[Combined echocardiographic and Doppler ultrasonic diagnosis of carotid bifurcation--reliability and error].
Explore the source record for details and available documents.
Angiography↗
Biomedical subjects
L Keski-Nisula
Publications and source records attributed to L Keski-Nisula.
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↗
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↗
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↗
[Traumatic cortical hyperostosis in a child].
Explore the source record for details and available documents.
Bony Callus↗
[Experience with angioplasty of the lower extremities].
Explore the source record for details and available documents.
Aged↗
Injuries of the thoracolumbar junction. Clinical and radiological results in 149 patients.
In a series of 149 fractures of the thoracolumbar junction (Th12-L1), treated at the Central Hospital of Tampere from 1968 to 1975, 101 patients were seen after an average interval of 5 years. Over half of the fractures were sustained at home or in leisure hours. Over 90% were anterior wedge fractures. One patient died in the hospital of other injuries. The injury caused peraplegia in three cases and other neurological lesions in six. The treatment was conservative except in the patients with paraplegia, who were surgically treated. The patients were mobilized after an average of 15 days. The neurological condition did not deteriorate. Noteworthy changes of the radiological findings occurred during follow-up. The clinical result was considered good in two thirds of the patients, and 91% were able to return to work. The frequency of neurological findings was significant in patients showing radiological deformities. The force responsible for the fracture correlated with the radiological findings and the occurrence of neurological lesions. Narrowing of the vertebral canal and degenerative changes observed on admission had a significant and unfavorable effect on the clinical result.
Adolescent↗
Fractures of the lumbar spine. Clinical and radiological results in 94 patients.
Sixty-six (70 per cent) of 94 patients with fracture of the lumbar spine (L2-L5), treated at the Central Hospital of Tampere in 1968--1975, were seen after an average interval of 5 years and 4 months. The mean age of the patients at the time of injury was 40.4 years. Somewhat less than half the fractures were sustained at home or in leisure hours and one third were due to traffic accidents. Two thirds were anterior wedge fractures. One patient died in the hospital of other injuries sustained in the same accident. Paraplegia was caused in one case, other neurological lesions in six cases. The treatment was mainly conservative and based on the principle of early functional exercises. Surgery was used in 2 cases of fracture-dislocation. The patients were mobilized after an average of 19 days. The mean duration of hospital treatment was 26 days. Seventy-nine per cent were able to return to work after an average of 3.6 months. No noteworthy changes in the neurological state occurred during follow-up. Half the followed-up patients considered the state of their back at least good. Poor end-results were more frequent in patients over 40 years old than in those under 40. Radiological deformities were more often observed in patients showing neurological symptoms. Increased interspinous distance and flexion or compression deformities had an unfavourable effect on the clinical result.
Adolescent↗
Posterior fusion of the lumbosacral spine. Evaluation of the operative results and the factors influencing them.
The operative results of 79 patients subjected to posterior fusion of the lumbosacral spine were evaluated on the basis of a follow-up examination performed on average 5.4 years after operation. A method of evaluation was developed which measured the patients' subjective improvement and working capacity. The method proved appropriate for clinical use and gave a more correct picture of the operative result than methods relying on the patients' own opinion or the radiographic assessment as the only criterion. Sixty per cent of the patients were subjectively improved, 40 per cent had returned to their previous or a corresponding occupation and 24 per cent had a good operative result, assessed by the method applied. A statistical analysis was performed in order to find the factors influencing the operative results. Age over 40 years, heavy or moderately heavy preoperative work and over 6 months' preoperative disability had a statistically significant, unfavourable effect on the results. In the case of labourers in heavy occupations, working capacity was seldom restored to a degree sufficient for return to their previous work. The operative technique proved reliable with 91 per cent successful fusions, assessed from functional radiographs. Successful fusion did not imply a good operative result, although it did so more often than non-fusion. On the basis of this study, operative fusion of the lumbosacral spine seems to be of relatively little value in the treatment of patients suffering from low back pain, and factors other than purely medical or surgical have a considerable influence on the operative results.
Adolescent↗
[Errors in the radiological diagnosis of injuries of the cervical spine (author's transl)].
