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Biomedical subjects

U Lindblom

Publications and source records attributed to U Lindblom.

At least 37 records · Page 2Linked to original sources
PubMed1988

Diagnostic value of quantitative sensory testing (QST) in carpal tunnel syndrome.

The initial sensory symptoms of carpal tunnel syndrome (CTS) are usually intermittent and the clinical neurological examination is often normal. The aim of the present study was to determine the rate of impairment of different somatosensory modalities in CTS by means of the following tests: vibrametry, tactile pulses, von Frey hairs, two-point discrimination (2-PD), graphesthesia and warm and cold perception thresholds. The material consisted of 33 hands with CTS from 22 patients. Each of the first 3 tests was abnormal with elevated thresholds in 17 CTS hands (52%), 2-PD was abnormal in 10 hands (30%), graphesthesia in 8 hands (24%), and warm and cold thresholds in only 5 hands (15%). There was an overlap so that at least one test was abnormal in 27 of the 33 CTS hands (82%). Thus, impairment of sensibility can be demonstrated in a majority of patients with CTS if more than one test is applied. Vibrametry and von Frey hairs are recommended instead of the commonly used 2-PD, since abnormality was more often revealed and since they are equally easy to apply. No individual test was sensitive enough to qualify as a diagnostic criterion when it was applied with the hand in resting position. A significant increase in both sensitivity and specificity can be expected for any test if it is combined with provocation, such as wrist flexion, as has been demonstrated for vibrametry.

Adult↗
PubMed1988

Does acute intraoral pain alter cutaneous sensibility?

Cutaneous sensibility was tested in eight patients suffering from acute postoperative intraoral pain. Tactile-, cold-, warm-, and heat-pain thresholds as well as reaction time to cold pulses were unaffected by the presence of pain. However, reaction time to warm pulses was increased in the painful area on the day of pain compared to a non-painful state. The findings are discussed in relation to (1) functional convergence of different sensory fibres on central neurons (2) the phenomenon of diffuse noxious inhibitory controls and (3) secondary hyperalgesia. The observed effect of clinical pain on the warm pathway could be explained as an intrasegmental noxious inhibitory effect.

Adolescent↗
PubMed1988

Long-term clinical results after combined aortic and mitral valve replacement.

The results after 282 consecutive double (aortic & mitral) valve replacements (DVR) are compared with our previously reported experience after mitral (MVR, n = 810) and aortic valve replacement (AVR, n = 1753). All but one patient received Björk-Shiley valves. The follow-up which closed on August 1, 1985 was 99.3% and covered 16,869 patient-years (mean 6.3 years/patient). Autopsies were performed in 74% of all fatalities. Early mortality rates were identical in the three patient groups, and late mortality did not differ between MVR and DVR patients. The fraction of valve-related mortality was similar in all groups. Anticoagulant-related bleeding was equally common in all patient groups. The incidences of thromboembolism, reoperation and valve failure did not differ between MVR and DVR patients, but were significantly higher than among AVR patients. With the exception of a slightly increased incidence of prosthetic valve endocarditis, the results after DVR equal those after MVR. In cases with severe mitral valve disease but borderline aortic valve disease, primary DVR is clearly justified and eliminates the need for, and risks of, a secondary AVR.

Aged↗
PubMed1987

Sensory reinnervation and sensibility after superficial skin wounds in human patients.

In humans the innervation and sensibility after a superficial skin wound, the donor site for medium split thickness skin grafts, was investigated using sensibility tests and indirect immunohistochemistry with antibodies to neurofilament. After one to two weeks extensive sprouting of neurofilament immunoreactive nerve fibers was observed. Four weeks after the operation the wound had healed and the sensibility and distribution of neurofilament-positive nerve fibers resembled that of normal unoperated skin. These findings are discussed in view of recent studies indicating a role of sensory neurons in inflammation and wound healing.

Fluorescent Antibody Technique↗
PubMed1987

Sensory involvement in distal myopathy (Welander).

