Search PubMed⌕ Search

Biomedical subjects

S Akerman

Publications and source records attributed to S Akerman.

At least 55 records · Page 3Linked to original sources
PubMed1993

Calcified cartilage zone and its dimensional relationship to the articular cartilage in the human temporomandibular joint of elderly individuals.

The aim was to describe the appearance of the calcified cartilage zone (CCZ) and to determine its dimensional relationship to the articular cartilage thickness in the normal human temporomandibular joint. An autopsy material comprising 21 joints from 12 elderly individuals was examined microscopically. The appearance of the CCZ was examined, and the thickness of the CCZ and of the total articular cartilage was measured in 18 different positions in each joint. The CCZ was outlined by a flat or gently undulating tidemark and an irregular osteochondral junction. The cellularity of the CCZ varied extensively. The cells were numerous in the CCZ when the overlying articular cartilage displayed high cellularity. Statistical analysis of the measurements demonstrated a relationship (p < 0.001) between the thickness of the CCZ and of the articular cartilage. Our findings, both qualitative and quantitative, indicate a close relationship between the physiology of the CCZ and of the overlying articular cartilage.

Aged↗
PubMed1992

Pharmacokinetics of ara-C and ara-U in plasma and CSF after high-dose administration of cytosine arabinoside.

Cytosine arabinoside (ara-C) and uracil arabinoside (ara-U) levels were measured in the plasma, cerebrospinal fluid (CSF), and urine of 10 patients exhibiting primary central nervous system lymphoma who received 31 infusions of high-dose ara-C (3 g/m2) as part of their treatment regimen. Peak plasma and CSF ara-C levels were 10.8 and 1.5 micrograms/ml, respectively. Ara-C was cleared more rapidly from plasma than from CSF. Ara-U appeared rapidly in both plasma and CSF, reaching a peak that was 10 times higher than the corresponding ara-C concentration (104 and 11.2 micrograms/ml, respectively). Only 4%-6% of the dose was excreted unchanged in the urine, but 63%-73% of it appeared as ara-U within the first 24 h. The presence of leptomeningeal lymphoma did not affect the CSF level of ara-C or ara-U.

Arabinofuranosyluracil↗
PubMed1992

Phenotypic analysis of 1-B-D-arabinofuranosylcytosine deamination in patients treated with high doses and correlation with response.

Two phenotypes for 1-B-D-arabinofuranosylcytosine (ara-C) deamination corresponding to a ratio of distribution for "slow" (ratio, less than or equal to 14) vs "fast" (ratio, greater than 14) deaminators of 70%:30%, have been determined on the basis of studies on plasma ratios of 1-B-D-arabinofuranosyluracil/ara-C (ara-U/ara-C) in 56 subjects treated with high-dose ara-C (3 g/m2 infused i.v. over 3 h). A positive correlation of age with the concentration of ara-U was observed. In a subgroup of 36 patients with leukemia, the ara-U/ara-C pattern was similar to that observed for all 56 subjects. In these leukemic patients, who were treated with combinations of ara-C plus other conventional agents, a tendency toward a positive response (complete response + partial response) was found for those showing low ara-U/ara-C ratios (slow deaminators). The phenotypic effect of deamination in acute leukemia needs to be evaluated prospectively.

Adolescent↗
PubMed1992

Macroscopic and microscopic findings of areas with radiologic erosions in human temporomandibular joints.

The aim was to describe the macroscopic and microscopic findings of areas with radiologic erosions in the human temporomandibular joint. An autopsy material of 40 human joints, removed as blocks, was examined with tomography, and an erosion was found in 37 areas. A macroscopic and a microscopic examination focused on the presence of the calcified cartilage zone (CCZ) was performed in these areas. In the condyle 13 of 14 areas with a radiologic erosion showed denudation of bone macroscopically. Microscopically, these areas were covered by a thin fibrocellular tissue, and the CCZ was absent. In the temporal component, only 1 of the 23 areas showed bone exposure macroscopically. Microscopically, the soft tissue in these areas varied in thickness. The CCZ was missing in 13 of the 23 areas, even in some areas that appeared normal macroscopically and were microscopically covered by intact soft tissue. Thus, in areas with a radiologic erosion the macroscopic and microscopic appearance differed between the condyle and the temporal component. The nature of the findings is discussed.

Aged↗
PubMed1991

Radiologic changes in temporomandibular, hand, and foot joints of patients with rheumatoid arthritis.

Radiologic changes in the temporomandibular joint (TMJ) and in the joints of the hand and foot were recorded for 90 adult patients with rheumatoid arthritis. The severity of the changes was graded according to the Larsen classification of six grades (O to V), and mainly erosive changes were recorded. The assessment of the radiographs was performed with the aid of reference films. The radiologic changes in the TMJs corresponded to grade II (definite early abnormality) and paralleled those of most of the metacarpophalangeal and metatarsophalangeal joints. The most severe changes were localized to the wrists, with a median grade of III (moderate destructive abnormality). The severity of the changes was similar on the right and left sides of the TMJ. We conclude that TMJ involvement in patients with rheumatoid arthritis is severe and warrants a thorough initial clinical examination. Such a strategy will facilitate the diagnosis and treatment of TMJ changes in the early stages of the disease.

