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P Karjalainen

Publications and source records attributed to P Karjalainen.

At least 19 recordsLinked to original sources
PubMed2001

Loss of time-organized sympathetic skin responses in acute psychosis.

The aim of this study was to differentiate the response pattern characteristics of sympathetic skin responses (SSR) between unmedicated first psychotic subjects and healthy controls. We recorded SSR to novel auditory stimuli in 13 psychotic subjects and in 19 controls. There was no constant delay between a sudden change in the acoustic surroundings and SSR in psychotic subjects, whereas regularly this delay was 1.3 to 1.8 seconds in controls. The validity of the test was evaluated by blind rating responses to two categories. The lack of a regular time delay between a novel auditory stimulus and SSR suggests a timing disturbance in the neural networks regulating the autonomic nervous system responses in acute psychosis. Our finding and method may have future implications in evaluation of subtle autonomic nervous system alterations related, e.g., to drug effects.

Acoustic Stimulation↗
PubMed1997

Cross spectral analysis in assessment of baroreflex gain in patients with coronary artery disease.

BACKGROUND: Interest in determination of baroreflex sensitivity in clinical practice is growing because of its prognostic information in patients with heart disease. The purpose of the present study was to assess the feasibility of cross spectral analysis in the determination of baroreflex gain from spontaneous RR interval and systolic pressure fluctuations, and to compare the results to the traditional pharmacological method in patients with coronary artery disease. Methods. We measured the gain and time lag between RR interval and systolic pressure variabilities in the frequency domain, and compared baroreflex indexes obtained by this technique with standard phenylephrine tests in 32 patients with coronary artery disease. Results. Cross spectral analysis by fast Fourier transform techniques yielded acceptable (> 0.5) coherence between systolic pressure and RR interval in the mid- (0.07-0.15 Hz) and in the respiratory-frequency (0.15-0.40 Hz) band fluctuations in 30 patients (94%), with mean coherences of 0.69 and 0.74. The mean phase difference in the mid-frequency hand was greater than in the respiratory-frequency band (-83 vs -23 degrees, P < 0.001), suggesting that the mid-frequency fluctuations of RR intervals followed nearly 2 seconds after pressure changes, while respiratory-frequency fluctuations of RR intervals occurred nearly concomitantly with systolic pressure. The mean baroreflex slope derived from the bolus phenylephrine technique was 6.2 ms/mmHg (range 1.6-16.0), 5 patients had an abnormally low (<3 ms/mmHg) baroreflex sensitivity. Baroreflex gain determined by cross spectral analysis from the mid-frequency band correlated significantly (r = 0.60, P < 0.001, n = 27) with the baroreflex gain determined by the phenylephrine test, while the correlation in the respiratory-frequency band was not significant (r = 0.35, P = 0.09, n = 26). Conclusions. Baroreflex slopes derived from cross spectral techniques provide reliable (but not perfect) information regarding baroreflex gain derived from the clasic phenylephrine technique, even in patients with depressed baroreflex responses. Cross correlation calculation of spontaneous baroreflex slopes should be limited to data in the mid-frequency range, where the slopes are likely to reflect simple baroreflex physiology.

Adult↗
PubMed1992

Endurance training associated with slightly lowered serum estradiol levels decreases mineral density of canine skeleton.

The effects of long-term running exercise were studied in 20 beagle dogs. A total of 10 dogs ran from the age of 15 weeks to the age of 70 weeks in a progressive program for up to 40 km/day. A total of 10 sister dogs spent the study period in individual cages. When the dogs were 70 weeks old, bone mineral density of the vertebrae, hip, and radius was analyzed by dual-energy x-ray absorptiometry (DEXA; Lunar) and the vertebrae were also assessed by quantitative computed tomography (QCT; Siemens DR 1). Mineral density was lower in the running dogs than in the controls. The difference was greatest in the spine in the QCT analysis. Blood chemistry analyses revealed that the metabolism of the bone was significantly accelerated. The estradiol levels showed the trend to be reduced in the running group. The beneficial effect of exercise on mineral density has been shown in many earlier studies. However, in this study we demonstrate the possibility of adverse effects of long-term exercise on bone tissue. The change was associated with a decrease of serum estradiol level.

Alkaline Phosphatase↗
PubMed1991

Effects of long-term running on spinal mineral content in dogs.

The effects of long-term running were studied in 20 beagle dogs. Ten dogs ran from the age of 15 weeks to the age of 70 weeks in a progressive program for up to 40 km/day. Ten sister dogs spent the same time in individual cages. At the age of 70 weeks the spines of the dogs were studied with regard to mineral density using dual-energy X-ray absorptiometry and quantitative computed tomography. Mineral density was lower in the running dogs than in the controls.

Animals↗
PubMed1991

Thromboprophylaxis in patients with hip fractures: a prospective, randomized, comparative study between Org 10172 and dextran 70.

