Evaluation of cerebrovascular events via retinal angiography during transcatheter aortic valve implantation.

Objectives: Patients receiving transcatheter aortic valve implantation (TAVI) are elderly with multiple comorbidities and at increased risk of perioperative cerebrovascular events. Retinal vasculature represents a surrogate of central nervous system circulation and is noninvasively achievable by retinal imaging. The aim of this study was to evaluate the applicability of retinal angiography of microvascular complications and association to cerebral ischemic events during TAVI.

Surgical treatment of colorectal cancer in patients aged over 80 years.

Purpose: The aim of this study was to identify the clinical factors and tumour characteristics that predict the outcome in patients older than 80 years with colorectal cancer.

Patients And Methods: One hundred and four patients with colorectal cancer aged over 80 years were identified from a computer database, and their clinical variables were analysed by both univariate and multivariate analyses.

Results: All 104 patients underwent resective surgery, 87% radical and 13% palliative resection.

Clinicopathological features of colorectal cancer in patients over 70 years of age.

Objective: The aim was to identify the clinical factors and tumor characteristics that predict mortality and survival in patients older than 70 years with colorectal adenocarcinoma.

Material And Methods: One hundred and ninety-four patients with colorectal cancer aged over 70 years were identified from a computer database and their clinical variables were analyzed by both univariate and multivariate analyses.

Results: All patients underwent resective surgery, 79% radical and 21% palliative resection, and postoperative mortality was 6% being associated with the presence of postoperative complications, especially anastomotic leakage.

[Treatment of sigmoid diverticulitis].

Most patients, up to 75-80 percent, with anatomical diverticulosis will remain uncomplicated with a few symptoms. They might benefit of increasing their fruit and vegetable fibre intake and active movement. Advancing age of the Finnish population and decreasing daily consumption of dietary fibre led at the end of 1990' to increasing incidence of diverticle perforations.

Spectrum of disease and outcome among patients with acute diverticulitis.

Background: This study was designed to evaluate the natural history of patients admitted for acute diverticulitis.

Methods: Nine hundred and seventy-seven patients admitted to Oulu University Hospital for acute symptoms of diverticular disease during the 20-year period from 1986 to 2005 were identified using a database.

Results: Six hundred and ninety-five patients were admitted for uncomplicated diverticulitis and 282 for complicated diverticulitis.

[Prevention of complications of thyroid and parathyroid surgery].

The knowledge of parathyroid and thyroid anatomy helps a surgeon to localize important details and lessen complications, especially laryngeal palsy and hypoparathyroidism. The ligament of Berry and tuberculum Zuckerkandl cover the recurrent laryngeal nerve in the upper part of the thyroid lobes. The recurrent laryngeal nerve or its branches are exposed during the mobilization of these structures during total thyreoidectomy.

Clinicopathological features of colorectal cancer in patients under 40 years of age.

Objective: The aim was to identify the clinical factors and tumour characteristics that predict survival in patients younger than 40 years with colorectal adenocarcinoma.

Material And Methods: Fifty-nine patients with colorectal cancer aged under 40 years were identified from a computer database, and their clinical variables were analysed. The factors predicting long-term survival were compared by both univariate and multivariate analysis.

Acute sigmoid diverticulitis in young patients.

Background/aims: The natural history of young patients admitted for acute diverticulitis in terms of the virulence of the disease and the need for surgical treatment has remained controversial.

Methodology: One thousand eighty-one patients with acute diverticulitis admitted to our hospital from 1986 to 2006 were identified from a computer database and their clinical course was analysed Patients under or over 50 years of age were compared regarding uncomplicated and complicated diverticulitis, the number of admissions, operative procedures performed, morbidity, mortality and recurrence of diverticulitis.

Results: Eighty-one percent of the patients aged under 50 years were admitted for uncomplicated diverticulitis, whereas 36 % of the patients aged over 50 years were admitted for complicated diverticulitis (p = 0.

Elective surgery for recurrent diverticulitis.

Background/aims: After two documented episodes of uncomplicated diverticulitis, elective colon resection is recommended to prevent complications of the disease but the nature of symptoms in non-operated patients requires specification.

Methodology: A detailed questionnaire concerning clinical variables was mailed to two hundred and sixty patients admitted into our hospital for symptoms of acute sigmoid diverticulitis between 1981 and 2002. One hundred and seventy-one patients (70 percent) answered the questions adequately.

Computed tomography severity index and C-reactive protein values predicting mortality in emergency and intensive care units for patients with severe acute pancreatitis.

Background: Severe acute pancreatitis is a multisystem disease in which various local and systemic complications lead to high mortality. We retrospectively examined the clinical and biochemical factors that may influence the risk of mortality on admission to emergency and intensive care units (ICUs).

Methods: Sixty-eight patients were admitted into our hospital for acute pancreatitis and treated in our ICU for computed tomography-proven severe acute pancreatitis during the years 1997 to 2004.

Early cytokine responses after percutaneous magnetic resonance imaging guided laser thermoablation of malignant liver tumors.

An early systemic response induced by magnetic resonance imaging (MRI)-guided interstitial percutaneous laser thermoablation was analyzed in 13 consecutive patients with malignant liver tumors by serum interleukin (IL)-1beta, IL-6, IL-10, tumor necrosis factor (TNF)-alpha, its receptor TNFRI, and C-reactive protein (CRP) levels up to 72h after the procedures. Only IL-6 (p=0.033) and TNFRI (p<0.

