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Biomedical subjects

M Taavitsainen

Publications and source records attributed to M Taavitsainen.

At least 55 records · Page 3Linked to original sources
PubMed1991

Accuracy of adrenal biopsy guided by ultrasound and CT.

We reviewed the results of fine needle biopsy of the adrenal glands guided by ultrasonography or CT in 56 patients. The final diagnoses, obtained at operation, autopsy or follow-up were: metastasis (n = 22), adenoma (n = 21), adrenal cyst (n = 6), hematoma (n = 3), lymphoma (n = 1), pheochromocytoma (n = 1), lymph node (n = 1), and amyloid mass (n = 1). Sufficient cytologic material was obtained in 96.4% (54/56). The overall accuracy to differentiate benign from malignant disease was 85.7% (48/56), 2 were false-negative, one was false-positive. The biopsy was inconclusive ("possibly malignant") in 3 patients, 2 of whom had an additional cutting needle biopsy yielding a correct positive finding. No complications occurred. We conclude that in disseminated malignant disease with suspected adrenal metastases diagnostic results can be obtained with guided fine needle biopsy. Biopsy in primary adrenal lesions is helpful, especially if the aspirate of the lesion turns out to be composed of something other than adrenal cells.

Adrenal Gland Neoplasms↗
PubMed1991

Ultrasound guidance for pericardiocentesis.

Sonographic guidance with 41 punctures and 38 catheterizations was employed in 68 patients. The approach was either intercostal or subxiphoid. Most punctures were performed with a 1.4-mm-thick plastic-sheathed cannula after local anesthesia. Complications were observed in 7 patients. In one patient a catheter introduced with a movable core-type guidewire pierced the right ventricle wall with uneventful recovery after surgery. Intercostal drainage caused pleural pain in 2 patients, and in 2, leakage to the pleural space. Two patients with heart transplants had severe bradycardia and drop of blood pressure, one after needle drainage and the other during guidewire manipulation. Direct monitoring generally ensures a correct position of the instruments and hazards to adjacent organs can be avoided. In small effusions a simple needle aspiration with a plastic-sheathed cannula is safer than catheter drainage.

Adult↗
PubMed1990

Fine-needle aspiration biopsy of liver hemangioma.

The results of 36 consecutive fine-needle aspiration biopsies of liver hemangiomas at two University Hospitals from the years 1981-1988 are described. The sizes of the lesions were 1 to 15 cm. Six patients had malignant disease, and liver metastasis was considered possible. In 2 cases the chief complaint was related to liver enlargement, and 28 patients had other abdominal symptoms. The aspiration was performed to confirm a suggested hemangioma in 18 and because of inconclusive findings at imaging in 18 cases. The aspirations were performed with sonographic guidance using 0.7 to 0.8 mm outer diameter needles. Cellular material from a hemangioma was obtained in 21 cases; only blood was aspirated in 5 cases. Hepatocytes were seen among abundant blood cells in 10, and some fibroblasts in 5 cases. One patient had significant bleeding that was treated with a transfusion of two units of blood. Nine patients were treated surgically, and histologic samples confirmed the diagnosis of hemangioma. None of the 27 non-operated patients showed progression of the liver lesion at 3 to 48 months follow-up. Fine-needle aspiration biopsy is helpful in the diagnosis of liver hemangioma. Confusion with malignancy is unlikely. Further experience will show the frequency of complications.

Adult↗
PubMed1990

Percutaneous evacuation of abdominal abscesses and fluid collections--aspiration or catheter drainage?

Ninety-three abdominal abscesses and fluid collections (pseudocysts, hematomas and bilomas) in 79 patients were treated under radiological guidance, for a total of 111 procedures (23 needle aspirations (NA) of 17 foci and 88 catheter drainages (CD) of 84 foci). In eight foci both methods were used. Catheter drainage was curative in 65% of abscesses and in 56% of pseudocysts and improved the patients' condition before surgery in another 11% or 10%, respectively. The aim of CD could not be achieved in 24% of the abscesses and in 34% of the pseudocysts. Needle aspiration showed little effect being curative in only 6% and partially beneficial in 24% as all the foci were considered. Complications occurred in 8% of CD:s and in 0% of NA:s. We suggest that radiologically guided CD of abscesses and fluid collections should be the primary therapeutic approach in all cases where this can be performed safely. The therapeutic effect of NA was poor.

Abdomen↗
PubMed1988

Delayed presentation of blunt splenic injury.

Eleven patients with delayed presentation of splenic injury after blunt abdominal trauma treated during a 10 year period have been described. They represented 24 percent of all patients treated for blunt splenic injury in our department in that time period. Ten patients required operative treatment and one was treated nonoperatively. There were no deaths. The value of computerized tomography and ultrasonography in the accurate preoperative assessment of splenic injury has been documented. In addition, the various diagnostic and therapeutic possibilities in blunt splenic trauma have been discussed.

Adolescent↗
PubMed1988

Epidermoid cyst of the testis. Case report with a review of the literature.

Epidermoid cysts of the testis are rare, benign testicular tumors. Only 188 cases have been reported in the world literature until July 1986. There is controversy in the literature regarding whether local excision or enucleation of the cyst and sparing the testicle or orchiectomy is the preferred treatment approach of these lesions. A case with epidermoid cyst of testis, diagnosed correctly by ultrasound and frozen section and treated successfully by an excisional operation, is presented.

Adult↗
PubMed1987

Xanthogranulomatous pyelonephritis in a functioning kidney. A case report.

