Peptic ulcer surgery in the nineties: patient profile, immediate results and clinical findings.

The decreasing frequency of elective ulcer surgery and the persisting frequency of emergency surgery for peptic ulcer diseases has often been reported. The reason for the divergent epidemiological behaviour of the two subgroups of surgical candidates is not clear. The present cross-sectional, population-based analysis of patients undergoing peptic ulcer surgery evaluates the mode of preoperative therapy in elective and emergency cases.

Benign retroperitoneal schwannoma.

A rare case of benign retroperitoneal schwannoma in a 76-year-old man is reported. Ultrasound and computerized tomography disclosed two cystic retroperitoneal tumors sized 12 cm and 7 cm. The larger tumor was located anterior to psoas muscle and the smaller one was within the muscle.

Primary arterioenteric fistula between common iliac artery and ileum with massive bleeding.

Primary iliac artery aneurysms are rare, and a fistula to the terminal ileum with bleeding is very uncommon. A case with a primary massively bleeding iliaco-ileal fistula is described. In an emergency operation the common iliac artery was ligated and the fistula to the small bowel was resected.

Peptic ulcer surgery during the H2-receptor antagonist era: a population-based epidemiological study of ulcer surgery in Helsinki from 1972 to 1987.

To evaluate the effects of improvements in medical therapy on the incidence of, indications for and operative methods used in peptic ulcer surgery, all cases of primary peptic ulcer surgery among adults in the city of Helsinki in the years 1972, 1977, 1982 and 1987 were analysed. There was a total of 565 such cases in a population which consisted of 5.2 X 10(5) individuals in 1972 and 4.

Surgical treatment of gastric carcinoma.

To investigate changes in the results of treatment of gastric carcinoma, two 10-year periods between 1963 and 1982 with 641 and 630 patients, respectively, were compared. In the two groups, 94 percent and 92 percent of patients were operated on. The operation was considered curative in 200 and 265 patients in Groups 1 and 2, respectively.

Effect of PCO2 on intracellular pH in in vitro frog gastric mucosa.

Steady-state intracellular pH (pHi) in 0, 5, and 10% CO2-buffered Ringer solution in sheets of in vitro frog gastric antral or fundic mucosa has been measured using the pH-sensitive fluorescent dye 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein (BCECF). In tissues perfused with N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES)-100% O2 buffer [extracellular pH (pHo) = 7.14], steady-state pHi in antral surface cells was 7.

Human epidermal growth factor: renal production and absence from plasma.

Among the unsettled questions in the physiology of human epidermal growth factor (EGF) are (1) does EGF circulate in the blood and (2) what is the source of the abundant urinary immunoreactive EGF (irEGF). Therefore, we monitored the concentration of irEGF by an ultrasensitive assay in blood plasma from 5 healthy subjects every 20 min overnight carefully avoiding activation of platelets. Detectable levels (0.

Carcinoma of the stomach and its heredity in young patients.

The clinical and histopathologic characteristics of gastric carcinoma in young patients (less than 40 years old) were studied retrospectively. The carcinoma was of the diffuse type in 94% of the young patients, and typical features were poor prognosis, an equal sex ratio, and a strong association with blood group A. The family histories of the young patients were studied.

Near-total gastrectomy for gastric cancer.

Fifty-nine consecutive patients (95 percent) with gastric cancer of the distal portion of the stomach were operated on with 95 percent subtotal gastrectomy between 1975 and 1980. The operations were for cure in all cases. Twenty-five patients were alive after 5 years, for a crude 5 year survival rate of 42 percent.

Effect of ethanol on frog gastric mucosa. Electrophysiologic and morphologic correlations.

The effects of and recovery from luminal ethanol (0%-100%) were assessed in the in vitro chambered frog gastric mucosa. At concentrations of 5%-10%, the potential difference decreased during exposure, but recovered after washout. No gross or light microscopic changes were observed.

Urinary epidermal growth factor concentrations in various human malignancies.

We determined the concentrations of immunoreactive epidermal growth factor in the urine (U-irEGF) of 97 adult patients with various malignancies, including carcinomas of the urinary bladder, kidney, stomach, colon, rectum, breast, endometrium, uterine cervix, ovary, vagina, prostate, pancreas and thyroid, liposarcoma and skin melanoma. The relative U-irEGF concentrations (ng m-1 creatinine) were higher (P = 0.002) for the whole series of female patients than for healthy controls matched for sex and age.

