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Biomedical subjects

E Alhava

Publications and source records attributed to E Alhava.

At least 109 records · Page 6Linked to original sources
PubMed1995

The long-term outcome after negative appendix operation.

We evaluated the long-term outcome of "negative appendix" (NA) by analysing the follow-up results of 76 patients identified from a group of 670 appendectomized patients. Randomly selected and histologically proven cases of true acute appendicitis (TA) matched for age and sex were identified to construct case control pairs. Special interest was focused on gender and age, by analysing the results separately in men and women in two age groups (15-39 years and > or = 40 years). The results showed that NA was most common in women aged 15-39 years (21% of appendectomized cases in this age group). At follow-up examination after a mean follow-up of 2.9 years two-thirds of patients were symptomfree. Women aged 15-39 years had significantly more complaints (P < 0.05) and findings (P < 0.05) than patients with TA. In women aged > or = 40 years no significant differences were detected, nor in either age groups in men. Lactose intolerance was the most common finding in symptomatic patients. In conclusion, patients with NA were mostly young women. At long-term follow-up the great majority of patients were symptomfree and appeared not to have developed any serious disease. Routine follow-up for patients with NA does not thus seem necessary.

Adolescent↗
PubMed1995

Clodronate increases bone mineral density in young growing oophorectomized beagles.

Nineteen beagles (8.8 +/- 0.1 months, 8.5 +/- 0.2 kg, mean +/- SEM) were oophorectomized (OX) at the beginning of the study. The dogs were randomly allocated into three groups: control group (OX, n = 5), OX+clodronate 20 mg/kg orally group (OX + 20, n = 7) and OX+clodronate 40 mg/kg orally group (OX + 40, n = 7). Clodronate administration began the day following oophorectomy and was continued for eight months. Bone mineral density (BMD) was evaluated by dual energy X-ray absorptiometry (DEXA) at baseline and at four and eight months and by quantitative computed tomography (QCT) at baseline and at eight months. Bone biopsies were taken at the beginning and at the end of the study. The change in BMD (g/cm2) during eight months was +2.0% (NS) in OX, +2.3% (NS) in OX + 20 and +10.0% (P < 0.01) in OX + 40 group when measured by DEXA, QCT revealed the same results but in a lesser extent. There were no differences in static and dynamic histomorphometric parameters between the groups at the end of the study. In conclusion, clodronate at a dose 40 mg/kg/day orally increases BMD in young oophorectomized dogs.

Absorptiometry, Photon↗
PubMed1994

Exercise, smoking, and calcium intake during adolescence and early adulthood as determinants of peak bone mass. Cardiovascular Risk in Young Finns Study Group.

OBJECTIVE: To evaluate the contribution to peak bone mass of exercise, smoking, and calcium intake in adolescents and young adults. DESIGN: Prospective cohort study with end point measurement (bone mineral density) after 11 years' follow up for lifestyle. SETTING: Five university hospital clinics. SUBJECTS: 264 (153 females, 111 males) subjects aged 9 to 18 years at the beginning of the follow up and 20 to 29 years at the time of measurement of bone mineral density. MAIN OUTCOME MEASURE: Bone mineral density of lumbar spine and femoral neck by dual energy x ray absorptiometry; measures of physical activity and smoking and estimates of calcium intake repeated three times during follow up. RESULTS: In the groups with the lowest and highest levels of exercise the femoral bone mineral densities (adjusted for age and weight) were 0.918 and 0.988 g/cm2 for women (P = 0.015, analysis of covariance) and 0.943 and 1.042 g/cm2 for men (P = 0.005), respectively; at the lumbar spine the respective values were 1.045 and 1.131 (P = 0.005) for men. In men the femoral bone mineral densities (adjusted for age, weight, and exercise) were 1.022 and 0.923 g/cm2 for the groups with the lowest and highest values of smoking index (P = 0.054, analysis of covariance). In women the adjusted femoral bone mineral density increased by 4.7% together with increasing calcium intake (P = 0.089, analysis of covariance). In multiple regression analysis on bone mineral density of the femoral neck, weight, exercise, age, and smoking were independent predictors for men; with weight, exercise, and age for women. These predictors together explained 38% of the variance in bone mineral density in women and 46% in men. At the lumbar spine, weight, smoking, and exercise were predictors for men; and only weight for women. CONCLUSIONS: Regular exercise and not smoking is important in achieving maximal peak bone mass in adolescents and young adults.

