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Biomedical subjects

M Kontturi

Publications and source records attributed to M Kontturi.

At least 55 records · Page 3Linked to original sources
PubMed1987

The treatment of incomplete bladder emptying in females by bladder neck incision.

Thirty females suffering from incomplete bladder emptying underwent bladder neck incision. All patients had undergone some form of therapy earlier without success. The bladder neck incision was often an alternative to repeated catheterizations or an indwelling catheter. In 7 patients (23%) the result was excellent, 12 other patients (40%) benefited from the operation. The role of this operation and possible complications is discussed.

Adult↗
PubMed1986

Late urodynamic findings after surgery for cauda equina syndrome caused by a prolapsed lumbar intervertebral disk.

Bladder function was evaluated urodynamically in 17 patients operated on 2 to 3 years previously for the cauda equina syndrome caused by a prolapsed lumbar intervertebral disk. Of the patients 10 (59 per cent) reported the bladder function to be normal, while the other 7 had symptoms of obstruction or incontinence. Urodynamic findings were normal in 4 patients (24 per cent). In 3 patients (18 per cent) no detrusor contraction could be demonstrated in the pressure-flow electromyography study. Two patients (12 per cent) used the detrusor and straining during voiding. Cystometry showed an unstable detrusor in 3 patients (18 per cent). The remaining 5 patients (29 per cent) had either an increased bladder capacity or a decreased maximum flow rate. Neurological findings were normal in 2 patients (12 per cent). All of the patients with a decentralized detrusor had defective perianal sensation but detrusor contraction could be demonstrated in 3 who also had sensory impairment in the perianal region. Bladder function can be disturbed seriously in cauda equina patients without symptoms and, thus, all patients with the cauda equina syndrome should be tested urodynamically. An emergency operation seems to be capable of reducing late disturbances in bladder function. Regeneration of the autonomous nerves supplying the bladder and genitals may require an interval of several months to years.

Adult↗
PubMed1986

Bladder neck incision or transurethral electroresection for the treatment of urinary obstruction caused by a small benign prostate? A randomized urodynamic study.

Transurethral electroresection of the prostate (TURP) was compared with bladder neck incision (BNI) in the treatment of 24 patients with urinary obstruction caused by a small benign prostate. An evaluation of the urodynamic findings and subjective symptoms was undertaken before the operation and 6 months afterwards. Thirteen patients underwent TURP and 11 BNI. All patients except one in the BNI group subjectively considered the result good. The urodynamic evaluation showed that the detrusor pressure at maximum flow rate decreased more in the TURP group than in the BNI group and the urethral pressure profile was shorter after the operation. The maximum flow rates after the operation were similar in both groups. Retrograde ejaculation developed in 62% of the patients after TURP but none after BNI. BNI is recommended for men under 60 years with minimal prostatic hypertrophy and with an active sexual life.

Aged↗
PubMed1986

Postoperative urinary retention. I. Incidence and predisposing factors.

198 (3.8% comprising 4.7% of the males and 2.9% of the females) out of 5220 surgical patients developed total urinary retention postoperatively. The frequency of this condition increased with age and was highest after thoracotomies and endoprosthetic surgery of the hip joints. Voiding history was abnormal in 80% of the patients affected. Subclinical obstructive bladder dysfunction, over-distension of the bladder during the operation and in the recovery room after the operation, sympathomimetic and anticholinergic medication during or after anaesthesia, and an inability to stand or sit after surgery were common causes of retention. Premedication, type of anaesthesia, nature of the liquids given and postoperative analgetics seemed not to affect the incidence of retention. Postoperative urinary retention is an underestimated and mostly avoidable complication. Every patient should be asked for a urinary history before an elective operation. Infravesical obstruction should be relieved before any other elective surgical procedures are undertaken. In cases of emergency surgery prophylactic catheterization to prevent postoperative retention is recommended for patients with obstructive symptoms.

Adolescent↗
PubMed1986

Postoperative urinary retention. II. Micturition problems after the first catheterization.

198 out of 5220 surgical patients were catheterized because of unexpected postoperative urinary retention. In 39% of cases micturition succeeded after the first catheterization of the overdistended bladder, but 61% (58% of the males and 66% of the females) developed more copolicated voided problems. The volume of fluids given intravenously during anaesthesia, the volume of primary urinary retention and increasing age were predisposing factors for prolonged micturition difficulties. Hospitalization was protracted because of postoperative urinary retention in 21 patients, and for 20 males prostatic surgery was necessary to relieve persistent retention.

