PubMed HealthSearch

Biomedical subjects

J Kinnunen

Publications and source records attributed to J Kinnunen.

At least 19 recordsLinked to original sources

Lumbar spine interbody fusion with reinforced hydroxyapatite implants.

Porous coralline and synthetic hydroxyapatite blocks reinforced with either self-reinforced polyactide or polyglycolide were implanted into 15 lumbar intervertebral disc spaces in five minipigs in order to determine whether they could provide an osteoconductive bridge for interbody fusion. Histological examination and radiological analysis with plain films, computed tomography and magnetic resonance imaging were carried out. The osteoconductive properties were promising; creeping bone formation could be observed, although no complete fusion had been achieved at 24 weeks.

Animals

Bone malalignment in acute injuries of the wrist.

The purpose of this study was to analyze radiographic signs of carpal bone instability in patients with an acutely injured wrist. There were 80 patients (52 women and 28 men) with a fall on the outstretched hand. Fifty patients had a fracture of the distal radius, and eight had a scaphoid fracture. The patients with a bone fracture showed a larger scapholunate angle than those without a fracture (P less than 0.001, t-test). However, only four of them showed true carpal bone instability: two patients with a scaphoid fracture and one with a radius fracture had dorsiflexion instability of the wrist and one patient with a radius fracture had dorsal subluxation of the wrist. In addition, one patient without any bone fracture had scapholunate dissociation, one form of carpal bone instability. Although carpal bone instability is not frequent in an acutely injured wrist, its signs should be remembered in the radiographic analysis of the traumatic wrist to prevent subsequent articular disorders.

Acute Disease

Posttraumatic lumbar intraspinal extradural-intradural ossification.

A case of intraspinal calcification having mainly the configuration of an intradural cast is presented. The traumatic etiology is obvious, and we consider, that the dural sac and nerve root lacerations were associated with intradural as well as extradural hematomas, which later became calcified.

Adult

The cleansing enema. How many for a good quality double-contrast enema?

The effects of the 'tap-water enemas till clear' method of bowel cleansing on the technical quality of double-contrast enema (DCE) were studied in 123 outpatients referred for DCE. Patients with one or two tap-water enemas (1.75 litres) before the DCE had significantly more faecal residue and flocculation of contrast medium than patients with three or more enemas. However, the number of enemas did not correlate significantly with mucosal coating. The results suggest that at least three tap-water enemas should be given before DCE.

Adolescent

Double-contrast barium examination and endoscopy in the detection of small polyps of the large intestine.

The purpose of this study was to compare double-contrast barium examination (DCBE) and endoscopy in detection of small colonic polyps. In 57 patients DCBE revealed 106 polyps in the large intestine. On total colonoscopy, 62 polyps could be verified. The size of the polyps excised ranged from 2 to 15 mm. Compared with DCBE, colonoscopy verified 48 true positive, 44 false positive and 14 false negative polyps. In revealing a polyp less than 5 mm, DCBE had a sensitivity of 72%, whereas in detection of larger polyps the sensitivity was 81%. Histological verification was available in 52 of the 62 removed polyps. A tubular adenoma was found in 12 of the 29 diminutive polyps verified with histology. DCBE and colonoscopy could not differentiate between adenomas and hyperplastic polyps. Since a polyp less than 5 mm may represent an adenoma, a precancerous lesion, its removal is indicated during colonoscopy after DCBE has detected it.

Adenoma

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

Improved visualization of posterior fossa with clivoaxial CT scanning plane.

Eighteen patients clinically suspected of having acoustic neurinoma were studied in both orbitomeatal and clivoaxial (CA) (the plane perpendicular to clivus) CT scanning planes during the same sessions. On the CA cuts there were highly significantly less (p less than 0.001) artifacts. Also, the tentorium was highly significantly (p less than 0.001) better visualized on the CA cuts. CA cuts could be recommended in cases when artifacts disturb the diagnostics of posterior fossa pathology or when detailed topographic information about pathologic anatomy round the tentorium is needed.

Adult

Urography with spasmolytics.

The effects of glucagon (1 mg i.v.) and hyoscine butylbromide (Buscopan 20 mg i.v.) and placebo on the visualization of the pyelocalyceal systems and ureters was compared in a routine urography with abdominal compression in a double-blind, randomized trial comprising 189 kidneys and ureters. The visualization of the ureters in the supine position was highly significantly better than in the prone. In the prone position the ureteral visualization with Buscopan was marginally significantly better than with placebo or glucagon. Otherwise, neither Buscopan nor glucagon improved the pyeloureteral visualization. However, with glucagon the pyelocalyceal visualization was highly significantly poorer than with placebo, and marginally significantly poorer than with Buscopan.

