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Biomedical subjects

S Kostiainen

Publications and source records attributed to S Kostiainen.

12 recordsLinked to original sources
PubMed1992

Diagnosis and prognostic factors in malignant pleural mesothelioma: a retrospective analysis of sixty-five patients.

This report is an analysis of the medical records of 83 patients registered between 1960 and 1980 at Helsinki University Central Hospital as having malignant pleural mesothelioma. 65 of 83 patients had histologically confirmed malignant mesothelioma, and are the focus of this analysis. The remaining 18 (22%) patients were excluded because malignant mesothelioma was only confirmed cytologically, or because the primary tumor was not a mesothelioma. The ratio of men to women was 2:1.30 of 65 (46%) patients were not known or not likely to have been exposed to asbestos. The main symptoms at presentation were dyspnea, cough, chest pain, fatigue and weight loss. The median survival from diagnosis was 12 months, and from the onset of symptoms 18 months. Clinical stage and performance status were significant prognostic factors. Hematogenous metastases were present at autopsy in most cases. Disease and performance status therefore need to be well established and documented in clinical trials involving mesothelioma.

Adult↗
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↗
PubMed1979

Sudden postoperative death due to coronary thromboembolus.

In the last few years sudden deaths have been an object of active research in cardiology, as a high proportion of deaths from coronary arteriosclerosis are sudden and unexpected. In surgical materials, such sudden fatalities during the early postoperative period are relatively rare, because the patients are in the hospital under observation and intensive care can be started immediately in the event of coronary attacks. In the present rare case the patient died suddenly during the 5th postoperative night without any alarming symptoms of coronary thromboembolus.

Coronary Disease↗
PubMed1978

Concomitant groin hernia.

The incidence and significance of concomitant groin hernias were evaluated in a prospective study of 278 adult patients with an inguinal or femoral hernia. The material was collected in the three years 1975--77 and consisted of 290 electively operated groin hernias. The incidence of various combinations of primary inguinal and femoral hernias was 14%. Three of the 37 recurrent hernias (8%) were evidently caused by a concomitant hernial sac missed in the first operation.

Adult↗
PubMed1977

Parasternal mediastinotomy for implantation of a myocardial electrode. Experience of 71 patients.

The clinical experience of a pacemaker material of 71 petients in whom myocardial electrodes were implanted through left parasternal mediastinotomy is presented. The indication for implantation of a myocardial electrode was a complication of the transvenous electrode in 93% of the cases. Minor pulmonary/pleural complications with insignificant sequelae occurred in 18%. Wound infections accompanied by fistulisation as a late complication occurred in 4.2%. There was one (1.4%) postoperative death in hospital. Two patients died later at the end of the first postoperative month of causes not directly associated with surgery. These three patients were over 75 years of age. The material was followed up for an average of 21.5 months. The incidence of fistulisation during the follow-up period was 5.5%/patient-year. One case of breaking of the tip of the myocardial electrode was encountered during the follow-up. The mortality rate for the series was 7%/patient-year.

Adolescent↗
PubMed1977

Spontaneous pneumothorax.

A ten-year clinical series of 219 patients with spontaneous pneumothorax is presented with an average follow-up of 9 years. The vast majority of the patients were young men with a ruptured subpleural bleb. A slight increase in the incidence was noted in the older age groups with tuberculosis and chronic bronchitis as compared with the earlier series from the same hospital. The primary treatment was conservative in 197 and surgical in 22 cases. Recurrence of the pneumothorax occurred in 55 cases (25%). Primary conservative treatment failed in 41 cases, yielding 118 patients to operative approach. None of the patients treated by operation (plication or resection and suture of the bleb) had a later recurrence. Five re-operations were necessary: four because of a prolonged air leak after the first operation and one for bleeding. Two patients died on account of their pneumothorax, which gave a mortality of 1%. On the basis of the experience obtained, intercostal tube drainage is recommended as primary treatment; if it fails, thoracotomy seems to offer a good permanent result.

Adolescent↗
PubMed1976

Complications of transvenous and transtboracic electrodes.

Electrode complications in a series of 220 patients are presented. At the primary pacemaker implantation, 114 patients received transvenous and 106 transthoracic electrodes. For the transvenous technique the Elema unipolar electrode (EMT 588 and 588 B) was used exclusively and for the transthoracic technique an epicardial disc electrode (EMT 567) was used in 64 per cent and myocardial electrodes (Vitatron MIP 125, Medtronic 5814 and 6913) in 36 per cent. The material was followed up for an average of three years (from 2 to 10 years). The dislocation frequency of transvenous electrodes was 10.4 per cent/patient-year, as 21 per cent of the electrodes became dislodged. Of the electrode dislocations, forty per cent occurred within the first post-implantation month. Exit block at stimulation with transthoracic electrodes was seen in 8.1 per cent/patient-year. Infections were more common with the transvenous than with the other types of electrodes. The myocardial electrode was significantly (p less than 0.05) more reliable than the transvenous electrode during the follow-up evaluated in terms of uncomplicated function time of the primary electrode. As in Helsinki both endocardial and myocardial-epicardial pacemaker electrodes have been used it seems to be of interest to report the results from our pacemaker material.

Electrodes, Implanted↗
PubMed1975

Congenital partial absence of the left pericardium.

A 38 year old woman with congenital partial absence of the left pericardium is presented. The condition is fairly rare, usually diagnosed incidentally during intrathoracic operations or at autopsy. Eleven operatively corrected cases are reported in the literature. The present case was admitted because of transient attacks of chest pain, palpitation and dyspnoea. These attacks were brought on when she lay on her left side and were promptly relieved by a change of position. The chest radiograph revealed a prominence of the superior aspect of the left heart border and a slight laevo-position of the heart. A diagnostic pneumothorax on the left side confirmed the diagnosis of a pericardial defect. The defect was repaired by pericardioplasty. Operative correction of a partial left pericardial defect is indicated because of the danger of luxation of the heart out of the pericardium and sudden death. This has been reported, as well as a death caused by spreading of infection from the pleural cavity into the pericardium and heart.

Adult↗
PubMed1975

Spontaneous mediastinal emphysema: hamman's syndrome.

A case of spontaneous mediastinal emphysema (Hamman's syndrome) is described. The patient was a 21-year-old man, who had a sudden onset of substernal chest pain at rest associated with typical findings of Hamman's syndrome: subcutaneous emphysema of the neck, a precordial crunching sound synchronous with the heart beat and air in the mediastinum on chest x-ray. He recovered uneventfully. The pathogenesis and clinical picture of this rare condition are discussed.

Adult↗