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Biomedical subjects

J Lindahl

Publications and source records attributed to J Lindahl.

At least 19 recordsLinked to original sources
PubMed2006

Finnish Trauma Audit 2004: current state of trauma management in Finnish hospitals.

There is great variation in the organisation of trauma care in European countries. The state of trauma care in Finnish hospitals has not been appropriately reviewed in the past. The aim of the present study conducted by the Finnish Trauma Association (FTA) was to assess the number of Finnish hospitals admitting severe trauma patients, and to evaluate the organisation and training of trauma care in those hospitals. In 2004, a telephone survey to all the Finnish hospitals was conducted, and information on the number of severe trauma patients treated per month, the organisation of acute trauma care, and the existence of multidisciplinary trauma care training was collected. Thirty-six Finnish hospitals admitted trauma patients. The range of estimated number of severely injured trauma patients treated in individual hospitals per month varied from 0.5 to 12, resulting in an estimated number of 1000-1300 patients with severe trauma treated in Finland every year (19-25/100.000 inhabitants). About 20% of the hospitals had a trauma team, and 25% had a systematic trauma education program. Only one hospital had established multidisciplinary and systematic trauma team training. The case load of severe trauma patients is low in most Finnish hospitals making it difficult to obtain and maintain sufficient experience. Too many hospitals admit too few patients, and only a few hospitals have been working on updating their trauma management protocols and education. There is an obvious need for leadership, discussion, legislation and initiatives by the professional organisations and the government to establish a modern trauma system in Finland.

Education, Medical, Continuing↗
PubMed2005

Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail. A randomised study comparing post-operative rehabilitation.

We treated 108 patients with a pertrochanteric femoral fracture using either the dynamic hip screw or the proximal femoral nail in this prospective, randomised series. We compared walking ability before fracture, intra-operative variables and return to their residence. Patients treated with the proximal femoral nail (n = 42) had regained their pre-operative walking ability significantly (p = 0.04) more often by the four-month review than those treated with the dynamic hip screw (n = 41). Peri-operative or immediate post-operative measures of outcome did not differ between the groups, with the exception of operation time. The dynamic hip screw allowed a significantly greater compression of the fracture during the four-month follow-up, but consolidation of the fracture was comparable between the two groups. Two major losses of reduction were observed in each group, resulting in a total of four revision operations. Our results suggest that the use of the proximal femoral nail may allow a faster post-operative restoration of walking ability, when compared with the dynamic hip screw.

Aged↗
PubMed2004

Femoral shaft medialisation and neck-shaft angle in unstable pertrochanteric femoral fractures.

We analysed the time-dependent mean changes in the femoral neck length, neck-shaft angle and hip offset in a randomised study comprising 48 patients who were treated with the dynamic hip screw (DHS) or the proximal femoral nail (PFN) for an unstable intertrochanteric femoral fracture. As a consequence of fracture compression, the mean post-operative neck length was significantly shorter in patients treated with the DHS. During the first 6 weeks after the operation, a mean decrease of 4.6 degrees was observed in the neck-shaft angle, but there was not a significant difference between the treatment groups. The radiographic measures remained virtually unaffected during the interval from 6 weeks to 4 months in both groups. When the operated hip was compared to the opposite hip, patients who had received the DHS showed significantly greater medialisation of the femoral shaft at 4 months than those treated with the PFN. We thus recommend that unstable intertrochanteric fractures should be initially reduced in a slight valgus position in order to achieve an outcome after healing that is as normal as possible. As a result of differences in operative technique and implant stability, the PFN may be superior to the DHS in retaining the anatomical relations in the hip region in unstable intertrochanteric fractures.

Aged↗
PubMed2001

High-dose chemotherapy and APSCT as a potential cure for relapsing hemolysing AILD.

