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Biomedical subjects

S Tötterman

Publications and source records attributed to S Tötterman.

At least 19 recordsLinked to original sources

How many projections are really needed in angiographic assessment of the femoral bifurcation?

The purpose of this study was to analyze how many angiographic projections are needed in the diagnosis of hemodynamically significant stenoses of the femoral bifurcation. A total of 134 femoral bifurcations were examined with triplanar angiography in 67 patients (45 men and 22 women). The patients, ranging in age from 42 to 81 years (mean 63), suffered from incapacitating symptoms of peripheral arterial disease. The contralateral posterior oblique projection proved to be the most valuable in the assessment of hemodynamically significant arterial stenoses of the femoral bifurcation. An AP projection added information on stenoses of the inlets of the deep femoral artery in 9% of cases and on stenoses of the inlets of the superficial femoral artery in 6% of cases. An arteriographic examination should be started with a contralateral posterior oblique projection and this view will suffice in most cases.

Adult↗

Long term outcome after resection of the first rib for thoracic outlet syndrome.

A total of 112 first ribs in 103 patients were resected over 11 years for thoracic outlet syndrome. Seventy-seven patients (84 operations) were followed up for 2.5 years or more to assess the long term results of this procedure and the factors affecting them. One month after surgery 52 per cent of limbs were asymptomatic and 77 per cent were at least improved. A follow-up examination was performed, on average 6.1 years after the operation, by two independent examiners. This evaluation showed a permanent success rate of 37 per cent among 84 limbs examined. These long term results compare unfavourably with previously published data. The reason for the poor final outcome seemed to be difficulty in selecting patients for the operation. This was not aided by any of the preoperative tests. Patients in this study were evaluated by independent examiners, and only a total absence of preceding symptoms was accepted as the criterion for success. We emphasize the importance of unbiased evaluation and long term follow-up.

Adult↗

The effects of clinical data on radiological diagnostic performance in middle-face trauma.

To determine the effect of clinical information on the radiological diagnostic performance in middle-face injury, the medical records and radiographs of 618 patients with middle-face injury were reviewed. The information value of clinical data given in each x-ray requisition was evaluated. The radiological diagnoses were compared with the final clinical diagnoses both retrospectively and prospectively (with and without clinical data). Knowledge of clinical data with statistical significance changed the reader's decision threshold towards improved sensitivity but poorer specificity. Clinical data did not improve the radiologists' performance. Clinical data may be helpful in diagnostic tasks rather by increasing the sensitivity than the specificity.

Evaluation Studies as Topic↗

Intramuscular myxoma--a clinicopathological study of twenty-three cases.

Twenty-three cases of intramuscular myxoma were analyzed clinically and histologically. The mean age of the patients was 54 years, and two-thirds were women. Clinical follow-up of 2 to 17 years' duration revealed no recurrences or metastases. Intramuscular myxoma thus appears to be a completely benign tumor. One patient simultaneously had a myxoma in the muscle of the thigh and a lesion of fibrous dysplasia in the femur. In addition, 14 of 16 patients studied with x-ray had a significantly higher incidence of minor abnormalities in bones as compared with the normal population. The myxomas were characterized histologically by sparse cellularity, abundant intercellular material digestible with hyaluronidase, and lack of mitotic figures. At the ultrastructural level, the tumor cells showed characteristics of fibroblasts and myofibroblasts. Immunohistochemical analysis of intermediate filament proteins revealed vimentin- but no desmin-positivity in the tumor cells, and endothelial cell markers as well as S-100 protein were absent. This is compatible with fibroblastic-myofibroblastic nature of the myxoma cells.

Adult↗

Arteriomegaly.

The features of a patient with arteriomegaly of thoracic and abdominal aorta, common and external iliac, and femoral arteries are described.

Aged↗

Long term results of late reconstruction for anterior or anteromedial instability of the knee.

Forty-one patients who had had surgical repair for anterior or anteromedial instability of the knee were examined on average 3.7 years after the operation. Of these patients, 17 had been injured in sports activities, 11 in work accidents, 5 in traffic accidents and 8 during other activities. Twenty-six patients underwent intra-articular reconstruction of the anterior cruciate ligament where the Jones procedure was used, 7 with the HeyGroves procedure, and 2 by the Eriksson procedure. The remaining 6 patients were treated by transfer of the gracilis, semitendinosus tendon or fascia lata. During the operation, the medial collateral ligament was reefed in 4 knees and Mauck's reconstruction was performed on 4 knees. Medial meniscectomy was carried out in 9 patients. The results were evaluated using subjective, functional and objective criteria. The objective criteria included both clinical examination and stress radiography using a specially designed apparatus. Laxity of the medial collateral ligament and anterior drawer sign were recorded on radiographs, using the uninjured knee for comparison. The operation was estimated to have been successful subjectively (excellent or good) in 25 patients, functionally successful in 20 and objectively successful in 23 patients. In the personal opinion of 33 patients the knee improved. Meniscectomy and long follow-up time were found to cause a decrease in successful results. More arthritic changes appeared if meniscectomy had been performed. The patients returned to work within an average period of 3.7 months. In 7 cases the result was classified as functionally poor, and the knee required a subsequent operation.

Accidents↗

Panoramic zonography in evaluation of recurrent basal cell carcinoma of the face.

Nine patients with recurrent, facial basal cell carcinoma were followed up both clinically and radiographically using a panoramic technique. A cylindrical image track was used for panoramic radiography. Five patients had bony destruction due to tumour re-occurrence, four patients had bony defects caused by surgery. The confirmation of the results by surgery and/or follow-up shows that the spread of basal cell carcinoma into bone can be diagnosed using a panoramic technique.

Aged↗

Panoramic zonography in radiographing the carpus.

