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Biomedical subjects

R Korpela

Publications and source records attributed to R Korpela.

At least 73 records · Page 4Linked to original sources
PubMed1998

Comparison of a portable breath hydrogen analyser (Micro H2) with a Quintron MicroLyzer in measuring lactose maldigestion, and the evaluation of a Micro H2 for diagnosing hypolactasia.

The measurement of hydrogen in exhaled air and changes in the concentration of blood glucose and urine galactose excretion are indirect methods of diagnosing hypolactasia. The aim of this study was to compare a portable breath hydrogen analyser (Micro H2) with a widely used model (Quintron MicroLyzer) and to compare them with the blood glucose, urine galactose, and gastrointestinal symptoms in the lactose tolerance test. After an overnight fast, 44 volunteers (18-66 y) ingested 50 g lactose in a single oral dose. Changes in exhaled breath hydrogen concentrations were measured with the two analysers, and changes in blood glucose and urinary galactose were assayed for 4 h and used as a reference. Eighteen subjects were diagnosed as maldigesters according to our gold standard of at least two positive tests out of the three: breath hydrogen by Quintron, blood glucose concentration, and urine galactose excretion. The highest increase in the breath hydrogen concentration over the baseline was highly variable: 44-366 ppm (Micro H2) or 27-187 ppm (Quintron MicroLyzer). The sensitivity, specificity, and positive and negative predictive values of the Micro H2 compared to the gold standard were 83%, 96%, 94% and 89%, respectively. Overall agreement was 91% (95% CI 78-97%). Compared to the Quintron, the diagnoses were identical in 100% of the cases (92-100%). Thus, for diagnosing hypolactasia, the Micro H2 appeared as reliable for measuring breath hydrogen concentrations as Quintron MicroLyzer commonly used in oral lactose tolerance tests.

Adolescent↗
PubMed1998

Role of irritable bowel syndrome in subjective lactose intolerance.

It has been suggested that the symptoms of irritable bowel syndrome (IBS) may be wrongly attributed to lactose intolerance. We examined the relations among IBS, demographic factors, living habits, and lactose intolerance. On the basis of a lactose tolerance test with ethanol, 101 of the 427 healthy subjects studied were lactose maldigesters and 326 were lactose digesters. IBS was diagnosed by means of the Bowel Disease Questionnaire, according to the Rome criteria. The use of dairy products and symptoms experienced after their consumption were recorded. IBS was found in 15% of both the lactose maldigesters and lactose digesters. One-third of the subjects reported intolerance to dairy products containing < or = 20 g lactose. About half of this third were lactose maldigesters and about half were lactose digesters. As explanations for this subjective lactose intolerance, the logistic regression model estimated lactose maldigestion (odds ratio: 10.3; 95% CI: 5.2, 20.4), IBS (4.6; 2.1, 10.1), experience of symptoms other than gastrointestinal ones (2.3; 1.2, 4.5), and female sex (2.1; 1.1, 4.0). Characteristics common to both subjective lactose intolerance and IBS were female sex and the experience of abdominal pain in childhood (P < 0.01). Age, regularity of meals, and the amount of physical activity were not associated with either subjective lactose intolerance or IBS. Of the subjects with IBS, the percentage of lactose maldigesters was the same as in the whole study group (24%) but the number who reported lactose intolerance was higher (60% compared with 27%, P < 0.001). We showed a strong relation among subjective lactose intolerance, IBS, the experience of abdominal pain in childhood, and female sex.

Abdominal Pain↗
PubMed1998

Galacto-oligosaccharides relieve constipation in elderly people.

