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Biomedical subjects

S Rannikko

Publications and source records attributed to S Rannikko.

At least 73 records · Page 4Linked to original sources
PubMed1988

Enoxacin distribution in human tissues after multiple oral administration.

Enoxacin was administered to six patients undergoing nephrectomy; 200 mg was given orally twice a day for three days preoperatively. The last dose was given on the morning of the day of operation. Samples of blood, skin, subcutaneous fat, muscle, rib bone, and renal cortex and medulla were taken during the procedure. Urine was collected 24 h preoperatively. The concentrations of enoxacin in the different tissues were measured by an agar-well diffusion method. The mean (24 h) urinary excretion of enoxacin was 62.7% of the daily dose. The concentrations in renal cortex and medulla and muscles exceeded those in serum; the mean tissue/serum concentration ratios were 3.8, 3.2 and 1.4, respectively. The ratios for skin and fat were 0.8 and 0.2, respectively. Only four bone samples were obtained and two of them had no detectable levels. The results indicate that enoxacin may be effective for treatment of skin and soft tissue infections and infections in the upper and lower urinary tract.

Adipose Tissue↗
PubMed1988

The value of acid phosphatase measurements in predicting extraprostatic cancer growth before radical prostatectomy.

Acid phosphatase levels were determined using both an enzymatic method (32 cases) and radioimmunoassay (35 cases) in 35 patients with clinically localised prostatic cancer. All patients underwent total prostatectomy and pelvic lymphadenectomy. In cases of intracapsular prostatic cancer the level of prostatic acid phosphatase (PAP) measured by radioimmunoassay was 1.4 +/- 0.8 micrograms/l. In patients with either local extraprostatic disease or pelvic lymph node metastases the mean level of PAP was 3.5 +/- 2.8 micrograms/l. The difference was statistically significant. The specificity, sensitivity and accuracy of an elevated PAP (greater than 3.0 micrograms/l) in revealing extraprostatic extension of clinically localised prostatic cancer were 100, 37 and 66% respectively. When the enzymatic method was used, the level of acid phosphatase was elevated (greater than 13 u/l) in only 1 case. The specificity, sensitivity and accuracy of the enzymatic method were 100, 6 and 47% respectively. Elevation of PAP predicts, with a high degree of probability, either local extension outside the prostate or lymph node metastases. A normal PAP does not exclude extraprostatic extension of prostatic cancer.

Acid Phosphatase↗
PubMed1988

Aminoglutethimide for advanced prostatic cancer resistant to conventional hormonal therapy.

Aminoglutethimide (AG) and hydrocortisone (HC) were given to 20 patients with advanced prostatic cancer resistant to conventional hormonal therapy. Most patients had painful bone metastases and were heavily pretreated. 12 of 16 patients required narcotic analgetics. 8 of 20 were bedridden. AG + HC produced relief of bone pain in 12 patients (75%) and only 4 required narcotics after treatment. The performance status improved in 8 of 20 patients (40%). However, the number of bone metastases seen in bone scans decreased in only 4 patients (22%). The level of serum alkaline phosphatase decreased in 11 of 18 patients and that of acid phosphatase in 8 of 16 patients. The reduction of bone pain lasted approximately 4 months (range 1-15 months). The median lifespan between the start of AG treatment and death was 8 months (range 2-22 months). There was no difference in survival between responders and nonresponders. 3 patients had skin rash, 1 lethargy and 1 thrombocytopenia.

Aged↗
PubMed1988

Comparison of endocrine and radiation therapy in locally advanced prostatic cancer.

151 patients with locally advanced prostatic cancer (T3-4 M0), representing 38% of the 404 cancer patients in a Finnish multicenter study, were randomly assigned to one of three treatment arms: orchiectomy, estrogens or radiotherapy. During the 4-year follow-up period there were no significant differences in the progression rates (appearance of metastases in bone scan) between the therapy groups. The frequency of thromboembolic and other cardiovascular complications was highest in the estrogen group (13/50 patients). In the radiotherapy group, 19 of 45 patients had bowel or bladder complications. On the other hand, orchiectomy has few, if any, complications. The high risk of complications associated with estrogens and radiotherapy has to be taken into consideration in the selection of treatment.

Adenocarcinoma↗
PubMed1988

Serum bioactive and immunoreactive follicle-stimulating hormone in prostatic cancer patients during gonadotropin-releasing hormone agonist treatment and after orchidectomy.

