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Biomedical subjects

S Orava

Publications and source records attributed to S Orava.

At least 55 records · Page 3Linked to original sources
PubMed1991

Collagen synthesis in rat skeletal muscle during immobilization and remobilization.

The activities of prolyl 4-hydroxylase (PH) and galactosylhydroxylysine glucosyltransferase (GGT), which are both enzymes of collagen biosynthesis, and the concentration of hydroxyproline (Hyp) were measured in the soleus muscle (S) of rats after 3 and 42 days of cast immobilization. PH, GGT, and Hyp were also observed in S and tibialis anterior muscle (TA) at 0, 3, 7, and 14 days of remobilization after 7 days of cast immobilization. The activities of PH and GGT decreased significantly in shortened S after an immobilization of 3 days and were low thereafter. Immobilization for 7 days caused a decrease in the content of the soluble collagen in shortened S. Remobilization resulted in a rapid increase in the activities of collagen marker enzymes and the soluble collagen in S. In stretched TA, the specific activities of PH and GGT were increased significantly after 1 wk of immobilization and returned to the control levels during the remobilization period. The content of soluble collagen was above the control level after immobilization and returned to control level during the remobilization period in stretched TA. There were, at most, slight changes in the total content of insoluble collagen in S and TA. The results suggest rapid changes in the fractional synthesis rate of procollagen but, at most, slow changes in the stable content of muscular collagen during cast immobilization and remobilization. Muscle contractile activity and tension seem to be positive regulators of PH and GGT activities.

Animals↗
PubMed1991

Diagnosis and treatment of delayed and non-union stress fractures in athletes.

Stress fractures in athletes usually heal well with merely rest and conservative treatment. It has been estimated that in Finland 400-500 athletic stress fractures occur annually per year. In sports clinic series stress fractures comprise 3.3 to 4.6 per cent of all overuse injuries. Delayed and non-union have been reported to occur in athletes quite often, up to 10 per cent of athletic stress fractures in Finland. The reason is on the one hand delayed diagnosis due to late consultation of expert physicians, and on the other hand too short a rest from hard physical activity. Delayed and non-union are most often seen in the hallux sesamoids, mid-tibial staft, base of fifth metatarsal, tarsal navicular and olecranon. The pars articularis of the fourth and fifth lumbar vertebra is a site of stress fracture and spondylolysis. In this report the diagnosis, symptoms and findings as well as the operative treatment of these overuse injuries is discussed.

Athletic Injuries↗
PubMed1991

Overuse injuries of the Achilles tendon.

Among the 4,020 athletes (males 73%, females 27%) treated at the Department of Sports Medicine of the Deaconess Institute, Oulu, Finland in the period 1986-1989 there were 273 athletes with 330 of instances Achilles tendon overuse. Peritendinitis, tendinitis, partial rupture, retrocalcanear bursitis and insertiotendinitis were the most common diagnoses. Acute and subacute ailments were usually treated successfully by conservative means. 45.5% of the overuse injuries became chronic, failed to respond to conservative treatment and were treated surgically. The results were excellent or good in 86% of those operated on for chronic peritendinitis. The overall results were good in 69.3% of the patients.

Achilles Tendon↗
PubMed1991

Operative treatment of typical overuse injuries in sport.

In this report 670 operations, performed in 643 patients were analyzed. The indication for the surgery was a chronic symptomatic overuse injury caused by sports and physical activity. 552 (82.4%) of the operations were performed in men and 118 (17.6%) in women. The mean age of the patients was 24 years. Almost 90 per cent of the patients had presented following competitive sports and ten per cent recreational sports. More than 91 per cent of the operations were performed for lower extremity problems. The knee, foot and ankle regions needed surgical treatment most often in this series. Tendon and tendon sheath operations formed the majority (32%) of the operations. Chronic Achilles tendon problems (159) formed the biggest group of the diagnoses. Chronic overuse injuries do not respond always to conservative treatment. Surgery is often needed in the final stage of an overuse injury. The results of these operations are good.

