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Biomedical subjects

S Mattila

Publications and source records attributed to S Mattila.

At least 127 records · Page 7Linked to original sources
PubMed1982

Pulmonary arteriovenous fistulas.

During the 20-year-period 1959-78, 7 patients with pulmonary arteriovenous fistula were treated at the Department of Thoracic and Cardiovascular Surgery. There were 5 men and 2 women, with a mean age of 26 (14-47) years. Cyanosis with elevated haematocrit was present in 4, dyspnoea in 4, neurological signs in 3 (including one brain abscess and one hemiplegia). Systolic hum was audible in 3 cases. Three patients had the hereditary type of the disease (Rendu-Osler-Weber) with telangiectasiae also elsewhere in the body. The calculated right-to-left shunt varied from 14 to 56 per cent of the cardiac output. The treatment was lobectomy in all cases (4 upper lobe, one middle lobe and 2 lower lobe resections). The patient with a brain abscess underwent craniotomy prior to lobectomy and developed epilepsy necessitating anticonvulsive treatment. The other patients had an uneventful recovery with relief of the symptoms. During the follow-up time (2-20 years), one patient (with hemiplegia) died of myocardial infarction 10 years after the operation. The others were doing well. It is concluded that the safest way to treat a pulmonary arteriovenous fistula is to operate as soon as it has been detected in order to prevent the complications so often associated with the disease.

Adolescent↗
PubMed1982

The effects of a centrifugal pump as a left-ventricular-assist device in myocardial infarction.

Cardiogenic shock after acute myocardial infarction and open heart surgery having cardiopulmonary bypass may present a difficult clinical problem with high mortality. The present study was carried out to evaluate a newly developed laminar flow centrifugal pump as a left-ventricular-assist device to support the circulation and prevent myocardial damage in such situations. Experimentally induced acute myocardial infarction in dogs was used as the model. Cardiogenic shock was effected by ligating enough branches of the left coronary artery. In addition to recording the haemodynamic parameters, samples of myocardium were taken with a biopsy needle from the infarcted area, transitional zone and intact myocardium for determination of adenosine triphosphate, creatine phosphate and lactate. In the first phase of the work the effects of acute myocardial infarction on haemodynamics and high-energy compounds were defined, to form a basis for the evaluation of the pump as left-ventricular-assist device. Ligation of the branches of the left coronary artery produced a rapid fall in aortic pressure, cardiac output and cardiac performance, elevation of ST-segment in the ECG and fall in high-energy compounds. However, there was a marked spontaneous recovery in the transitional zone within 120 min, despite the haemodynamic deterioration. The laminar flow pump produced a significant improvement in the haemodynamic and metabolic parameters which exceeded the spontaneous changes noted previously.

Adenosine Triphosphate↗
PubMed1981

Effect of probucol on the activity of postheparin plasma lipoprotein lipase and hepatic lipase.

The effect of discontinuation of long term (34-56 months) probucol treatment on serum lipids, lipoproteins and on the activity of postheparin plasma lipoprotein and hepatic lipase ahs been studied in 10 healthy males participating in a primary prevention programme of coronary heart disease. A significant increase was observed in the activity of postheparin plasma lipoprotein lipase, in the total serum cholesterol concentration and in the serum concentrations of high density lipoprotein (HDL) cholesterol, HDL phospholipids and apoprotein AI after withdrawal of the drug No changes were seen in the serum triglyceride levels or in the activity of postheparin plasma hepatic lipase. The activity of postheparin plasma hepatic lipase tended to correlate with the serum concentration of HDL. No correlations were present between the individual changes in the serum levels of HDL and in the activity of postheparin plasma triglyceride lipases.

Apolipoprotein A-I↗
PubMed1981

Penetrating and perforating thoracic injuries.

Five hundred and eleven patients with penetrating or perforating chest injuries were admitted to the Department of Thoracic and Cardiovascular Surgery, University Central Hospital, Helsinki, during the 25-year-period 1952-77. There were 433 stab wounds, 59 gunshot wounds and 19 other penetrating injuries. The organs most often involved were lungs (major haemo- or pneumothorax in 385 patients), heart (63 patients) and liver (61 patients). About one third of the patients were in profound shock on admission. The treatment was immediate thoracotomy in 176 (35%) and laparotomy in 123 cases (24%). Tube thoracostomy was applied in 117 patients and needle aspiration performed in 88 patients. Nine patients died (mortality of 1.8%). Two patients required later open-heart procedure. One of them had an aortopulmonary fistula and the other a traumatic VSD combined with aortic valve lesion. One of the traumatic VSDs closed spontaneously during the follow-up time. An active operative approach in the early phase seems to guarantee the best final results, especially in the most critically ill patients.

Adolescent↗
PubMed1980

Effect of long-term antihypertensive and hypolipidemic treatment on high density lipoprotein cholesterol and apolipoproteins A-I and A-II.