Eleven patients with Welander distal myopathy were subjected to detailed sensory testing including measurements of perception thresholds for vibration and temperature in both hands and feet. The threshold values were compared with normal, age-corrected values and also with data from an age-matched control group consisting of patients with antecedent poliomyelitis with the same degree of paresis. The screening examination indicated impaired thermal sensibility in all 11 patients and impairment for at least one other sensory modality in 9 patients. In comparison with age-corrected normal values, the measured warm-cold difference limen was abnormal in the feet of 9 patients and the vibratory threshold at least at one test point in 6 patients. When compared with the data from the paretic controls, the thermal abnormality was significant with regard to warm and cold thresholds, the warm-cold difference limen and the heat pain threshold. The vibration threshold abnormality was significant in the feet. It is concluded that sensibility impairment is present in Welander's myopathy indicating a peripheral sensory neuropathy involving both unmyelinated (C-fibers) and myelinated fibers.

Aged↗
PubMed1987

Cortical evoked potentials and somatosensory perception in chronic spinal cord injury patients.

The correlation between somatosensory evoked potentials (SEPs) and sensory perception was studied in 110 patients with traumatic chronic spinal cord lesions. Perception thresholds over the legs for light touch, vibratory sensibility, temperature and thermal pain were tested together with recordings of tibial and peroneal SEPs. Tibial nerve SEPs correlated better with sensory perception than peroneal nerve SEPs. Normal tibial nerve SEPs were not present with absent or trace vibratory sensibility and vice versa. However, we found many exceptions to the correlation between temperature and pain perception and SEPs. Light touch, vibratory sensibility, and SEPs were highly correlated between each other, while temperature and pain perception correlated poorly to these other modalities. This represents an evident segregation of touch perception, vibratory sensibility and SEPs, which are thought to share dorsal columns as a common ascending pathway, and temperature and pain perception known to be related to the spinothalamic system.

Adolescent↗
PubMed1987

Sensibility and cutaneous reinnervation in free flaps.

Sensibility and sensory reinnervation were investigated in 19 free flaps, predominantly located on the lower extremities, between 2 months and 3 years after flap transfer. All patients showed deep pressure sensibility. In 10 of the patients, primarily those examined late after surgery, a heat pain threshold was obtained at about 50 degrees C. None of the patients had superficial sensibility of any other modality. No neurofilament-positive sensory nerve fibers were observed in the dermis or epidermis. In one patient nerve fibers were detected in the subcutaneous tissue. It is concluded that patients will have deep pressure sensibility of the flap area even early after the operation and that most patients will develop a heat pain sensitivity, probably due to subcutaneous reinnervation.

Adolescent↗
PubMed1987

Three-year clinical results with the Monostrut Björk-Shiley prosthesis.

Between November 1981 and June 1983, 351 patients underwent valve replacement with the Monostrut Björk-Shiley prosthesis. There were 214 aortic valve replacements, 101 mitral valve replacements, and 31 double (aortic and mitral) valve replacements. Four patients had valve implanted in the tricuspid position, and one patient underwent exchange of a valved, extracardiac conduit. Mean age was 61 years (range 2 to 78) and 186 (53%) were male. Concomitant procedures were performed in 52 patients (15%) and 17 (5%) were emergency operations. Early mortality (4.3%) was related to New York Heart Association Functional Class IV, emergency operation, or the presence of a concomitant procedure. Follow-up was 100% and covered 870 patients-years (mean 2.6 years per operative survivor). Postmortem examination was performed in 38 (79%) of the 48 fatalities. Only one patient suffered a sudden, unexplained death. The 3 year survival rate (early mortality excluded) was 88.6% (aortic valve replacement 89.2%, mitral valve replacement 89.3%, and double valve replacement 82.5%). The 3 year freedom from thromboembolism in patients receiving anticoagulants was as follows: aortic valve replacement 97.5%, mitral valve replacement 92.8%, and double valve replacement 100%. There were no instances of valve thrombosis or fatal embolism. In contrast, there were two instances of aortic valve thrombosis among 34 patients having aortic valve replacement without anticoagulation. The 3 year freedom from valve failure (modified Stanford definition) was as follows: aortic valve replacement 96.0%, mitral valve replacement 93.9%, and double valve replacement 89.7%. There were no mechanical failures. In conclusion, the Monostrut Björk-Shiley valve showed a low incidence of complications. There were no mechanical failures, no fatal emboli, and, when anticoagulants were administered, no valve thromboses.