Animals

Wire-guided biopsies of nonpalpable breast lesions.

The purpose of this study was to review the results of mammographic wire-guided biopsies of nonpalpable breast lesions and the features of the lesions in the preoperative examinations. Sixty women, mean age 50.2 years (range 31 to 74), underwent a wire-guided biopsy of the lesion. Twenty-nine patients had preoperative fine needle aspiration of the lesion. The radiographic diagnosis was correct in 33 patients (55%); 25 had breast cancer and 8 patients had a benign lesion. In 9 of the 14 patients with clustered microcalcifications in mammography and in 13 of the 15 patients with a mass noted in mammography, the cytological examination was correct. Nonpalpable mammographic masses with regular borders and normal fine needle aspiration examination do not require biopsy. In malignant mammographic appearances associated with a normal fine needle aspiration examination, biopsy of the lesion should always be done.

Adult

Double contrast barium meal and acetylcysteine.

In a prospective double blind study, acetylcysteine, a local and systemic respiratory tract mucolytic agent, or a placebo, were given to 100 patients prior to a double contrast barium meal to decrease the gastric mucus viscosity and to make the mucus layer thinner, in order to permit barium to outline the furrows surrounding the areae gastricae instead of the overlying thick mucus. However, acetylcysteine failed to improve either visualization of the areae gastricae or the general quality of the double contrast barium meal.

Acetylcysteine

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

Superior mesenteric artery syndrome. A follow-up study of 16 operated patients.

A series of 18 patients underwent surgery for upper abdominal symptoms and signs of superior mesenteric artery syndrome (SMAS). The diagnosis was made by simultaneous arteriography and barium meal. Findings at operation confirmed SMAS in every patient, and a duodenojejunostomy was performed. Duodenal and jejunal wall biopsy from 13 patients revealed normal myenteric and submucous plexuses. A follow-up study of 16 patients was performed after 7 years. At follow-up, the weight loss seen preoperatively had been corrected. However, symptoms were essentially similar to those found at the original examination. Only the frequency of the most distressing symptom, vomiting, was significantly decreased (p less than 0.05). The most striking features in the production of the "pincher mechanism" of the duodenum were found to be a short aortomesenteric distance together with sagittal parallelism between aorta and superior mesenteric artery. In conclusion, we recommend a conservative attitude in the treatment of SMAS. Surgical treatment with duodenojejunostomy may be indicated only if vomiting is a predominant symptom and proper conservative treatment has failed.

Adult

Effect of radiologist supervision on technician performance and image quality in radiography of middle face trauma.

Image quality in radiography of middle face trauma was compared within and outside office hours on the basis of the visibility of diagnostically important structures, and an evaluation of the major patient- and technician-related factors influencing image quality. Image quality was statistically significantly better within than outside office hours. This was due to the technician-related factors of patient positioning, X-ray beam limiting and centering. Since the analysis of variance revealed that alcohol intoxication (three times more common outside than within office hours) had no statistically significant effect on image quality, the difference must have been due to the only remaining variable--radiologist supervision, which was present only within office hours.

Allied Health Personnel

Analgesic efficacy and tolerability of diflunisal in oral surgery.

A double-blind, completely randomized study was carried out on 169 patients to compare the analgesic efficacy and tolerability of diflunisal with that of Veralgin after surgical removal of impacted third molars. One group received 1000 mg diflunisal (Donobid, MSD) 2 h preoperatively and then 500 mg twice daily for 2.5 days, and the other group Veralgin (aminophenazon. 286 mg, barbital. 114 mg, aethylmorph. hydrochlorid. 20 mg, Orion), a fixed combination widely used in Finland, 1 tablet twice daily beginning 2 h prior to operation. Visual analogue scales were used to estimate pain. Diflunisal was found to be superior in relieving pain in the early postoperative period, the associated frequency of adverse clinical experiences was lower and the final evaluation of analgesic efficacy by both the patients and the investigators, was in its favour. The study confirms that postoperative pain after third molar surgery can be controlled well without the use of mainly centrally acting combination analgesics.

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

Beer as colon lavage preparation.

Six patients received beer preparation prior to double contrast barium enema. The beer group scored slightly better (though not statistically significantly) both in the cleanliness and in the mucosal coating of the bowel than the control group with standard preparation. The fluid balance was unaltered. The patients in the beer group felt surprisingly well, likely due to the good fluid and energy balance provided by the beer. The beer preparation could be used in cases, when the patients are ready to intake beer and want to maintain a good nutritional status.

Adult