[Localization of a spontaneous cerebrospinal fluid fistula using metrizamide CT cisternography].
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Aged↗
Biomedical subjects
K Jokinen
Publications and source records attributed to K Jokinen.
Flupenthixol versus diazepam in the treatment of psychosomatic disorders: a double-blind, multi-centre trial in general practice.
In a Finnish general practice 120 patients with psychosomatic disorders, manifest as syndromes of tension headache, cardiac neurosis, dizziness or muscular tension, were randomly allocated to treatment over a 4-week period with either flupenthixol (1 to 2 mg per day) or diazepam (5 to 10 mg mg per day). The 4 syndromes and 12 associated symptoms (anxiety, fatigue, depression, pain, asthenia, muscle fatiguability, tension, dyspnoea, restlessness, palpitations, sleep disorders, and vertigo) were rated on a 4-point scale on entry, at 2 weeks and at 4 weeks. Both drugs reduced significantly the average total scores for syndromes and single symptoms after 2-weeks' treatment. Flupenthixol was the more effective in relieving fatigue and vertigo; diazepam in relieving headache, anxiety, tension, restlessness and sleep disturbance. Cardiac neurosis, palpitations and general muscular tension responded poorly to both drugs. After 4 weeks, relief of vertigo, pain and fatigue was more evident in the flupenthixol group, and of anxiety, tension and restlessness in the diazepam group. Side-effects were complained of at some stage by 17 patients in the flupenthixol group (9 of fatigue, 5 of sleep disturbance, 1 of constipation, 1 of extrapyramidal symptoms, and 1 of weight gain) and by 16 patients in the diazepam group (10 of fatigue, 4 of sleep problems and 2 of diarrhoea).
Adult↗
Intranasal ipratropium in the treatment of vasomotor rhinitis.
Ipratropium administered in the form of a nasal spray was compared with placebo in 30 patients with vasomotor rhinitis in a double-blind cross-over trial. There was a significant reduction in nasal hypersecretion during ipratropium treatment, but no effect on nasal blockage, sneezing or tickling. On the whole, 20 patients (66.7%) considered ipratropium worth using. 11 patients had mild side- effects, mainly nasal irritation, during ipratropium treatment and 7 with placebo. A therapeutical trial with ipratropium is appropriate in the management of severe rhinorrhoea in patients with vasomotor rhinitis.
Administration, Intranasal↗
Symptoms of carcinoma of the oesophagus.
Cancer of the oesophagus in its early stages is relatively asymptomatic, and the establishment of the diagnosis may be delayed because of the failure of the patient to seek early medical attention, or because the initial examining physician made an incorrect diagnosis. A good knowledge of the symptoms of the disease as well as an active role in diagnostic studies aid the physician in rapidly achieving the diagnosis. The most common symptoms in 162 patients with cancer of the oesophagus were: difficulty in swallowing (96%), loss of weight (42%), vomiting (25%), pain in the upper part of the abdomen (20%) and retrosternal pain (20%). The mean duration of symptoms before first presentation for medical attention was 3.1 months, and the correct diagnosis was generally established four to six weeks after the initial visit at the doctor's office. In 21.6% of cases, the initial visit did not lead to the correct diagnosis.
Adenocarcinoma↗
Symptoms and diagnostic delay in patients with carcinoma of oesophagus and gastric cardia: a retrospective study of 225 patients.
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Adult↗
Cryocauterization in the treatment of subglottic hemangioma in infants.
Cryocauterization seems to be an effective method of treating the subglottic hemangioma of infants. A series of five patients is presented. Cryotherapy, at temperatures of --40 degrees C or --70 degrees C for 60 or 30 seconds respectively, was given at intervals of 2 weeks, 3-6 sessions being required. during this time the child usually had to remain tracheostomized. No therapeutic or late complications were recorded. The patients have been followed up from 8 to 3 1/2 years, and none of them have shown disturbances of laryngeal development or predisposition to stricture.
Cryosurgery↗
Bacampicillin in acute maxillary sinusitis: concentration in sinus secretion and clinical effect. A randomized, double-blind study of two dosage regimens.
The clinical effect and the penetration of ampicillin into sinus secretion after oral administration of bacampicillin was studied in 47 patients with acute maxillary sinusitis allocated at random in treatment with 400 mg bacampicillin 3 times or 1200 mg twice daily. The overall clinical effect was similar and was assessed as "good" in 23/25 patients treated with 400 mg doses and in 19/22 treated with 1200 mg. Adverse reactions were reported by 4 patients. The concentrations of ampicillin obtained in sinus secretion were proportional to the dose given. The highest values after 400 mg bacampicillin were approximately 0.6 mg/l and after 1200 mg about 2 mg/l. Both dosages are applicable to treatment of acute maxillary sinusitis.
Acute Disease↗
Psychosomatic disorder: a treatment problem more difficult than neurosis? A comparative clinical study of psychosomatic and neurotic patients of the psychiatric policlinic of a general hospital.
Two patient groups from the psychiatric policlinic of a general hospital were compared, the first comprised 93 patients with severe psychosomatic disorders who were not diagnosed as neurotic, and the second, 133 neurotic patients without psychosomatic symptoms. The aim of the study was to clarify anamnestic and personality differences between the groups and investigate their treatment motivation. The psychosomatic patients showed less motivation for psychiatric treatment, even though their psychiatric impairment was more severe than that of the neurotics and although the extent of their psychological symptoms was equally great. Compared with the neurotic patients, the ability to tolerate stress was poorer and the attitude toward the interview and the interviewer was more defensive in the psychosomatic patients. Compared with the neurotics, medical services were utilized to a greater extent by the psychosomatic patients, and their childhood environment and background development were characterized by somewhat more psychological disturbance.
