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Biomedical subjects

K von Smitten

Publications and source records attributed to K von Smitten.

At least 55 records · Page 3Linked to original sources
PubMed1995

Testicular needle biopsy, open biopsy, epididymal aspiration and intracytoplasmic sperm injection in obstructive azoospermia.

Testicular or epididymal spermatozoa were obtained for in-vitro fertilization and intracytoplasmic sperm injection (ICSI) in 27 cycles out of 33 (in six men the azoospermia proved to have testicular causes). Testicular needle biopsy carried out in addition to surgical open biopsy proved to be an effective method to obtain spermatozoa for ICSI from patients with obstructive azoospermia. Thus it might be possible to replace scrotal operations by simple needle biopsies. Embryos resulting from ICSI with testicular spermatozoa were used in 19 transfers that resulted in six pregnancies. One pregnancy resulted from six embryo transfers from ICSI after microsurgical-epididymal sperm aspiration (MESA). The normal fertilization rates with testicular (37.3%) and MESA spermatozoa (53.7%) did not differ significantly from each other, but with testicular spermatozoa the rate was significantly lower than that obtained with ejaculated spermatozoa and ICSI (59.7%) in the matched couples. The abnormal fertilization of oocytes with one pronucleus was significantly higher with testicular spermatozoa than with ejaculated spermatozoa in the control couples.

Biopsy↗
PubMed1994

Gingival and dental status, salivary acidogenic bacteria, and yeast counts of patients with active or inactive Crohn's disease.

To investigate dental, gingival, and salivary aspects during an exacerbation of Crohn's disease, 53 patients with long-standing Crohn's disease were clinically, endoscopically, and radiologically examined. The patients were divided in two groups: 32 patients had active disease and 21 patients had inactive disease. Oral examination of the patients did not reveal any statistically significant differences in gingival or dental indexes between the groups, but patients with active disease tended to have higher scores of gingivitis than patients with inactive disease despite the fact that the patients with active disease were younger than those in remission. No differences between the groups were observed in salivary flow rate or buffering capacity. Lactobacilli and yeast counts of saliva tended to be higher among patients with active disease than with inactive disease, but the difference between the groups was significant only for high mutans streptococci counts.

Adult↗
PubMed1994

The prognostic value of insulin-like growth factor-I in breast cancer patients. Results of a follow-up study on 126 patients.

The insulin-like growth factor-I is an important mitogen and has a growth promoting property, especially in breast cancer. This work analyses the prognostic value of the insulin-like growth factor receptor-I (IGFR-I), which belongs to the group of membrane receptors for growth factors. The study included 126 patients. 49 patients (39%) were IGFR positive (> or = 4.0%). There was a significant correlation between IGFR and oestrogen receptor (ER) status (P = 0.001), but not between IGFR and progesterone receptor status (PR; P = 0.07). There was no correlation between node status and IGFR. The expression of IGFR had a strong significance in the disease-free analysis (P = 0.0108). The IGFR status was not of predictive value in the node-negative subgroup (64 patients). Within the ER-negative group, the disease-free analysis further stratified with IGFR revealed that patients with IGFR-positive and ER-negative cancers are in a worse situation than IGFR-negative ER-negative cancer patients (P = 0.01).

Adult↗
PubMed1993

Oral findings in patients with active or inactive Crohn's disease.

The frequency and type of oral mucosal lesions, dental infections, and salivary constituents were evaluated in 53 patients with Crohn's disease, who were divided into inactive, mildly active, and severely active groups on the basis of clinical and endoscopic criteria. Buccal biopsies from nine patients with active disease showed morphologic changes that suggested Crohn's disease-related lesions. Panoramic radiographs revealed more infectious foci in the teeth of patients with active Crohn's disease than in patients with inactive disease. Salivary flow rate, buffering capacity, total protein, amylase, and IgA and IgG concentrations did not differ with respect to the activity of Crohn's disease. The observed mucosal inflammation in patients with active Crohn's disease, although high in frequency, was mild and did not need therapy, but the great number of dental infections in association with the activity of Crohn's disease should be taken into account in the treatment of these patients.

Adult↗
PubMed1993

Prognostic value of Ki-67 immunolabelling in primary operable breast cancer.

