Biomedical subjects

O Ekberg

Publications and source records attributed to O Ekberg.

At least 199 records · Page 11Linked to original sources

PubMedDate not supplied

Post-operative lesions of the common bile-duct. A cholangiographic investigation.

Cholangiograms were reviewed of 190 patients with gall-bladder disease, who were consecutively operated upon with common bile-duct exploration during a 2.5-year period. Nine patients were excluded for various reasons. In 86 patients endoscopy of the duodenum was also performed after surgery. In 181 patients post-operative cholangiography revealed the following lesions, not found at the pre-explorative examinations: Fistula to the duodenum in 27, ulcers or sinus tracts in 11, ectasia and/or irregularities in another 11. In 17 patients retained calculi were found. The clinical significance of the iatrogenic lesions is probably low, but they must be recognized as such in order not to be radiologically misinterpreted.

Adult↗

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Pharyngeal dysfunctions and their interrelationship in patients with dysphagia.

Cineradiographic examination of the pharynx is a valuable tool for evaluation of patients with swallowing complaints. The direct functional imaging is the essence of cineradiography of the pharynx during swallowing. In this way the motor function of the pharynx can be monitored. The kind and number of specific dysfunction can give a valuable information about the severity of pharyngeal impairment. Using a scoring system compensation and decompensation of pharyngeal function can be assessed, thereby offering an understanding of the patients' swallowing ability.

Adult↗

PubMedDate not supplied

The width of the pharyngo-esophageal junction area.

In order to elucidate the pharyngo-esophageal segment in normal and abnormal conditions the width of the pharyngo-esophageal junction area on three different levels: hypopharynx, infracricoid segment of the cervical esophagus (ICCO) and cervical esophagus was measured in 150 non-dysphagial volunteers and in 252 dysphagial patients examined with cineradiography during barium swallowing. The result indicates that a narrow ICCO in absolute figures reflects the size of the swallowed bolus and is not a predictor of pharyngeal abnormality, per se. However, when the width of the ICCO in a.p. projection is less than 3/4 of the width in lateral projection this can indicate a narrow ICCO and should lead to endoscopy for further evaluation.

Adult↗

PubMedDate not supplied

Elevation of the pharynx and the width of the pharyngo-esophageal segment during swallow.

The elevation of the pharynx and larynx at swallowing in 10 patients with a defective relaxation of the cricopharyngeal muscle, was compared with that in 10 normals. The pharynx and larynx moved higher among patients with a defective relaxation of the cricopharyngeal muscle. Therefore, it can be concluded that a defective relaxation of the cricopharyngeal muscle at swallowing has no relationship to a defective pharyngo-laryngeal elevation.

Aged↗

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Gastroesophageal reflux and pharyngeal function.

Pharyngeal function and gastroesophageal reflux were compared in 84 dysphagic patients examined clinically and radiologically. Cricopharyngeal muscle incoordination, assessed cineradiographically, was revealed in 5 of 41 patients (12%) without and 17 of 43 patients (40%) with gastroesophageal reflux assessed clinically (p less than 0.05). Thus, there was a positive correlation between dysfunction of the cricopharyngeal muscle and gastroesophageal reflux. There was no correlation with other types of pharyngeal dysfunction. Our results support the assumption of a positive relationship between gastroesophageal reflux and pharyngeal function in terms of cricopharyngeal dysfunction. The pathogenesis of this relation was, however, not revealed.

Adult↗

PubMedDate not supplied

Radiologic evaluation of the oral stage of swallowing.

The oral stage of swallowing was radiologically evaluated in 19 patients with swallowing complaints. Eight patients had had surgical resection and reconstruction due to tumours of the tongue, floor of the mouth or mandible. Eleven patients had suffered from cerebrovascular disease. All patients had incoordination of tongue movements including defective initiation of pharyngeal swallow. In patients who had undergone surgical resection, oral dysfunction correlated with the extension of resection as well as type of reconstruction, and was more profound compared with the disorder present in patients with cerebrovascular disease. Moreover, muscular derangement due to surgery of the floor of the mouth interfered with the elevation of the hyoid bone, larynx and pharynx and thereby the pharyngeal stage of swallowing also became abnormal. Cineradiography seems to be an appropriate method for evaluation of the oral stage of swallowing in patients with deglutition complaints.

Aged↗

PubMedDate not supplied

Dimension of the pharyngo-esophageal segment in dysfunction of the cricopharyngeal muscle.

Defective relaxation of the cricopharyngeal muscle (cricopharyngeal dysfunction) is radiographically demonstrated as a posterior impression into the pharyngo-esophageal segment of the gullet in patients with dysphagia. It has been assumed that this impression implies a mechanical obstacle to the swallowed bolus. Therefore, the width of the pharyngo-esophageal segment was measured in three groups of individuals; 139 non-dysphagic volunteers, 25 dysphagic patients with a normal relaxation of the cricopharyngeus and 25 dysphagic patients with cricopharyngeal dysfunction. Compared with the other two groups of patients studied the patients with cricopharyngeal dysfunction were found to have a slightly wider gullet above and below the cricopharyngeal muscle. However, at the level of the cricopharyngeal muscle they had an equal sized or slightly narrower lumen than the patients in the two control groups. The results obtained suggest that the posterior impression due to cricopharyngeal dysfunction does not cause a substantial mechanical obstacle to swallowing in the majority of patients.

