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Biomedical subjects

S Laitinen

Publications and source records attributed to S Laitinen.

At least 55 records · Page 3Linked to original sources
PubMed1992

Early results of follow-up after radical resection for colorectal cancer. Preliminary results of a prospective randomized trial.

One-hundred and six consecutive patients were included in a prospective study of intensive monitoring after radical resection for colorectal cancer, 54 being randomized into a conventional follow-up group (Group I) and 52 into an intensified follow-up group (Group II). After a median follow-up of 2 years the overall rate of detection recurrence in Group I was 24% (13/54) and in Group II 25% (13/52). The recurrence rates among those followed up for at least 2 years were 36% (10/28) and 30% (9/30), respectively. Of the recurrences in Group I, one was local, five regional and six distant, and the corresponding figures in Group II were three, four and five. One radical extirpation of a local perineal recurrence has been performed in Group I, whereas two intestinal reresections for local anastomotic recurrences and two hepatic resections for solitary hepatic metastases have been performed in Group II. Mortality to date is 13% (7/54) in Group I and 8% (4/52) in Group II. Two adenomatous polyps have been removed from the colon in Group I during endoscopic surveillance and seven in Group II. These preliminary results encourage us to continue the trial up to 5 years after primary surgery.

Adult↗
PubMed1992

Dietary intake of 70- to 89-year-old men in eastern and western Finland.

A detailed dietary history interview of 70- to 89-year-old men, 98 from eastern and 129 from western Finland, was obtained as part of a 30-year follow-up survey within the Seven Countries Study. The average energy intake was similar in level, about 2700 kcal, in both areas. The percentage of total energy intake from fat was 39.1% in the west, and 36.5% in the east. The P/S ratio was about the same, 0.27 and 0.29, in eastern and western areas, respectively. The intake of most micronutrients was similar in the two cohorts. Only the intake of vitamins A and C and phosphorus, manganese, copper and zinc was higher in eastern Finland than in western Finland. The nutritional density of the diet of the eastern cohort was slightly higher than that of the western one due to their higher consumption of rye products, vegetables and berries, and also sour milk and fish and fish products. The diet met the general recommendations and was comparable to that of younger age groups.

Aged↗
PubMed1992

A follow-up study of the diet of Finnish diabetic adolescents.

Changes with age and time in energy-adjusted food consumption and nutrient intake of 74 diabetic subjects initially aged 12-17 years were studied. Food consumption was measured by the 48-h recall method. During the three-year follow-up (from 1985 to 1988), the proportion of carbohydrate of total energy intake decreased from 49% to 47%, that of fat increased from 33% to 36% and that of protein decreased slightly. The densities of fibre and several vitamins decreased in the diet of the diabetic adolescents. These unfavourable changes in the diet of diabetic adolescents took place with increasing age and duration of diabetes, while virtually no changes with time were detected.

Adolescent↗
PubMed1992

Relationship between bacterial counts and endotoxin concentrations in the air of wastewater treatment plants.

The relationship between bacterial counts and endotoxin concentrations in air samples was studied. Selective EMB medium favored the growth of a larger portion of airborne gram-negative bacteria than LES Endo or MacConkey medium and was a good predictor of the endotoxin levels determined with a chromogenic Limulus assay of the air of wastewater treatment plants. The bacterial counts determined with nonselective media correlated poorly with airborne endotoxin levels; however, R2A medium yielded higher viable bacterial counts than TYG medium. Direct counting by epifluorescence microscopy yielded the highest bacterial counts, but no correlation was obtained between total bacterial counts and endotoxin concentrations.

Air Microbiology↗
PubMed1992

Complications of peptic ulcer disease before and after the introduction of H2-receptor antagonists.

This study was undertaken in order to evaluate the incidence of operations for bleeding, perforated and obstructing peptic ulcers in a defined population before and after the introduction of H2-receptor antagonists. The annual incidence of surgery for all peptic ulcer complications increased slightly, from 6.9 per 10(5) individuals in 1977 to 14.2 per 10(5) in 1989 (n.s.), whereas the annual incidence of operations for ulcer bleeding and perforation remained relatively stable, varying from 2.8 to 8.9 per 10(5) inhabitants and from 2.3 to 7.5 per 10(5) inhabitants during the study period. Operations performed for gastric outlet obstruction did not increase, varying from 0.8 to 2.2 per 10(5) individuals over the study period. The annual proportion of emergency operations did not increase. Young men and old women were often operated on for bleeding (p less than 0.0001) and perforated ulcers (p less than 0.01). Duodenal ulcer bleeding and perforation were more frequent in the young patient groups. Overall mortality after operations performed for bleeding was 15%, and that after operations for perforation or obstruction, 17% and 8%, respectively. The mean age of the fatalities, 63 +/- 13 years, was significantly higher than that of those who survived after operation, 53 +/- 15 years (p 0.0001). Mortality was higher after operations for gastric ulcer complications (22%) than after operations for duodenal ulcer complications (10%) (p less than 0.01).

