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Biomedical subjects

J Heikkinen

Publications and source records attributed to J Heikkinen.

At least 73 records · Page 4Linked to original sources
PubMed1989

Anaerobic vaginosis: treatment with tinidazole vaginal tablets.

A prospective randomized trial comprising 90 patients was undertaken to evaluate three different regimens of tinidazole in the treatment of anaerobic vaginosis. Each group consisted of 30 women. The three regimens were: (A) oral tinidazole (150 mg X 2) for 7 days, (B) same oral treatment as above but also the partner received 500 mg X 2 for 4 days, and (C) intravaginal tinidazole (500 mg) at bedtime for 2 weeks. After clinical diagnosis and treatment the patients were reassessed at 1 and 3 months. The overall cure rate was significantly (p less than 0.05) higher in group C than in the other groups. After 3 months, 70% of the cases in group C were asymptomatic, while in the other groups the rate was 42 and 43%, respectively. The intrauterine contraceptive device (IUCD) played an important role in the etiology of relapses and also in the decreased cure rates particularly seen in groups A and B. Among the women in group C using an IUCD, 80% were cured, while in groups A and B only 30 and 29% were cured. All regimens were well tolerated. The treatment of anaerobic vaginosis with vaginal tinidazole was effective and particularly useful if an IUCD was in concurrent use.

Adult↗
PubMed1988

Serum bile acid concentrations as an indicator of liver dysfunction induced during danazol therapy.

The effects of danazol therapy (600 mg/day) on the liver function of 16 women with endometriosis were investigated. The primary bile acids (cholic acid [CA] and chenodeoxycholic acid [CDCA]) were analyzed with radioimmunoassays in the fasting state and after a test meal. Also, the conventional liver function tests were performed. Ultrasonography was used to detect any possible changes in the gallbladder function. The fasting concentrations of CA increased (P less than 0.05) during therapy, while those of CDCA did not change. The ratio of CA/CDCA also increased (P less than 0.001). The maximal response of CA after the test meal increased (P less than 0.01) during the trial. As regards the other liver function tests, only the transaminases significantly increased (P less than 0.01) after 1 month of therapy but showed a tendency to decrease later during the trial. The gallbladder's volume and function did not change. All the parameters studied normalized within 1 month of cessation of danazol therapy. Danazol seems to have a rather mild effect on liver function. The analyzed parameters indicate transient cell wall injury and slight disturbances in liver cell uptake and secretion mechanism and also of synthesis activity.

Adult↗
PubMed1988

Hormonal and clinical effects of ketoconazole in hirsute women.

The effects of ketoconazole on pituitary-ovarian function and adrenal function were evaluated in nine hirsute women treated with 400-1200 mg/day for 1-6 months. High dose (800-1200 mg/day) ketoconazole treatment decreased serum androstenedione, dehydroepiandrosterone, and testosterone (T) concentrations, while that of 17 alpha-hydroxyprogesterone increased, suggesting a steroidogenic block at the level of 17,20-desmolase. The decreased serum T and increased sex hormone-binding globulin concentrations led to a significant decrease in the free androgen index. Serum estradiol, cortisol, and dehydroepiandrosterone sulfate concentrations did not change. The serum LH concentration and the LH to FSH ratio increased during treatment, suggesting a negative feedback effect of T on pituitary LH secretion. The hormonal changes that occurred during high dose ketoconazole therapy persisted during subsequent low dose (400 mg/day) treatment. The therapeutic effect of ketoconazole on hirsutism manifested itself at 6 months. We conclude that ketoconazole reduces excessive androgen production in a dose-dependent manner and decreases the free androgen index in hirsute women; these changes are accompanied by significant alleviation of hirsutism.

Adult↗
PubMed1986

Dynamic evaluation of prolactin secretion by successive TRH and metoclopramide stimulations.

We evaluated the clinical applicability of a 2-h test in which the prolactin (Prl) responses to thyrotrophin releasing hormone (TRH)(200 micrograms iv) and the dopamine antagonist, metoclopramide (MC; 10 mg iv) were studied successively, 1 h apart. Nine healthy women were studied with TRH-MC test and with another test in which MC alone was used or the drugs were given in opposite order. The preceding TRH injection did not affect the Prl responses to MC, nor did preceding MC affect the Prl response to TRH. With the TRH-MC test, Prl responses to TRH and MC were significantly lowered in amenorrhoea (N = 8) and hyperprolactinaemia (N = 15) regardless of whether or not treated with bromocriptine, and to MC only in oligomenorrhoea (n = 11). In normoprolactinaemic galactorrhoea (N = 7) the responses were similar as in healthy women. The ratio between Prl responses to TRH and MC was significantly higher in women with bromocriptine-treated hyperprolactinaemia (1.06 +/- 0.8, SD) than in healthy controls (0.34 +/- 0.13). The capacity of pituitary lactotrophs to secrete Prl in response TRH and MC can be evaluated with a 2-h test which has potential for investigation of pituitary Prl dynamics in gynaecological endocrine disorders, particularly in amenorrhoea and hyperprolactinaemia.

