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12 records – page 1 of 2.

Acute type A aortic dissection--diagnostic aspects and surgical experience.

https://arctichealth.org/en/permalink/ahliterature54947
Source
Scand J Thorac Cardiovasc Surg. 1994;28(2):61-6
Publication Type
Article
Date
1994
Author
R. Pokela
T. Juvonen
J. Satta
P. Kärkölä
Author Affiliation
Department of Surgery, Oulu University Hospital, Finland.
Source
Scand J Thorac Cardiovasc Surg. 1994;28(2):61-6
Date
1994
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Aged
Anastomosis, Surgical - adverse effects
Aneurysm, Dissecting - diagnosis - surgery
Angiography, Digital Subtraction
Aortic Aneurysm - diagnosis - surgery
Aortic Aneurysm, Thoracic - surgery
Blood Vessel Prosthesis
Cardiac Tamponade - ultrasonography
Echocardiography, Transesophageal
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications
Reoperation
Survival Rate
Tomography, X-Ray Computed
Treatment Outcome
Abstract
Acute type A aortic dissection was surgically treated in 33 patients aged 20-65 years, all critically ill on admission to hospital. Transthoracic echocardiography revealed pericardiac tamponade in eight cases of extreme emergency, indicating surgery without need of additional imaging. Transesophageal echocardiography provided a definitive diagnosis in 16 cases, with excellent reliability and no false positive findings. Composite graft replacement with button technique was used in 24 patients and other methods of repair in nine. The perioperative mortality was 12% (4/33) and the late mortality 7% (2/29). The actuarial 5-year survival rate was 73%. No aortic root reoperation was required during follow-up for a mean of 4 years. Transesophageal echocardiography proved to be an accurate tool for speedy diagnosis of acute type A aortic dissection and open composite graft replacement with button technique highly satisfactory treatment, avoiding late aortic root problems.
PubMed ID
7863287 View in PubMed
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Anomalies at the thoracic outlet are frequent in the general population.

https://arctichealth.org/en/permalink/ahliterature214787
Source
Am J Surg. 1995 Jul;170(1):33-7
Publication Type
Article
Date
Jul-1995
Author
T. Juvonen
J. Satta
P. Laitala
K. Luukkonen
J. Nissinen
Author Affiliation
Department of Surgery, University of Oulu, Finland.
Source
Am J Surg. 1995 Jul;170(1):33-7
Date
Jul-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Brachial Plexus - abnormalities
Cadaver
Congenital Abnormalities - classification - epidemiology
Female
Finland
Humans
Male
Middle Aged
Prevalence
Risk factors
Subclavian Artery - abnormalities
Thoracic Outlet Syndrome - epidemiology
Thorax - abnormalities
Abstract
Abnormal anatomy at the thoracic outlet is frequent in patients operated on for thoracic outlet syndrome (TOS). The present study was designed to find out the rate of thoracic outlet anomalies in the general population.
Fifty cadavers representing a general population were subjected to a total of 98 meticulously performed cervical dissections to ascertain the frequency of congenital anomalies in the thoracocervicoaxillary region.
During the 98 cervical dissections, 62 instances of abnormal anatomy of the thoracic outlet were found, and fully normal anatomy was found in 36 cases. Of the total 69 abnormalies, 66 could be classified according to Roos: 37 were type 3 abnormalities, 15 were type 5, 9 were type 11, and there was 1 each of type 4, type 6, type 7, type 9, and type 10 abnormalities. The remaining 3 abnormalities did not fit into Roos' classification. Only 10% (5/50) of the cadavers had a bilaterally normal anatomy.
The results demonstrate that abnormal structures, such as congenital bands in the thoracic outlet, are more common in the general population than had previously been described. We suggest that fibrous bands confer a predisposition for TOS following a certain degree of stress or injury.
Notes
Comment In: Am J Surg. 1995 Nov;170(5):5247485748
PubMed ID
7793491 View in PubMed
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Effects of diclofenac in the prevention of pericardial effusion after coronary artery bypass surgery. A prospective, randomized study.

