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Biomedical subjects

J Merikanto

Publications and source records attributed to J Merikanto.

At least 19 recordsLinked to original sources
PubMed1997

The value of MRI in early Perthes' disease: an MRI study with a 2-year follow-up.

Eleven hips in nine patients with Perthes' disease were studied by plain radiography at 3-month and MRI at 6-month intervals over a period of 2 years. The aim was to clarify the value of MRI in estimating epiphyseal involvement and in predicting uncoverage of the epiphysis. Signal intensities of the epiphysis and metaphysis were visually evaluated from T1- (T1W) and T2-weighted (T2W) images. The extent of decreased signal intensity (DSI) in the epiphyses was volumetrically calculated from T1W images and then compared with follow-up radiographs. The area of epiphyseal DSI corresponding best with Catterall's classification was seen by MRI 3-8 months after the first symptoms. MRI images obtained earlier usually showed less involvement than the follow-up radiographs. However, two features predicting extensive epiphyseal necrosis were: (1) DSI on both T1W and T2W images covering over two-thirds of the epiphysis and (2) diffuse bone marrow oedema of the femoral neck and metaphysis. When T1W images showed a reappearance of high signal intensity patches in the lateral quarter of the epiphysis, no clinically significant uncoverage was seen during the follow-up. Extensive epiphyseal necrosis can, therefore, sometimes be predicted by MRI even within the first 3 months, but MRI visualises epiphyseal involvement more clearly 3-8 months after the first symptoms.

Child↗
PubMed1996

Critical aspects of neonatal surgery in clubfoot.

Good results after early operative treatment of clubfoot has been reported by some investigators. Most have recommended early conservative treatment and later surgical procedures in resistant cases. Operation immediately after birth is demanding, and the operative team must master all problems of neonatal surgery, anesthesiology, and postoperative care. Conservative treatment in experienced hands may lead to a satisfactory result in one third of cases. We recommend primarily conservative treatment, but patients with resistant cases must undergo operation at age 2-5 months. We need more prospective studies and generally accepted grading systems of results.

Clubfoot↗
PubMed1993

Spinal deformity induced by radiotherapy for solid tumours in childhood: a long-term follow up study.

A group of 44 individuals were re-evaluated at a median follow up time of 19 years after radiotherapy for childhood cancer involving some part of the vertebral column. The median age at diagnosis was 2.6 years. The diagnosis included Wilms' tumour (n = 24), neuroblastoma (n = 9) and other solid tumours (n = 11). Scoliosis with or without kyphosis was the most common spinal deformity and was found in 40/44 patients. The apex of the major curvature was on the lumbar vertebral body 1-3 in 23 cases. The kyphosis and lordosis were greater in the subjects with tumour other than Wilms' (P = 0.04 both). Of the subjects restudied, 35 had detectable local soft tissue atrophy in the region of irradiation. Scoliotic deformity often enhanced cosmetic handicap/defect. Five subjects reported some symptoms related to the back; they had more severe scoliotic and kyphotic deformity (P = 0.02). Spinal abnormalities were common in these survivors, but subjective complaints were unusual.

Adolescent↗
PubMed1993

[Radiologic findings in renal metastases].

US and CT findings in 41 cases of renal metastasis with known primary malignancy, mostly lymphoma and pulmonary carcinoma, are analysed retrospectively. All of them were examined with US and 22 with CT. The renal metastases were bilateral in 20 cases and multiple in 21. The echo structure was "infiltrative" in 20, non-infiltrative in 21, homogeneous in 11 and non-homogeneous in 30. 33 metastases were echo-poor, 5 were hyperechoic, two iso-echoic and one of mixed echogenicity. The lymphomas were usually homogeneous, infiltrative and echo-poor, whereas the metastases of pulmonary primaries were usually nonhomogeneous, non-infiltrative, echo-poor and some hyperechoic. None of hyperechoic metastases were lymphomas. One case out of 22 examined with CT indicated a false negative US finding, while 4 US examinations showed only some of the lesions detected with CT. The lesions were hypodense and non-homogeneous in plain CT and gave non-homogeneous enhancement in all cases except for 4 with homogeneous lesions. CT showed smaller and more numerous lesions than US.

Adult↗
PubMed1993

Microangiography--a sensitive method for studying experimental diabetic nephropathy.

Microangiographic and conventional histopathologic investigations of the kidney were compared in 15 alloxan diabetic and 7 nondiabetic control rats. Contrary to the relatively sparse histologic lesions, microangiography disclosed advanced vascular abnormalities, including arteriolar aneurysms, which increased with the duration of diabetes. It is concluded that microangiography is a sensitive and suitable method for studying the development of microvascular lesions of the kidney in experimental diabetes.

Alloxan↗
PubMed1992

Foot deformities in diastrophic dysplasia. An analysis of 102 patients.

The exceptionally high prevalence of diastrophic dysplasia in Finland has enabled us to analyse the foot deformities of 102 patients at their first orthopaedic evaluation and classify 204 feet into five categories. The most common finding (43%) was a foot with tarsal valgus deformity and metatarsus adductus; 37% showed either equinovarus adductus (29%) or equinus (8%) deformities. At the first examination 13% showed metatarsus adductus deformity alone, and 7% were clinically normal. The expression 'club foot', generally used for the foot deformity in diastrophic dysplasia is a misnomer. There is a wide spectrum of deformities, some of them specific for the condition.

Adolescent↗
PubMed1991

The spine in diastrophic dysplasia.

