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Biomedical subjects

K Jokinen

Publications and source records attributed to K Jokinen.

At least 73 records · Page 4Linked to original sources
PubMed1977

Celestin tube palliation of unresectable esophageal carcinoma.

Celestin tube intubation was performed in 108 patients with unresectable carcinoma of the esophagus and cardia, in 83 per cent as the initial operation and in 17 per cent after exploration. The hospital mortality rate was 16 per cent, including a 7.4 per cent mortality rate from technical causes. The most frequent causes of death were perforations of the esophagus and cardia and aspiration pneumonia. Nonfatal complications occurred in 13 per cent of surviving patients, obstruction and dislodgment of the tube being the most common. All patients were able to swallow at discharge, and 91 per cent of them could take food by mouth until the time of death. In 9 per cent, additional palliation, usually esophagoscopy or gastrostomy, was required. Ninety-one patients survived one to 21 months (average 5.8 months). The 6 month survival rate was 44 per cent and the one-year survival 9 per cent.

Aged↗
PubMed1977

Carcinoma of the oesophagus and cardia.

234 patients, 146 with carcinoma of the oesophagus and 88 with carcinoma of the cardia are reported. There were 82 females and 152 males, mean age 62 years. The overall operability and resectability of the whole series was 38% and 23%. In cardiac carcinoma operability was 50% and resectability 32%, while in oesophageal carcinoma it was 31% and 18% respectively. 54 patients underwent resection, 44 received irradiation, and in 136 patients only palliative treatment was possible. The overall hospital mortality after resection was 15%, after oesophageal resection 12%, after cardiac resection 18%, and after palliative procedures 14%. Anastomotic leakage occurred in 9 patients (17%), four of whom died. The overall 5-year survival rate for the whole series was 4%, after resection 11%, and after radiotherapy 4%. No patient in the palliative group survived for 2 years. The mean survival time after irradiation was 11.5 months and after palliative procedures 5.5 months. The 5-year survival rate after oesophageal resection was 13% and after cardiac resection 6%.

Cardia↗
PubMed1977

Haemoptysis. A bronchological evaluation.

A series of 342 patients with haemoptysis, who underwent bronchological examination at Päivärinne Chest Hospital during the period 1967-73, is presented. The most frequent cause of haemoptysis was bronchial carcinoma (86 cases, 25%), with chronic bronchitis in 73 cases (21.5%, inactive pulmonary tuberculosis in 33 (9.5%), bronchiectasis in 22 (t.5%), active pulmonary tuberculosis in 21 (6%) and pneumonia in 17 (5%). The cause of bleeding remained unkown in 73 cases (21.5%). Bronchoscopic findings were normal in 86 patients (25%) and only inflammatory mucosal changes were found by bronchoscopy in 181 patients (53%). A bleeding bronchial carcinoma was identified in 42 patients. The exact bleeding point was observed in the mucosa in 10 patients, and bleeding could be traced to the segmental bronchus in 18 patients, to the lobar bronchus in 2 and to the main bronchus in 3. One attack of haemoptysis, in a case of tuberculosis ended fatally. In all cases in which bleeding was still present at the time of bronchoscopy the bleeding point could be traced at least to the segmental bronchus.

Adolescent↗
PubMed1977

Acquired tracheobronchomalacia.

In a series of 2150 patients subjected to bronchoscopy 94 (4.5%) were found to have tracheobronchomalacia. Tracheomalacia alone was diagnosed in 21 patients (22%), tracheobronchomalacia in 59 (63%) and bronchomalacia alone in 14 (15%). Mild malacic changes were noted in 44 patients (47%), moderate in 38 (40.5%) and severe in 12 (12.5%). The main symptoms were dyspnoea (63%), chronic cough with expectoration (49%) and haemoptysis (33%), and the most frequent concurrent diseases chronic bronchitis (53%), bronchial cancer (27.5%) and pulmonary tuberculosis (19%). Bronchoscopy performed under local anaesthesia enabled the dynamics of the tracea and bronchi to be observed during spontaneous breathing and during coughing, and it is the best available diagnostic procedure. Histologically the number of longitudinal elastic fibres in the pars membranacea was clearly reduced throughout the whole tracheal area in one patient with tracheomalacia but no differences were found in the amount of collagen, mucopolysaccharides and elastin in the cartilages of trachea and bronchi. This disease seems to be associated with chronic obstructive pulmonary diseases such as chronic bronchitis, and it apparently shares the same aetiological factors.

Aged↗
PubMed1976

Benign cartilagenous tumour of the temporomandibular joint.

An unusual case of a benign cartilagenous tumour of the temporomandibular joint is presented. The difficulties encountered in histological diagnosis, the benign behaviour of the tumour and the need for restraint in treatment are emphasized.

Adult↗
PubMed1976

Destruction of ossicles in chronic otitis media.

The purpose of this study is to investigate the differences in the destruction of ossicles in chronic ear disease caused solely (monoinfection) by one of the most common three bacteria, namely Staphylococcus aureus, Pseudomonas aeruginosa or Proteus strain. Material included 337 cases from 1,093 radically operated ears both with cholesteatoma and without cholesteatoma and in addition cholesteatomatous ears without signs of infection since diagnosed. In 190 ears with cholesteatoma but without discharge the ossicular chain was found damaged at the time of operation in 75 per cent and in 147 discharging ears with cholesteatoma in 79-97 per cent. In infected ears without cholesteatoma the chain was broken in 59-78 per cent. In all groups the most extensive lesions were caused by Proteus strains. This was also the fact in microscopic studies concerning extension and severity of histopathological findings. It seems to us that vascular bone erosion caused by active granulation tissue, the process triggered initially by infection, is the main mechanism for destruction of ossicles both in cholesteatomatous and in non-cholesteatomatous ears. From the histological point of view the ossicles in ears with Staphylococcus aureus and Proteus strains can be so destroyed that their use for autografts is questionable.

