[Fractures visible in the thoracic radiographs of alcoholics].
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Biomedical subjects
Publications and source records attributed to A Kivisaari.
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In a review of 127 urethrocystograms carried out on 92 males with spinal cord injury the following conclusions were drawn. (1) In the presence of vesico-ureteric reflux or urethral reflux into the male adnexa, bladder outlet obstruction should be suspected. (2) Lesions of the anterior urethra develop easily as the result of indwelling catheterisation in patients lacking sensation. A retrograde urethrogram is necessary to demonstrate these lesions. (3) Severe trabeculation of the bladder wall can be a sign of high-pressure outlet obstruction. (4) Dilatation of the bladder neck in patients with detrusor sphincter dyssynergia may lead to total urinary incontinence after sphincterotomy. (5) Urethrocystography is not a valid investigation to detect bladder stones.
Two hundred and six intravenous urograms on 119 patients with spinal cord injury were reviewed and the findings correlated with the clinical data. Fifty (42%) of 119 patients had pathological changes in their upper urinary tracts. The most common feature was impaired renal emptying. Patients with normal and pathological upper tracts had similar findings according to the number of positive urine cultures during the first post-injury year, but in the follow-up those with pathological urograms showed bacteriuria significantly more often. Febrile urinary tract infections at least once a year were encountered in the follow-up of 40% of the patients with pathological urograms, as compared with 8% with normal urograms. All patients with severe renal changes had impaired emptying from the kidneys. This supports the view that the basic patho-physiological mechanism leading to upper tract deterioration in patients with spinal cord injury is a functional or mechanical obstruction of the lower urinary tract. This should be treated actively before irreversible renal changes develop.
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Comparisons of the non-ionic medium iohexol with the ionic media Na-Ca-Mg metrizoate and meglumine iodamide, were performed in two separate trials. The difference in diagnostic properties between the media was not significant. There was a significantly lower frequency of subjective sensations after iohexol than after metrizoate, whereas the difference between iohexol and iodamide in this respect was small. Regarding other adverse reactions there was a small advantage in favour of iohexol compared with metrizoate, whereas iohexol caused significantly less adverse reactions than iodamide.
A 77-year-old man with spontaneous rupture of an abdominal aortic aneurysm into the left renal vein, in the presence of an anomalous retroaortic left renal vein is described. The patient was operated and recovered without complications. In the previous literature seven similar cases were found.
The renal blood flow as examined in six dogs for 2 h after contrast agent injection into the renal artery using the dye dilution method. After injection of an ionic contrast agent (iodamide) there was an initial vasodilatation and later constriction, but the blood flow was back to normal after 10-15 min. Ioxaglate caused a similar initial response, but after a relatively large dose the blood flow remained below normal for 2 h. Metrizamide caused an immediate reduction in the blood flow, which remained constantly reduced for 2 h. A total cessation of the renal blood flow was seen in two cases.
Fifteen patients with frequent anginal chest pain underwent diagnostic cardiac catheterization. After coronary arteriography a specially designed cardiac catheter was seated in the aortic root, permitting the continuous infusion of krypton-81m into the right and left aortic sinuses. A gamma camera, areas of interest and a visual display unit were used to record images and the regional myocardial equilibrium of activity before, during and after a standarized atrial pacing test. The unique physical properties of krypton-81m allowed the continuous imaging and recording of moment to moment changes in regional myocardial perfusion. This investigation revealed that when the coronary arteriogram was normal or revealed lumonal stenosis of less than 50 percent, regional myocardial perfusion was uniform at rest and during stress. Two patients with a previous history of myocardial infarction had defects of regional perfusion at rest and during stress. Krypton scintigraphy demonstrated reversible regional defects in myocardial perfusion during stress in seven patients with greater than 70 percent stenosis of one or more coronary arteries. Alterations in regional myocardial perfusion occurred within 30 seconds of the start of atrial pacing in all the patients and preceded the onset of electrocardiographic signs of ischemia or chest pain.
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A computed radiography system (Digiscan, Siemens) connected to an image workstation (Siemens) has been used for 1 1/2 years in our department. The image quality is good and it has been possible to reduce radiation dose by about 30% without any appreciable loss of image quality. The image workstation has been used in cases where image postprocessing is considered to be useful. For routine reporting of X-ray images the workstation is too slow although the image quality is comparable to that of the computed radiography film.
To evaluate the use of ultra low-field (0.02 T) magnetic resonance (MR) imaging in the diagnosis of musculoskeletal infection, MR examinations with T2 weighted sequences were performed in 61 patients thought to be suffering from one of four major diagnostic categories: Soft-tissue abscesses (n = 22), osteomyelitis (n = 21), septic arthritis (n = 9) and spondylitis (n = 9). Infection was confirmed for 37 of these 61 patients. The verified abscesses, arthritis, spondylitis and acute osteomyelitis could be detected by 0.02 T MR. The sensitivity was poor in cases of chronic osteomyelitis. There was one false positive finding in a patient with a possible soft tissue infection. The 0.02 T MR examination failed four times. Two patients were too heavy and another 2 patients had magnetic material in or near the scanning field. Compared with computed tomography and isotope scanning, 0.02 T MR proved a little more informative, but without any statistical significance.