Search PubMed⌕ Search

Biomedical subjects

K Irjala

Publications and source records attributed to K Irjala.

At least 145 records · Page 8Linked to original sources
PubMed1988

Comparative evaluation of serum thyroxine, free thyroxine and thyrotropin determinations in screening of thyroid function.

We assessed a highly sensitive immunoradiometric thyrotropin (TSH) assay in screening thyroid dysfunction in 130 consecutive outpatients from a department of medicine and 224 patients from a municipal health centre. In addition to clinical examination, three routine tests were done: a thyroxine radioimmunoassay, an analogue-based free thyroxine assay and an immunoradiometric TSH assay. Triiodothyronine and the TRH test were done, if the findings were discrepant. Discrepancy existed in 24% of cases. The TSH assay had no false negative results (sensitivity 100%). Therefore TSH could screen all patients with thyroid dysfunction. Free thyroxine was the most specific assay (specificity 96%), but many subclinically or overtly hypothyroid patients would have been missed, if that assay had been used alone. We conclude that TSH(IRMA) is the best first-line measurement for thyroid dysfunction testing among outpatients. An abnormal TSH result alone is not diagnostic, but should be followed by the measurement of thyroxine or free thyroxine.

Adolescent↗
PubMed1988

Stability of serum fructosamine during storage.

Stability of serum fructosamine during storage was evaluated in serum specimens obtained from 27 diabetic individuals. The samples were divided into six aliquots, which were stored at -20 degrees C and -70 degrees C for two, eight, and 16 months. The minor systematic differences between the six treatments contrasted with the considerable variation of individual specimens. The mean percentage changes in the six treatments ranged between -4.6% and 7.5%, whereas the changes in individual specimens ranged from -20% to 26.7%. Several factors evidently contribute to this variation, one being progressive in vitro glycation, especially at -20 degrees C. Small changes in fructosamine concentrations between consecutively drawn specimens, determined after storage, evidently should be interpreted cautiously. Low temperatures, at least -70 degrees C, are preferable to minimize pre-analytical variation during storage.

Blood Glucose↗
PubMed1988

High dose brain CT with ioxaglate and diatrizoate adverse reactions and effects on urine protein tests.

Sodium meglumine ioxaglate (320 or 306 mg I/ml) and meglumine diatrizoate (306 mg I/ml) in an intravenous dose of 2 ml/kg were compared in a randomized double-blind test on the brain CT of 209 patients. Side effects were noted in 56% of the ioxaglate group and 90% of the diatrizoate group. Diatrizoate caused a sensation of heat significantly more often and more intensely, but the frequencies of other side effects did not differ significantly. No severe reactions occurred. The quality of the CT scans was equal. Neither ioxaglate nor diatrizoate impaired renal function. False-positive strip tests and falsely elevated protein values measured by the biuretic method were found in particular in the ioxaglate group. The results of urine protein measurements and strip tests are misleading on the day of the examination with both ioxaglate and diatrizoate.

Adult↗
PubMed1987

Problems with PEG-based precipitation methods in the determination of HDL2- and HDL3-cholesterol.

In this study a comparison of two polyethylene glycol (PEG)-based precipitation methods, that is, one using PEG-6000/DS-15000 and the other using two different concentrations of PEG-20000 are presented. The total HDL-cholesterol values measured with the PEG-6000 procedure were higher (13%) than those measured with PEG-20000 (r = 0.91) in 16 pooled serum samples tested. The HDL2- and HDL3-cholesterol values measured with the two methods differed markedly from each other in spite of the moderate correlation (HDL2: r = 0.74; HDL3: r = 0.26) observed. The advantage of the PEG-20000 method as compared with the other method was its simplicity and rapidity. The separation of HDL2/HDL3 is more or less arbitrary in both methods used and further studies are needed for the estimation of optimal conditions for subclass separation.

Chemical Precipitation↗
PubMed1987

Serum creatine kinase and lactate dehydrogenase during cardiac irradiation.

