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Biomedical subjects

A Kauppila

Publications and source records attributed to A Kauppila.

At least 253 records · Page 14Linked to original sources

Intraamniotic or intravenous injection of dehydroepiandrosterone sulfate in midgestation: effect on prolactin level in maternal serum and amniotic fluid.

The influence of dehydroepiandrosterone sulfate (DHEA-S) on PRL levels in maternal serum and amniotic fluid at midgestation was evaluated in a series of 32 women admitted for midtrimester abortion. Serum was collected hourly for 6 h in 13 women after intraamniotic (ia) instillation (100--200 mg) or in 10 women after iv injection (100 mg) of DHEA-S, and in 9 control women. Serum PRL levels rose significantly (P less than 0.05) 3--6 h after ia and 2--6 h after iv administration of DHEA-S but was unchanged in the control group. The elevation of serum PRL levels is most likely secondary to increased levels of serum estrogens which accompany ia or iv administration of DHEA-S. This suggests that maternal pituitary PRL secretion is responsive to additional stimulation by endogenous estrogens at midgestation. The amniotic fluid PRL level ranged from 1109-2473 ng/ml, with no consistent change after administration of ia DHEA-S, intimating that estrogens may not be implicated in the control of PRL in amniotic fluid.

Amnion↗

Intramuscular ACTH or placebo in the treatment of hyperemesis gravidarum.

Thirty-two women with hyperemesis gravidarum were treated with intramuscular ACTH (0.5 mg) or placebo for 4 days in a randomized double-blind trial. The two treatments were equally effective in relieving hyperemesis, although the function of the adrenal cortex was stimulated only during the ACTH therapy. The administration of ACTH thus appears useless for the treatment of severe vomiting in early pregnancy.

Adrenocorticotropic Hormone↗

Anti-prostglandin therapy in prevention of side-effects of intrauterine contraceptive devices.

The efficacy of an anti-prostaglandin, tolfenamic acid (T.A.), in the prevention of side-effects after insertion of a copper-T200 intrauterine contraceptive device (I.U.D.) was evaluated in a double-blind trial in 160 women. T.A. relieved pain and reduced bleeding after insertion and during three subsequent menstruations without serious side-effects. A scoring system for the assessment of I.U.D. side-effects showed that the acceptability of I.U.D. was significantly better in women treated with T.A. than in those given placebo.

Clinical Trials as Topic↗

Effects of intravenous isoxsuprine and ritodrine, with and without concomitant dexamethasone, on fetoplacental and pituitary hormones and cyclic adenosine monophosphate during late pregnancy.

Beta sympathomimetic drugs are used to inhibit preterm labor and glucocorticoids to accelerate fetal pulmonary maturation. A study was designed to investigate the hormonal effects of intravenous infusion of isoxsuprine 150 to 200 mcg. per minute or ritodrine 100 to 150 mcg. per minute in a series of 28 women at 28 to 40 weeks' gestation, with and without concomitant dexamethasone therapy. Serial serum samples taken before and during the six hours of infusion were assayed for cyclic adenosine-3,5-monophosphate (AMP), estradiol, estriol, progesterone, human placental lactogen (hPL), thyrotropin (TSH), follicle-stimulating hormone (FSH), and human growth hormone (gGH). Ritodrine was more potent than isoxsuprine in increasing the circulating levels of cyclic AMP. The levels of placental steroid hormones decreased slightly, as did the ratio of progesterone to estradiol. Human placental lactogen and pituitary hormones showed no consistent changes. Simultaneous administration of dexamethasone did not modify these results.

Adult↗

Effects of ritodrine and isoxsuprine with and without dexamethasone during late pregnancy.

beta-Adrenergic agents are used to inhibit preterm labor and glucocorticoids to accelerate fetal pulmonary maturation. A study was designed to investigate the metabolic effects of intravenous infusion of ritodrine (150 to 100 microgram/min) or isoxsuprine (200 to 150 microgram/min) in a series of 28 patients with gestations of 28 to 40 weeks, with and without concomitant dexamethasone therapy. Ritodrine was more potent than isoxsuprine in increasing the circulating levels of cyclic AMP, glucose, insulin, and triglycerides. The diabetogenic effect of both ritodrine and isoxsuprine was so slight that it did not have any clinical significance in women with normal glucose tolerance. The results were similar when these beta-adrenergic tocolytics were given to women concomitantly with intramuscular dexamethasone therapy, although dexamethasone appeared to minimally impair carbohydrate metabolism. Both ritodrine and isoxsuprine caused a significant fall in serum iron and potassium, and this effect was unaltered by dexamethasone. Serial serum potassium levels should be obtained during long-term infusion of beta-mimetics.