A 34-year-old woman with xanthogranulomatous pyelonephritis mimicking a renal tumour is presented. Preoperative examinations including renal ultrasonography, computed tomography, renal angiography and fine needle biopsy could not exclude malignancy. The diseased kidney had good function and there was no history or signs of urinary tract infection or calculi. During operation a frozen section biopsy showed xanthogranulomatous pyelonephritis and a kidney-saving enucleation of the tumour was performed. The patient recovered uneventfully with good kidney function on the operated side.

Adult↗
PubMed1986

The value of routine sonography in clinically suspected acute cholecystitis.

Upper abdominal sonography was used as a routine emergency study to diagnose acute cholecystitis in 135 patients clinically suspected of having the disease. Ten radiologists with various experience in sonography performed the studies. Fifty-six patients had acute cholecystitis. Altogether 52 cholecystectomies were performed, mainly within 48 h of admission. Acute cholecystitis was diagnosed correctly in 52 cases (sensitivity, 93%) and excluded correctly in 75 cases (specificity, 95%; overall accuracy, 94%). Of the four patients with a false-negative study, calculi without signs of cholecystitis were detected in three, and distention and tenderness without calculi in one case. The final diagnoses in four false-positive studies were chronic cholecystitis in two cases, carcinoma of the gallbladder in one case, and pancreatitis in one case. The results of sonography as a continual emergency service provided by a staff with various experience are equal to those published in other studies performed mainly by an expert staff with long experience.

Acute Disease↗
PubMed1986

Ultrasonography of the gallbladder in patients with a clinical suspicion of acute cholecystitis.

The prevalence of ultrasonographic (US) signs described in the literature in cases of acute cholecystitis (wall thickening, increased volume, roundness and local tenderness of the gallbladder, an anechoic layer in the gallbladder wall and cholelithiasis were studied in 136 consecutive patients referred for US examination with clinically suspected acute cholecystitis (AC). Of the patients, 56 had AC, 21 chronic cholecystitis, 2 carcinoma of the gallbladder, and 57 extrabiliary diseases. In AC, frequent findings in addition to cholelithiasis were wall thickening (79%) and an increased volume (64%). Almost one third of the patients had local tenderness (sonographic Murphy sign) (29%), and 27% of the gallbladders had a rounded form. All these features were, however, rather frequently detected also in chronic cholecystitis (5-33%) and in the 2 carcinoma patients, and also sporadically in extrabiliary diseases. A anechoic layer in the gallbladder wall was the only sign confined to AC, but was detected only in 2 cases. Roundness of the gallbladder occurred only in either acute or chronic cholecystitis. The combination of at least two diagnostic findings was noticed in 91% in AC, rather frequently in chronic cholecystitis (43%) and in both carcinoma patients, but only in 1 patient in the extrabiliary disease group. Three or more signs were seen only in gallbladder diseases (48%), but AC, chronic cholecystitis or carcinoma groups could not be completely differentiated (prevalences 63, 10 and 50%).

Acute Disease↗
PubMed1984

Diagnostic value of ultrasound, computed tomography, and angiography in ruptured aortic aneurysms.

Some ruptural aneurysms cause nonspecific symptoms and the patients are referred for radiological examination because of the problems of differential diagnosis from conditions such as renal colic, diverticulitis, herniated disc, aortic dissection etc. Seven such patients have been examined either with ultrasonography, computed tomography or angiography. The diagnostic methods are compared. The more recent US and CT imaging methods are sufficiently rapid and reliable for diagnostic purposes, which should improve the prognosis for patients requiring immediate surgery for ruptured aortic aneurysms.

Aged↗
PubMed1981

Ultrasound examination and cholescintigraphy in cholestasis.

The results of ultrasound, cholescintigraphy, and their combination, were analysed in 57 patients with cholestasis. At ultrasound, the presence of an extrahepatic obstruction was correctly diagnosed in 13 and at cholescintigraphy in 14 of 18 cases. The correct diagnosis increased to 17 when the information was combined. In the 31 patients with intrahepatic disease, absence of extrahepatic obstruction was correctly predicted in 26 cases with either method alone, whereas the combined use yielded a correct result in 29.

Adolescent↗
PubMed1981

Ultrasound guided fine-needle biopsy of mass lesions affecting the hepatobiliary tract.

Ultrasound guided fine-needle biopsy of mass lesions affecting the hepatobiliary tract in 67 patients is reported. A free-hand approach was used without a special biopsy transducer. All aspirates were sufficient and relevant. A correct cytologic diagnosis was reached in 91 per cent of the 57 malignant cases. In addition, malignancy was correctly suggested in 5 cases. In 33 per cent of the cases with unknown primary tumor, cytology determined the origin of the malignancy. No complications occurred.

Adult↗
PubMed1981

Duodenogastric reflux in patients with heartburn and oesophagitis.

Forty patients with signs and symptoms of gastro-oesophageal reflux were studied with cholescintigraphy, a noninvasive method, to detect duodenogastric reflux. 150 patients subjected to cholescintigraphy for various medical reasons served as controls. Ten per cent of the patients wit signs and symptoms of gastro-oesophageal reflux and 14% of the control patients had duodenogastric reflux. Of the four patients with gastro-oesophageal and duodenogastric reflux three had ulcers or strictures on oesophagoscopy, whereas one had normal endoscopic appearance. The differences in the frequency of duodenogastric reflux between these groups are not statistically significant.

Adult↗