Thirty patients irradiated to a major part of the heart had serial determinations of serum total creatine kinase (S-CK), creatine kinase subunit B (S-CK-B), total lactate dehydrogenase (S-LD) and lactate dehydrogenase isoenzyme 1 (S-LD-1) activity at the beginning, at the end and 1-4 months after radiotherapy. One patient had an elevated total S-CK activity three months after radiotherapy, but none of the patients had an elevated S-CK-B activity during follow-up. Three patients had elevated serum LD before irradiation, two patients during and two patients after radiotherapy, but only one patient had an elevated S-LD-1 activity, which decreased during irradiation. We conclude that the heart muscle is not injured by cardiac irradiation to such an extent that CK, CK-B, LD and LD-1 activities rise in serum, if moderate doses (39-62 Gy, NSD 1,137-1,775 rets) are delivered to the heart.

Adult↗
PubMed1987

Temazepam versus flunitrazepam as an oral premedication in adult surgical patients.

In a randomized study, 20 patients received temazepam 20 mg orally the night before and 20 mg in the morning of an operation performed under spinal analgesia (Group I); 20 patients received flunitrazepam I mg similarly (Group 2). Different aspects of the premedication were evaluated verbally, with the aid of a visual analogue scale, Maddox wing apparatus, the critical flicker fusion threshold test, blood pressure and heart rate measurements, serum and CSF cortisol and plasma ADH measurements, as well as CSF drug level determinations. Clinically, temazepam 20 mg proved to be comparable with flunitrazepam I mg, although the latter more effectively prevented cardiovascular changes and pre-operative hormonal stress reaction. No correlation was found between the CSF drug level (bioassayed by radioreceptor assay) and the clinical response of the two benzodiazepines, nor was there any correlation between the cortisol or ADH levels versus the CSF drug levels. On the whole, flunitrazepam proved to be marginally better than temazepam as an oral premedicant.

Administration, Oral↗
PubMed1987

Serum antibody-bound insulin as a measure of insulin antibodies in diabetic children.

The usefulness of the measurement of serum antibody-bound and total immunoreactive insulin (IRI) concentrations in the assessment of insulin antibodies was evaluated in a material comprising 49 insulin-dependent diabetic children with a mean age at onset of 8.6 years (range 0.8-16 years) treated with highly purified porcine insulins. Serum antibody-bound and total IRI concentrations of individual patients were compared with insulin antibody levels measured with 3 different insulin antibody assays. The correlation coefficients of insulin antibody levels with concentrations of serum antibody-bound IRI ranged from 0.75-0.79. In serum samples with moderate or high insulin antibody levels most of the insulin was in the form of insulin-insulin antibody immunocomplexes. Thereby a very close correlation was found between antibody-bound and total serum IRI concentrations (r = 0.98) in this material. Residual endogenous insulin secretion decreased with increasing duration of diabetes. No significant correlation was found between the duration of diabetes and serum antibody-bound IRI concentrations. High serum antibody-bound IRI concentrations were associated with low glucagon-stimulated plasma C-peptide levels. Although the determination of serum antibody-bound IRI concentrations does not characterize insulin antibodies with regard to binding capacity and affinity constants, it yields information of the actual degree of insulin binding in the circulation. This information may be useful in assessing the benefits of transferring diabetics with high insulin antibody titers from conventional to highly purified porcine or human insulin therapy.

Adolescent↗
PubMed1987

Serum free estriol inefficient in the detection of intrauterine growth retardation.

The value of a single serum free estriol (E3) measurement in the detection of intrauterine growth retardation (IUGR) was investigated. Among the group of 40 mothers later giving birth to a growth retarded baby, E3 was low, i.g. below the level of two lower standard deviations of the mean values, in 9 cases. In the control group of 50 mothers with appropriately grown newborns, none of the E3 values was low. In a group of 42 mothers with a low E3 level, only 10 gave birth to a growth retarded baby. Hence, the sensitivity of a single E3 measurement to detect IUGR is 38%, the specificity 61% and the predictive value 37%. E3 measurement is neither efficient nor accurate in the detection of IUGR.

Estriol↗
PubMed1987

Serum fructosamine in the assessment of glycaemic control in diabetes mellitus.

