[The Söderberg prize to Per-Ingvar Brånemark for osseointegrated implants].
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Awards and Prizes↗
Biomedical subjects
K G Thorngren
Publications and source records attributed to K G Thorngren.
Perceived health in hip-fracture patients: a prospective follow-up of 100 patients.
We report the impact of the treatment and rehabilitation in hip-fracture patients by using self-assessment instruments of perceived health and relate them to objective outcome assessments, such as ADL (personal hygiene/dressing), walking ability and technical complications. Subjective and objective status for 100 hip-fracture patients admitted from their own home, and rehabilitated in primary health care, were registered over 1 year after fracture. Mean age was 74, and 80% of the patients were women. Two self-assessment questionnaires: the Nottingham Health Profile (NHP part 1) and the Mood Adjective Checklist (MACL) were answered by the patients 6 and 12 months after fracture and compared with functional status (ADL, and walking ability) 4 months after fracture. Problems related to the hip fracture such as pain and physical mobility had most effect on the self-assessment questionnaire (NHP) and were in accordance with the district physiotherapists' evaluation of function. Patients with complications (resulting in nail extraction and total hip replacement) after the primary hip osteosynthesis and patients with a poor function 4 months after fracture had scores in the self-assessment questionnaires indicating a more pronounced and distressing impact of the disease. Small changes in subjective mood (MACL) were found. In an acute, curable, disease such as hip fracture the objective outcome seems as informative as the subjective evaluations of patients' self-assessment.
Activities of Daily Living↗
Treatment of hip fracture in Finland and Sweden. Prospective comparison of 788 cases in three hospitals.
A prospective population-based study of hip fracture treatment was performed during 1989 in the regional hospitals of Oulu (Finland) and Sundsvall and Lund (Sweden). For cervical fractures hemiarthroplasty was preferred in Oulu and osteosynthesis in Sundsvall and Lund. For trochanteric fractures screw-plate was preferred in Oulu and Lund and Ender-nailing in Sundsvall. A shorter mean time at the orthopedic department in Oulu (13 days) was compensated by a lower (14 percent) fraction of patients directly discharged to own home. A somewhat longer mean orthopedic hospitalization time in Sundsvall (19 days) and Lund (17 days) was combined with a higher discharge to own home (49 percent and 35 percent). Prospective multicenter comparisons of treatment combinations (both operation and rehabilitation) permit identification of programs that are optimal for both patient and society.
Activities of Daily Living↗
Bone morphogenetic protein induces bone in the squirrel monkey, but bone matrix does not.
Demineralized bone matrix (DBM) reproducibly induces extraskeletal bone formation in rodents, but its effects in dogs and primates are negative or uncertain. In previous studies on the squirrel monkey, DBM did not induce bone, although the same implants were effective in nude rats. In the present study, the DBM was augmented with recombinant human bone morphogenetic protein-2 (BMP-2). Bone was formed in 10 of 12 monkeys, as verified by histology and calcium content. However, in 4 monkeys, the induced bone mass appeared smaller than the original implant. DBM controls induced microscopic amounts of bone in 2 out of 10 monkeys. In the nude rats, all DBM controls and augmented implants induced bone. The difficulties in achieving bone induction in higher animals may be overcome, at least partially, by using a higher concentration of the inductive protein than is present in DBM.
Animals↗
Influence of alpha-MSH and ACTH on cortical bone remodelling in hypophysectomized rats.
Hypophysectomy increases both periosteal resorption and endosteal apposition along the femur diaphysis in rat. Administration of alpha-MSH decreased the periosteal resorption but had no effect on the endosteal apposition. ACTH had only minor effects on the endosteum. Thus, alpha-MSH and ACTH, in the doses used, have different effects on cortical bone in rat. The effect of alpha-MSH on cortical bone could be an effect of the hormone alone or by its stimulation of other factors.
Adrenocorticotropic Hormone↗
Normal grip strength.
