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Biomedical subjects

L Ala-Ketola

Publications and source records attributed to L Ala-Ketola.

At least 19 recordsLinked to original sources
PubMed1984

Percutaneous dilatation of lower leg arteries.

Percutaneous transluminal angioplasty was introduced in the X-ray department of the Central Hospital of Etel ä- Pohjanmaa in 1981 for the treatment of arteriosclerosis of the leg. The first year material consisted of 43 patients. Of the 45 lesions treated 16 were iliac stenoses, 12 femoropopliteal stenoses, 16 femoropopliteal occlusions, and one occlusion of the deep femoral artery. In 20 cases, angioplasty was performed for limb salvage from amputation, in 23 because of claudication. Technical success was achieved in every stenosis and in 10 out of the 16 femoropopliteal occlusions (63 per cent). One year cumulative patency rate was 81% in iliac stenoses, 66% in femoropopliteal stenoses, and 50% in femoropopliteal occlusions. Diabetes had an adverse effect on the results. Excluding patients with diabetes, the corresponding figures were 88%, 89%, and 60% respectively.

Aged↗
PubMed1984

Ankle arthrography in acute injuries.

Ankle arthrography has proved to be a simple, quick, and useful method in evaluating the ligamentous ruptures in connection with ankle injuries. The observations of the present authors are based on almost 5000 arthrographies . On the lateral side, the ligamentous ruptures spring up in an anteroposterior direction so that the FTA ligament is ruptured first, and, in a continuing injure mechanism, the FC ligament is the next to be ruptured. Isolated ruptures of the FC ligament do not occur. The rupture of the FTP ligament does not appear in arthrography. The rupture of the deltoid ligament is rarer and it usually appears in connection with a pronation lateral rotation injury, especially if the patient has a high fibular fracture and there is no simultaneous fracture of the medial malleolus. The ruptures of tibiofibular ligaments are connected with pronation lateral injuries and fractures of the fibula, if the fracture is situated at the level of the talo-crural joint line or cranial to it.

Acute Disease↗
PubMed1984

Duplex ultrasound imaging of the carotid arteries.

Duplex ultrasound examination of vessels includes both high resolution imaging in real time mode and rangegated Doppler with spectral analysis. Velocity spectra are calculated, and blood velocity ratios are determined. The duplex ultrasound examination seems to be a suitable method for screening of patients for angiography.

Blood Flow Velocity↗
PubMed1981

Pre- and postoperative bead chain urethrocystography in female stress urinary incontinence.

The effects of suprapubic Marshall-Marchetti-Krantz (MMK) operation or vaginal Kelly's operation on roentgenographic anatomy of the lower urinary tract were elucidated by means of chain urethrocystography (UCG). A selected series of 30 postoperatively continent and 70 incontinent patients were examined both preoperatively and 3-4 years after operation. Both the urethral inclination (UI) and the posterior urethrovesical (PUV) angle decreased after the operation. The decrease was more marked after successful than unsuccessful operations. The MMK operation reduced the UI and the PUV angle significantly more than did Kelly's operation in both successful and unsuccessful cases. The position of the bladder base or the PUV junction was not altered significantly by either of the operations, whether successful or unsuccessful. The patients with postoperative detrusor instability had roentgen-anatomical findings similar to those of continent patients.

Female↗
PubMed1978

Stress fractures caused by physical exercise.

A series of 142 stress fractures caused by sporting activities and physical exercise is presented. 121 fractures occurred in athletes and 21 in non-competitive sportsmen. Distance runners presented with 68 fractures, skiers 12, sprinters 10, orienteering runners 9, vaulters 3, and football-players 3 fractures. Athletes engaged in other events had fewer stress fractures. 76 fractures occurred in the tibia, 26 in the metatarsal bones, 20 in the fibula, 5 in the femoral neck, 4 in the femoral shaft, and 2 in the metacapal bones, lower pubic arch and sesamoid bones of the first MTP-joint. There was one fracture of each of the following: the humeral shaft, the ulna, the vertebral arch of L 5, the tarsal navicular and the proximal phalanx of the fifth toe. The treatment was generally a pause in training for 4-6 weeks, on the average. Running caused most of the stress fractures; the rest followed jumping exercises. The athletes mostly developed stress fractures during a period of alteration from one training session to another or during the preparation period close to the competition season. Joggers usually developped stress fractures 2-4 months after the beginning of regular training.

Adolescent↗
PubMed1977

Avulsion fractures in athletes.

34 cases of avulsion fractures are described. Each fracture took place during athletic training or competition. Excepting six sportsmen participating in a general fitness programme, every patient was an active competitive athlete. There were six women and 28 men; their average age was 20.1 years, raised by a few middle-aged "fitness sportsmen". Most avulsion fractures took place in sprinters and hurdlers; next were middle and long distance renner, footballers, fitness joggers, skiers and ice-hockey players. The most usual location of a fracture was the anterior pelvic spines; avulsion fractures were also detected in various parts of lower limbs. There were fewer avulsion fractures in the area of the trunk and upper extremities. Roetgenologically, the diagnosis of an avulsion fracture is generally easy to make. However, the diagnosis is facilitated by knowing the mechanism of the injury, the technique of the athletic event, and some of the training methods. Generally, a fracture heals well, even if it requires both sufficient immobilisation and some delay in resuming physical exertion.

Adolescent↗
PubMed1977

Arthrography in the diagnosis of ligament injuries and classification of ankle injuries.

