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Biomedical subjects

E S Heikkinen

Publications and source records attributed to E S Heikkinen.

At least 19 recordsLinked to original sources
PubMed1999

Congenital pseudarthrosis of the tibia. Treatment and outcome at skeletal maturity in 10 children.

We present the clinical characteristics of 14 children with congenital pseudarthrosis of the tibia (CPT) treated in northern Finland at Oulu University Hospital during the years 1968-1996. The incidence of CPT in northern Finland was 3.5/10(5) during years 1962-1996, which is higher than in previous reports. The estimated prevalence of pseudarthrosis was 1.8/10(5). The first 10 children with a mean follow-up time of 19 years from the first grafting procedure and 14 years from the last grafts, all had a solid bony union and could walk without external support at the last follow-up. The best treatment, especially in unfavorable types, seems to be a radical resection of the pseudarthrosis and reconstruction with a free vascularized fibular graft.

Age Determination by Skeleton↗
PubMed1986

Ball and spring or slit and core valve for hydrocephalus shunting?

Ventriculoperitoneal or ventriculoatrial shunting is the main method used in the management of hydrocephalic children. It is, however, associated with frequent complications. In order to reduce the risk of complications several types of shunts have been developed. In vitro studies have been performed to compare different types of shunts (1), but clinical studies concerning the efficiency of different shunt constructions are scanty (2). In the present study the Hakim-Cordis valve and the Pudenz-Heyer valve were compared in a series of 148 patients who had undergone 573 shunt operations for hydrocephalus. No significant differences were observed in the efficiency of these two shunts, though there was an increased rate of catheter rupture for the Pudenz-Heyer valve and an increased tendency for development of slit ventricles for the Hakim-Cordis valve. The patency rate for the Pudenz-Heyer valve proved to be statistically significantly higher (p less than 0.001) than that for the Hakim-Cordis valve, while there was a slight difference in the tolerance for high CSF protein levels favoring the Hakim-Cordis valve.

Cerebrospinal Fluid Shunts↗
PubMed1984

Congenital choledochal cyst opening into the intraduodenal part of the common bile duct and complicated by cystolithiasis and acute pancreatitis.

The aim of this report was to present an interesting surgically treated patient having a rare type III choledochal cyst with peculiar clinical course. Anatomically the cyst was a diverticulum of ampulla Vater. It contained stones and was lined by duodenal mucosa. At admission the patient had an actual, severe pancreatitis simulating appendicitis. Two laparotomies were done before the final successful cystoduodenostomy. Ultrasonography was the most illustrative and reliable preoperative diagnostic method.

Adolescent↗
PubMed1982

Diagnostic imaging of focal nodular hyperplasia of the liver developing during nitrofurantoin therapy.

An asymptomatic palpable liver tumor developed in a six-year-old girl seven months after commencement of prophylactic nitrofurantoin therapy for recurrent urinary tract infections. The tumor was examined by 99mTc colloid radionuclide scan, compound ultrasonography and angiography. Ultrasonography demonstrated a large, solid tumor (5 x 5 x 8 cm) in the right lobe of the liver which had an echogenic central core surrounded by an area giving low-amplitude echoes. Angiography disclosed that the tumor was well demarcated and hypervascular, containing large tortuous arteries. The uptake of radionuclide in the tumor was normal. The tumor was resected and the pathological findings were typical for focal nodular hyperplasia (FNH) of the liver. The combination of the findings of these three diagnostic imaging methods is probably specific for uncomplicated FNH, a benign and innocuous tumor of the liver.

Aorta, Abdominal↗
PubMed1980

Multicystic kidney. A clinical and histological study of 13 patients.

Multicystic kidney (MK) was diagnosed in 13 patients at the University Central Hospital of Oulu during the 9 year period 1970--78. In the district of the hospital the evaluated incidence of MK was 0.3 per 1000 live-born children. 12 of the patients were infants aged under one year. Two of these died soon after birth; one had severe extraurinary anomalies and the other had bilateral MK. The removal of MK was performed in ten cases. In ten operated and two autopsied patients the cystic dysplasia involved the kidney entirely. There was no discernible normal renal parenchyma and the ipsilateral ureter was always abnormal. On the opposite side one patient had a severe ureteric stenosis with hydronephrosis, and 4 patients had vesicoureteral reflux. Extraurinary anomalies were also common. Three patients had a significant cardiovascular abnormality. The accurate diagnosis could usually be obtained preoperatively. It was found that typical findings of physical examination, plain films, intravenous urography and B-mode ultrasound give sufficient information for accurate diagnosis to be made in most cases. Mictiocystography and endoscopy were required for associated urinary anomalies. Following the diagnosis, the removal of MK should be performed at the correct time, and also if asymptomatic, because these can become symptomatic later in life.

Adolescent↗
PubMed1977

Diagnostic and operative problems in multiple pheochromocytomas.

Two children, aged 14 yr, with multiple pheochromocytomas are presented. Both patients had a positive family history. In the preoperative aortographies the intra-adrenal pheochromocytomas of both patients were well visualized, but not the extra-adrenal tumors of the first case. Chlorpromazine as an adrenergic blocking agent was successfully used in the preoperative treatment. Postoperative catecholamine excretion in the first case was repeatedly slightly increased indicating residual pheochromocytoma. In addition to the bilateral adrenal pheochromocytomas, multiple islet cell adrenomas and cholecystolithiasis were revealed at the operation of the second case. After bilateral adrenalectomy and total pancreaticoduodenectomy, regular follow-up examinations were carried out for 28 months. Hyperparathyroidism and signs of possible medullary thryoid carcinoma were discovered. Thus the patient had an unique pattern of MEA syndrome.

Adenoma, Islet Cell↗
PubMed1976

The effect of intertrochanteric osteotomy on the venous drainage of the femoral neck in Perthes' disease.

Intraosseous femoral neck venography was performed both pre- and postoperatively on 30 patients with Perthes' disease. At the time of the operation (osteotomy) and the preoperative venographies, the disease was in the initial stage in 16 patients, in the fragmentation stage in eight patients and in the restitution stage in six patients. As shown previously the venous drainage of the femoral neck preoperatively, in the initial and fragmentation stages of the disease, was different from the venous pattern of the healthy (control) hips in every case, indicating an obstruction of the venous flow. 4-15 months after the osteotomies this venous obstruction had disappeared completely or almost completely in most cases. This normalization happened sooner than expected on the basis of our findings with conservatively-treated patients.

Child↗