https://arctichealth.org/en/permalink/ahliterature53698
Source
J Cardiovasc Surg (Torino). 2002 Aug;43(4):449-53
Publication Type
Article
Date
Aug-2002
Author
M. Niva
F. Biancari
J. Valkama
J. Juvonen
J. Satta
T. Juvonen
Author Affiliation
Department of Cardiothoracic and Vascular Surgery, Oulu University Hospital, Finland.
Source
J Cardiovasc Surg (Torino). 2002 Aug;43(4):449-53
Date
Aug-2002
Language
English
Publication Type
Article
Keywords
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Coronary Artery Bypass
Diclofenac - therapeutic use
Female
Humans
Incidence
Male
Middle Aged
Pericardial Effusion - prevention & control
Postoperative Complications - prevention & control
Prospective Studies
Abstract
BACKGROUND: It is suggested that pericardial effusions after cardiac surgery can be managed with non-steroid anti-inflammatory drugs, but the efficacy of this therapy is not well established. This study was planned to evaluate the efficacy of the prophylactic use of diclofenac in the prevention of pericardial effusion after coronary artery bypass surgery. METHODS: In a prospective, randomized study, diclofenac sodium 50 mg was administered orally every 8 hours to 22 patients in the postoperative period. The control group consisted of 19 patients who were not given postoperatively either steroids or non-steroid anti-inflammatory drugs. RESULTS: Twelve patients of the diclofenac-treated group (54.5%) and 7 of the control group (36.8%) experienced supraventricular arrhythmias postoperatively. There was no statistically significant difference in the size of postoperative pericardial effusion as well as in the occurrence of pleural effusion in both groups. However, there was a higher rate of significant pericardial effusion (grade I-III) in the control group as compared with the diclofenac-treated group (52.6% vs 31.8%, p=ns). Based on chest X-ray findings, patients in the control group had higher incidence of pleural effusion either alone (42.1% vs 22.7%, p=ns) or combined with pericardial effusion (21.0% vs 13.6%, p=ns). Patients who received diclofenac had lower median C-reactive protein concentration (76.0+/-45.2 mg/L) than the patients of the control group (99.6+/-47.8 mg/L), (p=ns). CONCLUSIONS: The results of the present study suggest that diclofenac, even if without a striking effect, may lessen the degree of inflammatory reaction after cardiac surgery and may be useful in the prevention and in the management of early pericardial effusion after cardiac surgery.
PubMed ID
12124550 View in PubMed
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Elevated circulating levels of inflammatory cytokines in patients with abdominal aortic aneurysm.

https://arctichealth.org/en/permalink/ahliterature54453
Source
Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):2843-7
Publication Type
Article
Date
Nov-1997
Author
J. Juvonen
H M Surcel
J. Satta
A M Teppo
A. Bloigu
H. Syrjälä
J. Airaksinen
M. Leinonen
P. Saikku
T. Juvonen
Author Affiliation
National Public Health Institute, Oulu, Finland.
Source
Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):2843-7
Date
Nov-1997
Language
English
Publication Type
Article
Keywords
Aortic Aneurysm, Abdominal - blood - pathology
Aortitis - blood
Cohort Studies
Collagen - metabolism
Comparative Study
Coronary Arteriosclerosis - blood
Cytokines - blood
Extracellular Matrix Proteins - metabolism
Female
Humans
Hypertension - epidemiology
Interferon Type II - blood
Interleukin-1 - blood
Interleukin-6 - blood
Male
Middle Aged
Peptide Fragments - analysis
Procollagen - analysis
Research Support, Non-U.S. Gov't
Sex Factors
Smoking - epidemiology
Tumor Necrosis Factor-alpha - analysis
Abstract
The basic feature in the pathogenesis of abdominal aortic aneurysm (AAA) is the degradation of extracellular matrix components. This process is induced partly by cytokines secreted from inflammatory and mesenchymal cells. Circulating levels of inflammatory cytokines were studied in AAA patients and compared with subjects suffering from atherosclerotic disease only. Furthermore, the predictive value of cytokine concentrations was evaluated for aneurysm expansion rate. Circulating levels of interleukin 1 beta (IL-1 beta), interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma) were measured in 50 AAA patients (40 men, 10 women), 42 patients with coronary heart disease (CHD) (23 men, 19 women), and 38 controls whose angiogram was normal (17 men, 21 women). No differences in cytokine concentrations were found between the CHD patients and the controls. AAA disease was found to be associated with significantly higher IL-1 beta and IL-6 concentrations in both male patients (median concentrations of 19.40 pmol/L and 6.45 pmol/L, respectively) and female patients (19.26 pmol/L and 7.99 pmol/L) than in either the CHD patients or the controls (P
PubMed ID
9409264 View in PubMed
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Expression of MMP2, MMP9, MT1-MMP, TIMP1, and TIMP2 mRNA in valvular lesions of the heart.

