Assessment of aortic valve area in aortic stenosis by magnetic resonance imaging.
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Adult↗
Biomedical subjects
L Porkka
Publications and source records attributed to L Porkka.
Percutaneous evacuation of abdominal abscesses and fluid collections--aspiration or catheter drainage?
Ninety-three abdominal abscesses and fluid collections (pseudocysts, hematomas and bilomas) in 79 patients were treated under radiological guidance, for a total of 111 procedures (23 needle aspirations (NA) of 17 foci and 88 catheter drainages (CD) of 84 foci). In eight foci both methods were used. Catheter drainage was curative in 65% of abscesses and in 56% of pseudocysts and improved the patients' condition before surgery in another 11% or 10%, respectively. The aim of CD could not be achieved in 24% of the abscesses and in 34% of the pseudocysts. Needle aspiration showed little effect being curative in only 6% and partially beneficial in 24% as all the foci were considered. Complications occurred in 8% of CD:s and in 0% of NA:s. We suggest that radiologically guided CD of abscesses and fluid collections should be the primary therapeutic approach in all cases where this can be performed safely. The therapeutic effect of NA was poor.
Abdomen↗
Xylitol vs glucose: effect on the rate of gastric emptying and motilin, insulin, and gastric inhibitory polypeptide release.
The effect of xylitol and glucose on the rate of gastric emptying and intestinal transit and on motilin, gastric inhibitory polypeptide (GIP), and insulin release were studied in human volunteers. A single oral dose of 200 mL water containing 30 g glucose or 30 g xylitol, mixed with a 99mtechnetium-tin (99mTc-Sn) colloid, was used. Similar dosing without the label was used in motilin, GIP, and insulin studies. Xylitol decreased the rate of gastric emptying but concomitantly accelerated intestinal transit compared with glucose. The half-times for gastric emptying were 77.5 +/- 4.6 and 39.8 +/- 3.4 min after ingestion of xylitol and glucose solutions, respectively. Glucose suppressed motilin and stimulated GIP secretion; xylitol stimulated motilin secretion but had no effect on GIP, which is currently the main candidate for the role of enterogastrone. The accelerated intestinal transit and increase in plasma motilin observed after xylitol ingestion were thought to be causally related to the diarrhea and gastrointestinal discomfort produced by it.
Colloids↗
Evaluation of cervical disc degeneration with ultralow field MRI and discography. An experimental study on cadavers.
The purpose of this study was to test the value of low-field magnetic resonance imaging (MRI) and discography in visualizing disc degeneration of the cervical spine. Plain roentgenograms, MR images, discograms, and macroanatomic appearance of the cervical spines of ten cadavers were compared. At levels C4-5-C7-T1, general disc degeneration seen in discography correlated well with macroanatomy (weighted kappa (Kw) = 0.77). The nuclear shape in MRI showed a weak correlation with macroanatomy (Kw = 0.31) and general disc degeneration in discography (Kw = 0.32), whereas nuclear intensity in MRI underestimated such changes. Magnetic resonance imaging showed posterior extension of the nucleus in most cases where moderate or severe leaking was seen in discography. The latter phenomenon represents an increase to our information on structural changes not available by any other noninvasive and nonirradiative method of examination.
Adult↗
Experiences of clodronate treatment of multifocal eosinophilic granuloma of bone.
Clodronate, an inhibitor of osteoclast function, reduces bone resorption in osteolytic metastases and in multiple myeloma. We have evaluated its ability to decrease bone destruction in patients with multifocal eosinophilic granuloma of the skeleton. Two patients, whose multifocal bone granulomas appeared with a frequency of about 6 months, received 1.6 g day-1 oral clodronate for 6 months. Both patients had a reduction in serum calcium level which was accompanied by a decline in the fasting urinary hydroxyproline/creatinine and calcium/creatinine ratios and a slight increase in parathyroid hormone (PTH) level. Pain relief was observed in both patients. No new bone lesions were seen during the treatment and the old lesions healed. After discontinuing the therapy, however, new painful lesions appeared after 5 years in patient 1 and after 3, 4 and 5 years in patient 2. We suppose that clodronate delayed the appearance of new granulomas.
