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Biomedical subjects

S Soimakallio

Publications and source records attributed to S Soimakallio.

At least 73 records · Page 4Linked to original sources
PubMed1990

Carbon dioxide gas as a perfusion medium for the sapphire probe in laser ablation of human atheromatous plaques: comparison study with saline.

The effectiveness of CO2 gas as a perfusion medium was compared to that of saline in laser ablation of human atheromatous plaque. In an experimental circulation-occlusion model using flowing whole blood, human cadaveric arterial samples were irradiated by a sapphire probe with the Nd-YAG laser. The following experiments were performed: 1) lasing without perfusion, 2) lasing with saline perfusion of the probe, and 3) lasing with CO2 perfusion. Different perfusion flow rates of saline and CO2 were used. Results showed that the mean ablation area was 1.6-fold larger with CO2 than with saline perfusion (P less than 0.05, Student's t test). The mean lateral injury at the site adjacent to the ablation crater and at the area directly facing the probe was not significantly different with either perfusion medium. The larger ablation area with CO2 was probably due to the fact that CO2 is a good insulator for maintaining a higher probe temperature and keeps the probe free of blood debris. In conclusion, our results show that CO2 perfusion facilitates more effective laser ablation of atheromatous plaque than saline perfusion by the sapphire probe with the continuous wave Nd-YAG laser.

Aged↗
PubMed1990

Shoulder impingement syndrome: sonographic evaluation.

A method of shoulder sonography in which lateral and anterior elevation of the arm is used during scanning was demonstrated to be effective in cases of suspected impingement syndrome. The value of the method lies in its ability to demonstrate fluid collection in the subacromial-subdeltoid bursal system, with gradual distention of the bursa and lateral pooling of fluid to the subdeltoid portion while the arm is elevated. In 102 of 381 patients studied, surgical diagnosis was available for correlation. Among this group there were seven false-negative and three false-positive sonographic findings. A comparison of sonographic with surgical findings demonstrated a sensitivity of 81% and a specificity of 95% in stages I-III, and a sensitivity of 71% and a specificity of 96% in early stages I and II of the impingement syndrome. The results of dynamic shoulder sonographic examination with fluoroscopic radiography provide valuable information in patients with suspected early-stage impingement syndrome.

Acromion↗
PubMed1990

Percutaneous transluminal laser angioplasty. Progress over the past two years.

The progress in percutaneous transluminal laser angioplasty (PTLA) over the past two years is presented. The technical development includes the application of new equipments to laser sources, delivery systems and monitors. We review new experimental research in rapidly establishing animal models and human postmortem specimens, as well as efforts to select adequate wave length and irradiation time for laser energy with suitable infusion media. A summary of clinical trials is given on expanding usage, complication rates and long-term patency of PTLA. The current trends in PTLA respecting guide wire assisted balloon angioplasty and other recanalization methods are described.

Angioplasty, Balloon↗
PubMed1990

Ultrasonography and computed tomography in diffuse liver disease with cholestasis.

Ultrasonography (US) and computed tomography (CT) were performed on respectively 67 and 42 (altogether 72) patients, for the assessment of intrahepatic cholestasis. The diagnostic ability to differentiate between malignant (17 patients) and benign (55 patients) liver disease was analyzed. Coarse echogenicity of the liver led to inconclusive results in differentiating between cirrhosis (2 out of 29 patients) and malignant infiltration (4 out of 15 patients) by US. Other benign liver diseases in 23 patients, including acute hepatitis, chronic active hepatitis, fatty liver, and liver congestion, were correctly interpreted as benign. CT correctly disclosed malignant liver disease in all cases. A false positive diagnosis of malignancy was encountered in 4 (out of 17) patients with decompensated hepatic cirrhosis because of non-homogeneous expansive areas on CT in 3 cases. The true cause was in 2 patients non-uniform fatty infiltration, and in one patient with acute hepatitis A, small hypodense lesions. Among cholestatic patients, decompensated cirrhosis and malignant liver infiltration could not always be differentiated on US or CT.

