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Biomedical subjects

M Riihelä

Publications and source records attributed to M Riihelä.

10 recordsLinked to original sources
PubMed1995

Liver involvement and its course in patients operated on for ulcerative colitis.

The prevalence of associated liver involvement in 214 patients with ulcerative colitis undergoing definitive surgery was evaluated, with special emphasis on the subsequent course of liver changes. At the time of colectomy or proctocolectomy 45 patients (21%) had more than transient liver involvement, and 13 (6.1%) fulfilled the criteria of primary sclerosing cholangitis (PSC). Of the other 32 patients with minor liver involvement four had steatosis, one chronic active hepatitis, one viral A hepatitis, and 14 possibly early sclerosing cholangitis or unspecific reactive hepatitis. During a mean follow-up of nine years, four patients with PSC (31%) showed clinical progression, but none of those with minor histological changes or those with no liver disease at surgery did so. Alkaline phosphatase levels showed a decreasing tendency, and minor histological changes improved after surgery, while repeated cholangiography mostly demonstrated progression or a static state. The results indicate that asymptomatic sclerosing cholangitis in association with ulcerative colitis is not always a progressive disease, and proctocolectomy may have a beneficial effect on the long-term course of sclerosing cholangitis in its early phase.

Adult↗
PubMed1994

Chronic nonatropic ('superficial') gastritis increases the risk of gastric carcinoma. A case-control study.

Atrophic gastritis is a well-known risk condition for gastric carcinoma (GCA). Less is known about the risk of GCA in subjects with nonatrophic ('superficial') gastritis. To investigate this, we estimated the risk of GCA in patients with nonatrophic gastritis as compared with that in subjects with normal, nongastritic mucosa. Two hundred and forty-three consecutive GCA patients and 1408 non-GCA outpatients (controls), for whom histologic data (endoscopic biopsy) of gastric mucosa was available, were included in the study. To estimate the relative risk (RR) of GCA, the odds ratio of gastritis was calculated in patients and controls by adjusting for age and sex. The RR (95% confidence interval) of GCA in patients with nonatrophic antral gastritis and with nonatrophic pangastritis was 1.8 (1.2-2.7) and 2.5 (1.4-4.3), respectively. Correspondingly, the risks of GCA were 9.1 (5.4-15.5) in patients with atrophic antral gastritis or pangastritis (atrophy of any degree) and 4.4 (1.9-10) in those with severe atrophic corpus gastritis (severe corpus limited atrophy of 'A type'). In nonatrophic gastritis the risk of diffuse-type GCA was emphasized, whereas the risk of intestinal-type GCA was emphasized in patients with atrophic gastritis. These results indicate that an increased risk of GCA is not confined to subjects with atrophic gastritis but is also slightly but significantly increased in patients with chronic nonatrophic gastritis.

Adult↗
PubMed1993

A bioresorbable urethral stent. An experimental study.

The aim of the present study was to examine the suitability of biodegradable polymers as materials for a urethral stent. A new urethral stent made of biodegradable self-reinforced poly-L-lactide (SR-PLLA) was implanted in 16 male rabbits after urethrotomy. Seven stents of stainless steel served as controls. The dimensions of the two types of stents were identical: length 15 mm, diameter 8.2 mm. The mechanical construction was a helical spiral. The SR-PLLA spiral was sustained with three microspirals, and the whole device was coated with DL-lactide to achieve an active initial tissue reaction and better tissue penetration. The SR-PLLA stent showed more favourable implantation properties than the steel one. Within 6 months all PLLA stents had implanted, and the tissue reaction around the stent material was minimal. The helical spiral of stainless steel induced a remarkable inflammatory reaction due to poor implantation properties. We suggest that biodegradable SR-PLLA is a promising material for a urethral stent to prevent re-stenosis of urethral strictures.

Absorption↗
PubMed1992

Morphological effects of photodynamic therapy on rabbit bladder using Photofrin II and Photosan intravesically and intravenously.

Photodynamic therapy (PDT) has proved effective against superficial papillary bladder tumours and focal and diffuse carcinoma in situ. Effective topical administration of the sensitiser would be a welcome improvement. The morphological effects of PDT on the normal bladder were examined in 13 rabbits when 2 photosensitisers (Photofrin II and Photosan III) were applied intravesically (5 mg/kg for 1 h) and compared with intravenous administration (3 or 5 mg/kg). Four animals served as controls without a sensitiser. Intravesical red light (630 nm) from an argon dye laser was used to activate the photosensitiser, using light doses of 12 or 24 J/cm2. The animals were sacrificed either 1 or 5 to 7 days after the laser treatment. Intravenous dosage induced bladder wall oedema/haemorrhage and total necrosis of the epithelium. There was no difference between the effects of the 2 sensitisers. Intravesical application induced superficial epithelial necrosis. The control animals treated with laser light alone showed slight superficial injury to the cell layer.

