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M Ala-Opas

Publications and source records attributed to M Ala-Opas.

At least 37 records · Page 2Linked to original sources
PubMed1999

Alpha-catenin expression has prognostic value in local and locally advanced prostate cancer.

Normally functioning cell-cell adhesion plays an important role in the maintenance of tissue architecture and cell cohesion. E-cadherin is an important adhesion molecule of epithelial cells. In many types of cancer the expression of E-cadherin is reduced leading to increased risk of disease progression. alpha-Catenin is one of the intracellular elements of the E-cadherin-catenin complex. The abnormalities in the expression of alpha-catenin seem to associate with malignant cellular features and disease progression in prostate cancer. To further analyse the significance of alpha-catenin expression, we studied 215 cases of prostate cancer by immunohistochemistry and the results were related to other known prognostic factors and patient survival during a mean follow-up period of 13 years. alpha-Catenin expression was down-regulated in 19% of the cases and 3% of the tumours were totally alpha-catenin-negative. The abnormal alpha-catenin expression and cytoplasmic signal were significantly linked with high T-category, metastatic disease, high Gleason score, perineural growth, high mitotic rate, high S phase fraction and DNA aneuploidy (P < 0.05 for all). In the survival analysis, reduced alpha-catenin expression (P = 0.06) and cytoplasmic signal (P = 0.04) were related to unfavourable patient outcome. In the multivariate analysis, including TM-classification and Gleason score, alpha-catenin expression had independent prognostic value in T1-2 M0 tumors. In the M0 tumours, abnormal alpha-catenin signal was independently associated with recurrence-free survival as well. The results indicate that down-regulation of alpha-catenin is related to several malignant cellular features, and it seems to have prognostic significance in the early phases of cancer progression. We suggest that alpha-catenin expression can provide prognostic information in early prostate cancer.

Adult↗
PubMed1999

Expression of cyclins A and D and p21(waf1/cip1) proteins in renal cell cancer and their relation to clinicopathological variables and patient survival.

We have studied 118 renal cell carcinomas to analyse the expressions of cyclins A and D1 and p21(waf1/cip1), and their relationship to clinical and histopathological parameters as well as to clinical outcome. Cyclins A and D1 and cyclin-dependent kinase inhibitor p21 (waf1/cip1) were not expressed in normal renal tissue. Staining signals of cyclin D1 and p21(waf1/cip1) were always nuclear but cyclin A was also expressed in the cytoplasm of the tumour cells. The mean (range) fractions of cyclin A, cyclin D1 and p21(waf1/cip1)-positive tumour cells were 2.2% (range 0-20%), 23.3% (range 0-90%) and 6.8% (range 0-70%) respectively. The expression of cyclin A was related to venous invasion, high nuclear grade, high mitotic rate, high Ki-67 and high PCNA expressions (P < or = 0.006 for all). The expression of cyclin D1 was linked with age over 65 years, low nuclear grade and high p53 expression (P < or = 0.05 for all). An inverse correlation was present between p21(waf1/cip1) and cyclin D1 (P = 0.011). Cyclin A predicted survival in the entire study group (P = 0.0014), in T1-4/N0-2/M0 (P = 0.0007) and in T1-2/N0/M0 tumours (P = 0.0007). Cyclin A was also a powerful predictor of disease-free survival in T1-4/N0/M0 (P = 0.0027) tumours (P = 0.0007). Cyclin D1 and p21(waf1/cip1) were not significantly related to survival or disease-free survival in any of the groups. In the entire material the independent prognostic factors were the presence of distant metastases (relative risk (RR) 5.16, P < 0.001), T category (RR 2.68, P < 0.001), Ki-67 expression (RR 1.02, P = 0.026) and cyclin A expression (RR 1.12, P = 0.001). The independent predictors in T1-4/N0/M0 tumours were T-category (RR 2.67, P = 0.001) and cyclin A (RR 1.21, P < 0.001), and in T1-2/N0/M0 tumours the only significant predictor was cyclin A (RR 1.19, P = 0.0002). In renal cell carcinoma, cyclin A is a powerful and independent prognostic factor in all clinical stages of the disease, whereas cyclin D1 and p21(waf1/cip1) have no prognostic value.

Adult↗
PubMed1999

Contact laser prostatectomy compared to TURP in prostatic hyperplasia smaller than 40 ml. Six-month follow-up with complex urodynamic assessment.

