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Biomedical subjects

S Valtonen

Publications and source records attributed to S Valtonen.

At least 37 records · Page 2Linked to original sources
PubMed1986

Outcome of patients after transcranial operation for pituitary adenoma.

A retrospective study of 111 craniotomies for pituitary adenomas was analyzed. The follow-up time was 14-33 years. Thirteen patients died from complications of primary or secondary operations, 23 of causes otherwise related to the tumor and 20 of unrelated causes. 40% of patients surviving the primary operation had recurrence of their tumor. Radiotherapy did not prevent recurrences, but postponed their occurrence. Some tumors appeared very late, the last one 18 years after operation. 70% of the surviving patients need hormone substitution, but only 8 patients have severe impairment of vision.

Adenoma↗
PubMed1985

Intracranial hemangiopericytoma: radiology, surgery, radiotherapy, and outcome in 21 patients.

At operation, 21 meningeal intracranial hemangiopericytomas resembled meningiomas, but differed histologically. They were frequently attached to sinuses, occipitally located, bled profusely at operation, and had a higher risk of recurrence and metastasis. Specific preoperative diagnosis is possible: computed tomography scan showed a meningiomalike tumor, which on the angiogram looked malignant and highly vascular. Two tumors showed a malignant growth pattern on computed tomography scan, "mushrooming." After a radical removal, three patients have lived for more than 10 years without recurrence; two of them were irradiated postoperatively. Three recurrent tumors were treated with radiotherapy only; one responded favorably.

Adolescent↗
PubMed1985

The growth rate of intracranial meningiomas and its relation to histology. An analysis of 43 patients.

The growth rate of intracranial meningiomas was studied in 43 patients against a histologic grading based on the degree of anaplasia. The mean time for doubling of the tumor volume was 415 days (138-1045) in grade I (benign), 178 days (34-551) in grade II (atypical), and 205 days (30-472) in grade III (anaplastic). The difference between grade I and the combined grades II-III was highly significant. Both the mitotic index and the absence of calcification on the computed tomography scan correlated strongly with the doubling time. The growth rate should be carefully considered in planning therapy and timing computed tomography studies for patients with meningioma.

Adolescent↗
PubMed1985

Prolactinoma of the pituitary containing amyloid.

A transsphenoidal operation was performed in a 27 year old man because of a large intrasellar expansion and marked hyperprolactinaemia (33 000 mU/l). The tumour found in the operation bulged into the sphenoidal sinus and was extirpated. On histopathological examination the tumour consisted mainly of congophilic amyloid spherules with intermingled sparse adenoma cells. The adenoma cells were strongly positive for prolactin in immunoperoxidase staining, and in electron microscopy they contained secretory granules. Ultrastructurally the amyloid spherules consisted of masses of concentrical extracellular amyloid filament bundles.

Adenoma↗
PubMed1982

Operative management of chromophobe pituitary tumour recurrences.

Twenty-three operations were performed for recurrences of previously treated chromophobe pituitary adenomas. Eleven operations were transcranial, and 12 were transsphenoidal. Twenty-two patients were operated on because of deteriorating eyesight; this improved in ten patients, deteriorated further in three, and did not significantly change in the remaining nine patients. There was one postoperative death. The patients generally had hypopituitarism already at the time of diagnosis, and it tended to increase during treatment. The results are certainly worse than after primary operations, but there is no alternative for handling a sizeable recurrence that has already affected the optic pathways.

Adenoma, Chromophobe↗
PubMed1982

Trial with human leucocyte interferon and vidarabine in herpes simplex virus encephalitis: diagnostic and therapeutic problems.

A combination therapy of human interferon, vidarabine, and dexamethasone was administered to six patients with proven (Patients I-III) or presumed (Patients IV-VI) herpes simplex virus encephalitis (HSVE). Interferon combined with dexamethasone was given to one patient with presumed HSVE (Patient VII). Leucopenia and elevated serum transaminase levels appeared in all patients and a diffuse bleeding in one of them. Patients II, III and IV died, 26, 43, and 209 days after the onset of encephalitis, respectively. Patients I, V, VI, and VII were left with moderate brain damage although their physical condition was good. HSV encephalitis presents diagnostic difficulties, complementary diagnostic methods are needed, and current therapeutic trials must be considered as preliminary.

Adult↗
PubMed1982

Recurrence of chromophobe pituitary adenomas after operation and postoperative radiotherapy.

The rate of recurrence is reported in a prospective study of 56 patients (28 men, 28 women) with large chromophobe pituitary adenoma (with or without hyperprolactinemia). The surgical approach was transfrontal in 44 and transseptosphenoidal in 12 patients. Cryoapplication was combined with the transsphenoidal operation. All but one patient received postoperative pituitary irradiation. Altogether, 11 (20%) clinical relapses (10 men) occurred between 0.5 and 6 years after the transfrontal operation. Patients that relapsed had had larger tumors than those remaining in remission. Occurrence of the tumors appeared with a deterioration of the visual field defect in 9 patients. There were no differences in the degrees of hypopituitarism in patients who relapsed as compared to patients remaining in remission.