Serum bioactive and immunoreactive FSH levels were measured in five prostatic cancer patients during treatment for 6 months with the GnRH agonist analog buserelin (Hoechst; 600 micrograms, intranasally, 3 times per day) and for up to 12 weeks after subsequent orchidectomy. FSH bioactivity was measured using a sensitive specific in vitro granulosa cells aromatase bioassay. Before buserelin treatment, mean serum FSH bioactivity and immunoreactivity were 19.7 +/- 4.1 (+/- SE) IU/L (n = 5) and 13.7 +/- 3.8 IU/L, respectively, with a bioactivity to immunoactivity (B/I) ratio of 1.7 +/- 0.2. After the initiation of treatment with the GnRH agonist, FSH bio- and immunoactivities both transiently increased for 1-3 days. The increase in bioactivity was greater and prolonged, and the B/I ratio increased nearly 7-fold in 2 weeks. Serum FSH immunoreactivity declined to below the pretreatment level in 5 days and remained low for the rest of the treatment period. In contrast, serum FSH bioactivity did not decrease significantly below the pretreatment level during the 6-month treatment period, although the B/I ratio returned slowly toward the pretreatment value. After orchidectomy, both FSH activities increased dramatically, and the B/I ratio rose transiently from 1.5 to 7 in 2 weeks. Interestingly, serum FSH bioactivity and immunoreactivity decreased significantly (P less than 0.05) 1 day after orchidectomy in the buserelin-treated patients. In contrast, serum FSH immunoreactivity increased during the same period (P less than 0.05) in patients treated only by orchidectomy (FSH bioactivity was not measured). In conclusion, serum FSH bioactivity increases acutely more than FSH immunoreactivity after initiation of GnRH agonist treatment or orchidectomy. In the former case, serum FSH bioactivity subsequently returned to the pretreatment range. A clear decline during long term agonist treatment occurred only in serum FSH immunoreactivity, in contrast to the concomitant decline in serum LH bio- and immunoreactivities reported previously. The persistence of bioactive FSH may explain the inconsistent effects of GnRH agonist treatment on the suppression of spermatogenesis. The acute decrease in serum FSH after orchidectomy in the buserelin-treated men suggests that the testes may produce a factor that stimulates pituitary FSH secretion.

Adult↗
PubMed1988

Histological and functional changes of the testis tissue during GnRH agonist treatment of prostatic cancer.

The purpose of this study was to examine long-term effects of GnRH agonists on human testicular histology and endocrine function. Patients with advanced prostate cancer (n = 7) were treated with the potent GnRH agonist analogue buserelin (Bu, Hoechst), 600 micrograms X 3/day intranasally. After 6 months, the patients were orchiectomized, and the testis tissue was used for histological studies and measurements of endocrine function in vitro. Fourteen other patients with matching ages and extent of the disease were castrated as the first form of therapy, and their testis tissue was used as controls (C). Severe atrophy of seminiferous tubules was seen in light microscopy in the testes of the Bu treated patients. Many tubules showed only Sertoli cells, and the seminiferous epithelium was frequently absent. In contrast, no clear changes were seen in the number of Leydig cells. Testicular content of testosterone (T) decreased greater than 95% by Bu treatment: C = 1.5 +/- 0.2 nmol/g wet wt (x +/- SE); Bu = 0.070 +/- 0.019 nmol/g. Likewise, a drop of 80% occurred in testicular high affinity receptors for FSH: C = 0.37 +/- 0.019 pmol/g; Bu = 0.067 +/- 0.009 pmol/g. In contrast, the number of LH receptors was unaffected by the treatment, C = 0.18 +/- 0.033; Bu = 0.18 +/- 0.032 pmol/g. When testis slices were incubated in the presence of maximally stimulating concentration of hCG (100 ng/ml), both groups of tissue responded similarly with a 50% increase in T production, albeit the absolute production rate was reduced by 95% in the Bu group. When several steroid precursors of T were analyzed in the incubation media, it appeared that decreased androgen synthesis was most clearly due to decreased 3 beta-hydroxysteroid dehydrogenase activity. It is concluded that long-term treatment with GnRH agonists in prostatic cancer patients brings about dramatic damage of seminiferous tubular function and reduces testicular androgen producing capacity, but has no effect on testicular capability of responding immediately to LH stimulation.

Aged↗
PubMed1988

Orchiectomy, estrogen therapy and radiotherapy in locally advanced (T3-4 M0) prostatic cancer.

In this randomized trial 151 patients with locally advanced prostatic carcinoma (T3-4 M0) were treated with orchiectomy, estrogens or radiotherapy. In comparison of these therapy modalities attention was paid to the progression free survival and to the complications associated with these therapies. There was no significant difference in the progression free survival during the four-year follow-up period. The frequency of cardiovascular complications was highest in the estrogen group, where 13 of 50 patients had 19 complications. In the radiotherapy group 19 of 45 patients had bowel or bladder complications.