OBJECTIVE: To compare the efficacy and safety of contact laser vaporization (CLV) of the prostate and transurethral resection of the prostate (TURP). MATERIAL AND METHODS: Fifty patients with symptomatic prostatic hyperplasia with prostate volumes less than 40 ml were randomized to CLV or TURP treatment. All patients had infravesical obstruction confirmed preoperatively by pressure-flow studies. RESULTS: CLV lasted longer (51 +/- 13 min versus 34 +/- 12 min; p < 0.001), caused less bleeding (57 +/- 49 ml versus 175 +/- 133 ml; p < 0.001) and required longer bladder drainage time (4.3 +/- 6.1 versus 1.7 +/- 0.8 days; p < 0.01) than TURP. At 6-month follow-up, both treatments had improved objective urinary parameters and effectively reduced subjective symptoms. There were no significant differences between the study groups in symptoms scores (DanPSS-1), peak urinary flow rates (Qmax) and post-void residuals (PVR). Six months after treatment the detrusor pressure at peak urinary flow rate (PdetQmax) was 38.3 +/- 9.7 cm H2O in CLV patients and 31.3 +/- 9.9 cm H2O in TURP patients (NS). CLV treatment caused less retrograde ejaculation than TURP (1/16 potent CLV men versus 13/16 potent TURP men; p < 0.001). CONCLUSIONS: Contact laser prostatectomy proved to be a safe procedure which improved subjective and objective urinary parameters during 6-month follow-up as effectively as TURP in the treatment of symptomatic infravesical obstruction caused by minimal or moderate benign prostate enlargement.

Aged↗
PubMed1999

New bioabsorbable polylactide ureteral stent in the treatment of ureteral lesions: an experimental study.

OBJECTIVE: To evaluate the suitability of a new biodegradable double-helical spiral self-reinforced poly-L,D-lactide copolymer (SR-PLA 96; L/D ratio 96/4) stent as a device for ureteral stenting in respect to changes in kidney function during the biodegradation process. MATERIALS AND METHODS: Sixteen dogs were used as experimental animals and were subdivided into two groups of eight. In Group A, both ureters were cut transversally, sutured, and stented. The right ureter was stented using an SR-PLA 96 stent, whereas a double-J C-Flex stent was used on the left side. Cystotomy was performed at 6 weeks to remove the double-J stents. In Group B, the right ureter of each dog was cut and stented in similar manner using an SR-PLA 96 stent, whereas the left ureters served as untreated controls, and cystotomy was not performed. Serum creatinine and nitrogen values were measured, urine was analyzed for signs of infection, and renal function was evaluated by urography and renography examinations preoperatively and at 6, 12, and 24 weeks postoperatively, at which time points, the dogs were euthanized and the ureters dissected to find persistent SR-PLA 96 particles and macroscopic local changes. There were no urinary tract infections found during the study. RESULTS: In the SR-PLA 96-stented ureters, obstructive hydronephrosis and stricture formation were observed in two cases (11%), with distal displacement of the SR-PLA 96 stent in another case (5.5%). In two additional renal units, a temporary prolongation in the kidney washout time was observed at 6-week renogram examinations. In the C-Flex-stented ureters, temporary changes in renography studies were observed in three cases (37.5%) at 6 weeks. Kidney washout times were protracted at 6 weeks in the pigtail-stented ureters in Group A as a sign of a pressure rise in the renal pelvis secondary to the direct connection between the renal pelvis and bladder, whereas pressure remained normal in SR-PLA 96-stented ureters. In Group B, renal function remained normal after ureteral repair in SR-PLA 96-stented ureters compared with the controls. CONCLUSIONS: The double-helical apical stent design offers some advantages over a double-J design. The risk of pressure-induced kidney damage is lowered, because there is no direct connection between the bladder and renal pelvis, and the risk of upper urinary tract infections is reduced. The biodegradation of the device necessitates the removal of the stent. These preliminary results suggest that a biodegradable SR-PLA 96 stent with more effective expansion capacity can be used for stenting after a ureteral repair.

Absorbable Implants↗
PubMed1999

BTA test is superior to voided urine cytology in detecting malignant bladder tumours.

