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Marita Laurila

Publications and source records attributed to Marita Laurila.

6 recordsLinked to original sources

Detection rates of high-grade prostate cancer during subsequent screening visits. Results of the European Randomized Screening Study for Prostate Cancer.

Screening for prostate cancer using prostate-specific antigen (PSA) tests has led to a stage and grade shift as compared to the pre-PSA era. Effectiveness of screening for prostate cancer should be manifested by a reduction in detection rate of aggressive cancers during subsequent screening. In 6 centers of the European Randomized Screening study for Prostate Cancer, a total of 58,710 men were tested for prostate cancer. Screening centers differed with regard to age-range, screening interval and biopsy indications. During the 2nd visit, the proportion of Gleason score 6 cancers increased from 62.5 to 75%, mainly at the expense of Gleason score 7 cancers. High-grade (Gleason score 8-10) cancer detection rates varied per screening center during the 1st visit from 5.1 to 41.1, and during the 2nd visit from 6.4 to 29.3/10,000 men. The overall detection rate of high-grade cancers showed a reduction during the 2nd visit from 26 to 12/10,000 men, an effect mainly attributable to the screening center with the highest cancer detection rate (i.e. 507/10,000 men). Variations in detection rates among screening centers related among others to biopsy compliance and age range.

Age Factors↗

Biocompatibility properties of a new braided biodegradable urethral stent: a comparison with a biodegradable spiral and a braided metallic stent in the rabbit urethra.

OBJECTIVE: To compare the biocompatibility properties of a new braided biodegradable self-reinforced poly-L-lactic acid (SR-PLLA) urethral stent to the former spiral biodegradable SR-PLLA stent and the stainless steel stent in a rabbit model. MATERIALS AND METHODS: In all, 54 male New Zealand White rabbits were anaesthetized and stents inserted into the prostatic urethra, three of each kind for each sample time. The rabbits were killed after 1, 3, 6, 9, 12 or 15 months and light microscopy and scanning electron microscopy used to analyse the effects. RESULTS: The disintegration of the braided SR-PLLA stent was more closely controlled than that of the spiral SR-PLLA stent. The metallic stent induced epithelial hyperplasia and polyposis earlier than the biodegradable stents, and in these rabbits the polyposis disappeared after the disintegration process. There were no differences in the histological analyses between the biodegradable stents, whereas the metallic stents caused the strongest inflammatory reactions. CONCLUSIONS: The braided SR-PLLA urethral stent functioned well in the rabbit urethra and clinical studies are already planned.

Absorbable Implants↗

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Journal Article↗

Biocompatibility and implantation properties of 2 differently braided, biodegradable, self-reinforced polylactic acid urethral stents: an experimental study in the rabbit.

PURPOSE: Biodegradable urethral stents have been in clinical use for more than 10 years. To solve the problems connected with the helical spiral configuration of the stents used to date we developed a new tubular mesh configuration and evaluated the biocompatibility properties and degradation time of 2 differently braided stents in the rabbit urethra. MATERIALS AND METHODS: The biodegradable, self-expanding stents were made of self-reinforced polylactic acid polymer blended with BaSO4 (Alfa Chem, Kings Point, New York). Two braiding patterns, namely a diamond 1/1 and a regular 2/2 + 1 (Prodesco, Perkasie, Pennsylvania), were used to produce a tubular mesh configuration. Stainless steel stents with 1/1 braiding served as controls. The stents were inserted into the posterior urethra of 36 male rabbits. The animals were sacrificed after 1 week, 1 month, 6 months or 12 months. Light microscopy and scanning electron microscopy analyses were done. RESULTS: Tissue reactions to operative trauma were seen in all specimens at week 1. The changes gradually abated in the biodegradable stent groups, whereas chronic inflammatory changes and fibrosis were increasingly seen with metallic stents after 6 months. Epithelial hyperplasia increased with time for all stent types and materials. As expected, stent fragmentation started at 6 months. CONCLUSIONS: Biodegradable polymers are suitable materials for braided urethral stents. However, the braided configuration of the stent with a decreased mass of material does not prevent the development of epithelial hyperplasia. The biodegradable, self-expanding, braided stents functioned well in the rabbit urethra and are suitable for clinical studies.

Absorbable Implants↗

Biocompatibility, encrustation and biodegradation of ofloxacine and silver nitrate coated poly-L-lactic acid stents in rabbit urethra.

The purpose of this study was to evaluate the biocompatibility, encrustation and biodegradation properties of silver nitrate and ofloxacine blended caprolactone-L-lactide copolymer coated self-reinforced poly-L-lactic acid (SR-PLLA) urospirals in situ in the male rabbit urethra. SR-PLLA urospirals coated with 10% by weight silver nitrate or 5% by weight ofloxacine blended copolymer or pure copolymer were inserted into the posterior urethra of 18 male rabbits. No prophylactic antibiotics were given. The animals were sacrificed 1 or 6 months after insertion. Urethral tissue reactions were histologically scored semiquantitavely and the appearence of the stents assessed using scanning electron microscopy. The biodegradation time of SR-PLLA stents was remarkably reduced by the caprolactone coating. Silver nitrate and ofloxacine blended copolymer coated urospirals caused less tissue reaction than urospirals with a pure copolymer coating. Silver nitrate coating effectively prevented biofilm formation and stent encrustation. Silver nitrate and ofloxacine blended copolymer coated SR-PLLA urospirals had good biocompatibility properties in rabbit urethra. In particular, coating with silver nitrate may provide possibilities of preventing bacterial adhesion to bioabsorbable stents.

Animals↗

Rabbit muscle and urethral in situ biocompatibility properties of the self-reinforced L-lactide-glycolic acid copolymer 80: 20 spiral stent.

PURPOSE: A new type of self-reinforced L-lactide-glycolic acid copolymer, molar ratio 80:20, stent was developed. We evaluated the tissue biocompatibility properties of the new material. MATERIALS AND METHODS: Rods made of self-reinforced L-lactide-glycolic acid copolymer were inserted into rabbit dorsal muscles and rods of latex or polyvinylchloride and silicone served as positive and negative controls, respectively. Urethral stents of self-reinforced L-lactide-glycolic acid copolymer and steel were inserted in situ via cystoscopy into the rabbit prostatic urethra. The animals were sacrificed after 2 weeks, 1, 2 and 3 months, respectively. In situ histological analysis was done. Tissue reactions around the implantation types were analyzed histologically and scored semiquantitatively. In addition, macroscopic analysis was done of the urethral in situ stents. RESULTS: In rabbit muscle implantation test tissue reaction to the self-reinforced L-lactide-glycolic acid copolymer stent resembled that of negative control silicone. Less than moderate chronic inflammatory changes gradually subsided after 2 weeks. Foreign materials in the tissue and the reaction to these materials began to disappear after 1 month and at 3 months were completely absent. All rabbits fitted with the stent voided normally postoperatively. Self-reinforced L-lactide-glycolic acid copolymer stents were soft, partially fragmented and easily disintegrated when touched at 2 months, and were almost completely degraded at 3 months. The material did not encroach into the urethral wall macroscopically or microscopically. No calcification on the self-reinforced L-lactide-glycolic acid copolymer stents or bladder stone formation was seen. CONCLUSIONS: The new self-reinforced L-lactide-glycolic acid copolymer 80:20 material is safe, highly biocompatible and suited for future clinical use. It is most appropriate for preventing postoperative urinary retention after most minimally invasive thermal treatments for benign prostatic hyperplasia.

Animals↗