Biomedical subjects

R K Haapiainen

Publications and source records attributed to R K Haapiainen.

27 records · Page 2Linked to original sources

PubMed1990

Pyelo-intestino-cutaneous conduit in the treatment of renal carcinoma of solitary kidneys.

A pyelo-intestino-cutaneous conduit, either by colonic or ileal segment, was used successfully in 4 patients with urothelial carcinoma affecting a solitary kidney. Primary healing was good but involved the risk of stricture formation. During the follow-up period (10-48 months), repeated endoscopic check-ups were easily performed through the conduit, enabling coagulation of recurrent tumour growth. Two patients are still alive and well; 2 are dead.

Aged↗

PubMed1990

Prostate tumour markers as an aid in the staging of prostatic cancer.

Serum acid phosphatase activity (ACP), prostate specific phosphatase (PAP) and prostate specific antigen (PSA) were measured in 100 patients with prostatic cancer. The patients were divided into 4 groups: T1-2 MO, T3-4 MO and M1 patients with less than or equal to 10 or greater than 10 metastatic foci in bone scintigraphy. The mean serum ACP levels were almost identical in the T1-2 MO and T3-4 MO groups and there was no significant difference between the mean PAP values. Significantly higher PSA levels were observed in the MO patients in the extracapsular category compared with those in the intracapsular category. The mean serum levels of all 3 tumour markers were significantly higher in the M1 than in the MO category. PSA seems to be the marker of choice as a diagnostic aid for differentiating between patients with intracapsular and those with extracapsular tumour growth. In prostatic cancer patients with bone metastases these markers were of similar value for staging the disease.

Acid Phosphatase↗

PubMed1990

Intraoperative removal of pancreatic duct calculus with a rigid ureterorenoscope and ultrasonic lithotripsy.

A 51-year-old man with chronic relapsing pancreatitis and recurrent episodes of acute attacks had an impacted ductal stone deep in the head of the pancreas. A staghorn calculus, 1 cm in diameter, was successfully disintegrated and removed intraoperatively with use of a visual endourologic technique and ultrasonic lithotripsy. Because of a dilated pancreatic duct and pseudocyst formation near the tail of the pancreas, distal pancreatic resection and longitudinal pancreaticojejunostomy were performed. Postoperatively, no pancreas irritation has been verified, and the patient has remained without symptoms.

Calculi↗

PubMed1989

Diagnosis and treatment of patients with renal trauma.

In this selective study, 59% of the patients had a renal injury (laceration, rupture or pedicle injury). A normal IVU excluded significant renal injury after blunt trauma. Renal angiography was more accurate than ultrasonography or computed tomography in determining the extent of the injury. A retroperitoneal haematoma found during laparotomy should be explored if significant renal trauma cannot be excluded. Renal salvage after rupture or pedicle injury should be attempted in stable patients.

Adolescent↗

PubMed1989

High dose polyoestradiol phosphate with and without acetosalicylic acid versus orchiectomy in the treatment of prostatic cancer. Finnprostate Group.

The clinical efficacy of high dose (160 mg) polyoestradiol phosphate (PEP) was compared with that of orchiectomy in a prospective randomised multicentre study including 200 prostatic cancer patients. The effect of daily low dose (75 mg) acetosalicylic acid (ASA) on possible cardiovascular complications during the first 6 months of therapy was also evaluated. Oestrogen-treated patients had more progressions, but follow-up was too short to draw any definite conclusions on the efficacy of treatment. There was no cardiovascular mortality and there were no thromboembolic complications in any treatment group. It was concluded that parenteral high dose PEP is not associated with an increased risk of cardiovascular complications and there is no need for daily low dose ASA.

Aged↗

PubMed1988

Stab wounds of the liver. An evaluation of 131 consecutive cases.

