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Biomedical subjects

P Halttunen

Publications and source records attributed to P Halttunen.

At least 19 recordsLinked to original sources
PubMed1990

Recurrence and malignant transformation of endotracheal chondroma.

An endotracheal chondroma with recurrent course and malignant transformation is described. The first chondroma recurrence appeared 5 years after the primary operation, with no histopathological signs of malignancy. A second recurrence after a further 6 years showed obvious histological evidence of malignant chondrosarcoma. A third recurrence after 1 more year metastasized to various organs and led to the patient's death 14 years from the date of primary diagnosis.

Brain Neoplasms↗
PubMed1990

Bronchoplastic procedures in the treatment of endobronchial carcinoid tumors.

Pulmonary carcinoid tumor was surgically treated in 33 patients during a 22-year period. The tumor was polypoid and endobronchial in 19 (58%) of the patients. Conventional operation was required in 12 (63%) of the 19, viz. pneumonectomy (1), bilobectomy (1), lobectomy (9) or lingulectomy (1). In one of these 12 patients, metastasis to a salivary gland was found 15 years postoperatively, and to the mediastinum after 16 years. The other seven patients (5 female, 2 male) were treated with bronchoplasty, or with lobectomy and bronchial resection including bronchoplasty, to avoid more extensive pulmonary resection. All seven were recalled for follow-up examination 5 months to 10 years postoperatively. No recurrence or metastasis of the tumor was found, and spirometry and radiospirometry showed that the saved pulmonary tissue was functional.

Adolescent↗
PubMed1990

Benign mesenchymal tumours of the lung including sclerosing haemangiomas.

Clinical aspects of twelve patients with benign mesenchymal lung tumours including four so-called sclerosing haemangiomas were studied. The age of the patients varied from 17 to 62 years (mean 40 years). Seven patients were female and five were male. The benign tumour was enucleated in five cases and excised by segmentectomy in one case. Three tumours were removed by lobectomy, and one by bilobectomy including bronchial resection and bronchoplasty. Two tumours (an endobronchial leiomyoma and fibroma) were removed by bronchial resection. Two patients who had previous hysterectomy for uterine leiomyomas had intraparenchymal pulmonary leiomyomas with histologically benign appearance. Although these tumours might represent metastases from uterine tumours, the follow-up of 5 and 8 years did not reveal clinically malignant features. None of the patients in this series showed tumour recurrences. Our results confirm earlier observations suggesting that the so-called sclerosing haemangioma is actually an epithelial, not a mesenchymal tumour.

Adult↗
PubMed1987

Intravascular bronchioloalveolar tumor.

A 17-year-old girl was operated for a solitary well-circumscribed pulmonary parenchymal tumor and reoperated ten times for multiple recurrent similar pulmonary tumors during 24 years. Histologic examination revealed the so-called intravascular bronchioloalveolar tumor (IVBAT) in all instances. The patient died from pneumonia superimposed on decreased respiratory function 24 years after the onset of disease. This is the longest survival so far reported in IVBAT. The treatment was surgical in all phases of the disease, and the patient did not receive radiotherapy or cytostatic drug therapy. Mediastinal and pleural tumor nodules were removed 17 years from the first pulmonary operation, and 24 years after the first operation a fibrous tumor was removed from the retroperitoneal space. Immunohistologically, the tumor cells were positive for vimentin-type of intermediate filaments, in line with their mesenchymal nature. Endothelial markers, Factor VIII-related antigen and Ulex europaeus I lectin binding, were not found in convincingly neoplastic cells, and Schwann cell, epithelial cell, muscle cell, and histiocytic markers were absent. Thus, IVBAT appears to be a low-grade malignant mesenchymal neoplasm, composed of poorly differentiated mesenchymal cells, whose exact nature remains undefined with the currently used cell-type markers.

Adolescent↗
PubMed1986

Postoperative active specific immunotherapy with supportive measures in patients suffering from recurrent metastasized melanoma: case reports of six patients.