Adenoma, Chromophobe↗
PubMed1981

Pituitary function in prolactinoma. Effect of surgery and postoperative bromocriptine therapy.

Forty-five women and fifteen men with prolactinomas have been treated surgically. Patients with large tumours received pituitary irradiation and postoperative hyperprolactinaemia was treated with bromocriptine. The patients have been followed-up for 6-36 months following the operation. The tumours were larger and the levels of production higher in men as compared with women. All women had amenorrhoea. Galactorrhoea was present in forty-three women but not in the men. After surgery serum prolactin levels fell significantly in all women but remained above normal in thirty-six; prolactin remained high in twelve men. Bromocriptine effectively decreased the postoperative hyperprolactinaemia. The surgical complications were oculomotor nerve paresis in one woman and one man. After surgery six (23%) women developed impaired GH secretion, six (15%) impaired thyroid function, eight (18%) impaired cortisol secretion and five (17%) impaired LH secretion in isolation or combination which had not been present preoperatively. Three patients relapsed. Fifteen women menstruated after surgery and ten began to do so during the subsequent bromocriptine treatment. Thus, menstruation was restored in all six women with microadenomas in sixteen of twenty patients with intrasellar macroadenomas and three of nineteen patients with suprasellar adenomas. The preoperative LH-reserve proved to be an important prognostic indicator. Nine patients, i.e. 50% of patients desiring fertility became pregnant. In the men gonadal function deteriorated in four patients and did not improve in any without testosterone treatment.

Adenoma↗
PubMed1980

Herpes simplex virus encephalitis: new diagnostic and clinical features and results of therapy.

Six patients with herpes simplex virus (HSV) encephalitis underwent diagnostic and clinical evaluation. The HSV or its antigenic material was found in three brain biopsy specimens. In the remaining three cases, the diagnosis was supported by detection of HSV antibodies in the CSF. Cell count and total protein concentration in the CSF reached a maximum level at three weeks and two months, respectively. The IgG index and HSV antibody level in the CSF often remained constant after reaching maximal values. In three patients, a transient low serum sodium level was observed. Characteristic EEG changes were present five to 11 days after the onset of symptoms. Computerized tomographic scanning revealed a temporal low-density lesion. Three patients became deeply comatose and had respiratory failure. The patient without vidarabine therapy and one of the five patients treated with vidarabine died.

Antibodies, Viral↗
PubMed1977

Avoidable factors contributing to death after head injury.

We reviewed 116 patients, known to have talked before dying after head injury, to discover factors which had contributed to death but which might have been avoided. All the patients were admitted to a neurosurgical unit and had a neuropathological post-mortem examination. One or more avoidable factors were identified in 86 patients (74%); an avoidable factor was judged certainly to have contributed to death in 63 patients (54%). The most common avoidable factor was delay in the treatment of an intracranial haematoma; others included poorly controlled epilepsy, meningitis, hypoxia, and hypotension. Changes in the management of patients with head injuries which reduce the incidence of avoidable factors should decrease mortality from this condition.

Airway Obstruction↗
PubMed1977

Subdural effusion: results after treatment with subdural-pleural shunts.

In an unselected material of 22 consecutive patients subdural effusion, which did not respond to repeated taps, was treated with subdural-pleural shunt operation using nonvalve silicone catheters. After a mean follow-up time of 3 years 4 months, 17 patients (77%) were mentally and 15 patients (69%) neurologically normal. The results are certainly not worse than results achieved with craniotomies and membranectomies. A shunt operation is more simple and less hazardous than membranectomy and we agree with the opinion that the latter is an obsolete procedure in the treatment of persistent subdural effusions.

Cerebrospinal Fluid Shunts↗
PubMed1975

Respiration and acid-base balance of blood after diffuse experimental brain injury.

Diffuse brain injury in rabbits was caused by injecting olive oil and saline into one internal carotid artery. In this report, the fourth of a series, the effects of this experimental brain injury on respiration and acid-base balance of blood are analyzed. The animals that withstood the injury best were those that had a lower pre-traumatic pCO2; the animals that suffered a rise in intracranial pressure and succumbed to the injury quickly did so in spite of pronounced hyperventilation after the injury. Arterial pCO2 immediately before the injury was the only significant prognostic factor in this analysis. Respiratory rate only dropped immediately before respiratory arrest and death. The findings concerning pCO2 tally with results after experimental ligation of a cerebral artery, but less so with results after other types of experimental brain injury. This emphasizes again that conclusions drawn from one type of brain injury must not be extrapolated to other types.

Acid-Base Equilibrium↗
PubMed1975

Arterial oxygen tension and high intracranial pressure.

Arterial oxygen and carbon dioxide tension was measured in spontaneously breathing rabbits whose intracranial pressure was raised by a freeze lesion, oil embolism, or hydrostatic pressure. Reports elsewhere had stated that high intracranial pressure led to hypoxaemia. In this series of experiments, arterial oxygen tension appeared to rise and carbon dioxide tension appeared to drop. Both changes were slight and not significant statistically. There was no evidence to suggest that arterial hypoxaemia is caused by high intracranial pressure.

Animals↗