Adult↗
The effects of lactulose-sweetened yoghurt on the rate of gastric emptying and intestinal transit in healthy human volunteers.
A non-invasive, radioisotopic method was utilised to study the effects of a lactulose-sweetened yoghurt product on gastric emptying and intestinal transit. Healthy human volunteers were given 99mtechnetium-DTPA-labelled lactulose yoghurt before and after adaptation to the product. A control group received a similarly labelled glucose solution. Gastric emptying and intestinal transit were evaluated by scintigraphy. The mean half-time for gastric emptying for glucose was 39.8 +/- 3.4 min and for lactulose yoghurt, 31.3 +/- 11.0 min. After 10 days' adaptation, the corresponding value for lactulose yoghurt was 25.2 +/- 8.2 min. Intestinal transit time was faster after lactulose yoghurt than after glucose solution and did not change during adaptation. The observed effects indicate that lactulose yoghurt may be beneficial in the treatment or chronic constipation using dietary methods.
Adult↗
Comparative evaluation of [123I]14-p-iodophenyl-beta-methyltetradecanoic acid and thallium-201 in the detection of infarcted areas in the dog heart using SPECT.
The concept of using beta-methyl-branched long-chain fatty acids for assessment of myocardial fatty acid uptake and perfusion was extended to the use of radioiodinated fatty acid with stabilization of iodine on the omega-phenyl ring. Beagle dogs were injected with thallium-201 and imaged 15 min after injection. The next day the dogs were infarcted by occluding the LAD, and 2 h later they were injected with [123I]14-p-iodophenyl-beta-methyltetradecanoic acid [123I]BMTDA and imaged for 90 min using a gated SPECT procedure. Maximum uptake of BMTDA in the heart was reached 2 min post injection and the activity level remained constant in the heart during the imaging period. The activity ratio of target to nontarget areas in the tomographic slices was significantly better for the BMTDA imaging compared to 201Tl (P greater than 0.01).
Animals↗
Evaluation of salmon calcitonin treatment in bone metastases from breast cancer--a controlled trial.
Salmon calcitonin 100 MRCU/day or a saline placebo were given in daily injections for at least three months to 49 patients with bone metastases from breast cancer in a randomized double-blind trial. All patients were normocalcemic, and most patients had stable or regressing disease at start of trial. No improvement in general performance or bone pain was detected as measured by a visual analogue scale, the daily duration of pain or consumption of analgetic drugs. Calcitonin had no effect on disease progression as judged by bone scans and radiographs. Calcitonin therapy did not affect serum calcium, alkaline phosphatase, bone gla-protein, or the urinary excretion of calcium and hydroxyproline. Serum phosphate and magnesium decreased significantly during calcitonin treatment (p = 0.01, and 0.00005, respectively). It was concluded that salmon calcitonin in this dosage has no discernible effect on skeletal pain, general performance, bone metabolism or disease progression in patients with breast cancer metastatic to bone. A significant decrease in serum phosphate and magnesium probably indicated an effect of calcitonin on the renal excretion of these ions.
Bone Neoplasms↗
Clodronate for osteolytic metastases due to breast cancer.
Breast-cancer patients with multiple osteolytic bone metastases were treated with clodronate (Cl2MDP) 1.6 g/day (17 patients) or placebo (17 patients) for 12 months. Bone pain, extension of bone metastases and formation of new osteolytic foci were reduced by Cl2MDP, and development of severe hypercalcaemia was prevented. After withdrawal of treatment, the patients were followed up for at least 12 months. New bone metastases developed in both groups. There were, however, less fractures and less hypercalcaemia in the Cl2MDP than in the placebo group. The survival rate was higher in the Cl2MDP group than in the placebo group. No side-effects were observed in the Cl2MDP group.
Aged↗
The response evaluation of bone metastases in mammary carcinoma. The value of radiology, scintigraphy, and biochemical markers of bone metabolism.
