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O Kauppila

Publications and source records attributed to O Kauppila.

At least 19 recordsLinked to original sources
PubMed1986

Operative technique for the repair of posthysterectomy vaginal prolapse.

The operative technique of our own modified sacral colpopexy with a fascial strip for the repair of posthysterectomy vaginal prolapse is described. The complete removal of the enterocele is important. The fascial strip remains extraperitoneal. Only absorbable sutures have been used. Excellent vaginal support was achieved in all cases operated on with the method described. Possible cystocele and rectocele must be corrected separately prior to sacral colpopexy.

Female↗
PubMed1985

Uterine sarcomas.

During 1962-1980, 44 uterine sarcomas were treated at the Department of Obstetrics and Gynaecology of Tampere University Central Hospital. Of the sarcomas, 35 (79%) were leiomyosarcomas, six (14%) endometrial stromal sarcomas and three (7%) endometrial carcinosarcomas. The 5-year survival for patients with leiomyosarcoma was 51 per cent. The 5-year survival rate for the premenopausal patients was 73% and that for postmenopausal patients 20%. The most important prognostic indicator was the gross presentation of the tumor at the time of surgery. Of the 5-year survival patients 94% were of clinical Stage I and of the failed patients 55%, respectively. Rather poor correlation was noted between the mitotic activity and survival rate. Metastases to the lungs were the most common failure pathway. All six patients with endometrial stromal sarcomas died within 25 months after the diagnosis. High oestrogen and progestin receptor concentrations were demonstrated in the endometrial stromal sarcoma.

Adult↗
PubMed1985

Relationship of vulvar lichen sclerosus et atrophicus to carcinoma.

Lichen sclerosus et atrophicus was an associated lesion in 16 of 30 (53%) patients with invasive vulvar carcinoma. In one case invasive carcinoma developed in the background of lichen sclerosus et atrophicus. Additionally in one case lichen sclerosus was found at the margin of the carcinoma. Despite the low malignant potential, patients with vulvar lichen sclerosus et atrophicus need long-standing observation and recurrent histologic examinations.

Aged↗
PubMed1985

Prolapse of the vagina after hysterectomy.

Twenty-two patients were operated upon for posthysterectomy vaginal prolapse. The original operation had been abdominal hysterectomy in 11 patients and vaginal hysterectomy in an additional 11 patients. All of the corrective operations were performed abdominally. Vaginal sacropexy was performed upon eight patients with our own modified method using a fascial strip taken from the rectum sheath. Dexon sutures were used in the attachment of the strip to the apex of the vagina and to the periosteum of the sacrum. The fascial strip was peritonealized. A high resection of the enterocele sac was performed. Excellent permanent vaginal support was achieved in all of these patients. Other methods of operation used included direct fixation of the vaginal apex to the presacral fascia, fixation of the vagina with round ligaments and the method according to Williams and Richardson. More than one-half of the patients had recurrences.

Adult↗
PubMed1984

A prospective, randomized, national trial for treatment of ovarian cancer: the role of chemotherapy and external irradiation.

A prospective, randomized, national trial for comparing the effects of cytotoxic agents and radiotherapy on survival in primary epithelial ovarian cancer stages I-IV was carried out in 363 patients. After laparotomy, the patients were staged according to disease spread and randomized into treatment groups within each stage. The single or combined cytotoxic agents used were: cyclophosphamide (C) and vincristine (V); 5-fluorouracil (F) and dactinomycin (D) and V; treosulfan (T); and CF. In stages I, II and III there was one treatment group receiving external irradiation; in stage IV only different cytostatics were used. It was found that, in stage I, surgery alone was superior to surgery +CV or surgery + irradiation. In stage II disease, no differences in survival between treatment groups receiving pelvic irradiation or FDV, and in stage III between whole abdomen + pelvic irradiation or CV or FDV were found. In stage IV, FDV, T and CF were of similar, poor efficacy. The authors conclude that in stage I pelvic irradiation or combined chemotherapy do not improve survival. In advanced disease, chemotherapy may be better tolerated and thus preferable to whole abdomen irradiation; the combination of more modern cancer drugs with the ones used in this study is probably likely to improve the treatment results.

Abdomen↗
PubMed1984

Intravenous leiomyomatosis.

Intravenous leiomyomatosis of the uterus with extension to the right common iliac vein in a 34-year-old woman is reported. The successful treatment consisted of abdominal hysterectomy, bilateral salpingo-oophorectomy, venotomy and extraction of 3 cm long mobile tumour from the right common iliac vein. The presence of cytoplasmic oestrogen and progesterone receptors in the tumours indicates that intravenous leiomyoma is hormone-dependent.

Adult↗
PubMed1982

Results of treatment of primary ovarian carcinoma.

A retrospective evaluation of 146 patients with primary ovarian carcinoma treated in the University Central Hospital of Tampere over the period 1962-1971 is presented. Diagnosis and clinical stage of the carcinoma were always confirmed operatively. 54.1% of the cases were diagnosed at clinical stage I-II. The mode of treatment was surgery without any adjuvant therapy in only 15 cases (10.3%), surgery and chemotherapy in 55 cases (37.7%), surgery combined with chemotherapy and radiotherapy in 29 cases (19.9%) and surgery combined with radiotherapy in 13 cases (8.9%). In 34 cases of advanced ovarian cancer the operation remained explorative. Chemotherapy comprised high-dose cyclosphosphamide therapy and radiotherapy was given as external irradiation. The 5-year survival rate in the entire material was 47.9%; in stage I 82.3%, stage II 58.8%, stage III 23.1% and stage IV 0%. The prognosis was best for patients with mucinous cystadenocarcinoma and poorest for patients with anaplastic and endometrioid adenocarcinoma.