Absorptiometry, Photon↗
PubMed1994

Cocaine N-demethylation and the metabolism-related hepatotoxicity can be prevented by cytochrome P450 3A inhibitors.

Cocaine is eliminated and detoxified principally through the metabolism of nonspecific plasma and tissue esterases. Microsomal oxidative metabolism is of importance in cocaine N-demethylation, this being a principal pathway of cocaine bioactivation and hepatotoxicity. The contribution of different cytochrome P450 (CYP) enzymes to cocaine N-demethylase activity was studied in vitro with DBA/2 mouse and human liver microsomes, and cocaine hepatotoxicity was examined in vivo in DBA/2 male mice. Species dependent enzyme kinetics was observed. Cocaine N-demethylase displayed two Km values in murine liver (40-60 microM and 2-3 mM), whereas only one Km value was observed in human liver microsomes (2.3-2.7 mM). We suggest that CYP3A plays a prominent role in the N-demethylation of cocaine for the following reasons: (i) pregnenolone-16 alpha-carbonitrile, an inducer of CYP3As increases cocaine N-demethylase in parallel with testosterone 6 beta-hydroxylase activity and immunoreactive 3A protein in mouse liver; (ii) human and mouse cocaine N-demethylase and testosterone 6 beta-hydroxylase activities can be inhibited by triacetyloleandomycin, cannabidiol, or gestodene, all selective inhibitors of CYP3A P450s; (iii) antibodies directed against P450s within subfamilies 1A, 2A, 2B, 2C, or 2E inhibited cocaine N-demethylase activity only marginally, and finally, (iv) treatment of mice with triacetyloleandomycin or cannabidiol in vivo significantly attenuated the cocaine-elicited hepatotoxicity as assessed by the serum alanine aminotransferase activity and liver histology in parallel with decreased cocaine N-demethylase activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Bone mineral density and risk factors for osteoporosis--a population-based study of 1600 perimenopausal women.

Population-based epidemiological studies on osteoporosis are few. Our study evaluated the effects of menopause and certain putative behavioural risk factors on bone mineral density (BMD). Spinal and femoral neck BMD were measured with dual X-ray absorptiometry (DXA) from 1600 perimenopausal women aged 48-59 years (mean 53.2 years) with no diseases or medications known to affect bone metabolism. These women were a selected sample of the Kuopio Osteoporosis Risk Factor and Prevention Study population (n = 14,220). There was a wide variation of BMD among perimenopausal women. Menopause had a major effect on BMD. Postmenopausal women had significantly lower BMD in both spine (-6.2%) and femoral neck (-3.9%) as compared with premenopausal women. Multiple regression analysis showed that weight, menopausal status, age, and grip strength were significant independent predictors of both spinal and femoral BMD. Additionally, physical activity was found to be a significant predictor of femoral BMD, and alcohol consumption was a significant predictor of spinal BMD. However, current anthropometric and lifestyle factors explained only 18.7-25.4% of the variability of BMD. Therefore, the estimation of the risk factor status at menopause is not an adequate substitute for bone densitometry. However, our results may in part help clinicians to identify the risk groups at which to direct bone density measurements.

Absorptiometry, Photon↗
PubMed1994

Tumour-associated trypsin inhibitor in the diagnosis of pancreatic carcinoma.

The serum values of tumour-associated trypsin inhibitor (TATI) were measured in a prospective series of 97 patients with jaundice, 36 patients with unjaundiced cholestasis and 21 patients with suspicion of chronic pancreatitis or a pancreatic tumour, to assess its value in diagnosing pancreatic cancer. There were altogether 15 patients with cancer of the pancreas and 2 patients with cancer of the papilla of Vater. The highest serum TATI values were noticed in patients with choledocholithiasis, and raised values were also seen in patients with malignant disease of the liver or bile ducts. In the patients with pancreatic cancer, chronic pancreatitis or benign liver disease, the serum TATI values showed lower levels. The sensitivity of TATI in diagnosing pancreatic cancer was 41.1% with a specificity of 63.5% and an efficiency of 61.0%. In comparison to carcinoembryonic antigen (CEA), carbohydrate antigens CA 50, CA 242, tissue polypeptide antigen and tissue polypeptide-specific antigen, TATI showed a lower diagnostic value. When TATI was analysed in combination with the other markers (two tests positive), the combination of CEA with TATI reached the highest specificity (95.6%), efficiency (89.6%) and positive likelihood ratio (9.3). The results suggest that the diagnostic value of TATI is inferior to that of the established markers, but because of its different nature, it may be of help when used in combination as a complementary serum tumour marker in the diagnosis of pancreatic cancer.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1994

The effect of previous oral contraceptive use on bone mineral density in perimenopausal women.

