Nils Gunnar Toremalm

Histologic features of the temporomandibular joint disk and posterior disk attachment: Comparison of symptom-free persons with normally positioned disks and patients with internal derangement☆

To gain further knowledge about the differences between normal and pathologic anatomy of the temporomandibular joint disk, we examined histologically disks obtained at autopsy from 10 symptom-free persons and compared our findings with observations involving 17 surgically removed disks. The surgical patients had internal derangement and severe long-standing temporomandibular joint pain and dysfunction. The normal disks were biconcave, whereas the surgically removed disks were deformed and thicker than the normal disks. Chondrocytes (4 joints), a surface layer of proliferative connective tissue (4 joints), vessels (2 joints), and splitting (4 joints) were seen in the surgical specimens but not in the normal specimens. The surgical specimens also showed higher maximal density of fibroblasts and vessels. It was concluded that surgically removed temporomandibular joint disks demonstrated several histologic alterations that were not seen in normal disks. These characteristics may serve as the basis for development of a histologic grading of pathologic conditions of the temporomandibular joint disk and the posterior disk attachment.

A Method for Standardized Studies of Mucociliary Activity

A method for observing ciliary activity of mucous membrane is described and tested. Ordinary laboratory equipment is used. Variations of surface light reflections due to secretional wave movements are recorded under various conditions. The temperature and humidity parameters can be controlled. The method is standardized with regard to the following variable factors:(1) intensity of light source, (2) optical and electrical magnification, (3) extent of area observed, and (4) recording speed. Rheological aspects of the mucociliary system will be discussed further in subsequent papers, together with temperature and humidity effects.ZUSAMMENFASSUNGEine Methode zur Beobachtung der Flimmeraktivitat von Schleimhautepithelen wird beschrieben und erprobt. ubliche Laboratoriumsausrustung kommt zur Anwendung. Die durch Sekretwellenbewegungen verursachten Veranderungen des Lichtreflexes von der Schleimhautoberflache werden unter verschiedenen Bedingungen registriert. Temperatur und Feuchtigkeit konnen kontrolliert wer...

The Influence of Temperature On Mucociliary Activity Temperature range 20°C-40°C

In vitro experiments have been performed on mucous membranes from rabbit tracheae in order to investigate the influence of temperatures between 20° and 40°C on the mucociliary activity.The following results have been obtained:1. The mucociliary activity including mucociliary wave frequency and coordination of wave patterns is most regular at or near the body temperature.2. From body temperature to room temperature a 50 % reduction of the wave frequency was demonstrated together with irregular changes in frequency and amplitude.3. The effect of temperature alterations was reversible within at most 3 hours.4. The relationship between mucociliary wave movements and temperatures between 20° and 40°C looked practically linear, contrary to most temperature-dependent physiological processes. This indicates that more than one factor is involved in the surface light reflections, e.g. the intracellular activity and mucus rheology.

The Mucociliary Activity of the Upper Respiratory Tract

A clinical in vivo - in vitro method for functional mucociliary studies via surface-light reflections is described as well as a method for intracellular recording of electrical activities in ciliated cells. Two types of surface-light reflections can be recognized - one from the secretion layer and one from the tops of lashing cilia. Internal and external cell activities als well as muco-rheological factors can be compared under the control of environmental influences such as air temperature, humidity and gas mixtures. The method can also be used for different clinical purposes.

A Heat-And-Moisture Exchanger for Post-Tracheotomy Care An Experimental Study

This paper deals with the variations in perspiratio insensibilis during normal nasal respiration and breathing through a tracheostoma. Widely used methods for moistening the inspired air of tracheotomized patients are listed and discussed. An aluminium foil heat-and-moisture exchanger (HME) for direct application to the tracheal cannula is described and tested experimentally in order to determine its air flow resistance as well as its heat and moisture recovery efficiency.

The Daily Amount of Tracheo-Bronchial Secretions in Man: A Method for Continuous Tracheal Aspiration in Laryngectomized and Tracheotomized Patients

A new method for intermittent self-regulated aspirations of tracheobronchial secretions (TBS) through a modified tracheal cannula provided with a heat-and-moisture exchanger is described and tested on laryngectomized and tracheotomized patients. The normal source, elimination and daily amount of the total respiratory tract fluid (RTF) and of the pure tracheo-bronchial secretions in adults are briefly discussed on the basis of the present results. It is assumed that the daily output of TBS does not exceed 0.5 ml per kg body-weight per 24 hours during physiological conditions. The suction device may also be used for therapeutic aspirations.

Air-Flow Patterns and Ciliary Activity in the Trachea after Tracheotomy: A Method of Determination in vitro of the Kate of Ciliary Beat in a Tracheal Model

An experimental method for studying the rate of ciliary beat on pieces of respiratory mucous membranes exposed to artificial to-and-fro ventilation has been evolved and tested.The influence on the rate of ciliary beat exerted by some aerodynamic factors just below a constriction (e.g. the larynx, a tracheal cannula, a pathological stenosis) in the airways is demonstrated.The efficiency of heat-and-moisture exchangers (HMEs) used in posttracheotomy care appears from their influence upon the function of respiratory mucous membranes.It is also shown that ciliary activity, which has been stopped by drying for a short time, can be regained with the use of a HME.Finally, the present method seems well suited for testing the influence exerted by single physical factors and also by chemical substances on the rate of the ciliary beat of respiratory mucous membranes.

POSTOPERATIVE CARE AND COMPLICATIONS AFTER TRACHEOTOMY IN INFANTS AND CHILDREN: A Clinical and Experimental Study

A continuous uniform post‐tracheotomy care adopted in a hospital with more than 200 tracheotomies annually is described. No noteworthy complications were seen in 25 consecutive cases of children under 10 years of age. The results are compared with earlier statistics, and prophylactic steps are discussed.

LXXIV A Method for Humidifying Inspired Air in Posttracheotomy Care

Al l over the world the number of tracheotomies has increased during the last decade owing to extended indications. Attention has more and more tended to be focused on the postoperative care of these cases since the majority of complications, above all pulmonary ones, appear in the postoperative stage (e.g., tracheobronchitis, atelectases, pneumonias, etc . ) . Infection and secretional occlusion of the air passage are favored by several factors, e.g.:

Mucociliary Wave Pattern An analysis of surface light reflections

Experiments were performed regarding surface light reflections obtained from the rabbit trachea in vitro with a standardized method using a microscope-photo-multiplier technique. Comparative experiments have been made on a water surface with induced surface waves. The result of these studies revealed that the surface reflections obtained from mucous membranes of the respiratory tract are composed of at least two components, i.e. from the mucous surface and from the carpet of cilia beneath the surface.ZUSAMMENFASSUNGMittels einer standardisierten Mikroskop-Photomultiplikator-Technik sind in in vitro Experimenten die Lichtreflexe von der Oberflache der Trachealschleimhaut von Kaninchen studiert worden. Vergleichende Versuche wurden an einer Wasseroberflache mit induzierten Wellen durchgefuhrt. Durch die Resultate von diesen Studien konnte nachgewiesen werden, dass sich die Oberflachenreflexe von respiratorischer Schleimhaut aus mindestens zwei Komponenten zusammensetzen, und zwar dem Reflex von der Schleimo...