Serum fructosamine determination was evaluated in the assessment of glycaemic control in diabetes mellitus. Intra- and inter-assay variation of the method was 0.5-0.8 and 1.5-2.9%, respectively. The fructosamine concentration in serum was found to be stable for at least 10 days independent of prevailing serum glucose concentration is stored at +4 degrees C or colder. Stability of serum fructosamine with respect to rapid fluctuations of blood glucose was of the same order as that of HbA1c. The reference interval (mean +/- 2 SD) for 92 non-diabetic individuals was 1.9-2.7 mmol/l. Good correlation was found between HbA1c and serum fructosamine (r = 0.79). Serum fructosamine and HbA1c correlated well with the mean blood glucose values of the preceding week (r = 0.88 and 0.75, respectively, p less than 0.001). Significant correlations of fructosamine and HbA1c with fasting blood glucose were also found (r = 0.53 and 0.55, respectively, p less than 0.001). Fructosamine determined simultaneously with fasting blood glucose in 65 oral glucose tolerance tests (OGTT) did not separate normal subjects from those with impaired glucose tolerance. Two of the three subjects with diabetic response in the OGTT had, however, elevated fructosamine concentrations. Determination of serum fructosamine is a technically simple, reproducible and moderately inexpensive method for the assessment of glycaemic control in diabetes mellitus. Standardization of the method is, however, not without problems. Uniformity of the calibration and assay protocol is essential for reliable interlaboratory comparison of results. Physiological states altering the rate of synthesis or elimination of serum proteins should be considered in the interpretation of fructosamine levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Oral temazepam as a premedicant in elderly general surgical patients.

In elderly, general surgical patients, oral temazepam 20 mg given in a soft gelatin capsule proved to be a useful light premedicant when given before spinal anaesthesia. In comparison with placebo, it caused preoperative subjective sedation, prevented an increase in heart rate and decreased serum cortisol, but not serum antidiuretic hormone levels. However, simple devices (linear analogue scale, Maddox wing test, critical flicker fusion apparatus) appeared to be quite ineffective in differentiating the clinical effects of temazepam from those of placebo. Temazepam given in a soft gelatin capsule to patients in the supine position had a reasonably fast gastrointestinal absorption, but its blood-lumbar cerebrospinal fluid penetration rate appeared to be quite slow.

Aged↗
PubMed1986

Sex steroid, gonadotropin, cortisol, and prolactin levels in healthy, massively obese women: correlation with abdominal fat cell size and effect of weight reduction.

To examine hormonal status in obese, gynecologically normal women we studied 25 regularly menstruating, massively obese (mean weight, 120 kg) women participating in a weight reduction program and 25 age-matched normal weight (mean weight, 60 kg) women. Serum 17 beta-estradiol (E2), estrone (E1), androstenedione (A), dehydroepiandrosterone sulfate, testosterone, LH, FSH, PRL, and cortisol concentrations were measured during the follicular phase of the menstrual cycle. Waist to hip ratio and abdominal fat cell size were measured at the beginning of the study. The serum levels of E2 (P less than 0.04) as well as those of A, SHBG, and LH (P less than 0.002) were lower in the obese group. Consequently, the testosterone to SHBG ratio and the E1 to A ratio were higher and the LH to FSH ratio was lower in this group. Waist to hip ratio did not correlate with the levels of circulating hormones or SHBG, but an inverse correlation was found between abdominal fat cell size and A as well as the LH to FSH ratio in the nonhirsute women of the obese group. Subsequent to moderate weight reduction (13.2 kg), serum A and E1 levels (P less than 0.01) increased, and serum cortisol levels decreased (P less than 0.001). Thus, massive obesity is associated with abnormalities in hormonal balance in gynecologically symptomless women, there being an association between E1, E2, A, LH, cortisol, and relative weight and/or abdominal fat cell size.

Adipose Tissue↗
PubMed1986

Interpretation of oral glucose tolerance test: capillary-venous difference in blood glucose and the effect of analytical method.

Factors affecting the evaluation of oral glucose tolerance (OGT) test have been studied. The test was performed on 95 women pregnant at 30-32 weeks of gestation and to 112 control subjects (68 female and 44 male). Pregnant and non-pregnant subjects were further divided into two subgroups according to normal or abnormal response in glucose tolerance test. Venous (vB) and capillary (cB) blood specimens were collected simultaneously for blood glucose determinations. In one series the o-toluidine method and in another the enzymatic glucose dehydrogenase method were used. Inter-relations of capillary and venous blood glucose levels were examined with respect to gestation, glucose tolerance and analytical method. Mean venous blood glucose was higher than capillary blood glucose in fasting blood (0-sample) for all subjects, when o-toluidine (o-tol) method was used, but with glucose dehydrogenase (GDH) no significant capillary-venous difference was seen. At blood glucose concentrations after glucose intake (1 and 2 h) mean capillary glucose was higher in all subgroups when measured by GDH, but by o-tol method only in the non-pregnant subjects with normal OGT response. In pregnant subjects with normal or abnormal OGT response, and in non-pregnant ones with abnormal response, mean venous glucose was higher or of the same order as capillary glucose. These findings emphasize the need of standardization of the sampling procedures and of the analytical methods used for measurement of blood glucose concentration as well as demonstrate the possibilities of misinterpretation of OGT test results.

