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Biomedical subjects

A Kauppila

Publications and source records attributed to A Kauppila.

At least 181 records · Page 10Linked to original sources
PubMed1982

Sulpiride improves inadequate lactation.

Twenty-eight newly delivered mothers with inadequate lactation volunteered for a placebo-controlled double-blind trial of sulpiride 50 mg thrice daily for four weeks. Treatment was allocated at random, and serum prolactin concentrations and breast-milk yields were measured before and serially during the trial. Of the 26 women who completed the trial, 14 had taken sulpiride and 12 the placebo. In the sulpiride-treatment group the mean maternal serum prolactin concentration rose from 49.0 +/- SE 3.6 micrograms/l to a maximum of 402.1 +/0 43.2 micrograms/l at two weeks; in the placebo-treated group, however, the concentration fell during the trial (from 84.7 +/- 24.0 micrograms/l to 47.8 +/- 8.6 micrograms/l). Mean breast-milk yields also increased in the sulpiride-treatment group (by an average of 212-265 ml) and fell in the women given placebo. Of the 14 infants in the sulpiride-treatment group, four did not need supplementary feeds during the trial; in the control group, however, all infants continued to require such feeds. Infants in the sulpiride-treatment group gained significantly more weight than did the controls (p less than 0.05). Three women taking sulpiride complained of mild side effects, but none occurred in the infants. These findings suggest that sulpiride is an effective treatment for inadequate lactation in the puerperium.

Clinical Trials as Topic↗
PubMed1982

Serum sex steroid and peptide hormone concentrations, and endometrial estrogen and progestin receptor levels during administration of human leukocyte interferon.

Five normally cycling healthy women were given daily subcutaneous injections of human leukocyte interferon (3 X 10(6) units/day) from the 3rd through 23rd day of the menstrual cycle, and serum steroid and peptide hormone concentrations monitored at 3-day intervals during the treatment and the preceding control cycle. Concentrations of cytosol and nuclear estrogen receptors (ERC and ERN, respectively) and progestin receptors (PRC and PRN) were also measured from endometrial biopsies taken on the 24th day of the control and treatment cycle. In addition, an extensive monitoring of clinical chemical and hematological tests from the blood samples were performed. Serum estradiol and progesterone concentrations were significantly decreased during the treatment cycle, suggesting that interferon interacts in vivo with the function of both FSH and LH. No significant changes were observed in the serum peptide hormone concentrations measured (FSH, LH, prolactin, insulin, growth hormone and TSH); neither were the levels of endometrial ERC, ERN, PRC and PRN affected by interferon administration. As expected, interferon administration resulted in decreased leukocyte counts. Moreover, an increasing tendency in the activities of serum alkaline phosphatase and gamma-glutamyltransferase during the interferon therapy shows that interferon may slightly interfere with the liver function. These results suggest that one of the mechanisms by which interferon treatment may affect the growth of hormone-dependent neoplasms could be the interaction with production and/or function of circulating hormonal compounds.

Adult↗
PubMed1982

Placental transfer of clenbuterol early in human pregnancy.

After administration of clenbuterol 80 microgram p.o., a beta-adrenoceptor agonist, the concentrations of (14C-labelled) clenbuterol in fetus, placenta and maternal plasma in 9 patients at 9-12 weeks gestation were measured during therapeutic abortion. The time interval between the administration and abortion ranged from 120 to 280 min. The mean concentrations of clenbuterol in maternal plasma, fetus and placenta were 0.37 (range 0.22-0.56), 0.32 (0.14-0.48) and 0.91 (0.12-1.73) ng equivalents per ml or per gram of tissue wet weight. The mean concentration ratio of clenbuterol between fetus and maternal plasma was 0.84 (6 cases); it did not vary with time. The concentration of clenbuterol in three amniotic fluid samples ranged from 0.06 to 0.16 ng/ml (mean 0.11). Maternal plasma concentrations showed wide variability of the pharmacokinetic phase at the time of abortion. The studies indicate that clenbuterol crosses the placenta early in human pregnancy and that it accumulates in the placenta.