The aim of the study was to investigate whether galacto-oligosaccharides (GOS) relieve constipation in elderly people. The final study population consisted of 14 female subjects, mean age 79.6 (69-87) years, who suffered from constipation. The study was a double-blind two-period cross-over study. Both study periods lasted 2 weeks. The subjects ingested either 2 control yoghurts or 2 GOS-containing yoghurts daily. The yoghurts were otherwise similar, but the daily dose of GOS (Elix'or, BWP, Holland) from the GOS yoghurt was 9 g. The regular use of laxatives was stopped during the study periods and laxatives were used only when necessary. All the subjects reported the function of their intestines daily in a questionnaire. The defecation frequency per week (mean, range) was higher during the GOS period (7.1, 3-15) than during the control period (5.9, 1-14). GOS had no statistically significant effect on the use of laxatives, the consistency of feces or the ease of defecation, although GOS seemed to make defecation easier (p = 0.07). The adverse gastrointestinal symptoms were similar during both the control and the GOS periods. GOS seem to relieve constipation in most elderly people but the responses differ individually.

Aged↗
PubMed1998

Dietary factors in the pathogenesis and treatment of hypertension.

Data accumulated from epidemiological observations, intervention trials and studies on experimental animals provide a growing body of evidence of the influence of various dietary components on blood pressure. Dietary sodium, usually taken in the form of sodium chloride (common salt), is positively associated with blood pressure, and in many hypertensive patients reduction in sodium intake lowers blood pressure. On the other hand, in certain patients potassium, calcium and magnesium may be protective electrolytes against hypertension. Dietary fats, especially n-3 polyunsaturated fatty acids, may also influence blood pressure, whereas the possible role of other macronutrients, such as proteins and carbohydrates, or vitamins in the regulation of blood pressure is less well understood. Occasional ingestion of coffee transiently increases blood pressure, but the effects of habitual coffee consumption are controversial. Excessive use of alcohol on a regular basis has been associated with elevated blood pressure. It has also been shown in case reports that large amounts of liquorice lead to the development of hypertension. Thus, with appropriate dietary modifications, it is possible to prevent the development of high blood pressure and to treat hypertensive patients with fewer drugs and with lower doses. In some patients antihypertensive medication may not be at all necessary.

Diet↗
PubMed1998

Increased fecal frequency and gastrointestinal symptoms following ingestion of galacto-oligosaccharide-containing yogurt.

Gastrointestinal symptoms and fecal frequency following ingestion of yogurt containing 15 g of galacto-oligosaccharides (GOS) per d were observed in 12 healthy volunteers. The effect of GOS on intestinal microflora was also studied in six volunteers. Defecation frequency increased during the administration period, but gastrointestinal symptoms, especially flatulence, also increased. The level of fecal bifidobacteria did not increase by the yogurt intake, but a significant increase was observed in the fecal bacteria growing on MRS media. The results indicate that dietary GOS increase gastrointestinal symptoms and fecal frequency in normal adults and have an effect on intestinal microecosystem.

Adult↗
PubMed1997

Lactobacillus rhamnosus GG (ATCC 53103) and platelet aggregation in vitro.

Lactobacillus rhamnosus GG is an experimentally and clinically well documented probiotic used in different dairy products. The present study aimed to investigate the safety aspects of Lactobacillus rhamnosus GG, particularly with respect to platelet aggregation, the initiating event in thrombosis. Platelet rich plasma was separated from the blood of healthy volunteers, and the effects of Lactobacillus rhamnosus GG (ATCC 53103), Lactobacillus rhamnosus (ATCC 7469) and Enterococcus faecium T2L6 in different dilutions on spontaneous, ADP- and adrenaline-induced aggregation were tested. The bacteria did not influence spontaneous aggregation. Only Enterococcus faecium T2L6 enhanced the adrenaline-induced aggregation, with a less clear effect on ADP-induced aggregation.

Adult↗
PubMed1997

Amrinone versus dopamine-nitroglycerin after reconstructive surgery for complete atrioventricular septal defect.

