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Biomedical subjects

E Tierala

Publications and source records attributed to E Tierala.

11 recordsLinked to original sources
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

Intraoperative ultrasound as an aid to surgical strategy in liver tumor.

Ultrasonography of the liver was performed on 27 patients during laparotomy for liver lesions--11 primary and 13 metastatic mainly colon/rectum malignancies, and three benign conditions. Supplementary information on the liver parenchyma was provided in 11 cases (41%) in which the surgical strategy was decided simply by inspection and palpation of the liver. Ultrasound was most valuable for visualizing the vascular anatomy of the liver, giving clarification in 18 cases (66%), especially the relationship of tumor to portal and hepatic veins. This was decisive for the surgical strategy in four cases, enabling resection in two and modifying planned procedure in two. In a case of polycystic liver, ultrasonography imaged deep-lying cysts and aided the fenestration procedure. Liver resection was performed in 16 cases without operative mortality. Hepatic ultrasonography is useful for determining tumor spread, but of even greater value for the determination of strategy by clarifying tumor/vascular anatomic relationships.

Adult↗
PubMed1989

Omnipaque and Gastrografin in gastrointestinal follow-through examinations.

The non-ionic low-osmolar contrast medium Omnipaque was compared with the conventional ionic high-osmolar contrast medium Gastrografin in a randomized, double blind study comprising 71 consecutive gastrointestinal follow-through examinations performed because of suspected ileus or anastomosis control. The patients' reaction were confined to nausea, emesis and diarrhoe being very similar in both groups and related to the patients' illnesses. The taste of Gastrografin was more often judged unpleasant, but the difference was not significant. Omniplaque scored significantly better for contrast medium density and diagnostic visualisation in the small bowel, otherwise the differences were negligible. There were no significant differences in the transit time into the caecum. The high price of Omnipaque restricts its routine use. It may be diagnostically indicated in selected cases where greater accuracy in the delineation of pathologic anatomical details in the small bowel is desired.

Diatrizoate Meglumine↗
PubMed1988

Results and complications of percutaneous nephrostomy.

A series of 181 patients (158 with obstructive uropathy) treated by percutaneous nephrostomy (PN) in 1978-1987 is evaluated. In 8.3% of the patients PN did not succeed. The success rate of PN was lower when done outside normal working hours and before ultrasound guidance was used. Major complications occurred in 5.5% and minor ones in 10.5%. There was no direct mortality. The complications and the possible avoidance of them are discussed. In 68% of patients nephrostomy improved their clinical condition. The benefit of PN was closely related to the existing renal recovery potential following the relief of obstruction; a problem that has not yet been fully solved.

Adolescent↗
PubMed1978

Gross deformity of the spine; a lumbar myelographic risk with Conray and Dimer X.

Convulsions and fracture of the neck of the femur following myelography with Conray and Dimer X are reported in two patients with a gross post-tuberculous gibbus deformity of the thoracic spine. The possible causes of the increased risk associated with myelography of the patients with gibbus are discussed.

Femoral Neck Fractures↗
PubMedDate not supplied

Ultrasonically guided fine-needle aspiration biopsy in focal pancreatic lesions.

Ultrasonically guided fine-needle aspiration biopsy was performed in 100 patients with a focal pancreatic lesion. The lesion was a well-defined solid mass of 1 to 4 cm in 37 cases, a well-defined solid mass of 4.5 to 10 cm in 28 cases, an intrapancreatic cystic lesion in 23 cases, and an ill-defined prominent area in 12 cases. The samples were taken with a one-hand instrument and 0.7 to 0.9 mm disposable needles without a puncture adaptor. The material was sufficient for cytologic analysis in 98 cases. Malignant cells were obtained in 44 of the 49 cases with pancreatic carcinoma and lymphoma cells in one case with lymphomatous infiltration. Four of the six cases of cystadenoma could be identified cytologically. In solid inflammatory lesions, the nature of the lesion was seen in 12 of the 17 cases. There were no false positive reports of malignancy. The solid prominent areas of normal pancreatic tissue yielded normal cytologic samples. Aspirates of cystic lesions in the pancreas revealed one malignant case, and infected lesions could be differentiated from non-infected in the rest. There was one complication in a patient with an obstructed and dilated common bile duct. The aspiration procedure caused severe pain and the operation was performed earlier than scheduled. Diagnostic material is obtained in the majority of ultrasound guided aspiration biopsies of the pancreas. In malignancy, false negative results occur in about 10 per cent of cases.

Adult↗
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↗