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Biomedical subjects

K Liippo

Publications and source records attributed to K Liippo.

47 records · Page 3Linked to original sources
PubMed1990

Mediastinoscopy in relation to clinical evaluation.

The aim of the study was to evaluate the entire spectrum of mediastinoscopy, from common to rare conditions, in relation to clinical judgement. The 2021 consecutive patients comprised 992 with 'open' clinical diagnoses at mediastinoscopy and 1,029 with verified or presumptive diagnoses. In the first group the most common indications for mediastinoscopy were pulmonary infiltrate (73%) and mediastinal shadow (17%), and in the second group they were bronchogenic carcinoma (57%) and sarcoidosis (38%). Mediastinoscopy was classified as positive in 43% of the first, and 60% of the second group. Of the total series, 51% had positive mediastinoscopy findings, the most common being malignant disease (24%) and sarcoidosis (21%). Mediastinoscopy was useful especially for evaluating malignant mediastinal involvement, but also for differentiation of lymphadenopathies and in diagnosis of rare diseases.

Adolescent↗
PubMed1989

Mediastinoscopy: not needed preoperatively in CT-negative lung carcinoma?

The objective was to investigate the necessity of mediastinoscopy in preoperative staging of lung carcinoma in 57 operable patients. Noninvasive radiology was compared to mediastinoscopy and thoracotomy. Computed tomography (CT-scan) and mediastinoscopy were in agreement in 40 cases (70%). CT-scan was negative in 26 patients, of which 4 were false negatives. Mediastinoscopy is therefore of no benefit preoperatively for 85% (22 out of 26) of patients. Consequently, we have changed our staging policy and only patients with positive CT-scan are now subjected to mediastinoscopy.

Adult↗
PubMed1988

Inoperable non-small cell lung cancer: radiation with or without chemotherapy.

We report a randomized multicentre study of split-course radiotherapy (RT), with or without combination chemotherapy (CT), in 238 patients with inoperable non-small cell lung cancer (NSCLC), previously untreated, confined to one hemithorax and the mediastinal nodes. In both treatment groups RT consisted of 55 Gy in 20 F given over 7 weeks with a 3-week rest interval. CT consisted of the 3-drug regimen CAP: C = cyclophosphamide 400 mg/m2, A = adriamycin 40 mg/m2, P = cisplatin 40 mg/m2; 2 cycles of CAP given before RT, one during the rest interval and six after RT. Seventy per cent in the RT arm and 67% in the RT-CT arm had epidermoid carcinoma. No significant difference was apparent between the RT and the RT-CT arms with respect to objective response rates (CR + PR) (44 and 49%, respectively), median duration of response (278 and 320 days), local failure (31 and 20%), distant progression (23 and 20%) or median survival (311 and 322 days). The survival figures showed an almost significant (P = 0.05) therapeutic advantage of the combined regimen with stage IIIM0 disease. Progressive disease was the cause of death in 92% and 88%. We conclude that chemotherapy did not contribute significantly to either local control or survival as compared to radiotherapy alone.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Role of pulmonary diseases and physical condition in the regulation of vasoactive hormones.

Lungs have many non-respiratory metabolic functions, of which some take place in the capillary endothelium, while others are in parenchymal lung tissue. We have studied the role of the lungs in the metabolism of vasoactive and some other hormones by comparing patients who have undergone lung resection to those having various obstructive or fibrotic lung diseases. We have also compared these groups with persons in good physical health. The data suggested that lung resection patients had low angiotensin II levels in plasma but the response of angiotensin II to exercise was normal. Also adrenalin concentration was low in the lung resection group while dopamine did not show any significant difference between the groups. When hormone levels were correlated to the exercise data, renin levels were especially related to physical condition. Serum post-exercise renin values were inversely related to the uneven distribution of lung perfusion, possibly thus reflecting the diminished pulmonary vascularization. A negative association was found between angiotensin II and diffusion capacity. Thus, the angiotensin II levels may preferably be controlled by the non-circulatory functions of the lungs.

Adult↗
PubMed1988

Fatal asthma in two regions of Finland.

