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Biomedical subjects

T Tammela

Publications and source records attributed to T Tammela.

At least 19 recordsLinked to original sources
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

Efficacy and safety of clean intermittent catheterization in adults.

A prospective study was carried out on the efficacy and safety of clean intermittent catheterization (CIC). The series included 41 adults (15 females, 26 males), the mean follow-up time being 40 months. Most patients were suffering from neurogenic bladder disorders. All of them used a self-lubricating hydrophilic catheter. Thirty-one patients (76%) continued to undergo CIC, but 9 discontinued. Thirty patients (73%) experienced bacteriuria during the procedure. Three males had epididymitis. Contrary to many earlier reports, urinary tract infections seem to increase after CIC, raising the question of whether prophylactic antibiotic therapy should be used more often in these cases. There were no urethral complications suggesting that the self-lubricating hydrophilic catheters may be less traumatic than those used previously.

Adult↗
PubMed1991

Intravesical epirubicin with and without verapamil for the prophylaxis of superficial bladder tumours.

Seventy-five patients with recurrent bladder carcinoma were randomized after electroresection to receive either epirubicin (E) or epirubicin + verapamil (E + V) instillation of the bladder at regular intervals for 2 years. Samples of the bladder wall, tumour tissue and peripheral blood were taken from 20 patients. The average follow-up period was 21 months. Fifty per cent of the patients in the E group and 37% in the E + V group developed recurrent tumours. Recurrence rates (RR) were 6.3 and 4.7, respectively. Before the instillation therapy the RR was 16.0. There was a highly significant reduction of RR during the instillation therapies; in group E p less than 0.005 and in group E + V p less than 0.001. The difference between the treatment groups was not statistically significant. Verapamil increased epirubicin concentrations in both the bladder wall and the tumour tissue, but did not affect concentrations in the peripheral blood. Side effects were few and did not lead to discontinuation of treatment.

Administration, Intravesical↗
PubMed1991

Effect of prolonged experimental distension on the function and ultrastructure of the canine urinary bladder.

Urinary bladder distension was induced for 10 hours in dogs and micturition tests were made before over-stretching, immediately afterwards and 5 days later. Compliance and residual urine had increased and maximum pressure during voiding had decreased immediately after retention, but returned to normal after 5 days. Biopses for light microscopic and electronmicroscopic investigation taken from the anterior wall of the bladder on the fifth day showed submucosal haemorrhages and some necrosis. The consistent finding on electron microscopy was Schwann cell oedema, which was seen within the cytoplasm and between the cytoplasmic processes of the Schwann cells. Axonal degeneration was also a common finding. These anatomical changes, although found at the moment of functional recovery, may be linked to impaired conductivity of the nerves in the bladder wall, at least partly, causing its impaired function. Recovery of function occurs quite rapidly in healthy bladders.

Animals↗
PubMed1990

Immunohistochemical localization of carbonic anhydrase isoenzymes in the human male reproductive tract.

The distribution of human carbonic anhydrase (HCA) isoenzymes I, II and VI in the human male reproductive tract was studied using specific antisera against affinity purified isoenzymes in conjunction with the peroxidase-antiperoxidase complex method. HCA VI-specific staining could not be demonstrated in any of the tissues studied, and HCA I was observed only in red blood cells. Immunostaining denoted HCA II in the epithelia of the seminal vesicle, ampulla of the ductus deferens and distal ductus deferens. Some cells in the epithelium of the corpus and cauda epididymidis also stained for HCA II. The staining for HCA II in the epithelium of the reproductive tract declined from the strongly positive seminal vesicle to the proximal part of the ductus deferens, which stained negatively. There were also HCA II-positive particles derived from the apical protrusions of the epithelium in the lumina of the seminal vesicle, ampulla of the ductus deferens and ductus deferens. The physiological role of HCA II is linked to the secretion of bicarbonate into the seminal plasma and thereby to the regulation of sperm motility and pH in the seminal plasma.

Carbonic Anhydrases↗
PubMed1990

Effect of distension on adrenergic innervation of the rat urinary bladder.

The effect of distension on adrenergic innervation was investigated in the rat urinary bladder. Bladders were distended for 3 h by forced diuresis and balloon obstruction, and specimens were taken from the bladder dome, body and neck for the demonstration of glyoxylic acid-induced fluorescence of catecholamines. Depletion of catecholamines started after 10 h and was almost complete after 2 days. The fluorescence had recovered part way after 5-7 days and was practically normal after 21 days. Small, intensely fluorescent (SIF) cells in the ganglia continued to leak catecholamines throughout the 21-day study period. The primary clinical success of distension therapy for the treatment of unstable bladder may be at least partly due to a reversible disturbance in the function of the adrenergic nerves, which have an excitatory alpha-adrenergic dominance in such cases, but the persistent leakage from SIF cells raises the question of whether distension causes prolonged disturbances in bladder function.

