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Biomedical subjects

O Alfthan

Publications and source records attributed to O Alfthan.

At least 73 records · Page 4Linked to original sources
PubMed1984

Unexpected urethral strictures after short-term catheterization in open-heart surgery.

Urethral stricture was found in 59 of 478 male patients who had undergone open-heart surgery between June 79 and December 81. In 40/59 cases the stricture showed a string-of-pearls configuration or long narrowing of the penile urethra on the urethrogram. Burning pain and dysuria were the main symptoms, and the urinary stream started to weaken immediately after the removal of the siliconized latex catheter which had been routinely inserted at the time of the heart operation and usually kept indwelling for 3 days. The stricture epidemic stopped after change of the latex catheters to silicone-ones. The different catheters were investigated for cell toxicity. Eluates of catheters were added at different concentrations to cultures of various cell lines. The cell proliferation was measured by thymidine incorporation. The results were uniform and showed marked toxicity of the latex catheters against all investigated cell lines.

Cardiac Surgical Procedures↗
PubMed1984

Suprapubic cystostomy catheterization in open-heart surgery.

Monitoring of the urinary output is mandatory during open-heart surgery and in the immediate postoperative period. During 1980-81 we noticed an alarming rise in the number of post-catheterization urethral strictures affecting men who had undergone open-heart surgery. To avoid this serious complication, we switched from conventional urethral catheterization to suprapubic cystostomy for these patients. The first 93 cases with suprapubic drainage have now been analysed as regards the advantages and complications of this technique. The advantages were clear: The patients were satisfied with the method and no urethral strictures developed. The only side effect was haematuria, which in 9 cases led to occlusion of the catheter and required extraneous maneouvres. Suprapubic cystostomy thus seems to be a good alternative to conventional urethral catheterization in open-heart surgery. The possible causes of the urethral complications in this particular group of patients also are discussed.

Cardiac Surgical Procedures↗
PubMed1984

Adriamycin instillations as recurrence prophylaxis in superficial urinary bladder cancer.

Fourteen patients suffering from recurring superficial urinary bladder carcinoma were studied. 50 mg of adriamycin was instilled intravesically approximately once monthly over a period of more than 17 months. Recurrence index (RI) with adriamycin prophylaxis was statistically monthly significantly lower and per cystoscopy highly significantly lower than without prophylaxis. The recurrence rate (RR), as well as the mean annual recurrence rate (MARR) were similarly significantly lower with prophylaxis than without. The total response, an expression used earlier, was 86% following prophylactic instillation. 57% of the patients (8/14) suffered from bladder irritation and urinary tract infections occurred in three of them.

Aged↗
PubMed1983

Optimising mitomycin C activity during intravesical instillation.

Walker 256 carcinosarcoma was shown to be sensitive to mitomycin C in vitro. In order to make practical recommendations for the clinical intravesical use of mitomycin C, this cell line was used to evaluate the activity of mitomycin C under different conditions. Mitomycin C loses its antitumour activity rapidly at pH's below 6. At higher pH's (up to 10) mitomycin C is stable and suitable for intravesical application. To secure a sufficiently high pH in the bladder during intravesical treatment, phosphate buffer 0.05 M with a pH of 7.4 is recommended. Constituents of urine very little decrease the activity of buffered mitomycin C during a 2 h application. Prednisolone, which has been suggested to prevent the harmful chemical cystitis, has no inhibitory effect on the activity of mitomycin C.

Animals↗
PubMed1983

Character of urinary tract infections and pyelonephritic renal scarring after antireflux surgery.

We followed 40 girls who had undergone antireflux surgery (the Politano-Leadbetter technique) at the mean age of 5.2 years until they reached a mean age of 9.5 years. Each girl was matched with a control. The pairs were matched for age at the onset of urinary tract infections and time of operation or selection, number as well as grade (1 to 3) of severity of the preoperative episodes and grade (II to IV) of reflux. Followup time for each member of the pair was identical. Postoperatively, the incidence of pyelonephritic urinary tract infection episodes (grade 3) was significantly less (p less than 0.01) among the operated than the nonoperated cases (9 versus 29), while the number of symptomatic lower urinary tract infections (grade 2) was virtually the same (14 versus 19) in both groups. The operated cases had more asymptomatic bacteriuria (26 versus 12 episodes) so that the total numbers of episodes of bacteriuria (grades 1 through 3) were similar in both groups. Antireflux surgery did not prevent the progression of pyelonephritic renal scarring, which continued equally in operated and nonoperated cases.

