Neoadjuvant Chemotherapy Does Not Increase the Morbidity of Radical Cystectomy: A 10-year Retrospective Nationwide Study.

Background: Neoadjuvant chemotherapy (NAC) is underutilized in the treatment of bladder cancer (BC).

Objective: To investigate the effect of NAC on the risk of surgical complications for radical cystectomy (RC) in a population-based setting.

Design, Setting, And Participants: All radical cystectomies performed in Finland during 2005-2014 were included in the study.

Randomized clinical trial of tissue glue versus absorbable sutures for mesh fixation in local anaesthetic Lichtenstein hernia repair.

Background: Chronic pain may be a long-term problem related to mesh fixation and operative trauma after Lichtenstein hernioplasty. The aim of this study was to compare the feasibility and safety of tissue cyanoacrylate glue versus absorbable sutures for mesh fixation in Lichtenstein hernioplasty.

Methods: Lichtenstein hernioplasty was performed under local anaesthesia as a day-case operation in one of three hospitals.

Commentary: Nationwide analysis of complications related to inguinal hernia surgery in Finland: a 5 year register study of 55,000 operations.

Background: The aim of this study was to evaluate the incidence of severe complications of adult inguinal hernia surgery from 2003 to 2007 using data from the Finnish National Patient Insurance Association.

Methods: All major surgical complications are reported to the association because it handles financial compensation for patients' injuries without proof of malpractice. The number of inguinal hernioplasties was obtained from the National Hospital Discharge Registry.

Pubic magnetic resonance imaging findings in surgically and conservatively treated athletes with osteitis pubis compared to asymptomatic athletes during heavy training.

Background: Osteitis pubis is characterized by diffuse pain, inflammation, and bony changes in the pubic symphysis. Bone marrow edema in magnetic resonance imaging is associated with stress injury and osteitis of the pubic bone.

Hypothesis: Laparoscopic mesh repair decreases inflammation and pain in the pubic periosteum.

A single-surgeon randomized trial comparing three composite meshes on chronic pain after Lichtenstein hernia repair in local anesthesia.

Background: Chronic pain may be a long-term problem related to operative trauma and mesh material in Lichtenstein hernioplasty.

Study Design: Inguinal hernioplasty was performed under local anesthesia in 228 patients (232 hernias) in day-case surgery by the same surgeon and exactly by the same surgical technique. The patients were randomized to receive either a partly absorbable polypropylene-polyglactin mesh (Vypro II(R) 50 g/m(2), 79 hernias), a lightweight polypropylene mesh (Premilene Mesh LP(R) 55 g/m(2), 75 hernias) or a conventional densely woven polypropylene mesh (Premilene(R) 82 g/m(2), 78 hernias).

Feasibility of axillary ultrasound in the quality assessment of sentinel node biopsy in breast cancer surgery.

Background And Aims: The purpose of this study was to evaluate the efficacy of high-resolution axillary ultrasound (AU) in detecting the rate of recurrence after a negative sentinel node (SN) biopsy in patients with breast cancer and without additional axillary dissection.

Materials And Methods: The operating oncologic surgeon performed 196 consequent sentinel node biopsies during surgery of breast cancer. The sentinel nodes were identified by using preoperative lymphoscintigraphy, intraoperative gamma probe and Patent Blue dye.

Does laparoscopy used in open exploration alleviate pain associated with chronic intractable abdominal wall neuralgia?

Background: This study aimed to assess the efficacy of diagnostic laparoscopy and open exploration of trigger points (scar revision and neurectomy) in the treatment of intractable chronic abdominal wall pain.

Methods: This prospective nonrandomized study enrolled 24 patients (21 women) with an average age of 59 +/- 11 years. Abdominal wall pain was diagnosed by excluding other causes of pain and using multiple injections of bupivacain.

Incidence of occult inguinal and Spigelian hernias during laparoscopy of other reasons.

