Search PubMed⌕ Search

Biomedical subjects

E Kujansuu

Publications and source records attributed to E Kujansuu.

At least 55 records · Page 3Linked to original sources
PubMed1986

Prostaglandins, thromboxane and leukotriene in human follicular fluid.

The concentrations of prostaglandin E2 (PGE2), prostaglandin F2 alpha (PGF2 alpha), thromboxane B2 (TxB2) and leukotriene B4 (LTB4) were measured in the follicular fluid of 15 hyperstimulated human follicles. All the samples contained these eicosanoids. Ova were recovered in six aspirates; the measured levels of prostanoids and LTB4 did not differ significantly from the levels of nine aspirates without ova. The presence of LTB4 in human follicular fluid suggests that the products of the lipoxygenase pathway of arachidonic acid may also have a role in the function of the follicular fluid.

Adult↗
PubMed1985

Quantification of urethral closure function by SUI threshold after pubococcygeal sling operation.

Thirty-one female patients were investigated 4.8 +/- 2.5 years after pubococcygeal repair for stress urinary incontinence (SUI). Eighteen patients had a successful operation with total cure or marked improvement and 13 had a failed operation. The results of the operation were further evaluated clinically by detailed patient history and urodynamically by urethrocystometry (UCM). The severity of the SUI symptoms was evaluated by recording the physical stress causing incontinence, restrictions of daily activities and social life and use of protective pads. The symptoms were graded by the SUI score ranging from 0 to 10. The bladder pressure rise necessary for urinary leakage during coughing (The SUI threshold) was measured by UCM. The mean SUI score was 2.2 +/- 1.0 and 6.9 +/- 4.8 after successful and failed operations, respectively and the SUI threshold was 85 cm H2O and 57.5 cm H2O after successful and failed operations, respectively. The SUI threshold had a significant negative correlation with the SUI score. It is suggested that the SUI threshold is a valuable addition to UCM determining objectively the results of incontinence surgery. It should be measured each time an UCM is performed.

Aged↗
PubMed1984

Hormonal changes during the perinatal period: FSH, prolactin and some steroid hormones in the cord blood and peripheral serum of preterm and fullterm female infants.

Fetoplacental endocrine function during the last third of gestation, and first 5 days post partum, was studied by hormone measurements of umbilical cord arterial and venous serum in preterm (31-37 weeks gestation) and fullterm (39-42 weeks gestation) female newborn. Furthermore, hormones were measured in peripheral serum of fullterm female infants of 1, 3 and 5 days of age. The data were compared with those obtained previously in corresponding age groups of males. FSH was significantly (P less than 0.05) higher in the cord serum of preterm females (5.4 +/- 1.8 IU/I, SE, n = 30) than in males (1.5 +/- 0.08 IU/l, n = 27), and decreased significantly (P less than 0.05) in preterm females towards fullterm. PRL levels increased in both sexes towards the end of gestation (P less than 0.01), and decreased post partum, but no sex differences could be detected. Testosterone was significantly higher in the male serum samples (P less than 0.01-0.05), but only minor sex differences were seen in cord serum, or post partum, concentrations of the other steroids measured, pregnenolone, progesterone, 17-hydroxyprogesterone and androstenedione. Significant arterio-venous difference (higher in the vein) were seen at term in progesterone and 17-hydroxyprogesterone. The levels of these two steroids also decreased most clearly after birth. Female serum testosterone peaked at d 1 post partum (0.084 +/- 0.014 microgram/l, SE, n = 11), decreased thereafter, but remained at the intrauterine level, suggesting that the low female levels of this steroid are of fetal, rather than placental/maternal origin. The same seems to be true for androstenedione. Our data suggest that the fetal ovary is quiescent during the last weeks of gestation.

Androstenedione↗
PubMed1984

Degree of female stress urinary incontinence: an objective classification by simultaneous urethrocystometry.

Urodynamic examinations carried out on 45 patients with stress urinary incontinence (SUI) and 17 women without a history of incontinence using simultaneous microtransducer urethrocystometry were examined in order to develop an objective indicator of the severity of the condition. Five urethral pressure profiles (UPP) with stress were recorded, maintaining a constant coughing strength as seen in the bladder pressure rises. The coughing strength was increased stepwise for successive profiles. Zero urethral closure pressure, indicating genuine SUI, appeared with bladder pressure rises of less than 50, 75 and 100 mm Hg and of 100 mm Hg or more in 7, 27, 45 and 67% of the 45 symptomatic patients, respectively. 33% had a positive closure pressure in every UPP. 2 women without symptomatic incontinence had negative urethral closure pressures. The lowest bladder pressure rise needed for zero urethral closure pressure showed a significant negative correlation with the clinical grade of SUI and the degrees of social restriction experienced. We suggest that SUI can be classified urodynamically into minimal (lowest bladder pressure rise producing zero urethral closure pressure 100 mm Hg or more), mild (75-99 mm Hg), moderate (50-74 mm Hg) and severe forms (less than 50 mm Hg).

Adult↗
PubMed1983

Urodynamic analysis of successful and failed incontinence surgery.

