Biomedical subjects

K Irjala

Publications and source records attributed to K Irjala.

At least 109 records · Page 6Linked to original sources

PubMed1994

Iron-deficiency anemia is associated with high concentrations of transferrin receptor in serum.

We evaluated the use of transferrin receptor (TfR) in serum as an index of iron deficiency in 19 patients diagnosed as having iron-deficiency anemia, in 17 patients with anemia of chronic disease, and in a control group of 19 nonanemic patients who underwent elective ocular or nasopharyngeal surgery. The assessment of iron status of the anemic patients was based on the presence of stainable iron on bone marrow examination. In the patients with iron-deficiency anemia, the serum TfR concentration was 5.3 +/- 1.8 mg/L (mean +/- SD), significantly higher than in the control group (1.7 +/- 0.5 mg/L) or in the patients with anemia of chronic disease (1.6 +/- 0.4 mg/L). This study suggests that serum TfR measurement is a reliable index of iron depletion and potentially of importance in the diagnosis of iron-deficiency anemia.

Anemia, Hypochromic↗

PubMed1994

Phospholipase A2, C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis.

We compared the predictive value of determining group II phospholipase A2 (PLA2) in serum for diagnosing acute appendicitis with the predictive values of white blood cell count (WBC) and measurement of C-reactive protein (CRP). In this prospective study, we included 186 patients who were undergoing appendectomy after clinical diagnoses of acute appendicitis. The performance of each test was measured by receiver-operating characteristic curves. WBC was the test of choice in diagnosing uncomplicated acute appendicitis. However, in contrast to CRP and PLA2, which increased in patients with protracted inflammation, there was not a concomitant increase in WBC. Therefore, especially CRP, but also PLA2, were better indicators of appendiceal perforation or abscess formation than was WBC. Increased WBC, CRP, and PLA2 values did not unequivocally corroborate the clinical suspicion of appendicitis, but if all three values were within normal limits, acute appendicitis could be excluded with a 100% predictive value. PLA2 values showed a highly significant correlation with CRP but not with WBC values, which supports the view that PLA2 represents an acute-phase reactant.

Acute Disease↗

PubMed1994

Association of steroid hormone receptor content and flow cytometric DNA ploidy in endometrial carcinoma.

Flow cytometric DNA ploidy and sex steroid hormone receptor activity was measured in 55 endometrial carcinomas. DNA ploidy was measured on paraffin-embedded specimens and ER and PR activity was measured using both biochemical and immunohistochemical assay. Association of these parameters was tested using logistic regression model. Diploid or near diploid DNA histogram was seen in 40 cases (72.7%). All Grade 1 tumours (n = 15) were diploid whereas 38.5% of Grade 2 (n = 27) and Grade 3 (n = 13) tumours were aneuploid (grade 1 vs Grade 2 and 3, P = 0.0031). The mean value of ER was 109 +/- 120 (SD) fmol/mg protein for diploid tumours and 48 +/- 50 fmol/mg protein for aneuploid tumours (P = 0.0093). The corresponding values for PR were 226 +/- 262 fmol/mg protein and 75 +/- 102 fmol/mg protein (P = 0.0073), respectively. In immunohistochemical assay the mean HSCORE of ER was 45 +/- 77 for diploid tumours and 27 +/- 48 for aneuploid tumours (P = 0.43). The corresponding values for PR were 32 +/- 55 and 22 +/- 56, respectively (P = 0.58). In logistic regression analysis cytosolic PR content was associated with DNA ploidy.

Adult↗

PubMed1994

Ability of two new thyrotropin (TSH) assays to separate hyperthyroid patients from euthyroid patients with low TSH.

We evaluated the ability of new thyrotropin (TSH) assays to separate hyperthyroid (n = 50) patients from clinically euthyroid subjects with low TSH values (nodular goiter, n = 20, and nonthyroidal illness, n = 22). Only patients whose serum TSH was < 0.1 mIU/L by immunoradiometric assay were included. We used a new immunofluorometric method based on time-resolved fluorescence (TR-IFMA) and a new immunochemiluminometric assay (ICMA) to measure TSH in serum. Although the differences between the hyperthyroid patients and the euthyroid patients differed from each other by both methods (P = 0.0012 for TR-IFMA and P < 0.0001 for ICMA), there was no cutoff point that could definitely separate the groups. Thus, it is not possible to draw any definite conclusions on whether a patient is hyperthyroid or not, solely on the basis of TSH concentration measured with these new TSH assays.

