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Biomedical subjects

A Kauppila

Publications and source records attributed to A Kauppila.

At least 235 records · Page 13Linked to original sources
PubMed1980

Oral administration of TRH in puerperal women: effect on insufficient lactation, thyroid hormones and on the responses of TSH and prolactin to intravenous TRH.

Thirteen puerperal women with insufficient lactation were treated with thyrotrophin releasing hormone (TRH) 20 mg twice daily for two weeks. Intravenous (iv) TRH stimulation tests were done before the TRH therapy and within 3-5 h after the last dose of oral TRH. Plasma samples were assayed for prolactin (Prl), thyrotrophin (TSH), triiodothyronine (T3) and thyroxine (T4) by radioimmunoassays, and the lactational response was objectively monitored in 11 women. Oral TRH treatment was associated with significantly (P less than 0.05) depressed Prl levels (23.0 +/- 7.9 microgram/l vs. 61.4 +/- 26.2, mean +/- SEM), no change in TSH levels (3.7 +/- 0.4 IU/l vs. 4.0 +/- 0.4) but significantly (P less than 0.01) elevated T3 (2.17 +/- 1.14 nmol/l vs. 1.83 +/- 0.09) and T4 (131.6 +/- 7.9 nmol/l vs. 96.6 +/- 5.8) levels. Oral TRH entirely blocked the TSH response and significantly (P less than 0.01) blunted the Prl response to iv TRH stimulation. No improvement in lactation was observed.

Administration, Oral↗
PubMed1980

Results in the operative treatment of pelvic endometriosis.

Two hundred and eight patients treated surgically for endometriosis were reviewed one to four years later. The incidence of endometriosis in this survey was 17 per cent of all gynecological laparotomies. After operation, 30 per cent of the patients were symptomless, 60 per cent estimated the alleviation as good or moderate, and only 10 per cent had no benefit from the operation. In the 32 cases where infertility was the main indication for operation and other factors affecting fertility were excluded, 20 pregnancies of 19 women were achieved after operation.

Adult↗
PubMed1980

Maternal, fetal and neonatal effects of beta-adrenergic stimulation in connection with cesarean section.

To investigate the combined metabolic effects of beta-mimetic therapy and general anesthesia on maternal and fetal/neonatal metabolism, 14 patients were treated with isotonic saline, 11 with intravenous fenoterol (3 microgram/min) and 9 with intravenous isoxsuprine (150 microgram/min) for 30 minutes prior to cesarean section. The maternal heart rate and blood pressure as well as the maternal and fetal acid-base balance were followed. The neonatal glucose level was monitored for 36 hours after delivery. The heart rate and the diastolic and systolic blood pressure values increased during the operation in each group, without any marked differences between the groups. At delivery, the mean maternal BD (base-deficit) value was higher in the fenoterol patients than in the control patients, indicating a trend towards metabolic acidosis. The other values of acid-base balance in the maternal and umbilical arterial and venous blood did not reveal any differences between the groups. The neonatal glucose level at 2 hours after delivery was higher in the fenoterol group than in the control group. The other values recorded during 36 hours revealed no differences between the groups. Beta-mimetic treatment preceding general anesthesia in cesarean section does not have unfavorable effects on the mother, the fetus or the newborn. Such therapy thus does not seem contraindicated when uterine contractions should be rapidly suppressed in cases of fetal distress before operation.

Acid-Base Equilibrium↗
PubMed1980

Trophoblastic markers in the differential diagnosis of ectopic pregnancy.

The serum levels of pregnancy-specific beta-1-glycoprotein (PSBG) and human chorionic gonadotropin (hCG) were measured by radioimmunoassay in 79 women admitted to the hospital because of uterine bleeding and pain in the lower abdomen. In 25 out of 26 patients (96%) with operatively confirmed ectopic pregnancy, hCG was found; PSBG was found in 22 out of 23 (96%). There was 1 patient in whom neither marker was found. In all of 14 patients with clinical signs of intrauterine pregnancy both hCG and PSBG were present. The levels of hCG and PSBG in patients with ectopic pregnancy (1558 +/- 465 mIU/ml and 739 +/- 386 ng/ml) or with inevitable abortion (1282 +/- 810 mIU/ml and 1511 +/- 658 ng/ml) were lower than those found in uncomplicated pregnancy of the same gestational length (20,100 +/- 2200 mIU/ml and 2821 +/- 673 microgram/ml), whereas in cases of threatened abortion ending in delivery, the levels were normal for the gestational time. Of 39 patients without clinical signs of pregnancy, hCG was detectable in the serum in 3 women and PSBG in 11 others. Seven of these 14 had an intrauterine contraceptive device (IUD) in situ, suggesting the possibility of a subclinical abortion. Our results show that the diagnosis of ectopic pregnancy can be improved significantly by the highly sensitive radioimmunologic measurement of serum hCG and/or PSBG concentrations, but these tests do not distinguish intrauterine from extrauterine sources of trophoblastic markers.

