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L Niemitukia

Publications and source records attributed to L Niemitukia.

10 recordsLinked to original sources
PubMed2004

Magnetic resonance imaging of the rotator cuff in destroyed rheumatoid shoulder: comparison with findings during shoulder replacement.

PURPOSE: To evaluate the predictive value of preoperative magnetic resonance imaging (MRI) with respect to rotator cuff ruptures. MATERIAL AND METHODS: Thirty-one patients with rheumatic disease underwent preoperative MRI before shoulder arthroplasty. The scans were reviewed independently by two experienced radiologists. Three surgeons performed all the replacements (hemiarthroplasties), and the condition of the rotator cuff was assessed. Complete and massive tears of the rotator cuff were recorded and compared at surgery and on MRI. RESULTS: With MRI, 21 shoulders (68%) were classified as having complete or massive tears of the rotator cuff and at surgery 14 shoulders (45%). Cohen's kappa coefficient was 0.44 (95% CI: 0.16 to 0.72) and accuracy 0.71 (95% CI: 0.52 to 0.86). CONCLUSION: In severely destroyed rheumatoid shoulder, the findings of soft tissues were incoherent both with MRI and at surgery. The integrity of tendons could not readily be elucidated with MRI because of an inflammatory process and scarred tissues; in surgery, too, changes were frequently difficult to categorize. Preoperative MRI of severely destroyed rheumatoid shoulder before arthroplasty turned out to be of only minor importance.

Adult↗
PubMed2004

Long-term MRI findings in operated rotator cuff tear.

PURPOSE: To describe magnetic resonance imaging (MRI) findings at long-term follow-up after rotator cuff (RC) tear using standard MRI sequences without fat saturation. MATERIAL AND METHODS: Twenty-eight patients aged 55.8+/-7.6 underwent MRI examination 4.6+/-2.1 years after surgery for RC tear. Standard sequences in oblique coronal, oblique sagittal, and axial planes were obtained. The RC, including re-tears and tendon degeneration, was independently evaluated by two observers. Thickness of the supraspinatus tendon and narrowing of the subacromial space were measured. The clinical outcome was evaluated with the Constant score and compared with the MRI findings. RESULTS: The RC tear was traumatic in 18 (64%) patients and degenerative in 10 (36%). At follow-up, 11 (39%) had normal RC tendons with good clinical outcome. Four (14%) patients had painful tendinosis without RC tear. A full-thickness RC tear was found in 7 (25%) patients and a partial tear in 6 (21%). In one patient with a full-thickness tear, and in two with partial tear, tendinosis was found in another of the RC tendons. The subacromial space was narrowed in 13 (46%) of the patients. A narrowing of the subacromial space correlated with re-tear (P<0.05). CONCLUSIONS: The RC may be evaluated with standard MRI sequences without fat saturation at long-term follow-up. A normal appearance of the RC is correlated with good clinical outcome, while re-tear and tendinosis are associated with pain.

Adult↗
PubMed2001

WWW--an effective way of teaching radiology.

The Internet and especially the World Wide Web (WWW) have given new opportunities and challenges in teaching radiology. In Kuopio University and Kuopio University Hospital, we started to develop a new WWW-based radiology teaching file in 1996. Our file was made as a result of weaknesses in other files and as an answer to our local needs. The file consists of 1245 separate radiographs in 14 different categories. The language is Finnish, because the target use primarily is basic medical education in Finland. A small part has been translated into English. The quality of images was improved using a separate viewer (Osiris, Digital Imaging Unit, University Hospital of Geneva, Switzerland), which also allowed image manipulation needed with radiological images. We have monitored the utilisation of pages (Analog 1.92 beta-3.0/UNIX) and found the results encouraging. The follow-up time was 814 days (10 February 1997-27 September 1999), the total number of requests was 762797 and that for HTML pages is 288664. Monthly means are 27243 and 10309, respectively. The total number for visited domains is 61. The URL for these pages is http://www.uku.fi/laitokset/klrad/opetuskuvasto/.