Background: A true incidence of occult inguinal and Spigelian hernias in adult population is unknown. The frequency of incipient hernias was studied during laparoscopy of other abdominal diseases.

Methods: The 201 laparoscopic procedures included 104 cholecystectomies, 55 fundoplications, 36 diagnostic, and 6 miscellaneous operations.

Effect of screening mammography on the surgery of breast cancer in Finland: a population-based analysis during the years 1985-2004.

A nationwide mammographic screening of women aged 50 to 59 years commenced in Finland in January 1987. We studied the effect of screening on surgical diagnosis, treatment, and survival of breast cancer in one geographic area in Finland. We reviewed the medical records, survival data from Finnish Cancer Registry, and screening data from the Finnish Mammogrphic Working Group of 1049 women who underwent surgery for breast cancer in our hospital between the years 1985 and 2004.

Successful treatment of osteitis pubis by using totally extraperitoneal endoscopic technique.

Osteitis pubis is characterized by pain, inflammation, and sclerosis in the pubic symphysis. It is often a self-limiting disease in athletes, but persistent pain may occasionally need surgery. Video-assisted placement of extraperitoneal retropubic synthetic mesh to support the damaged area may hasten the healing of this injury.

Laparoscopy in chronic abdominal pain: a prospective nonrandomized long-term follow-up study.

Goal: Our aim was to assess the long-term efficacy of diagnostic laparoscopy and adhesiolysis on the treatment of intractable chronic abdominal pain.

Study: This was a prospective nonrandomized study of 72 patients (60 women and 12 men). One surgeon performed a total of 79 diagnostic laparoscopies including 61 adhesiolysis.

Long-term pain and recurrence after repair of ventral incisional hernias by open mesh: clinical and MRI study.

Background And Aims: Polypropylene mesh repair of large incisional ventral hernias has become increasingly popular. Long-term effects of the mesh on pain and abdominal muscles are not known.

Patients/methods: Retromuscular pre-peritoneal polypropylene mesh was placed by open technique in 84 consecutive patients with large ventral hernias (mean defect size 130 cm(2)).

Operative treatment of massive ventral hernia using polypropylene mesh: a challenge for surgeon and anesthesiologist.

Objects: Surgical repair of very large ventral hernias has become feasible after the introduction of synthetic meshes and developments in intensive-care treatment. In addition to the operative challenges, postoperative disorders in the cardiovascular system, tissue oxygenation, increased intra-abdominal pressure, and pulmonary embolism expose the patient to severe risks.

Methods: From 1997-2002 we operated on ten patients with giant ventral incisional or umbilical hernia (mean defect size 240 cm(2)) by using retromuscular polypropylene mesh.

Totally extraperitoneal endoscopic (TEP) treatment of sportsman's hernia.

Sportsman's hernia is a term used to describe a weakness or disruption of is a term used to describe the musculotendinous part of the posterior inguinal wall, which causes persistent groin pain in athletes. A video-assisted placement of extraperitoneal synthetic mesh to support the damaged area may heal this injury. Forty-one male athletes at an elite level (mean age 27 +/- 7.

Polymorphism in the peroxisome proliferator-activated receptor-gamma gene in women with polycystic ovary syndrome.

Background: In view of the strong evidence implicating peroxisome proliferator-activated receptor-gamma (PPARgamma) in adiposity and insulin resistance a study was carried out to investigate PPARgamma genotype frequencies in women with polycystic ovary syndrome (PCOS) and to elucidate its role in the pathogenesis of the syndrome.

Methods: The study involved 135 women with PCOS and 115 healthy control women who were genotyped for a known functional variant of the PPARgamma gene using single strand conformation polymorphism (SSCP) analysis.

Results: A significantly different allele distribution of the Pro12 Ala polymorphism of the PPARgamma gene was observed between the two groups, with the frequency of the variant Ala isoform being significantly reduced in the PCOS group (12.

Lichtenstein inguinal herniorraphy under local infiltration anaesthesia as rapid outpatient procedure.

