Biomedical subjects

R Punnonen

Publications and source records attributed to R Punnonen.

231 records · Page 13Linked to original sources

PubMedDate not supplied

Repeat laparotomy as a preclinical diagnostic and therapeutic method for treating ovarian carcinoma.

One hundred forty-two cases of epithelial ovarian carcinoma were treated from 1972 to 1976 in the Department of Obstetrics and Gynaecology, University Central Hospital, Turku, Finland. Repeat laparotomy was performed on 37 of the patients about six months after total extirpative surgery (group I). In addition, a second laparotomy was performed on 14 patients after partial surgery or exploratory laparotomy (group II). All patients were given external radiation therapy combined with cytostatic treatment prior to the repeat laparotomies. A preclinical carcinoma was detected in six of the 37 patients in group I. Two of them are asymptomatic after five years of follow-up. In group II, total surgery after initial partial or exploratory laparotomy succeeded in half of the cases. Serous and endometroid carcinomas appeared to respond best to conservative therapy preceding repeat laparotomy.

Female↗

PubMedDate not supplied

Serum estrone, estradiol and estriol concentrations during oral hormone therapy after oophorectomy.

Serum estrone, estradiol and estriol concentrations during estradiolvalerate-norgestrel therapy for women who have undergone oophorectomy were studied. The patients in one group received 1 mg of estradiolvalerate in the morning and 2 mg of estriolsuccinate in the evening. The estrone and estradiol concentrations of the first and fifth day were at roughly the same level and the treatment caused no estrogen cumulation. The estriol concentrations on the fifth day were distinctly higher than on the first, owing to the conversion of estrone and estradiol into estriol. The other group of women were placed on a regimen of 2 mg of estradiolvalerate plus 0.5 mg of norgestrel in the morning and 2 mg of estriolsuccinate in the evening. Here again, the estrone and estradiol concentrations on the first and fifth days were similar.

Castration↗

PubMedDate not supplied

Clonidine in the treatment of menopausal symptoms.

Thirty-seven women complaining of hot flushes, sweating and other menopausal symptoms were treated with clonidine. A double-blind crossover trial with placebo controls was undertaken. The clonidine dose was 2 X 0.025 mg/24 hours-0.075 mg/24 hours, increased if necessary at intervals of two weeks. The effect of clonidine did not differ significantly from placebo effect in the treatment of the symptoms. Side effects during clonidine management were slight and no difference was seen in their incidence compared with that in the patients treated with the placebo. A definitive placebo response was perceivable in the decreasing of symptoms.

Administration, Oral↗

PubMedDate not supplied

The effect of castration and estrogen therarapy on serum high-density lipoprotein cholesterol.

The effect of castration on serum high-density lipoprotein (HDL) cholesterol was studied in 11 women with fairly regular menstruation. The HDL cholesterol levels before and one month after castration did not differ significantly. The effect of intramuscular estrogen therapy on HDL cholesterol was investigated in six castrated women. Ten days after injections of both 10.0 mg of estradiol valerate and 2.5 mg of estradiol benzoate plus 10.0 mg of estradiol phenylpropionate, HDL cholesterol was increased significantly. Fifteen days later, HDL cholesterol levels returned to the pretreatment values.

Castration↗

PubMedDate not supplied

Ovarian production of estrogens in postmenopausal women.

We investigated the possible secretory capacity of the ovaries of 79 postmenopausal women with and without endometrial carcinoma using chemical, enzymehistochemical and ultrastructural methods. The mean serum levels of estrone, estradiol and total estrogens were higher in ovarian effluent blood than the corresponding values in cubital venous blood. There was a positive correlation between the difference of total estrogens in ovarian and cubital vein sera and, on the other hand, enzymehistochemical and ultrastructural findings in ovarian tissue. No statistical differences were found in the peripheral mean values of estrone and total estrogens between the two groups. The mean level of estradiol, however, seemed to be higher and that of estriol lower in the carcinoma patients than in the control groups.

3-Hydroxysteroid Dehydrogenases↗

PubMedDate not supplied

Demonstration of estrogen receptors in the skin.

The occurence of high affinity and limited capacity estrogen receptors in skin specimens was investigated and the concentrations of cytoplasmic and nuclear receptors were studied in 14 normal and 22 castrated women. The skin estrogen receptor levels were low in all cases examined, although they usually exceeded the limit value used for estrogen receptor levels in breast cancer tissue. The cytoplasmic and nuclear receptor concentrations in normal women varied from 2.4 to 9.0 and from 1.5 to 7.0 fmol/mg cytosol protein, respectively. The receptor was present as a very high affinity binding component (KD = 0.2- 1.6 x 10(-9)M). The estrogen receptor concentrations in the skin during estriol succinate and estriol valerate therapy were at roughly the same level as during the normal menstrual cycle. The patients who received no replacement therapy after castration displayed the lowest skin estrogen receptor levels. The share of nuclear receptors seemed to be smaller on average during the normal menstrual cycle and in castrated patients not given estrogen therapy than in women treated with estriol succinate or estradiol valerate.

Adult↗

PubMedDate not supplied

High-affinity binding of estrone, estradiol and estriol in human cervical myometrium and cervical and vaginal epithelium.

The estrogen receptor concentrations in the cervical myometrium and ectocervical and vaginal epithelium were very low soon after the menstrual bleeding. The receptor concentrations were considerably higher in the middle of the proliferative phase and in postmenopausal patients treated with vaginal estrogens. In these two groups the estrogen receptor concentrations were lowest in the vaginal epithelium and highest in the cervical myometrium. In all three tissues studied, estradiol had the highest affinity to the receptor protein, followed by estriol and estrone. The binding was specific for all three estrogens whereas a 1000-fold excess of progesterone, dihydrotestosterone and testosterone was required in order to obtain competition for the estrogen receptor. Sedimentation analysis showed that estriol and estradiol were bound to macromolecules sedimentation analysis showed that estriol and estradiol were bound to macromolecules sedimenting at 9.0 S and 3.5-4.6 S whereas estrone was bound only to the 4.6 S binding protein.

Adult↗

PubMedDate not supplied

Vitamin D and calcitonin treatment in patients with femoral neck fracture: a prospective controlled clinical study.

The effects on general and bone metabolism of femoral neck fracture patients of 0.25 micrograms alpha-calcoid given orally twice daily (n = 9) and 25 micrograms calcitonin given subcutaneously 30 times (n = 10) in 10 weeks were studied against a control (n = 11). Bone histology and histomorphometry showed non-age related osteoporosis in 30% and osteomalacia in 22% of the patients studied. Impaired serum vitamin D status was found in 47-88% of patients, secondary hyperparathyroidism and increased serum parathyroid hormone in 59% and decreased serum calcitonin levels in 69%. On histology, normal findings and non-age related osteoporosis on histology were associated with low serum levels of 25-hydroxyvitamin D3, 1,25- and 24,25-dihydroxyvitamin D3. Very high serum levels of 1,25-dihydroxyvitamin D3 and low levels of 25-hydroxyvitamin D3 occurred in fracture patients with osteomalacia. Calcitonin improved calcium balance, reduced osteoporosis and increased the serum 1,25- and 24,25-dihydroxyvitamin D3 levels but had no effect on osteomalacia. