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Biomedical subjects

K Irjala

Publications and source records attributed to K Irjala.

At least 73 records · Page 4Linked to original sources
PubMed1998

Serum total renin levels after ovarian electrocautery in women with polycystic ovary syndrome.

Recent observations have suggested an enhanced activity of the ovarian renin-angiotensin system in polycystic ovary syndrome (PCOS). Owing to technical restrictions, the direct measurement of ovarian renin-angiotensin activity is impossible. The measurement of total renin (active renin + prorenin) in serum is particularly valuable for analyzing the ovarian renin-angiotensin system, as 90% of circulating renin is in the form of prorenin and ovaries are the major extrarenal source of prorenin in females. Also, the renin synthesized by ovaries is in the form of prorenin. In the present study we hypothesized that ovarian trauma caused by electrocautery 'impairs' the activity of the ovarian renin-angiotensin system, which in turn would interrupt the endocrine vicious cycle of PCOS, and restore normal ovarian function. To test this, we examined the effect of ovarian electrocautery on serum levels of total renin in 11 oligomenorrheic women, aged 25 to 36 years, with PCOS and anovulatory infertility. Against our basic hypothesis the serum total renin levels remained unaltered after ovarian electrocautery, while the serum levels of luteinizing hormone, testosterone and androstenedione declined. The mechanism that induces ovulation without altering total renin levels in serum remains to be resolved.

Adult↗
PubMed1998

Regression-based reference limits and their reliability: example on hemoglobin during the first year of life.

Calculation of reference limits by regression analysis makes it unnecessary to partition the reference data into subgroups, and age-dependent limits can be estimated within as narrow age intervals as necessary. However, the reliability of the regression-based reference limits has not been considered before. To get valid regression-based confidence intervals (CIs) for reference limits, one must evaluate the convolution of two distributions. In this study, age-dependent reference limits with corresponding CIs were produced for blood hemoglobin concentrations over the age interval from newborns to 12 months. We describe how the variance associated with the reference limits can be estimated, and present a Table from which appropriate values can be chosen for the calculation of regression-based reference limits and exact CIs. Also, an equation for the calculation of approximate CIs is given. The data were modeled by linear regression in several cumulative age groups to find the transition zone where the slope changed. After defining this cutoff point, piecewise linear regression was applied. Reference limits and their CIs calculated by conventional and piecewise linear regression methods were almost the same in older age groups but differed significantly during the period of most rapid age-dependent changes, i.e., during the 2 months after birth.

Age Factors↗
PubMed1997

Serum transferrin receptor and its ratio to serum ferritin in the diagnosis of iron deficiency.

The objective of the study was to evaluate the diagnostic efficiency of laboratory tests, including serum transferrin receptor (TfR) measurements, in the diagnosis of iron depletion. The patient population consisted of 129 consecutive anemic patients at the University Hospital of Turku who were given a bone marrow examination. Of these patients, 48 had iron deficiency anemia (IDA), 64 anemia of chronic disease (ACD), and 17 patients had depleted iron stores and an infectious or an inflammatory condition (COMBI). Depletion of iron stores was defined as a complete absence of stainable iron in the bone marrow examination. Serum TfR concentrations were elevated in the vast majority of the IDA and COMBI patients, while in the ACD patients, the levels were within the reference limits reported earlier for healthy subjects. TfR measurement thus provided a reliable diagnosis of iron deficiency anemia (AUC(ROC) 0.98). Serum ferritin measurement also distinguished between IDA patients and ACD patients. However, the optimal decision limit for evaluation of ferritin measurements was considerably above the conventional lower reference limits, complicating the interpretation of this parameter. Calculation of the ratio TfR/log ferritin (TfR-F Index) is a way of combining TfR and ferritin results. This ratio provided an outstanding parameter for the identification of patients with depleted iron stores (AUC(ROC) 1.00). In anemic patients, TfR measurement is a valuable noninvasive tool for the diagnosis of iron depletion, and offers an attractive alternative to more conventional laboratory tests in the detection of depleted iron stores.

Adult↗
PubMed1997

Climacteric symptoms do not impair cognitive performances in postmenopause.

