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Biomedical subjects

K Huttunen

Publications and source records attributed to K Huttunen.

At least 37 records · Page 2Linked to original sources
PubMed1989

Reversed left internal mammary artery graft for coronary bypass. Evaluation of function with digital subtraction angiography and radionuclide imaging.

Reversed left internal mammary artery grafting with retrograde flow to the left anterior descending coronary branch was used in five of 500 consecutive bypass operations. The indications were significant stenosis in the left subclavian artery (3 patients) or the proximal left internal mammary artery (1) and proximal damage to the left internal mammary artery during dissection from the thoracic wall (1). The postoperative clinical course was smooth in all five patients, with no evidence of myocardial ischemia. In follow-up averaging 14 months four patients were asymptomatic. The reversed internal mammary artery graft was visualized with digital subtraction angiography in four cases. Radionuclide imaging during exercise confirmed graft patency in all but the symptomatic patient, who was found to have an area of reversible ischemia anteriorly in the left ventricle.

Adult↗
PubMed1989

Clinical characteristics and coronary anatomy in refractory unstable angina pectoris leading to coronary artery bypass grafting. The Kuopio experience.

One hundred patients with high-risk unstable and medication-resistant angina pectoris underwent coronary artery by-pass grafting. In 35 cases the angina was of early post-infarction type, in 60 it was progressive after previous stability and in five it was of recent onset. All had abnormal ECG in association with anginal attacks (ST depression in 76, ST elevation in 5, T-wave inversion in 15 and left bundle branch block in 4). The left main coronary artery was stenosed in 33 patients, and the respective figures for three-vessel, two-vessel and one-vessel disease were 53, 9 and 5. The average number of inserted peripheral grafts/patient was 4.6. The perioperative mortality rate was 1%. Seven patients had confirmed or probable perioperative myocardial infarction and two had late infarction during the hospital stay, but none had angina pectoris on discharge. Of 60 patients re-examined after 1 year, 47 were angina-free. Five had NYHA class III angina, but all were improved. In refractory unstable angina pectoris there is severe coronary artery involvement, but bypass grafting can give good results.

Adult↗
PubMed1988

Effort dyspnea after coronary bypass surgery.

One hundred consecutive patients were followed up for 6-36 months after coronary artery bypass surgery (CABS) for angina pectoris. Of the 98 survivors, 35 reported effort angina. Of the 63 angina-free patients, nine (14%), also had to interrupt ordinary activities such as walking upstairs/uphill, though now because of dyspnea. In exercise tests all nine denied chest pain, the limiting symptom being dyspnea. Chest radiograms were normal in these nine cases, and spirometry was largely unchanged from the preoperative findings (normal in 3 cases). Exercise tolerance was normal or near normal in six patients. The other three underwent pulmonary scintigraphy and cardiac catheterization at rest and during supine exercise. The scintigrams revealed no pulmonary emboli. Catheterization showed hypokinesis and raised pulmonary capillary wedge pressure during exercise in all three patients. The cause of the left myocardial failure was not established. Long-term evaluation of CABS should take into account both effort angina and effort dyspnea.

Angina Pectoris↗
PubMed1988

Angiographic studies of internal mammary artery grafts 11 years after coronary artery bypass grafting.

Of 99 consecutive patients with 101 internal mammary artery grafts, 91 of 97 hospital survivors (94%) underwent angiography 2 weeks after operation, 84 of 96 survivors (88%) after 1 year, 66 of 88 survivors (75%) after 5 years, and 37 of 69 survivors (54%) after 11 years (range 10 to 13 years). Thirty-five of the 37 patients who consented to a fourth postoperative angiographic study (95%, confidence limits 86% to 100%) still reported relieved angina 11 years after the operation, and seven patients (19%, confidence limits 5% to 33%) were completely free of symptoms. Angiographic findings in 30 patients with symptoms of angina were progression of the coronary artery disease in 22, (73%, confidence limits 56% to 91%), occluded or stenosed grafts in nine (30%, confidence limits 12% to 48%), and nonbypassed obstructions in six patients (20%, confidence limits 4% to 36%). The cumulative 11-year patency rate was 88%, confidence limits 81% to 95%, for internal mammary artery grafts and 61%, confidence limits 45% to 76% for saphenous vein grafts. Six of 18 saphenous vein grafts (33%, confidence limits 19% to 58%) occluded in the interval between 5 and 11 years after operation, and gross wall irregularities were observed in six of the 12 patent saphenous vein grafts. Unligated side branches and stenosis of the internal mammary artery did not prevent long-term graft patency. Internal mammary artery graft failures were related to technical errors during the operation and occurred when the internal mammary artery was used to bypass a low-grade coronary artery stenosis. In one patient, regression of a coronary artery stenosis was associated with a marked decrease in luminal size of the internal mammary artery graft before the 5-year follow-up. This single internal mammary artery graft became occluded in the interval between 5 and 11 years after the operation. Eleven of 36 internal mammary artery grafts (31%, confidence limits 14% to 47%) increased 15% to 40% in luminal diameter as a result of increased myocardial blood demand before the 11-year follow-up.