Blood Glucose↗
PubMed1986

Evaluation of a semiquantitative C-reactive protein latex slide test as compared to quantitative turbidimetric measurement in hospital laboratory practice.

Serum C-reactive protein (CRP) concentrations of 708 patients with suspected bacterial disease were estimated with a semiquantitative CRP latex slide test using cut-off levels of 20 and 40 mg/l and with quantitative turbidimetric technique. Latex slide tests gave 11.8% (80/708) discordant results. About 7% of tests gave clear disconcordant results (5% of those were positive and 2% negative tests). We conclude that CRP latex slide test is not useful in emergency laboratory in hospital material with a high incidence of bacterial infections.

Bacterial Infections↗
PubMed1986

Plasma and urinary C-peptide in the classification of adult diabetics.

Plasma and urinary C-peptide determinations in the discrimination between insulin-requiring and non-insulin-requiring diabetes were elevated in 61 adult diabetics. Specimens for C-peptide determinations were taken on two consecutive days: on the first day plasma C-peptide concentrations were determined before and 6 min after intravenous glucagon administration. On the second day 2- and 4-h urinary C-peptide excretion was measured after an individual breakfast. Results of urinary C-peptide analyses were expressed as molar concentration and also as molar quantity excreted (without any corrections and related to creatinine excretion). Glucagon-stimulated plasma C-peptide turned out to be a reliable criterion for the detection of insulin requirement. Sixty-nine per cent of diabetics included in this study were classifiable by basal plasma C-peptide concentrations. Two-hour postprandial urinary C-peptide/creatinine quotient turned out to be slightly less sensitive (89%) than the glucagon test (94%) and of equal specificity (96%). Glucagon-stimulated plasma C-peptide and postprandial urinary C-peptide excretion correlated significantly among insulin-requiring diabetics (r = 0.73), but not among non-insulin-requiring diabetics (r = 0.23). We regard determination of stimulated plasma C-peptide as a primary investigation for the direct assessment of endogenous insulin secretory reserves for clinical management decisions. Determination of postprandial urinary C-peptide is applicable in selected situations for non-invasive assessment of insulin secretion.

Adolescent↗
PubMed1986

Four monoclonal immunoglobulins in a patient with chronic lymphocytic leukemia.

We report here the case of a 73-year-old woman with chronic lymphocytic leukemia. Two years after the diagnosis, electrophoresis of her serum showed two monoclonal fractions, but our modified immunofixation procedure revealed four monoclonal immunoglobulins in five fractions: two IgG lambda fractions, one IgG kappa fraction, one IgA kappa fraction, and one IgG kappa fraction. This is an exceptionally high number of monoclonal immunoglobulins in a single patient. In the course of her disease the patient did not show any clinical, radiological, or laboratory signs of multiple myeloma or macroglobulinemia. The different monoclonal immunoglobulins were considered to be one expression of her B-lymphocytic malignancy.

Aged↗
PubMed1986

One-year follow-up of lipoprotein metabolism after pregnancy.

Serum lipid and lipoprotein fractions one day after delivery, 3 months later in lactating and nonlactating mothers and 12 months later after initiation of menstruation were investigated in a group of 62 women, 29 of which formed a truly longitudinal group. Total serum cholesterol decreased significantly within 3 months after delivery and a further significant decrease occurred during the following 9 months. LDL- and HDL-cholesterols showed also a significant decrease within the postpartal year. Serum triglycerides decreased within 3 months after delivery but no more significantly later. Apolipoprotein AI and B also decreased within 3 months after delivery. In lactating mothers, HDL-cholesterol: cholesterol ratio, apolipoprotein AI and apolipoprotein AI:B ratio were higher than in nonlactating women. During the luteal phase, serum cholesterol and LDL-cholesterol were lower and the HDL-cholesterol: cholesterol ratio was higher than earlier during the menstrual cycle. Data prove that pregnancy related changes in lipid metabolism did not wane within 3 months after delivery. They also show that lactation affects lipid metabolism.

Adolescent↗