Adolescent↗
PubMed1986

Sclerotherapy for hydroceles and epididymal cysts with ethanolamine oleate.

Seventeen patients with hydroceles or epididymal cysts were treated by tapping and injection with ethanolamine oleate. All 11 patients with hydroceles were cured. Three of six patients with epididymal cysts were cured. There were no cases of haematoma or infection. Sclerotherapy is recommended as primary treatment for all men over 50 years with hydroceles and for selected cases with epididymal cysts.

Adult↗
PubMed1985

Screening for carcinoma of the prostate. Rectal examination, and enzymatic and radioimmunologic measurements of serum acid phosphatase compared.

Veterans (n = 771, 54-76 years of age) from the Second World War, who attended a rehabilitation program arranged by the state between the years 1979 and 1983, were screened for prostatic cancer by rectal examination of the prostate and by measurement of serum prostate-specific acid phosphatase (PAP) concentration and enzyme activity (total and tartrate-labile). Nine cases with prostatic cancer confirmed by needle biopsy were found. Serum PAP concentrations were elevated in five of the nine cancer patients and rectal examination was positive in six of them, whereas the serum PAP concentration was elevated and rectal examination was positive simultaneously only in two patients. Serum PAP concentrations were elevated in 25 patients without prostatic cancer, and rectal palpation of the prostate resulted in 21 false-positive findings. The enzyme activity of serum acid phosphatase was not elevated in any of the nine patients diagnosed as having prostatic cancer. The predictive value of a positive finding in serum PAP concentration (16.7%) or rectal palpation of the prostate (22.2%) in this unselected, asymptomatic population was similar and low. Both tests together gave additive information.

Acid Phosphatase↗
PubMed1985

Effects of long-term administration of tamoxifen on steroid metabolism in prostatic carcinoma patients.

Six patients with advanced prostatic carcinoma were treated with tamoxifen (2 X 20 mg daily) for up to 3 months before orchiectomy. Blood samples for gonadotropin, sex steroid, and prostate-specific acid phosphatase (PAP) determinations were taken before tamoxifen treatment, daily for 1 week, and at monthly intervals. Steroid concentrations in the testis tissue and spermatic vein blood were assayed from samples taken at orchiectomy. No consistent changes were observed during tamoxifen treatment, although there was a transient drop in the mean concentrations of LH on days 3 and 4 of treatment. The circulating concentrations of estradiol tended to be increased at 1, 2, and 3 months of treatment. The spermatic vein concentrations of testosterone and its precursors tended to be higher than those in nontreated prostatic carcinoma patients previously reported from this laboratory, indicating slight stimulation of testicular steroidogenesis. There were no changes in circulating levels of PAP and no improvement in clinical condition, indicating that long-term tamoxifen administration is not effective in the treatment of prostate carcinoma.

Aged↗
PubMed1985

Immunoreactive prostatic acid phosphatase in prostatic cancer: diagnosis and followup of patients.

We compared the measurements of serum acid phosphatase activity to those obtained by radioimmunoassay of prostatic acid phosphatase in the sera of 126 untreated prostatic cancer patients. The catalytic activity of prostatic acid phosphatase was elevated in 32 per cent of the patients and the serum concentration of prostatic acid phosphatase was elevated in 66 per cent. Of these 126 patients 16 had stage T0-2M0N0-x disease, and enzyme activity and prostatic acid phosphatase concentration were increased in 0 and 38 per cent, respectively, in this group. Of the 110 patients with proved extracapsular cancer the corresponding figures were 36 and 70 per cent, respectively. We followed 109 of these 126 patients for 1 or more years after orchiectomy. A salient finding was that return of elevated serum prostatic acid phosphatase concentration to the health-associated reference interval within 7 days following castration indicated no progression of the disease at 1 year irrespective of the initial staging. The same was not detected by the measurement of catalytic activity of serum acid phosphatase. Our findings substantiate data showing that the measurement of circulating prostatic acid phosphatase is achieved better by immunological techniques than by measurements of catalytic activity of the enzyme. A novel aspect is the usefulness of immunological prostatic acid phosphatase measurements in evaluation of the prognosis of patients with metastatic prostatic carcinoma following ablative endocrine treatment.

Acid Phosphatase↗
PubMed1985

Ultrastructural localization of glycocalyx domains in human kidney podocytes using the lectin-gold technique.