Adolescent↗

Effect of maternal dexamethasone therapy on the levels of oestrogens, progesterone and chorionic gonadotrophin in amniotic fluid and maternal serum.

Ten women were given dexamethasone intramuscularly in order to accelerate fetal lung maturation. Amniotic fluid and maternal serum were assayed for oestrone, oestradiol-17beta, oestriol, progesterone and chorionic gonadotrophin by specific radioimmunoassays before and after the treatment. No hormonal changes were observed in amniotic fluid. The serum levels of oestrogens 2 to 5 days after treatment were not significantly different from those before treatment, indicating that the previously reported suppression of oestrogen production by glucocorticoids disappears rapidly after treatment stops.

Amniocentesis↗

Effect of oral thyrotropin releasing hormone on serum prolactin, thyrotropin and total thyroxine levels in postpartum women.

A study was designed to investigate the effects of oral administration of thyrotropin releasing hormone (TRH) on prolactin levels and on thyroid function during the early puerperium. Eight lactating mothers took a single dose of oral TRH (40 mg) while eight other volunteers had a placebo treatment. Serial serum samples taken before and after treatment were assayed for prolactin, thyrotropin (TSH) and total thyroxine (T4) by using specific radioimmunoassays. There was approximately twofold increase in prolactin level at 30--210 min, about sevenfold increase in the TSH level at 210 min, and a marked increasing trend in the T4 level during the study period only in the treatment group. Six mothers treated with TRH and two treated with placebo regarded milk secretion more abundant in post-test than pre-test feeding. However, before TRH could be extensively tested on mothers with deficient lactation a thorough study of the effects of oral TRH on thyroid function in the puerperium is mandatory.

Female↗

Investigation of gynecological cancer with nuclear magnetic relaxation methods.

Nuclear magnetic relaxation times T1 and T2 of cell water protons in benign and malignant uterine cervical tissue (37 samples taken from 22 patients) were measured using a resonance frequency of 19.8 MHz. The means of relaxation times recorded for malignant tissue were (mean +/- S.E.) T1 = 0.89 +/- 0.05 s, T2 = 0.072 +/- 0.009 s, and obtained from corresponding benign tissues (mean +/- S.E.) T1 = 0.72 +/- 0.01 s T2 = 0.056 +/- 0.003 s. The differences are statistically significant (T1:p less than 0.001, and T2:p less than 0.05). The effect of dysplasia and inflammatory changes in mucosa to the relaxation times were examined and the probable sources of error in the present method are discussed.

Carcinoma↗

Effect of fenoterol and isoxsuprine on myometrial and intervillous blood flow during late pregnancy.

The use of beta-adrenergic agonists in high-risk pregnancies has shown evidence of favorable effects on the fetus. Intravenous injections of 133Xe were given to evaluate the effects of short-term administration of fenoterol (3 microgram/min) and isoxsuprine (150 migrogram/min) on the intervillous and myometrial blood flow in a series of 48 women during the last trimester of pregnancy. Both fenoterol and isoxsuprine treatment increased the maternal heart rate significantly. There was a significant rise in myometrial blood flow when fenoterol was given, but the intervillous blood flow did not change significantly during the administration of either isoxsuprine or fenoterol. Previous oral isoxsuprine treatment did not diminish the cardiac effect of intravenous fenoterol, but the improvement in myometrial blood flow was eliminated. This result indicates that beta-adrenergic agonists may have a specific dilatational effect on the myometrial blood vessels. From the hemodynamic point of view, the beta-adrenergic agonists have a limited value in the treatment of chronic fetal asphyxia or intrauterine fetal growth retardation.

Ethanolamines↗

Umbilical cord and neonatal cortisol levels. Effect of gestational and neonatal factors.