Adolescent↗
PubMed1982

Screening of asymptomatic postmenopausal women for gynecological malignancies, with special reference to endometrial sampling methods.

To investigate the applicability of cytological and histological endometrial sampling methods and to study the incidence of silent premalignant or malignant gynecological diseases during the postmenopausal years, 415 asymptomatic women were examined both clinically and with cytological smears and 360 of them also examined with jet wash or pistolet aspiration and Vabra curettage. Examination with jet wash, pistolet aspiration and Vabra curettage was possible in 57.2%, 83.1% and 76.1% of the cases, respectively. The cytological specimens (jet wash, pistolet) and the Vabra curettage specimens were inadequate in 3.7% and 44.5% of cases, respectively. Our study revealed two malignant (one mammary and one gastric cancer with ovarian metastases), seven premalignant (four endometrial and three cervical) and 55 benign gynecological or mammary lesions, amounting to 15.4% of the 415 women. These results, with only four severe endometrial lesions, indicate the restriction of endometrial screening examinations to only well-defined high risk women. Of the methods used, the pistolet aspiration is the most recommendable due to its applicability, patient acceptance, diagnostic reliability and the low incidence of unsatisfactory samples.

Adult↗
PubMed1982

Effects of oral and intravenous TRH and metoclopramide on PRL and TSH secretion in women.

Pituitary secretion of PRL and TSH is under the control of inhibitory dopaminergic and stimulatory TRH-mediated mechanisms. To evaluate the relationships between these regulatory systems, ten healthy women were treated with oral TRH (20 mg twice daily), a dopamine blocking drug, metoclopramide (MC) (10 mg t.d.s.) or placebo for 1 week (from 8th to 14th cycle day). Serum concentrations of PRL, TSH, T3 and T4 were determined before, at the end, and 3 days after the treatments. In addition, PRL and TSH responses to i.v. TRH (200 micrograms) or MC (10 mg) were studied at the end of the oral treatments. Oral TRH treatment was accompanied by increases in basal T3 and T4 concentrations, no change in PRL, and a decrease in TSH 3 days after the end of treatment. Oral TRH did not modify the PRL response to i.v. MC while it eliminated the TSH response to i.v. MC, possibly because of elevated concentrations of thyroid hormones. Oral MC treatment raised the concentrations of PRL, T3 and T4, and also potentiated the PRL response to i.v. TRH, whereas the TSH response remained unaltered. These results demonstrate that dopaminergic and TRH-mediated mechanisms are related in the control of PRL and TSH secretions, perhaps directly or through thyroid hormones.

Administration, Oral↗
PubMed1982

Pituitary-adrenal and testicular function in preterm infants after prenatal dexamethasone treatment.

Pituitary-adrenal and testicular function was monitored by plasma ACTH and testosterone (T) measurements in preterm newborns (gestational age below 36 weeks), exposed in utero to dexamethasone treatment for prevention of respiratory distress syndrome. A group of age-matched premature newborns and full-term infants served as controls. The cord-blood ACTH level was high in each group (logarithmic means 65-75 ng/l), but decreased within the first 2 days of life to mean levels between 20-30 ng/l on days 3 to 10 inclusive. Dexamethasone treatment had no effect on the postnatal ACTH concentrations when compared with preterm or full-term controls. Similarly, no difference in plasma ACTH were found between untreated preterm and full-term infants during the first 10 days of life. T levels in mixed cord blood were on average 2-3 nmol/l in the preterm male infants. An increase to a mean level of 10 nmol/l was seen in 1 h and 1 d samples. Thereafter, the concentration of T decreased to 2-3 nmol/l on days 3-10 postnatally. No effect of dexamethasone treatment was seen on the postnatal pattern of plasma T. When preterm male and full-term male infants were compared, no difference was seen in the T peak in the first day of life. However, the 1-3, and 60-90 days concentrations of T were 2-fold (p less than 0.01-0.05) higher in the preterm group. It is concluded that prenatal dexamethasone treatment of the mother does not influence the postnatal pituitary-adrenal function as monitored by ACTH measurements. Likewise, no effect of this treatment was observed on the postnatal testicular activity of preterm male infants. The immediate postnatal peak in plasma T levels persisted longer in the preterm than in the full-term male infants.