Acute cholecystitis in the elderly.

Background/aims: The population of Finland is ageing fast, and acute cholecystitis is common among elderly people. Because the treatment options have changed greatly since the late 1980's, we wanted to find out whether the active treatment policy nowadays used in our hospital has some effects on operability, morbidity, mortality and the duration of the in-patient period. The numerous serious illnesses of elderly people that cause considerable morbidity and mortality underlines the importance of risk stratification, and clinical variables were therefore also tested for their ability to predict the probability of morbidity and mortality.

Prognostic factors of perforated sigmoid diverticulitis in the elderly.

Background: The Finnish population is aging fast and the prevalence of perforated sigmoid diverticulitis is simultaneously increasing in northern Finland. The fact that an increasing number of elderly patients, with their age-specific problems, are subjected to emergency surgery for acute diverticulitis underlines the importance of risk stratification.

Methods: One hundred and seventy-two patients admitted to Oulu University Hospital because of diverticular perforation from 1983 to 2002 were identified from the computer database.

Wire-guided excision of non-palpable breast cancer: determinants and correlations between radiologic and histologic margins and residual disease in re-excisions.

In cases of wire-guided excision of non-palpable breast cancer (WGE), data concerning the determinants and correlations between radiologic and histologic margins and residual cancer in re-excisions are sparse. A total of 21 variables in 66 WGE followed by 49 re-excisions were prospectively analyzed. In multivariate analysis, only large mammographic lesions were clearly related to positive margins in specimen radiography (P<0.

Risk factors for anastomotic leakage after left-sided colorectal resection with rectal anastomosis.

Purpose: To identify the risk factors for anastomotic leakage after left-sided colorectal resections with rectal anastomosis.

Methods: Forty-four patients with anastomotic leakage identified from a computer-generated database were compared with 44 control patients standardized for gender, age, and operative indication.

Results: The mean hospital stay was significantly prolonged in the leakage group, which resulted in a higher total cost of hospital treatment.

Factors that predict morbidity and mortality in patients with perforated peptic ulcers.

Background: The demographic changes of perforated peptic ulcer disease were assessed in a well-defined population in northern Finland. The high mortality from perforated peptic ulcer underlines the importance of risk stratification, and clinical variables and three scoring systems were therefore tested for their ability to predict the probability of morbidity and mortality.

Methods: Two hundred and eighty patients admitted to a university hospital with peptic ulcer perforation during the 22-year period 1979-2000 were identified using a computer database, and their clinical data were reviewed from the database and patient records.

Prognostic factors after surgery in patients younger than 50 years old with colorectal adenocarcinoma.

Background/aims: The factors predicting recurrence and survival were evaluated using a computer-generated database to identify the independent predictors of survival of colorectal cancer in patients under 50 years of age.

Methodology: One hundred and two patients under the age of 50 years with colorectal cancer who had been admitted into our hospital during the 20-year period of 1980-1999 were identified from a computer database. The factors possibly predicting recurrence were compared by bivariate analysis and the predictors of long-term survival by both univariate and multivariate analysis.

Prevalence of perforated sigmoid diverticulitis is increasing.

Introduction: The population of Finland is aging fast, and dietary fiber consumption has decreased during the past few decades; the prevalence of sigmoid diverticular perforation can therefore be anticipated to increase. This study presents our experience concerning the outcome of 133 patients admitted to a university hospital for diverticular perforation during a 15-year period.

Methods: One hundred thirty-three patients admitted into our hospital for sigmoid diverticular perforation during the 15-year period from 1986 to 2000 were identified using a computer database.

Survival after surgery for gastric cancer in patients over 70 years of age.

Background And Aims: The increase of the elderly population in western societies will result in a considerable increase of gastric cancer patients older than 70 years requiring surgery. However, higher postoperative morbidity and mortality rates after major surgery in the elderly are well recognized. The aim of this study was to evaluate the risk factors of mortality and predictors of survival in elderly patients with gastric cancer.

Prognostic factors predicting survival in the treatment of retroperitoneal sarcoma.

Methods: Retroperitoneal soft tissue sarcomas are rare tumours. The management of these tumours has been difficult because of low resectability and a high recurrence rate. A retrospective review of a prospectively compiled database of 32 consecutive patients with retroperitoneal sarcomas treated at Oulu University Hospital between 1977 and 1996 was performed.

Survival after operations for colorectal cancer in patients aged 75 years or over.

Objective: To define factors that predict mortality and survival in patients with colorectal cancer who are aged 75 or over.

Design: Retrospective study.

Setting: University hospital, Finland.

Adenoma of the papillae of Vater. Report of eleven cases.

Eleven patients with a preoperative diagnosis of adenoma of the papillae of Vater were followed up during the fifteen-year period from 1984 till 1998 in the Oulu University Hospital. Seven patients were treated primarily by transduodenal excision without any recurrences so far. One of these seven patients was found to have adenocarcinoma in a histological examination.

Percutaneous cholecystostomy in acute cholecystitis in high-risk patients: an analysis of 69 patients.

Background: Optimal treatment of acute cholecystitis in high-risk patients with acute cholecystitis continues to be a difficult therapeutic problem. With the development of more advanced radiological imaging techniques, percutaneous cholecystostomy (PCS) has been presented as an effective treatment alternative in critically ill patients. This paper reports our experiences of percutaneous cholecystostomy in the treatment of acute cholecystitis in a well defined high-risk patient group.