Angiography↗
PubMed1987

Isoprinosine enhances PHA responses and has potential effect on natural killer cell (NK) activity of uremic patients in vitro.

We studied the effect of an immuno-stimulating agent, isoprinosine, which is being marketed as an antiviral drug, on some immune functions in vitro in 14 uremic patients treated by hemodialysis and in 10 healthy controls. PHA and PPD induced stimulations of DNA synthesis and interleukin-2 (Il-2) production and NK cell activity were measured from peripheral blood mononuclear cells cultured with and without isoprinosine. PHA responses were enhanced by isoprinosine (100 micrograms/ml) both in the patient group (p less than 0.001) and in the control group (p less than 0.05) but PPD responses in neither. The enhancement of PHA responses was not due to an increased production of Il-2(T-cell growth factor). Isoprinosine augmented NK activity in those patients whose NK activity was initially low. No enhancement could be seen in the controls or in those patients whose NK activity was comparable to that of the controls. Our results motivate a clinical study with isoprinosine in uremic patients at the risk of virus infection.

Adjuvants, Immunologic↗
PubMed1987

Sonographic measurement of renal transplant area compared with scintigraphy.

A change in transplant size, which can easily be measured by ultrasound, is one indicator of acute or chronic rejection. We report here on 49 areal measurements of transplant size from a coronal section and compare the results with isotopically measured areas. The areas measured in the isotope examinations correlated well with those measured sonographically (r = 0.82) in the case of the 33 transplants with a normal perfusion index but poorly (r = 0.45) in those with an abnormal perfusion index. The sonographically measured transplant area was about 85 cm2 in cases of acute rejection, 54 cm2 in cases of chronic rejection and 62 cm2 in cases with normal or slightly impaired transplant function (creatinine level below 200 mumol). Sonography is more suitable than isotope examination for monitoring transplant size in cases with poor perfusion.

Graft Rejection↗
PubMed1985

Ultrasonographic findings in renal parenchymal diseases.

An analysis was made of the ultrasonographic findings in 112 patients with renal parenchymal disease verified histologically, or with an unambiguous clinical picture. The diseases were divided into glomerular and tubulo-interstitial types. The duration of the disease and renal insufficiency and, in cases of glomerular diseases, the presence of a nephrotic syndrome and the severity of the histological changes were also taken into account. An abnormal sonographic finding was recorded in 67% of the cases. A highly echogenic cortex was the most common abnormality, being slightly more frequent in the tubulo-interstitial diseases (75%) than in the glomerular ones (61%), but the difference was not significant. Changes in the medullary region were significantly more frequent in tubulo-interstitial cases (46%) than in glomerular ones, and significantly more frequent in acute than in chronic conditions. Parenchymal thinning was associated with chronic cases and thickening with acute tubulo-interstitial cases. The nephrotic syndrome increased the number of abnormal sonographic findings. No specific sonographic features could be established for either glomerular or tubulo-interstitial renal diseases.

Acute Kidney Injury↗
PubMed1984

Natural killer cell activity after open-heart surgery.

We studied the effects of elective open-heart surgery with cardiopulmonary bypass on peripheral blood natural killer (NK) cell activity in 12 patients with heart disease. Separated mononuclear cells from patients and control cells taken from healthy volunteers were incubated in microtiter plates for 24 h with 3H-thymidine-labelled K 562 cells as target cells. In this test system, higher counts per minute (cpm) values represent a greater number of surviving target cells and thus weaker NK activity. Results of cultures prepared from blood samples taken preoperatively were compared with those taken 2, 7 and 14 days postoperatively. NK cell activity was depressed (P less than 0.01) for 2 days after surgery. NK cell activity in the control samples did not change significantly. The results show an impairment of NK cell activity immediately after open-heart surgery.

Adult↗
PubMed1984

The neutrophil function of uremic patients treated by hemodialysis or CAPD.

The phagocytic, bactericidal and chemotactic function of blood neutrophils in uremic patients treated either by CAPD or hemodialysis was assessed in vitro. The phagocytosis was normal in 11 patients on CAPD treatment while it was significantly impaired in 13 patients on maintenance hemodialysis (HD) treatment. In addition the chemotactic function of neutrophils seemed to be better on CAPD treatment, when heat-inactivated serum, zymosan or casein were used as chemoattractants, but the difference was significant only with heat-inactivated serum. In contrast the chemotactic response to Staphylococcus aureus was better in patients on HD treatment. The intracellular killing of bacteria was normal in both patient groups. The more stable metabolic control of acid-base and electrolyte balance and the better clearance of middle molecules could explain the better performance of uremic neutrophils in the patients on CAPD treatment.

Adult↗