Seventy-nine patients were investigated by simultaneous urethrocystometry before and, on average, 15 months after vaginal and/or suprapubic operations for stress urinary incontinence. Subjective and objective success rates were 78% and 60%, respectively, with no significant differences between operation types. Patients with a low (less than 0.6) index of urethral relaxation at stress preoperatively indicating excessive loss of basal urethral pressure at stress, had objective success rates of 39% whereas a higher index was associated with a success rate of 70%. Maximal urethral closure pressure and functional urethral length did not correlate with the operative result and were virtually unchanged postoperatively. Successful operations increased the index of urethral relaxation at stress and urethral pressure peaks at stress especially in the distal functional urethra. No significant quantitative differences except for sling operations producing higher urethral closure pressure at stress in the proximal and lower in the distal functional urethra compared to the other operations were found. The results indicate, that successful operations eliminate the failure to maintain adequate basal urethral pressure at stress and emphasizes the importance of reflex activity of pelvic floor musculature at stress for continence.

Adult↗
PubMed1983

The effect of pelvic floor exercises on urethral function in female stress urinary incontinence: an urodynamic study.

Twenty four patients with grade II stress urinary incontinence were examined urodynamically before and after two months of pelvic floor exercises. On urethrocystometry positive urethral closure pressure was observed in five of the patients (21%) after the therapy. The positive closure pressure appeared only in the distal functional urethra, probably produced by reflex contraction of pelvic floor muscles at stress. Thirteen patients (54%) experienced subjective improvement while in eleven patients the stress incontinence remained unchanged. Active sphincter exercises appear useful in the primary treatment of stress urinary incontinence. Most suitable for this therapy are patients with slight or moderate urethral relaxation at stress and elderly patients with increased operative risks.

Adult↗
PubMed1982

Cytosol estrogen and progestin receptors in endometrial carcinoma of patients treated with surgery, radiotherapy, and progestin. Clinical correlates.

Cytosol progestin (PR) and estrogen receptor (ER) concentrations were measured in 114 endometrial carcinoma specimens from 109 patients; these levels were correlated with clinical and histopathologic characteristics, and with clinical outcome in 44 patients followed for at least two years after the primary therapy consisting of surgery, irradiation and adjuvant administration of progestin. Eighty percent of all specimens were simultaneously PR- and ER-positive (greater than or equal to 6 fmol and greater than or equal to 3 fmol/mg protein, respectively) whereas 10% were both PR- and ER-negative. Early clinical stages (I and II) were more often receptor-positive, and the receptor concentration in these tumors was higher than in advanced or recurrent disease. The same was the case for superficial as compared with deeply invasive lesions. Both PR and ER concentrations in well or moderately differentiated tumors were higher than in anaplastic carcinomas. PR and ER concentrations did not correlate with the age of menopausal status, body weight or carbohydrate metabolism of the patients. In the patient group followed up for two years or more, the receptor-poor tumors tended to behave more aggressively than did receptor-rich malignancies in relation to patient survival. The measurement of PR and ER concentrations in advanced endometrial carcinoma has been proved useful in the selection of hormonal or cytotoxic chemotherapy. The current results advocate their use of prognostic risk factors which might be useful in selection of the most efficient treatment modalities for individual patients.

Adult↗
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

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↗
PubMed1982

Urinary fistulae caused by gynaecological therapy seen in one urological unit.

37 urinary fistulae caused by gynaecological operations and radiotherapy were analyzed. The original disease was malignant in 24 cases and benign in 13 cases. The cause of the fistula was simple hysterectomy in 11 cases, radical hysterectomy in 5 cases, irradiation for pelvic malignancy and irradiation in 5 cases, vaginal operation in 5 cases, infection in 1 case and difficult labour in 1 case. 14 fistulae were closed transabdominally, 6 fistulae were closed transvaginally and 5 fistulae healed by conservative therapy. It was possible to close 2 of the 5 postradiation complex vesicovaginorectal fistulae. 22 patients left the hospital dry voiding via the urethra. Despite successful closure of the fistula 4 patients remained partially or totally incontinent. Using various forms of urinary and intestinal diversion procedures the social performance and quality of life of the patients unsuitable for functional closure of the fistula could be greatly improved.

Adult↗
PubMed1981

Pregnancy and delivery at the age of forty and over.

One hundred and eighty-six deliveries from mothers of age 40 and over at Oulu University Central Hospital during 1975-77 are summarized. The commonest maternal complications were pre-eclampsia (25.8%) and pathological glucose tolerance (7.0%). The cesarean section rate of the whole group was 126.7%, and for the primiparas, 47%. Placental complications were slightly but not significantly more common among parturients over 40 compared with our general obstetric population. The pregnancies did not adversely affect the mothers' health despite commonly occurring maternal diseases. The commonest pathological findings among the newborns were hyperbilirubinemia (7.9%), neonatal infections (4.2%), clavicular fractures (3.2%) and postpartum asphyxia (2.6%). Congenital anomalies occurred in 2.6% of the children and were the main cause of the perinatal mortality, which was 5/189 (2.6%). Prematurity and low birth weight were not increased.

Adult↗
PubMed1981

Increased rate of primary dysmenorrhea in women with spontaneous premature labor.

Prostaglandins (PG) are responsible for primary dysmenorrhea and may be involved in the start of preterm or fullterm labor. Therefore, in order to see if there is any association between these two PG-mediate conditions, the incidence of dysmenorrhea in 177 primiparous women with threatened premature labor was compared with that in 177 primiparous women without premature uterine contractions. Dysmenorrhea had occurred about two times more commonly in women with threatened or established premature labor than in the controls. If this finding is confirmed in prospective studies, dysmenorrhea should be regarded as a factor predisposing women to a premature labors.

Adult↗