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Biomedical subjects

S Soimakallio

Publications and source records attributed to S Soimakallio.

At least 55 records · Page 3Linked to original sources
PubMed1993

Incidence of community-acquired pneumonia in the population of four municipalities in eastern Finland.

Between September 1, 1981, and August 31, 1982, all patients with suspected or confirmed pneumonia among the 46,979 inhabitants of four municipalities in the province of Kuopio, Finland, were reported to a pneumonia register by their attending physicians. In addition, two study pathologists reported all cases of pneumonia found at autopsy, and two permanent registers were checked for retrospective identification of patients. Chest radiographs were obtained from 97% of all patients. The final diagnosis was based on radiologic or autopsy criteria. A total 546 patients (323 males and 223 females) had community-acquired pneumonia; of these, 37% were less than 15 years of age, and 31% were 60 years of age or older. Nineteen percent of the patients had defined chronic conditions, and 42% were admitted to hospital. The case fatality rate was 4%. The overall incidence of community-acquired pneumonia per 1,000 inhabitants per year was 11.6 (13.9 in males, 9.4 in females). The age-specific incidence per 1,000 inhabitants per year was as follows: age < 5 years, 36.0; age 5-14 years, 16.2; age 15-59 years, 6.0; age 60-74 years, 15.4; and age > or = 75 years, 34.2.

Adolescent↗
PubMed1993

Comparison of radiological findings and microbial aetiology of childhood pneumonia.

Sixty-one children were treated in hospital from 1981 to 1982 because of both radiologically and microbiologically verified viral or bacterial pneumonia. The chest radiographs were interpreted by two radiologists, not familiar with the clinical data, on two occasions three years apart, and only those patients with a definite alveolar (n = 27) or interstitial (n = 34) pneumonia at both evaluations were included in the present analysis. In addition, all patients had viral (n = 20), mixed viral-bacterial (n = 21) or bacterial (n = 20) infections diagnosed by viral or bacterial antibody or antigen assays. Viral infection alone was seen in 7 (26%), mixed viral-bacterial infection in 8 (30%) and bacterial infection alone in 12 (44%) of the 27 patients with alveolar pneumonia. The respective figures were 13 (38%), 13 (38%) and 8 (24%) for the 34 patients with interstitial pneumonia. C-reactive protein concentration was greater than 40 mg/l (a screening limit for viral and bacterial infections) in 15 (56%) of the patients with alveolar and in 11 (32%) of the patients with interstitial pneumonia. Thus 74% of the patients with alveolar and 62% with interstitial pneumonia had bacterial infection, either alone or as a mixed viral-bacterial infection. Our results suggest that the presence of an alveolar infiltrate in a chest radiograph is a specific but insensitive indicator of bacterial pneumonia. We conclude that patients with alveolar pneumonia should be treated with antibiotics. In patients with interstitial pneumonia, however, both viral and bacterial aetiology are possible. In those, the decision concerning antibiotic treatment should be based on clinical and laboratory findings.

C-Reactive Protein↗
PubMed1993

Chronic critical lower-limb ischemia: prospective trial of angioplasty with 1-36 months follow-up.

To determine the utility of percutaneous transluminal angioplasty (PTA) in the treatment of chronic critical lower-limb ischemia, a prospective study of 103 consecutive patients (117 limbs) was performed. Patients underwent PTA for a total of 209 lesions in the iliac (n = 4), femoropopliteal (n = 121), and infrapopliteal (n = 84) arteries and were followed up for 1-36 months (mean, 12 months). The primary technical success rate was 92% for stenosis and 80% for occlusion. Survival analysis with the Kaplan-Meier method revealed 1-, 2-, and 3-year limb salvage rates of 56%, 49%, and 49%, respectively. The following factors correlated favorably with limb salvage in Cox multiple regression analyses: a small number of diseased lower-limb vessels (one to five vs six to eight) and treated lesions per limb (one or two vs three to five), achieved peripheral runoff (one to three patent calf vessels vs none), and an occlusion as the successfully treated target lesion (instead of stenosis).

Angioplasty, Balloon, Coronary↗
PubMed1993

Asymptomatic deep venous thrombosis in the calf: accuracy and limitations of ultrasonography as a screening test after total knee arthroplasty.

Patients who have recently undergone total knee arthroplasty are at high risk of developing deep venous thrombosis (DVT) in the calf. The clinical diagnosis of DVT is difficult in these patients owing to recent operation. A combination of compression ultrasonography (US) and colour flow imaging was used as a screening method of asymptomatic DVT in 51 patients who had undergone total knee replacement surgery. Both limbs were examined by US from the common femoral vein to the ankle approximately 7 days after operation and the results were compared with bilateral venography. 12 patients (24%) developed infrapopliteal DVT on the operated side, in two cases the thrombosis extended to the lower part of popliteal vein. One patient had bilateral thrombosis. US showed sensitivity of 77%, specificity of 96% and overall accuracy of 93%. US seems to be a useful screening method for DVT after knee replacement operation.

Aged↗
PubMed1992

Endurance training associated with slightly lowered serum estradiol levels decreases mineral density of canine skeleton.