OBJECTIVE: To investigate whether information processing and attention performances are affected by climacteric vasomotor symptoms. METHODS: The study group comprised 66 healthy hysterectomized postmenopausal women. The subjects were divided into two subgroups (high symptomatic and low symptomatic) according to the quantity of climacteric vasomotor symptoms. Information processing was examined using CogniSpeed, a reaction time software that separates, for example, pure controlled processing and working memory from perceptual and motor components. Attention was examined by using visual and auditory tasks. The role of climacteric depression as a determinant of cognitive performance was evaluated by the Beck Depression Inventory and dividing subjects according to self-reported climacteric mood symptoms. The effects of serum oestrogen level and ageing on cognitive performances were also studied. RESULTS: Cognitive performances were similar in high symptomatic and low symptomatic women. On the Verification test younger women had shorter reaction times (P = 0.002) and on the Subtraction test they had fewer errors (P = 0.015) than older women. These tests required working memory and decision making. Accuracy in the tests of sustained and auditory attention worsened slightly with age. Cognitive performances neither correlated with scores on the Beck Depression scale nor with serum oestrogen level. Climacteric mood symptoms did not impair cognitive performance. CONCLUSIONS: Despite subjective complaints of memory impairment in association with climacteric vasomotor symptoms, our results did not support a direct cause-and-effect relationship. Thus, the minor deficits found in cognitive processing efficiency seem to be related rather to age than climacteric symptoms.

Aging↗
PubMed1997

Hypothalamic-pituitary axis remains intact after interferon-alpha treatment in hematologic diseases.

Many endocrinologic disturbances have been reported during and after interferon-alpha (IFN-alpha) treatment. These disturbances have often been caused by autoantibodies. The aim of this prospective study was to evaluate whether IFN-alpha causes hormonal changes and if it is necessary to search for such disturbances routinely. Ten patients with hematologic malignancies were examined before and after 4 months of IFN-alpha treatment. Pituitary function was tested by hypothalamic releasing hormones (thyrotropin-releasing hormone, TRH, growth hormone-releasing hormone, GHRH, gonadotropin-releasing hormone, GnRH). The adrenal glands were tested with the adrenocorticotropin (ACTH) test. The human chorionic gonadotropin (hCG) test was performed on the men (n = 4). The IFN treatment was well tolerated, and no long-term hormonal side effects were found. The testosterone/sex hormone binding globulin (SHBG) index tended to improve. There were no significant differences between the hormone responses before and after IFN-alpha treatment. We conclude that the hypothalamic-pituitary axis remains intact after IFN-alpha treatment. There is no need to follow patients endocrinologically if the patients are not predisposed by autoantibodies.

Adrenal Cortex↗
PubMed1997

Intake and indicators of iron and zinc status in children consuming diets low in saturated fat and cholesterol: the STRIP baby study. Special Turku Coronary Risk Factor Intervention Project for Babies.

A low-fat diet may predispose children to low meat consumption, low iron intake, and iron deficiency. In the randomized prospective Special Turku Coronary Risk Factor Intervention Project for Babies (STRIP baby study), families of 540 children were counseled to reduce exposure of children > 7 mo of age to known environmental risk factors for coronary heart disease. The control group consisted of 522 children whose families received no specific counseling concerning dietary fat. Iron and zinc intakes of 79 children aged 3-4 y (40 in the intervention group and 39 in the control group) were assessed with 4-d food records. The children in the intervention group consumed less saturated fat than those in the control group and had continuously higher ratios of dietary polyunsaturated to saturated fatty acids. Mean (+/- SD) daily iron intakes in the intervention and control groups were 8.8 +/- 4.2 mg and 8.6 +/- 2.8 mg, respectively. Laboratory findings in the intervention and control groups, respectively, were as follows: hemoglobin, 123 +/- 8 and 122 +/- 7 g/L; mean cell volume, 81.8 +/- 2.9 and 81.7 +/- 3.2 fL; mean corpuscular hemoglobin, 28.1 +/- 1.3 and 27.8 +/- 1.4 pg; ferritin, 21.8 +/- 11.6 and 19.2 +/- 12.4 microg/L; transferrin, 2.90 +/- 0.30 and 2.85 +/- 0.29 g/L; and transferrin receptor, 2.34 +/- 0.46 and 2.29 +/- 0.39 mg/L. There were no significant differences between the groups. Daily zinc intakes were 7.5 +/- 1.2 mg in the intervention group and 7.4 +/- 1.3 mg in the control group; respective serum zinc concentrations were 11.2 +/- 1.9 and 10.5 +/- 1.6 micromol/L (NS). In conclusion, long-term supervised use of a diet low in saturated fat and cholesterol did not influence intake or serum indicators of iron and zinc in children.