Animals↗
PubMed1990

Ceftazidime vs. tobramycin for serious infections in urological patients.

A prospective, randomized study was undertaken to compare the efficacy and safety of tobramycin and ceftazidime in the treatment of serious infections in 77 urological patients. Of the 39 tobramycin-treated and 38 ceftazidime-treated patients, 74% and 82%, respectively, were cured clinically. Microbiological cure rates were 72% and 79%, respectively. Three patients treated with tobramycin and two treated with ceftazidime developed a significant superinfection. Both drugs were tolerated well. Because of potential ototoxicity and nephrotoxicity the use of aminoglycosides is less advantageous than ceftazidime for seriously infected urological patients.

Adult↗
PubMed1990

A malignant Leydig cell tumour associated with testicular trauma and prostatic carcinoma.

A case of metastatic Leydig cell carcinoma without sex hormone overproduction is reported. The patient had had a prior testicular contusion trauma on the same side after which the testicle had been swollen and firm. The possible aetiological role of extreme trauma is discussed. Radical orchidectomy is recommended for large tumours because of the difficulty in predicting malignant potential, and routine follow-up with retroperitoneal ultrasound scanning for 10 years in all cases.

Aged↗
PubMed1989

Sarcoidosis of the bladder: a case report and literature review.

A case of bladder sarcoidosis in a woman with known systemic involvement of this disease is reported. The lesion improved and ureteral obstruction was relieved after transurethral resection and systemic corticosteroid treatment. Sarcoidosis and malacoplakia are believed to represent distinct disease processes in the bladder.

Female↗
PubMed1988

Comparison of long-term and short-term stretch on rat urinary bladder in vitro.

Distension of the human urinary bladder often causes prolonged impairment of its function. To investigate the effects of the duration of stretch on bladder smooth muscle the active length-tension relation, electrically evoked, was described in rat detrusor strips during a short-term and a long-term stretch. The amplitude of active tension increased at first and then decreased abruptly at greater stretch lengths, the maximum being at muscle lengths 230-250% (100% = resting length) in both types of stretches. When the strips had been at maximum length (300%) for three hours the amplitude was significantly decreased during release as compared to the amplitude found during stretch to the maximum length at comparable lengths. If the strips were released immediately from the maximum length the amplitude responded in an opposite manner. Therefore we conclude that the duration of stretching of bladder smooth muscle significantly affects its mechanical activity.

Animals↗
PubMed1988

Ethanolamine oleate as a sclerosant for testicular hydroceles and epididymal cysts.

Forty patients with testicular hydroceles and 16 patients with epididymal cysts were treated by tapping and injection of ethanolamine oleate; 97.5% of the hydroceles and 31% of the epididymal cysts were completely cured, 50% of the latter partly cured and 19% failed. About half of the patients experienced pain after treatment. Two patients developed infection. Ultrasonography showed no change in the testicular tissue during the follow-up period. Sclerotherapy with ethanolamine oleate is a rapid and cost-effective modality which can be recommended as primary treatment for hydroceles and for unilocular epididymal cysts, especially in elderly males.

Adult↗
PubMed1988

Sequentially alternating hormone chemotherapy with high-dose medroxy-progesterone acetate and low-dose epirubicin for the treatment of hormone-resistant metastatic prostatic cancer.

Thirty patients with hormone-resistant metastatic progressive prostatic carcinoma were treated with sequentially alternating hormone chemotherapy. They were given 1,000 mg medroxyprogesterone acetate (MPA) orally for 26 days followed by intravenous doses of 25 mg/m2 epirubicin weekly for 4 weeks. The median duration of the treatment was 29 weeks (range 8-84). In 2 patients a more than 50% reduction in the size of measurable lymph node metastases was observed and in 2 others skeletal metastases decreased. Serum acid phosphatase normalized in 6 patients. Twenty-five patients achieved a subjective response (median duration 24 weeks; range 4-76 weeks). Median survival from the start of treatment (30 +/- 16 weeks) was unrelated to the achievement of subjective response. Normalization of serum acid phosphatase and a more than 50% reduction in serum alkaline phosphatase correlated with the achievement of a subjective response. Toxicity was generally mild, but in 1 case therapy was discontinued because of suspected cardiotoxicity. Sequentially alternating high-dose MPA low-dose epirubicin hormone chemotherapy has a marginal objective effect but a good subjective effect on progressing hormone-resistant prostatic cancer.

Actuarial Analysis↗