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Biomedical subjects

T Havia

Publications and source records attributed to T Havia.

At least 37 records · Page 2Linked to original sources
PubMed1984

Finnish registry for familial adenomatosis coli.

Collecting of patients diagnosed to have familial adenomatous polyposis coli (FPC) in Finland and a centralized systematic screening of their family members were undertaken by the Depts. of Surgery of the five Finnish university hospitals. In all, 160 FPC patients belonging to 50 families could be identified, and they had 178 descendants at 50% risk. The frequency of FPC was 5.63 X 10(-5) (1:18,000), which may represent an underestimate. It gives rise, however, to four new FPC patients in Finland every year. The distribution of the origin of the FPC families was even over central Finland, but small aggregates, probably branches of the same families, were found. Of the 50 families, 28 (56%) had at least 2 affected members, whereas 22 had only 1. The gene penetrance was estimated to be 80-89% at minimum. Children of solitary FPC patients must be considered to have the same risk of inheriting the gene as do those of established familial patients. The necessity of a permanent national centralized organization for the screening and management of FPC is emphasized.

Adolescent↗
PubMed1983

Prolonged impairment of cell-mediated immunity after major abdominal surgery in malnourished patients.

The effect of the nutritional status on postoperative impairment of the immune response was studied in adults undergoing major abdominal surgery. The immune function was evaluated by measuring in vitro the lymphocytic response to phytohaemagglutinin (PHA), concanavalin A (Con A) and the purified protein derivative of tuberculin (PPD) in whole blood cultures, and in vivo delayed skin hypersensitivity to candida, mumps, streptokinase-streptodornase and PPD. Nutritional assessment was carried out by evaluating recent weight loss, the weight for height index and by measuring the arm muscle circumference (AMC), triceps skinfold thickness (TSF), the creatinine-height index (CHI) and the serum concentration of albumin and prealbumin. The patient was considered malnourished, if at least three of these criteria were abnormal. The immune parameters were measured preoperatively, at the end of the surgery and five days after operation. Before the operation both malnourished and well-nourished patients had normal lymphocytic responses, but the malnourished patients had a slower recovery of immune responses after the operation and they had an increased number of postoperative complications. No significant differences in the incidence of anergy were observed between the well and malnourished patients pre or postoperatively.

Journal Article↗
PubMed1983

Abdominal aortic aneurysms: a clinical and autopsy study of 408 patients.

The material consisted of 408 patients with abdominal aortic aneurysms between 1959-1969 (Period I) and 1970-1979 (Period II). Of the aneurysms 135 were ruptured of which 65 were operated on and 70 revealed at autopsy. Autopsy revealed that in Period I an incorrect diagnosis had been made in 12/24 (50%) of those cases in which rupture was the cause of death; in Period II an incorrect diagnosis was made in 6/46 (13.3%) of similar cases. During Period I, 16/26 (62%) of those operated on for aneurysms were rupture cases; during Period II rupture cases were 49/129 (38%). The mean age of patients operated on for rupture was 66 years (mean age of elective patients 64 years). The operative mortality rate in rupture cases was 63% (41/65): eleven of these patients died during the operation and 30 died during the postoperative period most often on account of late sequelae of the primary shock period or some type of cardiovascular complication. Among patients older than 70 years the mortality rate was 89%; in the younger age group 49%. All patients with free peritoneal rupture died. Preoperative shock, massive bleeding during the operation and duration of operation correlated with the high operative mortality rate. In elective cases the hospital mortality rate was 7%. Myocardial infarction was the most important cause of death. The mortality rate did not correlate with age, perioperative bleeding or the duration of the operation.

Adult↗
PubMed1979

Elevated mid-myocardial oxygen tension in the fibrillating heart during cardiopulmonary bypass.