Cineradiography↗

PubMedDate not supplied

Posture of the head and pharyngeal swallowing.

Closure of the laryngeal vestibule during swallowing is important for protection of the airways. The present investigation included 53 patients with dysphagia examined cineradiographically with the head held in resting posture, flexion and extension. The ability to protect the airways by the downward movement of the epiglottis and by obliteration of the laryngeal vestibule was studied in different postures of the head. Of 35 patients with normal laryngeal obliteration with the head in resting position 10 showed a defective closure at swallowing in extension. In 18 patients with defective closure of the laryngeal vestibule in resting position 9 were improved on flexion and two on extension of the head. In one patient with defective closure of the laryngeal vestibule in resting position swallowing in flexion showed an aggravated dysfunction. In four other patients the defective closure became more marked on extension. Four patients had less effective downward movement of the epiglottis with the head in extension. Of 10 patients with defective epiglottic movement with the head in resting position two were improved on tilting the head forwards. The results show that the position of the head influences the closure of the airways during swallowing. Patients with defective protection of the laryngeal vestibule should be instructed to swallow with the head tilted forwards.

Adolescent↗

PubMedDate not supplied

Pharyngeal swallowing in patients with paresis of the recurrent nerve.

Pharyngolaryngeal function during swallowing was investigated cineradiographically in 22 patients with paresis of the recurrent nerve. Nineteen of these patients (86%) had defective closure of the laryngeal vestibule: 10 patients had defective apposition of the corniculate cartilages, (paresis of the oblique cricoarytenoid muscle), 9 patients had defective apposition of the arytenoid cartilages, (paresis of the interarytenoid muscle), 13 patients had defective movement of the epiglottis (paresis of, i.a. the thyrohyoid muscle), 1 patient had defective closure of the subepiglottic portion of the vestibule (paresis of the thyroepiglottic muscle), 2 patients had defective closure of the supraglottic portion of the vestibule (paresis of the superior ventricular segment of the thyroarytenoid muscle). Five patients with immobility of the epiglottis also had paresis of the pharyngeal constrictor musculature indicating paresis of the superior laryngeal nerve. Our investigation has shown that patients with paresis of the recurrent nerve who present with dysphagia with or without aspiration should be examined cineradiographically for pharyngolaryngeal function during swallowing.

Adult↗

PubMedDate not supplied

Barium and meat. A comparison between pharyngeal swallow of fluid and solid boluses.

The influence of bolus consistency on pharyngeal swallow was radiologically studied in 24 individuals by comparing liquid barium and solid meat after chewing. Pharyngeal function was apparently performed synchronously and symmetrically on both boluses. No definite conclusion about the influence on epiglottic mobility, closure of the laryngeal vestibule and relaxation of the cricopharyngeal muscle could be drawn from this study. There was no difference in the elevation of the pharynx and larynx. The transit time for a solid bolus was shorter compared with that of a fluid bolus. The transit time for the apex of the bolus was shorter than for the tail. A more marked elevation of the pharynx and larynx was followed by a shorter transit time. The width of the pharyngo-esophageal segment was larger in the transverse than in the sagittal diameter during the passage of the bolus and larger on solid compared with fluid swallow. Our results reflect the ability of pharyngeal swallow to be executed with precision and with few alterations due to variable bolus consistency.

Adult↗

PubMedDate not supplied

Ultrasound examination of soft tissue injury of the lower limb in athletes.

We performed ultrasonography on 32 athletes complaining of intense pain in a swollen and tender thigh or calf after a contusion or stretching trauma. The ultrasonogram was used to visualize the presence and size of a suspected hematoma. The findings included the following: 7 patients with a circumscribed, anechoic lesion compatible with a liquefied hematoma; 10 patients with a circumscribed lesion of mixed echogenicity compatible with areas of liquefied hematoma, coagulated blood, and edema; and 15 patients with a diffuse change in echogenicity of the whole muscle. The circumscribed liquefied, and mixed hematoma were more common after contusion trauma, while the diffuse type was more common after injury caused by stretching. Ultrasonography is useful in localizing the hematoma and in characterizing the different types. Differentiation is important in diagnosis and choice of treatment.

Adolescent↗

PubMedDate not supplied

Closure of the laryngeal vestibule during deglutition.

With the aid of high-speed cineradiography (up to 100 frames per second) the closure of the laryngeal vestibule during deglutition was studied in 150 volunteers free from swallowing complaints. The closure was observed to be effected by a peristaltic-like wave from below. This was accomplished in two steps. First the caudal segment of the vestibule, the supraglottic space, was closed by an apposition of the side walls. Then the cranial segment of the vestibule, the supraglottic space, was closed by an apposition of the fixed part of the epiglottis to the arytenoid region. The subdivision of the vestibule was made by an imaginary plane between the interarytenoid incisure and incisure of the thyroid cartilage. This subdivision corresponds to the location of the thyroarytenoid muscles lateral to the supraglottic space and the thyroepiglottic muscles lateral to the subepiglottic space. In this way the two muscle pairs contribute indifferent and distinct ways to the closure of the vestibule during deglutition.