Aged↗
PubMed1991

Effect of biliary tract procedures on duodenogastric reflux and the gastric mucosa.

The effect of alterations in the biliary tract on the gastric milieu was evaluated in gallstone disease and after cholecystectomy or biliary fenestration and compared with a control group. Endoscopic bile reflux was often found in gallstone patients (67%) and almost always after cholecystectomy (89%). Gastric bile acid concentrations were greater in the gallstone patients than in the control patients, were higher still after cholecystectomy, and were highest after biliary fenestration. The pH of the gastric fluid was more alkaline in the cholecystectomized groups. Lysolecithin concentrations were generally low and did not differ between the groups, nor was there any difference in scintigraphic reflux between the groups. Endoscopic erythematous gastritis correlated with the grade of bile reflux and was a common finding after biliary tract procedures. There were no consistent histologic findings associated with duodenogastric reflux. Helicobacter pylori colonization rates were similar in the various patient groups and were not affected by the reflux grade.

Aged↗
PubMed1991

Endoscopy for the diagnosis of acute upper gastrointestinal bleeding.

Diagnostic gastroscopy was performed on 337 patients for acute upper gastrointestinal bleeding, with 88% (296 of 337) diagnostic accuracy. Peptic ulcer disease was the cause of bleeding in 43% of the cases, erosive gastritis in 16%, and oesophagitis in 11%. Of the 289 patients, 40% had associated lesions, the commonest being gastritis (31), hiatal hernia (24), oesophageal varices (16), and oesophagitis (16). An oesophageal site of the bleeding was most often detected in the patients under 50 years of age (p less than 0.001) and a gastric site among those over 70 years (p less than 0.05). Mallory-Weiss lesions were significantly more often the cause of bleeding among the youngest patients than in other age groups (p less than 0.001). The bleeding lesion was located in the stomach in 60% of the women and in 42% of the men (p less than 0.01) and in the duodenum in 13% and 28% (p less than 0.01), respectively. The principal causes of this difference was the high incidence of gastritis in the women and duodenal ulcer in the men.

Acute Disease↗
PubMed1991

Composition of the diet of young Finns in 1986.

The aim was to describe the energy intake and composition of the diet of 1200 9-, 12-, 15-, 18-, 21- and 24-year-old Finns in 1986 and changes in their diet from 1980 to 1986. Data on food consumption were collected using the 48 h recall method. In 1980 protein accounted for 14%, fat for 38% and carbohydrates for 48% of total energy intake, and in 1986 for 15%, 38% and 47%, respectively. The mean P/S ratio increased from 0.24 to 0.31 while the regional differences in the intakes of fatty acids remained unchanged, the P/S ratio being higher in urban than in rural areas and higher in western than in eastern Finland. In 1986 the diet of 15-, 18- and 24-year-old males contained more fat, saturated fatty acids and monounsaturated fatty acids but less sucrose than that of females. The difference in the diet between young men and women, if continued, might increase the male/female ratio at risk for coronary heart disease, which is already pronounced in Finland.

Adolescent↗
PubMed1991

Surgical management of intestinal obstruction after treatment for cancer. Case reports.

Eighty-five consecutive patients operated on for malignant intestinal obstruction after earlier treatment of cancer were studied retrospectively. The overall postoperative mortality was 22% (19/85) and morbidity 42% (36/85). Intra-abdominal sepsis (N = 5) and intestinal fistula (N = 3) were the most common complications, and seven deaths were attributed primarily to the underlying malignant disease. Emergency procedures (p less than 0.003) and age greater than 70 years (p less than 0.025) were significantly associated with fatal outcome. Just over half of the patients were relieved of their symptoms. The median survival was 8 months for the 25 patients who underwent resection and 2 months for the 60 patients for whom no resection was made. The cumulative 5-year survival was significantly better for patients who underwent resection than for those who did not (p less than 0.01) and in patients with regional cancers compared with those with distant growths (p less than 0.001). We conclude that operative treatment for malignant intestinal obstruction is indicated if widespread carcinomatosis and extensive tumour growth are excluded and that this surgery should be done urgently while there is still time to resuscitate the patient.

Abdominal Neoplasms↗
PubMed1991

A comparison of transthoracic and transhiatal resection for thoracic oesophageal cancer. Observations of 30 years.

