Biomedical subjects

M Taavitsainen

Publications and source records attributed to M Taavitsainen.

78 records · Page 5Linked to original sources

PubMedDate not supplied

Ultrasonography in carcinoma of the gallbladder.

Cholecystosonography in approximately 40,000 patients over five years in two university hospitals revealed 30 (75%) of the 40 macroscopic primary carcinomas. In 3 cases the carcinoma was obscured by gallstones with shadowing, in 3 cases the origin of a tumour mass was misinterpreted, and in 4 cases the neoplastic growth mimicked gallbladder inflammatory changes or sludge. Malignancy was incorrectly diagnosed or suggested in 25 patients. The most frequent cause of a false positive report was acute or chronic inflammation, found at surgery in 16 gallbladders. Four carcinomas of the pancreatic head were believed to be gallbladder tumours. Cirrhosis with marked gallbladder wall thickening, gastric carcinomas with metastases, a common duct carcinoma, and two cases of sludge (with normal control studies) caused a false suggestion of gallbladder carcinoma. The most frequent ultrasonographic finding in gallbladder carcinomas was a mass filling the gallbladder (15 diagnosed cases), followed by wall thickening (9 cases), and polypoid or fungating tumour (6 cases). Real-time ultrasonography is a useful method for the preoperative diagnosis of gallbladder carcinoma, but considerable diagnostic problems in the differentiation from inflammatory diseases may be encountered.

Adenocarcinoma↗

PubMedDate not supplied

Aspiration biopsy of the spleen in patients with sarcoidosis.

Fine-needle aspiration biopsy of the spleen was performed on 101 patients with suggested sarcoidosis; it was the final diagnosis in 79. Adequate specimens were obtained in all cases with a 0.8 X 80 mm or 0.7 X 40 mm disposable needle. Fine-needle biopsy specimens of the spleen showed a granulomatous reaction in 19 out of the 79 cases with sarcoidosis (24%). There were three minor biopsy complications that required no treatment.

Biopsy, Needle↗

PubMedDate not supplied

Ultrasonography in acute gallbladder perforation.

The files of patients with acute cholecystitis from two large university hospitals from the years 1978-1985 were employed to find the cases with acute gallbladder perforation for this study. Only those patients (n = 9) were selected for the analysis of sonographic signs of acute gallbladder perforation who had less than 48 hours of symptoms before sonography, and were operated upon within 24 hours of the sonography. Patients (n = 10) with non-complicated acute cholecystitis and identical in regard to the duration of the symptoms and the timing of the sonography and the operation formed a control group. The sonographic findings in patients with gallbladder perforation were pericholecystic fluid collections, free peritoneal fluid, disappearance of the gallbladder wall echoes, focal highly echogenic areas with acoustic shadows in the gallbladder, and an inhomogeneous, generally echo-poor gallbladder wall.

Acute Disease↗

PubMedDate not supplied

Ultrasound in renal pyogenic infection. Imaging and intervention.

A series of 34 patients with renal or perirenal pyogenic infection (18 with pyonephrosis, 10 with renal abscess and 6 with perirenal abscess) is presented to evaluate diagnosis with ultrasound and treatment with percutaneous ultrasound guided aspiration/drainage. Specific findings, defined as sediment echoes or dispersed internal echoes in a hydronephrotic renal collecting system, were noted in 39 per cent of pyonephrosis cases. Abscesses were mainly round or oval hypoechoic lesions measuring from 2 to 15 cm in diameter. Two abscesses were multilocular and one showed a septum. The appearance suggested tumor in 25 per cent. Because of this non-specificity of ultrasound we recommend diagnostic aspirations and further radiologic and other examinations in difficult cases. Four patients were treated by conservative means only, 13 with percutaneous aspiration or drainage, 9 with a combined drainage procedure and surgery, and 8 surgically. The length of the mean hospital stay was shortest in the group with the percutaneous drainage procedure (PDP) although the difference was not statistically significant. PDP was not effective in 12 per cent and surgery was used in these two cases to ensure cure. Complications occurred more often in the PDP group than in the surgery group but the most serious complication was a post-operative one. The different modes of treatment are discussed. The overall mortality was 5.9 per cent.

Abscess↗

PubMedDate not supplied

Sonographic analysis of enthesopathy in the lower extremities of patients with spondylarthropathy.

OBJECTIVE: Enthesopathy is one of the features characterizing patients with spondylarthropathies. Its diagnosis is usually based on clinical symptoms such as the presence of calcanear pain or tenderness at the insertion(s) of ligaments. More objective ways to estimate the presence and nature of enthesopathy are needed. Therefore, we analysed both by clinical and sonographic methods the presence of enthesopathy in the lower extremities of patients with spondylarthropathy. METHODS: 31 consecutive patients with spondylarthropathies (15 with reactive arthritis, 12 with ankylosing spondylitis, and 4 with psoriatic arthritis) were studied for the presence of enthesopathy in the lower extremities, independently by clinical examination and by high resolution sonography. RESULTS: Sonography detected inflammatory lesions in 44 entheses of 20 patients. Oedema at the insertion of the tendon was the most common finding. Signs of enthesitis were more common in the lower portion of the leg. In addition to enthesitis, bursitis was a common finding by sonography. By clinical examination, enthesitis was diagnosed in 56 sites in 20 patients, most frequently at the insertions of the Achilles tendon and the plantar fascia. Bursitis around the calcaneus and synovitis/pain in the hip and knee joints were most frequently misinterpreted to indicate enthesopathy at the clinical examination. In addition, half of the insertions with only oedema at sonography were clinically asymptomatic. CONCLUSIONS: Sonographic examination of ligamentous insertions offers morphologic information which is unobtainable by the clinical judgement of tenderness in the estimation of enthesopathy in patients with spondylarthropathies.

Adult↗

PubMedDate not supplied

Persistence of enthesopathic changes in patients with spondylarthropathy during a 6-month follow-up.

The persistence of enthesopathic changes was studied by ultrasound (US) in 23 patients with spondylarthropathy during a 6-month prospective trial with sulphasalazine (Salazopyrin). During the follow-up significant improvement was seen in the joint symptoms and in the laboratory variables. By US 78% of the patients had enthesopathy at entry and 74% after 6 months of follow-up. The plantar fascia was the enthesis most frequently affected. Treatment with sulphasalazine had no obvious influence on the persistence of enthesopathy. Enthesopathy is as a rule a constant phenomenon and is probably caused by chronic enthesitis. A parallel resolution of anatomic soft tissue changes and the clinical status was not seen on US. There was also no evidence of a favourable effect of sulphasalazine on enthesopathy in the 6-month follow-up.

Adult↗