Actuarial Analysis↗
PubMed1986

Sensibility after burn injury.

Thresholds for touch, temperature, pain and two-point discrimination were examined in 27 healthy subjects and in 36 burn patients. Three groups of injuries were examined; superficial dermal burns, which were allowed to heal spontaneously, deep dermal and subdermal burns treated by either early or late excision and skin grafting. Uninjured areas on the contralateral side served as control. In spontaneously healed superficial burns, the sensibility recovered to normal, except for touch. In deep dermal or subdermal burns all thresholds were significantly higher than in the corresponding control areas. There was no recovery beyond one month after the injury. The sensibility was better on the upper than on the lower extremities and also in deep dermal than in subdermal burns. There was no significant difference in sensibility between burns excised and grafted early or late, respectively. The results indicate that current treatment of deep dermal and subdermal burns is not followed by complete recovery of cutaneous sensation. Furthermore, even superficial burns results in incomplete recovery of touch sensibility.

Adult↗
PubMed1986

Vibratory perception thresholds at the clavicle in patients with spinal cord injury.

Vibratory perception thresholds were measured by an electromagnetic device applied over the clavicles of 64 patients with spinal cord injuries. Patients with neurological levels of C5 and below had low threshold values (0.63 +/- 0.23 micron of vibration amplitude; mean +/- SD) which were used as reference values. The patients with a neurological level of C1/2 had very high vibratory thresholds bilaterally (above 11.0 micron). Patients with C2/3-3/4 neurological levels also had significantly elevated thresholds (2.56 +/- 2.01 micron), while those with C4-C4/5 levels did not differ significantly from the reference group. The results agree with earlier observations that the C4 segment innervates the clavicle and imply that patients with a lesion at or above C4 may have elevated clavicular vibratory thresholds. It is concluded that vibrametry, a non-invasive technique, is applicable in patients with spinal cord injury and disease, and can be useful for assessment of sensory level and particularly for follow-up of such patients.

Adolescent↗
PubMed1985

Thermal sensitivity in uremic neuropathy.

Clinical neurological examination, nerve conduction velocity measurements, and quantitative tests of thermal and vibratory sensitivity were performed in 64 non-diabetic uremic patients, who were all treated with chronic maintenance dialysis. Clinical or neurographic signs of neuropathy were found in 83% of the patients. The most common abnormalities were reduced nerve conduction velocity, increased vibratory perception threshold, loss of tendon reflexes, and impaired temperature sensibility. Hypesthesia to pinprick or touch, or paresis were rarely found and none of them was ever the first sign of neuropathy. Thermal sensation was abnormal in 30% of the patients, which is a much higher prevalence than that which has previously been reported. There were no significant correlations between measures of thermal sensation and measures of large fibre dysfunction. Impaired thermal discrimination was the first sign of neuropathy in 15% of the patients. This indicates that a small fibre uremic neuropathy may exist as a separate entity.

Adult↗
PubMed1982

Neurophysiological measurement of pain.

Neurophysiological measurement of pain is a research goal rather than a reality today. The gap may be narrowed by combining different techniques. Electrophysiological methods with stimulation and recording directly from the afferent pathway should contribute to a more specific and differentiated picture of the mode of action of analgesics, as a basis for development of new therapies. Such electrophysiological methods can be combined with behavioural studies, both in humans and in animal pain models.

Electroencephalography↗
PubMed1980

[Sensitivity disturbances in patients with neurological pains (author's transl)].

The classical neurological investigation does not provide a satisfactory basis for a clear assessment in most patients with neuralgia. On the other hand, treatment up to now has remained problematic. In this situation measurements of sensitivity may be of benefit: they permit a precise diagnosis and follow-up of the lesions and moreover enable valuable statements allow on the pain perception of the patient. In this paper, the examination procedures for three types of sensitivity are described: touch, temperature and thermic pain. Examples of their application are discussed.

Evoked Potentials↗