The clinical results from postoperative active specific immunotherapy using autologous polymerized tumor material in six patients suffering from metastasized melanoma is reported. Correction of an alleged systemic deficiency leading to malignant cell transformation was attempted by administering certain essential trace elements, amino acids, vitamins, and a diet containing lipids, extracted from the mammalian central nervous system, after heating. Vaccinations against influenza were also given as a precaution against certain viral infections sometimes seen to precede melanoma recurrence. The clinical results with this postoperative adjuvant therapy are so encouraging that we suggest that sterile tumor tissue should be saved at operation and treated to produce insoluble particles as an option for postoperative treatment of patients suffering from metastasized melanoma. Prospective randomized studies are indicated.

Adult↗
PubMed1986

Tracheobronchomalacia in an adult with metaphyseal chondrodysplasia.

Anaesthetic complications such as obstruction of airways by submucosal cartilage-bone protuberances, immobility of the neck or instability of the atlanto-axial joint have been described earlier in paediatric patients with congenital osteochondral disorders. This report concerns a case in which tracheal collapse due to tracheobronchial malacia in an adult patient with metaphyseal chondrodysplasia evidently caused severe ventilatory difficulties in the induction of anaesthesia. The management of the patient on three subsequent occasions is described. During the first operation, support of the upper respiratory tract was performed. For this procedure, awake tracheal intubation with local anaesthesia applied to the larynx, vocal cords and trachea was used. After surgical correction of the bronchus of the right upper lobe and the stem bronchus, subsequent anaesthesias for surgical treatment of scoliosis could be conducted safely. The possibility of co-existing tracheobronchial malacia in patients with osteochondrodysplasias should be considered and tracheal intubation under local anaesthesia is recommended.

Adult↗
PubMed1986

A long-term double-blind comparison of doxazosin and atenolol in patients with mild to moderate essential hypertension.

The efficacy and safety of doxazosin and atenolol were compared following once-daily administration for up to 1 year, with a minimum of 20 weeks' active treatment. According to response, patients received doxazosin 1-16 mg day-1 or atenolol 50-100 mg day-1. Mean daily doses at the final efficacy assessment (between 20 weeks and 1 year) were doxazosin 11.8 mg and atenolol 94.2 mg. Atenolol produced somewhat greater falls in blood pressure than doxazosin. The differences were statistically significant in the supine but not in the standing position. A small mean reduction in heart rate was produced by doxazosin whereas atenolol produced a marked bradycardia. Analysis of the same patient group at 20 weeks revealed similar overall profiles of activity except that atenolol produced greater falls in blood pressure than in the longer term analysis. Serum concentrations of HDL/total cholesterol ratio were raised in the doxazosin treatment group and lowered in the atenolol group. Triglyceride concentrations fell in the doxazosin group and rose in the atenolol group. Significant differences (P less than 0.001) were observed between treatment groups for these parameters, all differences being in favour of doxazosin. Pharmacokinetics of doxazosin, measured at steady state in 36 patients, showed dose-related plasma concentrations, a mean half-life of about 12 h and relatively low intersubject variation. The incidence of side-effects was slightly greater for patients in the doxazosin group. Drug-related side-effects were mostly mild to moderate in severity with no serious drug-related occurrences in either treatment group. No serious drug-related abnormalities in laboratory biochemistry and haematology tests were observed in either treatment group.

Adult↗
PubMed1985

Active specific immunotherapy with supportive measures in the treatment of palliatively nephrectomized, renal adenocarcinoma patients. A thirteen-year follow-up study.

The results of a 13-year (1971-1984) follow-up of specific active immunotherapy using polymerized autologous tumor tissue with adjuvants and supportive measures, following palliative nephrectomy in 71 patients suffering from advanced renal adenocarcinoma, are presented. The control patient group comprised 56 patients who received the best possible conservative treatment available. The statistically calculated life expectancy in the immunotherapy group is 44.5 months (SE 5.7) and in the control group 19.0 months (SE 3.3). The difference is statistically highly significant (generalized Wilcoxon [Breslow], t = 14.9, p less than 0.0001). There were no serious side effects from the immunization. The supportive measures entailing the administration of factors involved in cell regulatory functions mediated by the central nervous system, amino acids, trace elements, hormones and vitamins has still to be optimized.