Local management in primary breast cancer. Our experience of 331 cases.

The peroperative exploration of axillary content gave wrong result from the stage of axillary nodes in every fourth case compared with the final result of axillary evacuation. There were no locoregional recurrences in stage I-patients irradiated after mastectomy. In postoperatively irradiated stage II-patients there were locoregional recurrences in 2.

Analysis of 58 patients surviving more than ten years after operative treatment of gastric cancer.

We evaluated 58 patients who were still alive more than ten years after operative treatment of gastric cancer. We reexamined their histologic specimens and compared them with those of matched paired controls of the same sex and age who had died of gastric cancer. Forty-two patients consented to a follow-up study.

Total and near-total gastrectomy for gastric cancer in patients over 70 years of age.

A total or near-total gastrectomy was performed in 52 patients over 70 years of age in our hospital from 1975 through 1982. The hospital mortality rate was 9.6 percent.

A suggested follow-up time for breast cancer patients.

The data for this study, consisting of 300 females treated for breast cancer in 1951-1961, were evaluated in order to ascertain when excess mortality from breast cancer disappears and what would be an appropriate follow-up period for investigational purposes. The clinical stages of the patients were classified as follows: 23.3%, stage I; 49%, stage II; 20.

Total gastrectomy with esophagojejunostomy. Analysis of 100 consecutive patients.

One hundred consecutive patients treated for gastric cancer by total gastrectomy from 1977 to 1982 at the second department of surgery of the Helsinki University Central Hospital were analyzed. The mean age of the patients was 61.5 years.

Changes in the treatment and prognosis of breast cancer.

The data of 331 women with breast cancer treated in the Second Department of Surgery, Helsinki University, during the period 1976-1980 (patient material, treatment, prognostic factors) is evaluated and compared with an equally large patient material treated during the period 1951-1961 in the same hospital. A breast lump was the main symptom in 94% and the tumour was found by the patient in most cases. Only two patients were younger than 30 years.

Factors influencing 5-year survival in gastric malignancies after total gastrectomy.

One hundred consecutive patients were analysed who had been treated with total gastrectomy in the Second Department of Surgery, Helsinki University Central Hospital, for malignancies of the stomach from 1977 to 1982. Hospital mortality was 8%. The 5-year survival rate in this selected group of patients was 43% and 34% for patients with gastric cancer.

A new type of sliding hiatus hernia.

A series of patients showing a previously unrecognized type of sliding hiatus hernia is presented and analyzed. This type of hernia is characterized by reflux of the mucous membrane of the Hiss angle into the lumen of the esophagus. The occurrence of mucosal prolapse is a secondary phase of gastroesophageal reflux.

The management of non-neoplastic esophageal perforation.

The clinical features, management and prognosis of non-neoplastic esophageal perforation are evaluated in a clinical series of 29 patients. Five of 12 spontaneous ruptures were caused by vomiting after alcoholic intake. There were 12 iatrogenic perforations, five of which were caused by esophageal dilatation, four by diagnostic endoscopy and three by endoscopic removal of foreign bodies.

5-Fluorouracil in the treatment of acute pancreatitis.

The present data show that treatment with 5-fluorouracil may be of some benefit, but the results are not at all as convincing or promising as those previously reported in clinical and experimental trails. One possible explanation is that the dose of 5-fluorouracil was too small. However, Russian clinical studies have reported good results with identical doses.

Determination of axillary nodal status in surgery of breast carcinoma: a prospective study of thirty-five patients.

Thirty-seven axillary status of patients with breast carcinoma was studied with preoperative and peroperative palpation before mastectomy and total axillary dissection. Special attention was paid to the clinical suspiciousness and size of axillary nodes. The preoperative axillary palpation gave false diagnosis of axillary content 27% of the time and peroperative, 19%.

Treatment of spontaneous rupture of the esophagus.

A series of 10 patients with spontaneous rupture of the esophagus is analysed. Early primary closure of the tear and good drainage of the mediastinum and pleural cavity give the best results in such cases. Correct diagnosis is difficult and is often missed in the acute phase.