Background: In Scandinavian countries the use of local anaesthesia combined with fast patient's discharge is still uncommon in inguinal herniorraphy.

Aims: To report the feasibility, safety, costs and long-term outcome in terms of pain and recurrence after 101 open inguinal herniorraphies operated under local anaesthesia as rapid outpatient procedure.

Methods: All patients were selected and operated using Lichtenstein polypropylene mesh herniorraphy by the same senior surgeon and one nurse.

Epidemiology and aetiology of middle ear cholesteatoma.

A total of 500 patients with cholesteatoma diagnosed and operated during 1982-91 in the region of Tampere University Hospital and Mikkeli Central Hospital in Finland were analysed retrospectively. The mean annual incidence was 9.2 per 100,000 inhabitants (range 3.

Clinical relevance of tubulus anomalies and compound cilia.

Transmission electron microscopy (TEM) from nasal mucosa and nasal mucociliary transport rate (MTR) with a radio-isotopic method were examined in 144 patients with various respiratory symptoms. Examinations were not performed during acute infections. In cases of increased amount of tubulus anomalies: nasal MTR was not significantly slower than in other patients, the disorientation of ciliary beat direction was significantly larger, there was no connection with increased amount of compound cilia and there was no correlation to any specific symptom or respiratory disease.

Association of incipient disc degeneration and instability in spondylolisthesis. A magnetic resonance and flexion-extension radiographic study of 20-year-old low back pain patients.

The concurrence of early disc degeneration and abnormal segmental motion in spondylolysis of young low back pain patients (n = 14) was investigated using magnetic resonance imaging (MRI) and flexion-extension radiography. Seven patients with L5 spondylolisthesis had normal discs on MRI and 7 had disc degeneration below the slipped vertebra. The parallel motion, angular mobility and centre of motion were similar in the degenerated discs and in normal discs.

Magnetic resonance study of disc degeneration in young low-back pain patients.

The correlation of roentgenographic findings, clinical history, and incipient disc degeneration (DD), diagnosed with magnetic resonance imaging, was analyzed in young patients with low-back pain (LBP). One or more lumbar discs were abnormal in 57% of the 20-year-old LBP patients (n = 75) and in 35% of the asymptomatic controls (n = 34) in MRI. Narrowed disc spaces and alterations attributed to lumbar Scheuermann's disease, shown on the radiographs, were always associated with DD in MRI.

Disc degeneration and lumbar instability. Magnetic resonance examination of 16 patients.

Flexion and extension radiographs of 75 young males with low back pain disclosed abnormal segmental motion of the lumbar spine in 16 patients with translational movements in 20 intervertebral segments. These 16 patients were further investigated by magnetic resonance imaging to assess disc degeneration in the unstable segments. On T2-weighted images of the 20 segments, the disc was normal in 13 and degenerated in only 7 patients.

Circulating lipid and lipoprotein concentrations during danazol and high-dose medroxyprogesterone acetate therapy of endometriosis.

In a study on endometriosis, ten patients were treated with danazol (200 mg three times a day) and ten patients with high-dose medroxyprogesterone acetate (MPA) (100 mg a day) for 6 months. The circulating high-density lipoprotein-cholesterol concentration decreased significantly in the danazol (53%) and in the MPA groups (26%); the change in the danazol group was significantly higher than that in the MPA group. Danazol also significantly increased the low-density lipoprotein-cholesterol levels (37%), whereas MPA had no significant effect.

Disc degeneration in Scheuermann disease.

Comparison of the radiographic signs of Scheuermann disease and the corresponding disc degeneration on thoracolumbar magnetic resonance (MR) images was made in 21 young patients. Marginal sclerosis, Schmorl nodes and narrowed disc spaces, but not irregular or wedge-shaped end-plates, were significantly associated with disc degeneration. Fifty-five percent of the discs in the patients with Scheuermann disease were abnormal on MRI, compared with 10% in asymptomatic controls.