Adolescent↗
PubMed1985

Contractility of maternal and fetal gallbladder: an ultrasonic study.

The volumes of the maternal and fetal gallbladder were examined by ultrasound in a fasting condition during the last trimester of pregnancy in 25 cases and then monitored for 180 min after a standard peroral test meal or glucose administration. The ratio of maternal to fetal gallbladder fasting volumes corresponded to the ratio of the weights. A significant decrease in maternal gallbladder size was observed at 30, 60, and 120 min in both groups, but the changes in the volume of the fetal gallbladder were not significant. This latter observation points toward a resting condition and passive role for the gallbladder in the antenatal gastrointestinal physiology of the fetus.

Cholecystokinin↗
PubMed1984

Gallbladder function and maternal bile acids in intrahepatic cholestasis of pregnancy.

Ultrasonic measurement of the gallbladder volume was taken in 8 nonpregnant, healthy women, in 7 women with normal pregnancies and in 7 women whose pregnancies were complicated by intrahepatic cholestasis of pregnancy, in the fasting state and 30, 60, 120 and 180 min after a test meal. At the same time the serum concentrations of cholic acid and chenodeoxycholic acid were measured. The fasting and ejection volumes of the gallbladder in cholestasis of pregnancy were greater than in normal pregnancy. The fasting volume of the gallbladder was greater, but the ejection volume smaller in normal pregnancy than in nonpregnant women. No difference in the ultrasonic appearance of the intra- and extrahepatic bile ducts was found between the groups. Serum bile acids were increased in cholestasis of pregnancy and did not display any decreasing tendency after the postprandial rise during the following 3 h. The results indicate that in cholestasis of pregnancy the gallbladder function and the enterohepatic circulation of bile acids are different from normal pregnancy. This may be associated with the great tendency to gallstones in these women. The large size of the gallbladder in cholestasis of pregnancy has differential diagnostic importance in the ultrasonic evaluation of a pregnant woman with liver disease.

Bile Acids and Salts↗
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

Effect of a standard test meal on serum bile acid levels in healthy nonpregnant and pregnant women and in patients with intrahepatic cholestasis of pregnancy.

Eight healthy nonpregnant women, nine pregnant women, and eight patients with intrahepatic cholestasis (IHC) of pregnancy were investigated. Serum samples were collected after overnight fasting just before the application of the test meal and 30, 60, 120 and 180 min afterwards for determination of serum cholic acid (CA), chenodeoxycholic acid (CDCA) and deoxycholic acid (DCA) concentrations by radioimmunoassays. After the test meal primary bile acid levels were increased significantly (p less than 0.01) in every group after one hour and CDCA concentrations increased to a greater extent and more rapidly than those of CA. In pregnant women there were two cases with increased CA levels after three hours. In patients with IHC of pregnancy CA concentrations after three hours were higher than the initial fasting levels in every case and also over the normal reference limit. The testing of liver function by measuring the serum concentrations of endogenous bile acids after the test meal seems to be useful and more sensitive than measuring the levels of fasting bile acids in the mild forms of IHC of pregnancy. Normal pregnancy also appears to result in a somewhat cholestatic condition.

Adult↗
PubMed1982

Serum bile acids during biphasic contraceptive treatment with ethinyl estradiol and norgestrel.

Twenty-nine women were treated with biphasic combined oral contraceptive pills containing ethinyl estradiol 0.05 mg and levonorgestrel 0.050-0.125 mg. Serum primary bile acids (cholic acid and chenodeoxycholic acid) and one secondary bile acid (deoxycholic acid) were measured by radioimmunoassay. The serum samples were collected before the treatment and at one, three and twelve months during the treatment. No significant changes were found in these bile acid levels during the treatment. The ratio of cholic/chenodeoxycholic acid did not change either. No pathological values were found in the conventional liver function tests although serum alanine aminotransferase activity was significantly increased after twelve months' treatment. It can therefore be concluded that the present contraceptive pill does not cause any liver dysfunction detectable by bile acid measurements of other "classical" liver function tests.

Adolescent↗
PubMed1982

Serum bile acid levels in intrahepatic cholestasis of pregnancy during treatment with phenobarbital or cholestyramine.