The normal grip strength was determined with the Martin Vigorimeter in 450 men and women aged 21--65 years. The grip strength decreased steadily with increasing age. Men were stronger than women and in both sexes the dominant hand was the strongest. The ratio dominant/non-dominant hand varied only slightly with age and sex and it could thus be a useful parameter in evaluation of grip strength under pathological conditions.
Adult↗
Effect of hypophysectomy on dentin production in maxillary incisors in the rat.
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Age Factors↗
Effect of pituitary hormones on dentin production in maxillary incisors in the rat.
The effect of pituitary hormones on dentin production and longitudinal growth of the maxillary incisors in normal and hypophysectomized rats was investigated. Bovine growth hormone was found to increase the dentin production slightly in normal rats and significantly in hypophysectomized rats. Other pituitary hormones showed no effects on dentin apposition in the doses and periods tested. The effects of the pituitary hormones on the longitudinal growth of the tooth were small or insignificant. The effects of growth hormone on the dentin apposition and the longitudinal growth of the tooth after hypophysectomy were smaller than the effects on longitudinal bone growth and cortical bone remodeling, indicating different sensitivity to hormones between different mineralized tissues.
Age Factors↗
Effect of thyroxine and growth hormone on dentin production in maxillary incisors in the rat.
Dentin production and longitudinal growth of maxillary incisors in female rats, age 60--95 d, were determined by the tetracycline technique in hypophysectomized rats after administration of growth hormone and thyroxine during age 75--95 d. Hypophysectomy was performed at age 60 d. Administration of thyroxine resulted in a considerable increase in dentin apposition and longitudinal growth of the tooth. The same effect, but somewhat lower, was registered for growth hormone. Growth hormone and thyroxine administered simultaneously had an additive synergistic effect. Compared with the effect of hypophysectomy and of hormone administration on longitudinal bone growth and cortical bone remodleing the effect on dentin production and longitudinal growth of the maxillary incisors in the same rats is less pronounced and shows a different pattern in reaction, indicating differences in sensitivity for different cell systems and difference in endocrine control.
Animals↗
Cortical bone remodeling in normal rat.
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Animals↗
Human somatomedin A and longitudinal bone growth in the hypophysectomized rat.
A somatomedin A preparation, when given at total doses of 14 and 70 U did not increase the longitudinal bone growth in hypophysectomized rats. Growth hormone (WHO) significantly increased the longitudinal bone growth.
Animals↗
Stimulation of longitudinal bone growth by hypophyseal hormones in the hypophysectomized rat.
The stimulating effect of different pituitary hormones on longitudinal bone growth was determined with tetracycline as intravital marker in hypophysectomized rats. Growth hormone was found to be the most effective growth stimulating pituitary hormone. At considerably higher doses, thyrotrophic hormone (TSH) and prolactin also showed growth stimulating pituitary hormone. At considerably higher doses, thyrotrophic hormone (TSH) and prolactin also showed growth stimulating activity. TSH exerts its effect via the production of thyroxine, whereas the growth stimulation by prolactin seems to be a direct effect of this hormone, similar to the effect of growth hormone. The LH, FSH, ACTH, MSH, vasopressin and oxytocin preparations did not stimulate longitudinal bone growth.
Adrenocorticotropic Hormone↗
Effect of administration frequency of growth hormone on longitudinal bone growth in the hypophysectomized rat.
The effect of the administration frequency of growth hormone on longitudinal bone growth was investigated with tetracycline as intravital marker of the bone growth of the proximal tibia in hypophysectomized rats. The total dose of growth hormone (NIH-GH-B16) and the administration period were the same in all compared experiments. It was possible to achieve an optimum growth response for a certain total dose of growth hormone by increasing the injection frequency. The period of hormone administration was 10 or 5 days followed by a 10 days withdrawal period. When the growth hormone was administered alone or in association with L-thyroxine for 10 days, the optimum injection frequency for growth hormone was found to be 1 inj./day in hypophysectomized rats and 2 inj./day in thyroxine-treated hypophysectomized rats. When the administration period was 5 days for growth hormone given in association with L-thyroxine, the growth stimulation induced by one daily growth hormone injection was the same as that induced by two or four daily injections of the same total dose. An increase in the administration frequency for a total daily dose of thyroxine from 1 to 2 inj./day did not increase the longitudinal bone growth either when thyroxine was given alone or in association with growth hormone.