To determine the factors associated with deaths from asthma we surveyed retrospectively all the death certificates issued in two regions of Finland (the province of Oulu and the province of Turku and Pori) over a ten-year period in which asthma had been given as the main cause of death. We then examined patients' records to check whether asthma was the main cause of death. A total of 156 deaths could be ascribed to asthma, 87 in patients under 65 at death and 69 over 65. More deaths tended to occur during the weekends, and in the younger age group more occurred during the night than by day. Previous drug treatment was considered inadequate in 45% of the cases. The management and drug treatment of the final exacerbation phase were also often inadequate, at least among the younger victims, and the terminal attack was usually short, death often occurring in three hours or less. Despite the shortcomings in treatment, the number of deaths from asthma in the younger age group has fallen in the province of Oulu over the last 20 years.

Adolescent↗
PubMed1987

Trimethoprim prophylaxis of acute exacerbations in chronic obstructive pulmonary diseases.

A double-blind randomized trial was carried out to study the efficacy and tolerance of trimethoprim with a daily single dose of 300 mg in long-term prophylaxis of acute exacerbations of chronic obstructive pulmonary diseases (COPD). The patients, 13 in the trimethoprim group and 11 in the placebo group, were followed up at fixed intervals and checked for respiratory functions and haematological parameters for six months. The number of exacerbations were significantly lower than during the previous winter in both groups: 0.6 compared to 3.8 in the trimethoprim group, and 0.6 to 3.0 in the placebo group. Tolerance of trimethoprim was good and did not differ from that of placebo. The necessity of double-blind trials in evaluating the prophylactic value of antibiotics in COPD is emphasized, since the exacerbations are also dependent on many unknown factors. There were no statistically significant differences in blood counts of folate levels.

Acute Disease↗
PubMed1983

Preparation of soluble apolipoproteins A-I, B, and C-II by a chromatofocusing column method, and evaluation of their concentrations in serum in pulmonary disease.

A chromatofocusing column method for isolating ApoB is described. LDL is first isolated by sequential ultracentrifugation and delipidated with n-butanol/diisopropyl ether. Chromatofocusing of ApoLDL yielded a large ApoB peak at pI 5.0-5.3. ApoA-I and ApoC-II were prepared analogously, with HDL and VLDL as the source of apoprotein. Antisera were raised in rabbits, and electroimmunoassay techniques were used for determination. ApoB was water-soluble after chromatofocusing. Intra-assay precision (CV) was 4.7% for ApoA-I, 7.8% for ApoB in the "rocket" electrophoresis. Interassay precision (CV) was 6% for ApoA-I and 8% for ApoB. Apolipoprotein concentrations were measured in subjects who had undergone lung resection and patients with obstructive pulmonary disease. After lung resection, the concentration of ApoA-I in serum was significantly decreased (p less than 0.001) and that of ApoB significantly increased (p less than 0.001) as compared with controls. The ApoA-I/ApoB ratio was significantly lower in the lung-resection group. ApoA-I and ApoB concentrations were unchanged in chronic obstructive pulmonary disease. ApoC-II concentrations in each group were similar to those for control subjects. Of the lipids, values for total cholesterol were above normal after lung resection (p less than 0.002), as were those for triglycerides (p less than 0.02).

Aged↗
PubMedDate not supplied

Bone mineral density in asthmatic women on high-dose inhaled beclomethasone dipropionate.

Inhaled corticosteroids are the cornerstone of the modern therapy for asthma. In recent years, inhaled corticosteroids have been used in higher doses than previously. This has caused concern about possible osteoporotic side-effects. We studied bone mineral densities (BMDs) in 19 non-smoking women (mean age 53 years, range 40-63) with newly diagnosed bronchial asthma and 19 voluntary healthy non-smoking women (mean age 53 years, range 43-67). In both groups, 13 subjects were postmenopausal. Patients started beclomethasone dipropionate from the spacer 500 micrograms twice daily as the sole corticosteroid therapy. BMDs were measured with dual-energy x-ray absorptiometry (DEXA) at the lumbar spine (L2-4) and at the left proximal femur (the neck, Ward's triangle and the trochanteric region). The measurements were made at baseline and 6 and 12 months thereafter. No significant changes were observed in the measured BMDs in either study group. The results show that inhaled beclomethasone dipropionate therapy 1000 micrograms/day for one year does not affect BMD. Further studies are needed to assess the effects of inhaled corticosteroid on BMD during a longer treatment period.

Absorptiometry, Photon↗