The records of 131 consecutive patients treated for liver stab wounds during a 20-year period were reviewed. All were operated on. Bleeding from the liver injury ceased spontaneously before operation in 41% of the cases. The chest, stomach and extremities were the most common sites of associated injury. In 36% the liver was the only injured organ. The liver injury was managed with simple surgical techniques in all but three cases. The mortality rate was 4.6%, and only one of the six deaths was directly attributable to the liver injury. Complications, mostly involving the lungs and the wound, arose in 27% of the series. Stab wounds of the liver are relatively benign and the great majority can be satisfactorily treated with simple surgery. Excluding juxtahepatic venous injuries, the mortality and morbidity are due mainly to associated injuries.

Adolescent↗

PubMedDate not supplied

Incidentalomas of the adrenal gland: 36 operated patients and review of literature.

Incidental discovery of an adrenal mass during radiologic examinations is common. Several recommendations have been made for the management of so-called incidentalomas. It has become clear that not all incidentalomas should be operated, but the criteria for nonoperative treatment have been under continuous debate. In this study 36 operated incidentalomas are presented, and the indications for operative treatment are discussed with a review of the recent literature on the subject. Four pheochromocytomas and three hormonally active cortical adenomas, two producing cortisol and one androgens, were found. In this series there were no malignancies. The operation could have been avoided in most cases, and patients could have been followed up with repeated radiologic examinations. It is suggested that masses smaller than 6 cm in diameter be followed radiologically after 3, 9, and 18 months. Masses between 3 and 6 cm could be further examined using magnetic resonance imaging and fine needle aspiration and then operated if features suggestive of malignancy are found. Masses larger than 6 cm in diameter should be treated operatively.

Adrenal Gland Neoplasms↗

PubMedDate not supplied

Papillary thyroid carcinoma: the new, age-related TNM classification system in a retrospective analysis of 199 patients.

The new, age-related TNM classification system of papillary thyroid carcinoma was applied in a retrospective analysis of 199 patients operated on during the 24-year period from 1956 through 1979 at the Second Department of Surgery, Helsinki University Central Hospital. According to the new staging system, 103 patients (under 45 years of age) and 96 T1 patients (45 years of age and older) were categorized into stage I. The incidence of carcinoma-positive cervical lymph nodes was highest among patients under 30 years of age at primary surgery. During the follow-up period of 6-29 years, cervical lymph node involvement was verified at reoperation in 20 patients (10%). Distant metastases (bone or lung) developed in 11 patients (5.5%). Thirty-one patients (16%) died from carcinoma. The prognostic value of stage grouping, in terms of metastatic tendency and cancer mortality, was clearly demonstrated in the present material, suggesting the suitability of this simplified, new, age-related staging system in clinical practice.

Adolescent↗

PubMedDate not supplied

Accidental injuries of the hepatoduodenal ligament.

OBJECTIVE: To report our experience in the management of accidental injuries to the structures of the hepatoduodenal ligament. DESIGN: Retrospective study of medical records. SETTING: University department of surgery. SUBJECTS: 8 patients admitted after accidents (road traffic accidents, n = 4; falls, n = 2; and gunshot and stab wounds, n = 1 each) who were found at laparotomy to have injuries of the structures of the hepatoduodenal ligament. INTERVENTIONS: Laparotomy in all cases. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: One patient died (13%) of multiple organ failure after a gunshot wound of the portal vein, liver, inferior vena cava, right renal artery, and right kidney. All patients had associated injuries. There were 3 complete transsections of the common bile duct, two of which were treated by Roux-en-Y cholecystojejunostomy and one by choledochojejunostomy over a T tube. Two lacerations of the common hepatic duct were treated by T tube choledochostomy. All injuries to blood vessels were sutured. Only one patient survived without any complications, and two developed cholangitis after cholecystojejunostomy that required further operation 5 and 16 months after the initial operation. CONCLUSIONS: Blunt injuries to the hepatoduodenal ligament are easily overlooked, leading to delayed morbidity. Complete transsections of the bile duct are best managed by choledochojejunostomy with a Roux-en-Y loop; T tube choledochostomy is usually sufficient when treating small partial lesions of lobar bile ducts; and most non-circumferential vascular lesions are best treated by suture.

Accidents↗