The transthoracic and transhiatal resection techniques are compared using the 30-year experience of Oulu University Central Hospital. During the period 1960-1982 we favoured resections trough a transthoracic route, while during the period 1983-1989 a transhiatal route was preferred. This change, and the more enthusiastic attitude adopted towards resection, has lead to an increase in resectability from 23% (46/203) to 62% (43/69) (P less than 0.0001). The difference between radical resections, 50% (23/46) and 37% (16/43) has remained non-significant. Morbidity was higher after transthoracic than transhiatal resections, 57% (26/46) versus 42% (18/43), whereas mortality was nearly the same, 11% (5/46) and 9% (4/43). Postoperative pulmonary complications occurred in 28% (13/46) after transthoracic resection and in 14% (6/43) after transhiatal resection. No significant difference was detected in the development of late anastomotic strictures, 33% (15/46) and 30% (13/43), respectively. We conclude that transhiatal resection is as safe as transthoracic resection and seems to allow more resections to be carried out without any increase in mortality or morbidity, but long-term survival remains poor.

Adenocarcinoma↗
PubMed1990

Palliative operations for colorectal cancer.

A review of 96 consecutive patients who underwent palliative surgery for primary colorectal cancer was undertaken to clarify the value of palliation achieved with surgical treatment. The overall rate of postoperative mortality was 8 percent (8 of 96) and the overall rate of postoperative morbidity was 24 percent (23 of 96). The mortality rate was 5 percent (3 of 66) after resective surgery and 17 percent (5 of 30) after nonresective surgery. Three deaths were related to the malignant disease, three were related to the intra-abdominal infection, and two were related to formation of intestinocutaneous fistulas. Of the 8 patients who died, 1 had a tumor with local visceral involvement only and 7 had a tumor with more distant spread. Median survival was 10 months for all patients, 15 months for patients treated with resective surgery, and 7 months for nonresected patients. Five patients (5 percent) have survived for longer than 5 years. The median relief of preoperative cancer symptoms was 4 months (4 months after resective surgery and 1 month after nonresective surgery). Twenty-five patients have undergone second surgery. It is concluded that palliative resective surgery for colorectal cancer can improve patient comfort with an acceptable postoperative mortality rate when cancer growth is localized and in favorable cases with more distant spread, whereas nonresective surgery fails to achieve symptom relief.

Adult↗
PubMed1989

Surgical treatment of recurrent colorectal cancer. Five-year follow-up.

Analysis of 81 consecutive patients with recurrent colorectal cancer was undertaken to evaluate the rationale and efficacy of surgical re-treatment. The disease-free interval after primary surgery and the diagnostic delay did not clearly differ between the modes of recurrences. Symptoms preceded the diagnosis of recurrence in 73% (59) of the cases, with pain being the most frequent symptom (n = 22). Of the patients, 58% (47) underwent reoperations, 38% (31) underwent reresections, and 10% (8) underwent radical resections. The overall postoperative mortality was 13%, and the postoperative morbidity was 45%. The postoperative relief of cancer symptoms after resective surgery was 8 months and, after nonresective surgery, 2 months. The median survival was 24 months for patients who underwent resections, 8 months for patients who were treated by nonresective surgery, and 15 months for patients who were treated conservatively. Radical resection clearly prolonged survival when compared with palliative resections and nonresective procedures. On the basis of these results, it was concluded that resective surgery, when possible, can improve survival and patient comfort after recurrence of colorectal cancer.

Aged↗
PubMed1987

Sucralfate versus placebo in treatment of non-ulcer dyspepsia.

One hundred fifty-one patients with non-ulcer dyspepsia, defined as chronic epigastric pain without concomitant symptoms of the irritable bowel syndrome and with no evidence of any organic disease other than macroscopic or microscopic gastritis/duodenitis seen at endoscopy on entry into the trial, were randomly assigned to treatment for four weeks with sucralfate or a placebo, 1 g three times a day one-half hour before meals, according to a double-blind model. Seventy-nine patients received sucralfate and 72 patients received a placebo. According to patients' subjective assessment of their symptoms at four weeks, 61 patients (77 percent) in the sucralfate group and 40 patients (56 percent) in the placebo group had become symptom-free or showed improvement, whereas the condition of 18 (23 percent) in the former group compared with 32 (44 percent) in the latter group remained unchanged or deteriorated. The difference between the groups was significant (p less than 0.01). The best response to sucralfate treatment (84 percent or more symptom-free or improved) was achieved in patients with mild or moderate symptoms and without macroscopic or microscopic inflammation of their gastric mucosa--a typical patient with non-ulcer dyspepsia. Our results indicate that sucralfate is significantly more effective than placebo in the treatment of non-ulcer dyspepsia.

