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Biomedical subjects

L Laasonen

Publications and source records attributed to L Laasonen.

At least 19 recordsLinked to original sources
PubMed1990

Suitability of the scapular flap for reconstructions of the foot.

Eighteen patients with mainly a traumatic soft-tissue defect of the foot underwent reconstruction with a microvascular free scapular flap. Of the 17 successful transfers, 13 were to the weight-bearing parts of the foot. The stability and contour of the flaps were assessed after an average follow-up time of 3 years (range 1 to 5 years). The thicknesses of the scapular donor site and flap and the recipient site were measured by an ultrasound technique. The resistance of the flap to shear was measured with a dynamometer. The ultrasound measurements aided in refining our operative technique. In early cases, the flap thickness after transfer could be more than double what it was in the donor area. With proper tightening, the thickness could be reduced, with improvement in contour but no increase in soft-tissue stability or shear resistance of the flap. Without proper tightening, the scapular flap tended to be redundant when transferred to the foot. For good results, the patient should be lean, since the optimal thickness of the scapular donor site was less than 6 mm and the maximum thickness should not exceed 8 to 10 mm. The differences in shear resistance between the flaps were not associated with the soft-tissue stability of the reconstruction. The relative laxity of the flap on the plantar surface was found by several patients to be subjectively unpleasant. Although good contour could be achieved when covering the plantar heel, the tendency of the flap to develop abrasions and superficial breakdowns made it unsatisfactory for covering this area.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

A subset of systemic lupus erythematosus with progressive cystic bone lesions.

Clinical and serological findings of 16 patients with systemic lupus erythematosus (SLE) who had progressive cystic bone lesions were compared with a control group of 19 patients with SLE without radiological evidence of bone cysts. Central nervous system manifestations, synovitis, and other radiologically observed skeletal abnormalities were more prevalent in the patients with cysts than in the control group. Higher concentrations of C reactive protein, and a greater incidence of rheumatoid factor positivity were seen in the patients with cysts than in the control patients, but no other serological differences were found. It is suggested that patients with SLE with progressive cystic lesions form a subgroup of the syndrome characterised by an increased acute phase reaction.

Bone Cysts↗
PubMed1990

Reposition of a displaced peritoneal catheter: the Helsinki whiplash method.

Dialysate outflow obstruction caused by displacement of the catheter tip is a relatively common complication of peritoneal dialysis, occurring in up to 20% of implanted catheters and often requiring surgical intervention. We describe a simple method used to reposition straight, Tenckhoff-type catheters. The procedure is performed under fluoroscopic control using a 2 mm thick catheter guide, bent fo form a slight curve. The catheter guide is introduced near the tip of the migrated catheter and then rotated in order to bring the catheter to the pelvis. Experiences over the five-year period 84-89 are summarized. In more than 60% of the patients, the first displacement occurred within one month of insertion of the catheter, and 70% of the catheters migrated to the right. The procedure was used in 21 patients to treat 50 displacements. In 86% of the cases the procedure was successful. 52% of the patients needed only one reposition while 48% experienced two or more displacements and subsequent repositions. Five patients eventually needed replacement of the catheter or were permanently switched to hemodialysis. The reposition procedure was practically free of complications.

Catheterization↗
PubMed1990

Interstitial cellular infiltration detected by fine-needle aspiration biopsy in nephritis.

