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Biomedical subjects

O Korkala

Publications and source records attributed to O Korkala.

At least 37 records · Page 2Linked to original sources
PubMed1990

Immunohistochemical demonstration of subclasses of inflammatory cells and active, collagen-producing fibroblasts in the synovial plicae of lumbar facet joints.

Plical tissue removed perioperatively from lumbar facet joints was studied immunohistochemically with the avidin-biotin-peroxidase complex (ABC) method for a putative presence of various subclasses of inflammatory cells and active collagen-producing fibroblasts. These methods have previously been used successfully for demonstrating specific inflammatory cells in rheumatoid arthritic synovium and cervical ligament and for studying regeneration of connective tissue, respectively. An overt inflammatory cellular response could not be demonstrated, as B lymphocytes were totally absent and no lymphocyte activation markers, either interleukin-2 receptor or immune-response-associated Ia antigens were expressed. Most of the immunoreactive cells observed were CD11b monocytes, and even these were only scattered in the connective tissue. Occasional activated collagen-producing fibroblasts were seen, suggesting in these few cases a possible regenerative response of the collagenous tissue, maybe induced by an impingement phenomenon, as such cells are not normally seen in resting connective tissue.

Collagen↗
PubMed1989

Allogeneic grafts for bone tumor. 21 cases of osteoarticular and segmental grafts.

We treated 21 aggressive and malignant bone tumors by wide resection and replacement with deep-frozen osteoarticular and segmental (intercalary and block) allografts. Radiologic and histologic studies showed a gradual accretion of new bone on the graft trabeculae, sometimes with total creeping substitution. Substantial resorption of grafted condylar bone occurred in 3 of 14 cases. One of them ended with arthrodesis; in the other 2 the result after augmentation autografts was fair. Radiographically, a gradual joint surface destruction was observed in all the osteoarticular grafts after 5 years, not correlating with joint function, however. Biopsies showed some cartilage regeneration. Each patient underwent, on an average, two operations. Function after osteoarticular grafts at 3-16 years was excellent in 1 case, good in 4, fair in 6, and poor in 1 case; 2 cases were too recent for evaluation. Function 3-12 years after segmental grafts was excellent in 3 cases and poor in 3 cases (1 amputation due to nonunion, 1 amputation due to recurrence, and 1 prosthetic replacement due to recurrence); 1 case was too recent for evaluation. We conclude that an allograft is an acceptable alternative in the reconstruction of large tumor defects. However, it still presents unsolved immunologic and preservation problems, which make the prognosis guarded.

Adolescent↗
PubMed1988

Experimental lengthening of tibial diaphysis: gap healing with or without gradual distraction.

Stepwise distraction of the rabbit tibia after a transverse diaphyseal osteotomy was performed in an external fixator. The goal was to clarify the fine-structural parameters of long-bone lengthening. The tibias were vertically cut and studied 5 weeks after the osteotomy, and the specimens with an initial gap without further lengthening were compared with those with a gap and stepwise distraction. The role of periosteal bone induction was essential for the ossification of a growing gap, whereas the ossification of a simple gap proceeded equally by the endosteal and periosteal routes. The distraction resulted in vertical organization of the premature callus tissue at the proximal pole of the distracted gap, while the distal part of the gap area was deficiently filled by endosteal bone but preliminary fixed by a bridge of periosteal callus tissue.

Animals↗
PubMed1988

Neuropeptides in synovium of patients with rheumatoid arthritis and osteoarthritis.

The presence of neural elements in synovial tissue proper has earlier been suggested on the basis of nonspecific silver impregnation techniques and is now confirmed in a study based on specific demonstration of cytoskeletal neurofilaments and various neuropeptides. With both the neurofilament and neuropeptide antisera, nerves were seen predominantly in a perivascular location, there being fewer nerves freely in the stromal tissue. In the synovium of patients with rheumatoid arthritis (RA), free stromal nerves stained with neurofilament antiserum often lacked neuropeptide immunoreactivity, while this was not the case in normal synovium or synovial samples from patients with osteoarthritis (OA). Furthermore, the intensity of staining of neurotransmitter peptides was weaker in RA than in OA or normal synovial tissue. It is suggested that neurogenic inflammation may play a role in RA and that neuropeptide nerves possibly release their mediators in RA.

Arthritis, Rheumatoid↗
PubMed1988

Austin Moore replacement hemiarthroplasty in femoral neck fractures of the elderly.