Child↗
PubMed1983

Tigason (etretinate) in prevention of recurrence of superficial bladder tumors. A double-blind clinical trial.

The effect of Tigason (etretinate) in the prevention of the recurrence of superficial bladder tumors (Ta-T1, grade 0 papilloma and grade 1 and 2 carcinoma) was studied in 30 patients in a double-blind, placebo-controlled study. Before beginning treatment, the bladder was cleared from all visible tumors by electrocoagulation or TUR. The duration of treatment ranged from 10 to 26 months. The overall preventive effect was significantly better (p less than 0.01) in Tigason-treated patients than in patients given placebo. Tigason was more effective in preventing the recurrence of grade 1 and 2 carcinoma than placebo. On grade 0 papilloma this difference was not so marked. Side effects were common and disturbing at high doses (50 mg/day), but Tigason was well tolerated at the final maintenance dose (25 mg/day). The results obtained from this first clinical study with Tigason in the prevention of recurrence of superficial bladder tumors are promising.

Aged↗
PubMed1983

Treatment of urethral stricture by urethroplasty or direct vision urethrotomy. A comparative retrospective study.

The outcome of treatment for urethral stricture is evaluated in two groups of patients in a retrospective study: 51 patients were treated with urethroplasty and 41 with direct vision urethrotomy. The groups did not differ greatly as regards primary success. It was 59% in the urethroplasty group and 61% in the urethrotomy group. This favours the view that the primary treatment of a urethral stricture should be direct vision urethrotomy whenever possible.

Adolescent↗
PubMed1983

Cisobitan in treatment of prostatic cancer. A prospective controlled multicentre study.

Cisobitan, an organosilicon compound with estrogenic and antigonadotropic properties has been evaluated clinically in comparison with an estrogen preparation. In a multicenter study a total of 140 patients with well and moderately well differentiated prostatic cancer were randomly allocated to treatment with Cisobitan or Estradurin/Etivex, 70 to each group. Of 34 patients with poorly differentiated prostatic cancer 18 were given Cisobitan--and 16 were given Estracyt-treatment. Among the patients with well and moderately well differentiated prostatic cancer there were, disregarding mortality, no major differences in subjective, objective or laboratory response to the two kinds of treatment. The pattern of side effects was similar, but oedema requiring diuretics occurred more often in the estrogen treated group. There was a significant difference in mortality at 12 months between the groups, two in the Cisobitan group and ten in the estrogen treated group. Cancer was the cause of death in two patients in the estrogen treated group. All other patients succumbed in cardiovascular diseases. At 24 months the difference in mortality rate was less pronounced: Another ten patients had died in the Cisobitan treated group and seven among the estrogen treated patients. Cancer was responsible for the deaths in seven of the Cisobitan patients compared to four of the estrogen treated patients. Within three years one more patient in both groups had died. Of the 34 patients with poorly differentiated cancer, twelve were alive at the 24 months' follow up, six in the Cisobitan group and six in the Estracyt group.

Clinical Trials as Topic↗
PubMed1983

Cellular origin and differentiation of renal carcinomas. A fluorescence microscopic study with kidney-specific antibodies, antiintermediate filament antibodies, and lectins.

Frozen sections of human renal carcinomas were studied in indirect immunofluorescence using antibodies against intermediate filaments of cytokeratin, desmin and vimentin type, and against proximal tubular brush border and distal tubular Tamm-Horsfall glycoprotein antigens, as well as with fluorochrome-labeled lectins in an attempt to study the origin and stage of differentiation of renal carcinomas. Eighty per cent of the renal carcinomas expressed the brush border antigens, whereas the Tamm-Horsfall glycoprotein could not be found. Antibodies against epidermal cytokeratins reacted only with collecting ducts in normal kidney, whereas antibodies against cytokeratins of Madin-Darby canine kidney epithelial cell line also reacted with glomerular and tubular epithelium. In 93% of the carcinomas tumor cells showed reactivity with both types of antikeratin antibodies. Vimentin, the cytoskeletal protein of mesenchymal cells, was present in the carcinoma cells of 53% of the tumors, although it was not present in normal tubular epithelium. Moreover, vimentin was expressed together with cytokeratin in the carcinoma cells in 57% of the keratin-positive samples as judged by double immunostaining, whereas the muscle type of intermediate filament protein, desmin, was not seen in the malignant cells. Binding sites for Lotus tetragonolobus agglutinin and soybean agglutinin, normally present in the cells of proximal tubules, were lacking or only faintly detectable in the neoplastic cells. Dolichos biflorus agglutinin, normally present in collecting ducts, was not detected in the tumors. The results show that most renal carcinomas express cytokeratin antigens as a sign of their epithelial origin and also show characteristics of proximal tubular cells. On the other hand, the results indicate that lectin-binding sites typical for normal differentiated tubular cells are profoundly modified in renal carcinomas. Ulex europaeus agglutinin did not bind to the malignant cells but decorated the endothelial cells of the tumors.

