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Biomedical subjects

T Lehtonen

Publications and source records attributed to T Lehtonen.

At least 19 recordsLinked to original sources
PubMed1992

Scandinavian clinical study of finasteride in the treatment of benign prostatic hyperplasia.

The effects of finasteride, a potent 5 alpha-reductase inhibitor, were assessed in patients with benign prostatic hyperplasia. Patients were treated with finasteride or placebo for 24 weeks in a double-blind multicenter study followed by a 12-month open-extension period. After 24 weeks, finasteride-treated patients, when compared to placebo-treated patients, showed a significant reduction in prostate volume (22.5% median decrease) and prostate significant antigen (32.4% median decrease), a significant increase in maximum urinary flow (1.6 ml/s mean increase from baseline) and a significant improvement in their obstructive symptom scores (two-point decrease from baseline). Finasteride was well tolerated, and the improvements in prostate volume, maximum urinary flow rate and obstructive symptom scores observed in the controlled study were maintained throughout the extension study.

5-alpha Reductase Inhibitors↗
PubMed1991

Localized amyloidosis of the urinary bladder.

Localized amyloidosis of the urinary bladder is a rare condition. Five patients, 1 with localized secondary amyloidosis, are described. The symptoms, macroscopic hematuria and tumor-like appearance in cystoscopy, may mimic bladder cancer. Diagnosis is based on histopathological examinations with Congo red staining. In most instances, the treatment of choice is transurethral resection and electrocoagulation. Because of the risk of recurrences, a close follow-up is recommended.

Aged↗
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↗
PubMed1991

Intramural ureteric injury due to acute dilatation.

The effect of balloon dilatation of the ureteric orifice and the intramural ureter was evaluated histologically and radiologically in eight piglets. The distal part of the ureter was dilated from its normal calibre of 4F to 12F. Four weeks after the procedure obvious histological signs due to the preceding dilatation were seen in seven of the eight ureters. In simultaneous radiological studies two ureters showed massive and one slight dilatation and two ureters showed vesicoureteral reflux. The results suggest cautious use of dilatation. Small calibre ureterscopes without ureteric dilatation should be preferred.

Animals↗
PubMed1991

Results of the management of ureteric stones with the ureterorenoscope.

Eighty ureterorenoscopies (URS) were performed for stone removal in 67 patients between January 1985 and April 1988. The success rates for stone removal were 54% in the lower third of the ureter, 70% in the middle third, 38% in the upper third, and 33% in the renal pelvis. The overall success rate was 42%. Open ureterolithotomy was performed after failed ureteroscopy nine times. There were two perforations of the ureter: one by the hook of the forceps and the other by the dormia basket. No significant late complications occurred in 51 patients after six to 36 months postoperatively. At the moment ureteroscopy is of value particularly in the treatment of lower or middle ureteric stones.

Adult↗
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

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↗
PubMed1989

Morphology of testicular germ cell tumours in treated and untreated cryptorchidism.

The histology of 75 testicular germ cell tumours in 73 patients with treated or untreated cryptorchidism was investigated in a group of 503 patients with testicular germ cell tumour and evaluated according to the WHO classification. The proportion of pure seminoma was associated with the height of the testis, being 87% in abdominal. 78% in inguinal and 50% in normally positioned testes. In patients operated upon for cryptorchidism, the current site of the testis seemed to be a more important determinant of this proportion than the original site. The proportion of pure seminoma which developed in testes after successful orchiopexy was equal to that in normally-descended testes (50%) and lower (39%) if orchiopexy had been performed before the age of 16 years. Similarly, among non-seminomas, a higher proportion of tumours containing teratoma tissue was found in cryptorchidism was successfully treated in childhood. It was concluded that a successful orchiopexy in childhood decreases especially the risk of seminoma.

Adolescent↗
PubMed1989

Illness behavior and personality changes in patients with chronic prostatitis during a two-year follow-up period.

Illness behavior and personality changes during a 2-year follow-up period were studied in 40 patients with chronic prostatitis. In the first study, the existence of psychic problems among the subjects was high. Sexual problems were striking. During the follow-up period the personality of the patients did not change, but subjective well-being, both psychosocial and somatic, was impaired. Sexual problems and homosexual behavior also increased. In addition, the cooperation of the patients markedly decreased and their illness behavior became problematic. The results indicate a strong need for psychic support of these patients.

Adult↗
PubMed1989

Trends in incidence and results of treatment of testicular germ cell tumours in Finland 1972-1983.

A nationwide series of 422 patients with testicular germ cell cancer diagnosed in Finland in 1972-1983 was analysed. The age-adjusted incidence rate, although very low (1.6 per 10(5) male population per year), has increased compared to that in previous decades. The 3-year survival rate has improved markedly and was during the last part of the period high in patients with local (stage I) and regional (stages IIA-B) disease (100% for seminoma and over 90% for non-seminoma patients) but still fairly poor in advanced stages (stages IIC-IV) (58% for seminoma and 26% for non-seminoma patients). The improvement of the survival rate was most marked in non-seminoma patients below the median age (28.5 years). Cisplatin based chemotherapy was one of the major reasons for the improved prognosis, not only in non-seminoma patients but also in those with seminoma. There was no trend with time concerning the stage distribution of the disease. On the basis of relapse rates in stage I non-seminoma and seminoma patients staged surgically and clinically respectively, accuracy of clinical staging but not of surgical staging seemed to have improved. During the early period surgically staged stage I-II non-seminoma patients had a slightly better prognosis than clinical stage I-II patients but a similar difference was not observed during the cisplatin era.