The correlation between response of metastatic bone lysis and bone pain, various biochemical markers of bone metabolism, and radiological and scintigraphic findings was investigated in 49 women with breast cancer included in a calcitonin supportive therapy trial. All patients had dominant skeletal disease and were on stable systemic treatment (cytotoxic or hormonal) for a least 6 months before the first response evaluation. Bone pain correlated poorly with treatment response. Changes in sclerotic metastases did not show any apparent relation to changes in lytic lesions. A correlation between bone scans and lytic activity on radiographs was found. The absolute level of biochemical bone markers did not correlate with treatment response, but seemed instead to reflect the rate of bone turnover. The relative level of bone markers with respect to baseline showed better correlation to treatment response. The best conventional marker of disease activity was urinary hydroxyproline/creatinine. Propeptide of Type III procollagen (PIIINP), a novel marker reflecting collagen turnover, promises to be at least as sensitive as hydroxyproline. Stable and regressing patients had the same prognosis and significantly longer survival than progressors.
Biomarkers, Tumor↗
Unprocessed bran and intermittent thiazide therapy in prevention of recurrent urinary calcium stones.
Both urinary calcium excretion and renal stone episodes are increased during the summer in Finland. Since thiazide and unprocessed bran are known to decrease urinary calcium excretion, we treated 73 patients with recurrent urinary stone formation by giving them unprocessed bran and intermittent thiazide. Of the patients, 32 had absorptive hypercalciuria and 41 had normal urinary calcium values. All patients were on a low-calcium and low-oxalate diet and took 40 g bran daily. Fourteen of the hypercalciuric and 14 of the normocalciuric patients were randomly allocated to use hydrochlorothiazide 50 mg b.i.d. from May to September. Reduction of stone formation was seen in all groups. The combination of thiazide + bran was superior to the bran on its own in inhibition of stone formation. Only 3/11 (27%) stones passed through during the summer in the thiazide + bran group as compared with the 11/17 (65%) in the bran group.
Adult↗
Cytogenetic investigations of patients on clodronate therapy for Paget's disease of bone.
In order to judge whether or not clodronate used for treatment of patients with Paget's disease of bone had an effect on the haematopoetic tissue, the frequency of chromosome/chromatid breaks in bone marrows and blood cells was evaluated. Seven patients were studied before treatment, after a few days of treatment and after greater than or equal to 2 months of treatment. Three additional patients were studied after exposure to clodronate for greater than or equal to 6 months. There was no significant increase in the occurrence of chromosomal aberrations induced by treatment. Thus no negative effect of clodronate on the haematopoetic tissue could be noted.
Aged↗
Treatment of skeletal disease in breast cancer: a controlled clodronate trial.
Normocalcaemic breast cancer patients with progressive osteolytic bone metastases were treated with clodronate 1.6 g/day (17) or placebo (17) for 12 months. Bone pain, extension of bone metastases and formation of new osteolytic foci were reduced by clodronate, and development of severe hypercalcaemia was prevented. After withdrawal of treatment the patients were followed-up for at at least 12 months. New bone metastases developed in both groups. There were, however, less fractures and less hypercalcaemia in the clodronate than in the placebo group. The survival rate was higher in the clodronate group than in the placebo group. No haematological toxicity was observed in the clodronate group.
Bone Neoplasms↗
Diphosphonates for osteolytic metastases.
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Bone Neoplasms↗
Experience with single photon emission computerized tomography (SPECT) in follow-up of sternotomy healing.