Adult↗

PubMed1994

Time-resolved immunofluorometric assay of total renin in plasma and follicular fluid.

We developed a new time-resolved immunofluorometric assay (TR-IFMA) using two monoclonal antibodies for the total renin measurement in human plasma and follicular fluid. No conversion of prorenin to renin was needed because the assay detected both renin and prorenin. The detection limit of the assay was 10 ng/L and the linear range was 10-25,000 ng/L. Within-assay precision (CV) was 15-8% at renin concentrations of 50-12,200 ng/L. Between-assay precision was 19-3% at concentrations of 100-18,000 ng/L. Analytical recovery of added renin was 85-104% (n = 5) in plasma samples and 104-119% (n = 3) in follicular fluids. For plasma, the reference interval was 78-262 ng/L in men (n = 44) and 36-226 ng/L in women (n = 43).

Enzyme Precursors↗

PubMed1993

Clinical utility of an international thyroid database.

Assessment of thyroid function is prone to errors from several sources. Confusion is most often due to inappropriate use of tests, especially in patients with acute non-thyroid illness. With these problems in mind we have designed an international prospective thyroid database in three countries, which registers clinical and laboratory data on new patients with suspected thyroid disease. An additional aim was to assess the use of a computerised decision support tool to interpret thyroid data. The database permits rapid access to temporal trends in thyroid tests, which is useful in monitoring therapy and in follow up for hyperthyroidism. Marked contrasts in local clinical practices have highlighted the challenge in providing a valid decision tool to serve all clinical needs. Experience with multi-centre databases such as this hold promise in the drive to coordinate the disciplines of laboratory analysis and clinical decision making.

Clinical Laboratory Information Systems↗

PubMed1993

Relaxation time changes of the uterus during the menstrual cycle: correlation with hormonal status.

Six women volunteers underwent pelvic MR imaging at 0.02 T four times during their menstrual cycle. The T1 and T2 relaxation times of the myometrium and endometrium were measured and correlated with the serum estradiol and progesterone levels. The magnitude of the relaxation times were highly individual but the pattern of their variation during the menstrual cycle was similar. The relaxation times were shortest at the beginning and end of the cycle. The most rapid increase occurred during the proliferative phase, followed by little or no increase through to the middle of the secretory phase. The T1 and T2 times of the endometrium correlated directly with the serum estradiol levels during the entire menstrual cycle (r = 0.5, P = 0.02) and the T2 times of the endometrium with the serum progesterone levels during the secretory phase (r = 0.6, P = 0.05). The correlation between the relaxation times of the myometrium and the serum hormonal levels was poor. The results indicate that the relaxation times of the myometrium and endometrium vary during the menstrual cycle reflecting the serum hormonal status. MR imaging of the uterus with relaxation time measurements may be clinically useful to examine the menstrual cycle and its pathology.

Adult↗

PubMed1993

Insulin hypersecretion together with high luteinizing hormone concentration augments androgen secretion in oral glucose tolerance test in women with polycystic ovarian disease.

Female hyperandrogenism is often associated with hyperinsulinaemia and insulin resistance. We evaluated the hormone responses in an oral glucose tolerance test to investigate the interactions of gonadotrophins, insulin, C-peptide and androgens in women with polycystic ovarian disease (PCOD). In 28 patients with ultrasonographically diagnosed PCOD, hyperinsulinaemia and insulin resistance were mainly associated with obesity. Both basal and cumulative sum of insulin to C-peptide ratios were high in obese subjects, suggesting decreasing hepatic removal of insulin caused by obesity. Nevertheless, in some lean PCOD women, despite normal fasting insulin concentrations, insulin hypersecretion existed. The mean concentration of testosterone decreased significantly during the oral glucose tolerance test both in PCOD and control women, and of androstenedione in the PCOD patients only. However, an increase in androgen responses was found in a subgroup of PCOD patients, who had both elevated luteinizing hormone (LH) concentrations and hyperinsulinaemic response to oral glucose. In the remaining PCOD patients an inverse correlation between LH and insulin was found. The patients with hyperinsulinaemia together with LH hypersecretion may represent a subgroup of PCOD with deranged regulation of androgen secretion.

