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Biomedical subjects

T Kallio

Publications and source records attributed to T Kallio.

At least 19 recordsLinked to original sources

Renal ultrasound findings and their clinical associations in nephropathia epidemica. Analysis of quantitative parameters.

PURPOSE: To evaluate renal US findings in patients with nephropathia epidemica (NE) and to determine whether changes in these findings are related to the clinical course of NE. MATERIAL AND METHODS: Renal US was undertaken in 23 hospital-treated NE patients during the acute phase of their disease (first study). The second US study was performed 3-6 months later. RESULTS: The resistive index (RI) was abnormal in 12 patients and fluid collections (perirenal, pleural, pericardial, ascites) were found in 13 patients in the first study. Renal length decreased in every patient, cortical parenchymal thickness in 19 patients and RI in 18 patients from the first to the second studies. The mean change was significant in all parameters. Increased RI and presence of fluid collections in the first study as well as a greater change in length and RI between the first and the second studies were associated with high maximum daily urine excretion, substantial change in body weight between the anuric and polyuric phases, high maximum serum creatinine and urea concentration, high blood leukocyte count and low hematocrit value. CONCLUSION: Renal US changes occurred in every patient with NE. The severity of the findings was associated with fluid volume overload and degree of clinical renal insufficiency.

Adolescent↗

Incidence of deep venous thrombosis after thoracotomy.

BACKGROUND: Incidence of deep venous thrombosis (DVT) after thoracotomy has not been widely studied. DVT is a frequent complication in major surgery involving abdominal and pelvic areas and lower extremities. The aim of the present study was to evaluate the rate of postoperative DVTs after surgery of the lung. METHODS: In this prospective study with 25 patients undergoing thoracotomy both legs were studied with venous duplex imaging (VDI) preoperatively and on the second postoperative day. Clinically manifest thromboembolic events during one-month postoperative period were reviewed from the patients' records. DVT prophylaxis included compression stockings and early mobilization without low-molecular weight heparin. RESULTS: Frequency of postoperative DVTs was 4%. There were no clinically manifest thromboembolic events during one-month postoperative period. In 8% of the patients an old DVT was found preoperatively. CONCLUSIONS: Based on this material, incidence of DVT is low after thoracotomy. Early mobilization and the use of compression stockings may be a sufficient form of prophylaxis in these patients. The relatively small sample size and the use of ultrasound as a screening method should be noted in judging the results.

Adult↗

Hepatic subcapsular steatosis in diabetic CAPD patients treated with intraperitoneal insulin. Description of a typical pattern.

PURPOSE: To describe a specific imaging pattern of hepatic fatty change typical of diabetic patients on continuous ambulatory peritoneal dialysis (CAPD) treated with intraperitoneal (i.p.) insulin. MATERIAL AND METHODS: Liver ultrasound was applied in 16 CAPD patients with insulin-dependent diabetes mellitus. Presence of hepatic subcapsular steatosis and maximum thickness of the fatty layer were recorded. Liver MR examination was made of 1 patient found to have extensive subcapsular steatosis. RESULTS: Hepatic ultrasound revealed a typical pattern of subcapsular steatosis ("coating-of-fat") in 7/8 patients treated with i.p. insulin. None (0/8) of the diabetic CAPD patients treated with subcutaneous insulin had subcapsular steatosis. CONCLUSION: Hepatic subcapsular steatosis is specific to CAPD patients on i.p. insulin treatment. To our knowledge this is the first report to describe imaging findings in this particular form of hepatic fatty change.

Adult↗

Validity of ultrasonography in diagnosis of acute maxillary sinusitis.