Diastrophic dysplasia is an autosomal recessive disorder of the skeleton, characterized by disproportionate short stature, generalized joint deformities, club feet, deformed ear pinnae, and, frequently, spinal deformity and cleft palate. Diastrophic dysplasia is more common in Finland than elsewhere. We studied 101 patients with an age range from newborns to 79 years to find out the frequency and type of spinal deformities, the early signs of progressive cases, and to follow the natural history of the disease. In the follow-up study, 17 patients were under 10 years, 21 under 21 years, and 63 over 21 years of age. One-third of the patients had cervical kyphosis; in the most severe case the kyphosis was 180 degrees and led to quadriplegia during anesthesia. In three patients, cervical kyphosis resolved spontaneously before the age of 5 years. The overall frequency of scoliosis was 37%; 49% in women and 22% in men. Only 13 patients had curves greater than 50 degrees; these curves constituted distinct rotation at the apex from the early evolution of the curve. The early signs of severe curves were detectable at the age of 2 to 4 years. Only two patients were operated on because of scoliosis; one with fusion in situ and the other instrumented with the pediatric Cotrel-Dubousset instrumentation. Three patients had a brace, which did not prevent the progression of the curve. Symptoms referring to a narrow spinal canal were registered in four patients, two of which were operated on; a lumbar posterior decompressive procedure was made at adult age.

Adolescent↗
PubMed1990

Radiological and cytological detection of renal pelvic transitional-cell carcinoma.

We evaluated US, CT, intravenous urography, arteriography, retrograde pyelography and urine cytology results in a series of 23 patients with renal pelvic transitional-cell carcinomas, 14 of whom underwent US, 17 i.v. urography, 8 CT, 15 arteriography, 9 retrograde pyelography, and 17 patients urine cytology. A tumour was identified in 5 patients (36%) at US, in 11 patients (61%) at urography, in 7 (88%) at CT, in 10 patients (67%) at arteriography, and in 8 (89%) at retrograde pyelography. Urine cytology was assessed as showing changes consistent with Papanicolaou class III-V in 15 (88%) of 17 patients. When renal pelvic cancer is suspected, intravenous urography should be performed as the initial radiological examination and followed by CT, which may also identify tumour spread. Arteriography and retrograde pyelography are sometimes complementary investigations. Repeated urinary cytology is mandatory. Our results show that US alone is unreliable in detecting renal pelvic cancer.

Adult↗
PubMed1988

Ultrasound in the detection of adrenal tumours.

An analysis was made of the ultrasound (US) findings in 110 patients with proven or ultrasonographically suspected adrenal tumours. A total of 212 glands were imaged, 117 of which contained a tumour. The diagnosis was confirmed histologically in 50 cases and by imaging and follow-up in 162 cases. Normal glands were visualized ultrasonically in 27 out of 40 glands on the right and 5 out of 55 on the left. US detected 55 out of 59 primary adrenal tumours and 49 out of 58 secondary tumours, showing a sensitivity of 89%. In 13 tumours ultrasonography gave a false negative result, and in 13 cases a false positive one. Benign or primary malignant tumours and metastases could not be differentiated on the basis of echo-structure, but a large heterogeneous tumour in a patient with no known extra-adrenal malignancy is probably a primary malignant adrenal tumour.

Adenoma↗
PubMed1987

Carpal tunnel syndrome in childhood.

Carpal tunnel syndrome is extremely rare in childhood and in almost all previously reported cases it has been secondary to some underlying condition. Three 13- to 14-year-old girls are described with idiopathic carpal tunnel syndrome, confirmed by EMG and relieved by surgical decompression. A noteworthy feature in children is short-lasting but severe attacks of pain, which may be the main symptom. Correct diagnosis is important to avoid unnecessary examinations and, if indicated, the syndrome can be cured by surgery.

Adolescent↗
PubMed1983

Effect of intrauterine thymectomy on granulation tissue formation. An experimental study.

Intrauterine thymectomy was successfully performed on 9 guinea pig foetuses at the gestational age of 36-48 days. This resulted in a significant suppression of the phytohemagglutinin (PHA) response of the whole blood lymphocytes at the age of 3 mth. The in utero-thymectomized guinea pigs and their littermate non-thymectomized controls were operated on by making 4 symmetrical dorsal skin incisions and by subcutaneously implanting 8 standardized pieces of viscose cellulose sponge. On the 1st, 3rd, 5th and 10th days the tensile strength of the wounds was determined and the implants were analysed histologically and enzymehistochemically. At the time of incipient fibroplasia on the 5th post-operative day, the tensile strength of the wounds, the number of fibroblasts and the activities of aminopeptidase and succinate dehydrogenase were clearly less in the guinea pigs which had been thymectomized in utero. These findings indicate that adequate thymic function was necessary for normal fibroblast proliferation, since intrauterine thymectomy led to a temporary delay in the beginning of the fibroblastic phase in wound healing.

Animals↗
PubMed1981

Ectopia cordis.

Ectopia cordis is a rare congenital anomaly with an unknown incidence. The heart lies totally or partially outside the thoracic cage. Sternal cleft without cardiac protrusion outside the thorax is not included. The condition is often associated with various cardiac and extracardiac anomalies. During the period 1968-1978 three cases of thoracic total ectopia cordis were encountered. Surgical correction was unsuccessful. This has been the outcome in all but one case of thoracic forms of total ectopia cordis reported earlier in the literature.

Heart Defects, Congenital↗
PubMed1980

Immunologic consequences of neonatal splenectomy.

The hazard of overwhelming postsplenectomy infection has been suggested to be greatest in children operated upon before 1 yr of age. In this work immune functions of 3 children, splenectomized within 2 days after birth were studied. The opsonic activity of the sera of all patients towards pneumococcus was decreased. The other immunologic findings were normal. These observations support the concept that all splenectomized patients should receive pneumococcal polysaccharide vaccine and in case of any infection adequate antibiotic therapy must be started very soon after the first symptoms.

Humans↗