The bone mineral density (BMD) of the lumbar vertebrae L2-4 and femoral neck was determined by dual-energy X-ray absorptiometry (DXA) in 3222 perimenopausal women-a random stratified sample of the population-based Kuopio Osteoporosis Study (OSTPRE). The mean age of the women was 53.4 years (range 47.9-59.6 years). Twenty-nine percent of the women were past users of oral contraceptives (OC) containing 50 micrograms or less of ethinyl estradiol and 7.4% (n = 250) of the women reported OC use for more than 6 years. There was a slight but statistically significant difference between OC users (n = 939) and non-users (n = 2283) in lumbar BMD (1.134 +/- 0.155 g/cm2 v 1.123 +/- 0.161 g/cm2, p = 0.014). A statistically significant difference was recorded also after adjustment for years since menopause, duration of hormonal replacement therapy (HRT) and present weight (p = 0.044). When the analysis was performed among women who had never used oestrogen replacement therapy (n = 1427) and among premenopausal women (n = 387), no differences in BMD were found between OC users and non-users. Similarly, femoral neck BMD did not differ between the groups. This population-based study demonstrated a slightly higher lumbar BMD among past OC users. However, OC users and non-users differed from each other in many behavioral characteristics. Thus, the differences in BMD may be accounted for more by other factors than by past OC use itself. The low-dosage estrogen OCs used today would not be expected to have any positive bone effects among future perimenopausal women.

Bone Density↗
PubMed1994

Effects of histamine, H1, H2 and Hic receptor antagonists and alpha-fluoromethylhistidine on the growth of human colorectal cancer in the subrenal capsule assay.

Biogenic amines play an important role in regulating cell proliferation in the normal and neoplastic colon. Elevated histidine decarboxylase (HDC) activity has been measured in human colorectal tumors. H2 antagonists can suppress the growth of colorectal cancer and their inclusion in human therapy has been proposed. We studied the effects of histamine, cimetidine, mepyramine and alpha-fluoromethylhistidine (FMH) on the growth of colorectal tumors in ten patients in the 6-day mouse subrenal capsule assay (SRCA). The effect of the Hic antagonist DPPE was tested in two assays. In summary, a reduction of tumor size was achieved with histamine and DPPE. In addition, significant inhibition of tumor growth was seen in the FMH-treated animals. When pooled by their growth potential, as assessed by the growth of saline-treated controls, FMH and DPPE caused distinct tumor reduction in rapidly growing tumors. In the moderately growing tumors, histamine and mepyramine were the most effective.

Animals↗
PubMed1994

The effect of fluoridated drinking water on axial bone mineral density--a population-based study.

Bone mineral density (BMD) of the spine and femoral neck was measured in a random stratified sample of 3222 perimenopausal women aged 47-59 years. A total of 969 women had used fluoridated drinking water (1.0-1.2 mg/l) for over 10 years. These women were compared with 2253 women with low levels of fluoride in drinking water (< 0.3 mg/l). BMD of the spine was significantly higher in the fluoride group than in the non-fluoride group (1.138 +/- 0.165 vs. 1.123 +/- 0.156 g/cm2, P = 0.026). Femoral neck BMDs did not differ between the groups. When the BMD values were adjusted for confounding factors (age, weight, menopausal status, calcium intake, physical activity level, deliveries, alcohol consumption and estrogen use), the differences between the groups increased (P < 0.001 for the spine and P = 0.004 for the femoral neck, respectively). There was no significant difference between the groups in the prevalence of self-reported fractures sustained during 1980-1989. We propose that the fluoridation of drinking water has a slight increasing effect on axial BMD in women in low fluoride areas.

Absorptiometry, Photon↗
PubMed1994

A prospective study of serum tumour markers carcinoembryonic antigen, carbohydrate antigens 50 and 242, tissue polypeptide antigen and tissue polypeptide specific antigen in the diagnosis of pancreatic cancer with special reference to multivariate diagnostic score.