BACKGROUND: Accurate diagnosis of maxillary sinusitis is difficult on the basis of clinical examination only because the signs and symptoms of sinusitis are nonspecific. A simple, rapid, and readily available method for diagnosing maxillary sinusitis in primary care would increase the accuracy of the diagnoses and thus reduce unnecessary antibiotic treatment. OBJECTIVE: To investigate the validity of ultrasonography compared with radiography and magnetic resonance imaging (MRI) in detection of maxillary sinusitis. DESIGN: Ultrasonography and plain-film radiography of the paranasal sinuses were performed on all patients and MRI was performed on 40 randomly selected patients on day 7 of the study. SETTING: Study office at the Department of Pediatrics of Turku University Hospital, Turku, Finland. PATIENTS: One hundred ninety-seven young adults who contacted the study office within 48 hours of the onset of symptoms of the common cold. MAIN OUTCOME MEASURES: Detection rates of maxillary sinusitis by ultrasonography, radiography, and MRI. RESULTS: Acute maxillary sinusitis was diagnosed in 24% of the sinuses by radiography and in 28% by MRI. Compared with MRI findings, the sensitivity of ultrasonography for detection of maxillary sinusitis was 64% (specificity, 95%). Using a 2-step diagnostic approach in which radiological findings were additionally considered in cases of negative ultrasound findings, a sensitivity of 86% (specificity, 95%) was observed. CONCLUSIONS: The high specificity of ultrasonography indicates that a positive ultrasound finding can be regarded as evidence of maxillary sinusitis. The addition of plain-film radiography in cases of negative ultrasound findings increases the diagnostic sensitivity to clinically acceptable levels without loss in specificity. Active use of ultrasonography would substantially decrease the need for radiological imaging of the sinuses and also help reduce unnecessary antibiotic treatment in primary care. Arch Otolaryngol Head Neck Surg. 2000;126:1482-1486

Acute Disease↗

Imaging end-stage kidney disease in adults. Low-field MR imaging with magnetization transfer vs. ultrasonography.

PURPOSE: To 1) assess the potential of magnetization transfer (MT)-weighted MR imaging to improve the often poor visibility of native kidneys in patients with a renal transplant; and 2) compare low-field MR imaging and ultrasonography (US) for imaging these fibrotic kidney remnants. MATERIAL AND METHODS: Seventy-two native kidneys of 36 patients were prospectively evaluated with US and MR. In low-field (0.1 T) MR imaging, T1-, T2- and MT-weighted sequences were used. MT-weighted images were compared with T2-weighted images in their ability to delineate the kidneys from their surroundings whereas US and MR were compared for detection of renal cysts and possible solid tumors. RESULTS: MT-weighted images proved superior to conventional T2-weighted images in producing contrast between the kidney remnants and their fatty surroundings. Although US revealed a few small renal cysts that were not seen at MR images, no statistical difference was found between the two modalities in this respect. CONCLUSION: MT imaging, due to its unique protein-specific signal depression, offers significantly improved visualization and delineation of end-stage kidneys. US, because its better availability and cost-benefit ratio, remains the method-of-choice compared to low-field MR imaging in detecting cysts in multicystic kidneys. MR investigation is helpful in selected patients and may be used as an alternative.

Adult↗

The occurrence of the post-thrombotic changes after an acute deep venous thrombosis. A prospective two-year follow-up study.

BACKGROUND: The aim of the study is to investigate the development of subjective and objective findings during the first two years after DVT (deep venous thrombosis). METHODS: This prospective two-year follow-up study was established in Tampere University Hospital in Finland. Twenty-six patients with a two-year follow-up after a phlebographically confirmed DVT were followed. Patients were treated conventionally with heparin and warfarin. Phlebography was repeated 7 months after DVT. Color-flow duplex imaging (CFDI) was performed in both legs 7 and 20 months after DVT. The subjective symptoms in both legs were recorded at the beginning and at the end of the follow-up. The development of venous reflux, obstruction and subjective symptoms after DVT were studied. RESULTS: 50% of the legs with DVT had a pathological (deep reflux or obstructive change) CFDI-finding in the popliteal segment after a 20-month follow-up. The pathological findings in the control legs were rare. The rate of recanalisation was high. There was no difference between calf and more proximal DVTs. Pain (62%), oedema (46%) and pigmentation (35%) were common and only 27% of the legs with DVT were asymptomatic. CONCLUSIONS: The development of the post-thrombotic syndrome begins quite early. The frequency of the subjective symptoms is high. Calf DVT may lead to postthrombotic sequelae in the popliteal segment.

Acute Disease↗

Sinusitis in the common cold.

