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Biomedical subjects

J Pietilä

Publications and source records attributed to J Pietilä.

15 recordsLinked to original sources

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

Reproducibility of skin blood flow, perfusion pressure and oxygen tension measurements in advanced lower limb ischaemia.

Since no generally-accepted non-invasive test is available for quantification of advanced distal ischaemia of the lower limb, the reproducibility of Laser Doppler flowmetry, skin perfusion pressure and transcutaneous oxygen tension measurement was assessed in 21 patients with severe occlusive arterial disease. The mean coefficients of variation for these methods were 0.11, 0.12 and 0.19 respectively over a 15-minute period without detachment of the measuring devices, and 0.30, 0.29 and 0.37 respectively from day-to-day. However, if tcpO2 values below 10 mmHg were excluded the corresponding coefficients of variation for this method were 0.08 and 0.31. Thus interventional changes may be detected during continuous monitoring with a reasonable degree of accuracy, but single values can hardly be expected to predict the outcome for the foot in a prospective series, nor can they be used in therapeutic trials of drug action. Major changes in peripheral circulation, for example the effect of revascularisation procedures, can be evaluated using any of the methods studied.

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

Non-invasive characterisation of angiopathy in the diabetic foot.

A comparison between 19 consecutive insulin dependent diabetic patients with a history of or current foot ulcers, gangrene or infection, with 14 arteriosclerotic patients with advanced lower limb ischaemia was performed using measurements of ankle and great toe systolic blood pressure, forefoot skin perfusion pressure and pulse volume assessment. Although clinical examination was usually sufficient to distinguish different types of diabetic foot, the vascular laboratory often gave additional information about the vascular component of the diabetic foot. In this study, great toe systolic pressure appeared to be the best indicator of the degree of macroangiopathy. The role of microangiopathy in the development of diabetic foot remains uncertain. The major factor responsible for diabetic foot in addition to neuropathy seems to be macroangiopathy which is not different from that of arteriosclerotic occlusive disease.

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

Assessment of exercise tolerance of cardiac patients by bicycle, treadmill and treadmill plus isometric exercise with and without nifedipine.

Seventeen post-myocardial infarction patients experiencing angina on effort performed 6 different exercise tests until they reached symptom-limited maximal level, 3 after placebo and 3 after oral administration of 10 mg of the Calcium antagonist, nifedipine, in a randomized, double blind, cross-over controlled study. Four of the tests were conventional bicycle and treadmill tests with stepwise increasing load. In 2 of the tests an isometric exercise of carrying a weight averaging 6 kg and corresponding to about 30% of maximal grip strength was added to the treadmill walking. When the exercise was stopped because of moderately severe angina, the product of heart rate and systolic blood pressure did not show any statistically significant difference between the tests. However, in the treadmill plus isometric test the work time was shorter and the slope of the treadmill was less than in the treadmill test. The difference was caused partly by non-cardiac factors, namely fatigue of the hand muscles. In routine exercise tests of coronary patients the addition of an isometric to a dynamic load did not give substantially more information than dynamic exercise alone. Nifedipine caused a modest increase of exercise tolerance in all tests, the increase being greatest in the treadmill plus isometric test. The increase in exercise tolerance was seen also in patients receiving beta-blocking agent.

Aged

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

Skeletal changes in dentists and farmers in Finland.

Two groups were studied: dentists and farmers from the Turku area. Radiologic examination of both groups included the spinal column, rib cage and shoulder joint. Spondylosis of the cervical spine was present in 68 (52.1%) of the dentists and 59 (19.2%) of the farmers. Lumbar spondylosis was more common among farmers than among dentists in the corresponding age group. Changes in the shoulder joint occurred significantly more often in dentists than in farmers. The findings in this study indicate that dentists appear to belong to the group doing heavy work.

Adult

The effect of perfusion on post-operative viability in the replanted rabbit ear: measured by laser Doppler flowmetry and skin temperature.

The effect of perfusion by heparinized Ringer solution on post-operative microcirculation in rabbit ear replants was studied. One ear in each of five rabbits was replanted after perfusion with heparinized Ringer solution and these were compared with five replantations of rabbit ears without perfusion. The ears were studied post-operatively for 2 1/2 days by skin temperature monitoring and Laser Doppler Flowmetry (LDF). During the first day after replantation the perfused ears had better capillary flow, whereafter no significant differences were noted. LDF was more sensitive to changes in capillary blood flow, and this seems to make the reproducibility of LDF poor. It is, however, a suitable method for continued observation of post-operative viability.

Animals

[Effect of S-carboxy-methyl-L-cysteine on the radiologic visualization of the mucosa in double-contrast examination of the stomach].

The radiographic pattern of the areae gastricae is produced by barium lying in the intersecting grooves 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. As S-carboxy-methyl-L-cysteine has been shown to be an effective respiratory tract mucolytic when administered by mouth and, may also render the gastric mucus layer thinner, it was tested as a pretreatment agent in a routine double contrast upper-gastrointestinal study to improve the visualization of the areae gastricae. In a double-blind study 53 of 103 patients took S-carboxy-methyl-L-cysteine in a dosage of 750 mg three times daily for three days before the examination. Results of the present study show that mucolysis induced by the administered doses of S-carboxy-methyl-L-cysteine did not significantly affect micromucosal visualization during double-contrast barium meal.

Adult

Weight, stroma to gland ratio, and mitotic activity of the human hyperplastic prostate.

The growth of the hyperplastic prostate of 12 patients was studied with an in vitro 3H-thymidine labeling method. The prostates were weighed and the stroma to gland ratio was analyzed. The mitotic activity of the glandular epithelium averaged 0.36 per cent (+/- 0.06 SE). No mitotic activity was found in the stromal tissue. There was a positive correlation between the weight of the prostate and the labeling Index of the glandular epithelium. Thus, the prostatic hyperplasia of these patients appeared to be purely glandular in form. The stroma to gland ratio was 70 to 80 per cent. It was found that most of the glandular follicles were mitotically quiescent, and that the mitotic activity was concentrated in a few of the follices. The results indicate that the growth of the hyperplastic prostate is caused both by the mitotic activity (hyperplasia) of the glandular epithelium and by the stromal hypertrophy. Thus, in vitro assay of the mitotic activity of the prostatic biopsies can be used for the estimation of the weight of the hyperplastic prostate. The possible role of the stroma in regulation of the mitotic activity of the glandular epithelium has been discussed.

Aged