The prognostic value of Ki-67 immunohistochemical labelling was evaluated in 327 operable primary carcinomas of the breast. The follow-up time was up to 4 years (mean 2.7 years). The disease-free survival in Ki-67 positive patients was shorter than in Ki-67 negative patients (P < 0.005). By combining the Ki-67 expression with ER receptors and stage, subgroups with a different disease-free survival were identified. In stage II patients there was a significant difference (P < 0.005) in disease-free survival between Ki-67 positive/ER negative and Ki-67 negative/ER positive patients. In node negative patients there was no such difference. The disease-free survival according to different prognostic factors, stage, ER and node status, were separately examined using a Cox's proportional hazards model. ER (P < 0.0001), the Ki-67 (P < 0.02), tumour size (P < 0.0001) and nodal status (P < 0.006) were independent prognostic factors. We conclude that the potential value of Ki-67 labelling for prognostic evaluation of patients with breast carcinoma is good.

Adult↗
PubMed1993

Sperm aspiration from vas deferens and in-vitro fertilization in cases of non-treatable anejaculation.

Spermatozoa were aspirated from the proximal vas deferens of five men with persistent anejaculation which could not be overcome by using a vibrator or electro-ejaculation. Three men had spinal cord injury, one man had undergone a pelvic lymphadenectomy, and in one of them the aetiology was unknown. Fairly good numbers of spermatozoa (from 7.5 to 170 million) with progressive motility from 24 to 75% were obtained from all the eight microsurgically performed aspiration attempts. In vitro fertilization (IVF) was successful in seven attempts. Eight embryo transfers (six with fresh and two with frozen embryos) resulted in three pregnancies. The pregnancy rates, 37% per aspiration and 37% per embryo transfer, show that in this small group of patients, aspiration of spermatozoa from the vas deferens followed by IVF-embryo transfer is a promising method in the management of infertility caused by persistent anejaculation.

Adult↗
PubMed1993

Epididymal sperm aspiration and use of donor spermatozoa when necessary for in-vitro fertilization, and vasoepididymostomy: an acceptable combination in the treatment of obstructive azoospermia.

Infertility due to obstructive azoospermia in 24 men was treated with a combination of scrotal exploration, microsurgical sperm aspiration and vasoepididymostomy, at the same operation. In-vitro fertilization (IVF) and embryo transfer were performed using epididymal spermatozoa. Donor spermatozoa were used if no motile epididymal spermatozoa were obtained. With this combination, emotionally and economically acceptable pregnancy rates were achieved: 24% per aspiration, 43% per embryo transfer, and 25% per couple. One twin pregnancy resulting in the birth of two healthy female infants and one ongoing twin pregnancy were achieved with epididymal spermatozoa; four pregnancies (one twin, two singletons, one abortion) were achieved with donor spermatozoa.

Adult↗
PubMed1993

Concentrations of pancreatic secretory trypsin inhibitor (PSTI), acute phase proteins, and neopterin in Crohn's disease. Comparison with clinical disease activity and endoscopical findings.

The usefulness of pancreatic secretory trypsin inhibitor (PSTI) as a marker of chronic inflammation was studied in patients with Crohn's disease. Pancreatic secretory trypsin inhibitor was compared with other laboratory tests (C-reactive protein, orosomucoid, and urinary neopterin), for evaluation of disease activity as measured by a clinical scoring system and endoscopical findings. The clinical utility of the tests was compared by four different methods. All tests showed significant differences in laboratory values between inactive and severely active disease. Using earlier established cut-off values PSTI showed the best combination of sensitivity and specificity for differentiation between inactive and severely active disease. When the efficacy of the test was compared by ROC-curve analysis, neopterin and orosomucoid produced the best combination of sensitivity and specificity, but for both assays the earlier established cut-off levels were too high for optimal separation between active and inactive disease. There was a poor agreement between endoscopically and clinically determined disease activity and the laboratory tests correlated better with clinical activity. The present study shows that serum PSTI reflects changes in the clinical activity of Crohn's disease equally well as C-reactive protein, which previously has been found to be an useful index of disease activity.

Adult↗
PubMed1993

Increased urinary excretion of iohexol after enteral administration in patients with ileal Crohn's disease. A new test for disease activity.