Abortion, Spontaneous↗
PubMed1980

Steroid receptors in normal, hyperplastic and malignant human endometria.

Oestrogen and progestin receptors are present in the cytosol and nuclear compartments of normal human endometrium, partly associated with their endogenous ligand hormones. Receptor concentrations fluctuate in relation to the menstrual cycle. Hyperplastic endometrium tends to contain high concentrations of cytosol progestin receptor, whereas the levels of cytosol and nuclear progestin receptors in endometrial adenocarcinoma are lower than in non-neoplastic endometrium. The receptor levels seem to decline with decreasing differentiation of the tumour. Progestin treatment extending over several weeks decreases cellular oestrogen and progestin receptor content in both hyperplastic and malignant endometria. Information based on small patient series suggests that patients suffering from advanced or recurrent endometrial carcinoma and having significant concentrations of both receptors in the tumour tend to have a more indolent clinical course than patients with absent or low tumour receptors. Patients whose lesions are progestin receptor-rich more frequently respond to progestin administration than those with receptor-poor tumours. In contrast, patients with advanced or recurrent disease after progestin treatment and with low tumour oestrogen and progestin receptor concentrations respond more often to combination cytotoxic chemotherapy than patients with higher tumour receptor levels. More data are needed about the clinical correlates of receptor determinations in human endometrial carcinoma to confirm these encouraging preliminary results, before the clinical significance of the determinations can be settled. since there are marked differences in the receptor concentrations reported by various investigators, possibly for methodological reasons, comparison of receptor data and treatment results from different groups is sometimes very difficult.

Breast Neoplasms↗
PubMed1980

Decreased intervillous and unchanged myometrial blood flow in supine recumbency.

The supine position in late pregnancy is associated with many hemodynamic changes caused by compression of the inferior vena cava and a resulting fall in cardiac output. To investigate the effect of this position on uteroplacental blood flow, 22 women with normal (N = 12) or hypertensive (N = 10) pregnancy were investigated using the intravenous 133Xe washout method, in both the supine and left-tilted (45-degree) lateral positions. The intervillous blood flow (113 +/- 48 ml/min/dl) was lower in the supine position than in the left-tilted position (141 +/- 48 ml/min/dl) (P less than 0.01), while the myometrial blood flow was similar in both (9.0 +/- 3.3 ml/min/100 g in supine and 8.7 +/- 2.7 ml/min/100 g in left-tilted position). The results suggest that the autoregulation system for uteroplacental circulation is operative only in the nonplacental component of the pregnant uterus.

Adolescent↗
PubMed1980

Unaltered neonatal cell-mediated immunity after prenatal dexamethasone treatment.

To evaluate the effect of prenatal short-term dexamethasone therapy on neonatal cell-mediated immunity, 6 premature infants born after such therapy and 4 controls of the same age were studied by determining blood leukocyte count, relative and absolute amount of acid alphanaphthyl acetate esterase (ANAE)-positive cells, and lymphocyte response to both phytohemagglutinin (PHA) and pokeweed mitogen (PWM) stimulation. All parameters studied were similar in newborns with or without prenatal maternal dexamethasone treatment. The increase in the number of lymphocytes and ANAE-positive cells during the first week of life was similar in both groups. The neonatal peripheral blood lymphocyte function thus does not seem to be disturbed by prenatal short-term dexamethasone treatment.

Dexamethasone↗
PubMed1980

Treatment of ureteral strictures after therapy for carcinoma of the uterus.

The long term result after the operative treatment of 29 ureteral strictures by various methods in 19 patients treated radically for a malignant tumor of the uterus was evaluated an average of 50 months after the urologic reconstructive surgery. Four patients died of repeat carcinoma and one patient died of a pulmonary embolism before the follow-up examination. In the other patients, a clinical examination, isotopic nephrography, intravenous pyelography, midstream culture and sediment as well as serum creatinine assay demonstrated that transureteroureterostomy resulted in a good, or satisfactory, outcome in patients with a unilateral stricture. A similar outcome was obtained by ileal replacement of the ureter, provided renal function had not been impaired preoperatively. The results obtained with the bladder flap operation, ureterolysis and cutaneous ureterostomy were poor. The significance of early detection and active therapy for strictures is emphasized. Nonradiated tissue should be used for the reconstructive procedure.