Adenocarcinoma↗
PubMed1988

Pretreatment hormone levels in prostatic cancer.

Pretreatment plasma concentrations of total testosterone, prolactin, and total estradiol-17 beta (E2) were measured in 123 prostatic cancer patients who were categorized into groups according to the UICC classification. Patients with intracapsular tumour without metastases had significantly higher (p less than 0.05) pretreatment total estradiol levels than those with more advanced disease. The patients were treated either by orchiectomy or estrogens. The mean follow-up time was 48 months. Higher pretreatment estradiol and testosterone levels were associated with better survival. Prolactin assays seemed to be of no value in this respect.

Aged↗
PubMed1987

Echogenic structure of prostatic cancer imaged on radical prostatectomy specimens.

Twenty radical prostatectomy specimens were scanned ultrasonically in vitro using a transrectal ultrasonic probe to evaluate the ultrasonic pattern of prostatic cancer. Histological and ultrasonic findings of the same areas were compared. No ultrasonic pattern specific for intracapsular prostatic cancer was found. Most often (in 40% of cases) the areas of prostatic cancer appeared hypoechoic on the ultrasonograms. In 30% of cases the carcinoma had a hyperechoic or mixed ultrasonic pattern, and in 30% the echo structure of the prostate was fairly uniform; intracapsular cancer could not be detected ultrasonically in these latter cases. The lack of a specific ultrasonic pattern for intracapsular prostatic carcinoma reduces the value of transrectal ultrasonography in detecting early intracapsular cancers. The main value of ultrasonography in patients with prostatic cancer is in the preoperative staging of the disease and in the follow-up of patients.

Humans↗
PubMed1987

Computerized tomography and transrectal ultrasound in the assessment of local extension of prostatic cancer before radical retropubic prostatectomy.

The value of computerized tomography and transrectal ultrasound in the demonstration of local extension of prostatic cancer was evaluated in 38 patients undergoing radical retropubic prostatectomy. Transrectal ultrasound proved to be reliable for the demonstration of local extension of cancer beyond the prostatic capsule (sensitivity 86 per cent, specificity 94 per cent and accuracy 90 per cent). Invasion of the seminal vesicles was demonstrated by ultrasound, with a sensitivity of 29 per cent, specificity 100 per cent and accuracy 77 per cent. The addition of transrectal ultrasound scanning to clinical evaluation increased sensitivity in relation to detection of extraprostatic involvement from 15 to 92 per cent. When computerized tomography scanning was added to clinical examination, the sensitivity increased from 15 to only 46 per cent. Transrectal ultrasound is valuable for the preoperative evaluation of patients in whom radical prostatectomy is being considered as treatment for clinically localized prostatic cancer.

Humans↗
PubMed1987

Calculation of the estimated collective effective dose equivalent (SE) due to x-ray diagnostic examinations--estimate of the SE in Finland.

The collective effective dose equivalent caused by diagnostic x-ray examinations in Finland has been estimated. The influence of how the remaining organs are selected, as specified by the International Commission on Radiological Protection (ICRP), on the effective dose equivalent, HE, has been studied. The doses to 23 different organs, including the six primary organs and 17 relevant remaining organs, were calculated. The HE was assessed by first choosing the five most exposed remaining organs according to the ICRP, and subsequently the 12 remaining organs. Depending on the type of examination, the difference in the respective effective dose equivalents was typically 20-40%. The estimated dose equivalent per capita is 0.7 mSv.

Finland↗
PubMed1986

Correlation of pretreatment plasma levels of estradiol and sex-hormone-binding globulin-binding capacity with clinical stage and survival of patients with prostatic cancer.

Pretreatment plasma concentrations of estradiol-17 beta (E2) and the binding capacity of sex-hormone-binding globulin (SHBG) were measured in 116 patients with prostatic cancer (PC) categorized into groups according to the UICC classification. By using the SHBG and E2 values, free percentage E2 and free E2 values were calculated. The patients were randomized to orchiectomy or estrogen treatment, and the mean follow-up time was 42 months. Statistically significant higher (P less than .05) pretreatment free E2 and/or E2 values were observed in subjects in which the cancer did not exceed beyond the capsule and was more differentiated and had not metastasized. SHBG values increased significantly (P less than .05) with decreasing differentiation. It was observed in addition that survival was statistically significantly longer (P less than .05) in subjects with high pretreatment E2 values compared to those with low values when the patients were grouped into three groups according to plasma E2 concentration, ie, 125-175, 75-124, and 20-74 pmol/liter. Survival was particularly poor in the group treated by orchiectomy with the lowest E2 values and statistically significantly different (P less than .05) from that of the corresponding group treated by estrogens. However, the overall survival with the two treatments did not differ statistically significantly. Our results support the view that endogenous E2 levels play an inhibitory role in the growth, metastasizing tendency, and differentiation of the tumor and that estrogen treatment may be the treatment of choice for those with low pretreatment E2 levels; for those with medium or high levels orchiectomy seems to be as valuable as estrogen treatment.

