Biomedical subjects

M Harju

Publications and source records attributed to M Harju.

At least 19 recordsLinked to original sources

PubMed2003

Individual patient variation and inter-rater reliability of lower calyceal infundibular width on routine intravenous pyelography.

OBJECTIVE: To standardise infundibular width (IFW) measurement, to determine patient variability, and to determine inter-rater variability on intravenous pyelography (IVP). PATIENTS AND METHODS: Fifty outpatient IVP films were randomly drawn from two hospitals between 1 July 1998 and 31 August 1999, and examined to measure the lower calyceal IFW on the 5, 10 and 20 min films with compression, and after voiding. Kidneys with previous renal surgery, hydronephrosis or renal anatomical anomalies were excluded; in all, 81 kidneys from 50 patients were examined. The IFW was measured at the narrowest point along the infundibulum. All 50 films were then reviewed by two urologists unaware of their origin, to determine the inter-rater reliability of the infundibular measurements. RESULTS: Analysis of variance (anova) with posthoc analysis showed a significant difference in IFW at each phase of the IVP (repeated measures anova, P < 0.001). The mean (95% confidence interval) IFW was greatest on the compression film, at 4.4 (2.6) mm, and least on the postvoid film, at 1.6 (2.1) mm. Overall inter-rater reliability was 0.9780 (intraclass correlation coefficient), and the Pearson correlation between each rater for the IFW at each phase of the IVP was >/= 0.886. CONCLUSIONS: There is wide variability in lower calyceal IFW among the various IVP films in a given study. Thus any predictive value of the IFW must be standardized for the timing and IVP film type (compression, postvoid, etc.). The inter-rater reliability of IFW is high, suggesting that if used correctly it may be more useful in predicting the outcome after shock wave lithotripsy.

Adolescent↗

PubMed2001

Blood flow of the optic nerve head and peripapillary retina in exfoliation syndrome with unilateral glaucoma or ocular hypertension.

BACKGROUND: The purpose was to study whether any differences exist in the optic nerve head (ONH) and peripapillary retinal blood flow between the two eyes of patients with unilateral exfoliation glaucoma or ocular hypertension (OHT) with exfoliation syndrome. METHODS: This cross-sectional study included 50 patients. All had exfoliation syndrome with glaucoma or OHT in one eye, and these eyes comprised the study group. The fellow eyes, all normotensive, comprised the control group. Blood flow was measured with scanning laser Doppler flowmetry in the lamina cribrosa region, in the rim area, and on the peripapillary retina. Multiple linear regression analyses were used to identify any associations between different factors and differences in flow. RESULTS: Flow in the rim area was significantly higher in the study eyes than in the control eyes, with a mean difference of 172 arbitrary units (P = 0.001). The difference of 40 units in the laminar area was of borderline significance (P = 0.065) and no significant difference was found in the peripapillary retina (P = 0.530). In the study eyes, blood flow of the ONH lamina and rim area decreased with increasing glaucomatous damage, and treatment with topical timolol was associated with reduced blood flow in the lamina cribrosa and rim area. Perfusion pressure was associated only with flow in the peripapillary area (P = 0.021). CONCLUSIONS: Advanced glaucomatous damage was associated with reduced flow both in the lamina cribrosa and the rim area but not in the peripapillary retina. Treatment with topical timolol was associated with decreased flow in the ONH.

Aged↗

PubMed2001

Scanning laser ophthalmoscopy of the optic nerve head in exfoliation glaucoma and ocular hypertension with exfoliation syndrome.

AIMS: To study the relation between optic nerve head topography (Heidelberg retina tomograph, HRT) and disc area, visual field index mean defect (MD), and intraocular pressure (IOP), and to see whether change in HRT parameters is associated with change in MD in a prospective follow up. METHODS: 80 consecutive patients (69 patients with exfoliation glaucoma and 11 with ocular hypertension combined with exfoliation syndrome) were examined before IOP reducing intervention and prospectively followed every 6 months for 2 years. RESULTS: At the entry point, multiple regression analysis showed significant linear association between MD and all HRT parameters, when controlling for disc area. Disc area showed significant association with cup area, cup/disc area ratio, rim area, cup volume, and mean RNFL thickness. Six months after intervention IOP had decreased significantly. Reversible changes in cup area, cup/disc area ratio, rim area, cup volume, rim volume, mean cup depth, and maximum cup depth were associated with decrease in IOP. During the follow up period from 6 month to 2 years, IOP did not change significantly, and MD was used as a measure of progression of glaucoma. During this period, only cup shape measure among HRT parameters showed significant association with subsequent change in MD. CONCLUSION: Disc area should be taken into account when using HRT to compare patients. Any effect of change in IOP should be also taken into account when using HRT in follow up. Cup shape measure is a promising indicator of progression of glaucomatous damage.