Adolescent↗
PubMed1990

Percutaneous nephrostomy in the management of urinary leakages and fistulas.

Treatment with percutaneous nephrostomy (PN) without co-existing stents was attempted in 18 patients with urinary fistulas and leakages. Seven patients were cured by PN alone. Two of these developed a ureteral stricture at the site of the lesion: one showed no impairment of urinary flow on the follow-up, the other needed continuous urological surveillance. In the remaining 6 cases PN provided temporary relief of the associated urinary stasis. Percutaneous nephrostomy could not be applied in 5 cases because of the lack of renal pelvic dilatation. Only catheter related complications occurred. Because of its easy and little traumatic technique, simple PN could be used as the primary therapeutic approach in such lesions.

Adult↗
PubMed1989

Reversed left internal mammary artery graft for coronary bypass. Evaluation of function with digital subtraction angiography and radionuclide imaging.

Reversed left internal mammary artery grafting with retrograde flow to the left anterior descending coronary branch was used in five of 500 consecutive bypass operations. The indications were significant stenosis in the left subclavian artery (3 patients) or the proximal left internal mammary artery (1) and proximal damage to the left internal mammary artery during dissection from the thoracic wall (1). The postoperative clinical course was smooth in all five patients, with no evidence of myocardial ischemia. In follow-up averaging 14 months four patients were asymptomatic. The reversed internal mammary artery graft was visualized with digital subtraction angiography in four cases. Radionuclide imaging during exercise confirmed graft patency in all but the symptomatic patient, who was found to have an area of reversible ischemia anteriorly in the left ventricle.

Adult↗
PubMed1989

Clinical characteristics and coronary anatomy in refractory unstable angina pectoris leading to coronary artery bypass grafting. The Kuopio experience.

One hundred patients with high-risk unstable and medication-resistant angina pectoris underwent coronary artery by-pass grafting. In 35 cases the angina was of early post-infarction type, in 60 it was progressive after previous stability and in five it was of recent onset. All had abnormal ECG in association with anginal attacks (ST depression in 76, ST elevation in 5, T-wave inversion in 15 and left bundle branch block in 4). The left main coronary artery was stenosed in 33 patients, and the respective figures for three-vessel, two-vessel and one-vessel disease were 53, 9 and 5. The average number of inserted peripheral grafts/patient was 4.6. The perioperative mortality rate was 1%. Seven patients had confirmed or probable perioperative myocardial infarction and two had late infarction during the hospital stay, but none had angina pectoris on discharge. Of 60 patients re-examined after 1 year, 47 were angina-free. Five had NYHA class III angina, but all were improved. In refractory unstable angina pectoris there is severe coronary artery involvement, but bypass grafting can give good results.

Adult↗
PubMed1988

Radiological findings in the lumbar spine of 39 young cross-country skiers with low back pain.

The lumbar spines of 39 active young cross-country skiers suffering from long lasting or frequently remitting low back pain (LBP) were examined by a new radiological method. Plain radiographs in lateral and anteroposterior views were taken. The spinal curves, anomalies, and possible degenerative changes were investigated. The radiological method chosen proved to be suitable for imaging the lumbar spine. There were various radiologically detectable abnormalities in the spine. The most common findings were functional scoliosis (in 49%) and different spinal anomalies (in 23%). The mean lumbar lordosis was 69 degrees (70 degrees in males and 64 degrees in females). The effect of abnormal lumbar posture on LBP should be further studied. None of the numerous radiological findings had an effect on therapy in these skiers.

Adolescent↗
PubMed1988

Digitalised endoscopic retrograde pancreatography (D-ERP): a comparison with ERCP.