The lectin-gold technique was used to reveal Helix pomatia lectin (HPL)-binding sites in human kidney glomeruli. HPL-binding sites were associated mainly with podocyte foot process bases, and extended over the lamina rara externa of the glomerular basement membrane. In addition, kidneys from blood group A1 donors showed labeling of capillary endothelial cells and erythrocytes. After neuraminidase digestion of the sections prior to incubation with HPL-gold complexes, HPL-binding sites appeared on previously negative regions of the glomerulus. This increase in labeling was particularly striking at the level of the podocyte-free surface (adjacent to the urinary space) in all kidneys, and on capillary endothelial cells from donors of blood groups other than A1. These results demonstrate the existence of two distinct glycocalyx domains in human kidney podocytes, and show the application of the lectin-gold technique for the high resolution, ultrastructural detection and quantification of lectin-binding sites in human material.

Adult↗
PubMed1984

Ultrasonography, arteriography and CT in the diagnosis of renal carcinoma.

The material consists of 130 renal carcinomas diagnosed and histologically verified in 1978-1983, of which 124 were examined ultrasonographically (US), 122 arteriographically and 39 with computed tomography (CT). Of these renal carcinomas, 10 were detected as random findings in US. The US examination detected or gave suspicion of carcinoma in 94% of the cases, arteriography in 98% and CT in 95%. US was generally performed as a primary examination, and the US finding was often known at the time of arteriography and CT. Being noninvasive, US is a suitable primary examination in cases where renal carcinoma is suspected.

Adolescent↗
PubMed1984

Ultrasonography, computed tomography and arteriography in the evaluation of the local spreading of malignant renal neoplasm.

In a series of 32 operated renal carcinoma patients, the ability of ultrasonography (US), computed tomography (CT) and arteriography to demonstrate the local spreading of renal carcinoma was investigated. Operation showed that 23 of the renal carcinomas were local. Nine carcinomas had spread locally. CT was the most sensitive indicator of local spreading (particularly perirenal extension). CT examinations, however, also gave most of the false positive findings. The number of false negative findings was highest in the US group.

Adolescent↗
PubMed1984

Radioimaging of the prostate and metastases of prostatic carcinoma with 99mTc-labelled prostatic acid phosphatase-specific antibodies and their Fab fragments.

A radioimmunodetection technique using 99mTc-labelled polyclonal antibodies raised in rabbits against human prostate-specific acid phosphatase was used to detect metastases of prostatic carcinoma. All the metastases observed by X-rays or bone scintigraphy in the four patients with M1-disease were revealed by the novel technique employed. In addition, in one of the patients studied, a distinct incorporation of radioactivity was also observed in the left inferior scapular region, which was not seen by conventional bone scanning, but was later confirmed by X-ray studies to be a metastatic process.

Acid Phosphatase↗
PubMed1983

Nuclear androgen receptors in the epithelium and stroma of human benign prostatic hypertrophic glands.

Androgen receptors have been characterized and quantified in nuclear extracts of separated epithelium and stroma from human benign prostatic hypertrophic (BPH) glands. Tritiated dihydrotestosterone was used as the ligand and incubation was carried out at 15 degrees C for 18-20 hr before separation of bound and free ligand using dextran-coated charcoal. The results were analysed by Scatchard-type analysis. The concentration of receptor was found to be significantly (p = 0.022) greater in stromal than in epithelial nuclei: 1765 +/- 152 vs 1030 +/- 227 fmol/mg DNA (SEM, n = 6). Fourteen competitors were tested and the results indicated the presence of specific androgen receptors rather than contaminating sex-hormone-binding globulin. This was also borne out by the results of agar gel electrophoresis and sucrose gradient ultracentrifugation studies. The results are in line with current opinion that prostatic stroma is an important androgen-sensitive tissue, particularly in human BPH.

Cell Nucleus↗
PubMed1982

Rapid endocrine effects of tamoxifen and testolactone in prostatic carcinoma patients.

The short-term (6-day) endocrine effects of tamoxifen and testolactone were investigated in men with prostatic carcinoma. Tamoxifen treatment (20 mg/day) did not affect the gonadotropin levels, but it temporarily increased prolactin, induced sex hormone-binding globulin production, and suppressed peripheral serum progesterone, 17-hydroxyprogesterone, androstenedione, testosterone, and 5 alpha-dihydrotestosterone concentrations. These changes were attributed to the estrogenic properties of tamoxifen, since no changes in peripheral serum estradiol concentrations were observed. Testolactone (1000 mg/day) decreased peripheral estradiol concentrations by 50% and increased the concentrations of the neutral steroids measured. The increases in serum FSH and LH were very small. This study corroborates the early estrogen-like action of tamoxifen, and the experiment with testolactone further suggests that endogenous estradiol has physiological functions in man, regulating gonadotropin and androgen production.

Aged↗