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Biomedical subjects

S Lähde

Publications and source records attributed to S Lähde.

At least 37 records · Page 2Linked to original sources
PubMed1997

Hepatobiliary and coexisting pancreatic duct abnormalities in patients with inflammatory bowel disease.

BACKGROUND: We performed a cross-sectional study to evaluate the prevalence of hepatobiliary disease in unselected patients with inflammatory bowel disease (IBD), to estimate the frequency of coexisting cholangiographic and pancreatographic duct abnormalities, and to correlate the findings with clinical, endoscopic, and histologic variables. METHODS: We screened 237 IBD patients for increased liver function values. Further, hepatobiliary evaluation consisted of transabdominal ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), and a liver biopsy. In addition, we evaluated the ERCP findings of patients with abnormal pancreatic screening tests (pancreatic enzymes or para-aminobenzoic acid excretion). RESULTS: Laboratory signs of hepatobiliary disease were found in 37 (16%) of our IBD patients. Abnormal liver test results were commoner in patients with Crohn's disease (CD) than in patients with ulcerative colitis (UC) (30.4% versus 11.2%, P < 0.05), and a similar trend was observed in the frequency of primary sclerosing cholangitis (PSC) in the respective groups of IBD patients. When the ERCP findings were combined with liver histology, 26 (11% of the whole study group) patients with PSC were found, with small-duct disease included. In 23 (10% of the whole study group) patients, definite cholangiographic changes consistent with PSC were found. Eleven (48%) of these showed coexisting pancreatic duct abnormalities. The prevalence of coexisting cholangiographic and pancreatographic duct changes in the whole study group was 4.6%. CONCLUSION: Hepatobiliary disease is at least equally common in patients with UC and CD. Coexisting cholangiographic and pancreatographic duct abnormalities in patients with IBD are relatively frequent and are considered extraintestinal manifestations of IBD.

Adult↗
PubMed1996

Roentgenographic findings of pneumonia caused by Chlamydia pneumoniae. A comparison with streptococcus pneumonia.

BACKGROUND: Pneumonia caused by Chlamydia pneumoniae or Streptococcus pneumoniae cannot be reliably differentiated by clinical signs or symptoms. OBJECTIVE: To find differences in the roentgenographic patterns of community-acquired pneumonia caused by C pneumoniae, S pneumoniae, or both in hospitalized patients during a C pneumoniae epidemic in Finland. METHODS: The patients were divided into 3 groups: 24 patients with serologic evidence of C pneumoniae only; 8 patients with combined C pneumoniae and S pneumoniae infection; and 13 patients with infection caused by S pneumoniae only. The chest roentgenograms obtained on admission to the hospital, during the hospital stay, and at follow-up visits were reevaluated by one of us (S.L.) who was unaware of the causative organism. In the final study groups, other causes of community-acquired pneumonia were excluded by a large pattern of microbiological methods. RESULTS: Bronchopneumonia was observed in 21 (88%) of the group with C pneumoniae and 10 (77%) of the group with S pneumoniae (P = .67). Lobar or sublobar (air space) pneumonia was seen in 7 (29%) of the patients with C pneumoniae compared with 7 (54%) with pneumonia caused by S pneumoniae. In the combined group, bronchopneumonia was seen as frequently as in the group with C pneumoniae, and air-space involvement was seen as frequently as in the group with S pneumoniae. The pneumonic shadowing was usually unilateral and in the lower lobes in all groups. Of the patients in the C pneumoniae group, 17% had residual abnormalities at follow-up visits. CONCLUSIONS: Roentgenographic changes cannot be used to differentiate pneumonia caused by C pneumoniae from that caused by S pneumoniae. Thus, initial antibiotic treatment should be directed at the pathogens that commonly cause community-acquired pneumonia.

Adolescent↗
PubMed1996

Thin-section CT in the examination of cervical disc herniation. A prospective study with 1-mm axial and helical images.

