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Biomedical subjects

V Myllylä

Publications and source records attributed to V Myllylä.

At least 19 recordsLinked to original sources
PubMed1992

Autotraction stress roentgenography for demonstration anterior and inferior instability of the shoulder joint.

A form of stress roentgenography is presented for the diagnosis of anterior and inferior shoulder instabilities. Stress is induced by anterioinferior traction concentrated on the shoulder during extension of the flexed hip, when patients hold their legs on the side being examined, with both hands. The anterior and inferior shifts of the humeral head in relation to the glenoid fossa then are measured from anteroposterior and modified axillary roentgenograms. This method was employed in 16 shoulders with recurrent anterior dislocation, 11 recurrent anterior subluxations, nine multidirectional instabilities, and 19 control shoulders. Mean anterior translations were 3 mm and 5 mm, and inferior translations were 7 mm and 10 mm for the control and recurrent dislocation groups, respectively. There were statistically no significant differences between those groups. In the recurrent anterior subluxations, the corresponding translations were of a completely different order, 21 mm and 19 mm, respectively, allowing the distinction from the controls and recurrent anterior dislocations in most cases. The shifts found in multidirectional instabilities, averaging 27 mm and 26 mm, respectively, were significantly greater than for the recurrent subluxations, but the differences were not great enough for accurate differential diagnosis in individual cases. Autotraction stress roentgenography of the shoulder may be of use in the diagnosis of recurrent anterior subluxations and anteroinferior multidirectional instabilities. It also gives good general views of the looseness of the glenohumeral joint.

Adolescent↗
PubMed1991

Aminoterminal propeptide of type III procollagen in cerebrospinal fluid. Variation with age and in childhood leukemia.

Analyses of the aminoterminal propeptide of type III procollagen (PIIINP) in the cerebrospinal fluid (CSF) of 55 children and five young adults without any structural central nervous system (CNS) lesion are reported. The concentration was age-dependent, in that infants and small children had quite high values, whereas the concentration remained relatively constant after the age of 1.5 years. The concentrations of PIIINP in the CSF of 44 children with acute lymphoblastic leukemia (ALL) were prospectively determined at the time of diagnosis and during treatment, since deposition of type III collagen is known to occur during fibroproliferative responses triggered by inflammation. Chemical arachnoiditis is known to be associated with intrathecal methotrexate therapy in children with leukemia. The mean concentration in these children at diagnosis (5.8 micrograms/l +/- SD 2.8 micrograms/l) did not differ from that in age-matched controls (6.7 micrograms/l +/- SD 3.2 micrograms/l). Depending on type of the disease, the children were treated according to two different protocols. PIIINP concentrations were significantly higher during the therapy phases which included intrathecally administered methotrexate (P less than 0.001) than at diagnosis of the disease. Corticosteroid treatments were always associated with a significant decrease in PIIINP concentrations (P less than 0.01 and P less than 0.001 in the two groups, respectively), irrespective of the therapy phase. The results suggest that an increase in PIIINP concentration in the CSF of children with ALL is an indicator of a fibroproliferative response in the arachnoid. Corticosteroids may repress this response and possibly also prevent the development of adhesions in the arachnoid.

Adolescent↗
PubMed1991

Acute acromioclavicular dislocations treated by fixation of the joint and ligament repair or reconstruction.

We reviewed 55 patients, median age 34 years, who had had acute complete acromioclavicular dislocation treated by transient acromioclavicular fixation with a Knowles pin and ligament repair by suturing or reconstruction of the superior acromioclavicular ligament with transfer of the coracoid end of the coracoacromial ligament onto the clavicle. At followup examination 50 patients showed at least a satisfactory result. Five cases, two of which had had subsequent resection of the distal end of the clavicle, were classified as poor, mainly because of pain, even though the functional result was good in three. Reconstruction of the superior acromioclavicular ligament, although it improved the anatomic result, was shown to be of no advantage and may even have caused discomfort. The numerous radiological findings of residual subluxation or dislocation, deformity of the distal end of the clavicle, soft tissue calcification and osteoarthritis or pathological physical findings did not correlate significantly with the clinical outcomes. In general this operation gave results comparable with those achieved by other operative methods. It is useful if surgery is preferred to conservative treatment.

Acromioclavicular Joint↗
PubMed1990

Radiological and cytological detection of renal pelvic transitional-cell carcinoma.