Antigens↗
PubMed1982

Comparison of radioimmunological and conventional acid phosphatase assays in the serum of prostatic cancer patients.

Measurements of serum prostatic acid phosphatase concentrations (PAP) by radioimmunoassay (RIA) were compared with the conventional measurements of serum acid phosphatase activities using p-nitrophenylphosphate (pNPP, tot.) and magnesium thymolphthalein monophosphate (TMP) as substrates and L(+)-tartrate (pNPP, tr.) as inhibitor in five prostatic cancer patients before therapy and in 13 during therapy. Elevated serum acid phosphatase activities were detected in 2, 2 and 3 of the 5 untreated patients when using pNPP (tot.), pNPP (tr.) and TMP enzyme assays, respectively. RIA for PAP detected elevated concentrations of the enzyme in 4 of these patients' sera. Three of the patients without metastases and one patient with suspected metastases had elevated concentrations of PAP by RIA. Serum acid phosphatase isoenzyme 2, which is mainly of prostatic origin, was separated chromatographically from serum samples with increased acid phosphatase activity. It represented 60--92% of the total activity, when TMP was used as substrate. Significant correlations (beta less than 0.001) were observed between all conventional enzyme activity measurements used and PAP by RIA within the whole patient group (n = 18), but no correlations existed within the patient group (p = 6) of high normal, or low abnormal serum PAP (2.7--6.6 micrograms/l). In addition, PAP measured by RIA better reflected the clinical state of the 13 patients under treatment than the conventional enzyme assays investigated.

Acid Phosphatase↗
PubMed1982

Treatment of postprostatectomy incontinence.

Every surgeon who is involved in prostatic surgery should have a good knowledge of the anatomy and the physiology of the urinary bladder and the sphincter system in male. The cause and the treatment of postprostatectomy incontinence is discussed in detail. The expectancy time in postprostatectomy incontinence is recommended to be long enough (1-1 1/2 years) because this harmful complication of 1-2 degree leaks in 85% within a year. So far the operative treatment of 2-3 grade postoperative incontinence is limited to the use of Scott prosthesis where the success rate varies according to different authors from 60 to 85% in 5 years observation time.

Adolescent↗
PubMed1981

The role of vesicoureteral reflux in paediatric urinary-tract infection.

Observations are reported from a series of 284 children, 68 boys and 216 girls, who had had one or more episodes of urinary tract infection (UTI) and had vesicoureteral reflux (VUR) of grade II, III or VI. In 6 of the boys and 43 of the girls the Politano-Leadbetter operation for correction of VUR was performed. Only in grade III or IV VUR was the cure rate--considered solely as cessation of reflux--significantly higher in surgically than in non-surgically treated children. Irrespective of sex or mode of treatment, the number of episodes of UTI tended to diminish as the children grew older. For more precise comparisons, two individually matched groups of 40 girls were studied. One girl in each pair was operated on. Within these matched pairs, the frequency of UTI episodes according to age did not differ appreciably. Nor did the number of UTI episodes before and after the time of operation differ significantly when analysis was made according to grade of reflux. Thus, although disappearance of surgically treated grades III and IV VUR was more rapid and more frequent than spontaneous cessation of reflux, the observations in the matched pair series indicated that antireflux surgery does not affect the incidence of UTI.

Adolescent↗
PubMed1981

Preoperative treatment with azlocillin in complicated urinary tract infections.

Eighteen patients, aged 18-84 years, with complicated urinary tract infections admitted to hospital were treated preoperatively with azlocillin (Securopen) for 5 to 10 days. Two patients having chronic pyelonephritis were not operated. Isolates bacteria were Pseudomonas aeruginosa (14), Proteus mirabilis (3), Escherichia coli (2) and Klebsiella spp. (1). Serum concentrations and urine recovery were measured on the fifth day of treatment. The mean serum half-life was 1.85 h and the mean value of the urine recovery 47% of the single dose. On the 5th day of treatment the urine was sterile in 80% of the patients. In 12 patients (60%) the urine was still sterile when controlled 2-6 months after operation and prophylactic postoperative treatment with nitrofurantoin or trimethoprim-sulfamethoxazole.

Adolescent↗