Search PubMed⌕ Search

Biomedical subjects

P Kiilholma

Publications and source records attributed to P Kiilholma.

At least 37 records · Page 2Linked to original sources
PubMed1994

Operative treatment of advanced cervical cancer after full pelvic irradiation.

We present three patients with advanced carcinoma of the uterine cervix treated with full pelvic irradiation followed by surgery 21-37 weeks after the radiation therapy. In two cases chemotherapy was given after radiotherapy due to clinical or radiological residual disease. Postoperative treatment was dependent on histological examination of the surgical specimens. If indicated chemotherapy was started or continued after surgery. No major operative complications were noticed in these three patients in spite of full preoperative pelvic radiation. The information obtained from these operations was valuable in determining the further treatment of the patients. All three patients are clinically disease free at the moment, but longer follow-up will show if this treatment modality can increase survival of advanced carcinoma of the uterine cervix.

Adenocarcinoma↗
PubMed1994

Outcome of thirty patients who underwent repair of posthysterectomy prolapse of the vaginal vault with abdominal sacral colpopexy.

Thirty women experiencing posthysterectomy prolapse of the vaginal vault were treated with abdominal sacral colpopexy between 1984 and 1991. Lyodura (lyophilized cerebral dura mater allograft transplant) was used as the suspensory material in 81 percent and Gore-Tex (reinforced polytetrafluoroethylene) in 16 percent of the operations. There were no perioperative or postoperative complications. At the follow-up examination (mean, three years), good vaginal vault support was observed in 85 percent of the patients. Significant cystocele were seen in 18 percent, and vault prolapse, enterocele, rectocele and chronic perineal laceration each in 15 percent of the patients. At follow-up study, 22 percent of the patients experienced dyspareunia and 41 percent had decreased sexual interest and coital events. Development of stress urinary incontinence in 18 percent of patients was noted. Concomitant Burch colposuspension will cure and prevent stress incontinence and anterior vaginal relaxation. Abdominal sacral colpopexy appears to be a safe and effective method in the treatment of posthysterectomy prolapse of the vaginal vault. In our experience, it seems that coexistent cystocele and rectocele should be corrected in the connection with sacral colpopexy.

Abdomen↗
PubMed1993

Di- and tetracarboxylate derivatives of pyridines, bipyridines and terpyridines as luminogenic reagents for time-resolved fluorometric determination of terbium and dysprosium.

A group of compounds composed of pyridine, 2,2'-bipyridine and 2,2':6',2''-terpyridine as the energy absorbing, triplet sensitizing moieties and two or four carboxylic acids as the chelating groups were synthesized and their ability to enhance terbium ion luminescence was elucidated. The dicarboxylic acid derivatives form highly luminescent Tb3+ chelates with luminescence quantum yields approaching 50%. Additional groups, such as methoxy groups or additional pyridine rings in the aromatic structure can be utilized to shift the excitation maxima towards longer wavelengths in order to produce more practicable excitation for practical use. The ligands giving the highest Tb3+ emissions were further evaluated in a two-step fluorescence enhancement system constructed for specific binding assays based on the simultaneous use of three or four ions as the labels (Eu3+, Tb3+, Sm3+ and Dy3+). In the two-step procedure, the first step comprises dissociative fluorescence enhancement based on an acidic solution of an aromatic beta-diketone used as the luminogenic ligand, whereafter Eu3+ and Sm3+ are quantitated. In the second step, the lanthanide ions form new chelates with the added ligands. These ligands are able to transfer the excitation energy they have absorbed with high efficiency to the chelated ions and produce high ion luminescence for Tb3+ and Dy3+.

2,2'-Dipyridyl↗
PubMed1993

Urinary dysfunction in Lyme disease.

