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Biomedical subjects

A Sivula

Publications and source records attributed to A Sivula.

At least 37 records · Page 2Linked to original sources
PubMed1984

Chronic subdural hematoma: demonstration by magnetic resonance.

The ability of magnetic resonance (MR) to identify intracranial hematomas was tested in five patients with clinical and computed tomographic signs of chronic subdural hematoma. The extracerebral collections were displayed as a zone of bright intensity using the T1-weighted inversion recovery (IR 1,500/400) sequence, reflecting the lesions' short T1 relaxation times. The collections also showed high intensity using the spin echo (SE) sequence, with a longer delay of 100 ms and 160 ms, reflecting the long T2 relaxation time. The spin echo sequence with a repetition time of 500 ms and an echo delay of 160 ms (SE 500/160) almost effaced other structures in the image, thus increasing the specificity of this pulse scheme for detection of chronic blood collections. Although in two of the five patients the subdural hematomas were in the isodense CT phase, all were easily visualized with MR.

Adult↗
PubMed1984

The changing picture of primary hyperparathyroidism in the years 1956-1979.

The aim of this study was to examine the development of the clinical appearance of primary hyperparathyroidism in a material of 334 patients operated on for PHPT in the years 1956-79. The material was divided into three parts: 72 patients from the years 1956-70, 102 patients from the years 1971-75 and 160 patients from the years 1976-79. A marked change was observed in the structure of the material: the mean age of both men and women increased, and the group of women over 50 years became dominating. Symptoms such as renal stones, cystic bone changes and hypercalcaemic crisis proportionally decreased, and nonspecific symptoms as malaise, fatigue and various pains increased. The number of asymptomatic patients also steadily increased. The preoperative serum calcium values were lower in the consecutive groups. The number of small adenomas increased but, on the other hand, the number of big adenomas remained the same. The ratio between single adenomas and multiglandular disease remained unchanged in the three periods. In our material, the general development of the clinical appearance of PHPT seems to have taken only one decade. In the latest period PHPT has been diagnosed considerably more often than before, and the disease has usually been treated at an earlier stage. However, the severe forms of the disease have been diagnosed as frequently in all of the periods.

Adenoma↗
PubMed1983

Nuclear magnetic resonance (NMR) imaging of intracerebral hemorrhage in the acute and resolving phases.

Nuclear magnetic resonance imaging of intracerebral hemorrhage revealed a considerable difference in the appearance of the bleedings in the acute and resolving phases. Attention is drawn to the shortening of the relaxation time T1 within the first 2 weeks after the acute onset of symptoms with the location of the change at the periphery of the lesion. The change was most evident with T1 dependent inversion recovery sequence (IR 1,500/400). With this pulse scheme the acute hemorrhage was visualized as a dark area during its early days. A bright zone, reflecting the shorter T1, was not seen until the resolving phase at the end of the 1st week. Although its pathophysiological aspects are so far unknown, this finding may offer an opportunity for dating intracerebral hemorrhages.

Acute Disease↗
PubMed1983

Serial nuclear magnetic resonance (NMR) imaging in patients with cerebral infarction.

Seven patients with supratentorial infarction were studied by means of serial nuclear magnetic resonance imaging using saturation recovery (SR) and proton density (PD) sequences. The earliest changes were visible in the more sensitive T1 dependent images (SR) and may reflect the cytotoxic component of ischemic brain edema. Further progress was also clearly discernible in the PD images and may mainly reflect the slower vasogenic component of ischemic brain edema. Nuclear magnetic resonance imaging seems to provide a new approach to early diagnosis of ischemic brain infarction. Furthermore, it may elucidate some aspects of the pathophysiology of ischemic stroke in man.

Adult↗
PubMed1982

The desmoid tumor. II. Analysis of factors possibly contributing to the etiology and growth behavior.

