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Biomedical subjects

M Kontturi

Publications and source records attributed to M Kontturi.

At least 73 records · Page 4Linked to original sources
PubMed1982

Radioimmunoassayable prostate-specific acid phosphatase in peripheral and bone marrow sera compared in diagnosis of prostatic cancer patients.

Measurements of human prostate-specific acid phosphatase by radioimmunoassay in peripheral and bone marrow sera were compared. We studied 20 patients with benign prostatic hyperplasia, 27 with untreated prostatic cancer without bone metastases and 11 with metastases, in addition to 7 with cancer treated by hormonal therapy. The prostate-specific acid phosphatase concentrations in peripheral and bone marrow serum samples were equal and did not exceed the upper limit of our health-associated reference interval, 2.8 microgram. per 1. (mean plus 2 standard deviations) in patients with prostatic hyperplasia. Of 27 prostatic cancer patients without bone metastases the concentration of prostate-specific acid phosphatase was elevated in the peripheral sera of 20 and in the bone marrow sera of 21, and 21 had an extracapsular tumor (stage T3 to T4). Prostate-specific acid phosphatase concentrations were elevated in peripheral and bone marrow serum specimens of all 11 patients with metastases and bone marrow cytology studies were positive in 2. There was no difference in prostate-specific acid phosphatase concentrations in peripheral and bone marrow serum specimens from prostatic cancer patients undergoing hormonal treatment. We conclude that the use of bone marrow serum for the measurement of radioimmunoassayable prostate-specific acid phosphatase in prostatic cancer patients does not provide any further information in regard to the detection of prostatic cancer compared to the use of peripheral serum specimens. Falsely positive findings in bone marrow specimens were not observed with the method used.

Acid Phosphatase↗
PubMed1982

Function of the intestinal substituted bladder.

Bladder function of 15 patients treated with total cystectomy, subtotal cystectomy or bladder resection, combined with sigmoidal, caecal or ileal cystoplasty, was evaluated with synchronous bladder pressure-flow-electromyography studies. Micturition was good or satisfactory in 14 patients. Eight patients had nocturnal incontinence. Bladder-sphincter dyssynergia of varying degree impaired the function of the intestinal substituted bladder in 9 patients. However, in selected cases intestinal cystoplasty is the best solution for retaining the normal way of voiding. After total cystoprostatectomy it is possible to replace the motor function of the bladder with sigmoidal cystoplastic substitution of the bladder. Patients with sigmoidal bladders also gradually developed sensations of fullness closely simulating those of their earlier bladders.

Adult↗
PubMed1982

Ureteric complications following treatment of gynaecological cancer.

The incidence, development and diagnosis of ureteric injuries secondary to radical operative or radiological treatment of uterine malignancy is described. Special attention is paid to the importance of early detection and management. Immediate peroperative repair of surgical ureteric damage gives most favourable results. Also in postoperatively diagnosed ureteric lesions the definitive treatment has to be carried out without delay. Ureteroneocystostomy, psoas-hitch procedure or transureteroureterostomy are the most preferable methods. In the late ureteric strictures secondary to radiotherapy the operation techniques employing nonirradiated tissues are recommended, eg. transureteroureterostomy, ileal replacement of strictured ureter and ileo-uretero-cystostomy or ileo-uretero-cutaneostomy. An ureteric prosthesis or ureteric stent may also be used in special cases. Ureteric complications following operative or radiological treatment of pelvic malignancy are usually curable. Therefore the employment of isotope renography or intravenous pyelography regularly is essential in the follow-up of asymptomatic patients and always immediately at the appearance of any urinary tract complaint in patients previously treated for pelvic malignancy.

Female↗
PubMed1982

Urinary fistulae caused by gynaecological therapy seen in one urological unit.

37 urinary fistulae caused by gynaecological operations and radiotherapy were analyzed. The original disease was malignant in 24 cases and benign in 13 cases. The cause of the fistula was simple hysterectomy in 11 cases, radical hysterectomy in 5 cases, irradiation for pelvic malignancy and irradiation in 5 cases, vaginal operation in 5 cases, infection in 1 case and difficult labour in 1 case. 14 fistulae were closed transabdominally, 6 fistulae were closed transvaginally and 5 fistulae healed by conservative therapy. It was possible to close 2 of the 5 postradiation complex vesicovaginorectal fistulae. 22 patients left the hospital dry voiding via the urethra. Despite successful closure of the fistula 4 patients remained partially or totally incontinent. Using various forms of urinary and intestinal diversion procedures the social performance and quality of life of the patients unsuitable for functional closure of the fistula could be greatly improved.

Adult↗
PubMed1981

Androgens and prostate-specific acid phosphatase in whole tissue and in separated epithelium from human benign prostatic hypertrophic glands.