Lyme disease, which is caused by the spirochete Borrelia burgdorferi, is associated with a variety of neurological sequelae. We describe 7 patients with neuro-borreliosis who also had lower urinary tract dysfunction. Urodynamic evaluation revealed detrusor hyperreflexia in 5 patients and detrusor areflexia in 2. Detrusor external sphincter dyssynergia was not noted on electromyography in any patient. We observed that the urinary tract may be involved in 2 respects in the course of Lyme disease: 1) voiding dysfunction may be part of neuro-borreliosis and 2) the spirochete may directly invade the urinary tract. In 1 patient bladder infection by the Lyme spirochete was documented on biopsy. Neurological and urological symptoms in all patients were slow to resolve and convalescence was protracted. Relapses of active Lyme disease and residual neurological deficits were common. Urologists practicing in areas endemic for Lyme disease need to be aware of B. burgdorferi infection in the differential diagnosis of neurogenic bladder dysfunction. Conservative bladder management including clean intermittent catheterization guided by urodynamic evaluation is recommended.

Adult↗
PubMed1993

Effects of abdominal hysterectomy on urinary and sexual symptoms.

A prospective study of 102 women undergoing abdominal hysterectomy for benign conditions was performed in order to evaluate pre- and post-operative urinary and sexual symptoms. The mean age of the patients was 44.9 years (range 30-65). Urinary disorders such as urgency, dysuria, frequency, nocturia, slow bladder emptying, sensation of residual urine as well as stress and urge incontinence were observed pre-operatively and 2, 6 and 12 months post-operatively. Dyspareunia, libido and the number of orgasms were evaluated as disorders affecting sexual life. At follow-up 12 months post-operatively a statistically significant decrease in stress incontinence, frequency and nocturia was observed. Dyspareunia was also significantly less frequent and increased libido was experienced. It was concluded that abdominal hysterectomy does not provoke adverse urinary or sexual symptoms and that it can have beneficial effects.

Adult↗
PubMed1993

Modified Burch colposuspension for stress urinary incontinence in females.

Modified Burch colposuspension was performed upon 186 women having clinically and urodynamically verified stress urinary incontinence (SUI). After two years, 91 percent of the patients were cured or markedly improved. The success rate was as much as 95 percent among the patients who underwent Burch colposuspension as a first operative treatment for incontinence. In the patients with recurrent SUI, the cure rate was 82 percent. Failures appeared mostly during the first six months. There were no significant differences in cure rates between the patients who underwent concomitant hysterectomy and those who did not. The comparison of two different suture materials, Dexon (polyglycolic acid) and Maxon (polyglyconate monofilament absorbable) did not produce any significant differences. Temporary urinary retention was the most common postoperative complaint. During the six to 12 postoperative months, 19 percent of the patients experienced urgency and 9 percent had mild voiding difficulties. After one year, 12 percent of the patients had rectocele or enterocele, or both, which were surgically corrected. We conclude that modified Burch colposuspension is a safe and effective primary surgical method for the treatment of stress urinary incontinence in women.

Adult↗
PubMed1992

Technique of external sphincter balloon dilatation.

We report on our technique and early experience with balloon dilatation of the external sphincter in 7 spinal cord-injured men with detrusor external sphincter dyssynergia and elevated voiding pressure. Following dilatation, bladder emptying into condom catheters was achieved in all patients without dribbling incontinence.

Adult↗
PubMed1991

Disappointing effect of endoscopic Teflon injection for female stress incontinence.

Twenty-two women were treated with endoscopic, transurethral, submucosal Teflon injection for moderate or severe urinary stress incontinence. The short-term effect was rather good, but he long-term results were disappointing. After 5 years, only 4 patients were completely or sufficiently continent and had not required any additional treatment for incontinence. Three major complications, paraurethral abscess, urethral diverticulum and Teflon granuloma with urethral wall prolapse occurred. Subsequent suprapubic urethropexy for the patients with inadequate response did not produce the usual good results.

Aged↗
PubMed1990

Perforation of the uterus following IUD insertion in the puerperium.