OBJECTIVES: To compare the effectiveness and safety of amrinone and a combination of dopamine and nitroglycerin in infants after reconstructive surgery for congenital heart disease. DESIGN: A prospective, randomized, double-blind study. SETTING: Pediatric intensive care unit in a university hospital. PARTICIPANTS: Thirty-two infants with complete atrioventricular septal defect. INTERVENTIONS: Amrinone loading dose, 2 mg/kg, followed by a maintenance infusion, 7.5 micrograms/kg/min, was given to 17 infants before separation from cardiopulmonary bypass. The remaining 15 patients received a combination of dopamine, 5 micrograms/kg/min, and nitroglycerin, 1 microgram/kg/min. MEASUREMENTS AND MAIN RESULTS: The circulatory state of the patients was evaluated from 4 to 18 hours after cardiopulmonary bypass. The systemic blood flow index, calculated using the Fick principle, was higher in the amrinone group (2.5 +/- 0.7 L/min/m2) compared with the dopamine-nitroglycerin group (2.0 +/- 0.6 L/min/m2, mean +/- SD). The pulmonary blood flow index in the amrinone group was higher (2.9 +/- 0.6 L/min/m2) than in the dopamine-nitroglycerin group (2.2 +/- 0.6 L/min/m2); no significant difference was noted in the mean pulmonary artery pressure. The oxygen extraction ratio was higher in the dopamine-nitroglycerin group (0.41 +/- 0.07) compared with the amrinone group (0.34 +/- 0.08). Despite lower platelet counts in the amrinone group, no hemorrhagic complications were seen in any patient. CONCLUSIONS: With this dosage regimen, amrinone provides a higher cardiac output, more favorable oxygen dynamics, and lower pulmonary vascular resistance than dopamine and nitroglycerin.

Amrinone↗
PubMed1997

Milk fat does not affect the symptoms of lactose intolerance.

OBJECTIVE: This study investigated the role of the fat content of milk on symptoms of lactose intolerance. DESIGN: Subjects recorded intolerance symptoms using a visual analogue scale (VAS) following ingestion of three test milks for varying fat content for a two-day period. SUBJECTS/SETTING: The subjects were thirty adult volunteers, patients of two Estonian out-patient clinics with diagnosed lactose intolerance. The study milks were drunk at home or at work. All thirty subjects completed the study protocol. INTERVENTION: Each subject drank, in random order, fat-free milk (4.9% lactose), high-fat milk (8% fat, 4.9% lactose), and a lactose-free and fat-free control milk. They drank 200 ml of the milk twice a day for two days, one milk type per session, with five days between sessions. The subjects noted their gastrointestinal symptoms during the test periods and during a 5 d milk-free period at the beginning of the study. The occurrence and severity of symptoms were compared. A global measure of the severity of symptoms was defined by computing the sum of the symptoms scores. RESULTS: The sum of symptoms was higher during all milk periods than during the milk-free period (P < 0.01). There were no statistically significant differences in the occurrence or severity of symptoms during the fat-free milk period compared with the high-fat milk period. CONCLUSIONS: Even a marked difference in the fat content of milk did not affect the symptoms of lactose intolerance. Consequently, there seems to be no case for recommending full-fat milk products in the treatment of lactose intolerance.

Adolescent↗
PubMed1997

Recovery of Lactobacillus rhamnosus GG from human colonic biopsies.

The colonization of Lactobacillus rhamnosus GG (ATCC 53103, henceforth L.GG) in five human colonoscopy patients was studied. The test subjects consumed whey drink fermented with the bacterium for 12 d before the colonoscopy. The presence of L.GG was subsequently checked both in the faecal samples and in the colonic biopsies obtained from various locations in the large intestine. In all patients L.GG was the dominant faecal lactic acid bacterium as a result of the administration. In four patients L.GG could also be recovered from the biopsies, while with one patient (suffering from ulcerative colitis diagnosed during the colonoscopy) no L.GG was detected in the biopsy samples. The results suggest that L.GG is able to adhere in vivo to the colon. Study of the faecal samples alone is apparently not sufficient for elucidation of the gastrointestinal ecology of probiotic bacteria.

Adult↗
PubMed1997

Paediatric cardiac arrest and resuscitation provided by physician-staffed emergency care units.