Animals↗
Effect of fracture on longitudinal bone growth in rats.
The growth rate in proximal tibia and distal radius in rats was investigated by the tetracycline method after femoral fracture, tibiofibular fracture, and metatarsal fracture. Up to 1 to 2 weeks after the fracture, a higher growth rate was recorded on the fractured side than on the unfractured side. This effect occurred later after tibiofibular fracture than after femoral and metatarsal fracture, but was almost of the same size and about 8 per cent of the normal growth rate. This difference in growth rate was caused partly by a general group retardation compared with the normal growth rate, and partly by a local growth stimulation in the fractured extremity. The growth retardation was pronounced after tibiofibular fracture, but was insignificant after femoral and metatarsal fracture. The growth rate on the fractured side after the latter two types of fractures was higher than under normal conditions. Thirty days after all types of fractures, the growth rate was normal, both in fractured extremity and in other growth regions.
Age Factors↗
Conditions influencing the dose-response effect of growth hormone on longitudinal bone growth in the hypophysectomized rat.
Various factors that might influence the dose-response effect of growth hormone on the longitudinal bone growth were investigated with tetracycline as intravital marker of the bone growth in hypophysectomized rats. These are of practical importance for the bioassay of growth hormone. The growth response was found to be almost the same for subcutaneous and intraperitoneal injection, whereas the intravenous route resulted in significantly lower growth response. The administration of growth hormone in various volumes subcutaneously did not significantly influence the dose-dependent growth response. Freezing of the dissolved growth hormone or addition of NaOH to the solution had no significant effect on growth response. Cortisone acetate 0.5 mg/kg given at hypophysectomy increased the post-operative survival somewhat, without having any post-operative depressing influence on the growth hormone-induced longitudinal bone growth. The present investigation showed that in standardized conditions the dose-dependent growth response is constant.
Animals↗
Effect of venous stasis on longitudinal bone growth in the rabbit.
The effect of ligation of veins on the longitudinal bone growth was studied in growing white rabbits. The daily longitudinal bone growth was determined with the tettacycline technique from the day before up to 40 days after operation. Ligation of the femoral vein, the circumflexal veins, and the deep femoral vein resulted in a temporary venous stasis. Additional ligation of the sciatic vein resulted in the same degree of venous stasis but a more longstanding effect. Neither of the operations resulted in growth stimulation or growth retardation compared with the control side. On the contrary, the ligation resulted in a minor temporary general growth retardation during the first days after the operation.
Animals↗
Primary osteonecrosis in the knee evaluated by histopathology and specimen scintimetry related to clinical radiography, scintimetry and MR.
Arthroplasty for primary osteonecrosis of the femoral condyle of the knee was performed in 5 patients and the resected pieces of bone were studied histologically. The patients had been given 99 mm-Tc-MDP preoperatively and the scintimetric uptake in the resected bone pieces was determined. All patients had changes typical for osteonecrosis preoperatively on radiographs and scintimetry. In one case MRI investigation was performed. The histological investigation showed necrotic bone with empty lacunae and fatty degeneration corresponding to the osteonecrosis center. A reparative bone formation, osteoblastic activity, cartilage formation and bands of fibrovascular granulation tissue were observed at the borders to intact bone. The scintimetric uptake of the resected bone pieces showed a high uptake corresponding to the osteonecrosis center. The MR examination showed a well demarcated osteonecrotic region. The findings emphasize the localized nature of the osteonecrosis disease.
Aged↗