We evaluated US, CT, intravenous urography, arteriography, retrograde pyelography and urine cytology results in a series of 23 patients with renal pelvic transitional-cell carcinomas, 14 of whom underwent US, 17 i.v. urography, 8 CT, 15 arteriography, 9 retrograde pyelography, and 17 patients urine cytology. A tumour was identified in 5 patients (36%) at US, in 11 patients (61%) at urography, in 7 (88%) at CT, in 10 patients (67%) at arteriography, and in 8 (89%) at retrograde pyelography. Urine cytology was assessed as showing changes consistent with Papanicolaou class III-V in 15 (88%) of 17 patients. When renal pelvic cancer is suspected, intravenous urography should be performed as the initial radiological examination and followed by CT, which may also identify tumour spread. Arteriography and retrograde pyelography are sometimes complementary investigations. Repeated urinary cytology is mandatory. Our results show that US alone is unreliable in detecting renal pelvic cancer.

Adult↗
PubMed1990

Primary malignant sacrococcygeal tumours: reasons for diagnostic delay.

Primary malignant sacrococcygeal tumours are relatively rare and difficult to detect. In our series of nine cases there were five sarcomas, two chordomas, one lymphoma and one myeloma. The tumours were from 5 to 16 cm in diameter when detected. The patient delay varied from 2 to 12 months, the doctors' delay from 2 to 6 months. The radiological method leading to the diagnosis was plain film in four, CT in three, tomography in one, and myelography in one. CT showed especially the soft tissue involvement. In four cases, the tumour was not visible on the plain film. The tumour was palpable per rectum in three cases. Our experiences show that many sacrococcygeal tumours are missed in a plain X-ray. Tomography and CT produce the most useful diagnostic information. CT and MRI are replacing conventional tomography. We believe that CT examinations of the sacrococcygeal region should be performed when symptoms suggest a tumour to be present.

Adult↗
PubMed1990

Serum carbonic anhydrase III and myoglobin concentrations in acute myocardial infarction.

Serum concentrations of myoglobin (S-Myo) and carbonic anhydrase III (S-CA III; EC 4.2.1.1), a skeletal muscle-specific protein, were measured by RIA in 26 patients with acute myocardial infarction, 14 patients with neuromuscular diseases, and six healthy subjects before and after physical exercise. S-Myo was increased in infarct patients, whereas S-CA III was not altered. In patients with neuromuscular diseases and in healthy subjects after physical exercise, both S-Myo and S-CA III were significantly increased. S-CA III and S-Myo also showed identical peak times, 2 h postexercise. The S-Myo/S-CA III ratio was always higher in infarct patients than in the other groups. Thus, the combination of S-CA III and S-Myo determinations is useful to differentiate whether serum myoglobin is originating from myocardium or from skeletal muscle.

Adult↗
PubMed1990

Intussusception in infancy and childhood.

Experiences of the diagnosis and treatment of 41 patients with intussusception are presented. The most common signs and symptoms upon presentation were vomiting (83%), colicky pain (83%), rectal bleeding (66%) and abdominal mass (51%). All four features occurred together in only 20% of cases. Ultrasound was the primary mode of investigation in four children, giving a finding characteristic of intussusception. 27 patients were examined with barium enema, and hydrostatic reduction was tried. A barium enema gave the correct diagnosis on all cases and a successful reduction of sign and symptoms in 12 patients (44%). In the other 29 cases laparotomy was performed to achieve reduction, primarily in 14 patients and after an unsuccessful barium edema in 15.84% of the patients presenting after a delay of more than 24 hours needed surgery, compared with 59% of those presenting earlier.

Adolescent↗
PubMed1989

Pharmacokinetics and metabolism of selegiline.

Selegiline is readily absorbed from the gastrointestinal tract. It is distributed rapidly into the tissues, including the brain. It is the L-form of selegiline that is an active MAO-B inhibitor, the D-(+)-form being 25 times less active. Selegiline is metabolised into L-(-)-desmethylselegiline (DES), L-(-)-amphetamine (A) and L-(-)-methamphetamine (MA), mainly in the liver. We measured the steady state concentrations of the metabolites in the serum and cerebrospinal fluid (CSF) of patients with Parkinson's or Alzheimer's diseases who were on continuous selegiline therapy. The mean concentrations in serum and CSF were similar, and were not affected by the addition of levodopa. The mean concentrations of patients with Alzheimer's or Parkinson's disease were 6.5 +/- 2.5 ng/ml for A, 14.7 +/- 6.5 ng/ml for MA and 0.9 +/- 0.7 ng/ml for DES. The metabolites of selegiline were excreted in urine, and the recovery as metabolites was 87%. Due to the stereospecificity and the low CSF concentrations of the (-)amphetamine metabolites during the therapy with 10 mg selegiline, these metabolites do not seem to contribute significantly to the clinical efficacy of selegiline.

Aged↗
PubMed1988

Effects of denervation and immobilization on collagen synthesis in rat skeletal muscle and tendon.