162 femoral neck fractures were treated with Moore endoprostheses. Primary mortality was eight per cent, and after an average of seven years postoperatively 25 per cent of the patients were alive. Complications were recorded in 22 cases. Nine of the patients underwent a further operation. Thirty-one patients participated in a clinical follow-up study and eight patients answered a subjective questionnaire. Two hips showed excellent, eight good, ten fair and twenty-two hips poor results. The use of hemiendoprosthetic replacement should be reserved for displaced fractures and for patients with a short life expectancy. In cases of even initial osteoarthritis primary total hip arthroplasty should be performed if an endoprosthetic replacement is considered.

Aged↗
PubMed1987

A prospective study of the treatment of severe tears of the lateral ligament of the ankle.

A prospective randomized clinical study was undertaken to compare bandaging, plaster cast immobilisation and operative treatment for recent tears of the lateral ligament of the ankle. The follow-up period was two years. Subjectively, only the fear of giving-way showed a clear difference in favour of operative repair. Objective evaluation, including stress radiographs, demonstrated no statistical differences between the three methods of treatment. Although bandaging appeared somewhat less satisfactory with respect to the resulting stability of the ankle, the differences were not statistically significant. The lateral ligament in patients over 40 years of age showed a statistically significant tendency to heal less well than that of younger patients. Severe ankle sprains in patients under 40 years of age should preferably be treated by operation, especially in younger patients and if the person is physically active. Lateral ligament tears in patients over 40 years of age should be treated conservatively and a secondary reconstruction carried out later, if necessary.

Adolescent↗
PubMed1987

Hemijoint allografts in the treatment of low grade malignant and aggressive bone tumours about the knee.

Nine consecutive patients undergoing osteoarticular allogenic transplantation for low grade malignant or aggressively benign tumours have been followed up for between 8 to 15 years. Eight patients had functioning knees whilst 1 ended in arthrodesis. Of the functioning knees all had full extension but only 3 could flex more than 90 degrees. Seven patients had returned to work. Radiologically all the knees showed progressive deterioration. In spite of this only three knees were painful with exercise and none at rest. We conclude that hemijoint allografts represent a useful alternative to make good a bony defect after tumour resection about the knee, but that the ultimate result of such a reconstruction depends on survival of the joint surfaces.

Adolescent↗
PubMed1987

Evolution of substance P immunofluorescent nerves in callus tissue during fracture healing.

Tibial fractures were experimentally produced in rats. The fractures were allowed to heal spontaneously. Samples of callus tissue were studied by a specific immunohistochemical method for substance P, the peptide which is found in sensory nerves and probably plays a role in nociceptive nerve transmission. The control periosteum contained a rich network of substance P immunofluorescent nerves. The early callus tissue also contained such sensory nerves, the peak frequency of which was at the end of the second week. It is proposed that the substance P-containing nerves play a protective nociceptive role during fracture healing.

Animals↗
PubMed1987

Treatment of delayed union and non-union of the carpal scaphoid with a compression staple and cancellous bone grafting--new method and preliminary results.

Scaphoid non-union (eight cases) and delayed union (three cases) were treated by compression staple and inlay of cancellous bone from iliac crest between the bony fragments. Union was achieved in ten of the cases (91 per cent). The consolidation time was 8-12 weeks in seven cases and 24 weeks or more in three cases. The compression stable fixation connected with bone grafting is a new and simple method to treat chronic fractures of the carpal scaphoid which is a difficult problem. The early results appear promising.

Adult↗
PubMed1987

[External fixation in open fractures of leg. Analysis of traps and complications of the method].

A consecutive series of 51 compound tibial fractures treated by external fixation have been reviewed. All the cases whose progress was marred by complications were analysed separately. From this analysis, the following conclusions have been reached: 1. A gap at the fracture site, due to loss of bone substance or to distraction of the fragments should be treated as soon as possible by bone grafts. 2. Inadequate reduction should be corrected at the time of primary treatment. 3. Pins inserted into the region of the fracture should be repositioned early to prevent infection along the pin tracks. 4. If a sequestrum is evident, it is often necessary to remove such a focus of infection. 5. Weight-bearing, whenever feasible, should be started as soon as possible. A patellar-tendon-bearing orthosis or unilateral semi-elastic external fixation are possible satisfactory solutions in this respect. 6. When the fracture site is infected and contains necrotic fragments, the superiority of external fixation over internal fixation is obvious. The method makes it possible to stabilise the fragments without interfering with local healing and allows the exposed bone to be covered in a stable environment. Because of this analysis of the complications and pitfalls of external fixation, we have been able to put forward a regimen of treatment that may improve results.