Adolescent↗

PubMed1993

External analytical quality assurance for proteins.

In the Nordic Protein Project an external control scheme (external quality assessment) was combined with the two other indispensable aspects of analytical quality, i.e. standardization (with a common high quality calibrator) and specification of needed analytical quality for sharing common reference intervals for nine serum proteins in the Nordic countries. The quality specifications are reliable for the purpose and given in clinical chemical terms--ready for application to the control systems. Further, a control design for disclosing external and internal errors, separately, is designed with respect to calibration and robustness towards analytical interference from turbid patient samples.

Chemistry Techniques, Analytical↗

PubMed1993

Method for determining reference changes from patients' serial data: example of cardiac enzymes.

Changes between serial laboratory test results can be significant, even if none of the individual results exceeds the reference interval. We developed a statistical method for the calculation of reference change limits from routine patients' data for situations in which the majority of the patients can be considered suitable reference subjects. The method was applied to cardiac enzyme data [creatine kinase (CK; EC 2.7.3.2), creatine kinase isoenzyme MB (CK-2), lactate dehydrogenase (LD; EC 1.1.1.28), and lactate dehydrogenase isoenzyme 1 (LD-1)] from 2029 consecutive patients. We used hospital discharge diagnoses to exclude patients with the diagnosis of myocardial infarction or myocarditis, but we also studied the characteristics of the method on unselected patients' data. The reference change limits derived from the diagnosis-selected patient group were as follows (U/L, activity measurements in serum at 37 degrees C according to Scandinavian recommendations): CK from -39 to 27, CK-2 from -8 to 7, LD from -86 to 85, and LD-1 from -19 to 15. Similar limits were obtained by conventional statistical methods from a group of 29 hospitalized patients with no myocardial symptoms. Our results suggest that it is possible to produce clinically applicable reference change limits from routine data.

Adolescent↗

PubMed1993

Hormonal responses to physical exercise in patients with polycystic ovarian syndrome.

OBJECTIVE: To examine the effects of obesity and polycystic ovarian syndrome (PCOS) on the endocrine responses to physical exercise. SETTING: Outpatient clinic of reproductive endocrinology at the University Central Hospital of Turku and the Department of Pharmacology, University of Turku, Turku, Finland. PATIENTS: Nine oligomenorrheic women with PCOS (body mass index [BMI] 19.5 to 46.0 kg/m2) and eight control women with regular menstrual cycles (BMI 20.0 to 53.5 kg/m2). INTERVENTIONS: A bicycle ergometer test was performed at 8 A.M. RESULTS: The only hormone response that was different between PCOS patients and controls was the exercise-induced increase in circulating GH levels. This response was significantly greater in controls than in PCOS patients. There was also a negative correlation between the GH response and BMI. The increases in the concentrations of adrenaline, noradrenaline, 3,4-dihydroxyphenylglycol, glucose, and insulin:C-peptide ratios during the bicycle ergometer test were correlated negatively to BMI. CONCLUSION: Obesity is an important determinant of the hormonal responses to physical exercise. This applies also to women with PCOS. Taking obesity into account in the analysis of exercise-induced hormone responses, only little, if any, of the variation in the hormonal responses measured by us could be attributed to PCOS per se. The only hormone response that was different between PCOS patients and controls was the GH response.

Adult↗

PubMed1993

A model for quality achievement--the NORDKEM protein project.

UNLABELLED: The Nordic protein project demonstrates a model for the process of achieving analytical quality. GOAL: based on use of common reference intervals leading to the quality specifications. Creation of quality: through common high quality calibrator (with IFCC-values) (external factor) and individual trouble-shooting and guidelines (internal factor). Control of quality: with specially designed set of control samples and problem-related evaluation of control data. Establishing common reference intervals: through associated projects.

Blood Proteins↗

PubMed1993

Clinical and laboratory studies of time-resolved fluorescence immunoassays of thyrotropin and free triiodothyronine.