https://arctichealth.org/en/permalink/ahliterature53915
Source
J Pathol. 2001 Jun;194(2):225-31
Publication Type
Article
Date
Jun-2001
Author
Y. Soini
J. Satta
M. Määttä
H. Autio-Harmainen
Author Affiliation
Department of Pathology, University of Oulu and Oulu University Hospital, Oulu, Finland. msoini@cc.oulu.fi
Source
J Pathol. 2001 Jun;194(2):225-31
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Aortic Valve - enzymology
Female
Gelatinase A - analysis - genetics
Gelatinase B - analysis - genetics
Heart Valve Diseases - enzymology
Heart Valves - enzymology
Humans
Immunohistochemistry - methods
In Situ Hybridization - methods
Male
Matrix Metalloproteinases - analysis
Metalloendopeptidases - analysis - genetics
Middle Aged
Mitral Valve - enzymology
RNA, Messenger - analysis
Tissue Inhibitor of Metalloproteinase-1 - analysis - genetics
Tissue Inhibitor of Metalloproteinase-2 - analysis - genetics
Tissue Inhibitor of Metalloproteinases - analysis
Abstract
Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) play an important role in several diseases. This study was undertaken to investigate the mRNA synthesis of MMP2, MMP9, membrane-type 1 (MT1)-MMP, and matrix metalloproteinase inhibitors TIMP1 and TIMP2 by in situ hybridization in a set of heart mitral and aortic valves operatively removed due to degenerative or inflammatory valvular diseases. The material consisted of 21 valves, eight with endocarditis and 13 with a degenerative valvular disease. The samples were studied by in situ hybridization with specific probes for MMP2, MMP9, MT1-MMP, TIMP1, and TIMP2. Synthesis of MMP2 mRNA was found in seven valves, five with endocarditis and two with degenerative valvular disease. Signals for MMP9 mRNA were found in two cases with endocarditis and five cases with degenerative valvular disease. No signal for MT1-MMP mRNA was found in the lesions. TIMP1 mRNA, on the other hand, was found in 17 cases, both endocarditis and degenerative valvular disease. TIMP2 mRNA was found in three cases of endocarditis. The signals for MMP2, MMP9, TIMP1, and TIMP2 mRNA were localized in endothelial cells and in fibroblast-like cells expressing alpha-smooth muscle actin, thus showing myofibroblast-type differentiation. The results show that matrix metalloproteinases MMP2 and MMP9, and matrix metalloproteinase inhibitors TIMP1 and TIMP2 mRNAs are synthesized in diseased valves and suggest that they may contribute to matrix remodelling in valvular disease.
PubMed ID
11400152 View in PubMed
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Multiple endocrine neoplastic-associated thymic carcinoid tumour in close relatives: octreotide scan as a new diagnostic and follow-up modality. Two case reports.

