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Biomedical subjects

S Mattila

Publications and source records attributed to S Mattila.

At least 19 recordsLinked to original sources
PubMed1992

Long-term blood flow potentials in sequential internal mammary artery grafts. Exercise thallium scan for myocardial perfusion study.

In two groups of patients, coronary artery bypass surgery for angina pectoris included internal mammary artery (IMA) sequential grafts (group I) or single grafts (group II). At postoperative angiography all grafts were patent. In addition, the patients received on average 1.8 vein grafts into other coronary arteries. The mean interval to postoperative follow-up was 9.5 years in group I and 9.7 years in group II. The preoperative incidence of acute myocardial infarction was 44% and 45% in groups I and II. Exercise thallium scan at follow-up showed IMA graft-related ischemia in 33% of the patients with sequential graft and in 64% of those with single graft (ns). Our results indicated that sequential IMA grafts functioned at least as well as single grafts and maintained adequate myocardial supply even 10 years postoperatively. Internal mammary arteries are superior graft material and can be recommended both as single and as sequential graft in coronary artery bypass surgery.

Aged↗
PubMed1992

Peripheral excimer laser-assisted angioplasty. Preliminary clinical experience.

A non-thermal Xenon-Chloride excimer laser was used for peripheral arterial recanalization in eight patients with obliterating atherosclerosis of the superficial femoral artery. All patients had a total occlusion with severe claudication or pain at rest. There were three complications, which all led to thrombosis of the irradiated artery. In one, the puncture site in the artery had to be closed operatively. All vessels were followed up radiographically three months after the procedure. In seven patients the vessel was patent. Several investigators have warranted caution in using thermal lasers (continuous wave Nd:YAG or argon) for angioplasty. The non-thermal excimer laser is a viable alternative--although not without problems. Initial experiences with the new device are described.

Aged↗
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↗
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

ASD in patients over 40 years of age.

To evaluate the benefits of operative treatment of congenital heart disease in older age groups, a clinical study on patients over 40 years of age with atrial septal defect was carried out. The series consisted of 125 consecutive patients operated on between 1966 and 1974. There were 8 cases with a primum, 12 cases with a sinus venosus type of secundum and 105 cases with a simple secundum defect. The operative mortality was 2 patients (1.6%). It was due to myocardial infarction in one case and high pulmonary vascular resistance in the other. On re-examination 3-6 months postoperatively, 107 patients were improved, 13 patients unchanged and 3 patients were worse than before operation. On re-evaluation after an average period of 6 years, 88 patients were still improved. 32 patients unchanged and 3 patients were worse compared with their pre-operative status. On the basis of the results and the previous reports on atrial septal defect without operation, the surgical correction of ASD even in older age groups can be recommended. The problem of deterioration of some patients, despite a good immediate postoperative result, is discussed.

Adult↗
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

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

Cardiac disturbances after pneumonectomy--the value of prophylactic digitalization.

The incidence of postoperative cardiac disturbances and the value of prophylactic digitalization were studied retrospectively in 143 patients undergoing pneumonectomy for carcinoma of the lung. Cardiac arrhythmias occurred in 29% and tachycardia episodes in 30% of the patients. The incidence of myocardial infarction was 2%. Operative mortality was 4%. The cardiac disturbances developed more often after left than after right pneumonectomy. The age of the patients, a history of angina pectoris or hypertension did not markedly increase the incidence of cardiac disturbances, neither did operative factors, such as pericardiotomy, left atrial resection, major bleeding nor postoperative empyema. Prophylactic digitalization significantly reduced postoperative cardiac disorders, their frequency being 33% in the group of patients who received prophylactic digitalis compared with 65% in the group that did not.

Adult↗
PubMed1978

Recurrent small bowel obstruction caused by a benign tumor. A report of two cases.

Two cases of primary small bowel tumors causing an acute intussusception are presented. In one case two polyps were found and in the other case a lipoma in the wall of the jejunum. In both cases there were symptoms of recurrent bowel obstruction for several months before the acute condition. Although intussusception caused by a benign tumor of the small bowel is a rare condition it should be taken into consideration in the differential diagnosis of abdominal pain of doubtful origin.

Adult↗
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

The efficacy of single dose of pindolol in hypertension.

The effect of pindolol was studied in 32 patients suffering from hypertension of WHO grad I or II. 25 of these patients respondered to pindolol administered three times daily, and were thereafter treated with a single 20-40 mg dose of pindolol. Normotension was achieved in 15 patients and a satisfactory result in five patients but three patients did not respond to the single dose and two had to interrupt their treatment because of side effects. The side effects were generally mild. As a significant observation NaCl retention was found. It may be due to the preceeding diuretic treatment in most patients, but nevertheless needs further investigations.

