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M Ruutu

Publications and source records attributed to M Ruutu.

35 records · Page 2Linked to original sources
PubMed1985

Cystometrographic patterns in predicting bladder function after spinal cord injury.

The cystometrographic patterns together with and sphincter electromyograms of 62 patients with recent spinal cord injury wer analysed. Four main patterns could be distinguished. The patients with well-developed detrusor reflex gained easy emptying of the bladder significantly more often than those with supranuclear injury but weak or unsustained detrusor contractions, or those with mixed spinal lesions. The patients with mixed lesions and low compliance bladders had the most severe incontinence problems. One fourth of the total series had various degrees of upper tract dilatation in their first urogram, and these changes occurred more often in patients with high detrusor activity. Urinary tract infections occurred in all patients but less often in those with areflexic bladders. This group of patients was also most suitable for intermittent self-catheterisation.

Adolescent↗
PubMed1985

Toxicity testing of urinary catheters.

The tissue toxicity of 23 urinary catheter batches (6 latex and 2 non-latex brands) was tested in vitro and in vivo. In vitro, a human T-cell leukemia line (JM) was cultured in the presence of different concentrations of eluates made from the catheters. The cytotoxicity of the eluates was assessed from their ability to inhibit DNA synthesis measured by incorporation of 3H-thymidine. In vivo, two methods were used. Strips of catheters were implanted into the rabbit dorsal muscle and pieces of catheters were implanted into the rat peritoneal cavity. After four days, the foreign body reaction, type of inflammation and necrosis were quantified macroscopically and by light microscopy. The results of the in vitro cytotoxicity test were correlated with those of in vivo methods. The rat peritoneal implantation test correlated better with the cell culture test (P less than 0.01) than with the rabbit muscle implantation test (P less than 0.05). Based on the clinical experience of urethral stricture complications caused by urinary catheters, catheters yielding eluate which at 30% dilution inhibited 50% DNA synthesis were regarded as toxic. According to this, the rabbit muscle implantation test was not reliable in testing the tissue toxicity of urinary catheters, while the cell culture test was quantitative and seemed to correlate with both the rat peritoneal implantation test and with the clinical complications observed.

Animals↗
PubMed1985

Cytotoxicity of latex urinary catheters.

After an epidemic of severe urethral strictures in cardiac surgery patients, all brand latex catheters marketed in Finland were investigated for cellular toxicity with eluates made from the catheters. Four of the seven brands, including the one involved in the stricture cases, showed marked cytotoxicity and inhibited almost all cell growth in various human cell cultures when a 30% catheter eluate was used. DNA histograms of cells cultured with toxic catheter eluate showed inhibition of DNA synthesis. Silicone catheters did not influence cell growth, which correlates with the finding that no new stricture cases were seen after the latex catheters were replaced with silicone ones. Attention is paid to the facts that international standards regarding urethral catheter toxicity are lacking and that catheter quality control is insufficient.

Adult↗
PubMed1985

Hypoprothrombinaemia and bleeding during administration of cefamandole and cefoperazone. Report of three cases.

Deficiency of vitamin K-dependent coagulation factors caused by the cephalosporin derivatives cefamandole, cefoperazone and moxalactam has been recently recognized. It has been suggested that this adverse reaction may result from vitamin K deficiency caused by eradication of the vitamin K producing intestinal bacteria or inhibition of action of vitamin K 1. Three patients are described in whom hypoprothrombinaemic bleeding developed during administration of cefamandole or cefoperazone. All patients were elderly, had previous malnutrition or had been on parenteral nutrition without vitamin K supplementation. One patient had renal failure. Bleeding manifested 5-14 days after the start of antibiotic treatment. Other causes of the bleeding were excluded. One case was fatal and in 2 cases the coagulopathy was corrected by administration of vitamin K 1 or fresh frozen plasma and cessation of the antibiotic. We recommend prophylactic administration of vitamin K 1 during cefamandole or cefoperazone treatment to patients at risk, i.e. elderly malnourished patients especially those with renal failure or on parenteral nutrition.

Aged↗
PubMed1985

Early results of the Finnish Multicentre Study of Prostatic Cancer (Finnprostate).

Four hundred and four prostatic cancer patients diagnosed in the years 1979-1982 in nine Finnish hospitals have been followed up for a mean period of three years. The aim of this study is to evaluate the situation of this malignancy in the Finnish male population and to discuss the diagnostic procedures and treatment modalities. In one fifth of the patients the carcinoma was as incidental finding on microscopical examination of tissue removed by transurethral resection or enucleation for presumed benign prostatic hyperplasia. At the diagnostic moment 69% of the tumours were locally advanced beyond the prostatic capsule and one third of all cases had metastasized. 134 out of 404 (33%) have died and 45% of these of prostatic cancer. Survival was adversely affected by the tumour differentiation grade. In non-metastasized cases the local extent of the tumour had no notable effect on prognosis. Some early comparisons are made between orchidectomy and oestrogen therapy.