Arthrography was assessed in 300 cases of ankle injury to determine its diagnostic information yield and its aid in classifying ankle injuries. No complications occurred as a result of the procedure. In 59 cases, information gained from the procedure was verified at surgery. Arthrography was considered to give valuable information in 85% of the cases of ligament ruptures.

Ankle Injuries↗
PubMed1977

Results of operative treatment of stress urinary incontinence with special reference to preoperative clinical and radiological evaluation.

Operative results of stress urinary incontinence are discussed on the basis of a follow-up study made 3-5 years after the operation. The series consisted of 301 patients operated on during 1969-1971. The most significant anamnestic feature was the great number of multiparas: 67% of the patients had given birth to at least 4 children. The choice of the operative method was based on Green's urethrocystographic classification into type I and type II. The healing was complete or satisfactory in 85% of the total material. In the group operated on according to type I the outcome was good in 88%, while in the type II group it was good in 84%. Incontinence of degree I was cured in 89% of the cases, while patients of degree III in only 72%. If there was a significant urgency component observable in the incontinence symptoms preoperatively, a good outcome was only attained in 64%. In pure or dominant stress incontinence the corresponding outcome was 88%. Hysterectomy combined to the operation seemed to improve the results. Age, parity, duration of the incontinence symptoms, weight and changes of weight after the operation had no significant effect on the healing. The authors emphasize the importance of careful differential diagnosis based on the anamnesis and examinations in choosing the therapeutic method for incontinence patients.

Adult↗
PubMed1977

Immediate surgical treatment of major renal trauma.

Of the 77 cases of renal trauma treated at Oulu University Central Hospital during the years 1965--1975, 60 injuries were minor and 17 severe. 73 of these injuries were closed and 4 penetrating. The rate of operative treatment in severe renal injuries was 88% minor renal injuries being treated conservatively. Primary exploration was done in 18 of the 77 cases and in all patients with penetrating injuries. Only 7 of the 73 patients with blunt trauma and one of the 4 patients with penetrating injury required nephrectomy, including one patient with renal carcinoma. 6 of the 77 patients died, most as a result of severe associated injuries, giving a mortality of 8%. None of the surviving patients treated for renal trauma suffered from major complications. In 13 of the 18 patients operated upon, renal injury was the main indication for operation. Operation was performed in 5 of the 18 patients after immediate radiological evaluation. The advantages of immediate surgical management in severe renal injuries are early and final treatment, short hospital stay, and low incidence of complications. Qualifications for emergency surgery are access to renal angiography and familiarity with reparative renal procedures.

Accidents↗
PubMed1977

Subcutaneous rupture of the urinary bladder.

Fourteen patients operated upon for subcutaneous bladder perforation are reported. The majority of the patients (11/14) had intraperitoneal rupture of the bladder and multiple associated injuries (10/14), most often pelvic fractures (9/14). In 12 patients the injury was caused by a road traffic accident. 2 patients with extraperitoneal rupture presented with a typical history of a blow or kick in the lower abdomen following a drinking session. In doubtful cases cystography was the diagnostic method of choice. The principles of treatment we recommend are well known: urinary drainage with a catheter in all cases, and in intraperitoneal ruptures, prompt surgery.

Accidents↗
PubMed1977

Traumatic splenic rupture.

71 patients with traumatic splenic rupture are reported. Most had severe associated injuries. In 44 patients the mechanism of trauma was blunt, in 10 penetrating, and in 17 iatrogenic, occurring most commonly (11/17) during operations for peptic ulcer. Splenectomy gave use to thrombocytosis which reached its peak about 2 weeks and returned to normal within one month after operation. Postoperative complications occurred in 24 of the 60 surviving patients (40%) of which most, 17 patients (30%) were infectious in origin. One patient developed deep venous thrombosis. Mortality was 16%. Associated injuries were the main cause of death in most patients (9/11), the ruptured spleen being responsible for only 2 deaths. None of the 17 patients with injury to the spleen alone died, whether associated with fractures of the left lower ribs or not. Primary unconsciousness, shock on admission, and multiple injuries, especially renal and hepatic, increased the mortality rate markedly. The necessity of drainage, the possibility of increased susceptibility of splenectomized patients to infection and thromboembolic complications and their prevention are briefly discussed.

Accidents↗
PubMed1977

Management of injuries of the large intestine.

Blunt trauma accounted for 1/3 of the 32 patients operated upon for injuries of the large intestine and penetrating wounds for 2/3. Most of the blunt injuries (9/10) were caused by traffic accidents, and more than half of the penetrating ones (12/22) were stab wounds. The transverse colon was most commonly affected, followed by the ascending, descending and sigmoid colon, rectum and mesentery. Perforation of the small intestine was the most frequent associated intra-abdominal injury, occurring in 11 patients (34%). Most patients (22/32) underwent simple suture, 6 patients suture with proximal colostomy, 3 primary resection and one exteriorization, combined in all cases with broad-spectrum antibiotic coverage and drainage of the abdominal cavity. Injuries to the right and transverse colon were managed mainly with simple suture, and those to the left colon and rectum with suture and proximal colostomy. 50% of the patients had complications, most frequently wound infection and intra-abdominal abscess. The patients with simple suture had fewer complications than the others. In the absence of complicating factors injuries to the colon are best managed with simple suture, whereas in the presence of complicating factors and in injuries of the rectum, suture or resection with proximal colostomy, especially in cases of severe tissue destruction, remains the treatment of choice.

Accidents↗