PURPOSE: The aim of the investigation was to determine whether thin-section high-resolution CT imaging could replace MR imaging and/or myelography in preoperative evaluation of radiculopathy and/or myelopathy. MATERIAL AND METHODS: A total of 120 patients, referred for cervical myelography (n=107) or MR imaging (n=13), were further examined with 1-mm non-contrast CT of the suspected disc space, including at least the next cephalic and caudal interspaces. Thirty-seven patients underwent Cloward's operation, at which 32 were found to have disc herniation. RESULTS: The sensitivities of CT (n=37), myelography (n=29) and MR imaging (n=8) were 66%, 84%, and 86%, respectively. The corresponding figures for false-positives were 8%, 10%, and 13%. Artefacts caused by wide shoulders in the 1-mm CT images were estimated to have contributed to a false-negative finding in 8 cases. The remaining 3 false-negatives were retrospectively considered evaluation errors. The true-positive CT findings usually presented with a local disc bulge measuring over 80 HU in density. Local ligamentous hypertrophy presented an indistinguishable finding in 3 cases, yielding false-positive CT findings. CONCLUSION: Conventional thin-section CT is considered a usable alternative for the evaluation of suspected cervical disc herniations in selected patients. Stocky patients with wide shoulders and a short neck are not suitable candidates, even when new generation equipment is available.

Adult↗
PubMed1996

Helical CT in the examination of bile duct obstruction.

PURPOSE: To assess the role of helical CT in the examination of cholestasis. MATERIAL AND METHODS: The US and CT reports of 36 consecutive patients with confirmed bile duct obstruction were evaluated in retrospect, the given diagnoses were compared with each other, and the final diagnoses confirmed by ERCP, surgery, fine needle or endoscopic biopsy, or autopsy. The bile duct was evaluated from helical 3-mm or 5-mm images reconstructed with 1-mm or 2-mm spacings, respectively, obtained after a bolus injection of 140 ml contrast medium containing 300 mg I/ml. Cross-section images and 2-D reformats displaying the extrahepatic bile duct in its full length were recorded for the interpretation. RESULTS: An obstruction secondary to a choledochal gall stone was present in 14 patients, a tumoral obstruction in 18, a post-inflammatory stricture in 2, and chronic pancreatitis in one patient. In one patient the obstruction present at US was over at CT. A choledochal stone was correctly diagnosed at US in 14% and at CT in 71% of the cases. A correct tumor diagnosis was achieved in 28% and 44% of the cases, respectively. Benign and malignant bile duct wall involvement could not be reliably discriminated. The 2-D display was of significant value in assessing the nature and extent of the obstructive agent. CONCLUSION: Helical CT supplemented with 2-D reformats was a useful method in the cases of cholestasis where US failed to demonstrate the cause of obstruction. An impacted stone can be visualized with high confidence while a tumoral obstruction is to be suspected when the cause of blockage is not directly visible.

Aged↗
PubMed1996

Pancreatic duct abnormalities and pancreatic function in patients with chronic inflammatory bowel disease.

BACKGROUND: We performed a cross-sectional study to estimate the prevalence of duct abnormalities and exocrine pancreatic dysfunction in an unselected group of patients with inflammatory bowel disease (IBD) and to correlated the findings with clinical, endoscopic, and histologic variables. METHODS: A total of 237 IBD patients were screened for pancreatic enzymes and with a PABA test. Seventy-one (30%) patients with values more than twice the upper normal limit in biochemical tests or with a PABA test < 40% were further evaluated. The pancreatic evaluation included endoscopic retrograde pancreatography, ultrasonography, and a secretin test. The endoscopic and histologic findings were systematically evaluated. RESULTS: The secretin test was completed in 54 patients, and in 10 (19%) it showed a decreased maximal bicarbonate concentration, corresponding to 4% of the whole study group. The pancreatograms of 59 patients were studied. In 20 (34%) patients unequivocal duct abnormalities were found. The prevalence of pancreatic duct abnormalities in IBD was 8.4%. CONCLUSION: Our results show the presence of pancreatic duct abnormalities and exocrine pancreatic insufficiency in some patients with IBD.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1995

Low-cost digital teleradiology.