The aim of this study was to assess by a stepwise multivariate discriminant analysis the value of four current serum tumour markers - carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 50 and CA 242 and tissue polypeptide antigen (TPA) - and a new serum tumour marker, tissue polypeptide specific antigen (TPS), in the diagnosis of pancreatic cancer. The serum values were measured in a prospective series of patients with jaundice, with unjaundiced cholestasis and with a suspicion of chronic pancreatitis or a pancreatic tumour (n = 193). There were 24 patients with a cancer of the pancreas and two patients with a cancer of the papilla of Vater in this series. Our results showed that CA 50 (P < 0.001) and TPA (P < 0.01) were the best marker tests in predicting pancreatic malignancy. Also, the TPS (P = 0.07) and CA 242 (P = 0.08) tests showed marginally significant independent discriminating power, while the CEA test did not (P = 0.12). In order to sum up the contributions of different markers, a diagnostic score (DSI) was developed. The discrimination function was: DS1 = CA 50 x 1.75 + TPA x 0.62 + TPS x (-0.37) + CA 242 x (-1.21). The sensitivity of DS1 in detecting pancreatic cancer was 36% with a specificity of 90% and an efficiency of 82%. When the combination of CA 50 and TPA was used as a test, the discrimination function (DS2) was: DS2 = CA 50 x 0.69 + TPA x 0.67. The sensitivity of DS2 was 44% with a 88% specificity and an efficiency of 82%. According to this analysis, the further advantage gained by a computer-aided scoring system seems to be limited, since despite the considerably high specificity and efficiency its sensitivity remained low. In the present analysis the best combination in diagnosing pancreatic cancer was the combination of CA 50 and TPA.

Adult↗
PubMed1994

Decreased axial bone mineral density in perimenopausal women with rheumatoid arthritis--a population based study.

OBJECTIVES: Although periarticular osteoporosis is a well-recognised phenomenon in rheumatoid arthritis (RA), there is considerable controversy over whether RA is associated with more generalised osteoporosis. The aetiology of this bone loss is probably multifactorial, including both life-style risk factors and disease-related determinants. Population-based studies on bone mineral density (BMD) in RA have not previously been conducted, and the purpose of the present cross-sectional population-based study was to determine whether patients with RA are at an increased risk of having osteoporosis. Furthermore, the determinants of BMD in RA patients were investigated. METHODS: BMD at the spine and femoral neck was measured in 143 women with RA. The control group consisted of 1611 women with no disease or taking any drugs known to affect bone metabolism. The study population was a random stratified sample from the Kuopio Osteoporosis Study, which included all perimenopausal women aged 47-56 years residing in Kuopio Province, Eastern Finland in 1989 (n = 14,220). The mean age of the patients at the time of densitometry was 53.7 years. RESULTS: The mean (SD) spinal and femoral neck BMD was significantly lower in patients with RA compared with controls [spine: 1.067 (0.161) v 1.129 (0.157) g/cm2, p < 0.001; femoral neck: 0.851 (0.136) v 0.932 (0.123) g/cm2, p < 0.001]. Analysis of variance showed that at the spine the difference was significant only in patients having corticosteroid treatment, whereas at the femoral neck patients with non-steroid treatment also had significantly lower BMD. When confounding factors were corrected, no significant difference could be found between non-steroid and corticosteroid treated patients with RA, suggesting that the independent effect of corticosteroids on BMD is only minimal. Multiple regression analysis found age, weight and functional grade to be significant predictors of spinal BMD (R2 = 0.403, p < 0.001). In the femoral neck weight, cumulative corticosteroid dose and functional grade were significant predictors of BMD (R2 = 0.410, p < 0.001). CONCLUSIONS: RA is associated with generalised osteoporosis. The physical impairment and body weight are the major determinants of both spinal and femoral bone mass in RA patients. The cumulative corticosteroid dose was also a significant determinant of femoral neck BMD. However, the independent effect of corticosteroids is questionable because the use of corticosteroids may be an indicator of more severe disease.

Absorptiometry, Photon↗
PubMed1994

Diagnostic value of tissue polypeptide specific antigen in patients with pancreatic carcinoma.

We evaluated the clinical utility of a new tumor marker tissue polypeptide specific antigen (TPS) in the diagnosis of pancreatic carcinoma. Serum concentrations were determined in 113 patients with jaundice, in 18 patients with laboratory values suggesting cholestasis and in 60 patients with suspicion of chronic pancreatitis or pancreatic tumor. Twenty-four of these 191 patients had pancreatic carcinoma and 2 patients had carcinoma of the papilla of Vater. The highest median serum TPS value was detected in patients with malignant liver disease, but high median values were also measured in patients with pancreatic cancer, bile duct cancer or benign liver disease. The sensitivity of TPS was 50.0%, with a specificity of 73% and an efficiency of 70%. In comparison with carcinoembryonic antigen (CEA), CA 50 and CA 242, the TPS test showed lower sensitivity, but the differences in specificity and negative predictive value were considerably smaller. The utility of TPS as a complementary test was also analyzed. When TPS was combined with other marker tests, their specificities clearly improved, being highest in the combination of TPS and CA 242 (92.5%). In this combination, efficiency and positive likelihood ratio were also clearly better (85% and 5.6) than those of the marker tests alone. In conclusion, TPS seems less accurate than CEA, CA 50 or CA 242 in the diagnosis of pancreatic cancer, but because of its different nature it may be considered to be used as a complementary test.