To evaluate the effect of the type of delivery, gestational age, maternal dexamethasone treatment, and neonatal complications on the serum cortisol levels in early infancy, a total of 92 neonates were investigated with 611 cortisol determinations (specific radioimmunoassay after Lipidex chromatography). Umbilical cord blood samples were taken immediately after delivery and capillary blood samples from the infant's heel 30--60 minutes after delivery and at 8:00 AM and PM on the second, fourth, and sixth days of life. Umbilical cord cortisol concentration after elective cesarean section was lower than after emergency cesarean section or after normal vaginal delivery, while neonatal cortisol values did not show any correlation with the type of delivery. Prematurity did not affect neonatal cortisol levels. In postterm infants the activation of cortisol production was retarded to some degree. After maternal dexamethasone therapy, neonatal cortisol concentration decreased 30--60 minutes after delivery, but from the second day on it was at the same level as in infants without maternal therapy. Respiratory distress syndrome, especially in fatal cases, caused an elevation in neonatal cortisol levels, while hyperbilirubinemia did not have an effect on plasma cortisol concentrations of the neonates.

Adult↗

Adrenocorticotrophic hormone during the first day of life.

The plasma concentration of ACTH (by radioimmunoassay) was measured in 56 healthy parturients and their newborns. Umbilical cord and maternal venous blood were collected immediately after delivery. In addition one venous blood sample was taken from 50 newborns at the age of 15, 30, 60 min, 2, 6, 12, or 24 h. The maternal and cord plasma ACTH levels were higher than the levels in healthy nonpregnant women. There are no differences between the mean maternal (226 +/- 146 pg/ml) and cord (226 +/- 147 pg/ml) values of ACTH. The high ACTH levels of cord plasma remain unchanged for 30 min, decrease significantly during the 1-6 h after birth, because of the elimination process of the circulated foetal ACTH, and increase over the next 12-24 h and slightly thereafter indicating an initiation of neonatal pituitary ACTH secretion. The plasma ACTH level in the mothers with membranes ruptured for 1-5 h was significantly (P less than 0.05) higher compared with that in the mothers with membranes ruptured for less than 1 h. However, the duration of ruptured membranes appeared to have no effect on the cord blood ACTH level.

Adrenocorticotropic Hormone↗

ACTH levels in maternal, fetal and neonatal plasma after short-term prenatal dexamethasone therapy.

The effect of prenatal dexamethasone therapy (12, 8 and 4 mg doses given intramuscularly on three consecutive days) on ACTH levels in maternal plasma (n=33), mixed umbilical cord plasma (n=31) and plasma from the newborn (n=29) was studied, and the results were compared with those obtained in 56 healthy parturients and 50 of their newborn. Maternal ACTH after delivery was significantly lower in the mothers treated with dexamethasone than in the control group. Cord ACTH values were similar in the two groups. ACTH levels fell during the early neonatal period, but only at 12 to 24 hours were the ACTH levels significantly lower in the dexamethasone group than in the controls. Gestational age, birth weight and the interval between the dexamethasone therapy and delivery had no significant effect on cord ACTH levels. Short-term prenatal dexamethasone therapy seemed to have very little effect on ACTH secretion in the mother, in the fetus and in the newborn.

Adolescent↗

Results of operative treatment of stress urinary incontinence with special reference to preoperative clinical and radiological evaluation.

Operative results of stress urinary incontinence are discussed on the basis of a follow-up study made 3-5 years after the operation. The series consisted of 301 patients operated on during 1969-1971. The most significant anamnestic feature was the great number of multiparas: 67% of the patients had given birth to at least 4 children. The choice of the operative method was based on Green's urethrocystographic classification into type I and type II. The healing was complete or satisfactory in 85% of the total material. In the group operated on according to type I the outcome was good in 88%, while in the type II group it was good in 84%. Incontinence of degree I was cured in 89% of the cases, while patients of degree III in only 72%. If there was a significant urgency component observable in the incontinence symptoms preoperatively, a good outcome was only attained in 64%. In pure or dominant stress incontinence the corresponding outcome was 88%. Hysterectomy combined to the operation seemed to improve the results. Age, parity, duration of the incontinence symptoms, weight and changes of weight after the operation had no significant effect on the healing. The authors emphasize the importance of careful differential diagnosis based on the anamnesis and examinations in choosing the therapeutic method for incontinence patients.

Adult↗