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Biomedical subjects

V M Puolakka

Publications and source records attributed to V M Puolakka.

5 recordsLinked to original sources
PubMed2000

Weekly mitomycin C followed by monthly bacillus Calmette-Guerin or alternating monthly interferon-alpha2B and bacillus Calmette-Guerin for prophylaxis of recurrent papillary superficial bladder carcinoma.

PURPOSE: We evaluated alternatives to bacillus Calmette-Guerin (BCG) monotherapy using a new combination of chemotherapy and immunotherapy for recurrent superficial bladder carcinoma. MATERIALS AND METHODS: A total of 236 patients with frequently recurrent stage Ta or T1 bladder tumors were enrolled in our prospective, randomized, multicenter Finnbladder IV study. The initial mitomycin C instillation was instilled in all patients perioperatively after transurethral resection, followed by 4 weekly instillations of mitomycin C. Thereafter patients were randomized to receive monthly for up to 1 year BCG only or interferon-alpha2b and BCG alternating monthly. Primary end points were time to initial recurrence, recurrence rate (number of recurrences per patient-year) and recurrence index (number of recurrent tumors per patient-year). RESULTS: Of the 236 randomized patients 205 were eligible for study with a median overall followup of 30.7 months. Monthly BCG was superior to alternating monthly interferon-alpha and/or BCG with respect to time to initial recurrence (log rank test p <0.00001) as well as recurrence rate (0.4 versus 0.9, p <0.00001) and index (0.9 versus 3.0, p <0.00001). Side effects were limited. CONCLUSIONS: Monthly BCG given for up to 1 year preceded by perioperative and an additional 4 weekly mitomycin C instillations is a well tolerated mode of instillation therapy, providing excellent tumor control comparable to that of the best reported instillation regimens. No benefit was obtained by alternating interferon-alpha2b with BCG.

Adjuvants, Immunologic↗
PubMed1993

Randomized controlled study of chemoprophylaxis in transurethral prostatectomy.

We studied 599 evaluable patients with benign prostatic hypertrophy at 7 urological units. Before transurethral prostatectomy the patients were randomized into 3 groups: group 1--197 patients given single-dose ceftriaxone (2 gm.), group 2--203 patients given 160/800 mg. trimethoprimsulfamethoxazole and group 3--199 controls given no antimicrobial prophylaxis. Patients with a preoperative indwelling catheter, positive urine culture, signs of active infection or preoperative antibiotic treatment were excluded. Postoperative infectious complications were demonstrated in 15 of 197 (7.6%), 25 of 203 (12.3%) and 43 of 199 (21.6%) patients in the study groups, respectively. The difference in infectious complications between groups 1 and 3 was statistically highly significant (p < 0.01) and between groups 2 and 3 it was significant (p < 0.05). Single-dose antibiotic prophylaxis proved to be useful in the prevention of serious infectious complications after transurethral prostatectomy.

Aged↗
PubMed1988

Expression of the human transferrin receptor in subrenal capsule assay in the mouse.

The expression of a cell proliferation marker, the human transferrin receptor, was studied in ten human gastrointestinal tumors prior to and after implantation under the renal capsule in the mouse (1-6 days). These data were compared to the increase in tumor size in situ, and to the infiltration of inflammatory cells. All tumors studied expressed the transferrin receptor prior to implantation. Forty of 47 implants expressed the receptor, the strongest expression occurring on day 4, accompanied by a reorganization of tumor tissue to a morphology similar to that before implantation. On days 5 and 6 the expression of the transferrin receptor declined. Implants showed maximal increase in size on days 1 and 2, decreased in size on days 3 and 4, and increased again on days 5 and 6. The increase in the size of the implants on days 5 and 6 was accompanied by considerable infiltration of inflammatory cells, and was probably mostly a result of invading host cells and inflammation. If size alone is used as a criterion for tumor proliferation in this subrenal capsule assay, day 4 seems to be the most appropriate for evaluation. This is supported by a strong expression of a proliferation marker, the human transferrin receptor, during this time.

Animals↗
PubMedDate not supplied

Transurethral prostatectomy in patients with preoperative bacteriuria: double-blind study with oral fleroxacin and cefalexin.

We compared oral fleroxacin and cefalexin in the prevention of postoperative infectious complications after transurethral prostatectomy (TURP) in patients with preoperative bacteriuria. 95 patients underwent TURP due to benign prostatic hyperplasia with preoperative bacteriuria. The therapy consisted of 7 days of oral fleroxacin 400 mg once a day or cefalexin 500 mg three times daily. After 2 weeks, 62% of the urine samples were sterile in the fleroxacin groups but only 37% in the cefalexin group (p = 0.047). Patients in the cefalexin group had also statistically significantly more symptoms of urinary tract infections. After 6 weeks, the bacterial eradication rate was 53% in the fleroxacin group and 37% in the cefalexin group. There were no septicemias. TURP can be performed with reasonable safety with this oral antibiotic therapy.

Administration, Oral↗