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Biomedical subjects

A Hakkiluoto

Publications and source records attributed to A Hakkiluoto.

At least 19 recordsLinked to original sources
PubMed1995

Frequency of hereditary nonpolyposis colorectal cancer. A prospective multicenter study in Finland.

PURPOSE: Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal dominant cancer syndrome characterized by early onset of colorectal carcinomas (CRC). Recently, two HNPCC genes have been mapped and cloned, one in the short arm of chromosome 2 and another in the short arm of chromosome 3. There has been a major controversy about the frequency of HNPCC. The few estimates available have been based on series selected by age or series representing local area. The purpose of the present study was to design a nonselected, prospective, multicenter study, taking into account the family background and other risk factors of CRC. METHODS: The proportion of HNPCC of all (N = 406) CRC cases was evaluated in a prospective multicenter study. Family history and other risk factors were investigated over a 12-month period for all new CRC patients in ten hospitals. These cases constituted 23 percent of all CRCs diagnosed in Finland during the study period. RESULTS: Three (0.7 percent) cases of verified and seven (1.7 percent) cases of suspected HNPCC were identified, following the evaluation of all families with features indicative of susceptibility to cancer. The proportion of identifiable risk factors of CRC was 5.8-7.5 percent (HNPCC, 0.7-2.4 percent; previous CRC, 3.4 percent; ulcerative colitis, 1.0 percent; familial adenomatous polyposis coli, 0.7 percent). CONCLUSION. This prospective multicenter study revealed that the frequency of hereditary colorectal cancer is lower than in some previous studies, when diagnosis is based on extensive pedigree analysis. This result with recent findings of common ancestral founding mutation in Finnish HNPCC families indicates that there may be geographic differences in the occurrence of HNPCC. However, this does not change the fact that identification of HNPCC--perhaps one of the most common inherited diseases identified in humans--has become a question of vital importance now when diagnosis of the syndrome and large-scale screening of gene carriers using specific tests are on the horizon.

Adult↗
PubMed1992

Open management with mesh and zipper of patients with intra-abdominal abscesses or diffuse peritonitis.

OBJECTIVE: To evaluate the open management of intra-abdominal abscesses and persistent peritonitis by the "mesh and zipper" technique, and to assess the predictive value of the APACHE II score. DESIGN: Prospective open study. SUBJECTS: 21 consecutive patients with life-threatening peritonitis. INTERVENTIONS: Insertion of mesh and zipper and lavage once or twice daily with several litres of warmed saline. MAIN OUTCOME MEASURE: Mortality. RESULTS: Eleven of the 21 patients died (52%). The APACHE II score accurately predicted outcome, in that no patient who scored less than 20 points died, and no patient who scored more than 26 points lived. CONCLUSION: The mesh and zipper technique with daily intraperitoneal lavage is effective in the treatment of life-threatening peritonitis and the APACHE II score is an accurate predictor of survival.

Abscess↗
PubMed1984

Radiopertechnetate imaging of haemorrhagic Meckel's diverticulum.

Meckel's diverticulum is rarely seen on the standard small bowel follow-through and the diagnosis may be overlooked unless 99mTc -pertechnetate scanning or other complementary radiological examinations are performed. Three cases of bleeding Meckel's diverticulum with a negative barium sulphate meal examination and positive 99mTc -pertechnetate scanning are presented.

Adolescent↗
PubMed1982

Gastric polyps; their morphological and endoscopical characteristics and relation to gastric carcinoma.

In 13 200 consecutive gastroscopies polyp-like lesions were found in 454 patients and of these 425 were examined histologically. Tumours other than polyps were excluded and there remained 357 cases which were divided in four groups: adenoma (8%), hyperplastic polyp (34%), foveolar hyperplasia (21%) and inflammatory polyp (36%). Transitional forms between different groups were seen and sometimes characteristics of different polyptypes could be seen within one and same polyp. In addition, the mean age of the patients increased in order: inflammatory polyp, foveolar hyperplasia, hyperplastic polyp and adenoma, suggesting that the different groups are not separate entities but represent related stages in the morphogenesis of gastric polyps. 219 cases out of 357 patients were re-examined endoscopically on average 2.5 years after the first examination. This examination revealed new polyps in 26% of all cases and spontaneous disappearance of the polyps in 14% of cases suggesting that gastric polyps, particularly those of the hyperplastic and inflammatory type are in a dynamically labile state. Gastric carcinoma was found in 27 (8%) of patients with polyps. In 4 of these cases the carcinoma was found at the re-examination (which in 3 cases was performed within 0.5 and in 1 case within 1.5 year). In 14 cases carcinoma was found inside the polyps and in 6 of these carcinoma was "early" in its growth. In 13 cases carcinoma was found outside the polyps and in all of these carcinoma was "advanced". Carcinoma was found in 38% of adenoma cases and in 5% of cases with polyps other than adenomas.

Adenoma↗
PubMed1978

Ectopic liver.

Abnormally positioned liver tissue is rare but can occasionally cause clinical symptoms. The four main types are: 1. Accessory liver lobe that can reach a considerable size and is attached to the liver by a stalk. 2. Small accessory liver lobe which is attached to the liver but is usually small, about 10-30 g in weight. 3. Ectopic liver which is situated outside the liver without any connection with it. It is usually attached to the gallbladder or intra-abdominal ligaments. 4. Microscopic ectopic liver which is found occasionally in the wall of the gallbladder. The literature is reviewed and two cases of ectopic liver are described.

Adult↗
PubMed1977

Relative risk of stump cancer following partial gastrectomy.