Fine-needle aspiration biopsy (FNAB) was used to detect renal mononuclear interstitial inflammation in 56 patients with various types of nephritis (20 IgA nephropathy, 8 focal necrotizing glomerulonephritis, 7 interstitial nephritis, 6 non-classifiable chronic glomerulonephritis, 5 mesangial proliferative (non-IgA) chronic glomerulonephritis, 4 focal glomerulosclerosis, 6 normal histology, who were examined for microscopic hematuria, and 7 controls). Regular renal biopsies for histological and immunofluorescence studies were simultaneously obtained, and available for comparative analysis (not controls). Differential counts of mononuclear infiltration and subtyping of T-cell infiltration into T-helper (T-h) and T-suppressor-cytotoxic (T-s-c) cells, as detected by immunoperoxidase stains from FNAB, were correlated to clinical manifestations and renal function tests. Generally, our results indicated increased mononuclear cell infiltration (monocytes, lymphocytes, and/or activated lymphocytes) in FNAB of patients with IgA nephropathy, interstitial nephritis or focal necrotizing glomerulonephritis (especially monocytes in IgA nephropathy and interstitial nephritis, p less than 0.05 compared with controls, lymphocytes in focal necrotizing glomerulonephritis, and non-classifiable glomerulonephritis, p less than 0.02 and 0.05, respectively). The number of infiltrating activated lymphocytes was significantly increased in focal necrotizing glomerulonephritis, interstitial nephritis and focal glomerulosclerosis, p less than 0.05, less than 0.01 and less than 0.01, respectively. FNAB was at least as sensitive as histological examination for the quantification of interstitial cellular infiltration, and it allowed for cytological differential counts. Patients had decreased T-h and increased T-s-c cell counts, which were accentuated in FNAB compared with peripheral blood, although there were strong positive correlations between local and peripheral counts (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

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↗
PubMed1989

Renal papillary necrosis in patients with IDDM.

Although diabetes mellitus is reported in 29% of patients with renal papillary necrosis (RPN), the frequency of RPN among patients with insulin-dependent diabetes mellitus (IDDM) has from autopsy studies been estimated to be only 4.4%. In vivo data on the prevalence of RPN in patients with IDDM have been lacking. We therefore studied the prevalence of RPN in 76 patients with long-standing IDDM and in 34 age-matched control subjects by intravenous urography. None of the control subjects showed radiographic signs of papillary necrosis. RPN was observed in 18 patients (23.7%); 15 were women (83.3%). Age and duration of diabetes was not different between patients with and without papillary necrosis, and there was no significant difference between the two groups regarding the prevalence of microangiopathic complications, i.e., proliferative retinopathy and diabetic nephropathy. Microscopic hematuria was three times more frequent in patients with than without RPN (44 vs. 16%; P less than .02). In addition, pyuria was reported in 40% of patients with papillary necrosis, and 61% of them gave a positive history of urinary tract infection compared to 16% (P less than 05) and 32% (P less than .02), respectively, in patients without papillary necrosis. It is concluded that RPN is a more frequent complication of long-standing IDDM than appreciated from autopsy studies, and being female and having a history of urinary tract infection are associated with an increased risk of RPN.

Adult↗
PubMed1989

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↗
PubMed1987

Renal mononuclear inflammatory cell populations in membranous glomerulonephritis: a fine-needle aspiration biopsy study.

Fine-needle aspiration biopsy (FNAB) technique was applied to the detection of alterations in renal inflammatory cell subsets in seven healthy control persons and 24 patients with membranous glomerulonephritis (MGN). Eighteen of the patients had nephrotic syndrome, and the rest had either persistent proteinuria or remission of the disease. Only one patient showed impaired renal function. Compared with the controls, FNAB revealed a significantly (p less than 0.01) increased number of mononuclear inflammatory cells (MIC, the sum in increment percentages of lymphocytes and monocytes) in MGN. This was mainly due to relative lymphocytosis; the number of monocytes was high particularly in patients with daily urine protein excretion in excess of 5 g. The duration of the disease did not clearly correlate with the degree of lympho- or monocytosis. In nine patients the results of the renal needle biopsy and FNAB could be compared. Biopsy revealed signs of MIC infiltration in 5/9 patients and FNAB in 7/9 patients. T-lymphocyte subsets in FNAB and peripheral blood were analyzed using monoclonal antibodies and indirect immunoperoxidase technique. The OKT4/OKT8 ratio in FNAB was 0.96 +/- 0.07 (s.e.m.) in patients and 1.49 +/- 0.12 in controls (p less than 0.01). In peripheral blood these ratios were 0.8 +/- 0.07 and 1.43 +/- 0.13 (p less than 0.001), respectively. The alterations were due to a decreased number of OKT4 positive lymphocytes. These studies suggest an associated interstitial accumulation of MIC and an imbalance between T helper/inducer and T suppressor/cytotoxic cells in MGN.

Adult↗
PubMed1985

Radiological progression of rheumatoid arthritis in renal transplant recipients.