The concentrations of prostate-specific acid phosphatase (PAP), testosterone, 5 alpha-dihydrotestosterone (5 alpha-DHT), 5 alpha-androstane-3 alpha, 17 beta-diol, androstenedione, 5 alpha-androstanedione, and androsterone were measured by specific radioimmunoassays in whole pieces and in separated epithelium from human benign prostatic hypertrophic (BPH) tissues. Significant correlations were noted between the concentrations of PAP and 5 alpha-DHT, and PAP and 5 alpha-androstane-3 alpha, 17 beta-diol in the epithelium, and between PAP and androstenedione, and PAP and testosterone PAP is androgen dependent, particularly as regards 5 alpha-DHT, whereas 5 alpha-androstane-3 alpha, 17 beta-diol may operate after conversion to 5 alpha-DHT. There is no obvious explanation for the correlations noted in whole tissue, but is suggested that circulating androgens, representing the androgen source for the prostate, primarily determine the production of PAP. The majority of the PAP in BPH tissues is located extracellularly.

Acid Phosphatase↗
PubMed1981

Long-term effects of endocrine treatment on serum pituitary hormones in advanced prostatic carcinoma patients.

Peripheral serum concentrations of FSH, LH, prolactin and ACTH were measured in 22 patients with advanced prostatic carcinoma treated by castration, polyestradiol phosphate (Estradurin) administration and a combination of castration and Estradurin administration during the first 12 months of treatment. Estradurin treatment alone (80 mg i.m.l once a month) did not result in any significant changes in the circulating concentrations of FSH, LH and prolactin. Therefore, the clear-cut inhibition of testicular steroidogenesis observed under this kind of treatment does not appear to be due to an inhibition of pituitary gonadotropin secretion, and is most likely due to a direct estrogen effect on Leydig cells. Castration led to grossly elevated serum FSH and LH levels. In this group, serum FSH remained at a high level, whereas LH was close to pretreatment levels 9 months after castration, suggesting differences in pituitary capacity to secrete FSH and LH under these conditions. Concentrations of circulating FSH, and to a lesser extent LH, in the combination treatment group were between those found in the castration and estrogen-only treatment groups, suggesting that the secretion of both gonadotropins can be suppressed by estrogen. No changes in serum prolactin and ACTH concentrations were seen in the three treatment groups.

Adrenocorticotropic Hormone↗
PubMed1981

Transient high serum prostate-specific acid phosphatase measured by radioimmunoassay in prostatic infarction.

Extremely high concentration, 172-hold the upper limit of reference range, of serum prostate-specific acid phosphatase was measured by radioimmunoassay in a patient subsequently shown to have prostatic infarction associated with prostatic hyperplasia. Following retropubic prostatectomy, the serum concentration of acid phosphatase returned to normal range. This finding shows that even grossly elevated levels of prostatic acid phosphatase enzyme protein in serum are not specific for prostatic carcinoma.

Acid Phosphatase↗
PubMed1981

The effect of manipulation of the prostate gland on serum prostate-specific acid phosphatase measured by radioimmunoassay.

We investigated the effects of digital prostatic palpation, cystoscopy, and biopsy of the prostate on the concentrations of serum prostate-specific acid phosphatase (PAP) measured by radioimmunoassay. Serum concentrations of PAP in patients with normal or hyperplastic prostates did not exceed the upper limit of our reference range (4 microgram per liter) during the 48 hr after digital prostatic palpation. The serum concentrations of PAP did not significantly increase in patients with carcinomatous prostates after digital examination of the prostate. Serum PAP did increase in patients with benign prostatic hyperplasia soon after cystoscopy of biopsy of the prostate. No diurnal variation in the serum concentrations of PAP during the follow-up of 48 hr was detected in the patient groups with normal, benign hyperplastic, or carcinomatous prostates not subjected to rectal examination.

Acid Phosphatase↗
PubMed1981

Effectiveness of radioimmunoassay of human prostate-specific acid phosphatase in the diagnosis and follow-up of therapy in prostatic carcinoma.

The radioimmunoassay of human prostate-specific acid phosphatase and the measurement of the catalytic activity of acid phosphatase using p-nitrophenyl phosphate as substrate were compared in the diagnosis and follow-up of therapy of prostatic cancer patients. We monitored 17 patients without metastases and eight patients with metastases for 12 months. We detected elevation of the catalytic activity of acid phosphatase [the upper limit for the reference range was mean + 2 (S.D.)] in 24% of the sera of all these patients (n = 25), and the concentration of prostate-specific acid phosphatase measured by radioimmunoassay [the upper limit for the reference range was mean + 3 (S.D.)] was elevated in 80% of these samples before therapy. The radioimmunological measurement of prostate-specific acid phosphatase was therefore more efficient in detecting prostatic cancer than was measurement of the catalytic activity. Favorable effects of the various forms of endocrine treatment were detected more clearly by the measurement of immunoassayable prostatic acid phosphatase than by the measurement of catalytic activity. Activation of the disease during various forms of endocrine treatment of prostatic carcinoma is possibly more efficiently signaled by radioimmunoassay than by measurement of catalytic activity.