Carcinoma↗
PubMed1980

Inefficacy of 17 alpha-hydroxyprogesterone caproate in the prevention of prematurity in twin pregnancy.

There are indications that prophylactic administration of 17 alpha-hydroxyprogesterone caproate (17 alpha-OHP-C) could be beneficial in the treatment of women at risk for preterm delivery. Since twin pregnancy is commonly associated with prematurity, 77 women with twin pregnancy were treated during the last trimester until the 37th gestational week with weekly injections of either 17 alpha-OHP-C or a placebo, following double-blind principles. The gestational length and birth weight and the outcome of the neonates were similar in both groups. The administration of 17 alpha-OHP-C thus seems ineffective in the prevention of prematurity risks associated with twin pregnancy.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1979

Effect of dexamethasone on prolactin secretion in late pregnancy.

It is established that PRL secretion is regulated by estrogens. Glucocorticoids, on the other hand, suppress estrogen secretion during pregnancy and may also inhibit PRL by direct hypothalamopituitary action. In this study PRL and estradiol were determined with specific radioimmunoassays in 14 women during gestational weeks 28 to 34 prior to, during, and following short-term intramuscular dexamethasone administration (12, 8, and 4 mg on three consecutive days) used for prophylaxis of RDS in preterm infants. There were no significant alterations in PRL serum concentrations; estradiol showed a significant drop (P less than 0.001) during all 3 days of treatment, returning to the pretreatment level on posttreatment day 1. The PRL and TSH responses to 200 micrograms of intravenous TRH on day 2 or 3 of dexamethasone treatment in six women during late pregnancy were not inhibited. Short-term dexamethasone treatment with pharmacologic doses does not suppress the physiologic secretion and release of PRL or the release induced by TRH during late pregnancy.

Adolescent↗
PubMed1979

Raised serum human chorionic gonadotrophin concentrations in hyperemesis gravidarum.

Serum human chorionic gonadotrophin (HCG) concentrations were determined by radioimmunoassay with an antiserum specific to HCG beta-subunit in 42 patients with hyperemesis gravidarum and 115 women with normal pregnancies. Mean concentrations (+/- SE of mean) were higher in the women with hyperemesis gravidarum at 7-8 weeks (40.8 +/- 5.2 IU/ml v 22.1 +/- 1.4 IU/ml; P less than 0.001), 9-11 weeks (38.1 +/- 2.3 IU/ml v 27.1 +/- 2.1 IU/ml; P less than 0.0025), and 12-14 weeks of gestation (35.9 +/- 4.2 IU/ml v 25.1 +/- 1.7 IU/ml; P less than 0.005), but there was no difference between the two groups at 15-20 weeks of gestation. In the hyperemesis gravidarum group primigravid women had a higher (P less than 0.005) mean HCG concentration (41.8 +/- 4.0 IU/ml) than multigravid women (32.2 +/- 2.3 IU/ml). The results suggest a causal relation between a high serum HCG concentration and hyperemesis gravidarum.

Adult↗
PubMed1979

The refief of primary dysmenorrhea by ketoprofen and indomethacin.

The prostaglandin biosynthesis inhibitors ketoprofen and indomethacin were compared in the treatment of primary dysmenorrhea in a double-blind, cross-over trial involving 23 patients. Each drug was used for 2-4 days during 3 consecutive menstruations in randomized order. Good or moderate overall relief was obtained in 60 of the 68 ketoprofen-treated menstruations (88%). A dysmenorrhea score, based on subjective estimations of 8 symptoms, similarly decreased from a mean (+/- S.E.M.) basal level of 9.6 +/- 0.6 to 3.6 +/- 0.3 during ketoprofen treatment and to 4.0 +/- 0.3 during indomethacin. Both drugs relieved pelvic and lower back pains and eliminated vomiting and diarrhea in 82-97% of the cycles whereas headache, fatigue and nervousness were less frequently alleviated (40-67%). Eighteen of the 23 women (78%) had been unable to work during the first day of menstruation, the rate of working days lost was reduced to 4% with ketoprofen and 9 with indomethacin. Mild side-effects occurred during 12 ketoprofen and 14 indomethacin therapies. Ketoprofen thus seems to be as effective and tolerable as indomethacin in the treatment of primary dysmenorrhea.