The panoramic radiography technique enables the visualization of different image layers. In the search for a method for improving the radiological fracture diagnosis of the carpal bones the suitability of this technique for visualization of the carpal bones was tested. For panoramic zonography, Zonarc (Palomex, Finland) and its programme with cylindrical image layer with 85 mm radius was used. The present study showed that panoramic technique is suitable for discerning the carpal bones but not for demonstrating their skeletal details.

Carpal Bones↗

Effect of sodium bicarbonate pretreatment on barium coating of mucosa during double contrast barium meal.

The radiographic pattern of the areae gastricae is produced by barium lying in the intersecting furrows of the gastric mucosal surface. However, if the mucus layer on the gastric mucosa is thick, it interferes with the barium coating of the areae gastricae during double contrast barium meal. As sodium bicarbonate decreases the viscosity of mucus and thus may make the gastric mucus layer thinner, it was evaluated as a pretreatment agent in a routine double contrast upper-gastrointestinal study to improve the visualization of the areae gastricae. In a single blind study, 53 of 106 patients took sodium bicarbonate water mixtures at bedtime the day before and on the morning of the examination. According to the results of the present study mucolysis induced by the used doses of sodium bicarbonate does not significantly affect micromucosal visualization during double-contrast barium meal.

Adult↗

Panoramic zonography in ear radiography.

Thirty ears in 15 patients were examined by plain film radiography and by panoramic zonography with two tracks: A cylindrical concave image layer with 26 mm. radius and a paired sagittal image layer, at 51 mm. distance from midline. The films were interpreted according to the visibility of 23 different anatomic details. On panoramic films the visualization was better in 14 details, equal in 6 and worse in 3 compared to the plain films. The result suggests that panoramic techniques can replace conventional radiography of the ear.

Adult↗

Comparison of the visibility of the anatomical structures of the facial skeleton in panoramic zonography and linear tomography.

The value of cylindrical panoramic radiography (using one rotational axis), a modification of orthopantomography (using three rotational axes), in radiographic examination of maxillo-facial skeleton was estimated by evaluating the visualization of anatomical structures of the facial skeleton on cylindrical panoramic and linear tomographic radiographs of 51 patients examined with both methods. The radiographs were independently reviewed by four radiologists. The visualization of the lateral wall of the orbit and maxillary sinus, nasal septum, alveolar process and zygomatic corpus was better on cylindrical panoramic radiographs. Linear tomography visualized the media wall of orbit better. In visualizing the frontal sinus, orbital floor, medial wall of maxillary sinus and hard palate there were no significant differences between linear tomography and panoramic zonography.

Adolescent↗

Radiation doses during panoramic zonography, linear tomography and plain film radiography of maxillo-facial skeleton. A comparative study.

The radiation doses to the organs and the skin of the head and neck during plain film radiography, a-p and p-a linear tomography and panoramic zonography of the maxillo-facial skeleton were measured on a sliced anatomic Alderson skull phantom with LiF (TLD-100) thermoluminescence chips. The doses were clearly highest during the linear tomography. Also the doses during the plain film radiography were quite high. Compared to the conventional methods the doses from the panoramic Zonography were minimal.

Cervical Vertebrae↗

The effect of ethacrynic acid on biliary excretion, concentration of ioglycamide and bile flow in dogs.

The effect of ethacrynic acid (EA), an agent which increases bile acid independent bile flow, on the biliary excretion and concentration intravenously administered biliary contrast agent ioglycamide was studied on cholecystectomized anesthetized dogs equipped with Thomas cannula through which the common bile duct could be cannulated. One hour after cannulation i.v. infusion of ioglycamide at a rate of 4 mu mol./min./kg. was started. Two hours later 1 mg./kg. of ethacrynic acid was injected intravenously. This procedure was repeated three times on four dogs, five dogs receiving comparable volume of saline at comparable time serving as controls. Bile was collected at 15 min. intervals and simultaneous i.v. blood samples were taken. EA injection caused decrease in biliary ioglycamide concentration and biliary excretion of ioglycamide and a slight but statistically not significant decrease in bile flow. Since EA is an organic anion and the increase in bile flow induced by it has been shown to be related to the biliary excretion of its metabolites, it may be suggested that EA as an organic anion inhibited biliary excretion and hepatic uptake of ioglycamide but having lower choleretic effect its excretion could not increase the bile flow.

Animals↗

The effect of taurocholate on canine bile flow, biliary excretion and concentration of ioglycamide.

The bile acid taurocholate increases the biliary excretion of organic anions, such as sulfobromophthalein (BSP), bilirubin and iopanoic acid. In the present study has been investigated the effect of taurocholate on 1. Canine biliary excretion and concentration of the i.v. contrast medium ioglycamide and 2. Canine bile flow. The experimental model consisted of cholecystectomized, anaesthetized dogs with a fistula, through which the common bile duct could be catheterized and drained. One hour after cannulation, i.v. infusion of ioglycamide at a rate of 4 mumol/min./kg. was started. Two hours after the infusion start a control group received i.v. infusion of saline, while in another a 1.5% sodium taurocholate infusion was started with stepwise increases with 30 min. intervals from 0.4 to 0.8, 1.6 and 3.2 mumol/min./kg. Compared with control, all rates of taurocholate infusion increased bile flow and decreased biliary ioglycamide concentration. Although the bile flow with increasing taurocholate infusion rates was enhanced, the biliary ioglycamide excretion did not increase. The results indicate that ioglycamide and taurocholate are excreted into bile by separate excretion mechanisms. As taurocholate increases the biliary excretion of some other organic anions, it supports the hypothesis that organic anions are excreted into bile by more than two excretion mechanisms, taurocholate affecting only some of them.

Animals↗