A prospective, randomized, assessor-blind trial has been undertaken to compare the thromboprophylactic effect and safety of the heparinoid Org 10172 (a mixture of low molecular-weight sulfated glycosaminoglycuronides) and dextran 70 in patients operated on for hip fracture. Prestudy biostatistical calculations led to the need for 260 patients. Three hundred eight patients were randomized and 19 were excluded after randomization, the majority because of postponed surgery. Analyses were made on the 289 patients on an intention-to-treat basis, as well as on the 247 patients given correct prophylaxis. Diagnosis of deep vein thrombosis was based on bilateral ascending phlebography on postoperative days 10 through 12. The frequency of deep vein thrombosis on an intention-to-treat basis was 10% in the Org 10172 group and 30% in the dextran 70 group and, on the basis of correct prophylaxis, 12% and 31%, respectively, both differences being significant (p less than 0.001). Two-month mortality rates were equal in the groups. Three fatal pulmonary emboli were seen in the dextran group. Significantly more patients in the dextran group received postoperative transfusions; no other differences in various hemorrhagic parameters were seen. Thus it can be concluded that Org 10172 has a significantly better thromboprophylactic effect than does dextran in patients with hip fractures without significant side effects.

Aged↗
PubMed1991

Removal of inhaled 99mTc-labelled particles of disodium cromoglycate from the lungs.

Disodium cromoglycate particles were labelled with 99mTc by spray-drying technique. The in vitro dissolution profile as well as the leakage of radioactivity from the drug particles were determined using a through-flow cell method. The radioactive drug particles were mixed with a lactose carrier and inhaled from a dry powder device by five healthy volunteers. The removal of the inhaled drug particles from the lungs was evaluated by a gamma camera. A close relationship between the dissolution of the drug as such and the leakage of radioactivity was noted. Gamma scintigraphy indicated a biphasic exponential removal of radioactivity from the lung region. The slow component with the halftime of about 55 min was mainly due to the dissolution of drug particles in the lungs. The halftime of the fast component describing mucociliary clearance was less than 10 min. This process was the dominating one for the removal of the drug from the lungs. The experiment thus showed that the main fraction of the inhaled dose was deposited in the tracheobronchial region. Accordingly, only a small portion of the dose initially deposited in the lung can be absorbed and induce a therapeutic effect.

Aerosols↗
PubMed1990

The use of fibrinogen uptake test in screening for deep vein thrombosis in patients with hip fracture.

255 hip fracture patients were studied by 125I-fibrinogen uptake test and bilateral phlebography. We found the sensitivity of fibrinogen scanning to be 44% for the non-operated limb and 50% for the calves. The predictive value of a negative result was found to be 92% and 93% respectively. We conclude that the use of fibrinogen uptake test as single diagnosticum is not valid and can only be recommended in combination with phlebography when studying patient where the frequency of DVT is expected to be low.

Fibrinogen↗
PubMed1986

The value of scintigraphy and computed tomography for the differential diagnosis of primary hyperaldosteronism.

Adrenocortical adenoma is the most common cause of primary hyperaldosteronism. Most tumours are small, less than 2 cm in diameter and, therefore, their localization may be difficult. We have compared two different methods, adrenal scintigraphy (AS) and computed tomography (CT) in the differential diagnosis of 12 patients with primary hyperaldosteronism. AS was performed using either [131I]cholesterol or 6-iodomethyl-19-norcholesterol during dexamethasone suppression. Of the patients, five showed a normal CT and symmetrical uptake of the isotope as AS. They were considered representative of bilateral hyperplasia. All showed good therapeutic response to spironolactone. Seven patients had an adrenocortical adenoma verified at operation. The CT finding indicated a tumour in five patients. This was correct in four, but in one patient the adenoma was found in the contralateral adrenal gland. In two patients with an adenoma, CT was considered normal. AS correctly indicated the tumour in all seven patients. The uptake was unilateral in six, and bilateral but clearly asymmetrical in one patient. The results indicate that AS is superior to CT in the pre-operative localization of aldosteroma. Although CT remains the primary method for the investigation of these patients, AS should be applied always when CT does not unequivocally indicate the presence and localization of an adrenal tumour.

Adenoma↗
PubMed1986

Trabecular osteopenia in Colles' fracture.

Bone density was measured in 23 postmenopausal women with Colles' fracture. Trabecular spine density was measured by quantitative computed tomography. The bone mineral density in the distal radius and in the diaphysis of the radius and ulna was measured by the gamma ray attenuation method. Compared with age-matched controls, the patients were found to have reduced trabecular bone mass in the spine and distal radius, but no osteopenia in the diaphysis of the radius and ulna. The mean age-corrected decrease was 0.7 SD in the spine and 0.5 SD in the distal end of the radius. The results suggest that patients with Colles' fracture have trabecular but not cortical osteopenia.

Aged↗
PubMed1985

Bone density in women with spinal and hip fractures.