Eighty histologically verified cases of the desmoid tumor (DT) have been analyzed with regard to factors possibly contributing to the etiology and/or growth behavior of this uncommon neoplasm. Considering the four statistical age components, the "fertile" female and "menopausal" varieties of the DT grew distinctly faster (0.1 less than P greater than 0.05 and less than 0.05), and the female "juvenile" variety distinctly slower (0.1 less than P greater than 0.05) than the male DTs. In a visual estimate, the fertile female patients had a significant (P less than 0.01) predisposition to estrogen predominance, while fewer patients than expected displayed progesterone predominance or were at balance (P = NS and less than 0.01, respectively). Thirty-two per cent of the patients with an abdominal DT had been previously operated in the region of subsequent tumor growth. Significantly more pregnancies were observed in patients with abdominal DT than with extra-abdominal DT (P less than 0.05). On only one occasion did sigmoideoscopy reveal colonic polyposis (Gardner's syndrome). The most striking observation was, however, that up to 80% of the affected patients (compared with less than 5% in the normal control population, P less than 0.05) had multiple minor bone anomalies demonstrable by x-ray screening of the mandible, chest, and long bones. We suggest that a generalized (inherited or mutant) defect in growth regulation of connective tissue is the most important underlying cause for the DT. However, the other factors, including hormonal effects, trauma, and pregnancy contribute to the growth behavior of the tumor.

Adolescent↗
PubMed1982

Familial and sporadic thyroglobulin deficiency with goitre and hypothyroidism.

The thyroid proteins and iodocompounds were analysed in the thyroid tissue of 4 patients with nontoxic goitre. Subtotal thyroidectomy was performed for tracheal compression. The thyroid components were labelled with a trace amount of 125I before operation. One patient had congenital goitre and hypothyroidism with cretinoid features. Three other patients belonged to the same family. Two had congenital goitre, one of them with subclinical and biochemical hypothyroidism. There was a range of thyroglobulin (TG) deficiency ranging from virtual absence of TG in the most affected patient to 17% of normal in the least affected one. There seemed to be an inverse relationship between TG content and clinical signs. Also with decreasing TG more iodocompounds were found in the 3-8 S region on gradient centrifugation. In the most affected patient all the radioactivity was in the 3-8 S region, in the least affected one it was all found in the 19 S and 27 S regions. The other patients had an intermediate pattern. The 3-8 S fraction contained albumin, IgG and some material which reacted like TG on immunoelectrophoresis except for the least affected patient. The iodine content was normal whereas the iodination of TG was low-normal or low. Iodotyrosines and iodothyronines were found in all glands analysed on column chromatography but only in the most heavily affected patient did the ratio iodotyrosines/iodothyronines seem to be elevated. Evidently TG was not necessary for hormone formation in this gland but the efficiency of the matrix seemed not to suffice for normal hormone production.

Adult↗
PubMed1980

Glucocorticoid receptors in adrenocorticoid disorders.

Circulating human lymphocytes contain glucocorticoid receptors (GR). To see if adrenocortical imbalance is associated with changes in the level of GR, several patients with hypo- and hypercortisolism were studied. Peripheral lymphocytes were prepared by Ficoll-Hypaque gradients and were then subjected to a whole cell-binding assay measuring the total cellular receptor pool, with [3H]dexamethasone as the ligand. There were no significant differences in the cellular content of GR among healthy controls, 10 patients with Cushing's syndrome, and 3 patients suffering from Addison's disease; the absolute levels of GR were 4850 +/- 1340, 4900 +/- 2160, and 5640 +/- 1110 (mean +/- SD) receptors/cell, respectively. The mean equilibrium dissociation constants of the interaction of [3H]dexamethasone with the receptor were also about the same in the 3 groups (1-2 X 10(-8) M). Thus, aberrations in glucocorticoid balance strong enough to produce clear-cut clinical symptoms do not result in major alterations in the level of the peripheral GR. We also studied an additional patient who had hypercortisolism due to an adrenal adenoma but only slight clinical signs of hypercortisolism; interestingly, her cellular GR level was only 30% of normal. The lymphocytic GR content was also below normal in 2 patients with anorexia nervosa.

Addison Disease↗
PubMed1980

Pseudohypoparathyroidism associated with hypercalcitoninaemia.

A case of a 33 year old man with type I of pseudohypoparathyroidism associated with hypercalcitoninaemia and deficiency of prolactin and growth hormone is reported. The diagnosis of pseudohypoparathyroidism was made by recognition of the classic skeletal signs of Albright's osteodystrophy and confirmed by an infusion test with parathyroid hormone, which revealed a lack of both a cyclic AMP and phospaturic response. By investigation of the endocrine status the function of the pituitary/thyroid and pituitary/testis axes as well as the adrenal cortex was observed to be normal. The basal prolactin concentration was however, lower than normal and a lack of response in the growth hormone level in two glucagon tests was observed. Furthermore the basal calcitonin level was higher than normal and by provacation with pentagastrine the calcitonin secretion was very high despite an only slightly decreased serum calcium level. By operation the thyroid gland was normal and by light microscopy of a biopsy no signs of medullary carcinoma was observed. No good explanation for the high calcitonin basal level and secretion was found.