BACKGROUND: Acute community-acquired sinusitis is considered a bacterial complication of the common cold. Radiologic abnormalities in sinuses occur, however, in most patients with upper respiratory virus infections. OBJECTIVE: Assessment of the occurrence, clinical profile, laboratory findings, and outcome of radiologically confirmed sinusitis was carried out as part of a common cold study in young adults. METHODS: Clinical examinations and radiography of the paranasal sinuses were carried out on days 1, 7, and 21 in 197 patients with the common cold. The symptoms were recorded on diary cards on days 1 to 20. Ten viruses and 5 bacteria were studied as etiologic agents of common cold as reported earlier. Serum C reactive protein concentrations, erythrocyte sedimentation rates, and total white blood cell counts with differentials were determined in 40 randomized subjects on day 7. The effect of 6 days of intranasal fluticasone propionate treatment of the common cold in the prevention of sinusitis was analyzed. RESULTS: On day 7, 39% of patients with the common cold in the placebo group (n = 98) had sinusitis, which we would prefer to call viral sinusitis. The symptoms of patients with sinusitis and those without it were not clinically distinguishable. Viral infection was detected in 81.6% of patients with sinusitis. No significantly increased levels of antibodies to bacteria were detected. Serum C reactive protein concentrations, erythrocyte sedimentation rates, and white blood cell counts were low in patients with sinusitis. All patients made a clinical recovery within 21 days without antibiotic treatment. Fluticasone propionate treatment tended to prevent paranasal sinusitis, especially in rhinovirus-positive subjects. CONCLUSION: Viral sinusitis frequently occurs in the early days of the common cold, but it is a self-limited illness. The sinuses should not be imaged in patients with the common cold if the signs and symptoms of illness gradually become less severe and no specific signs suggestive of bacterial sinusitis occur.

Adult↗

Effect of fasting and food intake on magnetization transfer of human liver tissue.

Magnetization transfer (MT) technique is a promising method in differential diagnosis of diseases in parenchymal tissues. Basic knowledge about circumstances and elementary factors that influence MT and its parameters is still insufficient, however. Having a meal before the magnetic resonance (MR) examination could change liver MT parameters compared to fasting state through alteration in liver perfusion, blood flow, and content of portal blood (proteins and other derivates from a meal). If MT parameters can be altered by a meal, then MR liver studies should always be performed after fasting. Before MRI examinations we examined three healthy volunteers after a high-fat meal with Doppler ultrasound technique to find out duration and magnitude of changes in portal blood flow. Duration of > or = 50% increased peak-flow value compared to fasting state in portal vein was > 90 min, which is enough for our MR examination. With a low-field 0.1-T MR imager we examined 10 healthy volunteers after a short (range from 3 h 45 min to 17 h 30 min) fast and also immediately after a high-fat meal. Magnetization transfer parameters, magnetization transfer ratio (MTR) and magnetization transfer rate Rwm of liver tissue were determined. MTR changed significantly (Student paired two-tailed t-test, p = .0044) after a meal, but Rwm did not (p = .0952). We recommend a 4 h fast before MR examination that aims to determine the MTR of liver tissue.

Adult↗

Experiences with a teleradiology system in pulmonary diseases.

Chest radiographs of 43 patients were digitized and sent from Paimio Hospital to Turku University Central Hospital. Fifteen of the patients had a pneumothorax, 12 had interstitial lung disease and 16 were controls. The images were interpreted by 5 radiologists during their duty shift. The first reading session consisted of images with 1,024 x 1,024 pixel resolution and the second of images with 2,048 x 2,048 matrix followed by the original chest radiographs. ROC studies were performed from the answers based on a 5-point confidence scale. In the pneumothorax group the average area under the individual ROC curve was 0.928 with the 1,024 x 1,024 matrix and 0.983 with the 2,048 x 2,048 matrix. In the fibrosis group the average area under the individual ROC curve was 0.877 with the 1,024 x 1,024 matrix and 0.831 with the 2,048 x 2,048 matrix. The results suggest that the 1,024 x 1,024 matrix is adequate in the detection of pneumothoraces and fibrosis.

Evaluation Studies as Topic↗

Teleradiology in Turku University Hospital--diagnostic evaluation and clinical applications.