Administration, Intravesical↗
PubMed1992

Helicobacter pylori infection and chronic gastritis in gastric cancer.

AIMS: To investigate the prevalence of Helicobacter pylori associated chronic gastritis in patients with gastric cancer. METHODS: Serum IgG antibodies for H pylori were determined in 54 consecutive patients with gastric carcinoma. The prevalence of H pylori in gastric mucosa was also examined histologically (modified Giemsa) in 32 patients from whom adequate biopsy specimens of the antrum and corpus were available. Thirty five patients with gastrointestinal tumours outside the stomach and 48 with non-gastrointestinal malignancies served as controls. RESULTS: Of the 54 patients, 38 (70%) had H pylori antibodies (IgG) in their serum (three additional patients had H pylori antibodies IgA, class specific but not IgG specific). This prevalence was significantly higher (p less than 0.05) than that (49%) in the 35 controls. No differences in prevalence of H pylori antibodies were found between gastric cancer cases of intestinal (IGCA) or diffuse (DGCA) type, both these types showing H pylori antibodies (IgG) in 71% of the patients. In the subgroup of 32 subjects, five patients had normal gastric mucosa and four showed corpus limited atrophy ("pernicious anaemia type" atrophy of type A). All of these nine patients had no evidence of current or previous H pylori infection in serum (no IgG antibodies) or in tissue sections (negative Giemsa staining). The remaining 23 patients had antral or pangastritis, and all had evidence of current or previous H pylori infection. CONCLUSIONS: H pylori associated chronic gastritis was the associated disease in 75% of the patients with gastric cancer occurring equally often in both IGCA and DGCA groups. About 25% of cases seem to have a normal stomach or severe corpus limited atrophy, neither of which showed evidence of concomitant H pylori infection.

Adult↗
PubMed1991

Dysplasia and carcinoma in longstanding ulcerative colitis: an endoscopic and histological surveillance programme.

From 1976 to 1989 a total of 66 patients with longstanding ulcerative colitis were entered in a colonoscopic surveillance programme in order to detect dysplasia. Thirty patients had extensive or total ulcerative colitis and 36 left sided colitis. The median duration of the disease at the end of the follow up was 15.0 years. Altogether 182 colonoscopies (2.8 per patient), each involving approximately 20 biopsies from different sites of the colon, were performed. In the total or extensive colitis group, five patients had low grade and one patient had high grade dysplasia. In the left sided colitis group, three patients had low grade dysplasia. In three patients low grade dysplasia was detected in a macroscopic lesion or mass of colonic mucosa. Sixty per cent of the dysplasia specimens were from the right colon. The incidence of dysplasia was higher in patients with extensive colitis and increased with the duration of the disease. None of the patients have so far developed colorectal carcinoma. Our results indicate that a colonoscopic surveillance programme is a safe alternative to prophylactic colectomy in longstanding ulcerative colitis.

Adolescent↗
PubMed1991

Fibroepithelial polyps of the ureter.

Two cases of ureteric fibroepithelial polyps are presented. Macroscopic haematuria and flank pain were seen as symptoms in both cases. Intravenous urography, retrograde ureteropyelography, computed tomography, and ureterorenoscopy with visual biopsies were used as diagnostic methods. As a result of the preoperative diagnostics, saving surgical procedures (local excision and coagulation of the base of the tumour) were used with good results. The therapy of ureteric tumours should always be founded on the preoperative histological diagnosis and should be conservative transureteric or open surgical.

Adult↗
PubMed1990

Blood clot formation in angiographic catheters. In vitro tests with various contrast media.

Human blood was injected into angiographic catheters filled with contrast media or flushing media. The catheters were allowed to stand at 37 degrees C for 10, 20 or 30 min. Physiologic saline was then injected through the catheters, the catheter contents were shaken and filtered, and any clots were identified. Diatrizoate, ioxaglate, iohexol, iopamidol and iopromide were tested. Physiologic and heparinized saline were used as controls. At 10 min, clots were found in 65 per cent of the catheters filled with physiologic saline, in 25 per cent with non-ionic media, in 19 per cent with heparinized saline, and in 4 per cent with ionic contrast media. At 30 min, all catheters with physiologic saline, 85 per cent with non-ionic contrast media, 46 per cent with heparinized saline and 23 per cent with ionic contrast media contained a clot. Although all the contrast media were anticoagulants, a more careful angiographic technique is needed for non-ionic media. All the non-ionic agents showed equal results. Physiologic saline without heparin is not suitable for flushing during angiography.

Angiography↗