Clinical Trials as Topic↗
PubMed1977

The effect of digoxin on the contractility of transplanted heart.

The effects of digoxin on the contractility of orthotopically transplanted heart was studied in dogs. Intravenously administered digoxin produced a fall in the rate and output of the transplanted heart without any change in stroke volume, whereas the output of the intact heart was slightly improved due to a small increase of stroke volume. This difference was thought to be due to the action of digitalis which is mediated via the nervous pathways, which are interrupted in the transplanted heart.

Animals↗
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↗
PubMed1977

Surgical treatment of carcinoma of the oesophagus and cardia.

A clinical series of 216 patients with carcinoma of the oesophagus or cardia, who underwent surgical resection of the oesophagus, is presented. There were 104 patients with oesophageal carcinoma and 112 patients with carcinoma of the cardia. Histologically, there were 102 squamous cell carcinomas, 98 adenocarcinomas, 11 anaplastic carcinomas and 7 non-differentiated carcinomas. Oesophago-gastrotomy was the procedure mostly used; colon interposition was done in only 13 cases. The hospital mortality was 21%. The 5-year survival rate for the whole series after oesophageal resection was 23%. The duration of symptoms, location of the tumour, age and sex of the patients, pre- or postoperative radiotherapy and the histological type of the tumour had only a minor bearing on survival. The two most important prognostic factors were the spread of the tumour at time of operation and a preceding lye stricture. The 5-year survival rate was 34% for the patients with a local tumour at operation and 44% for those in whom the carcinoma developed at the site of a previous lye stricture. The variance of the results in the literature is discussed. Surgical approach to the carcinoma of the oesophagus and cardia is recommended in all the cases in which the patient and tumour seem to be eligible for resection.

Adult↗
PubMed1977

Traumatic diaphragmatic hernia. Report of 50 cases.

The writers report a clinical series of 50 patients with traumatic diaphragmatic hernia. There were 36 hernias on the left side and 14 on the right. Stab or bullet wound was the cause of the hernia in 27 cases. The other 23 cases were due to traffic accidents or other blunt injuries. Immediate operative repair was done in 30 cases; in 20 cases the operation was carried out after a time interval of 11.5 years post trauma on an average. Plain chest X-ray, barium meal or enema and pneumoperitoneum were the most valuable diagnostic tools. Visceral injuries were discovered in 53% of cases caused by traffic accidents. The omentum, stomach, colon and spleen were the organs most frequently herniated. In two cases perforation of the stomach occurred before the operation. There were three cases of pericardial rupture associated with the diaphragmatic hernia in the series. The repair was done via thoracotomy in 28 cases, via laparotomy in 4 cases; and both thoracotomy and laparotomy were carried out in 18 cases. The hospital mortality was 2%. One of the patients died of peritonitis and renal failure following perforation of the stomach and intestines on the 9th postoperative day. Recurrence of the hernia occurred twice in one case. Re-examination revealed striction of the diaphragmatic movement in 11 cases. The clinical features, diagnosis and operative treatment are discussed.

Adolescent↗
PubMed1976

Donor-circulation as cardiopulmonary bypass in experimental heart transplantation.

Heart transplantation was performed on 21 mongrel dogs using donor-circulation of another, bigger dog, instead of the heart-lung machine. All the dogs survived the operation. They showed a moderate metabolic acidosis, which was more related to a reduced blood flow of the recipient than to inadequate oxygenation capacity of the pump dog during transplantation, and which was corrected by administration of bicarbonate after the procedure. The technique was superior to disposable oxygenators in reducing the expense of the operation and providing a more gentle perfusion.

Acid-Base Equilibrium↗
PubMed1976

Thymectomy for myasthenia gravis.

Thymectomy was performed on 31 patients with myasthenia gravis. Four of them had thymoma, 17 hyperplasia and 9 had normal thymic histology on microscopy. Discontinuation of anticholinergic medication together with tracheostomy, artificial ventilation and intensive observation were essential in the postoperative management. All the patients survived operation and were discharged from hospital. Sixty-eight per cent of the patients were in remission or improved after an average follow-up of 2.5 years. If the patients with thymoma were excluded, 74% were improved and, if only the patients with thymic hyperplasia were included in the series, 89% were improved after thymectomy. The severity of disease and duration of symptoms pre-operatively seemed to be of minor importance for the results of operation, since good results were obtained also in patients with a long history and in clinical classes III and IV. Two patients developed tracheal stenosis as a complication of intubation with a tracheostomy tube. Tracheal resection was performed in one of them and endobronchial removal of granulation tissue producing the stenosis in the other. Both recovered uneventfully. One patient, who was asymptomatic and without medication for myasthenia, died suddenly of acute cerebral bleeding 3 years after thymectomy.

Adolescent↗