Humans↗
PubMed2001

Mitral valve prolapse and mitral regurgitation are common in patients with polycystic kidney disease type 1.

Patients with autosomal dominant polycystic kidney disease (ADPKD) have an increased occurrence of cardiac valve abnormalities. However, the prevalence of cardiac abnormalities in patients with a uniform genotype of ADPKD has not been previously reported. We performed M-mode and color Doppler echocardiography on 109 patients from 16 families with polycystic kidney disease type 1 (PKD1). Findings were compared with those of 73 unaffected family members and 73 healthy controls. Mitral valve prolapse was found in 26% of patients with PKD1, 14% of unaffected relatives, and 10% of control subjects. The prevalence of hemodynamically significant mitral regurgitation (grade 2 or 3) was 13%, 4%, and 3%, respectively. Prevalences of grade 2 or 3 aortic regurgitation (8%, 4%, and 3%, respectively) and tricuspid regurgitation (4%, 6%, and 7%, respectively) were not significantly different among the three groups. Left ventricular hypertrophy (LVH) was found in 19% of subjects with PKD1, 6% of unaffected relatives, and 4% of control subjects. Systolic blood pressure and severity of renal insufficiency were related to mitral regurgitation and LVH in subjects with PKD1. The prevalence of cardiac valve abnormalities did not differ between unaffected relatives and control subjects. Mitral valve prolapse is a characteristic finding in patients with PKD1. Conversely, mitral regurgitation and LVH are likely to be secondary to elevated blood pressure in these patients.

Adolescent↗
PubMed1997

Familial intracranial aneurysms.

BACKGROUND: We set out to determine the prevalence of incidental intracranial aneurysms in first-degree relatives aged 30 years or more of people with intracranial aneurysms, and to see if polycystic kidney disease contributes to the aggregation of familial intracranial aneurysms. METHODS: 91 families with two or more affected members had previously been identified from a 14 year series of 1150 intracranial aneurysm patients treated at the University Hospital of Kuopio, Finland. Magnetic resonance angiography was used as a preliminary screening method, followed by conventional four-vessel angiography to verify suspected aneurysms. Participants were also screened for polycystic kidneys by ultrasonography. FINDINGS: Incidental aneurysms were detected in 40 individuals: 38 of 438 individuals from 85 families without polycystic kidney disease or other diagnosed heritable disorders, and two of 22 individuals from six families known to have polycystic kidney disease. The crude and age-adjusted prevalence of incidental intracranial aneurysms among screened first-degree relatives was 8.7 (SE 1.3)% (95% CI 6.2-11.7) and 9.1 (1.4)% (6.2-11.7), respectively, for the familial group and the crude prevalence for the polycystic kidney group was 9.1 (6.1)% (1.1-29.2). INTERPRETATION: Our results demonstrate a high prevalence of incidental intracranial aneurysms among first-degree relatives aged 30 years or older of patients with the condition and indicate that the risk of having an aneurysm is about four times higher for a close relative than for someone from the general population. Also, polycystic kidney disease families are a small fraction of the familial intracranial aneurysm families.

Adult↗
PubMed1995

Long-distance running alters bone anthropometry, elemental composition and mineral density of young dogs.

Ten young beagle dogs were run on a treadmill for 1 year, the last 15 weeks 40 km/day. Thereafter bone anthropometric variables, elemental composition, mineral density (BMD) and serum markers of bone metabolism were analyzed and compared with matched-paired control dogs. More osteophytes developed, weight-bearing bones grew larger and BMD of axial skeleton was reduced in the trained group. Zinc and sodium accumulated in bones of the runners. Zinc correlated negatively with BMD. Serum osteocalcin and C-terminal propeptide of type I procollagen did not correlate with the observed differences in BMD. This experiment implies that intensive endurance training in adolescence may reduce the peak bone mass and alter the structural properties of bone.