The activities of prolyl 4-hydroxylase (PH) and galactosylhydroxylysyl glucosyltransferase (GGT), both enzymes of collagen biosynthesis, and the concentration of hydroxyproline (HYP) were measured in the gastrocnemius, soleus, and tibialis anterior muscles of rats after sciatic nerve neurectomy combined with cast immobilization of the denervated limb for 1 and 3 wk. PH and GGT were also observed in Achilles and tibialis anterior tendons after cast immobilization without neurectomy. After neurectomy the specific PH activity in the denervated gastrocnemius muscle increased by 215% (P less than 0.001). The specific GGT activity increased by 92-110% (P less than 0.01) in the denervated gastrocnemius, soleus, and tibialis anterior muscles. Elevation of the muscular HYP concentration by 118-170% (P less than 0.001) in the denervated muscles was observed. The PH, GGT, and HYP responses of the denervated muscles immobilized at a lengthened or shortened position during denervation atrophy did not generally differ significantly from those of the unfixed denervated ones. The specific PH and GGT activities of the disused tendons decreased by 62 (P less than 0.01) and 25% (P less than 0.001), respectively, in tendons immobilized in a chronically shortened position. The results suggest that denervation atrophy of skeletal muscle is associated with both an increased level of muscular collagen biosynthesis and with an increased muscular collagen concentration. The PH and GGT responses of the cast-immobilized tendons suggest adaptive changes in collagen biosynthesis of the disused tendon.

Adaptation, Physiological↗
PubMed1987

CT detection and location of intraorbital foreign bodies. Experiments with wood and glass.

The series comprises 27 patients examined by CT to detect, locate or exclude a foreign body. 22 of them actually had an orbital foreign body. In three cases CT was the primary method and showed the foreign body correctly, while in 18 it was first detected in plain films and CT was performed to locate it. 20 metallic foreign bodies were hyperdense in appearance. Two cases had wooden foreign bodies, one with a density of +10 HU and the other hypodense with a value of about -434 to -446 HU. The latter piece of wood was first interpreted falsely as a bubble of gas. The results proved that the detection of metal is easy, but differentiation between wood and gas is problematical. Experiments conducted to determine the CT densities of different pieces of wood gave results varying from -618 HU to +23 HU. The highest densities obtained for glass varied from +522 HU to +2000 HU. The density of a plastic lens was -105 HU.

Adolescent↗
PubMed1987

Ultrasound in acute and chronic cholecystitis.

Sonograms of 412 consecutive patients with operatively and histologically proven acute or chronic cholecystitis were reviewed retrospectively. 267 of them had been operated on in an acute phase of gallbladder disease and 145 had undergone an elective operation. 236 patients had an operative and/or histological diagnosis of acute cholecystitis and 176 both operatively and histologically confirmed chronic cholecystitis. A thickened gallbladder wall was seen in 80% of acute cases, wall sonolucency in 39%, dilated gallbladder in 60%, sludge in 26% and stones in 75%, the corresponding proportions of the chronic cases being 18%, 4%, 12%, 13% and 93%. A contracted gallbladder with stones was seen in 15% of the chronic and 1% of the acute cholecystitis cases. 90% of the acute cases had two or more sonographic abnormalities, whereas 70% of the chronic cases had only one abnormality, most frequently gallstones. Only one normal sonographic finding was recorded in each group.

Acute Disease↗
PubMed1987

Problematic diagnosis of bronchial foreign bodies in children.

Bronchial foreign bodies by children are dangerous and require immediate therapeutic measures. Findings and significance of chest film in the diagnosis of bronchial foreign bodies in 24 children were analysed. All patients were symptomatic. 18 patients had an abnormal and 6 normal auscultation finding. In three cases the physician did not suspect aspiration, and the diagnosis was delayed, which caused the death of one child. Roentgenpositive foreign bodies were found in 8 and -negative in 16 cases. Secondary changes (obstructive emphysema, atelectasis, pneumonia) were seen in 16 cases. In emergency cases the chest films were analysed by physician and later by a radiologist, who found 88% of them to be abnormal. Fluoroscopy of expiratory chest film helps to detect the unilateral emphysema more distinctly. The diagnosis must always be confirmed with bronchoscopy and extraction thereby is the adequate treatment of bronchial bodies.

Adolescent↗
PubMed1987

Thoracic spine CT, diagnostic efficacy.

In 67 patients the diagnostic efficacy of thoracic spine CT was assessed. Diagnoses suspected clinically or by other examination methods could be confirmed by CT in 81% and excluded in 18% of cases. In one per cent (one case) the diagnosis, myelopathia vascularis, could not be seen by CT nor by myelography. In 49 cases the results of thoracic spine CT and myelography were compared with each other. CT gave additional information to myelography in 27% (13/49), but not in 73% (36/49). In 27% (18/67) of the whole material CT was able to replace myelography. It seems that CT is useless if myelography is normal, but CT may be useful in tumors, infections and medullary diseases. In traumas CT may replace myelography.

Female↗