BACKGROUND AND AIMS: In a prospective study, Bard BTA (bladder tumour antigen) test was compared to voided urine cytology (VUC) in detecting primary and recurrent bladder cancer (BC). MATERIALS AND METHODS: 407 control cystoscopies, BTA test and VUC were performed on 150 patients, of which 96 (23.6%) recurrent tumours were found, and 43 patients with a new BC were noticed. RESULTS: BTA test was superior to VUC in detecting superficial Ta (23% vs. 3%, p < 0.001) and grade 1 (16% vs. 0%, p < 0.001) as well as grade 2 (35% vs. 11%, p < 0.01) tumours. In Tis and T2-T4 tumours as well as in grade 3 tumours both tests performed similarly. The sensitivity of BTA test compared to VUC in detecting recurrent tumours was higher (24 % vs. 9%, p < 0.01), but VUC had more specificity than BTA test (99% vs. 80%, p < 0.001). CONCLUSIONS: BTA test was superior to VUC in detecting BC and its recurrence. The simultaneous use of the BTA test and VUC did not add any information in detecting tumour growth in the bladder as compared to the BTA test alone.

Aged↗
PubMed1998

Expression of CD44 standard and variant-v6 proteins in transitional cell bladder tumours and their relation to prognosis during a long-term follow-up.

The expression of the standard CD44 (CD44s) and its v6 isoform (CD44v6) was analysed immunohistochemically in 173 cases of transitional cell bladder cancer. The results of immunohistochemical analyses were related to established prognostic factors and clinical follow-up data. The expression intensity of CD44s in non-basal tumour cells was significantly related to TN classification, S-phase fraction (SPF), mitotic index, grade, density of tumour infiltrating lymphocytes. The expression intensity of CD44v6 in non-basal tumour cells was inversely related to DNA ploidy, SPF, and mitotic index. The expression intensity of CD44v6 in basal tumour cells was also inversely related to T-category, grade, papillary status, DNA ploidy, SPF, and mitotic index. Strong expression of CD44s in non-basal tumour cells was related to unfavourable outcome in univariate analysis (p = 0.008), whereas the strong expression of CD44v6 in both non-basal cells (p = 0.005) and basal cells (p = 0.0008) was related to high survival probability. In multivariate survival analysis, the expression intensity of CD44v6 was independently related to favourable outcome in muscle invasive tumours, while in superficial tumours, CD44s was an independent prognostic factor. The results suggest that the expression of CD44s and CD44v6 is associated with malignant features and prognosis in bladder cancer.

Adult↗
PubMed1998

Expression of p21(waf1/cip1) protein in transitional cell bladder tumours and its prognostic value.

OBJECTIVES: p21(waf1/cip1) protein is a cyclin-dependent kinase inhibitor able to arrest the cell at the G1 phase by inhibiting DNA replication through interaction with proliferating cell nuclear antigen (PCNA). Experimental analyses of human bladder cancer cell lines show that p21 might be considered a tumour suppressor gene since it is able to induce apoptosis like p53. The prognostic value and expression of p21(waf1/cip1) is incompletely studied in bladder cancer at present. METHODS: The expression of p21 protein was immunohistochemically analysed in paraffin-embedded specimens of 186 patients with primary transitional cell bladder tumours. The results of immunohistochemical analysis were related to known prognostic factors and complete long clinical follow-up data (over 11 years). RESULTS: The expression of p21(waf1/cip1) protein was significantly related to DNA ploidy, S phase fraction, mitotic index, apoptotic index, morphometric nuclear factors, and the expression of p53 and PCNA proteins, whereas it was unrelated to grade or TNM classification. In univariate survival analysis, the expression of p21(waf1/cip1) protein was not significantly related to prognosis. Independent prognostic factors were T category, papillary status and mitotic index. CONCLUSION: The results indicate that although the expression of p21(waf1/cip1) protein is related to indicators of cell proliferation, apoptosis and p53 expression, it has no better prognostic value than already established prognostic factors in bladder cancer.

Adult↗
PubMed1997

Prognostic value of Ki-67 expression in renal cell carcinomas.