Bone density in the lumbar spine and distal radius of 98 postmenopausal women was measured by quantitative computed tomography and in the distal radius by gamma ray attenuation. Nineteen had spinal fragility fractures, 30 had recent hip fractures while 49 were healthy control subjects. The trabecular bone density in spines of the control subjects showed a linear correlation with age corresponding to an annual decrease of 1 per cent and total decrease of 44 per cent between 46 and 86 years of age. Both patient groups had bone density reduction at the spine and peripheral measuring sites as compared with controls. In the distal radius, the reduction in bone density was of the same magnitude in both patients groups but in the spine, the reduction in patients with spinal fracture was more extensive than that in patients with hip fracture. Trabecular bone density in the distal radius and spine correlated in control and hip fracture patients, but not in spinal fracture patients. The results support the opinion that two forms of osteoporosis exist. One is characterised by excessive trabecular bone loss in the axial skeleton leading to spinal fractures; the second is due to equal extents of axial and peripheral osteopenia, found in connection with hip fractures.

Adult↗
PubMed1985

Late effects of proximal gastric vagotomy compared with antrectomy and selective vagotomy for chronic duodenal ulcer. A randomized study with 5-year follow-up.

Twenty-three patients who had been given a proximal gastric vagotomy and 29 patients who had had an antrectomy were examined periodically for 5 years after their operations for duodenal ulcers. Five years after surgery, 83% of the proximal gastric vagotomy patients and 86% of the antrectomy and selective vagotomy patients were included in Visick grades I-II. We found 4/24 recurrent ulcers in the vagotomy group and 1/29 in the antrectomy group; in addition 3 of the antrectomy patients had to be reoperated. Acid secretion was reduced by 54% in the vagotomy patients and by over 90% in the antrectomized patients. In the group that had had a proximal gastric vagotomy, maximal acid secretion in the insulin test decreased by 78%. Body weight did not decrease and haematological status did not worsen in either group. Intestinal absorption of fat, xylose and vitamin B12, serum calcium levels and urinary excretion did not change during the follow-up. One year after the operation, the level of serum alkaline phosphatase had risen, and urinary excretion of hydroxyproline had increased in the resected group but after five years, these values were unchanged. Mineral density of bone unchanged decreased significantly in both groups. We conclude that during five years after surgery antrectomy with selective vagotomy does not cause more metabolic disturbances than proximal gastric vagotomy, but is followed by more mechanical problems than proximal gastric vagotomy.

Adult↗
PubMed1984

Screening for postoperative pulmonary embolism on the basis of clinical symptomatology, routine electrocardiography and plain chest radiography.

The incidence of pulmonary embolism (PE) and the usefulness of various screening methods for its detection were studied in 108 patients undergoing elective hip surgery. Twenty patients had PE as shown by perfusion-ventilation lung scintigraphy. Six of them had symptoms of embolism. Clinical symptoms of PE, highly suggestive electrocardiographic (ECG) signs and signs in chest radiographs showed high specificity but low sensitivity with regard to PE. If the non-specific ECG signs and the symptoms and signs of deep vein thrombosis in the calves had also been taken into account, it would have been possible to identify 95% of the patients with PE. The use of all these screening tests revealed a suspicion of PE in two thirds of the patients. The simplest way to screen for postoperative PE seems to be to use a combination of the symptoms and signs of both PE and deep vein thrombosis, and to identify any tachycardia. This method gave a sensitivity of 85%.

Electrocardiography↗
PubMed1984

Carbamazepine and bone mineral metabolism.

The status of bone mineral metabolism was studied in 21 epileptic out-patients receiving carbamazepine as the sole anticonvulsant drug. Hypocalcaemia was found in 3, hypophosphataemia in one and elevated serum alkaline phosphatase in 4 of the cases. Serum 25-hydroxyvitamin D values were significantly lower in the patients than in the controls. No statistically significant difference was observed in bone mineral density between the patients and controls. Histomorphometric analysis of the iliac crest cancellous bone did not reveal any statistically significant difference in the amount of trabecular bone or osteoid between the patients and controls, but the patients had an increased amount of trabecular resorption surfaces. An increased amount of osteoid, suggesting histological osteomalacia, was found in 2 of the 18 biopsies. We conclude that epileptic out-patients receiving carbamazepine therapy have vitamin D deficiency and may develop osteomalacic changes in their skeleton.

Adolescent↗
PubMed1984

Long-term follow-up after Billroth I and II partial gastrectomy. Gastrointestinal tract function and changes in bone metabolism.

Late results of Billroth I (BI) partial gastrectomy for peptic ulcer in 19 patients were compared with those in 19 patients who had undergone Billroth II (B II) operation. The groups were matched for age and sex and were re-examined 21 to 27 years postoperatively. The study included notation of abdominal symptoms and haematologic status and tests of calcium metabolism with serum D-vitamin concentrations [S-25(OH)D2 and S-25(OH)D3], A-vitamin absorption, lactose and d-xylose tolerance and barium meal transit time to assess intestinal function, gastroscopy with biopsies, and measurement of bone mineral density, using the 241Am gamma ray attenuation method. In the paired comparisons of B I and B II patients, no significant difference was found in haematologic status or results of intestinal function tests. The serum alkaline phosphatase activity was significantly higher after B II than after B I, whereas S-25(OH)D2 and S-25(OH)D3 were significantly higher in the B I group. Other data for calcium metabolism showed no significant intergroup difference. Bone mineral density likewise was not significantly different in the two groups, but in both of them the values were significantly lower than in healthy control subjects. Most patients in both Billroth groups had atrophic mucosal gastritis.

Aged↗