Iohexol is a water-soluble contrast medium that is partly absorbed/permeated through mucosa of the small bowel and excreted unchanged in the urine. Iohexol was administered orally to 12 patients with Crohn's disease of the ileum and to 10 healthy controls to measure its excretion in the urine. The location and activity of Crohn's disease were determined by barium double-contrast radiography in all patients and by ileoscopy and biopsy in 9 patients. Iohexol concentrations in serum and 24-hour urine were measured using reversed phase high-performance liquid chromatography. Urinary excretion of iohexol was significantly greater in patients with active Crohn's disease than in controls. We suggest this method as a new way of measuring Crohn's disease activity and mucosal damage in the small bowel. Bowel inflammation and mucosal cell damage are strongly indicated if the iohexol excreted in the urine is over 1% of the oral intake.

Administration, Oral↗
PubMed1992

The impact of adjuvant radiotherapy and cytotoxic chemotherapy on the outcome of immediate breast reconstruction by tissue expansion after mastectomy for breast cancer.

In an attempt to evaluate the impact of radiation therapy and cytotoxic chemotherapy on the outcome of immediate breast reconstruction by tissue expansion after mastectomy a prospective study on 32 patients was performed. The radiation therapy significantly worsened the surgical outcome, because the irradiated patients more often had pectoral muscle stiffness making the expansion more painful and the reconstructed breast too small, hard and with insufficient ptosis to obtain a natural breast mould. These results indicate that this technique should be avoided in patients likely to receive postoperative adjuvant cytotoxic chemotherapy and radiation therapy, thus reducing the indication to a small group of patients undergoing mastectomy for widespread ductal carcinoma in situ.

Adult↗
PubMed1990

Wire-guided biopsies of nonpalpable breast lesions.

The purpose of this study was to review the results of mammographic wire-guided biopsies of nonpalpable breast lesions and the features of the lesions in the preoperative examinations. Sixty women, mean age 50.2 years (range 31 to 74), underwent a wire-guided biopsy of the lesion. Twenty-nine patients had preoperative fine needle aspiration of the lesion. The radiographic diagnosis was correct in 33 patients (55%); 25 had breast cancer and 8 patients had a benign lesion. In 9 of the 14 patients with clustered microcalcifications in mammography and in 13 of the 15 patients with a mass noted in mammography, the cytological examination was correct. Nonpalpable mammographic masses with regular borders and normal fine needle aspiration examination do not require biopsy. In malignant mammographic appearances associated with a normal fine needle aspiration examination, biopsy of the lesion should always be done.

Adult↗
PubMed1989

Long term outcome after resection of the first rib for thoracic outlet syndrome.

A total of 112 first ribs in 103 patients were resected over 11 years for thoracic outlet syndrome. Seventy-seven patients (84 operations) were followed up for 2.5 years or more to assess the long term results of this procedure and the factors affecting them. One month after surgery 52 per cent of limbs were asymptomatic and 77 per cent were at least improved. A follow-up examination was performed, on average 6.1 years after the operation, by two independent examiners. This evaluation showed a permanent success rate of 37 per cent among 84 limbs examined. These long term results compare unfavourably with previously published data. The reason for the poor final outcome seemed to be difficulty in selecting patients for the operation. This was not aided by any of the preoperative tests. Patients in this study were evaluated by independent examiners, and only a total absence of preceding symptoms was accepted as the criterion for success. We emphasize the importance of unbiased evaluation and long term follow-up.

Adult↗
PubMed1989

The incidence of Crohn's disease in the Helsinki metropolitan area during 1975-1985.

The hospital incidence of Crohn's disease in the Helsinki metropolitan area during 1975-1985 was studied retrospectively. The resident population in this urban, well-defined district was 790,000 in the year 1985. During this period 193 new patients suffering from Crohn's disease were diagnosed. The annual incidence increased three times from 1/100,000 to 3/100,000, while the annual mean incidence was 2,3/100,000. The age-specific incidence was highest in the age-groups 15-24 with no sex difference. After the initial rapid increase the incidence of Crohn's disease in the Helsinki metropolitan area has stabilized on the level 3/100,000. These figures are similar to those reported from other Scandinavian and Western countries.

Adolescent↗