The frequency of fractures of the cervical spine has increased with the rise in traffic accidents, but the radiological diagnosis of fractures at the initial examination remains unsatisfactory. A false negative diagnosis in the accident department was made in 25 out of 86 patients (29%) by a surgeon and in 12 patients (14%) by a radiologist. Poor radiographic quality was an important source of error, particularly for the diffult fractures in the cranial and caudal parts of the cervical spine. Half the fractures of the arch of the atlas and of the odontoid were missed initially. There was also difficulty in diagnosing fractures of the articular processes, evulsion fractures of the vertebrae and unilateral subluxation. Since the late results of missed vertebral fractures may be fatal, it is necessary to make more use of those signs which may indicate a fracture. Widening of the pre-vertebral soft tissues was seen in 33 out of 100 patients and an increased distance between articular facets on the A. P. projection in 19 out of 100 patients. Angled A. P. projections are useful for the diagnosis of fractures of articular facets in bed-ridden patients. Fractures in the lower cervical spine are well seen on oblique supine views. In larger accident departments, tomography and immediate radiological consultation should be available.
Accidents↗
Prenatal collapse of cysts in a dysplastic kidney.
Postnatal regression of prenatally or neonatally detected multicystic dysplastic kidney disease has been widely documented. However, renal cysts can regress during gestation, although they usually become larger in utero. We present a case of prenatally detected multicystic dysplastic kidney with an atypical course. During the third trimester, unilateral multicystic renal lesions in the fetus first enlarged and later involuted; by the second postpartum year, the kidney had become hypoplastic and nonfunctional. Our case also shows that before birth, blood flow in the affected kidney, measured with Doppler imaging, was normal until the cysts involuted.
Adult↗
M385T polymorphism in the factor V gene, but not Leiden mutation, is associated with placental abruption in Finnish women.
This study determines whether genetic variability in the gene encoding factor V contributes to differences in susceptibility to placental abruption. Allele and genotype frequencies of three single nucleotide polymorphisms (SNPs) in the factor V gene leading to nonsynonymous changes (M385T in exon 8, and R485K and R506Q [Leiden mutation] in exon 10) were studied in 116 Caucasian women with placental abruption and 112 healthy controls. Single-point analysis was expanded to haplotype analysis and haplotype frequencies were estimated using an expectation-maximisation (EM) algorithm. Comparison of single-point allele and genotype distributions of SNPs in exon 8 and exon 10 of the factor V gene revealed statistically significant differences in M385T allele (P = 0.021) and genotype ( P = 0.013) frequencies between the patients and the control subjects. The C allele of SNP M385T was significantly less frequent among the patients (7%) vs. the control subjects (13%), at an odds ratio of 0.48 (95% CI 0.25-0.91). Allele and genotype differences between the patients and control subjects as regards R485K and Leiden mutation were not significant. In haplotype estimation analysis, there was a significantly lower frequency of haplotype T-R-R encoding the T385-R485-R506 variant in the group with placental abruption vs. the control group (P = 0.038) at an odds ratio of 0.519 (95% CI 0.272-0.987). We conclude that T385 is less frequent among the patient group than in the control group. The M385T variant in the factor V gene other than the Leiden mutation may play a role in disease susceptibility.
Abruptio Placentae↗
Preoperative physical examination for primary vascular access--reliability in determining vessel quality.
BACKGROUND AND AIMS: The purpose of this prospective clinical study was to evaluate the reliability and adequacy of preoperative physical examination in determining the quality of vessels prior to primary vascular access procedure by performing peroperative completion fistulography. MATERIAL AND METHODS: 26 consecutive patients who were scheduled for primary vascular access surgery, between July 2001 and June 2002, were included. Findings between the preoperative physical examination and peroperative completion fistulography were compared. RESULTS: Of the 26 patients that were initially enrolled in the study, 4 patients were excluded because physical examination showed poor superficial arm veins and 2 patients had not undergone access procedure by the end of the study. The remaining twenty patients constituted the actual study group. The arteriovenous fistula could be performed at the chosen level and way in all 20 patients. The findings between preoperative physical examination and peroperative fistulography were compatible and the specificity of physical examination to detect patent inflow and outflow vessels was 100%. Due to the fact that 4 patients in whom a poor vein was suspected were excluded, the sensitivity could not be assessed. CONCLUSIONS: Preoperative physical examination seems to be reliable and adequate method in determining vessel quality prior primary vascular access surgery. According to our study, its specificity is high in determining patent inflow and out-flow vessels. However, because of exclusion of patients with suspected problem, sensitivity cannot be determined.
Adolescent↗