The effects of long-term running exercise were studied in 20 beagle dogs. A total of 10 dogs ran from the age of 15 weeks to the age of 70 weeks in a progressive program for up to 40 km/day. A total of 10 sister dogs spent the study period in individual cages. When the dogs were 70 weeks old, bone mineral density of the vertebrae, hip, and radius was analyzed by dual-energy x-ray absorptiometry (DEXA; Lunar) and the vertebrae were also assessed by quantitative computed tomography (QCT; Siemens DR 1). Mineral density was lower in the running dogs than in the controls. The difference was greatest in the spine in the QCT analysis. Blood chemistry analyses revealed that the metabolism of the bone was significantly accelerated. The estradiol levels showed the trend to be reduced in the running group. The beneficial effect of exercise on mineral density has been shown in many earlier studies. However, in this study we demonstrate the possibility of adverse effects of long-term exercise on bone tissue. The change was associated with a decrease of serum estradiol level.

Alkaline Phosphatase↗
PubMed1991

Effects of long-term running on spinal mineral content in dogs.

The effects of long-term running were studied in 20 beagle dogs. Ten dogs ran from the age of 15 weeks to the age of 70 weeks in a progressive program for up to 40 km/day. Ten sister dogs spent the same time in individual cages. At the age of 70 weeks the spines of the dogs were studied with regard to mineral density using dual-energy X-ray absorptiometry and quantitative computed tomography. Mineral density was lower in the running dogs than in the controls.

Animals↗
PubMed1991

CO2 gas perfusion: improved efficiency and safety with sapphire-probe laser ablation of human artery.

CO2 gas has been proposed as a new perfusion medium for laser angioplasty. To compare CO2 gas with conventional saline perfusion, 146 fresh specimens of normal and atheromatous human artery were irradiated with a neodymium: yttrium-aluminum-garnet laser with a sapphire probe in flowing whole blood in an experimental circulation-occlusion model. The dimensions of the ablation crater and the extent of the surrounding tissue damage were measured microscopically. Significantly better ablation of atheromatous plaque was achieved with CO2 perfusion than with saline perfusion: mean ablation areas were 5.0 mm2 versus 2.8 mm2, respectively (P = .001, Student t test). In contrast, the ablation areas on normal vessel wall were identical (mean, 3.4 mm2) with the two perfusion media. Moreover, CO2 gas functioned as a negative contrast agent and facilitated direct monitoring of the laser recanalization procedure. On an experimental basis, CO2 gas perfusion seems to improve the efficiency and safety of laser ablation in human arteries.

Aged↗
PubMed1991

Thromboprophylaxis in patients with hip fractures: a prospective, randomized, comparative study between Org 10172 and dextran 70.

A prospective, randomized, assessor-blind trial has been undertaken to compare the thromboprophylactic effect and safety of the heparinoid Org 10172 (a mixture of low molecular-weight sulfated glycosaminoglycuronides) and dextran 70 in patients operated on for hip fracture. Prestudy biostatistical calculations led to the need for 260 patients. Three hundred eight patients were randomized and 19 were excluded after randomization, the majority because of postponed surgery. Analyses were made on the 289 patients on an intention-to-treat basis, as well as on the 247 patients given correct prophylaxis. Diagnosis of deep vein thrombosis was based on bilateral ascending phlebography on postoperative days 10 through 12. The frequency of deep vein thrombosis on an intention-to-treat basis was 10% in the Org 10172 group and 30% in the dextran 70 group and, on the basis of correct prophylaxis, 12% and 31%, respectively, both differences being significant (p less than 0.001). Two-month mortality rates were equal in the groups. Three fatal pulmonary emboli were seen in the dextran group. Significantly more patients in the dextran group received postoperative transfusions; no other differences in various hemorrhagic parameters were seen. Thus it can be concluded that Org 10172 has a significantly better thromboprophylactic effect than does dextran in patients with hip fractures without significant side effects.

Aged↗
PubMed1991

Radiographic grading of extrinsic allergic alveolitis. A comparison between a modified ILO classification and a descriptive method.

We analyzed the acute phase radiographs of 107 consecutive patients with clinically confirmed extrinsic allergic alveolitis. Three readers independently recorded the profusion and the type of opacities according to the standard ILO criteria extended with categories x, y, z, and ground glass for description as proposed by McLoud et al. The profusion of the changes was grade 0 in 13%, grade 1 in 37%, grade 2 in 35%, and grade 3 in 15% of the interpretations. The type of predominant small opacities was p in 33%, x in 22%, s in 13%, t in 10%, q in 9%, and 0, r, u, y, and z in 13% of the interpretations. Ground glass density was seen in 8% of the recordings. The changes were predominantly located in the middle and lower lung zones. For comparison, according to the classification of Hapke et al. miliary changes (68%) predominated over fibrotic (27%) and normal (11%) recordings. The intraobserver agreement was good by both methods, but there was less interobserver variation with the ILO method. The semiquantitative standardized modified ILO scheme was considered more informative than Hapke's descriptive classification for epidemiologic and research purposes.