Adjuvants, Immunologic↗
PubMed1982

A new form of metaphyseal chondrodysplasia in two sibs: surgical treatment of tracheobronchial malacia and scoliosis.

We describe a 19-year-old male with a previously unrecognized form of disproportionate short stature, tracheobronchial malacia, and progressive scoliosis and his 28-year-old sister with the same but milder condition. The clinical characteristics were short limbs and digits and thoracolumbar scoliosis. Bone films showed progression from marked metaphyseal dysplasia of tubular bones in childhood to short and broad bones with mild dysplasia of the joints in adulthood. The vertebrae and the intervertebral plates were only mildly affected in spite of marked scoliosis. Trachea and bronchi were reinforced with surrounding acrylate mesh before surgical treatment of the scoliosis. Affected sibs of both sexes and healthy parents suggest an autosomal recessive mode of inheritance.

Abnormalities, Multiple↗
PubMed1982

Chronic unilateral hyperlucent lung. A consecutive series of 40 patients.

A clinical series of 40 consecutive patients with chronic unilateral hyperlucent lung was analysed. Swyer-James (MacLeod) syndrome turned out to be the most common diagnosis (18 patients, 45%). Other causes were localized emphysema (8 patients, 20%), congenital hypoplastic pulmonary artery (4 patients, 10%), previous massive pulmonary embolism (4 patients, 10%), bronchial carcinoma (3 patients, 7.5%), sequelae of radiation therapy (2 patients, 5%) and benign intrabronchial neoplasm (1 patient, 2.5%). The reduction of pulmonary vasculature was scored (0-9). The most extensive reduction was found in patients with Swyer-James syndrome (mean 5.8), whereas patients with bronchial cancer had the smallest changes (mean 3.0).

Adenoma↗
PubMed1982

Occlusion of the right pulmonary artery: a rare, late complication of radiation therapy.

Two cases of total occlusion of the right pulmonary artery 22 and 28 years after mediastinal irradiation are presented. The first patient is alive 29 years after the radiation therapy, and the second patient died of heart failure 31 years after the therapy. This very rare complication is one cause of radiological unilateral hyperlucent lung syndrome. The diagnosis can be confirmed by clinical history, clinical examination, chest roentgenogram, lung scan and pulmonary angiography.

Adult↗
PubMed1982

Surgical support of collapsing intrathoracic tracheomalacia after thyroidectomy.

Invalidating tracheal collapse occurred in a 55-year-old male farmer after extirpation of an intrathoracic goitre. The collapse was successfully treated by a new modification of supportive surgery developed by us, viz. circumferential application of heavy Marles mesh (Davol Inc., Box 8500, Cranston, R. I. 02920, USA) around the trachea.

Goiter, Substernal↗
PubMed1981

New surgical correction of central airway collapse in an asthmatic patient.

Circumferential support of the trachea and main bronchi is a new surgical method of preventing the collapse of the major airways. Heavy Marlex mesh is applied around the trachea and main bronchi and fixed with a Histoacryl adhesive. A severely asthmatic woman with total tracheal collapse during coughing underwent such a surgical application treatment successfully.

Adhesives↗
PubMed1979

Labetalol and pindolol in the treatment of hypertension: a comparative study.

Labetalol, a new hypotensive drug with both alpha- and beta-adrenoceptor antagonist properties, was compared with pindolol in a double blind cross-over study lasting 15 weeks. Both drugs caused a significant drop on blood pressure in both the standing and the supine position. The effect was seen after only two weeks treatment. The effect on the pulse rate was moderate. Three patients on pindolol (but none on labetalol) had to withdraw from the trial for medical reasons. In general the side effects recorded for labetalol and pindolol were mild. No postural hypotension was noticed with the moderate doses used in the study. Labetalol seems to be at least as effective as pindolol in mild to moderate hypertension.

Adult↗
PubMed1976

Solitary renal cyst, hypertension and renin.

Solitary renal cysts may cause renin hypersecretion with associated hypertension by compressing surrounding tissue and by distortion of renal vessels. Selective measurements of plasma renin activity in the renal veins can predict the antihypertensive effect of decompression. An illustrative case is presented and its significance is discussed.

Adult↗