The relative risk of stump cancer following partial gastrectomy for a benign gastroduodenal condition was estimated using an individually matched retrospective study design based on autopsy material. Data on all patients dying with gastric cancer and autopsied at the Central Laboratory of Pathology, University Central Hospital, Helsinki, during 1961-75 were collected. Matched pairs of the same sex and age were used as controls. Of the 464 patients dying with gastric cancer, 9 had undergone previous partial gastrectomy, while the respective number among the controls was 5. This result suggests that the risk of cancer in the gastric stump was not significantly increased as compared to the normal unoperated population.

Aged↗
PubMed1977

Gastric secretion and haematological findings in relation to mucosal atrophy after partial gastrectomy.

Twenty-one patients (4 females and 17 males) were re-examined 20 years after partial gastrectomy for benign peptic ulcer. Different stages of morphological change in the gastric stump mucosa were compared with haematological parameters as well as with gastric acid and IF secretions. Biopsy specimens were taken by the direct vision technique. Haematological values including also serum vitamin B12, folate and Schilling test were determined. Gastric acid and IF secretions were lower in all patients with "selective parietal cell atrophy" in the gastric mucosa compared with those of other patients. Serum B12 and Schilling test values showed the same tendency. The present study indicates that it is possible to determine the gastric function dependent on parietal cells according to morphological criteria.

Atrophy↗
PubMed1976

Selective loss of parietal cells in the gastric remnant following antral resection.

The mucosa of the gastric remnant of 41 subjects who had been operated upon 17-18 years earlier for peptic ulcer was studied histologically. The histological changes were classified as follows: 1) normal mucosa, 1; 2) simple gastritis, superficial or atrophic, 27; and 3) "selective loss of parietal cells", 13 subjects. The latter type was characterized by marked loss of parietal cells without corresponding loss of other epithelial elements and without an inflammatory reaction. These changes were thought to reflect a lack of a trophic action on parietal cells exerted by gastrointestinal hormones, as e.g. gastrins.

Aged↗
PubMed1976

Long-term follow-up study of patients operated on for benign peptic ulcer.

200 consecutive patients operated on for gastric (GU) or duodenal (DU) ulcer in 1956 to 1957 were followed up until 1974. 25 of them died within five years of primary operation and were excluded to eliminate the possibility of coexisting ulcer and malignancy at the time of operation. Four patients could not be traced and 65 died within the follow-up period, but none of them of gastric carcinoma. 46 out of 106 living patients came for re-examination and gastroscopy was performed in 42 of them. The remaining 60 patients were examined by questionnaire. According to the Finnish Cancer Registry none of them had gastric carcinoma. The expected number of gastric carcinomas in the present series was calculated to be 2.3 and of all malignancies 13.6, but only one gastric carcinoma and 19 other malignancies were detected. The gastric carcinoma detected endoscopically and verified bioptically and cytologically was microscopically of anaplastic type. Most of the patients were in excellent general condition without gastric complaints. The present series reveals no clearcut causal relationship between gastric resection and late development of stump carcinoma.

Adult↗
PubMed1976

Washing and direct vision brush cytology in the diagnosis of gastric carcinoma.

The diagnostic significance of direct vision brush cytology and simple washing cytology was studied in 3 series with gastric carcinoma verified at operation. Direct vision gastroscopic biopsy was performed in all patients. Both brush and washing cytology markedly increased the diagnostic reliability of gastroscopic biopsy. Wrong negative results (Papanicolau I-II) were found in 13% with brush cytology and in 34% with washing cytology. Direct comparison revealed that brush cytology was definitely superior to washing cytology in the diagnosis of gastric carcinoma. The results suggest a routine use of brush cytology in connection with gastroscopic biopsy.

Cytodiagnosis↗
PubMed1976

Dynamics of atrophic gastritis in male and female subjects after partial gastric resection -- an evaluation by stochastic analysis.

Forty-two subjects (33 male and 9 female) were examined 17 to 18 years after partial gastrectomy due to gastric or duodenal ulcer, with regard to morphological state of gastric body mucosa, specimens obtained by direct gastroscopy technique being evaluated by our scoring system. Our stochastic analysis was applied to the findings to obtain the "age-adjusted score' (AAS), representing the degree of progression of chronic gastritis with reference to a random population, independent of the subject's age. Higher susceptibility of males than females to progressing chronic gastritis, and higher than that of both males and females of the random population, was noted. The atrophic changes in males after gastrectomy showed no dependence on age.

Adult↗
PubMed1975

Ulcer simulating gastric carcinoma. I. Diagnostic considerations and treatment.

Small ulcer-simulating carcinomas accounted for 3.9% (48 cases) of the 1324 patients with carcinoma of the stomach treated at the Second Department of Surgery, University Centtive of a malignant ulcer in 52% of the cases whereas gastroscopy combined with exfoliative gastric cytology gave 73% correct results. In spite of preoperative suspicion of malignancy most patients were operated on as for a benign ulcer. Partial distal gastrectomy without splenectomy was performed in 93% of the patients. There was no hospital mortality. The 5-year survival rate by the actuarial method was 63%.

Adult↗
PubMed1975

Ulcer simulating gastric carcinoma. II. Histopathology and survival.

Forty eight benign-ulcer-simulating gastric carcinomas treated at the Second Departmxamined histologically. Twenty two cases (46%) were classified as adenocarcinomas, 15 (31%) were mucocellular and 11 (23%) were anaplastic poorly differentiated forms. Invasion was limited in the histological specimens to the mucosa or submucosa in 20 cases (43%) which also fulfilled the criterias for early gastric carcinoma. The five year survival rate, by the actuarial method, was 63%, which is good if compared with that of all gastric carcinomas. The good prognosis can mainly be explained by the high percentage of early carcinoma for which the 5 year survival rate was 77%.

Adenocarcinoma↗