Adolescent↗
PubMed1989

Early experience with percutaneous nephrolithotomy.

Fifty-four percutaneous nephrolithotomy (PNL) procedures were performed in 41 patients between May 1986 and December 1987. Six patients required more than one procedure and there was one failure which was treated by open ureterolithotomy. Most of the stones were initially found in the pelvicalyceal system, one in the lower third and nine in the middle or upper third of the ureter. There were five significant complications: one "steinstrasse" (accumulation of stone fragments in the distal ureter after the procedure), one massive perirenal haematoma, one intramural perforation by a ureteric catheter and two extravasations of irrigation fluid one of which necessitated intensive care. Most of the renal and upper ureteric stones have now been successfully removed percutaneously with good patient tolerance.

Female↗
PubMed1988

Comparison of magnetic resonance imaging with computed tomography and intravesical ultrasound in staging bladder cancer.

Magnetic resonance imaging (MRI), computed tomography (CT), and intravesical ultrasound (US) scanning were performed on 11 patients in whom infiltrative bladder cancer was suspected at cystoscopy. Equipment with magnetic field 0.02 T was used for the MRI. Tumors larger than 2 cm could be identified in all cases by MRI. In 3 of 4 cases in which the tumor was smaller than 2 cm, it could not be properly visualized and the degree of infiltration could not be assessed. When the tumor was visualized on MRI, tumor staging by MRI was correct in 7 of 8 cases (88%). Infiltration of the deep muscle layer of the bladder wall could be detected by MRI but not by CT. Intravesical US staging was correct in 7 of 9 cases (78%). As a noninvasive method, MRI is promising for the preoperative evaluation of bladder cancer and offers the advantage of imaging the bladder in different planes.

Adult↗
PubMed1988

Epidermoid cyst of the testis. Case report with a review of the literature.

Epidermoid cysts of the testis are rare, benign testicular tumors. Only 188 cases have been reported in the world literature until July 1986. There is controversy in the literature regarding whether local excision or enucleation of the cyst and sparing the testicle or orchiectomy is the preferred treatment approach of these lesions. A case with epidermoid cyst of testis, diagnosed correctly by ultrasound and frozen section and treated successfully by an excisional operation, is presented.

Adult↗
PubMed1988

Primary small cell cancer of the bladder. Report of a case and review of literature.

We report a case of a primary small cell cancer of the bladder with characteristic cytological, histological, histochemical, and ultrastructural features. The patient refused radical surgery and the tumour was treated by external radiation and chemotherapy. The residual tumour was electroresected transurethrally. After 15 months' follow-up a recurrent tumour was resected, but metastases were not found. Aggressive surgery as well as early institution of radiotherapy or chemotherapy are needed because of the aggressive nature of the tumour.

Aged↗
PubMed1988

Endo-ultrasonography for preoperative staging of rectal cancer.

Twenty-five intrarectal ultrasound (US) scannings were performed preoperatively for assessing the depth of infiltration of rectal neoplasms. One tumour located in the distal rectum could not be visualized on the ultrasonogram. US could correctly identify extraintestinal infiltration in 13 out of 14 cases with proved extrarectal involvement on histopathological examination. The overall accuracy of US in demonstrating tumour growth outside the rectal wall was 88%, sensitivity 93% and specificity 80%. Intrarectal US is a useful additional method in the preoperative evaluation of rectal neoplasms and provides more information about the depth of tumor infiltration compared with conventional methods thus helping decide the most appropriate therapy for the patient.

Humans↗
PubMed1986

99mTc-DTPA and 99mTc-DMSA renal gamma imaging in the surveillance of patients with conduit urinary diversion.

We studied renal anatomy and function using 99mTc-2-3 dimercaptosuccinic acid (DMSA) and 99mTc-diethylenetriaminepentaacetic acid (DTPA) in 27 patients with conduit urinary diversion. In this condition, free ureteral reflux is often associated with bacteriuria, and these factors are thought to precipitate progressive renal deterioration. Gamma-camera images provided valuable information concerning the structure of the renal parenchyma, the function of individual kidneys and possible ureteral obstruction, thus helping us to decide whether or not to instigate further treatment. The information gained using renal gamma imaging with 99mTc-DTPA and 99mTc-DMSA was complementary and partly overlapping. We preferred the use of 99mTc-DTPA because of its ability to visualise the ureters and the region of ureteroconduit anastomosis. Using diuretic medication, we were able to differentiate true ureteral obstruction from atony in 9 patients using 99mTc-DTPA.

Adult↗
PubMed1985

Mr 75,000 protein, a tumor marker in renal adenocarcinoma, reacting with antibodies to a synthetic peptide based on a cloned human endogenous retroviral nucleotide sequence.

Using a rabbit antiserum to a synthetic undecapeptide deduced from a cloned human retroviral gag-gene-related DNA sequence, we found a specific immunohistochemical reaction in all of 42 tested renal cell adenocarcinomas (RCC), while none of 17 similarly tested Wilms' tumors and 65 carcinomas at other sites were positive. The RCC included two cases that presented with distant metastases. It had not been possible to establish the origin of these until immunohistochemical staining revealed this typical reaction. Subsequent renal angiography disclosed the primary. In immunoblotting the antiserum detected an Mr 75,000 protein in RCC tissue, and this reaction was blocked by the undecapeptide. The usefulness of this protein as a tumor marker for RCC is discussed.

Adenocarcinoma↗