Acid Phosphatase↗
PubMed1980

Peripheral and prostatic vein steroid concentrations in benign prostatic hypertrophy patients before and after removal of the adenoma.

The concentrations of androgenic steroids and some of their precursors were determined in the prostatic and peripheral veins of 16 patients with benign prostatic hypertrophy (BPH). The same steroids were also measured in the peripheral vein after removal of the adenoma. The mean concentration of 5 alpha-dihydrotestosterone in prostatic vein (4.40 nmol/l +/- 0.37, mean +/- S.E.M.) was significantly higher than in peripheral vein (2.63 nmol/l +/- 0.30, mean +/- S.E.M.) indicating secretion of this steroid by the adenoma. We did not observe any correlation between the weight of the removed tissue and the secretion of 5 alpha-dihydrotestosterone. The concentrations of pregnenolone, progesterone, 17 alpha-hydroxyprogesterone, androstenedione, testosterone and androsterone were the same in the prostatic and peripheral veins. There were no changes in the concentrations of steroids measured before and 1 and 6 months after removal of the BPH adenoma. It therefore appears that the secretion of 5 alpha-dihydrotestosterone by the adenoma is insufficient to influence the circulating levels of this steroid.

Aged↗
PubMed1980

Long-term effects of endocrine treatment on serum steroids in advanced prostatic carcinoma patients.

The long-term effects of endocrine therapy, including polyestradiol phosphate (Estradurin) administration, castration, and their combination, on the circulating concentrations of pregnenolone, dehydroepiandrosterone, progesterone, 17 alpha-hydroxyprogesterone, androstenedione, testosterone, 5 alpha-dihydrotestosterone, and androsterone were investigated for 1 year in 22 patients with advanced prostatic carcinoma. Only Estradurin significantly reduced serum concentrations of testosterone, 5 alpha-dihydrotestosterone, and 17 alpha-hydroxyprogesterone. Orchidectomy resulted in a more pronounced decrease in the serum concentrations of testosterone and 5 alpha-dihydrotestosterone; Estradurin combined with orchidectomy led to no additional decrease. There were no consistent changes in the serum concentrations of other steroids measured. It is likely that Estradurin has a direct inhibitory effect on steroidogenesis in Leydig cells, but a significant residual testicular production of testosterone occurred during the period of Estradurin treatment, when given alone. No increase in serum concentrations of adrenal androgens or their precursors was observed during any of the three treatment regimens.

Aged↗
PubMed1980

Treatment of ureteral strictures after therapy for carcinoma of the uterus.

The long term result after the operative treatment of 29 ureteral strictures by various methods in 19 patients treated radically for a malignant tumor of the uterus was evaluated an average of 50 months after the urologic reconstructive surgery. Four patients died of repeat carcinoma and one patient died of a pulmonary embolism before the follow-up examination. In the other patients, a clinical examination, isotopic nephrography, intravenous pyelography, midstream culture and sediment as well as serum creatinine assay demonstrated that transureteroureterostomy resulted in a good, or satisfactory, outcome in patients with a unilateral stricture. A similar outcome was obtained by ileal replacement of the ureter, provided renal function had not been impaired preoperatively. The results obtained with the bladder flap operation, ureterolysis and cutaneous ureterostomy were poor. The significance of early detection and active therapy for strictures is emphasized. Nonradiated tissue should be used for the reconstructive procedure.

Carcinoma↗
PubMed1979

Testicular steroid secretion and peripheral serum steroid concentrations in patients with prostatic carcinoma after short-term estrogen treatment.

The short-term effects of the administration of estradiol on testicular steroid production were assessed by measuring the serum concentrations of testosterone, and a number of its precursors and metabolites, in the spermatic and peripheral veins of five inguinal hernia patients and one untreated prostatic carcinoma patient, as well as in 18 patients with advanced prostatic carcinoma, treated for 1 to 9 days with a single injection of 80 mg of polyestradiol phosphate (Estradurin). With the exception of progesterone, the treatment resulted in a significantly decreased testicular production of all steroids measured in spermatic vein serum; the same finding holds true for concentrations of testosterone, 5 alpha-dihydrotestosterone, and 17 alpha-hydroxyprogesterone in peripheral vein serum before and after treatment. By comparing the steroid concentrations in the spermatic and peripheral veins it is evident that the testicular production of all steroids measured persisted, although at a decreased level, even 7 to 9 days after Estradurin administration; this was most pronounced in the case of testosterone and 17 alpha-hydroxyprogesterone. It is apparent that the effect of estradiol on testicular steroid production is a gradual process which takes several days before it is clearly evident.

Androgens↗