Acid Phosphatase↗
PubMed1984

The value of urethrocystography in the investigation of patients with spinal cord injury.

In a review of 127 urethrocystograms carried out on 92 males with spinal cord injury the following conclusions were drawn. (1) In the presence of vesico-ureteric reflux or urethral reflux into the male adnexa, bladder outlet obstruction should be suspected. (2) Lesions of the anterior urethra develop easily as the result of indwelling catheterisation in patients lacking sensation. A retrograde urethrogram is necessary to demonstrate these lesions. (3) Severe trabeculation of the bladder wall can be a sign of high-pressure outlet obstruction. (4) Dilatation of the bladder neck in patients with detrusor sphincter dyssynergia may lead to total urinary incontinence after sphincterotomy. (5) Urethrocystography is not a valid investigation to detect bladder stones.

Adolescent↗
PubMed1984

Upper urinary tract changes in patients with spinal cord injury.

Two hundred and six intravenous urograms on 119 patients with spinal cord injury were reviewed and the findings correlated with the clinical data. Fifty (42%) of 119 patients had pathological changes in their upper urinary tracts. The most common feature was impaired renal emptying. Patients with normal and pathological upper tracts had similar findings according to the number of positive urine cultures during the first post-injury year, but in the follow-up those with pathological urograms showed bacteriuria significantly more often. Febrile urinary tract infections at least once a year were encountered in the follow-up of 40% of the patients with pathological urograms, as compared with 8% with normal urograms. All patients with severe renal changes had impaired emptying from the kidneys. This supports the view that the basic patho-physiological mechanism leading to upper tract deterioration in patients with spinal cord injury is a functional or mechanical obstruction of the lower urinary tract. This should be treated actively before irreversible renal changes develop.

Adolescent↗
PubMed1984

Bone scintigraphy and serum phosphatases in the detection and follow-up of bone metastases in prostatic cancer.

Bone scintigraphy, serum acid phosphatase activity (ACP), prostatic acid phosphatase by radioimmunoassay (PAP) and alkaline phosphatase activity (ALP) were studied in 117 consecutive patients with prostatic cancer. Serum PAP was more sensitive than ACP in indicating prostatic cancer in the 63 patients with normal bone scans: 28% had positive PAP tests and 15% positive ACP tests. In the 54 patients with bone metastases no difference in the frequency of positive PAP (84%) and ACP (85%) test was observed. Serum PAP and ACP, but not ALP, were useful for the assessment of the response to therapy particularly in patients without bone metastases. In the follow-up of patients with bone metastases the scan was more informative than any of the phosphatase assays studied.

Acid Phosphatase↗
PubMed1984

Unexpected urethral strictures after short-term catheterization in open-heart surgery.

Urethral stricture was found in 59 of 478 male patients who had undergone open-heart surgery between June 79 and December 81. In 40/59 cases the stricture showed a string-of-pearls configuration or long narrowing of the penile urethra on the urethrogram. Burning pain and dysuria were the main symptoms, and the urinary stream started to weaken immediately after the removal of the siliconized latex catheter which had been routinely inserted at the time of the heart operation and usually kept indwelling for 3 days. The stricture epidemic stopped after change of the latex catheters to silicone-ones. The different catheters were investigated for cell toxicity. Eluates of catheters were added at different concentrations to cultures of various cell lines. The cell proliferation was measured by thymidine incorporation. The results were uniform and showed marked toxicity of the latex catheters against all investigated cell lines.

Cardiac Surgical Procedures↗
PubMed1984

Suprapubic cystostomy catheterization in open-heart surgery.

Monitoring of the urinary output is mandatory during open-heart surgery and in the immediate postoperative period. During 1980-81 we noticed an alarming rise in the number of post-catheterization urethral strictures affecting men who had undergone open-heart surgery. To avoid this serious complication, we switched from conventional urethral catheterization to suprapubic cystostomy for these patients. The first 93 cases with suprapubic drainage have now been analysed as regards the advantages and complications of this technique. The advantages were clear: The patients were satisfied with the method and no urethral strictures developed. The only side effect was haematuria, which in 9 cases led to occlusion of the catheter and required extraneous maneouvres. Suprapubic cystostomy thus seems to be a good alternative to conventional urethral catheterization in open-heart surgery. The possible causes of the urethral complications in this particular group of patients also are discussed.

Cardiac Surgical Procedures↗
PubMed1984

Urinary tract complications in spinal cord injury patients.