Adolescent↗
PubMed1991

The hamstring syndrome--a new gluteal sciatica.

The condition in which pain is felt over the area at the ischial tuberosity and radiating down the back of the thigh is labelled the hamstring syndrome. The pain is typically incurred by assuming a sitting position, stretching the affected leg or/and running fast. The symptoms are caused by tight, tendinous structures of the hamstring muscle at the area of its insertion into the ischial tuberosity. Following division of these structures, complete relief is obtained.

Adolescent↗
PubMed1990

The effects of preimmobilization training and immobilization on collagen synthesis in rat skeletal muscle.

The activities of prolyl 4-hydroxylase (PH) and galactosylhydroxylysyl glucosyltransferase (GGT), both enzymes of collagen biosynthesis, and the concentration of hydroxyproline (Hyp) were measured in soleus and tibialis anterior muscle after periods of 0, 7 and 21 days of immobilization following a swimming training for a period of three weeks in rats. After swimming, the specific activities of PH and GGT were increased by 25% (N.S.) and 53% (p less than 0.01), respectively, in the soleus muscle. In the tibialis anterior muscle PH was increased by 31% (p less than 0.01) after exercise. During the first week of immobilization, PH activity in the shortened soleus muscle was decreased by 21% (p less than 0.001) and by 65% (p less than 0.001) below the control level in the trained and non-trained groups, respectively. The difference between these two groups is significant (p less than 0.001). The specific activity of PH decreased to control level after one week of immobilization in the tibialis anterior muscle. Hyp concentration increased significantly (p less than 0.05) in the shortened soleus muscle after one week of immobilization due to rapid atrophy of non-collagenous proteins, whereas in the tibialis anterior muscle no significant increase was observed until after three weeks of immobilization. The results suggest that swimming, which contains only concentric muscle work and lacks eccentric and weight bearing components, is a positive regulator of collagen biosynthesis. The results suggest also that preimmobilization training may slow down the deadaptive changes caused by disuse during the first week of immobilization.

Animals↗
PubMed1990

The effects of remobilization and exercise on collagen biosynthesis in rat tendon.

The activities of prolyl 4-hydroxylase (PH) and galactosylhydroxylysyl glucosyl-transferase (GGT), and the concentration of hydroxyproline (Hyp) were measured in the Achilles and tibialis anterior tendons of rats after periods of 0, 3, 7 and 14 days remobilization following a 7-day cast immobilization. PH, GGT and Hyp were also observed in the soleus and tibialis anterior muscles and the Achilles tendon 2, 5 and 10 days after a single bout of exhaustive exercise. During immobilization, the specific activity of PH decreased by 23% (P less than 0.05) and 54% (P less than 0.01) in the Achilles and tibialis anterior tendons. A less pronounced decrease was observed in GGT activity. During the remobilization experiment the specific activity of PH increased gradually, whereas GGT activity increased rapidly. The GGT activity was 61-66% (P less than 0.01) above the control value in the Achilles and tibialis anterior tendons after 3 days, decreasing to the control level after 14 days. Hyp concentration did not change significantly. In the exercise experiment, the specific activity of PH in the soleus muscle increased by 64% (P less than 0.05) 2 days after the prolonged exercise and then decreased gradually to the control level. There were no significant changes in PH or GGT activity in the tibialis anterior muscle. The specific activity of PH and GGT and Hyp concentration remained unchanged in the Achilles tendon. The results suggest that, in the tendon, restoring normal cage activity after immobilization results in acceleration of collagen synthesis. The results suggest also that collagen synthesis of the tendon is insensitive, but that of the soleus muscle is sensitive, to an acute increase in physical activity.

Animals↗
PubMed1987

Stress fractures in athletes.

