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Biomedical subjects

A Kauppila

Publications and source records attributed to A Kauppila.

At least 199 records · Page 11Linked to original sources
PubMed1982

Ureteric complications following treatment of gynaecological cancer.

The incidence, development and diagnosis of ureteric injuries secondary to radical operative or radiological treatment of uterine malignancy is described. Special attention is paid to the importance of early detection and management. Immediate peroperative repair of surgical ureteric damage gives most favourable results. Also in postoperatively diagnosed ureteric lesions the definitive treatment has to be carried out without delay. Ureteroneocystostomy, psoas-hitch procedure or transureteroureterostomy are the most preferable methods. In the late ureteric strictures secondary to radiotherapy the operation techniques employing nonirradiated tissues are recommended, eg. transureteroureterostomy, ileal replacement of strictured ureter and ileo-uretero-cystostomy or ileo-uretero-cutaneostomy. An ureteric prosthesis or ureteric stent may also be used in special cases. Ureteric complications following operative or radiological treatment of pelvic malignancy are usually curable. Therefore the employment of isotope renography or intravenous pyelography regularly is essential in the follow-up of asymptomatic patients and always immediately at the appearance of any urinary tract complaint in patients previously treated for pelvic malignancy.

Female↗
PubMed1981

Estrogen and progestin receptors in endometriosis lesions: comparison with endometrial tissue.

Cytosol estrogen (ER) and progestin (PR) receptors were quantified in 47 endometriosis lesions from 41 patients and compared with receptor measurements in the endometrial tissue of nine of these patients. Half of the specimens of endometriosis tissue contained PR only, in concentrations that were significantly lower than in the endometrium. Only 30% of the specimens of endometriosis tissue contained the two receptors simultaneously, and levels of ER were very low compared with those in the endometrium. Levels of PR in the specimens of endometriosis tissue were highest at the periovulatory period, whereas concentrations of ER tended to be highest at the beginning and close to the end of the cycle. These results suggest that regulation of these receptors is dissimilar in endometriosis lesions and endometrium. It remains to be seen whether differences in receptor distribution in the lesions of individual patients could explain differences in the course of this disease, and have therapeutic implications. The presence of PR in the majority of the endometriosis lesions is in accord with the favorable therapeutic response often obtained with progestin treatment of this disease.

Adult↗
PubMed1981

Postmenopausal hormone replacement therapy with estrogen periodically supplemented with antiestrogen.

To inhibit endometrial stimulation during postmenopausal estrogen therapy, 25 women with climacteric symptoms were treated with a daily dose of 1.25 mg of conjugated estrogens for 7 weeks followed by a period of 10 days with clomiphene citrate administration (50 mg per day). This combination was repeated three times during the 6-month trial. The marked relief of climacteric symptoms with estrogen was slightly less during clomiphene treatment. Uterine bleeding occurred five times during estrogen treatment periods but never during or after clomiphene supplementation. Histologic examination revealed endometrial atrophy in 41% of the samples after the first estrogen treatment, whereas after the first and third clomiphene periods this was increased to 77% and 73%, respectively. The first clomiphene treatment significantly decreased the concentrations of cytosol estrogen and progestin receptors in endometrium, as compared with the levels recorded at the end of the preceding estrogen therapy. The depression in the cytosol estrogen receptor concentration was persistent, whereas cytosol progestin receptor concentration tended to increase during the subsequent estrogen-plus-clomiphene treatment. Estrogen declined serum concentration of follicle-stimulating hormone (FSH), whereas the concentration of luteinizing hormone (LH) and prolactin remained unchanged. Clomiphene did not change the levels of these hormones from those observed during the estrogen treatment. The concentration of free fatty acids in serum was increased during the estrogen and clomiphene treatments, whereas the levels of cholesterol and high-density lipoprotein--cholesterol did not change. Our results suggest that this treatment regimen relieves climacteric symptoms without endometrial stimulation or other adverse effects. Thus, clomiphene appears to be a practical alternative to progestin for interruption of the postmenopausal endometrial effect of estrogen.

Clomiphene↗
PubMed1981

A dose response relation between improved lactation and metoclopramide.