Adult↗

PubMedDate not supplied

Small bowel barium examination in children. Diagnostic accuracy and clinical value as evaluated from 331 enteroclysis and follow-through examinations.

The indications for small bowel barium examination, the radiologic findings, and the clinical outcome were compared retrospectively in 331 children, aged 0 to 15 years. Sixty examinations (18%) were pathologic, which is in accordance with adult materials. The most common indications for referral were inflammatory bowel disease (48%) and small bowel obstruction (25%). The examinations were positive in 19 per cent and 17 per cent, respectively. Indications for referring patients with non-specific symptoms led to a low frequency of pathologic findings. A therapeutic or diagnostic procedure was performed in 38 of the 60 pathologic radiologic examinations (63%). In 18 patients (30%) a pathologic finding caused no change in therapy. No consistent difference in sensitivity, specificity or predictive values of a positive or negative result was found concerning enteroclysis or elective follow-through examination. For screening purposes of the small bowel in children follow-through examinations give adequate radiologic information and should be used instead of enteroclysis.

Adolescent↗

PubMedDate not supplied

Esophageal motor function evaluated by scintigraphy, video-radiography and manometry in diabetic patients.

Prolonged esophageal scintigraphic transit time is frequent in diabetic patients and is related to autonomic neuropathy. In this study, esophageal scintigraphic transit time was correlated to esophageal motor function as evaluated by video-radiography and manometry in 13 diabetic patients. An abnormal scintigraphic transit time (greater than 15 s) occurred in 6 patients. All patients with abnormal transit time showed abnormal results at video-radiography (n = 4) and/or manometry (n = 5), which were observed in only 2 of 7 patients with normal transit time (both with abnormal video-radiography and manometry). A prolonged scintigraphic transit appears reliable as an indicator of disturbed esophageal smooth muscle function since it is well correlated with abnormalities shown by a combination of video-radiography and manometry.

Adult↗

PubMedDate not supplied

Peristalsis in pharyngeal constrictor musculature in relation to positioning and gravity.

The motor activity of the pharyngeal constrictors in terms of peristalsis and protrusion depths was studied cineradiographically in 15 non-dysphagic volunteers in three positions: sitting, right decubitus horizontal, and head-down 30 degrees, during swallowing of a 10 ml bolus of thin liquid barium. Using a frame rate of 50/s the speed of peristalsis was calculated by frame counting. The speed of peristalsis and the depth of protrusion of the constrictor wall did not depend on the direction of gravity force in relation to the long axis of the pharynx. Neither the position of the hyoid bone nor its movement during pharyngeal swallowing changed in relation to position and gravity. Pharyngeal activity during swallowing in normal individuals is fairly stable and does not change in relation to gravity.

Adult↗

PubMedDate not supplied

Pharyngeal function in patients with rheumatoid arthritis of the cervical spine and temporomandibular joint.

Pharyngeal function was studied in 31 patients with rheumatoid arthritis. Eighteen of these patients had dysphagia. Cervical spine abnormalities were present in 14. Destruction of the capitulum and/or ramus of the mandible was registered in 9. Pharyngeal dysfunction was revealed in 20. Patients with a vertical dislocation of the C1-C2 in relation to the occipital bone and patients with destruction of the capitulum and/or ramus of the mandible had an increased frequency of pharyngeal dysfunction. Pharyngeal dysfunction is thought to be due to mechanical factors and caused by derangements of muscular attachments and turning points.

Arthritis, Rheumatoid↗

PubMedDate not supplied

The upper esophageal sphincter area.

The localization of the upper esophageal sphincter is partly controversial. The aim of the present study was to elucidate whether or not the sphincter area could be allocated within an area inferior to and separate from the cricopharyngeal muscle. Cineradiography of the pharyngo-esophageal segment in 252 dysphagial patients disclosed a posterior impression in 55 (22%). There were no signs of a circular impression or other indications of a sphincter localized inferior to the circopharyngeus as revealed on these cinefilms. Macro- and microscopic examination of 16 autopsy specimens revealed the level of the upper esophageal sphincter to be localized within the cricopharyngeal muscle. There was no indication of any sphincter inferior to the cricopharyngeus in the cervical esophagus.

Adult↗

PubMedDate not supplied

Pharyngeal dysfunction after total and subtotal oesophagectomy.

Pharyngeal function was studied using a cineradiographic technique in 9 patients following removal of the oesophagus with anastomosis of a substitute in the neck. Pharyngeal dysfunction was present and aspiration occurred in 8 of them. This possible complication should be considered when oesophageal reconstruction with cervical anastomosis is planned. Pharyngeal function should be examined before free eating is allowed.

Aged↗