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Biomedical subjects

P Aarnio

Publications and source records attributed to P Aarnio.

54 records · Page 3Linked to original sources
PubMed1991

Cytomegalovirus myocarditis in transplanted heart verified by endomyocardial biopsy.

Cytomegalovirus infections are common disorders after heart transplantations. Manifestation of the virus without a clinical disease is still more prevalent. Differentiation of clinical infections from cytomegalovirus activations without major pathogenetic importance issues a challenge in the follow-up of patients with cardiac transplants. The case describes a 56-year-old female patient with a multiple organ lethal infection and myocarditis due to cytomegalovirus diagnosed during life with endomyocardial biopsy.

Biopsy↗
PubMed1991

Pleural and pulmonary complications after bilateral internal mammary artery grafting.

The long-term patency of internal mammary artery (IMA) grafts in coronary bypass surgery is superior to that of saphenous vein grafts. To investigate if bilateral IMA grafting increases the complication rate, especially pleural problems, 100 patients with bilateral and 100 with unilateral IMA grafts were retrospectively studied. Preoperatively the groups did not differ in age, previous myocardial infarction, ejection fraction, NYHA classification or previous respiratory disease, but the coronary artery status was poorer in the bilateral IMA group. Postoperative pleural drainage was greater after bilateral IMA grafting (1074 vs. 497 ml, p less than 0.0001). Reoperation was required for bleeding in 10% of the patients with unilateral, and 20% of those with bilateral IMA grafting (p less than 0.05), and more blood was transfused in the latter group (5.9 vs. 4.7 units, p less than 0.01). Pleural effusion at discharge from hospital or 3 months postoperatively, pain in the sternotomy wound, pain on breathing and postoperative use of nitroglycerin did not differ significantly between the groups. Bilateral IMA grafting thus led to more bleeding and reoperations than single IMA grafting, but did not cause excessive pulmonary complications.

Blood Loss, Surgical↗
PubMed1991

Extracranial carotid artery aneurysms.

A material of eighteen patients with carotid artery aneurysms is presented. Mean age of the patients was 57.9 +/- 15.1 years. Most of the patients were asymptomatic or had only a pulsating mass on the neck. One patient had stroke and five TIA. Most common etiology was arteriosclerosis. Two patients got contralateral and two ipsilateral hemiparesis, one patient was unconscious immediately after the operation. Shunt was used on four of these patients. Three patients died, two for neurological reasons and one myocardial death. During the follow up time there were no carotid related diseases. Two patients died of cancer and two of heart attacks. Mean follow up time was 78.6 months. Eight patients attended the follow up studies which were performed by duplex scanning or angiography. They were free of neurological symptoms and their carotid arteries were patent.

Adult↗
PubMed1990

Surgery after heart transplantation.

Of 17 patients who underwent heart transplantation in 1985-1988, three were later operated for reasons unrelated to the transplant. Two of them had acute cholecystitis and one haemothorax, due to rupture of the internal mammary artery during endomyocardial biopsy. Cholecystectomy was performed in the first two cases and thoracotomy in the third, with uneventful recovery in all cases. Early diagnosis and adequate surgical treatment are necessary in these cases. Consideration of the immunosuppressive medication is important during and after operation.

Adolescent↗
PubMed1989

The possibility of using celiac trunk branches as coronary artery bypass grafts.

The internal mammary artery has proved to be superior to the saphenous vein for coronary artery bypass grafting, because of its arterial nature and closer approximation in size to the coronary arteries. But the internal mammary artery cannot reach the posterior surface of the heart as a pedicled graft. Two suitable intra-abdominal grafts can reach that surface, viz. the right gastroepiploic artery and the splenic artery. In experiments on eight dogs (weight 9-13.5 kg), the gastroepiploic artery was found to be too small for coronary artery anastomosis, and therefore the splenic artery was used. The size approximation with coronary artery (diameter less than 1 mm) was good. Four dogs survived the month of the study. In two of them the anastomosis was patent, in another the splenic artery was patent despite occlusion of the anastomosis, and in the fourth dog both anastomosis and graft were thrombosed. The possibility of using visceral arterial grafts in coronary surgery is discussed.

Anastomosis, Surgical↗
PubMed1989

Aortic graft--enteric fistula.

Aortic graft infection is a serious complication in vascular surgery. We present a series of three cases with aortoenteric fistula. In two patients an emergency operation was necessary and one underwent elective surgery. The infected Dacron aortobifemoral graft was removed and the aorta was sutured with monofilament sutures. An axillobifemoral bypass graft was inserted after the laparotomy closure and second skin preparation. Two patients are alive 2.5 years and six months postoperatively. One patient died 45 days postoperatively.

Aged↗
PubMed1988

Free internal mammary artery graft as canine femoral artery substitute.

Both right and left internal mammary artery (IMA) were dissected free in six dogs via median sternotomy, the left together with 2 cm-wide surrounding tissue and the right as naked artery. Free IMA grafts (3 cm long) were anastomosed end-to-end to the femoral arteries as bypass. Graft patency was assessed by palpation and Doppler analysis twice monthly. At 6 months all grafts were patent. They were harvested for light and scanning electron microscopy (SEM). Intimal thickening was seen in one specimen from each side. Medial fibrosis was more common in the IMA grafts with surrounding tissue. SEM showed endothelium in all grafts, but with some degeneration of endothelial cells. The study thus demonstrated maintenance of patency in free IMA grafts, which did not differ if the graft had been taken with or without surrounding tissue.

Animals↗
PubMed1988

Polydioxanone and polypropylene suture material in free internal mammary artery graft anastomoses.