A teleradiology link based on standard personal computers and a flat-bed CCD scanner was tested. A 64 kbit/s dial-up digital ISDN telephone line was used for transmission. A total of 254 films (174 uncompressed, 80 compressed) were sent. Ninety-six per cent of the uncompressed images and 98% of the compressed images were considered technically acceptable. The total diagnostic agreement between the acceptable transmitted images and the original films was 98%. Image quality was sufficient for diagnosis in CT and conventional chest and bone radiographs. However, a 256-step gray scale of the scanner was not sufficient for demanding situations, such as overexposed images with a high contrast gradient. The average speed of transmission was 60 kbit/s, which was considered adequate. The tested system suggests that a teleradiology link based on standard personal computers and programs works in situations where instant consultation is needed. However, the image digitization time with the prototype system was quite long, and a better user interface is under development.

Microcomputers↗
PubMed1995

Survival of patients after resection for lung cancer. Predictive value of staging by CT vs thoracotomy.

PURPOSE: The predictive value of staging of primary lung cancer by CT and thoracotomy with respect to survival was assessed in a series of 151 consecutive patients. MATERIAL AND METHODS: The new international staging system for lung cancer was used, with an additional indeterminate stage employed for cases in which a definite classification was impossible by CT. RESULTS: The survival rate curves for the stage groups assessed at CT and thoracotomy showed moderate to good parallelism. The patients with tumor stage I at thoracotomy but indeterminate or IIIa at CT had a significantly lower survival rate than those scored stage I at both. It was concluded that a sign of tumor spread obtained at any of the investigations should lead to an active approach, increasing the radicality of surgery or omitting noncurative operations.

Adult↗
PubMed1995

Wooden foreign bodies in CT. Case reports and experimental studies.

CT findings in 2 patients with a wooden foreign body in the orbital region soft tissue, and a series of CT measurements of wooden elements are presented. The wooden foreign bodies presented low HU numbers in CT and were initially interpreted as a gas collection. Different species of trees presented a large spectrum of densities, varying from the -550 HU of pine up to the +289 HU of ebony. The density of a spruce plank increased along with water-logging from -470 HU to -86 HU in 4 weeks, and peak enhancement up to 106 HU was found in the layer closest to the surface. It was concluded that a wooden foreign body in soft tissues may present CT patterns simulating materials as different as a gas bubble or a bone fragment.

Adult↗
PubMed1994

Contribution of chest and paranasal sinus radiographs to the management of acute asthma.

In order to evaluate the clinical utility of chest and paranasal sinus radiographs on admission in cases of acute asthma, the radiographs of adult patients admitted to our hospital for acute asthma over a period of 1 year were studied. The findings were specified afterwards by a senior diagnostic radiologist and their impact on the management of asthma was evaluated by reviewing the medical records of the patients retrospectively. Abnormalities were detected in 50% of the chest radiographs (55 of 110) and these resulted in management changes in 5% of cases (6 of 100). Abnormalities in any paranasal sinuses were detected in 85% of the sinus radiographs (93 of 100), and maxillary sinus abnormalities in 63% (70 of 100). 29% of the sinus abnormalities (32 of 110) resulted in an immediate alteration in treatment. Hence abnormalities were more common in the paranasal sinus radiographs than in the chest radiographs (p < 0.001), and the impact of the sinus radiographs on the treatment of asthma was also greater (p < 0.001). We recommend that while obtaining a chest radiograph routinely may be advisable in severe cases of acute asthma, at least when the patient is admitted to hospital, serious thought should be given to routinely obtaining a sinus radiograph in these cases as well.