Cannulation of the papilla of Vater was successful in 49 out of 65 cases (75.4%) and digital imaging of the pancreas in 38% of cases. Visualisation of the pancreatic duct with D-ERP was comparable to that of conventional ERCP. Absent or faint opacification of the parenchyma was seen in 39.5% of patients. Both methods were equally effective for the diagnosis of pancreatic tumours. D-ERP was better than ERCP for the diagnosis of chronic pancreatitis. Two patients (4.1%) had clinical evidence of mild acute pancreatitis following pancreatic duct injections.

Adult↗
PubMed1988

Reduction of radiation dose and imaging costs in scoliosis radiography. Application of large-screen image intensifier photofluorography.

Photofluorography using a large-field image intensifier (Siemens Optilux 57) was applied to scoliosis radiography and compared with a full-size rare-earth screen/film technique. When scoliosis radiography (PA-projection) was performed on 25 adolescent patients, the photofluorographs were found to be of comparable diagnostic quality with full-size films. A close correspondence between the imaging techniques was found in the Cobb angle measurements as well as in the grading of rotation with the pedicle method. The use of photofluorography results in a radiation dose reduction of about one-half and considerable savings in direct imaging costs and archive space. In our opinion the method is particularly well-suited for follow-up and screening evaluation of scoliosis, but in tall patients the image field size of 40 x 40 cm restricts its usefulness as initial examination.

Adolescent↗
PubMed1988

Image-intensifier photofluorography and conventional chest radiography: comparison of diagnostic efficacy.

Photofluorography with a large image intensifier, which provides an image field of 40 x 40 cm, reduces both the radiation dose and the imaging costs in chest radiography as compared with the film-screen technique. The two techniques were evaluated in a clinical study of 135 patients with suspected chest abnormalities. Photofluorographs and film-screen chest radiographs were interpreted independently by three radiologists. The diagnoses were confirmed by CT, follow-up radiographs, and clinical records. Among the 135 patients, 75 had primary lung cancer, 39 had pulmonary nodules, 52 had hilar or mediastinal abnormalities, 17 had pleural fluid, and 45 had pneumonic or atelectatic changes. Twenty-three normal subjects were included. Differences in diagnostic accuracy, measured by sensitivity and specificity, were not statistically significant. A larger number of true-positive cases (65%) with peripheral lung nodules were found by photofluorography than by film-screen radiography (54%) (p less than .05). The results suggest that the diagnostic accuracy of chest images made by photofluorography is sufficient to warrant using it instead of the film-screen technique in routine chest radiography, especially to detect lung tumors and metastases.

Humans↗
PubMed1986

Serum lipoprotein lipid and apoprotein levels as indicators of the severity of angiographically assessed coronary artery disease.

Serum lipoprotein cholesterol and triglycerides and apoproteins A-I, A-II and B were determined in 71 consecutive male subjects undergoing coronary angiography because of severe angina pectoris. Among the factors studied, apoprotein B, apoprotein B/A-I ratio, VLDL- and LDL cholesterol showed the most consistent association with the severity of coronary artery disease as assessed by angiography whereas serum HDL cholesterol and apoproteins A-I and A-II showed no correlation. Subjects with stenosis of the left main coronary artery had higher serum HDL cholesterol and apoprotein A-I and B levels than the others. In this series which comprised males with severe angina pectoris, derived from a population with high prevalence of coronary heart disease, LDL was the best indicator of the severity of coronary artery disease.

Adult↗
PubMed1986

Evaluation of an anatomical compensation filter for chest radiography.

An anatomical compensation filter for improving the radiographic demonstration of the mediastinal and retrocardiac areas of a chest radiograph has been evaluated. The filter, made of a transparent, light-weight lead-plastic material was attached to the X-ray collimator housing. The device reliably improved the visibility of normally underpenetrated areas without producing detectable artefacts, provided the patient was correctly positioned. Hilar structures were also slightly better visualised. At the same time there was no statistically significant deterioration in visualisation of peripheral pulmonary vessels or parenchymal structures. Rib details and pleural calcifications were less well seen, however, a result that was to be expected because of the X-ray beam hardening.

Aged↗