Adolescent↗
A pharmacokinetic study of bacampicillin in patients with chronic maxillary sinusitis.
The penetration of ampicillin into sinus mucosa and secretion after oral bacampicillin was studied in 30 patients subjected to radical maxillary sinus surgery. Bacampicillin in a dose of 1200 mg was administered orally before the operation and the concentrations in serum, sinus mucosa and secretion were assayed. The mean serum concentration (+/- SEM) reached its maximum of 13.4 +/- 1.2 micrograms/ml in about one hour. The mean concentrations in the secretion and mucosa after two to five hours were 1.6 +/- 0.5 micrograms/ml and 1.6 +/- 0.4 micrograms/ml respectively. The clinical course of the patients was mostly uneventful. Adverse effects probably caused by the drug were found in two cases.
Administration, Oral↗
Disodium chromoglycate therapy in perennial rhinitis.
DSCG was tested on 38 patients with perennial rhinitis in the form of a nasal spray (2%)in a double-blind cross-over trial. Few of the investigated parameters in the whole material showed any significant preference of DSCG. A marked drug order effect was shown; in the group receiving placebo first, most of the clinical parameters assessed both by the clinician and the patient were better for DSCG. A therapeutical trial with DSCG is worth trying in perennial rhinitis.
Administration, Intranasal↗
Chryotherapy in the treatment of subglottic hemangioma in infants.
Congenital laryngeal hemangioma in infants is situated typically in the subglottic region and causes respiratory obstruction at the age of 1--6 months. Hitherto fewer than one hundred cases have been reported. The mortality has been high and the therapy problematic. As a primary measure, tracheotomy must be performed. In the treatment of the tumour itself, large doses of corticosteroids, sclerosing agents, radiotherapy and surgical removal have been used. The results have hardly been encouraging. In five cases we have utilized cryotherapy. The hemangioma disappeared after 3--6 sessions. No therapeutic or late complications were connected with this mode of therapy.
Cryosurgery↗
Chronic intragastric bile contamination and lower esophageal sphincter competence. An experimental study in dogs.
The possible association between intragastric bile reflux and lower esophageal sphincter (LES) incompetence was elucidated in an experimental work in dogs. Chronic intragestric bile contamination was produced by cholecystogastrostomy. The effect of this procedure on LES competence was evaluated by manometric, radiologic and endoscopic studies two weeks, one month, and then once a month for 6 months after operation. No significant change occurred in LES pressure, and neither radiological reflux nor endoscopic evidence of esophagitis developed during the follow-up period. According to the present study intragastric bile reflux does not have a significant role in the pathogenesis of LES incompetence in the dog, but esophagitis effected by bile reflux seems to require previously existing LES incompetence.
Animals↗
Temporal bone findings in the late stage of secretory otitis media.
The temporal bone findings in a patient with secretory otitis media are presented. One ear had been fitted with tympanostomy tubes for five and the other for three years. Before death the latter ear had been without a tube for two years. Histological study revealed secreting tympanic mucosa with a very high density of goblet cells both in the ear with a ventilating tube in position and in the ear with an intact tympanic membrane. The case represents a late stage of secretory otitis media. It seems that ventilating tubes cause the degeneration and disappearance of subepithelial glands but the effect on goblet cells is less pronounced.
Child↗
Evaluation of patients with bronchial carcinoma.
Results of diagnostic procedures are presented on 259 successive patients with bronchial cancer at Päivärinne Chest Hospital during the period 1967-73. The most common tumours were epidermoid (56%), 'small cell' (20.5%) and adenocarcinoma (9.5%). In 106 patients (41%) chest radiography suggested a tumour, though bronchoscopy was normal, and in 22 cases (8.5%) the radiograph was normal but bronchoscopy revealed a tumour. In 10 (4%) both the radiological and the bronchoscopic findings were normal. A definite histopathological diagnosis was reached by bronchoscopy in 144 patients (44%), by mediastinoscopy in 14 (5%), by fine needle biopsy in 28 (11%) and operatively in 103 (40%). Using all methods of treatment prognosis was significantly better in the group that had been diagnosed by mass miniature radiography, or accidentally (29% alive) as compared with those who had symptoms of the disease (6%).
Adult↗
Bronchial findings in pulmonary tuberculosis.
A total of 297 bronchoscopies were performed on 238 patients with pulmonary tuberculosis at the Paivarinne Chest Hospital during the period 1967--1973. The tuberculous process was deemed active in 172 patients and inactive in 66. Active endobronchial tuberculosis was diagnosed in 20 patients, 11.6% of the active cases, whereas inactive sequelae of endobronchial tuberculosis appeared in 7% of the total material. Bronchography was performed on 163 patients; a normal bronchogram was obtained in 54% of the cases with minimal changes, 35% of the moderately advanced cases, 13% of the far advanced and 23% of the inactive cases. Sputum samples were more often positive for tubercle bacilli than the bronchial aspirates, and bacterial cultures from sputum samples were less reliable indicators of infection than were cultures from bronchial aspirates. Cytological smears revealed no difference between these two sampling methods.
Adult↗
Arachnoid cyst of the intraorbital portion of the optic nerve with unilateral disc oedema and transient shallowing of the anterior chamber. A case report.
An unusual occurrence of chronic monocular disc oedema, visual loss and shallowing of the anterior chamber in a patient with an arachnoid cyst involving a portion of the intraorbital optic nerve was reported. Decompression of the optic nerve sheath through a Krönlein approach was followed by prompt deepening of the anterior chamber and a gradual, delayed relief of the disc oedema. It is concluded that orbitotomy and decompression of the optic nerve sheath should be done before atrophic changes of the optic nerve and visual loss begin to develop.
Adult↗