During the 14-year period of 1971-1985, 368 stress fractures in 324 athletes were treated. The series contained 268 fractures in males and 100 fractures in females; 32 fractures occurred in children (less than 16 years), 117 in adolescents (16-19 years), and 219 in adults. Forty-six fractures were incurred by athletes at an international level, 274 by athletes at a national or district level and 48 by recreational athletes. Of the total cases, 72% occurred to runners and a further 12% to athletes in other sports after running exercises. The distribution of the stress fractures by site was: tibia 182, metatarsal bones 73, fibula 44, big toe sesamoid bones 15, femoral shaft 14, femoral neck 9, tarsal navicular 9, pelvis 7, olecranon 5 and other bones 10. Of the total fractures, 342 were treated conservatively and 26 fractures required surgical treatment. The operative indication was dislocation in 5 cases and delayed union/nonunion in 21 cases. The sites most often affected by delayed union were: anterior midtibia, sesamoid bones of the big toe, base of the fifth metatarsal, olecranon, and tarsal navicular. The athletes at an international level experienced the greatest risk of multiple separate fractures, protracted healing, or fractures requiring surgery.

Adolescent↗
PubMed1986

Stress fractures of the olecranon in javelin throwers.

Between the years 1977 and 1984, four javelin throwers with a stress fracture of the olecranon were seen and treated. In one patient, acute painful dislocation of the fracture occurred during a competitive throw. Two patients had stress fracture of the tip. The fracture treated conservatively healed in 18 months. The patient treated by excision of the tip was able to throw after 2 months. Two patients had slightly oblique, more distally located stress fractures, which were treated with a tension band and 2 Kirschner wires. The fractures healed in 4 months. One of the patients had a refracture 11 months after the primary operation. It was successfully treated with a compression screw and two bone pegs. Because of the high risk of delayed union and nonunion, stress fractures of the olecranon should be treated operatively in javelin throwers.

Adult↗
PubMed1986

Surgical treatment of patellar tendon pain in athletes.

A series of surgically treated patellar tendon lesions among athletes is presented. The material was collected during 5 years from three sports injury clinics and from two hospitals. During this period the authors treated about 150 cases of jumper's knee, of which 34 cases were treated by operation. The athletes were mostly volley ball players, jumpers or runners. The operation revealed a necrotic focus of the patellar tendon in 21 cases, the retinaculum was thick and adherent in 16 patients and an exostosis of the patellar insertion was seen in two cases. The necrotic areas were excised, the thick and adherent retinaculum was divided and the exostoses were excised and drilled. Surgical treatment of chronic patellar tendon pains may give good results in selected cases.

Adolescent↗
PubMed1986

Medical treatment of acute low back pain. Diflunisal compared with indomethacin in acute lumbago.

Diflunisal and indomethacin were compared in patients with acute lumbago in a double-blind prospective clinical trial. The dosage of diflunisal was 500 mg twice daily (d-group) and the dosage of indomethacin 50 mg three times daily (i-group). Out of 133 patients, 66 were in the d-group and 67 in the i-group. They were followed up for a week. In addition to the patient's own daily evaluation of pain and functional disability, control visits were performed by the investigators on days 0, 3 and 7. Both of the test drugs were effective in the dosages used. Patients' pain was decreased, functional disability was improved and patients' subjective evaluation of treatment efficacy was very similar to that of the investigators. There were no differences as to the treatment efficacy, but reports of side-effects were slightly less (p less than 0.05) in the d-group than in the i-group. If patients who had no side-effects were compared, the efficacy of diflunisal was better than indomethacin (p less than 0.05). It can be said that indomethacin was essentially as effective as diflunisal, but at the expense of an increased frequency of side-effects. In the d-group two patients (3%) and in i-group six patients (9%) discontinued the therapy because of side-effects. In acute lumbago rapid relief of pain and other harmful symptoms hastens improvement. For such indications the choice of drug therapy in general practice should be based in particular on considerations of safety and lack of potential side-effects in addition to efficacy.

Adolescent↗
PubMed1985

Stress fractures of the sesamoid bones of the first metatarsophalangeal joint in athletes.