C-Reactive Protein↗
PubMed1997

Serum leptin concentrations in women with polycystic ovary syndrome.

The role of gonadotropins, androgens, and insulin in the regulation of circulating leptin levels is obscure. In order to clarify the relationships of these parameters we studied serum leptin levels in 19 healthy control subjects and in 35 hyperandrogenic and hyperinsulinemic patients with polycystic ovary syndrome (PCOS). Serum leptin concentrations did not differ significantly between PCOS patients and control subjects. When PCOS and control groups were analyzed together by univariate analysis, serum leptin was positively correlated with body mass index (BMI), body weight, serum insulin, serum triglyceride, and serum free testosterone concentrations. Serum leptin was inversely correlated with serum sex hormone binding globulin (SHBG) concentrations. There were no significant correlations between serum leptin and testosterone, androstenedione, or gonadotropin concentrations. Serum insulin, triglyceride, and free testosterone concentrations were positively correlated, and serum SHBG was negatively correlated with BMI. However, when BMI on one hand and serum insulin, triglyceride, free testosterone, or SHBG on other hand were used as independent variables in the partial correlation analysis with leptin, BMI turned out to be the variable primarily responsible for all of the correlations with leptin. In conclusion, the concept that circulating leptin levels would be different in PCOS patients than in regularly menstruating control subjects is not supported by our data.

Adult↗
PubMed1997

Serum phospholipases A2 in patients undergoing panproctocolectomy because of severe ulcerative colitis.

A major role has been proposed for group II phospholipase A2 in the pathogenesis of local and generalised inflammatory reactions. Elevated catalytic activity and mass concentrations of this enzyme have been found in serum and tissue samples of the colon in patients with active ulcerative colitis. The cellular source(s) of group II phospholipase A2 in the blood circulation is (are) unknown. In the current prospective study, we investigated the mass concentration of group II phospholipase A2 and the catalytic activity concentration of phospholipase A2 in serial serum samples of 15 consecutive patients who underwent a standard panproctocolectomy operation for severe ulcerative colitis. Both the catalytic activity concentrations of phospholipase A2 and the mass concentrations of group II phospholipase A2 increased rapidly in serum samples to maximum values on the first postoperative day and then decreased (p = 0.002 and p < 0.001, respectively) in patients who recovered uneventfully. Three patients had postoperative complications that further increased the enzyme concentrations at the time of respective complications. The pattern of group II phospholipase A2 mass concentration profiles was similar to the profiles of C-reactive protein. The results show that the removal of the large bowel does not eliminate the potential to secrete group II phospholipase A2 into the blood circulation in these patients. Secretion of group II phospholipase A2 into the circulation after surgery seems to be a normal host response to a major abdominal operation and postoperative complications. Consequently, we conclude that the large bowel is not an important source of group II phospholipase A2 in sera of patients with ulcerative colitis. The results also support the assumptions that the catalytic activity of phospholipase A2 in serum is attributable to group II phospholipase A2 and that this enzyme is an acute phase protein.

Adult↗
PubMed1997

Evaluation of new immunoenzymometric assay for measuring soluble transferrin receptor to detect iron deficiency in anemic patients.

During the last few years the measurement of serum-soluble transferrin receptor (sTfR) has been introduced as a tool to detect iron deficiency and as an analyte to differentiate between anemia caused by iron deficiency (IDA) and that caused by chronic disease (ACD). Commercially available methods have emerged to make diagnostics by sTfR more readily accessible. We documented the analytical performance of a newly introduced IDeA sTfR immunoenzymometric assay (IEMA) by Orion Diagnostica. We also evaluated its clinical performance in 98 consecutive anemic patients, with information derived from bone marrow aspirate samples as the reference for iron status. The clinical usefulness of two other commercially available sTfR assays was assessed for comparison. The analytical performance and clinical applicability of the IDeA were sufficient to support reliable clinical work. We conclude that IDA and iron deficiency in the presence of inflammatory states can be differentiated efficiently from ACD with this new commercial test to measure sTfR.

