Biomedical subjects

E Silvennoinen

Publications and source records attributed to E Silvennoinen.

17 recordsLinked to original sources

PubMed1999

Outbreak of viral gastroenteritis due to drinking water contaminated by Norwalk-like viruses.

Heinävesi, a Finnish municipality with a population of 4860 inhabitants, had an outbreak of gastroenteritis in March 1998. On the basis of an epidemiologic survey, an estimated 1700-3000 cases of acute gastroenteritis occurred during the outbreak. Municipal water consumption was found to be associated with illness (risk ratio [RR]=3.5, 95% confidence interval, 3.11>RR>3.96). Norwalk-like virus (NLV) genogroup II (GGII) was identified in untreated water, treated water, and 4 tap water samples by use of reverse transcription-polymerase chain reaction. This was the first time NLVs had been detected in municipal tap water. Fifteen of 27 patient stool samples had NLV GGII, with an identical amplification product to that found in the water samples, indicating that the outbreak was caused by this virus. In some patients, NLV genogroup I was also encountered. This virus, however, could not be detected in the water samples. Inadequate chlorination contributed to the survival of the virus in the water.

Caliciviridae Infections↗

PubMed1996

Noncholesterol sterols in bile and stones of patients with cholesterol and pigment stones.

Human bile and cholesterol gallstones contain sterols including methylated (lanosterol and other dimethyl and monomethyl sterols), and demethylated cholesterol precursor sterols (delta 8-lathosterol, lathosterol, and desmosterol), plant sterols (campesterol and sitosterol), and cholestanol. The aim of the study was to analyze the noncholesterol sterols in gallbladder bile and stones from female and male patients with cholesterol stones (CS) and pigment stones (PS) to ascertain whether any sterol fraction contributes to the gallstone formation. Classification of gallstones to CS and PS was performed on the basis of the stone cholesterol content. The study group consisted of 165 consecutive cholecystectomized patients, 150 with CS and 15 with PS. Bile acids and sterols were quantitated using gas-liquid chromatography (GLC). The biliary lipid and noncholesterol sterol/cholesterol proportions were similar in the CS and PS patients. The proportions of methylated and plant sterols were significantly lower in the CS than in bile, whereas those of delta 8-lathosterol, lathosterol, and cholestanol were significantly higher. The PS, in contrast to the CS, were neither sex nor weight related. The bile acid and phospholipid concentrations and the proportions of lanosterol, delta 8,24-dimethylsterol, and sitosterol were up to 50 times higher and those of delta 8-lathosterol and lathosterol twice lower in the PS than in the CS. The results suggest that, in general, the stones with low cholesterol content are proportionately richer in nonpolar precursor and plant sterols and lower in demethylated precursors, the situation being opposite for the CS. The stone/bile ratios suggest that in both stone groups, but especially in the CS, levels of the polar precursor sterols and cholestanol were enriched in the stone, whereas levels of the nonpolar precursor sterols, and to a lesser extent plant sterols, were not enriched in the stone despite their high biliary proportions.

Bile↗

PubMed1990

Intestinal adhesions: an overlooked cause of the postcholecystectomy syndrome.

Intestinal adhesions after cholecystectomy are a possible cause of abdominal complaints. In this prospective autopsy study, we examined the frequency of intestinal adhesions in 100 consecutive patients who had had a cholecystectomy at some stage in their medical history. In addition, we retrospectively surveyed the patients' files in order to clarify the presence of significant postoperative abdominal complaints indicated by recordings of relaparotomy or gastrointestinal examinations in hospital after the initial cholecystectomy. We found that 9 (9%) of the patients had severe intestinal adhesions (small bowel or caecum tightly fixed to the bed of the gallbladder, forming a kink) at autopsy. Relaparotomy had been performed on 4 (4%) patients. Thirty-four (34%) patients had had significant abdominal complaints. The presence of these adhesions, particularly of distal ileum (6 patients), significantly (p = 0.005) accumulated in patients with recordings of postoperative complaints. The tumours, or tumour-like scars, in the cystic duct-stump and choledochal region found in 15 (15%) patients also independently correlated (p = 0.04) with the postoperative abdominal complaints. Other autopsy findings, such as peptic ulcers, cystic remnants, or choledochal stones showed no association with the complaints. We conclude that intestinal adhesions and scars in the choledochal region are clinically significant and relatively common causes of abdominal complaints after cholecystectomy, and that they should be considered after other causes, e.g. those of biliary origin, have been excluded.