Angioimmunoblastic lymphadenopathy with dysproteinemia (or dysgammaglobulinemia) (AILD) is a lymphoproliferative disorder with cytogenetic and molecular abnormalities characteristic of malignant T-cell lymphoma (angioimmunoblastic T-cell lymphoma -- AITL). We report the clinical course of a 58-year-old male patient with unusually aggressive AILD, including severe hemolysis and Guillain-Barré syndrome, who entered complete remission after CHOP therapy, but had a full relapse after 2 months. At relapse, treatment with high-dose chemotherapy followed by autologous peripheral stem cell transplantation (APSCT) with CD34 selected cells was shown to be successful. The patient is alive and disease-free 3 years after diagnosis and 32 months after APSCT. Considering the poor prognosis of the majority of patients with AILD, intensive treatment followed by APSCT, may be a subject for further studies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1999

Failure of reduction with an external fixator in the management of injuries of the pelvic ring. Long-term evaluation of 110 patients.

We reviewed 110 patients with an unstable fracture of the pelvic ring who had been treated with a trapezoidal external fixator after a mean follow-up of 4.1 years. There were eight open-book (type B1, B3-1) injuries, 62 lateral compression (type B2, B3-2) and 40 rotationally and vertically unstable (type C1-C3) injuries. The rate of complications was high with loss of reduction in 57%, malunion in 58%, nonunion in 5%, infection at the pin site in 24%, loosening of the pins in 2%, injury to the lateral femoral cutaneous nerve in 2%, and pressure sores in 3%. The external fixator failed to give and maintain a proper reduction in six of the eight open-book injuries, in 20 of the 62 lateral compression injuries, and in 38 of the 40 type-C injuries. Poor functional results were usually associated with failure of reduction and an unsatisfactory radiological appearance. In type-C injuries more than 10 mm of residual vertical displacement of the injury to the posterior pelvic ring was significantly related to poor outcome. In 14 patients in this unsatisfactory group poor functional results were also affected by associated nerve injuries. In lateral compression injuries the degree of displacement of fractures of the pubic rami caused by internal rotation of the hemipelvis was an important prognostic factor. External fixation may be useful in the acute phase of resuscitation but it is of limited value in the definitive treatment of an unstable type-C injury and in type-B open-book injuries. It is usually unnecessary in minimally displaced lateral compression injuries.

Activities of Daily Living↗
PubMed1997

Expression of LAZ3/BCL6 in follicular center (FC) B cells of reactive lymph nodes and FC-derived non-Hodgkin lymphomas.

Chromosomal translocation resulting in abnormal expression of the LAZ3/BCL6 gene in B cells has been implicated in the tumorigenesis of non-Hodgkin lymphoma (NHL). Therefore we studied the expression pattern of LAZ3/BCL6 by in situ hybridization with synthetic oligonucleotide probes in frozen tissue sections from five reactive lymph nodes and 38 B cell and non-B NHL. In addition, we investigated the expression of LAZ3/BCL6 by Northern blot analysis on multiple human tissues. The LAZ3/BCL6 transcript was found in a variety of tissues, including skeletal muscle, peripheral blood leukocytes, and weakly in normal lymph nodes. In the tumor samples, expression of LAZ3/BCL6 was observed in 68% of all B cell NHL and none of the non-B lymphomas. All cases of follicular, mixed small and large cell lymphomas showed LAZ3/BCL6 expression confined to the neoplastic follicles. A follicular expression pattern was also found in all non-malignant reactive lymph nodes. Hence, the expression of LAZ3/BCL6 does not correlate to malignancy, but reflects the origin of B cells from the germinal centers.

B-Lymphocytes↗
PubMed1993

A new approach to the internal fixation of unstable pelvic fractures.