OBJECTIVE: The aim of the study was to determine the prognostic power of Ki-67 immunostaining in renal cell carcinomas (RCC). METHODS: Clinical follow-up data were reviewed in 111 RCC and the results of Ki-67 immunolabelling were correlated to standard prognostic factors and survival data of the patients. RESULTS: Ki-67 expression correlated with tumor grade (p < 0.0001) and mitotic activity (p < 0.0001). In survival analysis Ki-67 expression could be used to divide patients into different prognostic groups (p = 0.0003). In separate analysis with M0 tumors Ki-67 immunolabelling was a powerful predictor of survival (p = 0.0016) as well as disease-free survival (DFS; p = 0.0067). In T1-2N0M0 tumors Ki-67 immunolabelling was superior (p = 0.0005) to other prognostic factors in survival analysis as well as in predicting DFS (p = 0.0006). Grade-2 tumors could be separated into distinct prognostic groups according to Ki-67 labelling (p = 0.0098). In Cox's multivariate analysis Ki-67 was an independent prognostic factor in all three subgroups of RCC. CONCLUSIONS: The results show that Ki-67 expression is an independent prognostic factor in renal adenocarcinoma and could be applied in defining proper therapy for patients suffering from this malignancy.

Adult↗
PubMed1997

Value of Ki-67 immunolabelling as a prognostic factor in prostate cancer.

OBJECTIVE(S): The aim of the study was to analyze the results of Ki-67 immunostaining in prostatic adenocarcinoma and to assess its prognostic value. METHODS: Clinical follow-up data was reviewed in 190 prostatic adenocarcinomas and the results of Ki-67 immunolabelling were correlated to standard prognostic factors and survival data of the patients. All stage and grade categories were included. RESULTS: Ki-67 expression correlated significantly with histological differentiation of tumors, indicators of cell proliferation, perineural growth, density of tumor-infiltrating lymphocytes and TM classification. In survival analysis, Ki-67 expression was able to discriminate patients into different prognostic groups (p = 0.0035). In a separate analysis including T1-2M0 tumors, Ki-67 immunolabelling was a significant predictor of survival (p = 0.0258). In Cox's multivariate analysis Ki-67 was an independent prognostic factor in the entire cohort. CONCLUSIONS: The results show that Ki-67 expression is a potentially useful prognostic factor in prostatic adenocarcinoma and it could be used as an additional criterion in defining a correct prognostic category in this malignancy.

Adenocarcinoma↗
PubMed1995

Concentrations of cadmium and lead in renal cell cancer.

The incidence of renal cancer increased during the 1980's in Finland. The influence of environmental factors on carcinogenesis has been discussed in recent years. We determined the concentrations of cadmium and lead in renal tissue in 13 renal cancer patients. The mean concentration of cadmium for women was 9430 micrograms/kg (range 3437-13,962 micrograms/kg) and for male patients 14,702 micrograms/kg (range 3263-21,272 micrograms/kg). The mean concentration of lead for women was 73 micrograms/kg (range 41-105 micrograms/kg) and for male patients 96 micrograms/kg (range 34-106 micrograms/kg). Our results showed that the mean concentrations of cadmium and lead were-low in the renal cortex of renal cell cancer patients.

Adult↗
PubMed1995

A new system for descriptive classification of stones in the upper urinary tract.

A descriptive classification is proposed to stratify upper urinary tract stones by their number, size and location. The system considers the minimal but most important factors regarding the choice of surgical treatment and its success. Its principle is adaptable to more complex staging systems already existing. Practical use of the system has shown it to reflect clinical events, and its simplicity offers an opportunity for compliance in routine clinical study. It facilitates easy computerized stratification of stones in the upper urinary tract.

Humans↗
PubMed1993

Prostakath in urinary outflow obstruction.

Prostatic stents are a new method in the treatment of urinary outflow obstruction caused by benign prostatic hyperplasia. In this study the usefulness of the PROSTAKATH urospiral was evaluated in a multicenter study for treatment of urinary outflow obstruction. There were 87 males with problems related to urination. Sixty-eight patients had total retention. The mean functioning time of the spiral was nine (1-35) months. The outflow obstruction was cleared in 69 (81%) patients. During follow-up, 33 spirals (39%) were removed; 15 of them within a few days after insertion. Altogether, transurethral resection of the prostate (TURP) was done on 22 patients, and transurethral incision of the prostate (TUIP) on four patients. Chronic urinary tract infection reduced significantly (P < 0.05) the functional time of the spiral; no other factors had influence on this variable. The spiral is a good alternative for treating urinary retention in patients waiting for prostatic surgery. The spiral may also be useful in the treatment of urinary obstruction caused by prostatic cancer. Recurrent vesical neck contracture can be prevented with the spiral. Entirely bedridden and demented patients do not benefit from this form of treatment.