Bone Resorption↗
PubMed1976

Mycotic flora in tonsils and adenoids. A microbiological and histological evaluation.

The tonsils of 147 patients with chronic tonsillitis and the adenoids of 134 children with recurrent respiratory infections were cultured for fungal organisms and studied microscopically. A control group consisted of 68 healthy persons. Positive cultures were obtained in 64% of patients with chronic tonsillitis, in 21% of children treated with adenoidectomy, and in 69% of the control group. Candida albicans, Saccharomyces sp. and Aspergillus were the most common organisms. The histological investigations revealed no evidence of pathogenecity in these organisms. They were found in the tonsillar crypts, and no granulomatous inflammation was seen surrounding them.

Adenoids↗
PubMed1976

Arterial and venous blood lidocaine concentrations after local anaesthesia of the respiratory tract using an ultrasonic nebulizer.

Arterial and venous blood lidocaine concentrations were intermittently measured in 15 bronchoscopy patients in whom local anaesthesia was induced by an inhalation technique. A DeVillbiss ultrasonic nebulizer model 3574 was used. The anaesthetic was 10 ml of 4% lidocaine without adrenaline. Blood concentrations were measured 5 min after commencement of inhalation, on completion of inhalation, and then after 10, 30 and 60 min. Statistically significantly higher concentrations were found in the arterial blood at the first two sampling times (P less than 0.01 and P less than 0.05, respectively). The highest average concentration in both arterial and venous blood eas reached 10 min after completion of anaesthesia. After 30 min, there was no difference between the arterial and venous samples; and after 60 min, the concentration was higher in venous blood. The highest individual concentration was 2.8 mug/ml in arterial blood and 2.1 mug/ml in venous blood, well below that reported to cause systemic toxic symptoms. Thus, the inhalation technique may be considered a safe means of inducing anaesthesia in the respiratory tract.

Adult↗
PubMed1976

Chronic bronchitis. A bronchologic evaluation.

214 patients with chronic bronchitis were subjected to bronchial studied at Päivärinne Chest Hospital during the period 1967-1973. Bronchoscopy alone gave a frequency of 30% for bronchiectases while the information from bronchography increased this figure to 44%. In addition, 24% of the patients showed bronchographic changes in the form of naked filling or mucus obstrcution. Sputum specimens were less reliable indicators of infection than bronichial aspirates in patients with chronic bronchitis. Tracheobroncho-malacia was found in 50 patients and greatly increased the gravity of the disease.

Adolescent↗
PubMed1975

Tracheostomy in children.

Tracheostomies were performed on 47 children, using the flap technique. Thirteen patients (28%) died of their basic disease and two (4%) died of complications resulting from the tracheostomy. Decannulation was difficult in four patients, and there was one case each of bleeding, infection, and tracheocutaneous fistula. Thus, the primary complication rate was 19%, including the two deaths. Clinical reexamination with tracheography was made on 20 patients after a follow-up period varying from four to ten years (average, eight years). One small stenotic ring in the area of the distal end of the cannula site and two slight depressions in the tracheal forewall were found. According to these results, the flap technique, if properly performed, is safe also in children.

Child↗
PubMed1975

Tumours of the parotid region.

Fifty-eight operatively treated tumours of the parotid region are presented. Of the tumours 85 per cent were benign and 15 per cent malignant. The percentage of pleomorphic adenomas was 36 per cent. During five years of observation there were no recurrences of benign tumours. Operative complications consisted of one paresis of the mandibular branch of the facial nerve and one death due to bleeding and aspiration during the first postoperative day. Frey's syndrome occurred postoperatively in 26 per cent of the cases. It is emphasized that parotid tumours should be concentrated to centres where surgeons have sufficient experience with these cases.

Adenoma, Pleomorphic↗
PubMed1975

Transcranial orbital decompression in severe cases of unilateral exophthalmos.

Intracranial transtemporal orbital decompressions in one case of massive fibrous dysplasia of temporal, parietal and maxillary bones and in two cases of meningioma of the sphenoidal region are described. Surgery for fibrous dysplasia, even if extensive, must always be modified according to cosmetic and functional aspects. In bone-invading meningioma, large decompressing resections should be made. They may save the eye and arrest the progress of the disease for long periods of time.

Adult↗
PubMed1975

Ultrasonic nebulizer in local anesthesia for bronchoscopy.

A method of utilizing an ultrasonic nebulizer (De Vilbiss 35 A) in local anesthesia for bronchoscopy is described. 10 ml of 4% Licocaine without adrenaline was used as anesthetic agent. Blood levels of Lidocaine were determined on 12 patients. The maximum blood levels were reached 6-8 min after the end of anesthesia. Blood lelvels ranged from 0.37 to 3.28 mug/ml being so in the nontoxic dosage range. A satisfactory anesthesia was achieved in 95% of the 1,043 patients subjected to bronchoscopy, while 5% felt that laryngeal anesthesia was not complete. In no case was it necessary to use the conventional way to complete the anesthesia. Nebulizer anesthesia was preferred by 100 persons who had been anesthetized by both the conventional method and the ultrasonic technique.

Adult↗