Eighteen patients with horizontally or vertically unstable pelvic fractures were operated on with a new intrapelvic technique. There were 11 horizontally unstable and seven vertically unstable pelvic ring fractures. The fractures were exposed through a low Pfannenstiel or lower midline incision combined with an incision at the iliac crest. This is referred to as the ilioanterior approach. At the operation, all lesions in the symphysis, rami, and in the sacroiliac region were reduced and fixed with reconstruction plates and screws. No intraoperative complications ensued. The average intraoperative blood loss was 930 ml and the operation time averaged two and one-half hours. The obtained reduction was maintained in all but one sacral fracture. All fractures united. The functional recovery was uneventful in all the patients. The good results obtained in this relatively small series encourage further development of operative techniques in unstable pelvic fractures.

Adolescent↗
PubMed1993

Bacterial contamination and closed suction drainage in open meniscectomy of the knee.

A prospective study was undertaken to investigate the occurrence and possible sources of microbial contamination in association with open meniscectomy of the knee. Sixty patients were randomized into three closed suction drainage regimens of 12, 24 and 48 hours' postoperative suction drainage, respectively. Specimens for bacterial culture were taken from the joint at the time of surgery, from the surgical suction tips, from the subcutaneous part of the drain surface and from the drain-contained fluid at the time of drain removal. The airborne bacterial contamination showed no marked role in this bacterial invasion into the joint, nor did the use of suction increase the risk. The vacuum suction drain, on the other hand, appeared to carry an obvious risk of bacterial invasion, as a parallel of time. In the present comparison this risk was minimal when the drain was removed 12 hours postoperatively.

Acinetobacter Infections↗
PubMed1989

99m-technetium-HmPAO-labelled leucocytes in the diagnosis of acute colonic diverticulitis.

Eighteen patients with abdominal symptoms clinically resembling acute colonic diverticulitis were studied with 99mTc-labelled leucocytes on average 5 days after the onset of symptoms. The diagnosis of diverticular disease was confirmed in all cases by means of barium enema or sigmoidoscopy. The leucocyte scan was positive in 13 patients, nonspecific in four and unclear in one patient. The diagnostic possibilities in acute colonic diverticulitis are discussed.

Acute Disease↗
PubMed1986

Incidence of heart disease and functional significance of changes in the electrocardiogram 10 years after radiotherapy for breast cancer.

Late cardiac complications after radiotherapy for breast cancer was studied in 197 patients examined before, 6 months after, and 10 years after treatment. The 10-year follow-up was done by survey of the files of patients who had died and re-examination of patients who were alive and free of cancer. Among 95 patients who died, 3 died of cardiopulmonary diseases. Autopsy in 32 patients showed serious cardiac abnormalities in 3. Of 102 patients alive at follow-up, 3 reported heart symptoms. Sixty-nine patients participated in the re-examination. Electrocardiogram (ECG) abnormalities were found in 19% of these patients before treatment; in 45% at 6 months, essentially due to T-wave changes in patients who had received left-sided irradiation; and in 45% at 10 years, with fewer T-wave abnormalities but more ST depression and ectopic beats. Average working capacity was 83 W before, 81 W at 6 months, and 84 W at ten years. Average heart volume was 680 ml before, 689 ml at 6 months, and 718 ml (P less than 0.01) 10 years after treatment. In conclusion, there was a high incidence of ECG T-wave changes, but they were reversible, and the perimyocardial damage indicated was functionally insignificant. The incidence of serious cardiac complications was low.

Autopsy↗
PubMed1984

Effect of ovulation on haem metabolism in rabbits.

To investigate the origin of the cyclic changes in the rate of endogenous carbon-monoxide production (nCO) during the menstrual cycle, haem turnover was determined before and after chorion gonadotropic hormone-induced ovulation in six female rabbits. 14C-labelled delta-aminolevulinic acid and glycine were administered and the excretion rate of 14CO (A14CO) was measured for determination of hepatic and bone-marrow haem turnover, respectively. Carbon-monoxide production (nCO) was measured to estimate total haem turnover. After ovulation A14CO was increased significantly the first 2 h of the early labelled peak after 14C-ALA administration and was increased also at the first determination during the early peak after 14C-glycine but statistically not significantly. The total excretion of labelled CO during the period of the early labelled peak was not increased with any of these precursors for haem synthesis. On the other hand nCO was increased 34% (P less than 0.05) during the post-ovulation period. As the increase in 'unassigned' haem turnover was small and may be unaccompanied by a contemporary increase in bilirubin/CO production, it was concluded that the increase in nCO during the post-ovulation period essentially depends on increased destruction of circulating red cells in the rabbit.