https://arctichealth.org/en/permalink/ahliterature21144
Source
Scand Cardiovasc J. 1999;33(1):49-53
Publication Type
Article
Date
1999
Author
J. Satta
A. Ahonen
S. Parkkila
L. Leinonen
M. Apaja-Sarkkinen
M. Lepojärvi
T. Juvonen
Author Affiliation
Department of Surgery, University of Oulu, Finland.
Source
Scand Cardiovasc J. 1999;33(1):49-53
Date
1999
Language
English
Publication Type
Article
Keywords
Carcinoid Tumor - genetics - radiography - radionuclide imaging - surgery
Hormones - diagnostic use
Humans
Indium Radioisotopes - diagnostic use
Male
Middle Aged
Multiple Endocrine Neoplasia Type 1 - genetics - radiography - radionuclide imaging - surgery
Octreotide - diagnostic use
Pentetic Acid - diagnostic use
Receptors, Somatostatin
Somatostatin - analogs & derivatives - diagnostic use
Thymus Gland - radiography - radionuclide imaging
Thymus Neoplasms - genetics - radiography - radionuclide imaging - surgery
Tomography, X-Ray Computed
Abstract
Thymic carcinoid tumours constitute less than 1% of all carcinoids, and differ markedly from true thymomas in natural history, morphology, prognosis and therapeutic options. New clinical and diagnostic modalities are described in two brothers with thymic carcinoid associated with multiple endocrine neoplasia syndrome. Octreotide scintigraphy proved useful for diagnosis and follow-up, and somatostatin receptor positivity may provide new prospects for treatment of non-resectable or recurrent tumour.
PubMed ID
10093860 View in PubMed
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Options for the management of poststernotomy mediastinitis.

https://arctichealth.org/en/permalink/ahliterature206049
Source
Scand Cardiovasc J. 1998;32(1):29-32
Publication Type
Article
Date
1998
Author
J. Satta
J. Lahtinen
L. Räisänen
E. Salmela
T. Juvonen
Author Affiliation
Department of Surgery, Oulu University Hospital, Finland.
Source
Scand Cardiovasc J. 1998;32(1):29-32
Date
1998
Language
English
Publication Type
Article
Keywords
Aged
Anti-Bacterial Agents - therapeutic use
Cardiopulmonary Bypass - adverse effects
Debridement
Female
Follow-Up Studies
Hospitals, University
Humans
Incidence
Male
Mediastinitis - epidemiology - microbiology - therapy
Middle Aged
Retrospective Studies
Sternum - surgery
Surgical Flaps
Surgical Wound Infection - epidemiology - etiology - therapy
Sweden - epidemiology
Therapeutic Irrigation
Thoracotomy - adverse effects
Abstract
The management of 27 consecutive deep sternotomy wound infections is reviewed. In 22 cases the initial treatment was debridement, sternal refixation and dilute antibiotic irrigation via multiple irrigation-suction catheters. In the nine cases (41%) in which these measures failed, more extensive sternal and costal cartilage debridement and closure with a muscle flap were performed. Five cases were initially managed with major reconstructive surgery. For reconstruction, a bilateral pectoralis major myocutaneous flap was used alone in eight cases, while in six the flap was insufficient to obliterate the whole poststernectomy space, and was supplemented with rectus abdominis muscle. Early mediastinitis can be effectively treated with thorough wound debridement and mediastinal irrigation, but if there is a two-week delay from the initial sternotomy to manifestation of infection, radical debridement with muscle flap closure should be seriously considered.
PubMed ID
9536503 View in PubMed
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Outcome of elective infrarenal abdominal aortic aneurysm repair--an analysis of 174 consecutive patients.

https://arctichealth.org/en/permalink/ahliterature54701
Source
Ann Chir Gynaecol. 1996;85(3):231-5
Publication Type
Article
Date
1996
Author
J. Satta
K. Immonen
A. Reinilä
R. Pokela
T. Juvonen
Author Affiliation
Department of Surgery, University of Oulu, Finland.
Source
Ann Chir Gynaecol. 1996;85(3):231-5
Date
1996
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - blood - complications - mortality - surgery
C-Reactive Protein - metabolism
Cause of Death
Comorbidity
Female
Humans
Male
Middle Aged
Predictive value of tests
Prognosis
Retrospective Studies
Risk factors
Treatment Outcome
Abstract
The aim of the study was to assess the surgical outcome of elective infrarenal abdominal aortic aneurysm (AAA) repair and the clinical and surgical factors that may predict this outcome. The series comprises 174 consecutive patients who underwent elective surgery for infrarenal AAA. Factors found to be predictive of early hospital death (4.5%) were aneurysm size (> 5 cm), ischaemic heart disease, chronic obstructive pulmonary disease (COPD), preoperatively elevated C-reactive protein (CRP) and a history of aneurysm-related pain preoperatively. The outcome was also very poor if the bacterial culture from the aneurysm sac was positive. On the whole, the abdominal aortic aneurysm operation effectively controls the disease and can be safely employed electively.
PubMed ID
8950446 View in PubMed
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Pericardial closure with polytetrafluoroethylene surgical membrane or biodegradable polyglycolic acid mesh after coronary artery bypass surgery--a baseline report.