Age Factors↗

PubMed2000

Corneal thickness and corneal endothelium in normotensive subjects with unilateral exfoliation syndrome.

PURPOSE: To examine the central corneal thickness (CCT) and corneal endothelium in both eyes of patients with unilateral exfoliation syndrome (EXS). To determine the effect of CCT on the measurement of intraocular pressure (IOP). METHODS: In this cross-sectional clinical study, comparisons were made of CCT (Humphrey Ultrasonic Pachometer), corneal endothelial cells (Keeler-Konan contact specular microscope) and IOP (Goldmann applanation tonometer) between the exfoliative (E) and fellow nonexfoliative (NE) eyes in 40 normotensive patients with unilateral EXS. The CCT was used to obtain a corrected value for the IOP. RESULTS: The E eyes had significantly higher values for CCT (0.528+/-0.030 vs 0.523+/-0.032 mm, P<0.01) and IOP (15.7+/-3.6 vs 14.4+/-2.9 mmHg, P<0.001) than the fellow NE eyes. The paired E and NE eyes did not differ in endothelial cell density (2779+/-540 vs 2870+/-386 cells/mm2), in the coefficient of variation of cell size (0.25+/-0.03 vs 0.26+/-0.03) or in the frequency of hexagonal cells (80.5+/-6.5 vs 82.0+/-5.0%). After correcting IOP for CCT, the E eyes still had significantly higher IOP than the NE eyes (15.1+/-4.4 vs 14.2+/-3.7 mmHg, P<0.05). CONCLUSION: Normotensive eyes with early EXS did not have quantitative (cell density) or qualitative (variation in cell size, frequency of hexagonal cells) morphological changes in corneal endothelium, but had higher values for IOP and CCT. After correcting IOP for CCT, the E eyes still had significantly higher IOP than the fellow NE eyes.

Aged↗

PubMed2000

Intraocular pressure and progression in exfoliative eyes with ocular hypertension or glaucoma.

PURPOSE: This retrospective study was conducted in exfoliative eyes in order to study the influence of IOP and other possible factors on the conversion from ocular hypertension (OHT) to glaucoma and progression of glaucoma. METHODS: 139 patients with exfoliation OHT or glaucoma with exfoliation syndrome were included (mean follow-up 5.2 +/- 3.6 years). The effects of age, gender, weighted mean IOP, maximum IOP, stage of glaucoma at the first visit, refraction, glaucoma medication, and interventions on the hazard of progression were studied by multivariate survival analysis. RESULTS: Conversion from OHT to glaucoma or progression of glaucoma was detected in 63 eyes (45.3%). A significant association with progression was found for age (relative risk 1.042; p-value 0.043), weighted mean IOP (1.076; <0.001), and stage of glaucoma (1.436; <0.001). History of trabeculectomy (0.360; 0.002) related to a decreased risk. CONCLUSION: The risk of conversion from OHT to glaucoma and progression of glaucoma increased in exfoliative eyes with severity of stage of glaucoma, weighted mean IOP, and the age of the patient. A history of trabeculectomy was related to decreased risk of progression.

Aged↗

PubMed1996

Postpartum recovery after severe pre-eclampsia and HELLP-syndrome.

Postpartum recovery was examined in 100 pregnancies complicated by severe pre-eclampsia, and in 15 pregnancies in which HELLP-syndrome as present. Albuminuria disappeared and diastolic blood pressure returned to normal (< 90 mmHg) in half of the cases within one week postpartum. Postpartum recovery in the cases with HELLP-syndrome did not differ from that seen in the pre-eclamptic patients. Thrombocytopenia showed spontaneous resolution within three days after delivery. In stepwise discriminant analysis, the incidence of IUGR predicted a slow postpartum recovery, but this did not apply to other factors. Such as diastolic blood pressure before delivery, duration of subjective symptoms, duration of pregnancy or severity of albuminuria. Elevated diastolic pressure and/or albuminuria were diagnosed two months postpartum in one third of the patients. If the development of eclampsia is prevented by correctly timing the induction of delivery, relatively good short-term postpartum recovery is probable after severe pre-eclampsia and HELLP-syndrome.

Adult↗

PubMed1996

Optic disc topography before and after trabeculectomy in advanced glaucoma.