Single photon emission computerized tomography (SPECT) was performed thrice in ten patients undergoing open-heart surgery--preoperatively and 2 and 12 weeks postoperatively. The operations were done for ischemic heart disease (5), aortic valvular stenosis (2), aortic valvular insufficiency (1), leaking mitral prosthetic valve (1) and combined aortic and mitral valvular stenosis and insufficiency (1). The healing process in the longitudinally divided sternum was evaluated from the SPECT study. Four conventional static images in two dimensions were registered in anteroposterior, posteroanterior and left and right lateral projections. A tomographic study was done. Quantitative analyses were performed. The ratio of the sternal counts to the counts from a thoracic vertebra was calculated for use as a reference. The activity ratios showed a similar pattern in six cases, with initial increases and at 12 weeks slight decrease compared with the preoperative values. In two cases the activity was still increasing after 12 postoperative weeks. One patient, with sternotomy also one year previously, showed only slightly increased activity. The activity at the areas of the sternal wires was increased in six cases. The study thus revealed differing patterns of isotope uptake, although recovery was uneventful in all patients. The differences may reflect the possibility that the operative course and the preoperative clinical status can influence the healing mechanisms.
Adult↗
Five years of experience with selective therapy in recurrent calcium nephrolithiasis.
We evaluated the efficacy of selective treatment in 126 patients with recurrent calcium urolithiasis who were chosen on the basis of ability to correct underlying physiochemical disturbances. Patients with hyperparathyroidism underwent an operation. Patients with renal hypercalciuria were treated with thiazide and those with absorptive hypercalciuria were given a low calcium, low oxalate diet with or without thiazide. The only treatment for normocalciuric patients was high fluid intake, which was suggested also to the other groups. A significant individual mean reduction in stone formation was observed in all groups after 5 years of treatment. However, only 48 per cent of the normocalciuric patients were in remission after 5 years of high fluid intake therapy and 45 per cent of those with absorptive hypercalciuria were free of recurrence with diet only. Thiazide treatment seemed to be effective despite the type of hypercalciuria. The effect of the treatment on stone formation was mediated through reduction of risk factors in the urine. Conversely, a high level of risk factors commonly predicted stone recurrence.
Adult↗
The effects of xylitol on gastric emptying and secretion of gastric inhibitory polypeptide in the rat.
The effects of xylitol on the rate of gastric emptying and plasma gastric inhibitory polypeptide secretion in the rat were studied to relate xylitol adaptation to these phenomena. Male Sprague-Dawley rats, weighing about 250-270 g, were either gradually adapted to 20% xylitol diets or given a basal diet. The animals were, after a 24-hour fast, given a 1.2 g/kg body weight dose of xylitol or glucose either alone or with a 99mTc-tin colloid marker to study gastric emptying by using a gamma camera. Blood was taken from the tail vein, and plasma was analyzed for immunoreactive gastric inhibitory polypeptide by using a double-antibody radioimmunoassay. Xylitol adaptation did not appear to have any effect on the secretion of gastric inhibitory polypeptide. However, adaptation of rats to 20% dietary xylitol appeared to change the rate of gastric emptying by decreasing it. Therefore, it was concluded that gastric emptying plays a role in the adaptation to high xylitol doses while gastric inhibitory polypeptide appears not to be involved.
Administration, Oral↗
Long-term results of adrenal surgery in patients with Cushing's syndrome due to adrenocortical adenoma.
Fourteen of 16 patients with Cushing's syndrome due to adrenal adenoma who had undergone adrenal surgery in the period 1967-1981 participated in a follow-up study 1 to 15 (mean 4.5) years after the operation. There were 14 unilateral and two bilateral adenomas. Two patients have died: one from postoperative complications, the other by suicide 10 years after surgery. None of the patients relapsed and none showed clinical features of Cushing's syndrome. However, five patients remained obese and four hypertensive. Furthermore, in the female patients the bone mineral density was lower than in age-matched controls. The function of the pituitary-adrenal axis recovered slowly. Postoperative replacement therapy was withdrawn 3 to 28 (mean 11.8) months after surgery in all but one patient. The function of the remaining adrenal gland was completely normal in 10 patients. In two patients the plasma cortisol response to ACTH-stimulation was still blunted and associated with elevated plasma ACTH-levels. The plasma ACTH-level was low in the only patient having persistent hypocortisolism. In conclusion, the results show that most patients with Cushing's syndrome due to adrenal adenoma recover fully after surgery. In some patients, however, the suppressed pituitary and/or adrenal fail to resume normal function.
Adenoma↗