Alveolitis, Extrinsic Allergic↗
PubMed1991

Evaluation of heart size and pulmonary vasculature. Conventional chest roentgenography and image intensifier photofluorography compared.

Inter- and intraobserver variation and diagnostic accuracy in estimation of heart size and pulmonary vasculature were evaluated for conventional film-screen technique and image intensifier photofluorography. Interpretation of 218 p.a. and lateral chest films by both imaging techniques was performed independently by 4 readers. Heart size relative to body surface area measured from the plain chest films was used as the reference in cardiac size determination. Overall diagnostic accuracies of conventional radiography and image intensifier photofluorography for cardiomegaly were close to each other, 0.70 vs 0.68, respectively. Specificity of film-screen radiography was better than that of photofluorography (0.92 vs 0.84, p less than 0.05). Interobserver agreement was poor both in assessment of the heart size and pulmonary vasculature (range of kappa coefficients 0.18-0.59) while the intraobserver consistency (kappa coefficients 0.60-0.85) was good to excellent. The results suggest a limited usefulness of visual assessment of heart size and pulmonary vasculature in chest roentgenographs.

Aged↗
PubMed1991

Electric behavior of low back muscles during lumbar pelvic rhythm in low back pain patients and healthy controls.

UNLABELLED: The functioning of low back muscles of back pain patients during flexion and reextension has not been properly investigated. In this study, we analyzed rectified, averaged electric activity (RMS EMG) and corresponding raw intramuscular (IM) EMG from lumbar paraspinal muscles to quantify the activity level during simple bending cycles in 87 back pain patients compared to 25 able-bodied controls. THE RESULTS: All functional phases seen in raw IM EMG were also shown in surface RMS EMG. Surface RMS EMG pattern seems to yield more information from activity level than IM EMG pattern. The RMS EMG patterns of back pain patients differed from those of controls as follows: (1) There was clearly noticeable activity during standing in back pain patients. (2) There was only a partial decrease of EMG activity after flexion in back pain patients with current pain. (3) The ratio of mean reached at maximal activity level during extension and flexion was less in patients (1.8, SD = 0.5, p less than .001) than able-bodied controls (3.2, SD = 0.8). (4) Segmental differences were observed in IM EMG activities in patients having hypermobility in bending x-ray. (5) Large peak potentials occurred during movements in patients having segmental hypermobility. THE RESULTS indicate that averaged surface recording is a valuable tool in the investigation of dynamic spine functions in back pain patients.

Adult↗
PubMed1991

Intermittent pneumatic compression therapy in posttraumatic lower limb edema: computed tomography and clinical measurements.

The purpose of our study was to assess the amount of posttraumatic lower limb edema and its distribution between subcutaneous and subfascial compartments before and after intermittent pneumatic compression (IPC) therapy in patients with fractures of the lower leg immobilized with a cast for six to 12 weeks. Computed tomography (CT) was used as an objective method of measuring the compartmental distribution of edema. Sixteen patients with a mean age of 37 years (range 19 to 64 years) were investigated by clinical measurement of the leg circumference and by CT at the ankle joint and at three equidistant (10cm) levels above it. The unaffected leg served as a control for the evaluation of the amount of edema and density of the tissues. Edema was found primarily in subcutaneous tissue. The IPC treatment decreased relative edema from 23% to 15.9% (p less than 0.01) as measured by CT, and from 23.5% to 13.2% as measured clinically. The density of muscle tissue increased 9% (p less than 0.01) and that of subcutaneous tissue decreased 5.6% (p less than 0.05). The IPC treatment influenced both the amount of edema and the density of tissue compartments.

Adult↗
PubMed1991

Laser ablation ability of different fiber tips on human arteries. The role of photothermal effect.

To compare laser ablation abilities of bare tip and metal probe as well as spectraprobe, specimens from human normal and atherosclerotic aorta were irradiated with Nd-YAG laser. To evaluate the influence of photothermal effect thermal energy productions of 3 tips were measured with a calorimeter. The results showed that the bare tip produced the most effective ablation in arterial atheroma, followed by the metal probe and the spectraprobe. Similarly, the ratio of the ablation area on atheroma to that on normal vessel was the best with the bare tip and the worst with the spectraprobe. However, the extent of surrounding tissue damage adjacent to the ablation crater was the largest with the bare tip and the smallest with the spectraprobe. These differences cannot be explained only by variations in the photothermal effect, since thermal energy production is proved to be almost equal among the 3 laser fiber tips.

Aged↗
PubMed1990

The use of fibrinogen uptake test in screening for deep vein thrombosis in patients with hip fracture.

255 hip fracture patients were studied by 125I-fibrinogen uptake test and bilateral phlebography. We found the sensitivity of fibrinogen scanning to be 44% for the non-operated limb and 50% for the calves. The predictive value of a negative result was found to be 92% and 93% respectively. We conclude that the use of fibrinogen uptake test as single diagnosticum is not valid and can only be recommended in combination with phlebography when studying patient where the frequency of DVT is expected to be low.

Fibrinogen↗