Adult↗

PubMed1987

Gastroduodenal peptic ulcers, duodenal adhesions, and upper gastrointestinal motility disturbances in patients who have undergone cholecystectomy.

The frequency of duodenal and gastric ulcer disease, the thickness of the pyloric muscle, and adhesions of the duodenum were evaluated in a routine, consecutive, prospective autopsy series of 100 patients, and the length of the pyloric canal, adhesions of the duodenum, and motility disturbances in the upper gastrointestinal series were studied in a separate radiologic material of 69 symptomatic patients with cholecystectomy in their history. Both series were compared with matched unoperated controls. The frequency of active gastric ulcers and ulcer scars was observed to be increased and that of active duodenal ulcers and ulcer scars decreased among the cholecystectomized patients in the autopsy series (p = 0.01 in both cases). This difference was not as pronounced when only active ulcers were included, but for active duodenal ulcers the difference was still significant (p = 0.04). One-fourth of the cholecystectomized patients but none of the controls had severe adhesions of the duodenum. In the autopsy series the thickness of the pyloric muscle and in the radiologic series the length of the radiologic pyloric canal were thickened/lengthened in an average of 26%/11% in patients who had undergone cholecystectomy (p less than 0.001 and p less than 0.10, respectively). The lengthening of the pyloric canal was in significant positive correlation with the motility disturbance/adhesion score of the upper gastrointestinal series.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

Diagnosis of acute knee ligament injuries: the value of stress radiography compared with clinical examination, stability under anaesthesia and arthroscopic or operative findings.

A consecutive series of 85 stress radiographic examinations was performed in order to evaluate the clinical reliability and use of stress radiography in disclosing acute knee ligament injuries. Eighty-three examinations were performed within one week of the injury. Sagittal stress examination discovered 27% of the 37 anterior cruciate ligament (ACL) tears and all four posterior cruciate tears. Valgus stress detected 56% of the medial collateral tears. The specificity of stress radiography was even reduced by the number of false positive stress results (n = 25) in posterior drawer or valgus-varus examinations. An ACL tear was, however, an isolated or major ligament injury in twenty (80%) of the false positive results. Clinical examination revealed all the medial collateral tears whereas only 40% of the anterior cruciate tears. The most reliable method for diagnosing acute knee injuries where clinical examination has failed in disclosing instability is examination under anaesthesia supplemented by acute arthroscopy.

Adolescent↗

PubMed1981

Comparison of dextranomer and streptokinase-streptodornase in the treatment of venous leg ulcers and other infected wounds.

The clinical efficacy of dextranomer (Debrisan) and streptokinase-streptodornase (Varidase) was compared in a controlled randomized in-patient study. There were two patient groups: Group A consisting of 28 patients with a total of 31 venous leg ulcers and Group B consisting of 56 patients with other infected wounds (posttraumatic and postoperative wounds, amputation stumps, burn wounds, arteriosclerotic ulcers, decubital ulcers, ulcers due to bone disease, rheumatic ulcers, ulcers due to erysipelas and wounds of mixed aetiology). Both agents have a good cleansing effect as well as a good effect on infection and wet necrosis. Dextranomer stimulates the formation of granulation tissue faster than streptokinase-streptodornase.

Bacterial Infections↗

PubMed1981

Tinidazole in the prophylaxis of post-appendicectomy infections.

A total of 223 consecutive suspected appendicitis patients were treated preoperatively with parenteral tinidazole or physiological saline (control group). An infusion of 500 mg tinidazole was given to 110 patients over 30 minutes beginning about 30 minutes before the start of the operation, the control group comprised 111 patients. Postoperative infections were diagnosed in three patients in the group receiving tinidazole (3%) and in 17 patients in the control group (15%). The difference was statistically significant. There were no side-effects due to the drugs. Tinidazole appears to be well suited to the prophylaxis of post-appendicectomy infections.

Adult↗

PubMed1970