Mid-myocardial tissue oxygen tension was measured in the left ventricular wall of the hearts of ten dogs by means of a Silastic tonometer implanted earlier. During cardiopulmonary bypass, myocardial PO2 was significantly higher in a spontaneously fibrillating heart (5.4 +/- 0.9 kPa) than during the initial beating period (3.7 +/- 0.5 kPa) or after defibrillation (4.0 +/- 0.7 kPa). In general, there was a tendency towards increased myocardial blood flow, elevated oxygen uptake and reduced coronary sinus oxygen content during ventricular fibrillation, compared with the situation in the beating heart. Myocardial lactate extraction remained unchanged during the different phases of cardiopulmonary bypass. The increase in mid-myocardial oxygen tension during ventricular fibrillation was probably due to increased total myocardial blood flow and redistribution of regional myocardial circulation. In two additional dogs, ventricular fibrillation resulted in left ventricular distension and a simultaneous fall of myocardial oxygen tension, which indicates the necessity of left ventricular decompression suction in a fibrillating heart during cardiopulmonary bypass.

Animals↗
PubMed1978

The re-use of previously implanted pacemakers.

Two methods were used to sterilize pacemakers recovered for reimplantation in other patients. In a series of 50 reimplantations there was no battery or pocket complication which could be attributed to these methods. We believe that reimplantation is justified especially as the economic factors will become much more important with the new long-lasting, hermetically sealed lithium pacemakers.

Aged↗
PubMed1977

Surgical treatment of aneurysms of the ascending aorta. With special reference to cystic medial necrosis of the aorta.

The clinical series comprised 14 patients with aneurysms of the ascending aorta. In the autopsy series, there were additionally 19 patients, who had died suddenly as a results of free perforation or dissection of the ascending aorta. In the clinical series, the cause of the aneurysmal formation was cystic medial necrosis in 10 patients, 8 of whom had severe aortic valve insufficiency. Twelve patients were operated on using extracorporeal circulation, Both the ascending aorta and aortic valve were replaced with prosthesis in 6 cases. Three patients underwent emergency surgery due to pericardial tamponade. All three died, despite a technically successful operation. One patient out of 9 electively operated upon died. A follow-up examination was carried out on the 5 surviving cystic medial necrosis patients. Aneurysms of the sinuses of Valsalva developed after supracoronary resection in 2 patients. The results showed that elective operations in the event of aneurysms of the ascending aorta can be carried out with an acceptably low mortality rate. However, after supracoronary resection, in cases of cystic medial necrosis, the risk of developing aneurysms of the proximal aortic remnant seems obvious. Therefore, in patients in whom the whole aortic root is involved, total removal of the ascending aorta and re-implantation of the coronary ostia into the prosthetic tube is preferable.

Adolescent↗
PubMed1977

Intramyocardial gas tensions in the canine heart.

Intramyocardial gas tensions were determined in the left ventricular wall of the canine heart by means of chronically implanted silastic tonometers. In the central zone of the myocardial wall the mean baseline PO2 was 22 mmHg and the mean baseline PCO2 28 mmHg. Breathing of pure oxygen elevated the myocardial PO2 to a level of 60 to 90 mmHg. Hypovolaemic shock induced by shedding 30% of the blood volume resulted in a sharp decrease of the myocardial PO2 and a marked increase of the myocardial PCO2. During hypovolaemia, ventilation with pure oxygen elevated the oxygen tension to the control level and, after re-infusion of the shed blood, the response of the myocardial PO2 to oxygen breathing became higher than normal. Correction of hypovolaemic with a plasma expander Haemaccel restored the myocardial oxygen tension to the baseline level. Ligation of the left anteior descending coronary artery produced a rapid fall of PO2 and a profound increase of PCO2 in the corresponding myocardial area. After coronary ligation, developing tissue ischaemia usually resulted in ventricular fibrillation within a few minutes. Cardiac massage was started immediately, but produced no correction of tissue gas tensions, although the arterial blood gases remained normal. Ligation of the right coronary artery or the left circumflex coronary artery for short periods increased the myocardial PO2 in the vicinity of the left anterior descending branch, probably due to reactive hyperaemia around the ischaemic tissue.