Adolescent↗
PubMed1991

Some anatomical factors of the upper compartment of the temporomandibular joint related to the disc position.

Temporomandibular joint (TMJ) arthrograms of 20 joints with superior disc position (SDP), 20 joints with anterior disc displacement with reduction (ADDWR), and 20 joints with anterior disc displacement without reduction (ADDWOR) were compared. The distance from the insertion of the posterior disc attachment of the upper joint compartment to the top of the mandibular fossa in joints with ADDWR was significantly longer than in joints with SDP and ADDWOR (p = 0.003). The distance from the top of the mandibular fossa to the top of the articular eminence in joints with ADDWR was significantly shorter than in joints with ADDWOR (p = 0.006). The entire distance of the upper joint compartment in joints with ADDWR was significantly longer than in joints with SDP and ADDWOR (p = 0.02).

Adult↗
PubMed1991

Angulation and prominence of the posterior slope of the eminence of the temporomandibular joint in relation to disc position.

A steep articular eminence has been proposed as an aetiological factor in internal derangement of the temporomandibular joint. Arthrograms of 20 joints each of three groups, superior disc position (SDP), anterior disc displacement with reduction (ADDWR) and anterior disc displacement without reduction (ADDWOR) were compared. No correlation was found between a steep articular eminence and anterior disc displacement. The posterior slope of the articular eminence of the joints with ADDWOR was significantly less prominent than in those with SDP and ADDWR.

Adolescent↗
PubMed1991

Short-term effects of intra-articular sodium hyaluronate, glucocorticoid, and saline injections on rheumatoid arthritis of the temporomandibular joint.

The short-term effect (4 weeks) of intra-articular injections of sodium hyaluronate, glucocorticoid, and saline was studied in three groups comprising 41 patients with rheumatoid arthritis of the temporomandibular joint. Sodium hyaluronate and glucocorticoid treatments had a significant positive effect according to the patients' subjective evaluation. A comprehensive clinical dysfunction score was reduced significantly in all groups, while the number of tender muscle regions was significantly reduced and the maximum voluntary mouth opening significantly increased in the glucocorticoid and sodium hyaluronate groups only.

Adolescent↗
PubMed1991

Therapy of refractory/relapsed acute leukemia with cytosine arabinoside plus tetrahydrouridine (an inhibitor of cytidine deaminase)--a pilot study.

Thirty two patients with refractory or recurrent acute leukemia or blast crisis of chronic myelocytic leukemia were treated with 1-beta-D-arabinofuranosylcytosine (Ara-C), 100 mg/m2 [group I (n = 15)] or 200 mg/m2 [group II (n = 18)], and tetrahydrouridine (THU) 350 mg/m2, given concurrently as a 3 h continuous intravenous infusion at 12 h interval for eight doses. Two of 13 (15.3%) evaluable patients in group I achieved a complete response, both of whom had acute myelocytic leukemia. In group II, seven of 14 evaluable patients (50%) obtained objective responses--six with complete responses (42.8%) and one with partial response (7%). Myelosuppression was seen in all patients with a median duration of 32.5 days (group I) and 36.3 days (group II), respectively. Non-hematologic toxicity consisted of nausea, vomiting, diarrhea, conjunctivitis, skin rash, hepatocellular toxicity, hemorrhage, and renal toxicity. Pharmacokinetic studies revealed, for group I, mean peak plasma Ara-C levels at 3 h (Cp3h) of 1254 ng/ml, area under the curve (AUC) 4651 ng x h/ml, total body clearance (TBC) 32.65 l/h/m2, renal clearance (RC) 7.04 l/h/m2 with a mean of 12.36% of the injected amount of Ara-C excreted unchanged in urine over the first 24 h. The corresponding mean values for group II are Cp3h 3305 ng/ml, AUC 15080 ng x h/ml, TBC 20.48 l/h/m2, RC 7.02 l/h/m2 and 26.23%. Ara-C 200 mg/m2 combined with THU gave serum Ara-C levels and response rates comparable to those achieved with high dose Ara-C (HiDAC) (greater than or equal to 1 g/m2). Central nervous system toxicity associated with HiDAC was not seen. Pharmacokinetics for uracil arabinoside (Ara-U) in patients treated with Ara-C 200 mg/m2 plus THU, were comparable to values seen with Ara-C for Cp3h, AUC and 24 h urine, amounting to 3160 ng/ml, 21717 ng x h/ml and 23.62% whereas TBC was significantly lower (p less than 0.001) for Ara-U than for Ara-C (3.02 versus 20.48 l/h/m2).

Adult↗
PubMed1990

Clinical and radiological findings in temporomandibular joints with disc perforation.