In a placebo-controlled, cross-over study, thirty-seven puerperal women with inadequate production of breast-milk were treated with 5, 10, or 15 mg of metoclopramide three times a day for 2 weeks. Doses of 10 or 15 mg significantly raised maternal serum prolactin; they also increased breast-milk secretion by 42.5 +/- 34.7 (SD) ml and 50.0 + 35.9 ml per feed, respectively. This effect was unrelated to the phase of the puerperium during which treatment was started. The increase in milk secretion was associated with a decreased need for supplementary feeds, and 33% of the infants of these mothers needed no supplementary feeds during treatment. 5 mg doses did not stimulate prolactin milk secretion. Although placebo had no objective effect on the milk yield, 24% of the women judged its effect to be good, and 89% of women on metoclopramide reported a good effect. Seven women on metoclopramide and three women on the placebo complained of slight side-effects. No adverse effects upon the infants were observed. Metoclopramide therapy may be useful for improving poor lactation.

Clinical Trials as Topic↗
PubMed1981

Comparison between fluproquazone and indomethacin in treatment of primary dysmenorrhoea.

Two prostaglandin synthesis inhibitors, fluproquazone (100 mg) and indomethacin (25 mg), were compared in a double-blind, crossover study for treatment of primary dysmenorrhoea in 31 patients. Each drug was used during two consecutive menstruations in randomized order. Both treatments significantly relieved spasmodic pains and other dysmenorrhoeic symptoms. No significant differences were found between the treatments in regard to the overall efficacy assessed at the end of each treated cycle. However, 20 patients preferred indomethacin and 7 patients fluproquazone. Three patients reported mild side-effects with fluproquazone as compared to five patients wih indomethacin. It is concluded that both treatments can be used for treatment of primary dysmenorrhoea.

Adolescent↗
PubMed1981

Maternal, fetal and aminiotic fluid ACTH, cortisol and prolactin in association with medical beta-adrenergic stimulation.

In view of observations indicating accelerated fetal pulmonary maturation after tocolytic therapy with beta-adrenergic agonists, this study was undertaken to determine whether the phenomenon is related to enhanced maternal or fetal ACTH, cortisol or prolactin secretion. The concentrations of ACTH, cortisol and prolactin in maternal venous blood, umbilical arterial and venous blood, and amniotic fluid were similar after short-term maternal intravenous infusion of isoxsuprine, fenoterol or isotonic saline, and they did not increase in the maternal venous blood during these treatments or during long-term treatment with intravenous ritodrine. These results suggest that the accelerated fetal pulmonary maturation induced by beta-adrenergic stimulation is not mediated by ACTH, cortisol or prolactin.

Adrenergic beta-Agonists↗
PubMed1981

Development and classification of parovarian cysts. An ultrastructural study.

In this study the scanning and transmission electron microscopical features of parovarian cysts were analyzed to further the determination of histogenesis, development, classification and differential diagnosis of these lesions. Paramesonephric type lesions showed ciliated and microvillous cells, sometimes in a wavy arrangement with grooves and holes, similar to the oviduct epithelium. The mesonephric type consisted of an epithelium of tightly arranged angular cells with minimally developed surface structures. Destruction of specialized surface structures was frequently seen, epithelial proliferation was uncommon.

Female↗
PubMed1981

Endometrioid ovarian tumors: morphology and relation to other endometrial conditions.

Ovarian adenocarcinomas of endometrioid type were studied by different histological and histochemical technics to determine their morphologic criteria, the development of these tumors as well as their relationship to different conditions of the endometrium. Mucin secretion was evident as was cellular polymorphism on the ultrastructural level. Surface analysis revealed an endometrium-like pattern with cells showing cilia as well as numerous microvilli, different from that of other ovarian epithelial surface tumors. Ovarian endometrial lesions showed pattern as well as occasional derangement of surface structures in histologically regular epithelium.

Adenocarcinoma↗
PubMed1981

Cyclic clomiphene citrate treatment lowers cytosol estrogen and progestin receptor concentrations in the endometrium of postmenopausal women on estrogen replacement therapy.

Clinical and experimental studies have indicated that a nonsteroidal antiestrogen, clomiphene citrate, might prevent the stimulatory action of estrogens on the human endometrium. To investigate the mechanisms of this effect, the treatment of 19 postmenopausal patients with conjugated estrogens for 6 months was supplemented cyclically for 10 days with clomiphene citrate after every 7 weeks. Ten patients ingested clomiphene citrate alone, whereas 9 patients continued estrogen treatment during clomiphene supplementation. Estrogen and progestin receptors were measured from the cytosol of the endometrium after the first estrogen period and after the first and third clomiphene treatment. The estrogen receptor concentration was significantly lower after both clomiphene supplementation periods than after the initial estrogen administration. The progestin receptor concentration was significantly lower only after the first clomiphene citrate period. The effect of clomiphene citrate was independent of the initial histological appearance of the endometrium and led to atrophy of the endometrium in most of the patients. Because the effect of clomiphene citrate was independent of simultaneous estrogen administration, it acted as a pure antiestrogen in this treatment modality. The relative decreases in estrogen and progestin receptor concentrations on the present treatment regimen were different from those previously found on progestin treatment and most likely occur via different mechanisms. It is not known whether these two treatment types will have additive effects.

