Annales chirurgiae et gynaecologiae. Supplementum最新文献

{"title":"Microinvasive lumbar disc surgery. A study on patients treated with microdiscectomy or percutaneous nucleotomy for disc herniation.","authors":"E Kotilainen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>During the last two decades, new microinvasive techniques have been introduced into the treatment of lumbar disc herniation. The potential benefits of microinvasive disc surgery are the reduced surgical trauma to the tissue, increased safety due to good visualization of the operation field under the microscope and, consequently, reduced postoperative morbidity and shorter hospitalization in comparison to conventional surgery. In this study, we evaluated the use of microdiscectomy and percutaneous nucleotomy in the treatment of patients with lumbar disc herniation. Of the 237 patients who underwent microdiscectomy for virgin single-level lumbar disc herniation, 92% informed that their sciatic pain had completely recovered or markedly diminished during a median postoperative follow-up of 2 years and 79% of these patients had returned to work. The outcome of the patients operated on for a disc protrusion was to some extent less satisfactory than the outcome of the patients operated on for a prolapse or a sequestrum. Further, of the 45 patients who underwent percutaneous nucleotomy, the sciatic pain had completely recovered or markedly diminished in 38 (84%) patients during a mean postoperative follow-up of 2 years and 78% of them had returned to work. Also in these patients, a protrusion-type of disc herniation was associated with an inferior outcome. After a mean postoperative follow-up of 3 years, the patients treated with microdiscectomy underwent repeated clinical examination. Segmental instability of the lumbar spine was observed in 22% of 190 patients studied. Lumbar instability correlated significantly (P < 0.0001) with an unsatisfactory long-term outcome in these patients. Clinical instability was preoperatively detected in 24% of the 45 patients treated with percutaneous nucleotomy. Also in these patients, instability predicted significantly (P < 0.05) an inferior outcome. On the first postoperative day, there was an extradural hematoma in 86% of the 44 patients studied with MRI. The incidence of hematomas was associated with the surgical method used: all 28 patients treated with microdiscectomy but only 10 (63%) of the 16 patients treated with percutaneous nucleotomy had a hematoma (P = 0.001). In addition, 25 (61%) of the 41 patients studied had an edematous epidural mass effect mimicking preoperative disc herniation. During follow-up for 6 months, the mass effect resolved completely in 10 of these patients but in 15 patients, MRI subsequently revealed either a disc prolapse or a protrusion. In addition, a protrusion was detected in 7 patients with no postoperative mass effect. There was, however, no association between these MRI findings and the clinical outcome of the patients.(ABSTRACT TRUNCATED AT 400 WORDS)</p>","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"209 ","pages":"1-50"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19067481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of bronchopulmonary dysplasia during an 11-year period in infants weighing less than 1500 g at birth.","authors":"A M Vanhatalo,&nbsp;H Ekblad,&nbsp;P Kero,&nbsp;R Erkkola","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We studied the occurrence of bronchopulmonary dysplasia (BPD) during an 11-year period in infants weighing less than 1500 g at birth and looked for differences between the periods 1980-1985 (216 infants) and 1986-1990 (217 infants). During the neonatal period, 91 infants died, which gives a neonatal survival rate of 79%. Forty-nine infants developed BPD, which is 11% of all infants and 14% of the infants surviving the neonatal period. The incidence of BPD did not change during the two study periods (11.6% and 11.1%). On the other hand, the study populations changed in many respects. The number of infants with a birth weight of less than 1000 g increased, the incidence of severe RDS increased, and infant mortality decreased. Hence, there was a small decrease in the incidence of BPD in infants surviving the neonatal period from 14.9% to 13.8%. Severe RDS and a birth weight of less than 1000 g were clearly related to the development of BPD. In these two risk-groups the decrease in the incidence of BPD in neonatal survivors was pronounced.</p>","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"208 ","pages":"113-6"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19085428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special issue in honour of Professor Matti Grönroos in recognition of his professorship in obstetrics and gynaecology at the University of Turku 1986-1992.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"208 ","pages":"3-116"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19085986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of steroid hormone receptor content and flow cytometric DNA ploidy in endometrial carcinoma.","authors":"S E Grénman,&nbsp;P Klemi,&nbsp;S Toikkanen,&nbsp;K Irjala,&nbsp;P Laippala,&nbsp;K Vähä-Eskeli,&nbsp;J Mäenpää,&nbsp;T Salmi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Flow cytometric DNA ploidy and sex steroid hormone receptor activity was measured in 55 endometrial carcinomas. DNA ploidy was measured on paraffin-embedded specimens and ER and PR activity was measured using both biochemical and immunohistochemical assay. Association of these parameters was tested using logistic regression model. Diploid or near diploid DNA histogram was seen in 40 cases (72.7%). All Grade 1 tumours (n = 15) were diploid whereas 38.5% of Grade 2 (n = 27) and Grade 3 (n = 13) tumours were aneuploid (grade 1 vs Grade 2 and 3, P = 0.0031). The mean value of ER was 109 +/- 120 (SD) fmol/mg protein for diploid tumours and 48 +/- 50 fmol/mg protein for aneuploid tumours (P = 0.0093). The corresponding values for PR were 226 +/- 262 fmol/mg protein and 75 +/- 102 fmol/mg protein (P = 0.0073), respectively. In immunohistochemical assay the mean HSCORE of ER was 45 +/- 77 for diploid tumours and 27 +/- 48 for aneuploid tumours (P = 0.43). The corresponding values for PR were 32 +/- 55 and 22 +/- 56, respectively (P = 0.58). In logistic regression analysis cytosolic PR content was associated with DNA ploidy.