Sixteen temporomandibular joints from 15 patients, reported to have disc perforation at arthrography, were studied. Pain from the TMJ region was reported by 11 patients. Clicking was found in 6 joints and crepitation in 6 joints. Nine patients displayed a deviation of the mandible at maximum mouth opening towards the affected side. The muscles of the affected side were tender on palpation more frequently than those on the contralateral side. The disc perforation was located in the posterior attachment in most joints. An anterior disc displacement was found in all joints except one, which exhibited a normal disc position. In 4 joints with an anterior disc displacement with reduction, the configuration of the discs varied, whereas in all 11 joints with an anterior disc displacement without reduction the disc was biconvex. In most joints, the condyle was located in a central position in the fossa in the intercuspal position and 13 joints were tomographically diagnosed as being osteoarthrotic. It is concluded that most joints with disc perforations are osteoarthrotic and the most severe clinical and radiological findings are associated with an anterior disc displacement without reduction.

Adult↗
PubMed1990

Reproductive pattern among women in 19th century Sweden.

Among the married female population in rural areas of 19th century Sweden infertility and subfertility were found in 7.5% and 6.1% respectively with increasing incidence during the latter half of the century. In relation to the age group 20-24, fecundity declined by 42% and 92% in the age groups 35-39 and 40-45 respectively. One-third of married women died before age 50. Re-marriages and step-parents were common. Less than half of the married women brought up the majority of the children in the community.

Female↗
PubMed1990

Diagnostic outcome and observer performance in sagittal tomography of the temporomandibular joint.

The diagnostic outcome and observer performance of sagittal tomography in detecting degenerative lesions of the temporomandibular joint was studied. Thirty tomograms depicting findings such as cyst, erosion, osteophyte and sclerosis and 30 with a normal appearance were selected. The joint status was verified histologically. Four observers evaluated the tomograms with the aid of reference tomograms, independent of the microscopic examination. The diagnostic accuracy was high (80-87%). The sensitivity was between 67% and 90% and the specificity between 73% and 93%. An osteophyte was, with few exceptions, a true finding whereas sclerosis most frequently was false. About two-thirds of the reports of cyst and erosion were found to be true. The interobserver overall agreement rates for any two observers varied between 68% and 90%, for three observers between 65% and 82%, and for all four observers was 63%. The Kappa value for any two observers was 0.40-0.80, indicating fair to substantial agreement. The intra-observer agreement was only somewhat higher than the interobserver. This study shows that, with the aid of reference tomograms, high diagnostic accuracy and observer agreement can be achieved in sagittal tomography.

Aged↗
PubMed1988

Relationship between clinical and radiologic findings of the temporomandibular joint in rheumatoid arthritis.

The relationship between clinical findings in the craniomandibular system and radiologic findings in the temporomandibular joint was investigated in 101 adults with rheumatoid arthritis. Radiologic changes were correlated with duration and severity of temporomandibular joint symptoms and general joint disease. The radiologic changes were also associated with loss of occlusal support, anterior open bite, and occlusal interferences. Most joints with crepitus exhibited radiologic erosion. Joints with mutilating changes were silent.

Adult↗
PubMed1988

Macroscopic and microscopic appearance of radiologic findings in temporomandibular joints from elderly individuals. An autopsy study.

The macroscopic and microscopic appearance of radiologic findings in 40 temporomandibular joints (TMJ) taken at autopsy from 20 elderly individuals was investigated. The radiologic signs of erosion and sclerosis were strongly associated with macroscopic articular surface destruction only on the condyle while the soft tissue lining was most often intact in areas with a sclerosis of the temporal component. Radiologic concavity, osteophyte, and flattening presented none or mild macroscopic changes. The microscopic appearance of erosion and cyst formation was characterized by the presence of a cell-rich fibrous and well-vascularized connective tissue. In 4 joints with fibrous ankylosis, an articular soft tissue lining was completely lacking. In areas with radiologic sclerosis, thickening of the cortical and subcortical bone was observed. Both erosions and sclerosis were found in most joints with anterior disc position or disc perforation. It was concluded that radiologic signs of erosion and sclerosis in the condyle are more reliable signs of joint disease than such changes in the temporal component.

Aged↗
PubMed1988

Intra-articular and skin surface temperature of the temporomandibular joint in patients with rheumatoid arthritis.

Intra-articular and skin surface temperatures of the temporomandibular joint (TMJ) were investigated in 34 patients with rheumatoid arthritis (RA). History was taken, and a clinical examination of the stomatognathic system was performed. The intra-articular temperature measurement was made with a thermocouple inserted through a needle, and the skin surface measurement was made with a thermocouple lateral to the condylar pole. The intra-articular temperature was lower for 37% and higher for 30% of the patients, whereas skin surface temperature was lower for 18% and higher for 6%, compared with normal individuals. Intra-articular and skin surface temperatures were positively correlated, and the average difference between skin surface and intra-articular temperatures was 1.6 degrees C. The intra-articular temperature was most strongly and positively correlated to the number of joint regions affected by RA and negatively correlated to the number of tender masticatory muscles, whereas skin surface temperature was most strongly and positively correlated to room temperature and negatively correlated to the number of tender masticatory muscles. These results indicate that pain and tenderness of masticatory muscles in RA are associated with hypothermia of the TMJ.

Adolescent↗