Aged↗
PubMed1992

Effect of oral clodronate on bone pain. A controlled study in patients with metastic prostatic cancer.

Although osteosclerotic metastases are characteristic of prostatic carcinoma, bone resorption is also accelerated. Since clodronate inhibits bone resorption and relieves bone pain, we have given it to patients with painful bone disease from prostatic cancer after failure of hormonal therapy. All patients received estramustine phosphate orally. Simultaneously they were randomly allocated to clodronate (36) and placebo (39) groups. Clodronate was given by mouth. The dose was 3.2 g for the first month, thereafter 1.6 g. Pain relief was more distinct in the clodronate group where one third of patients were totally free of bone pain. The use of analgesics stopped in 38% of patients on clodronate and in 18% on placebo which effect probably belongs to estramustine phosphate. Serum calcium concentration decreased more markedly in the clodronate group. Clodronate dose of 3.2 g seemed to be more potent than that of 1.6 g. Side effects were uncommon and occurred equally in both groups. No significant differences were seen in median survival or survival rates between the groups.

Administration, Oral↗
PubMed1991

Orchiectomy versus oestrogen in the treatment of advanced prostatic cancer.

The primary clinical efficacy of orchiectomy and the combination therapy of intramuscular polyoestradiol phosphate 80 mg monthly and oral ethinyl oestradiol 0.15 mg daily was evaluated by progression and cancer mortality rates in a series of 277 prostatic cancer patients representing part of the Finnprostate study. After a follow-up of 5 years there was a significant difference between the groups in terms of progression rate and prostatic cancer deaths. The oestrogen combination was more effective in delaying progression of the disease. The overall mortality rate was similar in both groups. About one-third of the patients were alive after 5 years.

Administration, Oral↗
PubMed1990

Diagnostic problems associated with cystinuria.

To elucidate the role of the urinary cystine concentration for the formation of urinary stones, 190 stone-formers were evaluated in this prospective study. Seven patients (3.8%) were heterozygous and one patient (0.5%) was homozygous for cystinuria; only two (1%) of them were cystine stone-formers. Two patients with calcium stones were heterozygous for cystinuria. This study confirms the observation that elevated concentrations of urine cystine are relatively infrequent among patients with urinary stones.

Adult↗
PubMed1990

Genital human papillomavirus infections in the male sexual partners of 45 female patients with papillomavirus infection.

Forty-five women with a confirmed genital human papillomavirus (HPV) infection and their regular male sexual partners were examined. The diagnosis of the women was based on the colposcopic examination with cytological and histological samples. The men were studied by using a similar microscopic technique. Penisscopic and histological examinations showed that 22 out of the 45 men had genital HPV infection although only 7 men showed visible condylomatous warts. In addition, nine men had clinical lesions highly suggestive to HPV infection in penisscopy but they had unspecific histological samples. 23 of these 31 men were symptom-free. These results further emphasize the importance of regular examinations of the male sexual partners of women with genital HPV infection in order to prevent recurrences and spreading of the infection.

Adult↗
PubMed1990

Recurrences of urolithiasis.

A total of 114 patients with urolithiasis were evaluated with particular attention to the number of stone attacks and the stone-free interval between them. Out of the 114 patients, 85 (75%) had a first stone episode. On the other hand, 10 out of 29 patients with recurrent stones had had as many as four or five stone episodes. The stone-free interval between the first and second and the second and third stone averaged nine and seven years, respectively. The ten patients (8%) with four and five stone attacks had an average stone-free interval of only two years. Operations were carried out on 14 of the 114 patients (12%) with 5 of them being operated on earlier twice. There were no significant differences in biochemical values between patients with the second and third, the fourth and fifth stone episodes, although biochemical disturbances were found to be involved in the aetiology of stone formation in each group. Methods of treating urinary stones have developed rapidly in recent years with the use of extracorporeal shock wave lithotripsy (ESWL). In spite of this, an extensive biochemical evaluation is indicated in patients with short stone-free intervals. Patients who are operated on should also be evaluated. Measures to prevent recurrent stone formation can be undertaken on the basis of the aetiology of the stone formation.

Adult↗