Radiological progression of rheumatoid arthritis (RA) was evaluated retrospectively in eight patients with amyloidosis secondary to classical or definite RA and successful renal transplantation. Wrist joints, metacarpophalangeal, proximal interphalangeal, and metatarsophalangeal joints were graded on a scale from 0 to 5. The annual progression rate was calculated separately for the time before and after transplantation. A slight acceleration of the progression was observed after transplantation and is assumed to be due to activation of the rheumatoid disease when the azotaemia was corrected.

Adult↗
PubMed1985

Aseptic necrosis of the femoral head following renal transplantation.

The occurrence of aseptic hip necrosis was investigated in 546 renal transplant patients (639 transplants) with graft survival for a minimum of 12 months. Aseptic hip necrosis developed in 39 hips in 29 patients (5.3%) from 3 to 121 months (mean 22 months) after the renal transplantation. There was no sex-related difference in incidence of hip necrosis. The complication was significantly more common among patients younger than 20 than among those older than 40 years. The development of hip necrosis did not correlate with type of renal disease, origin of graft (cadaver of living relative donor), side of transplant or length of dialysis treatment. The number of transplantations per patient did not influence the occurrence of hip necrosis. Analyses of serum concentrations of creatinine, calcium, phosphorus and parathormone before and at different periods after transplantation revealed no patterns predictive of hip necrosis. The pathogenesis of aseptic necrosis of the femoral head obviously is multifactorial.

Adolescent↗
PubMed1979

Urography and isotope renography following renal transplantation.

The clinical yield from routine urography following renal transplantation was compared with that from isotope renography. In 50 recipients of renal transplants, 59 urograms and 55 renograms were studied. The most common pathologic finding at urography was renal papillary necrosis (in 6 patients). This condition had no obvious correlation with the further fate of the transplant. There were no other significant pathologic changes. It is concluded that isotope renography can be regarded as sufficient for routine follow-up. One baseline urogram is useful, but additional urographies should be carried out only when clinically indicated.

Creatinine↗
PubMed1979

Interobserver variation in the evaluation of radiologic changes of rheumatoid arthritis.

The variation between four radiologists in the evaluation of hand, wrist, and foot radiographs of rheumatoid arthritis was examined. The recognition of individual radiologic changes varied considerably as judged by the findings of the different observers. Erosion and joint space narrowing were interpreted more uniformly than soft tissue swelling and osteoporosis. When the radiographs were graded from 0 to 5 using standard reference radiographs, more than 90% of them were graded uniformly or with a difference of only one grade. The investigation has shown that when applying grading of rheumatoid arthritis according to standard reference radiographs, the interobserver variation is considerably less than when pure individual radiological changes of rheumatoid arhtritis are considered.

Adult↗
PubMed1978

A new relative contraindication for lumbar myelography.

We have taken myelograms of six patients with grave post-tuberculous thoracic gibbus of the spine and gross deformity of the thoracic cage. Two of these patients suffered violent convulsions and fracture of the neck of the femur. In one patient the myelogram was taken with Conray Meglumine and in another with Dimer X. We suggest that a grave deformity of the thoracic cage is a relative contraindication for lumbar myelography with these water-soluble contrast media. We assume that the reduced tissue oxygenation in these patients results in a lower threshold for convulsions.

Femoral Neck Fractures↗
PubMed1978

Angiography and isotope renography in acute rejection of renal transplant.

Isotope renography and transplant angiography were performed during 37 acute episodes of renal transplant rejection. Renography demonstrated rejection in 70% of the irreversible and 55% of the reversible processes. Angiography, though reliable in irrerversible rejection, was diagnostic in only 30% of the reversible cases. Renography is the method of choice for diagnosing rejection and its accuracy is improved by repitition. Angiography should be reserved for patients whose renal function is not restored by treatment for rejection.

Evaluation Studies as Topic↗
PubMed1977

Renal artery stenosis in hypertensive renal transplant recipients.

Reconstruction of a stenotic renal artery was done on 5 hypertensive renal transplant recipients, all of whom had deterioration of renal function when the stenosis was detected. After reconstruction renal function improved in 4 of the patients. The blood pressure was easier to control in all 5 patients, with 3 becoming normotensive. A high preoperative plasma renin activity returned to normal postoperatively in 4 patients. No recurrences were observed after a followup of more than a year.

Adult↗