Adrenocorticotropic Hormone↗
PubMed1982

Danazol has progestin-like actions on the human endometrium.

The administration of danazol, 200 mg three times daily, from the 3rd to the 23rd day of the cycle to normally menstruating women exhibited the following actions on the human endometrium: significantly reduced cytosol oestrogen and progestin receptor concentrations, and declined 17 beta-hydroxysteroid dehydrogenase activity. Very similar results were obtained during medroxyprogesterone acetate (100 mg daily) treatment for the same period of time. Danazol administration did not decrease circulating gonadotrophin levels but clearly suppressed luteal serum oestradiol and progesterone concentrations. Danazol was found to bind in vitro to endometrial progestin receptor with an affinity approximately 3% of that of progesterone. These findings are compatible with the notion that a local progestin-like rather than a systemic action of danazol is the way by which its therapeutic effect is exerted. This may be potentiated by the suppression of circulating oestradiol levels.

17-Hydroxysteroid Dehydrogenases↗
PubMed1982

Detrusor instability score in the evaluation of stress urinary incontinence.

The major cause of failure in the surgical treatment of stress urinary incontinence (SUI) in women is an occult detrusor instability. In order to detect detrusor instability and its degree, urological histories were standardized by scoring the replies to ten specific questions with O (indicative of SUI), 1 or 2 (slightly and markedly indicative of detrusor instability, respectively). The sum of the scores was termed the "detrusor instability score" (DIS). The DIS was calculated for 134 patients both preoperatively and 2 years after operation, and 112 of these women were also evaluated by bead-chain urethrocystography (UCG) before operation. The 10% failure rate among the 72 patients with a DIS of 0-7 (exclusive or nearly exclusive detrusor instability) was significantly less than the 32% rate in the 62 women with a DIS of 8-16 (SUI complicated by marked detrusor instability). The 38% failure rate in 47 women of peri- or post-menopausal age and having a DIS of 8-16 was higher than the 10% in the other 87 women. An increased risk of failure was also found in patients who had a DIS of 8-16 together with either a urethral inclination angle of 80 degrees or less (46% failure rate in 28 women) or a posterior urethrovesical angle of 160 degree or less (43% failure rate in 30 women) in lateral bead-chain UCG during straining. The mean DIS decreased after successful surgery, but remained constant in cases of failure. The scored urological data facilitate the detection of patients with detrusor instability. This is potentiated by those lateral bead-chain UCG findings which indicate a low motility of the proximal urethra or bladder neck.

Adult↗
PubMed1982

Low LH (hCG) receptor concentration in ovarian follicles in endometriosis.

The concentration of LH (hCG) receptors in the granulosa cells of ovarian follicles was assayed in 20 patients with histologically proven endometriosis and in 6 control patients. The levels of receptors in 15 patients with ovarian endometriosis (0.48 +/- 0.46 fmol/mg protein) and in 5 patients with endometriosis without ovarian involvement (0.51 +/- 0.52 fmol/mg protein) were lower (p less than 0.01 and p less than 0.05, respectively) than in control patients (1.32 less than 0.61 fmol/mg protein). The severity of the disease was not reflected in the results. The low receptor concentration in endometriosis suggests a failure in the mechanism mediating LH action in the follicle.

Adult↗
PubMed1982

Clinical outcome in endometrial cancer.