https://arctichealth.org/en/permalink/ahliterature205614
Source
Ann Chir Gynaecol. 1998;87(1):36-9
Publication Type
Article
Date
1998
Author
J. Lahtinen
J. Satta
R. Pokela
J. Nissinen
T. Juvonen
Author Affiliation
Department of Surgery, Oulu University Hospital, Finland.
Source
Ann Chir Gynaecol. 1998;87(1):36-9
Date
1998
Language
English
Publication Type
Article
Keywords
Adult
Biocompatible Materials
Biodegradation, Environmental
Coronary Artery Bypass
Feasibility Studies
Female
Humans
Male
Membranes, Artificial
Middle Aged
Pericardium - surgery
Polyglycolic Acid - therapeutic use
Polytetrafluoroethylene - therapeutic use
Prospective Studies
Surgical Mesh
Treatment Outcome
Abstract
Complete and tight closure of the native pericardium may kink or even occlude bypass grafts after coronary artery bypass grafting (CABG) and therefore the feasibility of tight closure has been debated. The growing number of reoperations has raised the question how to reduce the risk of damage of the right ventricle and patent grafts. We are performing a prospective randomized trial aiming to evaluate the feasibility of polytetrafluoroethylene (PTFE) surgical membrane and biodegradable polygycolic acid (PGA) mesh as pericardial substitutes for closure purposes in patients undergoing primary isolated CABG surgery.
The series comprises 540 patients who underwent a primary isolated CABG procedure at the Oulu University Hospital from October 1989 to May 1994.
The baseline results suggest that the PTFE and PGA materials seem to be similar despite the subtle early expression of tamponade related to the PTFE membrane after postoperative bleeding.
PubMed ID
9598228 View in PubMed
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The rupture type determines the outcome for ruptured abdominal aortic aneurysm patients.

https://arctichealth.org/en/permalink/ahliterature210105
Source
Ann Chir Gynaecol. 1997;86(1):24-9
Publication Type
Article
Date
1997
Author
J. Satta
E. Läärä
A. Reinilä
K. Immonen
T. Juvonen
Author Affiliation
Department of Surgery, University of Oulu, Finland.
Source
Ann Chir Gynaecol. 1997;86(1):24-9
Date
1997
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - classification - mortality - surgery
Aortic Rupture - classification - mortality - surgery
Cause of Death
Emergencies
Female
Finland - epidemiology
Humans
Male
Middle Aged
Risk factors
Survival Rate
Abstract
The treatment of patients with ruptured abdominal aortic aneurysm (RAAA) poses a significant surgical challenge. To achieve improvement in survival, factors influencing case fatality must be identified and modified. The aim of the present survey was to determine the contribution of preoperative, perioperative and postoperative events in predicting the mortality among AAA patients undergoing an emergency operation.
Fifty-one consecutive patients with ruptured infrarenal abdominal aortic aneurysm and twenty-six patients with 'expanding symptomatic aneurysms' (EAAA) were reviewed retrospectively to determine the relative contributions of preoperative, perioperative and postoperative factors on mortality.
The 30-day mortality was 47% in the RAAA group and 12% in the EAAA group. The rupture type was the main predictor of the outcome for the RAAA patients, the mortalities being 88% and 29% among patients with free (n = 16) and contained (n = 35) ruptures, respectively. In conclusion, the best way of avoiding poor results in cases of emergency aneurysm repair is to aim at elective operations. After the rupture, the clinical course is mainly determined by the rupture type, which is unfortunately beyond the surgeon's control. Surgical expertise and the avoidance of technical error can significantly affect the survival.
PubMed ID
9181215 View in PubMed
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12 records – page 1 of 2.