Adenocarcinoma↗
PubMed1981

Pituitary-ovarian hormones after low-dose endometrial afterloading irradiation.

Low-dose endometrial after loading irradiation was used in 19 mentally retarded women for the induction of therapeutic amenorrhea. They were divided into two subgroups on the basis of age: 13 young patients (mean age 17 years, range 13-26 years) and six patients of middle age (mean age 42 years, range 34-44 years). In the young patients, during the 10-month follow-up period, the plasma E2 levels did not decrease. However, the FSH concentration increased. Late on, 2-9 years after treatment, the E2 levels were significantly higher than those of healthy postmenopausal women and did not differ from the values of healthy women in the sixth to seventh days of the menstrual cycle. At that time the FSH and LH levels were similar to reference values in reproductive age. The E2/E1 ratio was significantly higher than that of healthy women in the sixth to seventh days of the cycle and that of postmenopausal women. Most of the menstrual cycles were anovulatory but some ovulatory also occurred. The testosterone concentrations did not differ from reference values. The ovaries of the middle age patients were more sensitive to irradiation than those of the younger patients.

Adolescent↗
PubMed1981

Radical surgery in the treatment of vulvar squamous cell carcinoma.

A total of 58 cases of vulvar squamous cell carcinoma treated between 1962 and 1980 were analyzed. Of these, 32 were radically, 21 non-radically operated and 5 were treated with radiation only. The study showed that radical surgery is to be recommended in vulvar carcinoma. In addition to evacuation of the inguinal region the method should also include removal of iliac and obturator lymph nodes.

Adult↗
PubMed1981

Results of treatment for uterine cervical carcinoma.

A total of 229 patients with invasive cervical carcinoma were treated over a period of ten years 1962--1971. 152 (66%) of the patients were operated on. Radical surgery was performed in 107 cases. Radiotherapy was combined with the operation in 84 cases (55.2%) and 77 patients (33.6%) were treated with radiotherapy without operation. The overall 5-year survival rate in the material was 66.4%; in stage I 91.8%, stage II 50.0%, stage III 33.3% and stage IV 12.5%. Early complications were found in 11.3% and late complications in 14.8% of the patients.

Adult↗
PubMed1981

Results of treatment of endometrial cancer in Tampere University Central Hospital 1962--1971.

The aim of the present study was to ascertain the outcome of treatment of 212 patients with carcinoma of the body of the uterus in the University Central Hospital in Tampere over the period 1962--1971. Of the total number of patients involved, 182 were treated operatively. In 97 cases, additional radiation treatment was administered, 25 of these receiving preoperative radium therapy only. Progestin treatment was prescribed for 85 of the operated patients. Cytostatic (cyclophosphamide) treatment alone was applied in 8 cases. Results of treatment were assessed on the basis of five-year survival. The best results were obtained with radical surgery undertaken in the early stages of the disease, the five-year survival rate being 88.2%. The five-year survival rate in the entire material was 76.9%. In the present study combination of radiation or progestin treatment with surgery did not improve the results of treatment.

Aged↗
PubMed1981

Management of low birth weight breech delivery: should cesarean section be routine?

A total of 434 low birth weight deliveries between 1967 and 1976 were studied retrospectively. Of these, 217 were breech deliveries, and the other 217 constituted a control series of vertex deliveries. In the breech deliveries the perinatal mortality was 1.8 times that of the cephalic cases, and the neonatal mortality was 2.9 times greater. During the last 5 years of the study, the cesarean section rate increased for the group of infants weighing between 1500 and 2499 g; this policy did not improve the prognosis in breech presentations. Malformations and respiratory distress syndrome were more frequent in breech presentations. Conditions associated with the corrected perinatal mortality (cerebral hemorrhage, fetal asphyxia, prolapsed cord) were also more common in breech presentations, but especially in the group of infants weighing less than 1500 g. This weight group, for which the cesarean section rate did not rise, emerged in the study as a special area of concern. Conclusions and recommendations for management are presented.

Apgar Score↗
PubMed1975

[Cervical status and subjective symptoms in the normal pregnancy].

In 426 unselected pregnant women who came into the routine examination included in the maternity care and who were grouped according to the week of gestation the cervical status was examined and the subjective symptoms were observed. Attention was also paid to the correspondence between the occurrence of the subjective symptoms and the change in the cervical status. In total 984 examinations were carried out. Before the 33rd week of gestation no open internal orifice of the cervix uteri were found. All parities in total the cervix had become shorter (less than or equal to 2 cm) in 7,0 per cent of the cases before the 33rd week of gestation. Subjective symptoms occurred in 19,1 per cent of the cases. Towards the end of the gestational period the changes in the cervical status and the subjective symptoms became more frequent. In all the groups of gestational week the cervical status became pathologic significantly more frequently in pregnancies with subjective symptoms than in pregnancies with no symptoms.

Cervix Uteri↗