Acute Disease↗
PubMed1993

Late CT-findings in non-surgically treated lumbar disc herniations.

Eighteen patients with non-surgically treated lumbar disc herniation underwent follow-up CT examination at an average of 5.2 years (range 4.3-6.1 years) after their initial examination. In 12 of the patients disc herniation had resolved, although only five of these patients had complete relief of symptoms. Although disc herniation has a tendency to heal spontaneously, there is poor correlation between the morphological changes and the relief of pain.

Female↗
PubMed1993

Radiological findings in cases of gallbladder carcinoma.

Radiological findings in 80 cases of gallbladder carcinoma are analysed retrospectively. Seventy-nine of the patients had been examined by US (ultrasonography), 37 by CT (computed tomography), 26 by PTC (percutaneous transhepatic cholangiography), 17 by ERCP (endoscopic retrograde cholangio-pancreaticography), nine by angiography and 27 by US-guided FNB (fine needle biopsy). US showed the primary tumour in 68% and CT in 57%. In 67 cases the tumour had spread outside the gallbladder area, causing bile duct obstruction in 41. US showed the bile duct obstruction in 39 of these cases and CT in 20 out of 22 cases. US showed 73% of the cases that had spread to the liver; the sensitivity being 68% for direct invasion and 88% for peripheral liver metastases. The corresponding percentages for CT were 68, 67 and 75%, respectively. In lymph node enlargement, US showed the nodes in 70% of cases and CT in 52%. PTC showed either stenosis or total obstruction in 25 cases and failed in one case. ERCP showed a tumour in 76% and failed in 24%. Angiography failed to show the primary tumour in two instances out of nine. The results indicate that current imaging methods are insufficient for the accurate staging of gallbladder carcinoma.

Adult↗
PubMed1992

Combined CT-guided biopsy and cytology in diagnosis of bony lesions.

The results of 44 trephine (OD 1.4-4 mm) biopsies and 39 fine needle (0.7-0.9 mm) aspirations of skeletal, mainly vertebral, lesions performed under CT-guidance in 54 patients were evaluated. The fine needle sample was aspirated through the trephine as a complementary procedure in 29 patients and a fine needle aspiration only was performed in 10 patients. Trephine biopsy only was performed in 15 patients. Sufficient material for histologic and cytologic analyses was obtained in 93% (41/44) and 97% (38/39) and a correct benign or malignant diagnosis was obtained in 84% (37/44) and 90% (35/39), respectively. Among the combined examinations the fine needle aspiration alone was diagnostic in 2 cases while the trephine specimen alone provided diagnostic material in 2 cases. In 24 cases both the cytologic and histologic samples were adequate for diagnostic purposes. In one case both methods gave false-negative results. The combined use of cytologic and histologic samples in CT-guided bone biopsies increased diagnostic accuracy. The aorta was perforated once with a 1.4-mm needle but without sequelae. CT-guided bone biopsy was found to be a safe, reliable and cost-efficient method.

Adult↗
PubMed1991

Assessing non-resectability of lung cancer. The value of thoracic computed tomography.

To investigate whether the assessment of resectability of lung cancer can be reliably made on the basis of computed tomography (CT), the thoracic CT scans of 96 lung cancer patients who were operated on, and in whom the tumour was classified to be of stage III at preoperative CT or at thoracotomy, were analysed. Of the patients, 58 underwent complete resection of the tumour, whereas thoracotomy resulted in non-complete resection or exploration only in 38 cases. Overlapping of the CT findings in the groups of complete and non-successful resection was observed. The majority of tumours with apparent growth to the carina, trachea, oesophagus or great vessels at CT were completely resected. Tumours that only bordered on the pleura could not be distinguished from those with pleural invasion. Mediastinal lymph node enlargement did not always mean metastatic spread. We conclude that there is no definite sign that identifies non-resectability of lung tumours, and a certain proportion of non-curative thoracotomies must be accepted.

Adult↗