Aged↗
PubMed1986

Regulation of testicular steroidogenesis by gonadotropin-releasing hormone agonists and antagonists.

Clinical and experimental studies are described on the effects of a gonadotropin-releasing hormone (GnRH) agonist (A) and antagonist (Ant.) on testicular endocrine function. Testicular effects of long-term gonadotropin suppression by GnRH-A were assessed during treatment of prostatic cancer patients. The testis tissue removed after 6 months of A treatment had less than 5% of the testosterone(T)-producing capacity in comparison to testis tissue removed from untreated control patients. However, the LH receptors (R) and responsiveness of T output to LH stimulation in vitro were unchanged. FSH-R decreased by 70%. Hence, despite suppression of gonadotropins and testicular androgen production during long-term GnRH-A treatment the responsiveness to exogenous gonadotropins is maintained. The testicular effects of a gonadotropin suppression induced with GnRH-Ant. and testicular GnRH-R blockade were studied in rats. Besides decreases of gonadotropins and testicular T, systemic Ant. treatment decreased testicular Prl-R, but had no effect on LH-R or FSH-R. Bromocriptine-induced hypoprolactinemia, in contrast, decreased LH-R but had no effect on Prl-R. The results indicate reciprocal regulation of LH-R and Prl-R, and that testicular steroidogenesis and LH-R are under differential regulation, the former by LH, the latter by Prl. In another study, testicular GnRH-R, and consequently the action of a putative testicular GnRH-like factor, were blocked by unilateral intratesticular infusion of Ant. (1 week, Alzet osmotic pumps). The treatment resulted in 90% occupancy of testicular GnRH-R in the Ant.-infused testes, and this was associated with decreased levels of R for LH, FSH and Prl, and of T. The results indicated that the testicular GnRH-R have a physiological function in subtle stimulation of Leydig cell functions.

Acid Phosphatase↗
PubMed1986

Comparison of long-term indwelling catheters and bed-pads in the treatment of urinary incontinence in elderly patients.

Bed-pads and long-term indwelling catheters were compared in the treatment of urinary incontinence in two groups of eight elderly bedridden women. The same silicone catheter could be left in situ on average for 2 months. A detailed description of the changes of urinary bacterial flora in patients of both experimental groups is given. At the end of the 6 months' study all of the patients in both groups had significant bacteriuria (greater than or equal to 10(8) CFU/1), Proteus species being the most common pathogen in catheterised patients. The development of multiple resistance was observed in both groups, but it was more pronounced in the catheterised group. The indwelling catheter was more economical (P less than 0.001), but carried a higher risk of infection.

Aged↗
PubMed1986

Comparison of primary orchiectomy with oestrogen therapy in advanced prostatic cancer. A 2-year follow-up report of a national, prospective prostatic cancer study.

Two hundred and seventy-seven patients with advanced prostatic cancer were treated by either orchiectomy or oestrogen. During the 2-year follow-up period, the response to treatment was considered more favourable in the oestrogen group, and this response was particularly emphasised in patients with poorly differentiated tumour and metastases at the time of diagnosis. Further evaluations included the cardiovascular side effects of oestrogen therapy.

Cardiovascular Diseases↗
PubMed1986

T0 carcinoma of the prostate: influence of tumor extent and histologic grade on prognosis of untreated patients.

Eighty-two patients with T0 carcinoma of the prostate represent 20% of the 404 prostatic cancer patients in a Finnish multicenter study. The positive correlation between the poor differentiation grade and increasing tumor volume is presented. Since most of the patients (59/82) are not receiving any treatment, it is possible to evaluate the correlation between the pathologic findings and progression tendency of T0 carcinoma. There is evidence that patients with T0 carcinoma and diffuse involvement exhibit a worse prognosis than patients with a classic solitary intracapsular nodule (stage T1 or B1). A diffuse lesion and poorly or even moderately differentiated tumor requires an individually selected, aggressive therapy.

Adenocarcinoma↗