The concentrations of total serum cholesterol and triglycerides and serum HDL cholesterol, triglycerides and apoproteins A-I and A-II were measured in 119 men after 4 years of active participation in a multifactorial primary prevention trial of coronary heart disease. No difference was observed in total serum cholesterol, triglycerides, HDL lipids or apoproteins between the control subjects without medication and the men treated with antihypertensive drugs (beta-blockers alone or in combination with thiazides). The concentration of HDL cholesterol was significantly lower and that of apoprotein A-II significantly higher in the individuals treated with clofibrate than in the controls. On the other hand, the levels of both HDL cholesterol and apoprotein A-I were lower in the men treated with probucol than in the controls, whereas that of A-II was within the control limits. The ratio HDL cholesterol/apoprotein A-I was subnormal in all 3 groups treated with lipid-lowering drugs, as if the treatment had lowered the cholesterol saturation of the HDL fraction. The levels of HDL cholesterol and apoprotein A-I were negatively correlated with the length of the treatment in subjects treated with probucol but not in the other groups. These results suggest that in long-term use, probucol and possibly clofibrate lower both the concentration and the cholesterol/apoprotein ratio of the HDL fraction.

Antihypertensive Agents↗
PubMed1980

Ischaemic cardiac aneurysms and ventricular septal defects. Surgical treatment with and without revascularization.

During the period 1968--78, 35 patients with left ventricular aneurysm after acute myocardial infarction were operated on at the Department of Thoracic and Cardiovascular Surgery, University Central Hospital, Helsinki. Twenty patients underwent resection of the left ventricular aneurysm and had coronary bypass grafting (Group I) and 15 patients had aneurysmectomy without revascularization procedures (Group II). Most of the patients (21) had the operation within one year after acute myocardial infarction. The aneurysm was located in the anterior wall in 31 cases and in the posterior wall in 4 cases. Three patients in Group II had a concomitant ventricular septal rupture, which was repaired simultaneously with the aneurysmal resection. In average, the patients in Group I had bypass grafting in 1.8 coronary branches. There were no intra-operative deaths. Three patients in the revascularization group died and 2 patients in the non-revascularization group died during hospitalization (15% hospital mortality). Two patients in the revascularization group and one in the non-revascularization group died during the average follow-up time of 3.4 and 6.4 years for the respective groups (late mortality 10 and 7%). The rest of the patients were doing well, including those with repaired VSDs. Follow-up coronary angiography was carried out of 12 patients; in 10 all the grafts were patent and in 2 one revascularized coronary branch had a patent graft. Revascularization produced apparent relief of anginal symptoms. Its beneficial effects on longevity remained unestablished.

Adult↗
PubMed1980

The effect of glutaraldehyde-tanning on the elasticity of the human saphenous vein.

The elasticity of eighty-one vessel samples was evaluated by a tensile strength test. Twenty of these were untreated veins, 24 glutaraldehyde-pre-treated veins, 16 pre-treated implanted veins and 21 untreated arteries. The artery was the most elastic vessel. Glutaraldehyde-pre-treatment diminished the elasticity of veins, but added tensile strength. Insertion of glutaraldehyde-pre-treated human veins into carotid arteries of dogs did not alter the elastic properties of these grafts.

Animals↗
PubMed1980

Histological study of glutaraldehyde-processed vascular grafts of biological origin.

A total of 90 grafts of 100 mm in length was inserted as arterial and shunt conduits in 31 mongrel dogs. Histological changes before and after implantation were evaluated. Sections were stained with van Gieson, haematoxylin eosin and Wiegert's method for elastic fibres, and studied with light microscopy. Twenty five of the 42 cases studied showed classic signs of rejection around the graft, the strongest immunological response being seen in the fresh vein grafts. Glutaraldehyde pre-treatment diminished this reaction but it was still clearly visible in 13 of the 21 cases. Of the fourteen human umbilical vein grafts tanned with glutaraldehyde and used either as shunts or bypass grafts, seven showed only slight or moderate reaction and in seven cases no clear sign of rejection could be seen. The absence of intimal hyperplasia with this type of graft also showed its superiority over that of the human "non-umbilical" vein grafts. The problem in all the groups was the anastomotic area, where fibrous hyperplasia developed. The graft structure seemed to be well-preserved during the follow-up period of 6.0 months.

Animals↗
PubMed1980

Morphological study of flow surface of glutaraldehyde pre-treated vascular substitutes.

90 grafts were inserted as arterial and shunt conduits in 31 dogs. Human saphenous veins and umbilical veins were either fresh or treated with 0.2% v/v glutaraldehyde. 72 samples from these grafts were studied morphologically. Macroscopic inspection, and light, scanning and transmission microscopy was used. The insertion time of the grafts were kept in place for periods up to 6.0 months. The tanning procedure with glutaraldehyde destroyed all normal endothelial structures. However, the new vascular interface appeared to be quite thrombo-resistant, because only slight changes were found on the flow surface following surgery. Multiple collagen fibres were seen with fibrin like deposits predominating. In those grafts which were thrombosed the thrombus had its origin at the anastomotic site and the graft itself was free of thrombus. No endothelium could be seen in any case studied. Fresh untreated saphenous vein grafts studied as controls showed clear degenerative changes and thrombus accumulation on the inner surface. The same kind of changes were found also in the anastomosing artery.

Animals↗
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↗