</p>","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"208 ","pages":"10-4"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19085423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meconium aspiration syndrome.","authors":"R Erkkola,&nbsp;P Kero,&nbsp;H Suhonen-Polvi,&nbsp;H Korvenranta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the years 1977-82, 43 infants with the meconium aspiration syndrome (MAS) were managed at the Department of Paediatrics of Turku University Central Hospital (TUCH), Finland. Among 5,353 deliveries in one year the incidence of meconium staining was 8.7%. By extrapolation, the incidence of meconium aspiration in all newborns is approximately 0.13%. The mean duration of the pregnancies was 39.2 +/- 2.6 (SD) weeks and the weight of newborns was 3570 +/- 692 g which were similar to those of the reference group. The rate of Cesarean sections in the group with MAS was significantly higher than in the reference group (40% and 11.6%, respectively). Sixty-nine per cent of the newborns with MAS showed signs of depression during or after labour, while the incidence of same symptoms in the reference group was only 2.7% (P < 0.001). None of the infants with MAS died. Late sequelae were encountered in three babies in 1 to 6 years of follow-up.</p>","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"208 ","pages":"106-9"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19085426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow velocity waveforms in the uterine artery in high risk pregnancies.","authors":"J Pirhonen,&nbsp;R Erkkola","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Blood flow velocity investigations by applying Doppler method have emerged as a useful tool in obstetrics and gynaecology. The final role of the method is still to be established. Thus far, the umbilical artery Doppler indices have been preferred to the utero-placental indices. We have analysed the Doppler indices from the main branch of uterine artery in 280 women with singleton pregnancy in the third trimester. While fetal blood flow velocities in the cerebral arteries or in the umbilical artery are still unchanged, the increase in the uterine artery resistance may serve as an early indicator of the increased risk to the fetus.</p>","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"208 ","pages":"98-9"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19085807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First experiences from laparoscopically assisted hysterectomy in Finland in 1992.","authors":"J Mäkinen,&nbsp;J Sjöberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The first laparoscopic hysterectomy in Finland was performed in September 1992. We report the experiences of the first eleven patients operated in the Turku and Helsinki University Central Hospitals in 1992. The hospital stay (mean 2.6 days) and the sick leave (mean 2 weeks) were markedly shorter than those of conventional open surgery for uterine removal but the operation time was longer (mean 3.4 hours). One patient needed postoperative blood transfusion due to hemorrhage and one needed secondary surgical intervention due to bladder perforation unresponsive to conservative treatment. We look forward to more extensive use of this new technic as a competitive alternative to simple hysterectomy.</p>","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"208 ","pages":"59-61"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19085919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal mortality in Finland 1970-89.","authors":"R Erkkola","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>All cases of maternal death in the years 1970-89 in Finland were reviewed, and the clinical background was analyzed. There was a 47% decrease in the mortality when the two decades were compared. In the 1980's the maternal mortality was 4.74 per 100,000 births, which is comparable to figures from the other Nordic countries.</p>","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"208 ","pages":"72-5"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19085923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perineal ultrasound: an alternative for radiography for evaluating stress urinary incontinence in females.","authors":"P J Kiilholma,&nbsp;J I Mäkinen,&nbsp;Y A Pitkänen,&nbsp;M J Varpula","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Perineal sonography was used to assess the position and descent of the bladder neck at rest and during straining in 38 female patients with stress urinary incontinence. Twenty nine patients had primary and nine patients recurrent stress incontinence. There was a statistically significant positive correlation between the degree of sonographically determined bladder neck descent and the severity of stress incontinence by urodynamic criteria among the patients with primary but not with recurrent stress incontinence.</p>","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"208 ","pages":"43-5"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19085989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital stay due to various hysterectomies, caesarean section and normal delivery in Turku University Central Hospital area from 1983 to 1992.","authors":"J I Mäkinen,&nbsp;S S Meltomaa,&nbsp;U U Ekblad","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The optimal length of hospital stay in obstetrics and gynaecology has recently been much debated, as short hospitalisation times being commonly introduced as alternatives to conventional hospitalisations. The hospital stay for major gynaecological and obstetric surgery as well as normal delivery was studied in the hospitals working in area of the Turku University Central Hospital (population approximately 750,000). In the six studied hospitals the mean hospital stay for abdominal and vaginal hysterectomy decreased during the 1980s by one fifth. In 1992, the mean hospitalisation for hysterectomy varied from 7.4 to 8.3 and from 9.0 to 9.1 days, for abdominal and vaginal hysterectomy, respectively, and that of caesarean section from 8.1 to 8.6 days. The number of days in hospital required for normal delivery was 4.4-6.2 days. These figures are similar to the corresponding national average in Finland, but they also show that the discharge in our country occurs some 2 to 3 times later than what has recently been reported, e.g. from the U.S.A. Consequently, we find that there is a need for a prospective trial to find out how rational short hospitalisation is in the field of obstetrics and gynaecology in Finland.</p>","PeriodicalId":75497,"journal":{"name":"Annales chirurgiae et gynaecologiae. Supplementum","volume":"208 ","pages":"54-7"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19085993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}