Teleradiology installation between the Radiology Departments of the Main Hospital Compound and the Paimio Hospital, both belonging to the Turku University Central Hospital has been in clinical use since August 1991. It is based on Unix workstations with 1280 x 1024 pixel display with 216 shades of gray. It has been used to receive previous chest images from Paimio to be compared with recent films taken at TUCH Emergency Department. Scanning resolution of 1024 x 1024 pixels seems to be enough for reference images and probably sufficient for most other purposes.

Computer Terminals↗

Site-specific mutations in the D1 polypeptide affect the susceptibility of Synechocystis 6803 cells to photoinhibition.

Photoinhibition of photosystem II in the cyanobacterium Synechocystis 6803 was followed after site-specific mutagenesis of the D1 polypeptide. Mutations were created in the stromal/cytosolic loop connecting helices D and E. Two mutations E243K and CA1, a deletion of the three glutamates 242-244 and a substitution Q241H, were made in the putative cleavage area of the D1 polypeptide. A third mutation E229D was made in the PEST-like sequence. Mutants and control cells were illuminated and FV/FM was recorded. Compared to the control, the mutants were less photoinhibited. Fluorescence relaxation after a single flash was delayed in CA1. Restoration of FV/FM after photoinhibition in the mutants was totally dependent on protein synthesis while control cells were able to recover partially also when protein synthesis was inhibited. In addition, the protein synthesis-dependent recovery of CA1 was slowed down. Our results indicate a correlation between the mutated amino acids and photoinhibition of photosystem II.

Amino Acid Sequence↗

Distraction bone healing.

Bone formation by distraction was studied using three different experimental models: (1) Physeal distraction of the sheep radius was performed in 20 animals. (2) Distraction after osteotomy of the radius was carried out in 39 sheep. (3) Mandibular distraction after osteotomy was performed in 17 sheep. Formation of the organic matrix and osteogenesis were studied by radiographic, histologic, and biochemical methods as well as by electron microscopy. The mode of osteogenesis was essentially similar in all of these distraction models. Bone formation was preceded by organization of the collagenous matrix in the distraction area. In the beginning of the distraction, the gap was composed of a heterogeneous cell population, with large polymorphic fibroblast-like cells. The cells in the central part differentiated into fibroblasts, which remained functionally active as long as distraction proceeded. During physeal distraction, bone formed from the epiphyseal and metaphyseal sides as well as from the surrounding perichondrium. Also, in osteotomy distraction of both tubular bone and mandible, bone formed centripetally from the osteotomized bone ends toward the center of the gap. The organic matrix was composed almost solely of Type I collagen in the earliest stages, suggesting that the mode of osteogenesis differs from bone repair by fracture callus. The structure of the distracted segment was mainly lamellar trabecular. Corticalization of the lengthened bone segment occurred gradually after several months.

Animals↗

Assessment of blood echogenicity as an alternative measure to erythrocyte sedimentation rate.

OBJECTIVE: To determine the relation between erythrocyte sedimentation rate and blood echogenicity and whether measurement of erythrocyte sedimentation rate could be replaced by measurement of blood echogenicity in monitoring acute phase reactions. DESIGN: Simultaneous measurement of echogenicity of flowing blood and erythrocyte sedimentation rate in blood samples and comparison of results. SETTING: A radiological department in a university hospital. SUBJECTS: 83 patients with a suspected venous thrombosis and 36 healthy volunteers. MAIN OUTCOME MEASURES: Correlations between the erythrocyte sedimentation rate, packed cell volume, and echogenicity of flowing blood. RESULTS: Blood echogenicity correlated poorly with the packed cell volume, but strongly correlated with the erythrocyte sedimentation rate (when the packed cell volume was within reference limits) (correlation coefficient = 0.73). Blood samples with a greatly raised erythrocyte sedimentation rate were highly echogenic. Only one of the 30 samples with an erythrocyte sedimentation rate below 10 mm in first hour had a higher echogenicity than the least echogenic sample of the 19 with a sedimentation rate above 30 mm in first hour. CONCLUSIONS: Echogenicity of flowing blood correlates with the erythrocyte sedimentation rate and its measurement may compete with conventional methods for evaluating the long term changes in acute phase reactions. Also, it has the added advantage that non-invasive in vivo measurements of blood echogenicity may become possible.

Acute-Phase Reaction↗