Animals↗
PubMed1991

Radiographic grading of extrinsic allergic alveolitis. A comparison between a modified ILO classification and a descriptive method.

We analyzed the acute phase radiographs of 107 consecutive patients with clinically confirmed extrinsic allergic alveolitis. Three readers independently recorded the profusion and the type of opacities according to the standard ILO criteria extended with categories x, y, z, and ground glass for description as proposed by McLoud et al. The profusion of the changes was grade 0 in 13%, grade 1 in 37%, grade 2 in 35%, and grade 3 in 15% of the interpretations. The type of predominant small opacities was p in 33%, x in 22%, s in 13%, t in 10%, q in 9%, and 0, r, u, y, and z in 13% of the interpretations. Ground glass density was seen in 8% of the recordings. The changes were predominantly located in the middle and lower lung zones. For comparison, according to the classification of Hapke et al. miliary changes (68%) predominated over fibrotic (27%) and normal (11%) recordings. The intraobserver agreement was good by both methods, but there was less interobserver variation with the ILO method. The semiquantitative standardized modified ILO scheme was considered more informative than Hapke's descriptive classification for epidemiologic and research purposes.

Alveolitis, Extrinsic Allergic↗
PubMedDate not supplied

Muscle hypertrophy, strength development, and serum hormones during strength training in elderly women with fibromyalgia.

OBJECTIVE: To examine the effects of strength training on maximal force, cross-sectional area (CSA), and electromyographic (EMG) activity of muscles and serum hormone concentrations in elderly females with fibromyalgia (FM). METHODS: Twenty-six patients with FM were randomly assigned to a training (FMT; n = 13; mean age 60 years) or a control (FMC; n = 13; 59 years) group. FMT performed progressive strength training twice a week for 21 weeks. The measurements included maximal isometric and concentric leg extension forces, EMG activity of the vastus lateralis and medialis, CSA of the quadriceps femoris, and serum concentrations of testosterone (T), free testosterone (FT), growth hormone (GH), insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone sulfate (DHEAS), and cortisol. Subjectively perceived symptoms of FM were also assessed. RESULTS: All patients were able to complete the training. In FMT strength training led to increases of 36% (p<0.001) and 33% (p<0.001) in maximal isometric and concentric forces, respectively. The CSA increased by 5% (p<0.001) and the EMG activity in isometric action by 47% (p<0.001) and in concentric action by 57% (p<0.001). Basal serum hormone concentrations remained unaltered during strength training. The subjective perceived symptoms showed a minor decreasing tendency (ns). No statistically significant changes occurred in any of these parameters in FMC. CONCLUSION: Progressive strength training increases strength, CSA, and voluntary activation of the trained muscles in elderly women with FM, while the measured basal serum hormone concentrations remain unaltered. Strength training benefits the overall physical fitness of the patients without adverse effects or any exacerbation of symptoms and should be included in the rehabilitation programmes of elderly patients with FM.

Aged↗
PubMedDate not supplied

Preoperative electroneuromyography and myelography in cervical root compression.

The preoperative diagnostic accuracy of electroneuromyography and myelography was evaluated in 77 patients with cervical radiculopathy and/or myelopathy. In 57% of the patients, the affected root level could be determined with ENMG (accuracy 1-2 segments), 10% had a non-specific finding, and in 33% of the patients, ENMG was normal. If the symptoms had lasted less than three months, 67% of the patients had a localizing finding in ENMG. Among the 97 operated root levels, there were distinct findings in myelography in 79, minor root sheath deformities in 13, and the finding was negative in five. In addition, in myelography there were clearly pathological root sheath deformities at 20 and minor changes at 20 root levels which were not operated. ENMG and myelography have a complementary role in the diagnosis of cervical root compression. By combining the information of ENMG and myelography, the functional significance of the morphological root sheath deformities can be assessed.

Adult↗