BACKGROUND: Most paediatric cardiac arrest studies have been conducted in the USA, where paramedics provide prehospital emergency care. We wanted to study the outcome of paediatric cardiac arrest patients in an emergency medical system which is based on physician staffed emergency care units. METHODS: We analysed retrospectively the files of 100 prehospital cardiac arrest patients from Southern Finland during a 10-year study period. The patients were less than 16 years of age. RESULTS: Fifty patients were declared dead on the scene (DOS) without attempted resuscitation, and cardiopulmonary resuscitation (CPR) was initiated in 50 patients. The sudden infant death syndrome was the most common cause of arrest in the DOS patients (68%) as well as in those receiving CPR (36%). Asystole was the initial cardiac rhythm in 70% of the patients in whom CPR was attempted. Resuscitation was successful in 13 patients, 8 of whom were ultimately discharged. Six of the patients survived with mild or no disability and 4 of them had near-drowning aetiology. In multivariate analysis, the short duration of CPR (< or = 15 min) was the only factor significantly associated with better survival. CONCLUSIONS: Although prehospital care was provided by physicians, the overall rate of survival was found to be equally poor as reported from systems with paramedics. The only major difference between physician- and paramedic-staffed emergency care units is the ability of physicians to refrain from resuscitation already on the scene when prognosis is poor.

Adolescent↗
PubMed1997

Age and continuous lactose challenge modify lactase protein expression and enzyme activity in gut epithelium in the rat.

The activity of lactase enzyme declines after weaning. This study was to investigate changes in the lactase expression in the whole gastrointestinal tract during the development and the possibility that this and activity can be induced by lactose. Expression of lactase protein in the gut of 1-12-weeks old rats was studied by immunocytochemistry. Possible induction was evaluated by immunohistochemical and biochemical techniques in 8-week-old rats after lactose challenge for seven days. Lactase immunoreactivity was detected only in the small intestine and it decreased 20% during the week after weaning. A steady level of 40% lower than in the sucklings was found in the adult rats. In the lactose-challenged rats the optical density of immunoreactivity increased by about 30% in those that consumed the highest concentration of lactose. In the proximal jejunum, elevation of the enzymatic activity was three-fold. In the rat lactase protein expression decreased rapidly after weaning and expression and activity were induced by lactose-rich diet, most notably in the proximal jejunum.

Age Factors↗
PubMed1996

Prolonged granulocyte activation, as well as hypoxanthine and free radical production after open heart surgery in children.

OBJECTIVE: To investigate granulocyte activation, as well as hypoxanthine and free radical production in children during the first day after cardiopulmonary bypass. DESIGN: A prospective study of pediatric patients undergoing either cardiac surgery with a cardiopulmonary bypass or thoracotomy and extracardiac vascular surgery not requiring a cardiopulmonary bypass. SETTING: Operative and intensive care units, Children's Hospital, University of Helsinki, Finland. PATIENTS: Seven consecutive patients undergoing elective correction of a ventricular septal defect and six patients undergoing extracardiac surgery for ligation of a patent ductus arteriosus or repair a coarctation of the aorta. MEASUREMENTS AND MAIN RESULTS: Plasma concentrations of myeloperoxidase (140-334 micrograms/l preoperatively, 460-1692 micrograms/l at 0.2 h after declamping, 471-1386 micrograms/l at 0.5 h after declamping) and lactoferrin (77-258 micrograms/l preoperatively, 533-1783 at 0.2 h, 404-1482 micrograms/l at 0.5 h) as markers of granulocyte activation, and hypoxanthine (0-5.7 mumol/l preoperatively, 4.3-17.0 mumol/l at 0.2 h, 6.5-17.9 mumol/l at 0.5 h) increased in a biphasic manner at 0.2-0.5 h and 6-10 h postoperatively (all p < 0.05). Expired ethane, as an index of free radical activity, increased at 10 h postoperatively (36-119 pmol/kg per min preoperatively, 72-152 pmol/kg per min, p < 0.005). CONCLUSION: Granulocyte activation, and hypoxanthine and free radical production occur at least 10 h after cardiopulmonary bypass. In children undergoing open heart surgery, attempts to reduce free radical activity should be extended to the postoperative period.

Cardiopulmonary Bypass↗
PubMed1996

Whey mineral supplementation and arterial tone in mineralocorticoid-NaCl hypertension.

