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Biomedical subjects

R Luosto

Publications and source records attributed to R Luosto.

At least 55 records · Page 3Linked to original sources
PubMed1979

Surgical experience with simultaneous bilateral carotid endarterectomies.

Eighty patients who had undergone bilateral carotid endarterectomy at the same operation were reviewed. All operative procedures were performed under general anaesthesia and during systemic heparinization and in all but six cases by using internal shunt. There were three deaths related to the operation representing 3.8% hospital mortality. Transient neurological deficits were noted in four patients (5% incidence) and permanent neurological deficits in four patients (also 5% incidence). A 100% late follow-up after an average period of 48 months revealed that 85.7% of the long-term survivors were functionally normal or improved. There were ten late deaths with heart disease accounting for 50% and stroke 30%.

Aged↗
PubMed1979

Nonrotation anomaly of the bowel causing acute intestinal obstruction in adults. A report of two cases.

Two cases of acute intestinal obstruction in adults caused by a nonrotation anomaly of the bowel are presented. Both of the patients had suffered since chilhood from chronic, recurrent but rather mild abdominal symptoms which subsided spontaneously. In both cases volvulus of the cecum caused the acute abdominal condition, necessitating emergency operation. The nonrotation anomaly was an unsuspected discovery at laparotomy. The possibility of this type of congenital anomaly should be kept in mind whenever a patient has chronic recurrent abdominal symptoms or an acute abdominal condition.

Acute Disease↗
PubMed1978

Oesophageal diverticula. A follow-up study of 34 patients.

Of the 34 patients treated surgically for oesophageal diverticula during a 17-year yperiod, 14 had Zenker's and 20 thoracic diverticula. In addition to three diverticular perforations, the selection of the patients for surgery was based on major symptomatology and roentgenological retention in the diverticulum. The most usual method was a simple diverticulectomy. One patient was lost because of an oesophagopleural fistula, while non-lethal complications occurred in 10 patients. Twenty-nine patients were available for the follow-up study, which was made, on an average, 5.5 years postoperatively. Four had died of other causes. Seventeen patients regarded the results as good and 11 as acceptable. A roentgenological recurrence was detected after six Zenker's and four thoracic diverticulectomies by using the hypotonic double contrast method. Most recurrences caused only minor symptoms, if any. Two new diverticula were found in addition to the recurrences. Only one patient was reoperated on, while the slight discomfort felt by the others was not considered an indication for surgery.

Adult↗
PubMed1978

Clinical experience with surgical treatment of chronic intestinal ischaemia.

Fourteen patients suffering from abdominal angina have been operated on with different revascularization techniques. Preoperatively all of them had classical symptoms: postprandial pain and all except two had remarkable weight loss. There were six patients with isolated coeliac axis stenosis and in eight cases there were two or three diseased vessels. Liberation and reconstruction of the coeliac axis were carried out in six cases. Aorto-hepatic by pass graft was performed in three patients. Reinsertion of SMA was done in four and reinsertion of IMA in one case. Reconstruction of SMA with a by pass graft was carried out also in one case. There was no operative mortality. One of the patients died five weeks postoperatively at home from myocardial infarction. Another patient operated on in 1965 died seven years later at the age of 78 from myocardial infarction. He had had no further symptoms of abdominal angina postoperatively. The remaining 12 patients were relieved of their symptoms after the operation. They have been followed up for a mean of 5.5 years. The good long term results of arterial reconstructions in contrast to the poor prognosis without operation, favours early operation. The importance of early diagnosis and the importance of early operative treatment are emphasized.

Adult↗
PubMed1978

Left paraduodenal hernia with chronic abdominal symptoms.

A case of left paraduodenal hernia giving chronic abdominal symptoms is presented. For 3 years the patient had had unexplained abdominal pains, the reason for which was not found until a laparotomy was performed. A retrospective review of the x-ray films showed that an internal hernia should have been suspected from the small bowel follow-through and barium enema. The possible existence of an internal hernia in cases of unexplained abdominal pains is emphasized.

Abdomen↗
PubMed1978

Mediastinal tumours. A follow-up study of 208 patients.

During the twenty-year period 1954--1973, 208 patients were referred to the Department of Thoracic and Cardiovascular Surgery for treatment of mediastinal tumours. Forty-nine patients had malignant tumours (24%), 86 benign tumours and 73 non-neoplastic lesions. The most common histologic types were neurogenic tumours and malignant lymphomas, followed by thymomas and germinal tumours. Most non-neoplastic lesions were cysts. The mediastinal tumours were often asymptomatic, the malignant tumours in 31%, the benign tumours and tumourlike lesions in 65% of the cases. The most common symptom was pain, which occurred in one-fifth of the patients. The most useful diagnostic method was X-ray examination of the chest. However, a final diagnosis could usually be made only at operation. Thirteen malignant tumours were excised radically, 18 palliatively and 18 were only biopsied. Almost all benign tumours were radically excised. Forty-four patients received postoperative radiation therapy and 6 received chemotherapy. The hospital mortality was 8.2% for the patients with malignant tumours and 1.9% for those with benign tumours. At the end of the follow-up period, which varied from 2 to 21 years (median 10.3 years), 41% of the patients with malignant tumours were alive. Two patients with benign tumours had died of an apparently malignant change in a neurofibroma.

