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Biomedical subjects

P Mankinen

Publications and source records attributed to P Mankinen.

7 recordsLinked to original sources

Radiation exposure during percutaneous nephrostomy.

Radiation doses of radiologists, assistants and patients during 21 percutaneous nephrostomies (PN) (including 11 unilateral and 5 bilateral procedures) were measured using an area-exposure meter and thermoluminescent dosimeters. The mean fluoroscopy time per PN was 12 min and the mean product of air kerma and the cross-sectional area of the fluoroscopic beam was 8.0 (range 0.41-24) Gycm2. Doses to the radiologists and assistants were generally modest, and the yearly dose limits of ICRP will not be exceeded in practice. The doses to the radiologist's fingers were found to be the most restrictive in this study. Regarding the mean dose to the radiologist's fingers (190 muGy), the yearly dose limit of 500 mSv would be exceeded after about 2600 PNs provided that his fingers are not otherwise exposed. With the maximal finger dose of 1100 muGy, this would occur after about 450 yearly PNs.

Adult

Ultrasound guidance for pericardiocentesis.

Sonographic guidance with 41 punctures and 38 catheterizations was employed in 68 patients. The approach was either intercostal or subxiphoid. Most punctures were performed with a 1.4-mm-thick plastic-sheathed cannula after local anesthesia. Complications were observed in 7 patients. In one patient a catheter introduced with a movable core-type guidewire pierced the right ventricle wall with uneventful recovery after surgery. Intercostal drainage caused pleural pain in 2 patients, and in 2, leakage to the pleural space. Two patients with heart transplants had severe bradycardia and drop of blood pressure, one after needle drainage and the other during guidewire manipulation. Direct monitoring generally ensures a correct position of the instruments and hazards to adjacent organs can be avoided. In small effusions a simple needle aspiration with a plastic-sheathed cannula is safer than catheter drainage.

Adult

Double contrast barium meal and acetylcysteine.

In a prospective double blind study, acetylcysteine, a local and systemic respiratory tract mucolytic agent, or a placebo, were given to 100 patients prior to a double contrast barium meal to decrease the gastric mucus viscosity and to make the mucus layer thinner, in order to permit barium to outline the furrows surrounding the areae gastricae instead of the overlying thick mucus. However, acetylcysteine failed to improve either visualization of the areae gastricae or the general quality of the double contrast barium meal.

Acetylcysteine

Results and complications of percutaneous nephrostomy.

A series of 181 patients (158 with obstructive uropathy) treated by percutaneous nephrostomy (PN) in 1978-1987 is evaluated. In 8.3% of the patients PN did not succeed. The success rate of PN was lower when done outside normal working hours and before ultrasound guidance was used. Major complications occurred in 5.5% and minor ones in 10.5%. There was no direct mortality. The complications and the possible avoidance of them are discussed. In 68% of patients nephrostomy improved their clinical condition. The benefit of PN was closely related to the existing renal recovery potential following the relief of obstruction; a problem that has not yet been fully solved.

Adolescent

The effects of clinical data on radiological diagnostic performance in middle-face trauma.

To determine the effect of clinical information on the radiological diagnostic performance in middle-face injury, the medical records and radiographs of 618 patients with middle-face injury were reviewed. The information value of clinical data given in each x-ray requisition was evaluated. The radiological diagnoses were compared with the final clinical diagnoses both retrospectively and prospectively (with and without clinical data). Knowledge of clinical data with statistical significance changed the reader's decision threshold towards improved sensitivity but poorer specificity. Clinical data did not improve the radiologists' performance. Clinical data may be helpful in diagnostic tasks rather by increasing the sensitivity than the specificity.

Evaluation Studies as Topic

[Effect of S-carboxy-methyl-L-cysteine on the radiologic visualization of the mucosa in double-contrast examination of the stomach].

The radiographic pattern of the areae gastricae is produced by barium lying in the intersecting grooves of the gastric mucosal surface. However, if the mucus layer on the gastric mucosa is thick, it interferes with the barium coating of the areae gastricae. As S-carboxy-methyl-L-cysteine has been shown to be an effective respiratory tract mucolytic when administered by mouth and, may also render the gastric mucus layer thinner, it was tested as a pretreatment agent in a routine double contrast upper-gastrointestinal study to improve the visualization of the areae gastricae. In a double-blind study 53 of 103 patients took S-carboxy-methyl-L-cysteine in a dosage of 750 mg three times daily for three days before the examination. Results of the present study show that mucolysis induced by the administered doses of S-carboxy-methyl-L-cysteine did not significantly affect micromucosal visualization during double-contrast barium meal.

Adult