Perforation of the uterus by an IUD is very rare. However, during the puerperium when the uterus is small and the uterine wall is thin the risk of perforation increases. We present three patients treated within a rather short period of time at our institution for perforation of the uterus caused by IUD insertion 3-4 months after delivery. Although perforation is by no means always associated with pain, our patients did present with abdominal pain caused by this rare IUD-associated complication. One patient underwent laparotomy, and in two, laparoscopy sufficed to treat this complication.

Abdominal Pain↗
PubMed1990

Extradural administration of bupivacaine: pharmacokinetics and metabolism in pregnant and non-pregnant women.

We found a similar time (about 0.4 h) to maximum serum concentration after extradural administration of bupivacaine 1.78 (SD 0.27) mg kg-1 to six pregnant patients at term, 1.58 (0.13) mg kg-1 to six women younger than 65 yr and 1.50 mg kg-1 to six women older than 65 yr. There were no significant differences in terminal half-life. No unconjugated 4'-hydroxy-bupivacaine was detected in the serum and urine of pregnant patients, in contrast with the other groups. The pregnant patients had significantly greater serum concentrations of the N-dealkylated metabolite, N-desbutyl-bupivacaine (DBB), than the non-pregnant groups. In contrast with 4'-hydroxy-bupivacaine, no conjugated forms of bupivacaine and desbutyl-bupivacaine were detected in urine. The mean total urinary excretion of bupivacaine and its metabolites and their conjugates varied between 2.46 and 3.22% of the total dose administered in the three patient groups, indicating that both 4'-hydroxylation and N-dealkylation are minor metabolic pathways in man.

Adult↗
PubMed1989

Bladder perforation: uncommon complication with a misplaced IUD.

We report a unique case of uterine and bladder perforation by a copper intrauterine device (Nova-T). The patient presented with recurrent cystitis, which led to cystoscopy, where the horizontal arm of the IUD was seen intravesically. The IUD was removed vaginally by pulling the locator strings. The patient recovered without complications. The case shows that the new, second-generation IUDs may also cause bladder perforation.

Adult↗
PubMed1989

Influence of cellular DNA content on survival in ovarian carcinoma.

Flow cytometric analysis of nuclear DNA content was performed on paraffin-embedded tissue from 153 ovarian epithelial carcinomas. The DNA ploidy, DNA index, and S phase fraction were determined without knowing the final outcome of the patients. Fifty-one (38%) of the 134 classifiable histograms were considered to be diploid, 70 (52%) aneuploid, and 13 (10%) multiploid. The DNA index was a better prognostic factor for survival than DNA ploidy; 48% of the patients with a small DNA index (less than 1.3) survived for 5 years after the diagnosis, in contrast to 14% of the patients with a large DNA index (greater than 1.3) (P less than .0001). Carcinomas with a small S phase fraction (less than 11%) were associated with favorable survival (P = .0002). In multivariate analysis, the size of the residual tumor at surgery (P less than .001), the DNA index (P = .001), and the S phase fraction (P = .05) were the only significant independent prognostic factors. The results indicate that flow cytometric nuclear DNA content analysis provides important additional information for the estimation of survival in ovarian carcinoma.

Adult↗
PubMed1989

Cough urethrocystography: the best radiological evaluation of female stress urinary incontinence?

Urethrocystography and simultaneous urethrocystometry were performed on 40 women with primary urinary incontinence. The posterior urethrovesical angle, inclination angle, urethropelvic angle, and an orifice descent angle, not earlier described, were measured on radiographs obtained at rest, during coughing and during straining. The orifice descent angle was used to describe the descent of the internal urethral orifice in the cough radiographs, and was the only measurement that provided a significant correlation with urethrocystometry. The other angles measured, and radiographs obtained at rest or during straining were not useful in the evaluation of female stress urinary incontinence. The authors conclude that the best imaging method for the evaluation of female stress urinary incontinence is urethrocystography employing a single lateral view taken during coughing, with measurement of the orifice descent angle.

Cough↗