We evaluated a new time-resolved immunofluorometric assay (TR-IFMA) for thyrotropin (TSH) and a time-resolved fluoroimmunoassay (TR-FIA) for free triiodothyronine (FT3) in serum. Delfia hTSH Ultra is a solid-phase two-site TR-IFMA involving three monoclonal antibodies directed against different antigenic sites on the human TSH molecule. It offers improved analytical (+3 SD of zero) and functional (10% between-assay CV) detection limits of 0.001 and 0.016 mlU/L, respectively. Results of the assay agreed closely with those of a second-generation immunoradiometric assay (TSH-IRMA) for samples with TSH > 0.2 mlU/L (n = 114). The nonparametric reference interval for TSH in euthyroid men and women was 0.5-4.7 mlU/L (n = 200). The TSH concentrations of hyperthyroid subjects (n = 29) were < 0.016 mlU/L (median; range < 0.016-0.063 mlU/L). The Delfia FT3 assay, a solid-phase TR-FIA, is based on the back-titration principle and second-antibody separation. The parametric reference interval for FT3 in euthyroid men and women was 4.2-7.6 pmol/L (n = 320). The FT3 concentration in hyperthyroidism (n = 29) was 23 +/- 22 pmol/L (mean +/- SD; range 7.9-85 pmol/L). These methods offered rapid results (2-4 h for the whole procedure) and were simple to run.

Adult↗

PubMed1992

Responses of placental steroids, prostacyclin and thromboxane A2 to thermal stress during pregnancy.

The effect of heat stress on plasma prostacyclin and thromboxane A2 and serum estradiol, estriol and progesterone responses was studied in pregnant and non-pregnant women. Group I consisted of 15 healthy non-pregnant women, group II of 23 women 13-14 weeks pregnant, and group III of 23 women 36-37 weeks pregnant. Blood samples were taken before the heat stress, at the end of the stress (70 degrees C for 20 min) and 20 min and/or 45 min after the end of stress. The rectal temperature increased 0.3-0.4 degrees C. The concentration of progesterone did not change during the experiment but that of estradiol increased by 11% (P less than 0.005) in group II and by 10% (P less than 0.01) in group III after the end of the stress. Estriol increased only in group III (by 12%, P less than 0.005) after the end of the stress and the increase was higher as compared to group II (P less than 0.005). The metabolite of prostacyclin increased only in group III by 15% (P less than 0.05) during the heat stress. The metabolite of thromboxane A2 decreased in group II by 20% (P less than 0.005) at the end of the stress while there was no change in group III. The fetal heart rate reactivity remained unchanged and only few uterine contractions were recorded. The small changes found in the levels of prostanoids and placental steroids in response to heat stress do not seem to have any deleterious effects on fetal well-being. The slightly increased concentration of placental steroids may rather reflect changes in metabolism than an increase in uteroplacental blood flow.

6-Ketoprostaglandin F1 alpha↗

PubMed1992

Value of measurement of C-reactive protein in febrile patients with hematological malignancies.

The maximum serum levels of C-reactive protein (CRP) in 126 patients with hematological malignancies who had 554 febrile episodes were analyzed retrospectively with regard to documented infections and fever of unknown origin. The CRP levels were significantly higher when the blood culture was positive than when it was negative (p = 0.002). The CRP levels were significantly higher when the infection focus was identified than when it was not (p = 0.010). In patients with fever of unknown origin the CRP was significantly lower than in patients with microbiologically documented infections (p < 0.001). Cytotoxic treatment neither reduced nor enhanced the CRP reaction. The serial measurement of CRP is a reliable and readily available means for differentiating between bacterial infections and other causes of fever in patients with hematological malignancies, also during neutropenia and after cytotoxic treatment.

Adult↗

PubMed1992

Serum androgen and gonadotropin levels decline after progestogen-induced withdrawal bleeding in oligomenorrheic women with or without polycystic ovaries.