BACKGROUND AND OBJECTIVE: To analyze changes in the optic disc topography after filtration surgery. PATIENTS AND METHODS: Laser scanning tomography was performed in 10 eyes of 9 patients (mean age 65.6 +/- 8.1 years; age range 55 to 75 years) after a mean follow-up of 3.7 months, and in 8 eyes of 7 patients (mean age 63.1 +/- 7.6 years; age range 55 to 75 years) after a mean follow-up of 13.1 months. RESULTS: Preoperatively, the mean intraocular pressure (IOP) was 24.4 +/- 6.9 mm Hg with maximal medication. Postoperatively at 3.7 months it was 11.0 +/- 2.2 mm Hg, and at l2.1 months it was l3.6 +/- 2.8 mm Hg. An initial reduction in IOP of more than 30 percent at 3.7 months was achieved without medication in all but 1 eye. After 12.1 months, an IOP reduction of more than 30 percent was achieved in 6 of 8 eyes (1 with medication), while 2 eyes had IOP reductions of less than 15 percent (< or = 3 mm Hg) despite medication. In the 6 eyes, the optic disc cup volume showed a decrease of more than 30 percent, while the 2 eyes without marked IOP reductions had slight increases in cup volume. Of the 2 eyes without marked decreases in cup size, 1 had normal-tension glaucoma and 1 experienced an increase in IOP of more than 25 mm Hg during the first postoperative week. CONCLUSION: The postoperative IOP should be kept low enough to permit reversal of optic disc changes.

Aged↗

PubMed1994

A randomized, prospective study on the use of sodium hyaluronate (Healon) in trabeculectomy.

The effect of injecting sodium hyaluronate (Healon) before fistulization in trabeculectomy was investigated in a prospective, randomized study of 107 consecutive eyes. Fifty-two eyes were operated on with the viscoelastic and 55 without. An early postoperative intraocular pressure (IOP) peak of 21 mm Hg or more occurred in 27% of the study eyes versus 17% of the control eyes, an insignificant difference. The mean peak IOPs of the study and the control eyes did not differ significantly (29.8 +/- 9.0 mm Hg versus 32.7 +/- 10.2 mm Hg), nor did the mean IOPs and the need for glaucoma medications 1 month after surgery. Shallow/flat anterior chamber and choroidal detachment were equally frequent in both groups, but hyphema occurred significantly more often in the study group (40%) than in the control group (18%).

Aged↗

PubMed1992

Comparative effects of alpha-2 receptor agents and THA on the performance of adult and aged rats in the delayed non-matching to position task.

The present study investigated the effects of dexmedetomidine (an alpha-2 adrenoceptor agonist), atipamezole (an alpha-2 adrenoceptor antagonist) and tacrine (an inhibitor of acetylcholinesterase) on the performance of adult and aged rats in a delayed non-matching to position task assessing spatial short-term memory. Most of the aged rats were impaired in the pretraining phases and in the acquisition of the non-delayed version of the task. After a substantial training period of the delayed version of the task, both adult and aged rats reached their asymptotic level of performance. Both adult and aged rats showed a decline in the percent correct responses at the longest delays in this task, and a delay independent decrease in the percent correct responses across the delays (0-30 s) was found in the group of aged rats (25-month-old) as compared to the adults (10-month-old). Dexmedetomidine (0.3, 1.0 or 3.0 micrograms/kg), atipamezole (0.03, 0.3 or 3.0 mg/kg) and tacrine (1.0 or 3.0 mg/kg) did not increase the percent correct responses in adult or aged rats. The highest doses of dexmedetomidine and tacrine decreased behavioural activity of rats during this short-term memory testing. Atipamezole (0.03 mg/kg) increased behavioural activity of rats. The results suggest that acute, systemic administrations of alpha-2 drugs or an anticholinesterase do not improve short-term memory in rats.

Adrenergic alpha-2 Receptor Agonists↗

PubMed1989

Occlusal anomalies in 45,X/46,XX- and 46,Xi(Xq)-women (Turner syndrome).

A total of 20 individuals with X-chromosome aberrations, 14 45,X/46,XX-women and six 46,Xi(Xq)-women, were examined for occlusal anomalies. The controls were first-degree woman relatives and population women. The results showed that the most common type of malocclusion in both study groups was lateral cross bite. Also distal molar occlusion, increased maxillary overjet and in 45,X/46,XX-women open bite was found. 45,X/46,XX-women's occlusion seems to be more affected than that of 46,Xi(Xq)-women. Compared to 45,X-women, the present study groups show milder expression of malocclusion. One might speculate that enamel genes of the X-chromosome are involved in occlusal development.

Adult↗

PubMed1986