Clomiphene↗
PubMed1981

Metoclopramide increases prolactin release and milk secretion in puerperium without stimulating the secretion of thyrotropin and thyroid hormones.

To explore the effect of metoclopramide (MC) on the secretion of PRL, TSH, and thyroid hormones (T3 and T4) and on defective lactation, 17 mothers with poor lactation were treated with oral MC (10 mg. three times daily) for 3 weeks starting 18-141 days post partum. After a pause of 1 week, the medication was given for a further 2 weeks. The breast milk yield was monitored objectively before and during the trial. Furthermore, iv stimulation tests with MC (10 mg) and TRH (200 microgram) were done before and at the end of oral MC therapies. Oral MC increased the mean (+/-SEM) plasma PRL level from 36.6 +/- 9.2 to 90.6 +/- 7.5 ng/ml (P less than 0.001) after 1 week, and the PRL level remained elevated for as long as MC was administered. During the pause, the PRL level decreased to 19.5 +/- 7.5 ng/ml, but increased once again during the second MC treatment to 85.5 +/- 16.0 ng/ml (P less than 0.01). Plasma TSH, T3, and T4 did not change. The PRL level rose significantly after TRH and MC injections before and during oral treatments with MC, whereas the TSH concentrations were elevated only after TRH stimulation. The PRL response to iv MC or TRH and the TSH response to iv TRH were not affected by oral MC treatment. The mean daily milk volume increased from 433 +/- 55 to 626 +/- 75 ml (P less than 0.001) during the first treatment and from 390 +/- 73 to 606 +/- 56 ml (P less than 0.01) during the second oral MC treatment. Correspondingly, the volume of daily supplemental alimentation decreased from 348 +/- 61 to 280 +/- 59 ml (P less than 0.05) and from 526 +/- 68 to 363 +/- 66 ml (P less than 0.01), respectively. MC caused no significant side effects.

Adult↗
PubMed1981

Pre- and postoperative bead chain urethrocystography in female stress urinary incontinence.

The effects of suprapubic Marshall-Marchetti-Krantz (MMK) operation or vaginal Kelly's operation on roentgenographic anatomy of the lower urinary tract were elucidated by means of chain urethrocystography (UCG). A selected series of 30 postoperatively continent and 70 incontinent patients were examined both preoperatively and 3-4 years after operation. Both the urethral inclination (UI) and the posterior urethrovesical (PUV) angle decreased after the operation. The decrease was more marked after successful than unsuccessful operations. The MMK operation reduced the UI and the PUV angle significantly more than did Kelly's operation in both successful and unsuccessful cases. The position of the bladder base or the PUV junction was not altered significantly by either of the operations, whether successful or unsuccessful. The patients with postoperative detrusor instability had roentgen-anatomical findings similar to those of continent patients.

Female↗
PubMed1981

The lack of significant change in plasma progesterone and estradiol-17 beta levels before the onset of human labor.

Maternal plasma levels of progesterone and estradiol-17 beta were measured weekly by radioimmunoassay in 15 healthy women during the last trimester of normal pregnancy. There was a large individual variation for both hormones. The mean concentrations rose slightly with advancing gestational age but the ratio of progesterone to estradiol did not change. It is apparent that the onset of spontaneous labor cannot be predicted by measuring the levels of progesterone and estradiol-17 beta in maternal peripheral plasma.

Adolescent↗
PubMed1981

Advanced ovarian cancer with splenic infarct. A case report on diagnostic difficulties and favorable cytotoxic effects.

Findings obtained with and significance of eight methods of diagnosing splenic infarct combined with advanced ovarian cancer are presented. The internal structures of the affected spleen were visualized only by ultrasonography and computer-assisted roentgen-ray tomography, revealing the enlarged spleen with its multilocular fluid-filled structure. Total remission of this poorly differentiated ovarian adenocarcinoma was achieved by combined cytotoxic therapy with adriamycin, f-ftorafur and cisplatinum.

Adenocarcinoma↗