OBJECTIVE: To examine the effect of short-term progestogen treatment on androgen, gonadotropin, and sex hormone-binding globulin (SHBG) levels in oligomenorrheic women. DESIGN: Comparative study of changes in hormonal parameters in patients with or without ultrasonographically diagnosed polycystic ovarian disease (PCOD). SETTING: Open patient clinic of reproductive endocrinology at University Central Hospital of Turku, Finland. PATIENTS: Seventy-five oligomenorrheic women with (n = 51) or without (n = 24) PCOD. MAIN OUTCOME MEASURES: Serum concentrations of testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and SHBG. RESULTS: The levels of T, A, LH, and the LH:FSH ratios decreased significantly after oral treatment with medroxyprogesterone acetate (10 mg/d for 10 days) in non-PCOD women and in women with PCOD decreasing the frequencies of pathological laboratory findings, in particular elevated levels of LH:FSH ratio and A in PCOD women and of LH:FSH ratio in non-PCOD women. The levels of T, A, and LH as well as the LH:FSH ratio were significantly higher in women with PCOD. Obesity was associated with high free androgen indices, low LH:FSH ratios, and low concentrations of LH, A, and SHBG. CONCLUSIONS: The serum samples for hormonal analyses used as an aid in diagnosing PCOD should be obtained without pretreatment with progestogen because it masks the biochemical findings of PCOD.

Adolescent↗

PubMed1992

Blood glycated haemoglobin, serum fructosamine, serum glycated albumin and serum glycated total protein as measures of glycaemia in diabetes mellitus.

Blood glycated haemoglobin (HbAlc), serum fructosamine (FA), serum glycated albumin (GA), and serum glycated total protein (GTP) were determined in 61 subjects (19 pregnant women with gestational diabetes, 24 pregnant women with insulin-dependent diabetes mellitus [IDDM] and 18 nonpregnant subjects with IDDM). FA, GA, and GTP correlated with HbAlc similarly (r = 0.791, 0.816, and 0.794, respectively, p < 0.001). In a subgroup of 22 subjects data on blood glucose home monitoring was recorded and used for calculating mean blood glucose as an index of average glycaemia preceding sampling of the glycation products. Mean blood glucose levels preceding sampling of HbAlc by 2 months and FA, GA, or GTP by three weeks correlated significantly with HbAlc (r = 0.668, p < 0.001) and GA (r = 0.441, p < 0.05) whereas no significant correlation was found between mean blood glucose and FA (r = 0.003) or GTP (r = 0.252). In conclusion, such methods which measure specifically the non-enzymatic glycation of a single species of protein (i.e. FPLC for HbAlc and affinity chromatography for GA) are to be preferred for assessing glycaemia.

Adult↗

PubMed1992

Cardiac systolic time intervals and thyroid hormone levels during treatment of hypothyroidism.

This study was undertaken to compare results of modern serum thyroid hormone assays with cardiac systolic time intervals (STI) during thyroxine treatment in hypothyroid patients. The patients were assessed clinically (Billewicz index) and the STI and serum thyrotropin (TSH), total and free thyroxine (T4) and total and free triiodothyronine (T3) were determined in 16 hypothyroid women (Group I) treated with 50 micrograms increments of thyroxine, and in 13 women who had a history of thyroid carcinoma and high-dose thyroxine replacement therapy and had elevated thyroid hormone concentrations (Group II). The STI of 24 matched healthy female controls were used for reference of STI. The pre-ejection period (PEP) index and the PEP/LVET ratio (left ventricular ejection period) were greater in untreated overtly and mildly hypothyroid patients (p less than 0.05) than in the controls. During stable thyroxine therapy [mean daily dosage for Group I 137.5 (7.3) micrograms and for Group II 220 (61) micrograms] the PEP correlated with serum free T4 (FT4), as measured by a two-step method (SpectriaR) (r = -0.55, p less than 0.01, n = 29) and total T4 (r = -0.51, p less than 0.05, n = 29), but not with TSH, T3, FT3 or FT4 measured by an analogue method Amerlex-M(R). The TRH test was not valuable in follow-up because of the strong correlation between basal TSH and stimulated TSH values (r = 0.95). In conclusion, STI are useful for assessment of the thyroid state in untreated hypothyroid patients. Serum TSH becomes normal in the same time as STI and is the best for follow-up. If serum TSH is low and the patient is on stable thyroxine therapy, we recommend serum FT4 for monitoring thyroxine replacement. Two-step FT4 assays had the best correlation with STI, which has significance in patients with non-thyroidal illness.

Adolescent↗