An experimental study with six beagle dogs was conducted to evaluate a new monofilamentous absorbable suturing material--polydioxanone. Free internal mammary artery grafts, 3 cm long, were harvested via a median sternotomy and were implanted as arterial bypasses in femoral arteries (12 end-to-end anastomoses) and as arteriovenous shunts in the carotid artery-contralateral jugular vein position (12 end-to-side anastomoses). Twenty-four anastomoses were made with monofilamentous nonabsorbable suturing material, polypropylene (12 arterial, 12 shunts), to serve as control grafts. At 6 months the grafts and anastomoses were explanted and studied with light and scanning electron microscopes. Macroscopically, the polydioxanone sutures had disappeared. The major histologic finding was the foreign body reaction around the polypropylene sutures. In the electron microscopic study the endothelial line covered the anastomotic site and in the polypropylene anastomoses the suture material was bulging up from the anastomoses. No aneurysms or dilatations were seen. According to this study, polydioxanone is a suitable suturing material for small luminal arterial anastomoses and is superior to polypropylene suturing material because it causes no tissue or other late changes on the flow surfaces.

Animals↗
PubMed1985

Treatment of acute pancreatic injuries in childhood.

Eight cases of acute pancreatic injuries in children aged between 3 and 15 years are presented. All the injuries were blunt. Four children were managed with distal pancreatectomy and four with abdominal lavation and canalization. Three patients were classed as grade I and five to grade II in terms of severity of injury, according to the classification of Lucas. Hospital mortality was zero. In the follow-up study after the average time of three years and seven months, all eight patients were doing well. There were no postoperative diabetes in our patient sample.

Adolescent↗
PubMed1984

Sensory conduction velocity of plantar digital nerves in Morton's metatarsalgia.

The orthodromic sensory conduction velocity of the plantar interdigital nerves were measured with needle electrodes in 28 healthy subjects. The stimulating needle electrodes were placed close to the shaft of the proximal phalanx of the toe, and the recording needle electrode was placed behind the medial malleolus. We examined six subjects with clinical symptoms of entrapment of the common plantar digital nerve (Morton's metatarsalgia). Five of the subjects later had surgery. The conduction velocities of the affected interdigital nerves were abnormally slow. The method is technically simple, but more painful than conventional conduction studies.

Adult↗
PubMed1984

Radiopertechnetate imaging of haemorrhagic Meckel's diverticulum.

Meckel's diverticulum is rarely seen on the standard small bowel follow-through and the diagnosis may be overlooked unless 99mTc -pertechnetate scanning or other complementary radiological examinations are performed. Three cases of bleeding Meckel's diverticulum with a negative barium sulphate meal examination and positive 99mTc -pertechnetate scanning are presented.

Adolescent↗
PubMed1983

Left-sided carpal tunnel syndrome in butchers.

Butchers from two slaughterhouses were studied for carpal tunnel syndrome. The diagnosis was based on subjective symptoms and electroneurography. In about half of the otherwise healthy butchers there were various degrees of the syndrome in the nondominant hand, or, if the syndrome was bilateral, the nondominant side was more affected. So far two of the subjects have been operated on. The operative findings and results were consistent with carpal tunnel syndrome. The underlying cause for this occupational disorder is probably mechanical stress on the left hand. Various tools are held in the right hand, while the carcass is lifted, torn, and handled with the left hand. The butchers considered the load on the left hand more strenuous than the one on the right. The prolonged heavy grasping with the fingers of the left hand probably leads to thickening of the synovial membrane of the finger flexors within the carpal tunnel. The carpal tunnel is a relatively rigid structure, and an increased diameter of the flexor tendons may cause the carpal tunnel syndrome. This small cluster sample of butchers is not adequate for epidemiologic conclusions. However, carpal tunnel syndrome seems to be an important occupational disorder among butchers.

Abattoirs↗
PubMedDate not supplied

Sequential CT in monitoring experimental lung transplant.

The criteria for diagnosis of lung rejection remain controversial. In this study early changes in lung rejection were characterized using sequential CT with the aim of developing a sensitive and safe monitoring method, which would also provide specific information on graft status. Twenty-one experimental single lung transplants (SLTs) in piglets, including unmodified rejections, immunosuppressed recipients, and autogenic reimplants, were scanned using CT on days 3, 5, 7, 10, 14, 22 up to 134 days after operation. In addition to morphological analysis, bilateral densitometric CT measurements of the peripheral lung parenchyma were used to evaluate the intensity of interstitial infiltration of lung grafts. Altogether 67 postoperative CT studies were carried out. Simultaneous transbronchial/thoracic biopsies were undertaken. The mean follow-up time was 28 days (range 0-134 days). The experience obtained was then used in relation to SLT in a male patient for chronic obstructive pulmonary disease. All piglets had a typical hilar reimplantation response, which disappeared in 10-20 days. Two distinct patterns of radiological acute rejection were found. Increasing peripheral alveolar infiltrates reflected early massive rejection in untreated animals. In immunosuppressed animals, after the initial reimplantation response, acute rejection was detected as densitometrically measured diffuse interstitial infiltration over the whole graft. Local findings, like focal infections, were seen later in the lingula and basal portions of the graft. In the SLT patient, density changes preceded clinical rejection episodes, which responded to steroid therapy. In the experimental study, the lung graft was compared to normal contralateral lung. In the SLT patient, however, this was not possible, and, therefore, the subsequent repeated CT studies formed the basis of clinical follow-up. Sequential imaging and densitometric measurements allowed objective estimation of diffuse interstitial infiltration relating to rejection.

Animals↗