Adult↗
PubMed1979

Radiological assessment of nipple-valve insufficienty in Kock's continent reservoir ileostomy.

In a series of 51 continent reservoir ileostomies nipple-valve insufficiency developed in 15 patients who were examined radiographically to find the cause for the loss of continency. The radiological diagnosis was confirmed at reoperation. The causes for nipple-valve insufficiency were a total or partial disappearance of the nipple-valve by sliding of the invaginate (7 cases) and dislocation of an undamaged nipple out of the reservoir (8 cases). In these groups the radiological diagnosis was compatible with the operative findings in all but one case. At reoperation a fistula in the nipple-valve was found in 3 cases, but in no instance had this been diagnosed radiologically. A correct preoperative diagnosis is valuable, especially in cases of dislocation, where a danger exists that the real mechanism of valve insufficiency may remain obscure at operation.

Humans↗
PubMed1979

Detection of iodine, sulphur and phosphorus in histological thyroid sections by using electron probe microanalysis.

Electron probe microanalysis for iodine, sulphur and phosphorus was performed in histological frozen sections from thyroid tissue of 5 patients undergone thyroid surgery for benign disease. Iodine seemed to be localized in the colloid of the thyroid follicles. Phosphorus localized in areas which corresponded with the epithelium of the follicles. Sulphur showed a strong association with iodine both in localization and in relative amounts. It was suggested that iodine and sulphur reflect the presence of thyroglobulin in the colloid of thyroid follicles.

Electron Probe Microanalysis↗
PubMed1979

Suppression of the TSH response to TRH by thyroxine therapy in differentiated thyroid carcinoma patients.

Absent response of serum thyrotrophin (TSH) after stimulation with 200 micrograms synthetic thyrotrophin-releasing hormone (TRH) was used as a criterion of adequate suppression of TSH in the treatment of thyroid carcinoma patients with thyroxine. The mean causing total suppression of the response was 223 micrograms of thyroxine per day. At this dose level about 40% of the patients had serum thyroxine concentrations above the upper reference interval and only 10% had elevated triiodothyronine concentrations. In some patients the TSH response to TRH varied between absent and low normal when tested at long intervals. The ideal dose of thyroxine is obviously slightly higher than the smallest one causing total suppression of the TSH response to TRH, i.e. about 250 micrograms a day. The individual dose must be found using the TRH stimulation test because serum thyroid hormone levels cannot be used as a guideline for adequate dosage. In some patients the thyroid remnant of apparently normal thyroid tissue was not totally suppressed although the thyroxine dose was definitely above the level causing suppression of the response to TRH.

Adenocarcinoma↗
PubMed1979

Parathyroidectomy in chronic renal failure.

During the period 1971-1976, subtotal parathyroidectomy was performed on 34 patients with chronic renal failure, representing 8% of all uraemic patients treated on the Renal Ward. Preoperative treatment of renal failure was conservative therapy in 6, haemodialysis in 20 and renal transplantation in 8 patients. The operation was indicated by grave clinical symptoms (pruritus, bone pains and mental disturbances), gastric ulcer and radiological abnormalities (osteoporosis, fractures, subperiosteal resorption and metastatic calcifications). The serum immunoreactive parathyroid hormone was determined in 13 cases, and the value was elevated in all. The serum calcium level was elevated in 8 out of 34 cases. Less than 500 mg of parathyroid tissue was removed in 12 cases, between 500 and 6000 mg in 19 and over 6000 mg in 3. Nodular hyperplasia was present in 11 patients, diffuse hyperplasia in 23. Postoperatively marked falls in serum parathyroid hormone and serum calcium values were observed. The bone pains, pruritus and mental disturbances were alleviated, and the general condition was favourably influenced. The operation had a lesser and more retarded effect on the radiological changes. Complete recovery was only achieved with successful renal transplant. Parathyroidectomy often had a favourable effect on the grave symptoms and may, therefore, be considered in some cases of severe hyperparathyroidism secondary to chronic renal failure.

Adolescent↗