Biomarkers, Tumor↗
PubMed1994

Argyrophilic nucleolar organizer regions may help the differential diagnostic distinction between chronic pancreatitis and pancreatic ductal adenocarcinoma.

BACKGROUND: The aim of this study was to determine whether the number of argyrophilic nucleolar organizer regions (AgNORs) could be of diagnostic significance in differentiating between chronic pancreatitis and pancreatic ductal adenocarcinoma. METHODS: The number of AgNORs was enumerated in biopsy specimens of normal pancreas, chronic pancreatitis, and pancreatic ductal adenocarcinoma. RESULTS: The number of AgNORs was lower in patients with normal pancreas than in patients with chronic pancreatitis or pancreatic adenocarcinoma. In addition, the number of AgNORs was significantly lower in chronic pancreatitis than in pancreatic ductal adenocarcinoma (p < 0.001). CONCLUSIONS: The diagnosis of pancreatic adenocarcinoma is usually clear. Difficulties can be encountered, however, in cases of chronic pancreatitis, specially when biopsy material is small. Our results suggest that the number of AgNORs may help in distinguishing between chronic pancreatitis and pancreatic ductal adenocarcinoma, especially in diagnostically difficult specimens.

Adenocarcinoma↗
PubMed1994

Clodronate prevents immobilization osteopenia in rats.

We investigated the effect of clodronate on immobilization osteopenia (IO) induced by sciatic neurectomy in rats. 100 Wistar female rats were divided into 5 groups of 20 animals each: 1) sham-operated, control group, 2) IO+saline control group, 3) IO+clodronate 3 mg/kg/day, 4) IO+clodronate 10 mg/kg/day, and 5) IO+clodronate 30 mg/kg/day. Clodronate was administered subcutaneously beginning on the day after nerve sectioning. After 7 weeks, the animals were killed and both tibiae were removed. Bone mineral density, ash weight and calcium, phosphorus and magnesium contents of the ash of the tibiae were analyzed. The weight of the rats did not differ between the groups during the experiment. The ash weight of the tibiae decreased by 6.6 percent and the mineral density decreased by 5.1 percent after neurectomy. Clodronate reduced IO in a dose-dependent manner and the highest dose neutralized the effect of neurectomy. The calcium content of the ash decreased after neurectomy as compared to the sham-operated group, and clodronate increased it to the sham-operated level. The bone Ca/P ratio remained normal.

Animals↗
PubMed1994

Histomorphometry of periarticular bone in rheumatoid arthritis.

Periarticular osteoporosis is a common feature of rheumatoid arthritis. However, the cellular basis and the aetiology of periarticular bone loss have not been established. We studied periarticular bone samples obtained from metatarsal resections (n = 18) and total knee arthroplasties (n = 9) by histomorphometry. Autopsy material (n = 10) and patients with osteoarthrosis (n = 11) served as controls. Histomorphometrically, there was reduced trabecular bone volume and increased resorption surfaces in rheumatoid arthritis patients in most of the measured areas. The indices of bone turnover were most markedly increased in the vicinity of inflammatory cells and rheumatoid granulation tissue. Trabecular bone volume and the degree of inflammation as measured by the erythrocyte sedimentation rate (ESR) had a negative correlation. In addition, an elevated ESR was associated with increased osteoid parameters in periarticular bone. We conclude that periarticular bone loss in rheumatoid arthritis is due to increased bone resorption. Local inflammatory mediators might account for the increased bone turnover.

Adult↗
PubMed1994

Phaeochromocytoma in pregnancy.

A case of phaeochromocytoma diagnosed and treated during pregnancy is presented. The diagnosis was made by the typical paroxysmal symptoms with high blood pressure and confirmed by elevated plasma and urine catecholamine levels and ultrasound. After a short-term blockade with alpha and beta adrenergic antagonists an almost 10 cm large tumour was successfully excised at caesarean section. The problems with treatment of phaeochromocytoma during pregnancy are also discussed.

Adrenal Gland Neoplasms↗