Adult↗
PubMed1987

Prostacyclin and thromboxane in acute hemorrhagic pancreatitis in dogs.

To study the role of the vasodilatory, antiaggregatory prostacyclin (PGI2) and its endogenous antagonist thromboxane A2 (TxA2) in acute pancreatitis, we measured serum thromboxane B2 (TxB2, which indicates platelet TxA2 production) and plasma 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha, which indicates systemic PGI2 production) from sequential blood samples in trypsin and taurocholate induced acute canine hemorrhagic pancreatitis (AHP). In addition the effect of a prostaglandin synthesis inhibitor, ibuprofen, was studied and systemic (MAP) and pulmonary artery pressure (MPAP) were recorded for 4.5 hr. The animals were divided into a sham-operated group, an AHP group, an ibuprofen prophylaxis group, and an ibuprofen therapy group. In the sham group the parameters remained stable throughout the experiment. In the AHP group MAP decreased steadily and 6-keto-PGF1 alpha rose significantly from 80.0 +/- 7.8 to 956.0 +/- 287.0 pg/ml (P less than 0.001), whereas serum TxB2 and MPAP remained unchanged. Ibuprofen prophylaxis eliminated the initial fall in MAP and the rise of 6-keto-PGF1 alpha. Ibuprofen therapy normalized the initially decreased MAP and depressed the level of 6-keto-PGF1 alpha. We conclude that PGI2 may at least partly mediate the initial hypotension in canine AHP, whereas platelet TxA2 production obviously has a negligible role in the development of hemodynamic changes in AHP.

6-Ketoprostaglandin F1 alpha↗
PubMed1987

Staplers in palliative bypass surgery for unresectable pancreatic cancer.

To assess the role of stapling devices and routine gastroenterostomy in palliative bypass surgery, the hospital records of 150 consecutive patients with unresectable, histologically proven pancreatic adenocarcinoma requiring palliative bypass procedure were reviewed. During recent years staplers have gained increasing acceptance for construction of palliative anastomoses. Mortality and morbidity were lower after stapled anastomoses. The use of staplers for construction of double bypass reduced the operation time by 45 min (p less than 0.001). After initial biliary diversion 6% of the patients required later reoperation for gastric outlet obstruction. Routine gastroenterostomy made reoperation unnecessary. Delayed gastric emptying occurred, however, in 10% and significant upper gastrointestinal bleeding in 7% of the patients after prophylactic gastroenterostomy. We conclude that stapling devices are safe and practical in palliative bypass surgery and they significantly reduce operation time if more than one bypass is required. The relatively high incidence of delayed gastric emptying, and significant upper gastrointestinal bleeding after prophylactic gastroenterostomy and the infrequent occurrence of gastric outlet obstruction after initial biliary bypass together with the low mortality after reoperation, suggest that gastroenterostomy should be performed on a selective basis only.

Adenocarcinoma↗
PubMed1987

Adsorption of bile acids by sucralfate, antacids, and cholestyramine in vitro.

Sucralfate, one of the newer drugs shown to be effective in the treatment of peptic ulcer and esophagitis; cholestyramine, a known bile acid binder; and commercial antacid preparations of pure aluminum hydroxide, pure magnesium hydroxide, and a combination of aluminum hydroxide, magnesium hydroxide, and magnesium carbonate were tested in vitro for bile acid-binding capacity. Cholestyramine was found to be the most effective bile acid binder, with more than 90% of bile acids adsorbed at all of the pH values studied. Sucralfate proved efficacious at pH 4, 6, and 8, adsorbing about 50% of the bile acids, but its binding capacity decreased at pH 2. Pure aluminum hydroxide was the most effective of the various antacid preparations; it adsorbed about 90% of bile acids at pH 2, although this percentage was significantly reduced at pH 6 and 8. Sucralfate was significantly more effective as a bile acid absorbent at pH 4 than either the magnesium hydroxide or aluminum-magnesium hydroxide plus magnesium carbonate antacids, as effective as the aluminum hydroxide antacid, and significantly less effective than cholestyramine.

Adsorption↗
PubMed1986

Thyrotropin-releasing hormone in acute pancreatitis. A preliminary report.

The effect of thyrotropin-releasing hormone (TRH) in continuous infusion (a bolus of 400 micrograms followed by 200 micrograms/hour for 6 hours) was studied in 35 patients (17 TRH, 18 placebo) with acute pancreatitis in a double-blind investigation. Three hours after the start of infusion, significantly more patients were pain-free in the TRH group than in the placebo group, but not thereafter. TRH also significantly reduced the serum amylase and lipase levels, but did not influence the clinical course of pancreatitis.

Acute Disease↗