Adult↗
PubMed1997

Reference intervals for serum thyrotropin, free thyroxine and free triiodothyronine in healthy adults in Finland, measured by an immunoautomate based on time-resolved fluorescence (AutoDELFIA).

We have established reference intervals for healthy adults of serum thyrotropin, free thyroxine and free triiodothyronine using the AutoDELFIA (Wallac, Finland) automatic measuring device. The determination of reference intervals in a proper manner is costly, and many laboratories adopt reference ranges from the literature rather than determining them alone. This is the first report on reference values in thyroidology where this automatic system based on time-resolved fluorescence has been used. The reference intervals for thyrotropin, free thyroxine and free triiodothyronine were 0.6-4.3 mIU/l, 9.6-17.1 pmol/l and 4.3-7.5 pmol/l, respectively.

Adult↗
PubMed1996

Linking patient medication data with laboratory information system.

Dozens of new drugs are taken into clinical use each year. Even if the clinicians were able to learn the most important therapeutic effects of the drugs they prescribe, they would still be unable to remember all of their minor effects. After storing patient related medication data on computerized patient records it is possible to build decision support modules which automatically remind of possible drug influences on laboratory tests and cause alarms or alerts of drug interactions. Medication profiles coded using the Anatomical Therapeutic Chemical-code (ATC-code) constitutes a valuable part of an Electronic Patient Record (EPR). In this paper, we describe the benefits of our system. By building links to commercially available drug and laboratory databases we can automatically inform clinicians on clinically relevant drug influences on laboratory test results.

Clinical Laboratory Information Systems↗
PubMed1996

Serum free testosterone in polycystic ovary syndrome measured with a new reference method.

OBJECTIVE: To quantify the actual serum free T with a specific new reference method in women with polycystic ovary syndrome (PCOS) and to analyze the effects of serum free T, total T, and the T:sex hormone-binding globulin (SHBG) ratio on the diagnosis of PCOS. SETTING: Outpatient clinic of reproductive endocrinology at Turku University Central Hospital, Turku, Finland. PATIENTS: Forty-four oligomenorrheic women with PCOS and 26 weight-matched control women with regular menstrual cycles. MAIN OUTCOME MEASURES: The concentrations of free T, total T, androstenedione (A), LH, FSH, SHBG, and insulin in serum. RESULTS: The mean concentrations of free T, total T, A, and LH as well as the LH:FSH and T:SHBG ratios were higher, whereas the mean concentrations of FSH was lower in the women with PCOS than in healthy women. No differences were found in the free T, total T, or T:SHBG levels or in the body mass indexes (BMIs) between the hirsute (n=26) and nonhirsute (n = 18) women with PCOS. Both elevated free T concentrations and high T:SHBG ratios were associated with obesity, but serum total T was independent of BMI. The serum free T measurement discriminated PCOS women from controls to a similar extent as total T and T:SHBG ratio as judged by a receiver operating characteristics analysis. CONCLUSIONS: The present data indicate that determination of free T provides little additional information in the diagnosis of hirsutism or PCOS and does not have to be included to the basic evaluation of these patients. Only half of women with PCOS exhibited elevated serum free T concentrations.

Adolescent↗
PubMed1996

Optimal use of hormone determinations in the biochemical diagnosis of the polycystic ovary syndrome.