Nineteen patients suffering from the intrahepatic cholestasis (IHC) of pregnancy were studied. Twelve of them were treated with phenobarbital (100 mg/day) and seven with cholestyramine (18 g/day). The overnight fasting levels of serum cholic acid (CA), chenodeoxycholic acid (CDCA) and deoxycholic acid (DCA) were measured by radioimmunoassay. The activities of serum transaminases, gamma-glutamyltranspeptidase, alkaline phosphatase and total and conjugated bilirubins were also analyzed. It was found that there was no correlation between the itching symptom and the serum bile acid levels. During phenobarbital treatment serum bile acid concentrations did not change. Also, the other measured parameters as well as the CA/CDCA ratio did not change significantly. Transaminases had, however, a slight tendency to decrease. The therapy successfully relieved itching in half of the cases. There was no relationship between the relief of the itching and the change in the bile acid concentrations. Cholestyramine treatment did not decrease the CA level significantly, but that of the CDCA decreased (P less than 0.05) and the ratio of CA/CDCA increased (P less than 0.05). In the other analyzed liver function test results, an increase (P less than 0.05) occurred only in the concentrations of conjugated bilirubin. The itching was relieved in five of the seven cases during the first week of treatment, but after that the symptom tended to reappear. There was a slight correlation between the decrease in the CDCA level and in the relief of the itching. The two drugs did not cause any particular side effects.

Bile Acids and Salts↗
PubMed1982

Gall bladder volume and serum bile acids in cholestasis of pregnancy.

Gall bladder volume was measured by ultrasound in eight patients with cholestasis of pregnancy, in 21 normal pregnant women and in 14 non-pregnant women, and at the same time serum cholic and chenodeoxycholic acid levels were estimated. The gall bladder volume was 60% larger in cholestasis than that in normal pregnancy and more than two times larger in normal pregnancy than in non-pregnant women. The serum cholic and chenodeoxycholic acid concentrations were significantly higher in cholestasis of pregnancy than those in normal pregnancy.

Adult↗
PubMed1981

Serum bile acids and lipids during treatment of climacteric symptoms with natural oestrogen--progestin combinations.

Climacteric symptoms of 21 women were treated for 6 mth with sequential combination preparations containing natural oestrogen (oestradiol and oestriol) and norethisterone acetate as progestin. There were no significant changes during the treatment period in the serum alanine aminotransferase activity or concentrations of cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, cholic acid and deoxycholic acid. The concentration of chenodeoxycholic acid was, however, significantly decreased after 6 mth treatment. It thus appears that the above natural oestrogen--progestin combinations do not have adverse effects on hepatic function and lipid metabolism.

Adult↗
PubMed1981

Changes in serum bile acid concentrations during normal pregnancy, in patients with intrahepatic cholestasis of pregnancy and in pregnant women with itching.

Two primary bile acids, cholic acid (CA) and chenodeoxycholic acid (CDCA), and one secondary bile acid, deoxycholic acid (DCA), were measured by radioimmunoassay in pregnancy serum from 30 healthy women, 49 women with itching and 45 with intrahepatic cholestasis of pregnancy. All subjects were studied serially from between 16 and 20 weeks gestation until 35-60 days post partum. In healthy pregnant women, serum CA and DCA levels did not change significantly at any time. The mean CDCA level rose significantly towards term. In women with intrahepatic cholestasis, serum levels of CA and CDC were increased ten- and five-fold, respectively, at the time of appearance of clinical symptoms and the CA/CDCA ratio rose from 1/1 to 2/1; there was also a moderate increase in the serum concentration of DCA. In 4 of 8 women studied prospectively an increase in serum bile acid levels preceded the appearance of symptoms or other laboratory evidence of intrahepatic cholestasis. Nine of the women with itching with normal routine liver function test results had increases in serum CA and CDCA concentrations suggesting mild cholestasis.

Bile Acids and Salts↗
PubMed1980

Amniotic fluid bile acids in normal and pathologic pregnancy.

Radioimmunologic techniques were used to determine 2 primary bile acids (cholic and chenodeoxycholic acid) and 1 secondary bile acid (deoxycholic acid) from human amniotic fluid of healthy pregnant women and from patients with diabetes, toxemia, or intrahepatic cholestasis during pregnancy. In general, the mean bile acid concentrations in the amniotic fluid were very similar to those in the serum, although in paired samples from individual patients these 2 values did not correlate significantly. Very high levels of the 2 primary bile acids were measured from the amniotic fluid of patients with intrahepatic cholestasis. The mean values were about 70 times higher than those in the controls. Amniotic fluid cholic acid content was slightly elevated in diabetic and toxemic patients, too. Deoxycholic acid was consistently found in the amniotic fluid specimens, but there was no change in its concentration among the various groups. In this limited series of patients, no significant correlation was found between the bile acid concentrations in the amniotic fluid and signs of fetal distress at the time of amniocentesis, although the lowest maternal serum estriol and human placental lactogen values were associated with the highest amniotic fluid bile acid concentrations. The condition of the newborn infants did not correlate with amniotic fluid bile acid concentrations in any of the patient groups studied. It thus appears that high amniotic fluid bile acid content present a threat to the fetus, but further studies are needed to clarify this point.

Adult↗