Patients with endometrial carcinoma (N = 1113) were treated by conventional therapy, using surgery and radiotherapy, complemented by daily administration of 100 mg oral medroxyprogesterone acetate (MPA) for a 2-year period. Only 7.3% of the malignancies were at an advanced clinical stage (III or IV), whereas 75.9 and 16.8% of the carcinomas were detected at clinical stages I and II, respectively. The 5-year survival rate was 71.0% overall, and 77.8%, 61.0, 29.0, and 5.3 for clinical stages I, II, III, and IV, respectively. Patients with anaplastic carcinoma (grade 3) at all clinical stages had significantly lower survival rates than had patients with well-differentiated (grade 1) and moderately differentiated (grade 2) adenocarcinomas. Death of grade 1, grade 2 and grade 3 endometrial carcinoma during the first 2 years occurred in 4.7, 6.8, and 18.2% of cases, respectively, in stage II, indicating that adjuvant MPA cannot totally prevent the progression of endometrial malignancy. The incidence of anaplastic endometrial carcinoma increased with the spread of the disease. It often appeared in patients with low body weight or a second invasive malignancy, but seldom occurred in young patients or patients with diabetes, uterine myoma, or a history of previous estrogen use. The worsened prognosis associated with old age, low body weight, and presence of a second invasive malignancy thus seems at lest partly due to the increased incidence of anaplastic carcinoma, which, on the other hand, did not contribute to the decreased 5-year survival rate of patients with diabetes or severe hypertension.

Adenocarcinoma↗
PubMed1982

Fetal adrenocorticotropic hormone and prolactin at delivery.

The concentrations of adrenocorticotropic hormone (ACTH) and prolactin in fetal scalp and umbilical cord blood were measured in 49 full-term fetuses, 25 of whom were delivered spontaneously, 10 of whom underwent induced vaginal delivery, and 14 of whom underwent elective cesarean section. Serial fetal scalp blood samples taken during the 35 vaginal deliveries showed no change in concentration of these hormones. The mean (+/- SD) plasma level of ACTH in cord artery blood after vaginal delivery (315 +/- 249 ng/liter) was significantly higher (P less than .05) than after cesarean section (184 +/- 201 ng/liter), indicating that the fetal anterior pituitary is capable of responding to partal stress.

Adrenocorticotropic Hormone↗
PubMed1982

Bromocriptine and norethisterone in the treatment of premenstrual syndrome.

Thirty-six women suffering from premenstrual syndrome were treated with bromocriptine or norethisterone in a randomized placebo-controlled double-blind study. Bromocriptine decreased breast engorgement and irritability (P less than .01) and also decreased the total score of all symptoms (P less than .05). Weight gain during the luteal phase was smaller (P less than .05) during bromocriptine than during placebo treatment. Norethisterone treatment alleviated (P less than .05) breast tenderness. Changes in hormonal parameters and liver function tests during bromocriptine treatment were minimal, whereas norethisterone decreased serum levels of luteinizing hormone (P less than .01), follicle-stimulating hormone (P less than .001), and progesterone (P less than .05), while increasing the serum level of prolactin (P less than .01) and gamma-glutamyltranspeptidase activity (P less than .05). Serum levels of cholic acid and chenodeoxycholic acid remained unchanged during both therapies. Bromocriptine treatment brought about side effects in 6 and norethisterone in 3 women. At the doses used, bromocriptine appears more efficient than norethisterone with regard to premenstrual symptoms, although norethisterone is better tolerated.

Adult↗
PubMed1982

Scored urological history and urethrocystometry in the differential diagnosis of female urinary incontinence.

The diagnostic accuracy of a scored urological questionnaire in the differential diagnosis of female urinary incontinence was evaluated urodynamically in a series of 121 patients. A low urgency score (US) was present in 81% of the 57 patients with urodynamically proven stress urinary incontinence. About one third of the 37 patients with mixed incontinence had a low US. 6% of the 67 patients with a low US had unstable bladders. Of the 54 patients with a high US, 20% were stress incontinent, 37% mixed incontinent, 26% urge incontinent and 17% had no pathology on urethrocystometry. Degenerative changes in the urogenital area taking place with ageing may be responsible for high USs in some of the patients with pure stress incontinence. Urodynamic failures in the urethral closure function were identical in stress and mixed incontinence. It is recommended that patients with a high US should be investigated urodynamically before treatment.

Adult↗