Aminolevulinic Acid↗
PubMed1983

Electrocardiographic changes after radiation therapy for carcinoma of the breast. Incidence and functional significance.

Cardiovascular complications from irradiation for breast carcinoma were assessed by history, physical examination, ECG recording, exercise test and heart volume determination before and two and six months after treatment in 197 unselected patients. A deterioration in general condition during therapy was reported by about 50 per cent of the patients, with shortness of breath and palpitation of the heart as the most frequent complaints and with a gradual improvement after therapy. Clinically, one case of pericarditis was diagnosed. ECG T-wave abnormalities appeared in 35 per cent of the patients after treatment, essentially confined to patients with left-sided pre- or postoperative treatment, where the mean radiation dose to the anterior quarter of the heart usually exceeded 20 Gy. Physical working capacity two and six months after therapy did not seem to be influenced by irradiation alone, and no correlation existed between change in physical working capacity and appearance of ECG T-wave abnormalities. The heart volume increased by more than 200 ml in 2 patients but otherwise the changes in heart volume were small. A high incidence of ECG T-wave abnormalities following left-sided irradiation for breast carcinoma was noted, but in the short term these ECG changes were functionally insignificant.

Adult↗
PubMed1983

Manometric studies of lower esophageal sphincter in extreme obesity.

Esophageal manometry was performed in a group of extremely obese subjects in order to investigate the lower esophageal sphincter (LES) pressure and its relationship to extreme obesity, weight reduction and altered anatomy of the stomach. Forty subjects were examined before gastric surgery for treatment of their obesity, and 14 of these were reexamined after weight reduction. Normal LES pressure (20 mmHg) was found before operation, and also normal length and position of the LES. No significant changes were found in the group which was examined twice. In persons younger than 50, LES manometric findings do not seem to be influenced by extreme obesity, weight reduction or gastric surgery for obesity.

Body Weight↗
PubMed1980

The contributions of erythropoietic and nonerythropoietic haem turnover to the early labelle peak of endogenous CO formation in man.

The endogenous production of 14CO during the first week after administration of glycine-2-14C (early labelled peak, ELP) was determined in 13 healthy subjects. The subjects were studied during normal, suppressed or stimulated erythropoiesis induced by hypertransfusion and phlebotomy, respectively. The production of 14CO was calculated from determinations of the specific activity of the body CO store and the endogenous production of CO. The incorporation of labelled glycine into circulating red cell haemo;globin haem was calculated from the maximal specific activity of haemoglobin haem and the total amount of Hb. The average ELP was 73.0 X 10(3) disintegrations per min (dpm) and the incorportion of glycine into circulating haemoglobin haem 491 X 10(3) dpm in controls. The ELP and the incorporation of glycine increased by 86% and 92%, respectively, in phlebotomized subjects and decreased by 37% and 62%, respectively, in hypertransfused subjects. A linear regression equation was calculated for the relationship between ELP and erythropoiesis, expressed as the incorportion of glycine into circulating haemoglobin haem. The residual ELP remaining in the absence of erythropoiesis was 24.9 X 10(3) dpm calculated from data of all the subjects, and 32.8 X 10(3) dpm calculated from data of controls and hypertransfused subjects only. In conclusion, erythropoietic haem turnover was found to contribute about 60% and nonerythropoietic (mainly hepatic) haem turnover about 40% of the ELP in man.

Adult↗