). CONCLUSIONS: Well controlled heart transplant patients had normal heart and plasma Q, whereas plasma E was depressed. Muscle and plasma Q became depressed, particularly with rejection episodes and/or infections.

Adult↗
PubMed1997

Plasma selenium in healthy man before and after nutratherapy.

Females (n = 28) and males (n = 39) had their plasma analysed for selenium (Se), ubiquinone, alpha-tocopherol (vitamin E), the essential fatty acid (EFA) classes: omega-3 (omega-3, n-3) and omega-6 (omega-6, n-6) fatty acids. Selenium averaged 0.99 +/- 0.03 mumol/l and was positively related to plasma ubiquinone, alpha-tocopherol and the EFA index: the omega-6/omega-3 ratio. Food supplements (nutratherapy) with the lipophilic antioxidants ubiquinone and alpha-tocopherol (Q + E) had no effect on selenium but the addition of omega-3 fatty acids as a fish oil concentrate (Q + E + n-3) had (1.12 +/- 0.05 mumol/l, + 36%, p < 0.001). (Q + E) and (Q + E + n-3) with the addition of selenium (200 micrograms or 2.5 mumol a day) raised selenium but not higher than (Q + E + n-3) itself (1.17 +/- 0.12 mumol/l, p < 0.05). After (Q + E) alone, selenium was related as at base-line to both ubiquinone and alpha-tocopherol but not to any marker for EFA. After (Q + E + n-3), selenium was only related to ubiquinone. An unsatisfactory alpha-tocopherol nutratherapy was suggested as the explanation. EFA or markers for EFA were in no situation related to plasma selenium.

Adult↗
PubMed1997

Muscle characteristics in effort angina before and after CABG.

Seven males with effort angina undertook graded ergometer tests and had muscle biopsies taken from their vastus lateralis muscle before, and three and six months after coronary bypass surgery. Muscle fibre composition (percentage of slow twitch fibres), ubiquinone (vitamin Q), and oxidative and fermentative enzyme activities were determined. After six months, muscle ubiquinone and oxidative enzymes were still depressed, indicating sustained muscle trauma. The only peripheral changes were that muscle lactate dehydrogenase and its skeletal muscle-specific subunits and isozymes were increased 35% to 40% (P < 0.001) three to six months postsurgery. Onset of blood lactate accumulation (2.0 mmol/L), symptom-limited ('maximal') exercise and peak blood lactate increased linearly over time (r = 0.52, P < 0.05; r = 0.63, P < 0.01; and r = 0.76, P < 0.001, respectively). It is suggested that the initial physical performance increase was due to improved circulatory capacity, oxygen delivery and lactate efflux, whereas the increased fermentative capacity ('anaerobic power') first contributed after a lag of three or more months. Whether the muscle histochemical changes reflected a healing process (recovery) is speculative.

Angina Pectoris↗
PubMed1996

A cDNA coding for glutathione S-transferase from the unicellular green algae Coccomyxa sp.

A cDNA coding for glutathione S-transferase (GST) was cloned and sequenced from the unicellular green algae Coccomyxa sp. The predicted 215 amino acid polypeptide (23.9 kDa, pI 5.3) is most similar to the theta-type GSTs found in a variety of different eukaryotic organisms. Within this sub-class, the Coccomyxa GST is 42% identical (63% similar) to the flatfish Pleuronectes platessa homologue, and 24 to 35% (49-57%) to other theta-type GST's.

Amino Acid Sequence↗
PubMed1996

Discovery of an algal mitochondrial carbonic anhydrase: molecular cloning and characterization of a low-CO2-induced polypeptide in Chlamydomonas reinhardtii.

In green unicellular algae, several polypeptides are induced upon exposure to limiting CO2. We report here on the localization and characterization of one of these, a 22-kDa polypeptide in Chlamydomonas reinhardtii. This nuclear-encoded polypeptide is induced in the mitochondria by a lowering of the partial pressure of CO2 in the growth medium from 5% to air CO2 levels. Sequencing of two different cDNA clones coding for the polypeptide identified it as a 20.7-kDa beta-type carbonic anhydrase (CA; carbonate dehydratase, carbonate hydro-lyase, EC 4.2.1.1). The two clones differ in their nucleotide sequences but code for identical proteins, showing that this CA is encoded by at least two genes. Northern blot hybridization reveals that mRNA transcripts are only present in cells transferred to air CO2 levels. A comparison of the deduced amino acid sequence with those of other beta-CAs shows the largest degree of similarity with CA from the cyanobacterium Synechocystis (50% identity and 66% similarity). To our knowledge, this is the first identification and characterization of a mitochondrial CA from a photosynthetic organism.