The characteristics of urinary tract complications in a series of 202 spinal cord injury patients are described. Repeated urinary infection was the most usual problem. Upper urinary tract changes were detected in 61 patients (30%). 56 patients (28%) underwent bladder outlet surgery for problems with voiding. Urinary diversion was done to 8 patients (4%), and 12 (6%) were treated with permanent indwelling catheter or self-catheterization. The high incidence of bladder stones (29%) and urethral complications (14%) was regarded as due to indwelling catheterization at the early stage post-injury. Despite the high urinary tract morbidity, only one patient has so far died of renal failure.

Adolescent↗
PubMed1983

Treatment of urethral stricture by urethroplasty or direct vision urethrotomy. A comparative retrospective study.

The outcome of treatment for urethral stricture is evaluated in two groups of patients in a retrospective study: 51 patients were treated with urethroplasty and 41 with direct vision urethrotomy. The groups did not differ greatly as regards primary success. It was 59% in the urethroplasty group and 61% in the urethrotomy group. This favours the view that the primary treatment of a urethral stricture should be direct vision urethrotomy whenever possible.

Adolescent↗
PubMed1983

Cisobitan in treatment of prostatic cancer. A prospective controlled multicentre study.

Cisobitan, an organosilicon compound with estrogenic and antigonadotropic properties has been evaluated clinically in comparison with an estrogen preparation. In a multicenter study a total of 140 patients with well and moderately well differentiated prostatic cancer were randomly allocated to treatment with Cisobitan or Estradurin/Etivex, 70 to each group. Of 34 patients with poorly differentiated prostatic cancer 18 were given Cisobitan--and 16 were given Estracyt-treatment. Among the patients with well and moderately well differentiated prostatic cancer there were, disregarding mortality, no major differences in subjective, objective or laboratory response to the two kinds of treatment. The pattern of side effects was similar, but oedema requiring diuretics occurred more often in the estrogen treated group. There was a significant difference in mortality at 12 months between the groups, two in the Cisobitan group and ten in the estrogen treated group. Cancer was the cause of death in two patients in the estrogen treated group. All other patients succumbed in cardiovascular diseases. At 24 months the difference in mortality rate was less pronounced: Another ten patients had died in the Cisobitan treated group and seven among the estrogen treated patients. Cancer was responsible for the deaths in seven of the Cisobitan patients compared to four of the estrogen treated patients. Within three years one more patient in both groups had died. Of the 34 patients with poorly differentiated cancer, twelve were alive at the 24 months' follow up, six in the Cisobitan group and six in the Estracyt group.

Clinical Trials as Topic↗
PubMed1982

External sphincterotomy in patients with spinal cord injury.

Urological evaluation was performed on 63 spinal cord injury patients with micturition difficulties or repeated urinary tract infections. Detrusor external sphincter dyssynergia of varying degree was found in 36/63 (57%) of these patients with urological problems, and 15/36 (42%) of them were estimated to benefit by external sphincterotomy. Sphincterotomy was carried out in 11 patients. The effect on micturition problems was good, but intermittent bacteriuria continued despite the operation. However, marked febrile urinary tract infections appeared to subside.

Adult↗
PubMed1978

Renal angiography problems in live kidney donors.

We compared renal angiographic and operative findings in 88 live kidney donors. Fifty patients had normal arteriograms and uneventful nephrectomies. Abnormal renal parenchymal or main artery lesions were found in eight donors (9%). These included four renal artery stenoses; the kidney distal to the lesion was used for transplanting. Thirty one patients (35%) had multiple renal arteries. Only 24 of these (77%) were diagnosed at pre-operative angiography, though on review angiogram accuracy could be raised to 94%. Except for one patient the accessory renal arteries missed at angiography were tiny twigs; the small renal infarcts caused by ligating them did not impair transplant survival. There was one serious misdiagnosis of multiple renal arteries, preventable on review of the abdominal aortogram. We condiser pre-operative angiography an essential step for the live kidney donor. It is the most accurate way of ensuring that his remaining kidney will be structurally sound. Finding multiple renal arteries has a decisive impact on management. Abdominal aortography rather than routine selective arteriography is the safe and therefore preferable approach to these patients.

Humans↗
PubMedDate not supplied

Combined adrenal adenoma and myelolipoma in a patient with Conn syndrome. Case report.

Adrenal myelolipoma is an uncommon benign tumor usually discovered by chance in patients with hypertension, obesity, arteriosclerosis or cancer. The association with adrenocortical endocrine dysfunctions is rare. We report herein an unusual case, the second in the literature to the best of our knowledge, of combined adrenal adenoma and myelolipoma in a patient with Conn syndrome.

Adenoma↗