OBJECTIVE: The aim was to study the effects of supplementation of rat chow diet with whey mineral concentrate (Whey), a diet rich in milk minerals, on arterial responses in vitro in mineralocorticoid-NaCl hypertension. METHODS: Forty young Wistar rats were allocated to four groups: Wistar, Whey-Wistar, deoxycorticosterone (DOC), and Whey-DOC. DOC (10 mg kg-1 s.c.) was given twice a week and these rats drank 0.7% NaCl solution, while the others received equal volumes of vehicle (sesame oil) and drank tap water. The supplementation was performed by adding 25% whey mineral concentrate to the chow, which in particular increased the intake of potassium and also that of calcium and magnesium in the rats. Responses of mesenteric arterial rings were examined in standard organ chambers after 10 study weeks. RESULTS: During the 10 week study the DOC-NaCl treatment had a marked hypertensive effect in rats, while the whey mineral supplementation was without significant effect on blood pressure in the Whey-DOC and Whey-Wistar groups. Arterial relaxation induced by nitroprusside was attenuated in the DOC-treated rats, but was significantly shifted towards that of controls in the Whey-DOC group. Interestingly, endothelium-dependent relaxation to acetylcholine (ACh), which was clearly impaired in the DOC group, was comparable in the Whey-DOC and Wistar groups. Moreover, only in the DOC group the relaxation was improved by diclofenac suggesting that ACh was releasing cyclo-oxygenase-derived contractile factors from the endothelium, and the response was completely abolished by NG-nitro-L-arginine methyl ester (L-NAME). In contrast, diclofenac had a negligible effect on the response in the other groups which also showed distinct relaxations to ACh in the presence of L-NAME. This remaining response to ACh in Wistar rats was inhibited by the addition of apamin and glibenclamide, inhibitors of calcium-activated and ATP-sensitive potassium channels, respectively, suggesting that it was mediated by endothelium-dependent hyperpolarization. In the Whey-Wistar group arterial function did not differ from control Wistars. CONCLUSIONS: Supplementation with whey mineral concentrate had a protective effect on endothelium-mediated control of arterial tone in experimental DOC-NaCl hypertension.

Acetylcholine↗
PubMed1996

Sevoflurane-nitrous oxide or halothane-nitrous oxide for paediatric bronchoscopy and gastroscopy.

We have studied 120 infants and children, in three age groups (3-11 months, 1-5 yr and 6-15 yr), to compare anaesthesia with sevoflurane or halothane for bronchoscopy or gastroscopy, or both. Premedication or i.v. anaesthetic agents were not used. Patients were allocated randomly to receive either 7% sevoflurane or 3% halothane in 66% nitrous oxide in oxygen for induction of anaesthesia. The same inspired mixture was continued during bronchoscopy while the concentration of the inhalation agent was reduced by 50% during gastroscopy. Induction times were shorter for infants than for children and shorter for sevoflurane than for halothane. Cardiac arrhythmias were significantly more frequent during halothane than during sevoflurane anaesthesia. Physiological and psychomotor recovery were more rapid after sevoflurane than after halothane. At 24-h follow-up, children who received sevoflurane had significantly less nausea and vomiting. We conclude that sevoflurane was superior to halothane for paediatric bronchoscopy and gastroscopy.

Adolescent↗
PubMed1996

Pediatric prehospital care provided by a physician-staffed emergency medical helicopter unit in Finland.

During an 18-month period ending on March 15, 1994, data on all patients treated by the Helsinki Area Emergency Medical Air Service (HEMS) in Southern Finland were collected. The HEMS operates a physician-staffed helicopter unit which is dispatched by alarm centers connected to a national 112 emergency phone system. Of 1481 emergency missions during the study period, 89 (8%) involved children less than 17 years old. Common pediatric emergencies were trauma (31%), seizures (29%), respiratory problems (14%), and cardiac arrest (9%). Fourteen patients were intubated, an intravenous line was started in 58 patients, and 32 patients received intravenous medication. Cardiopulmonary resuscitation was initiated in nine patients. Ten patients were evacuated by helicopter, and 22 patients were transported by ground ambulance with a HEMS physician escort to the hospital. According to this study, the HEMS physician play an important role also in pediatric prehospital care in their operating area.

Adolescent↗