Amino Acid Sequence↗
PubMed1996

Muscle ubiquinone in healthy physically active males.

Thirty-five (35) healthy physically active males had muscle biopsies taken from their vastus lateralis muscle to analyze for ubiquinone (vitamin Q, UQ), oxidative (muscle fiber types expressed as %ST and citrate synthase activity, CS) and fermentative (lactate dehydrogenase, LD) profiles. Graded cycle ergometer exercise to determine the intensities corresponding to onset of blood lactate accumulation set to 4.0 mmol x l-1 (WOBLA) and symptom limited exercise ('maximal', WSL) were also undertaken. Eleven (11) subjects had also recently participated in a marathon race. UQ was positively related to CS (r = 0.67, p < 0.001) and %ST (r = 0.60, p < 0.001) but not to LD. UQ was also positively related to exercise capacity and/or marathon performance (e.g. WOBLA x kg-1 BW, r = 0.70, p < 0.001). It was suggested that muscle UQ allocation in man was related to variables describing molecular oxygen availability, respiratory activity and oxidative energy releasing processes but not to fermentation activity. UQ allocation to ST fibers/CS activity was suggested to be due to the double role of UQ: 1) as a mitochondrial coenzyme (CoQ10) and 2) as a nonspecific antioxidant.

Adult↗
PubMed1996

Muscle ubiquinone in male effort angina patients.

Seven (7) males with effort angina and listed for coronary by-pass surgery had muscle biopsies taken from their vastus lateralis muscle for determination of muscle fiber types (%ST), ubiquinone (vitamin Q, UQ), oxidative and fermentative enzyme activities. Graded cycle ergometer exercise to determine intensities corresponding to onset of blood lactate accumulation set to 2.0 mmol x l-1 (WOBLA) and symptom limited exercise ('maximal', WSL) were also undertaken. WOBLA was positively related to %ST (r = 0.92, p < 0.001). %ST was on the other hand inversely related to UQ (r = -0.82, p < 0.05), the heart specific LD subunit LD-H (r = -0.96, p < 0.001), the isozyme LD3 as the fraction of LD (%LD3) (r = -0.93, p < 0.01), and the CK isozyme CKMB as the fraction of CK (%CKMB) (r = -0.88, p < 0.05). It was suggested that muscle UQ depletion in the patients was related to molecular oxygen and free oxygen radical formation. The lack of antioxidants then caused a radical trauma specifically to the ST fiber and their mitochondria. This could be a cause and-effect explanation for the selective ST fiber downregulation in effort angina and heart failure in general.

Adult↗
PubMed1996

Muscle fibers, ubiquinone and exercise capacity in effort angina.

Seventeen male patients with ischaemic heart disease (IHD) and effort angina performed OBLA exercise stress tests (set to 2.0 mmol x l-1). They had muscle biopsies from the vastus lateralis muscle the day before coronary by-pass grafting, and from the internal and external intercostal, diaphragm and gastrocnemius muscles during surgery. They had a low WOBLA (83 +/- 6 W, mean +/- 1 S.E.M), WOBLA corresponded to 79 +/- 4% (% WOBLA) of WSL (symptom limited or 'maximal' capacity = 111 +/- 11 W). Peak blood lactate concentration averaged 2.9 mmol x l-1. Muscle fibre composition disclosed a depressed percent slow twitch (ST or 'red') muscle fibres in the vastus lateralis and intercostal muscles (%ST). The diaphragm and gastrocnemius muscles had normal %ST. Intercostal muscles had elevated values for the fast twitch muscle fibre (FT) subgroup FTa indicative of endurance adaptation. The vastus lateralis, gastrocnemius and diaphragm muscles had normal muscle ubiquinone (UQ) contents, whereas the intercostals were depleted. Plasma contents of the antioxidants UQ and alpha-tocopherol were low as compared to healthy man.

Aged↗