Over a period of 11 years 15 cases of stress fractures of the sesamoid bones of the first metatarsophalangeal (MTP) joint were treated in athletes. The mean age of the patients was 22.3 years, and there were 9 males and 6 females in the series. All patients were athletes, who began to suffer from the symptoms during training without any trauma. Eight fractures were located in the medial, six in the lateral sesamoid bone, and in one case both sesamoids were affected. The diagnosis was performed on the basis of the history, symptoms, clinical examination, and radiological, or isotope scanning findings. Ten of the patients were treated conservatively by prescribing an avoidance of excessive physical activity and better training shoes. In five cases surgical excision of the fragmented painful sesamoid bone was performed. There were no complications in the series and the athletes could start gradually training 6-8 weeks after the operation. The histology showed fibrotic non-union at the fracture site and supported the diagnosis of stress fracture. Three of the conservatively treated athletes had mild symptoms in intensive training, others had a good end result.

Adolescent↗
PubMed1985

Stress fracture of the navicular bone. Nine cases in athletes.

Nine cases of stress fractures of the tarsal navicular bone were treated in athletes. The diagnosis was made with radiographs and bone scan within 6 months. Only two patients were treated surgically. The only poor result was seen in a patient in whom the fracture was only explored.

Adolescent↗
PubMed1985

Stress fracture of the fifth metatarsal in athletes.

Between 1975 and 1984 11 athletes with stress fractures of the fifth metatarsal were treated. There were 6 diaphyseal fractures, all of them in runners, and 5 transverse fractures of the base (Jones' fractures). The diaphyseal fractures healed with rest in 3-4 weeks. One patient with Jones' fracture was treated conservatively with a non-weight-bearing toe-to-knee plaster with good results. Four patients with delayed unions were treated operatively, three with a tension band and two Kirschnerwires, one with drilling and a single, thick Kirschner-wire. The fractures treated operatively progressed to bony union in about 3 months. The tendency of the Jones' fracture to delayed union and non-union in active athletes makes special requirements to the initial therapy of stress fractures. Best results have been obtained with a toe-to-knee cast with non-weight-bearing for 6-7 weeks. In delayed unions we recommend a tension band fixation with two Kirschner-wires. Non-unions should be treated with curettage and bone-grafting.

Adult↗
PubMed1984

Total rupture of pectoralis major muscle in athletes.

Total rupture of the pectoralis major muscle is rare. It may follow a severe trauma or strenuous athletic exercise or performance. Five cases of total rupture of the pectoralis major muscle treated in athletes are reported. Two of them had made an extremely exerted effort in weight lifting, one was injured during a parachute landing, one was tackled in an ice hockey match, and one injured his pectoralis major muscle while pushing himself up from a swimming pool. In two cases the diagnosis was made early and in three cases 2-4 months after the injury. All of the patients were male and were treated successfully with surgery. Later they were able to exercise their sports. The weight lifters did not go on with competitive sports.

Adult↗
PubMed1984

Stress fracture of the mid-tibial shaft.

In a series of 151 tibial stress fractures in athletes and joggers, seven were located at the mid-third of the diaphysis. The diagnosis was made radiographically several months after the onset of symptoms; a transverse fissure line or gap was noted in the middle of the hypertrophied anterior tibial cortex. Histologic examination of a biopsy of the fracture line showed features resembling pseudoarthrosis. All the patients returned to physical activities.

Adult↗
PubMed1984

Posttraumatic osteolysis of the distal ends of the clavicle. Report of three cases.

Three cases of posttraumatic osteolysis of the lateral end of the clavicle are described. Two of the patients were judo participants who fell on their shoulder. They were treated primarily as partial acromio-clavicular joint dislocations. The third patient was a woman who fell from her bicycle and was treated surgically by a Knowless nail because of acromio-clavicular dislocation. The clinical and radiological findings of osteolysis developed slowly. The joint line was typically widened in the radiographs. The disorder settled spontaneously within one year. Further judo training was possible without symptoms. Distal osteolysis of the clavicle is a rare condition and it may well occur during injury at sport.

Acromioclavicular Joint↗