Adult↗
PubMed1978

Thoracic duct cyst of the mediastinum. A case report.

There are only a few reports in the literature on cysts of the thoracic duct. This case report concerns a 56-year-old female patient, who was operated on because of a mediastinal mass that later proved to be a cyst of the thoracic duct. The operation and immediate postoperative course were uneventful. Six months later, the patient was doing well and no further investigations were recommended.

Female↗
PubMed1978

Surgical experience with acute arterial occlusion in the upper extremities.

34 episodes of acute arterial occlusion in the upper limbs were treated surgically in 30 patients. In 32 cases the embolus was considered to have originated in the heart. In 27 cases the radial pulse was reestablished after the primary operative procedure and in 2 cases after an additional operative procedure. In 3 cases the pulse remained inpalpable and 2 amputations were needed. The earlier after the onset of the symptoms the operation was performed the better were the results. Two patients expired in the hospital during the first week after operation and there were 11 late deaths during the follow up period. The remaining 17 patients were followed for an average of 4.1 yrs. 15 of these patients have not shown any evidence of re-occlusion during the follow up period.

Acute Disease↗
PubMed1977

Thymomas and thymic cysts.

During a period of 20 years, 19 patients with thymomas and 5 with thymic cysts were surgically treated at this clinic. Excluding one operative death, none of these patients had died of causes related to the tumour 7.4 years (average) after operation. Two patients had died of unrelated causes, and in one case a recurrent mediastinal tumour was observed 3.5 years postoperatively. Myasthenia gravis, present at the time of operation in 3 cases, had been alleviated in one case, remained unchanged in another and become aggravated in the third case. In addition, one patient had developed myasthenia 7 years after resection of thymoma. In one case, a preoperative tentative diagnosis of lupus erythematosus disseminatus had been confirmed. Infiltrative growth was mascroscopically observed in only 2 cases. One of these patients died of haemorrhage during the operation; the other patient was in good health 1.5 years after partial resection and subsequent irradiation of the tumour. Four patients received radiotherapy. In one of the 15 cases treated solely by operation, the tumour fell to pieces on resection; a recurrent mediastinal tumour (cf. above) was removed 3,5 years later.

Adolescent↗
PubMed1977

Desmoid tumour compressing vital pelvic structures. A case report.

A case of a desmoid tumor is presented. The tumour was initially found in an appendectomy scar. Excision of the tumour was not radical enough and it recurred. During the second operation, a tumour weighing 940 g was excised. A segment of the right ureter and right iliac vessels were also resected and reconstructed. Recovery was uneventful. Moderate swelling due to lymphoedema in the right lower extremity persisted after the second operation. There has been no recurrence after the second operation eight years ago.

Adult↗
PubMed1976

Operative treatment of atherosclerotic lesions in innominate, subclavian and vertebral arteries. A follow-up study.

The follow-up study consists of 121 surgically treated atherosclerotic patients. The average age was 49 years and the male: female ratio 7:5. There were 165 obstructions or occlusions in this series. 59 of them suffered from a subclavian steal syndrome. Altogether 146 reconstructive procedures were perdormed. 78 of them were endarterectomies, 51 bypass graft operations, 15 transpositions of the subclavian artery to the common carotid artery and 2 were other procedures. Operative mortality occurred in 3 patients (2.5 %). Non fatal complications occurred in 26 patients, the most frequent of which was thrombosis ot the reconstructed artery (12 cases). In the follow-up study (mean follow-up time 3.5 years) data on 118 patients was available. During the follow-up time 15 patients had died of other reasons than cerebral ischaemia. 42 % of the patients considered the operative result good and 51 % satisfactory. 25 % of the patients were ar work before operation and 50 % after.

Adult↗
PubMed1976

Operative treatment of carotid artery occlusion. A follow-up study.

One hundred consecutive patients have been subjectes to 134 carotid artery reconstructive procedures. 81 patients had TIA syndrome, 2 had acutely progressing stroke and 17 had symptomless stenosis at the carotid artery bifurcation. In 121 instances a bifurcation endarterectomy was performed, in 6 cases the internal or common carotid artery was resected and reconstructed, in 5 cases allograft- and in 2 cases autologous vein was used for the reconstruction. An intraluminal shunt was used in 93 operations. Operative mortality occurred in 4 patients, one was a case of acutely progressing stroke. Late mortality occurred in 16 patients. A follow-up study was carried out in the remaining 80 patients. According to the patients' own judgement symptomatic relief was good in 52.5 %, satisfactory in 40 % and unchanged in 7.5 %.

Adult↗
PubMed1975

Pulmonary tumourlets.

Tumourlets are small benign proliferations of epithelial cells in the lung parenchyma. They are induced by fibrotic changes of the lung, most often by bronchiectasis. Four patients with pulmonary tumourlets are presented. The patients were from 22 to 46 years old, and three of them were female. All were known to have had bronchiectasis for many years. The tumourlets were found incidentally during microscopical study of operation specimens. In three instances multiple tumourlets were found. No signs of malignant behaviour were observed.

Adult↗