OBJECTIVE: To investigate, using logistic regression analysis and receiver operator characteristic analysis, the biochemical diagnosis of polycystic ovary syndrome (PCOS) and if it could be improved by using an array of hormone measurements chosen to yield optimal and cost-effective discrimination between women with PCOS and healthy women. DESIGN: Retrospective clinical study. SETTING: Outpatient clinic of reproductive endocrinology at Turku University Central Hospital, Turku, Finland. PATIENTS: Fifty-four oligomenorrheic women with PCOS diagnosed by ovarian ultrasonography, and 29 healthy regularly menstruating women with normal ovarian morphology. MAIN OUTCOME MEASURES: Concentrations of LH, FSH, androstenedione (A), T, and sex hormone-binding globulin in serum. RESULTS: Luteinizing hormone, FSH and A, when used in combination, were the hormonal analytes of highest clinical utility. Diagnostic sensitivity, specificity, and overall concordance of 98%, 93%, and 96%, respectively, were attained. Each of the analytes used alone yielded lower degree of discrimination. CONCLUSIONS: Simultaneous use of the levels of LH, FSH, and A in serum can be used effectively for classification between women with PCOS and healthy women.

Adolescent↗
PubMed1996

Normal serum uric acid concentrations in women with polycystic ovary syndrome.

Recently, an inverse correlation between serum uric acid concentrations and insulin sensitivity has been described in subjects with varying degrees of metabolic syndrome, suggesting that measurement of serum uric acid may provide a simple marker of insulin resistance. Several biochemical and clinical features of polycystic ovary syndrome (PCOS) resemble those of metabolic syndrome: women with PCOS are often obese; they are also at increased risk for the development of coronary artery disease, hypertension and diabetes mellitus. The objective of the present study was to analyse the usefulness of serum uric acid measurement in screening for the metabolic syndrome in women with PCOS. For that purpose serum concentrations of uric acid, insulin and triglycerides were measured in 38 women with PCOS and 20 weight-matched control women with regular menstrual cycles. No differences were found in the uric acid concentrations between the PCOS and control groups. The mean concentrations of triglycerides and fasting insulin were higher in the women with PCOS than in the healthy controls. Serum uric acid concentrations were inversely related to serum hormone-binding globulin (SHBG) concentrations, and positively with body mass index (BMI), insulin concentrations and testosterone:SHBG ratio in the PCOS group. Our results suggest that measurement of serum uric acid does not provide new means for identification of metabolic syndrome in patients with PCOS.

Adult↗
PubMed1995

Immunoreactive interleukin-6 and acute phase proteins as prognostic factors in multiple myeloma. Finnish Leukemia Group.

High serum level of bioactive interleukin-6 (IL-6) is regarded as a predictor of poor prognosis in multiple myeloma (MM). On the other hand, the reported levels of immunoreactive IL-6 have been highly variable, and the prognostic value of immunoreactive IL-6 in MM is not clear. We have analyzed the prognostic significance of serum immunoreactive IL-6, as measured by a sensitive immunosorbent assay, in 210 patients with newly diagnosed MM subsequently treated with intermittent melphalan and prednisone. The serum levels of acute phase proteins C-reactive protein (CRP), alpha 1-antitrypsin (alpha 1AT), and acid alpha 1-glycoprotein (orosomucoid; OM) were evaluated as surrogates for IL-6. Serum IL-6, CRP, alpha 1AT, and OM levels were raised in 42%, 40%, 41%, and 24% of the patients, respectively. There was a significant correlation between the clinical stage of the patients and serum IL-6 (P = .006), alpha 1AT (P = .001), and OM (P = .004) levels at diagnosis. At 3 years, 52% of the patients were alive. Univariate logistic regression analysis showed that high levels of IL-6 (P = .002), CRP (P = .02), alpha 1AT (P < .001), OM (P = .007), beta 2-microglobulin (beta 2M; P < .001), and thymidine kinase (P < .05) were all associated with 3-year mortality. In multivariate regression analysis, beta 2M (P < .0001) and alpha 1AT (P = .01) had independent prognostic significance. The patients with high levels of both beta 2M and alpha 1AT or IL-6 were at very high risk of dying within 3 years from diagnosis (16% and 21% of the patients in these groups were alive, respectively). When the patients were stratified according to the clinical stage, the prognostic significance of serum IL-6 and alpha 1AT was especially evident in stage II patients. When the patients were divided into two groups according to normal or raised serum IL-6 levels, the patients with high IL-6 levels had more frequent osteolytic bone lesions (P = .03) and a more aggressive disease. We conclude that serum immunoreactive IL-6 is a significant prognostic marker in MM.

Acute-Phase Proteins↗