Animals↗
PubMed1977

Acute effects of truncal vagotomy on gastric wall tissue gases in the dog.

Acute effects of truncal vagotomy on gastric wall tissue gases were studied in the dog by means of implanted Silastic tonometers. It was concluded that vagal denervation produces a significant fall of tissue PO2 in both corpus and antrum. Simultaneously, corpus PCO2 markedly decreases whereas antral PCO2 remains unchanged. The findings may be explained by a dual mechanism: reduced gastric blood flow and decreased metabolic activity in the parietal cell area. It is possible that reduction in CO2 accumulation decreases the supply of carbonic acid to the anhydrase system, thereby reducing the formation of hydrogen ions for acid production.

Animals↗
PubMed1976

Parenchymal gas tensions in canine lung.

Lung parenchymal oxygen and carbon dioxide tensions were measured in dogs by using chronically implanted Silastic tubes. The effects of pulmonary arterial ligation and bronchial occlusion on lung tissue gases were recorded. Prevention of venous return to the lung increased parenchymal oxygen tension markedly. Obstruction of airways and bronchial arteries resulted in a profound decrease in parenchymal oxygenation.

Animals↗
PubMed1976

Permanent endocardial pacing. An analysis of 90 patients.

Primary results and follow-up observations in 90 patients with permanent endocardial pacing--covering the period from 1970 to June 1974--are reported. The primary mortality was 3% (3/90), and mortality 4% (4/90). Electrode complications were the most common problem and occurred in 20% implantations. Early or late dislocation of the electrode tip was seen in 12%. With the improved technique is was possible to decrease it significantly through the period. The mean battery life time of Siemens-Elema pacemakers was 26 months. 10% of the failed batteries were replaced urgently. So far the rather high frequency of electrode complications diminishes the advantages of the pacemaker treatment.

Adolescent↗
PubMed1976

[Thymectomy in myasthenia gravis (author's transl)].

10 myasthenia patients were treated surgically during a four year period, 1970 TO 1973. Thymectomy was only resorted to in the most severe cases of the disease. A sternum splitting incision was preferred. Postoperative diffculties were usually avoided by routine use of a volume-controlled respirator. Oro-tracheal intubation was preferred to tracheostomy in order to avoid infection. In 9 patients it was possible to reduce the daily dose of medicine. Clinical improvement, sometimes delayed, occurred in 8 patients. All the patients had been incapacitated preoperatively but in 6 cases they were able to return to work. The mortality rate was nil. There was one case of postoperative pneumonia and one delayed sternal union.

Evaluation Studies as Topic↗
PubMed1976

Experiences with the Björk-Shiley tilting disc valve in aortic and mitral valve surgery.

During a four-year period, aortic or mitral valve replacements with the Björk-Shiley tilting disc valve were performed in 114 cases. The series comprises 75 aortic, 34 mitral and 5 double valve replacements. In the aortic valve group (AVR) concomitant resection of the ascending aorta (cystic medial necrosis aneurysm)) was carried out in 5 cases, aortocoronary bypass in 2 cases and closure of a VSD in one case. Antibiotic prophylaxis and postoperative anticoagulant treatment were used routinely. The hospital mortality rates were6 8.0% in the AVR-group (single aortic valve mortality 7.1 %), 8.8% in the MVR-group and 60% in the double valve group. Late mortality in the AVR-group was 2.8%. There were no late thromboembolic complications in this group. Aortography showed grade II--III regurgitation (paravalvular leaks) in 15 % of the cases. In the MVR-group the late mortality was 9.7%. One patient died because of malfunction (thrombosis) of the prosthesis. The thrombotic complication was obviously caused by discontinuation of anticoagulant therapy. The clinically estimated functional capacity NYHA classification) improved considerably, especially in the MVR-group.

Adolescent↗