Adult↗
PubMed1987

Acute complete acromioclavicular dislocation. A prospective randomized trial of fixation with smooth or threaded Kirschner wires or cortical screw.

During 1983-1984, 86 patients with complete dislocation of the acromioclavicular joint verified also by stress radiographs were operated on and followed-up for at least one year. In transfixation two smooth Kirschner wires, two threaded Kirschner wires or one cortical screw were used. The acromioclavicular ligament was sutured and the damaged disk removed, but the coracoclavicular ligament was left unsutured. At the one-year follow-up, the results were good in 82 patients according to the classification of Darrow et al. Radiologically, the acromioclavicular joint was in place in 67 patients. Partial dislocation was observed in 14 patients and complete dislocation in 5 patients. Clinical results were not related to the type of treatment. The only statistically significant difference was osteolysis of the lateral head of the clavicle; eight of the 13 cases of osteolysis were due to screw fixation (p less than 0.001).

Acromioclavicular Joint↗
PubMed1987

Christiansen replacement hemiarthroplasty in femoral neck fractures of the elderly.

A total of 108 femoral neck fractures were operated on by Christiansen hemiarthroplasty. Primary mortality was 4.8%, but after an average of 61 months only one-third of the patients were alive. Sixteen of the 40 hips of the living patients showed a poor result as evaluated by the Harris score or subjective outcome. Only four hips were wholly satisfactory at follow-up. It appears that Christiansen hemiarthroplasty has no advantages over other hemiendoprosthetic devices. It is suggested that undisplaced or minimally displaced fractures should not be treated by hemiarthroplasty but by compression osteosynthesis. The problem of displaced fractures still remains open. It appears, however, that primary total hip arthroplasty should be performed in cases of rheumatoid arthritis or even initial osteoarthritis, if an endoprosthetic replacement is considered.

Aged↗
PubMed1986

Ender nailing of trochanteric fractures. A review of 73 cases.

A clinical series of 73 patients with fractures of the trochanteric area of the femur was treated consecutively using ordinary Ender nails or two-dimensionally bent nails. Although primary mortality is low--three cases in the series--the method is affected by other complications. The most frequent of these was displacement of the nails, which led to a new operation in nine cases. Ender nailing is recommended in selected cases of pertrochanteric fractures of elderly people as a semiconservative method, when systemic illness or poor general condition contraindicates major surgical procedures.

Age Factors↗
PubMed1986

Scanning electron microscopical study of the effects of crystalloid and water-soluble glucocorticoids on articular cartilage.

A comparative scanning electron microscopical study on the topical effects of glucocorticoids on rat knee cartilage was undertaken. Water-soluble and crystalloid 'depot'-form glucocorticoids were tested. Cartilage destruction was dependent on the number of injections and was clearly more pronounced in the knees injected with crystalloid glucocorticoid. We conclude that repeated injection of the joint with glucocorticoids should be given only after careful consideration of the clinical state.

Animals↗
PubMed1986

Hip arthroplasty for alkaptonuric ochronosis. A case report.

Ochronotic arthropathy is present in about one third of the patients with alkaptonuria. The large joints, as well as the spinal column, are affected. In a typical case with a grave classic ochronotic arthro- and spondylopathy, arthroplasties of the hips greatly increased the patient's physical activity.

Hip↗
PubMed1985

The halo brace in unstable fractures of the cervical spine: a review of 14 cases.

A series of 14 patients with unstable fractures of the cervical spine, treated initially with skull traction and a few days later with a halo-thoracic brace, is described. Nine of the injuries were fractures of the odontoid process and the rest were at various levels. No patient with major neurological defects was included in the halo brace treatment. The halo brace provides significant advantages, including immediate mobilization with less time in hospital and less nursing. The results of the present series are encouraging; stable conditions were achieved in all cases.

Braces↗
PubMed1985

Immunohistochemical demonstration of nociceptors in the ligamentous structures of the lumbar spine.

Substance P, a physiologically potent neuropeptide is known to participate in the sensory, and especially nociceptive, transmission of neural impulses. On histologic grounds, the nerve terminals of the sinuvertebral nerve formerly have been suggested to be sensory in character and to mediate the low-back pain syndrome. Samples of paramedullary ligamentous structures were collected on disc operations. A positive immunoreaction as an indicator of substance P was confirmed in some nerve terminals of the posterior longitudinal ligament. Neither the yellow ligament nor the intervertebral disc showed such nociceptive-type nerves.

Humans↗