Adolescent↗
PubMed1979

Prostaglandin biosynthesis inhibitors and endometriosis.

Prostaglandins (PGs) may be involved in the development of the symptoms of endometriosis. Therefore 18 patients with pelvic endometriosis were treated in placebo controlled double-blind trial with different prostaglandin biosynthesis inhibitors. These drugs were: acetylsalicylic acid (0.5 g x 3) exerting a weak PG-synthetase inhibition, indomethacin (25 mg x 3) inhibiting PG-synthetase, and as a representative of fenamates, tolfenamic acid (200 mg x 3), which both inhibits PG-synthetase and antagonizes PGs at the target level. The therapeutic effect was evaluated using a specific endometriosis score separately during menstruation and in premenstrum. Prostaglandin biosynthesis inhibitors did not alleviate premenstrual complaints better than placebo. During menstruation tolfenamic acid relieved endometriotic symptoms more effectively than placebo while indomethacin and acetylsalicylic acid did not differ from placebo. A drug which inhibit both the synthesis and action of PGs can thus be used in the alleviation of secondary dysmenorrhea due to endometriosis.

Aspirin↗
PubMed1979

Placental steroid synthesis from DHEAS during dexamethasone therapy.

Maternal glucocorticoid treatment affects estrogen synthesis by decreasing estrogen precursors. Whether glucocorticoid has any effect on the placental conversion of estrogen precursors to estrogen is not known. A study was therefore undertaken to investigate the effect of 100 mg of intravenously administered dehydroepiandrosterone sulfate (DHEAS) on estradiol (E2), estriol (E3), and testosterone (T) serum levels. The test was conducted for 5 hours in 10 women treated with intramuscular dexamethasone and in 8 controls during the last trimester of pregnancy. The initial E2 and E3 serum concentrations were lower in women treated with dexamethasone than in controls, while T serum levels did not display any difference. Following the injection of DHEAS there was a significant increase in E2, with maximal levels reached between 1 and 3 hours after injection in both groups. Maximal levels of E2 were equal for both groups. There was no change in E3 levels after DHEAS administration in the nontreated group, while the increase in the dexamethasone group was significant. A significant rise in T, with maximal levels reached at 1 hour after infusion, was similar in both groups. It is concluded that maternal dexamethasone does not inhibit the conversion of DHEAS either to E2 in the placenta or to E3 and T.

Dehydroepiandrosterone↗
PubMed1979

Pituitary gonadotrophins and prolactin in patients with endometrial cancer, fibroids or ovarian tumours.

The serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and, prolactin (PRL) were measured before and after gonadotrophin releasing hormone (GnRH) and thyrotrophin releasing hormone (TRH) stimulation in 17 patients with endometrial cancer, in 15 patients with uterine fibroids, in 11 patients with ovarian cystadenomas or cancer and in 14 age-matched controls. The women with fibroids had a low FSH level and a diminished FSH response to GnRH but an excessive PRL response to TRH while the other patient groups did not differ from the controls. The results indicate no relation between pituitary function and endometrial or ovarian tumor.

Cystadenoma↗
PubMed1979

Serum gonadotrophins, prolactin and ovarian steroids in primary dysmenorrhoea.

Serum samples were collected from 27 women with incapacitating primary dysmenorrhoea and from 16 normal women in the early part of the cycle (between day 3 to 6), at midcycle (between days 13 to 16) and in the late part of the cycle (between days 23 to 26) for determination of FSH, LH, prolactin (PRL), 17 beta-oestradiol (E2) and progesterone (P). The gonadotrophin and P levels showed normal and similar ovulatory patterns in both groups. The PRL concentrations (mean +/- SD) in dysmenorrhoeic women were lower than normal in the early part (9.2 +/- 4.0 ng/ml vs 14.5 +/- 7.3 ng/ml, p less than 0.01) and in the late part of the cycle (11.7 +/- 5.2 ng/ml vs 16.5 +/- 10.2 ng/ml, p less than 0.05), but not so at midcycle (9.1 +/- 2.8 ng/ml vs 10.4 +/- 4.4 ng/ml, p greater than 0.05). The E2 level was higher than normal in dysmenorrhoeic women in the late cycle (163.0 +/- 76.7 pg/ml vs 93.3 +/- 64.3 PG/ML, p less than 0.01), but apart from this the ratio of E2/P did not differ between the groups. These hormonal changes may be related to an excessive production of endometrial prostaglandins in primary dysmenorrhoea.

Adolescent↗