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Biomedical subjects

O Takkunen

Publications and source records attributed to O Takkunen.

48 records · Page 3Linked to original sources
PubMed1982

A new form of metaphyseal chondrodysplasia in two sibs: surgical treatment of tracheobronchial malacia and scoliosis.

We describe a 19-year-old male with a previously unrecognized form of disproportionate short stature, tracheobronchial malacia, and progressive scoliosis and his 28-year-old sister with the same but milder condition. The clinical characteristics were short limbs and digits and thoracolumbar scoliosis. Bone films showed progression from marked metaphyseal dysplasia of tubular bones in childhood to short and broad bones with mild dysplasia of the joints in adulthood. The vertebrae and the intervertebral plates were only mildly affected in spite of marked scoliosis. Trachea and bronchi were reinforced with surrounding acrylate mesh before surgical treatment of the scoliosis. Affected sibs of both sexes and healthy parents suggest an autosomal recessive mode of inheritance.

Abnormalities, Multiple↗
PubMed1982

Advantages of glycopyrrolate over atropine during reversal of pancuronium block.

Atropine 0.015 mg kg-1 and glycopyrrolate 0.0075 mg kg-1 were compared as antimuscarinic agents during reversal of pancuronium block with neostigmine 0.03 mg kg-1 in 30 patients anaesthetized with thiopental - N2O- fentanyl and undergoing minor surgery. The decrease of heart rate was more pronounced in patients who received atropine-neostigmine. The mean of the lowest heart rate was 44.3 beats min-1 in the atropine group compared with 54.3 beats min-1 in the glycopyrrolate group. Five patients with atropine-neostigmine developed a transient nodal rhythm as compared with two of those receiving glycopyrrole-neostigmine (non-significant difference). Recovery from anaesthesia, as assessed by the awakening after the discontinuation of N2O administration, was more rapid in patients given glycopyrrolate. In conclusion, glycopyrrolate seems to have advantages over atropine when used during reversal of pancuronium block with neostigmine.

Adult↗
PubMed1981

Haemodynamic responses to antagonism of pancuronium and alcuronium block.

Using non-invasive methods, haemodynamic responses to antagonism of pancuronium (Pc) and alcuronium (Ac) block were compared in patients anaesthetized with thiopental-N2O-fentanyl and undergoing minor surgery. Neuromuscular block (90%) was maintained with Pc in 10 patients and Ac in 10 patients. After surgery, atropine 0.015 mg kg-1 and neostigmine 0.03 mg kg-1 (AN) were given simultaneously. The rate of reversal of the block was equal in the two groups. Between 4 and 16 min after AN, the decrease of heart rate (HR) was more pronounced in patients who had received Pc. The mean of the lowest HR was 43.2 beats min-1 in the Pc group, compared with 62.0 beats min-1 in the Ac group. The bradycardia was associated with a moderate decrease in arterial pressure in patients treated with Pc. However, due to an increase in stroke volume, mean cardiac output (CO) was not lower in the Pc group. Some patients treated with Pc developed a temporary nodal rhythm after AN and this was associated with a considerable decrease in CO. It is concluded that, in spite of marked bradycardia during antagonism of Pc block, circulation is well maintained, provided that sinus rhythm is present.

Adult↗
PubMed1980

Management of severe bronchial asthma in an intensive care unit.

Seventy-nine patients suffering from severe bronchial asthma were treated in the intensive care unit (ICU) between 1970 and 1978. This was 0.8% of the total number of asthmatic patients treated in Meilahti hospital during the same period. The major indication for admission to the ICU was severe airway obstruction leading to respiratory failure. In 65% tracheal intubation and mechanical ventilation were needed besides the conventional treatment. In spite of intensive care 9% of the patients died.

Airway Obstruction↗
PubMed1977

Bradycardia during antagonism of pancuronium-induced neuromuscular block.

Heart rate was compared in matched patients during antagonism of neuromuscular block induced by tubocurarine, pancuronium or alcuronium with neostigmine 0.03 mg kg-1 preceded by atropine 0.015 mg kg-1. The frequency of bradycardia was greater during antagonism of pancuronium compared with alcuronium. Although there was a difference between the group receiving pancuronium and that receiving tubocurarine, it was not statistically significant. The decrease in heart rate was more rapid and profound in the pancuronium group; seven of the 15 patients who received pancuronium required an additional dose of atropine as compared with only one patient who received tubocurarine. However, the difference in heart rate between those who received pancuronium and those receiving tubocurarine was short-lasting, whereas the heart rate of those who received alcuronium was higher than that in the other groups during the entire 60-min period of observation. The findings with pancuronium may be a result of its inhibitory effect on serum cholinesterase.

Adult↗
PubMed1975

The effect of different modes of artificial ventilation and of some prophylactic means on the incidence of postoperative deep vein thrombosis.

The occurrence of postoperative deep vein thrombosis (DVT) was studied in 209 elective surgery patients aged 40 years or over. Most of the operations were cholecystectomies or other major abdominal operations. In the detection of thrombosis the 125I-fibrinogen method was used. Of 209 patients, 51 (24.4%) developed postoperative DVT and of these 10 developed thrombosis in both legs. In 36% of the DVT cases the process started during the operation or on the first postoperative day. Clinical signs of DVT did not agree with the 125I-fibrinogen test very well, whereas the correlation of the 125I-fibrinogen test with phlebography was good: of the 17 patients with a postive 125I-fibrinogen test in whom a phlebography was done, the latter method revealed thrombosis in 14 patients (82.4%). The main purpose of the study was to determine whether the mode of mechanical ventilation used during anaesthesia has any effect on the occurrence of postoperative DVT. One hundred and nine patients received intermittent positive pressure ventilation (IPPV), whereas in 100 patients the intrathoracic pressure was decreased by applying intermittent positive-negative (--5 cmH2O) pressure ventilation (IPNPV). Ventilation was standardized in both groups by keeping the end-tidal CO2% at a constant level. Inspired oxygen concentration was the same in every patient. The decreasing effect of IPNPV on intrathoracic pressure and central venous pressure as compared with IPPV was confirmed in preliminary studies.

Adult↗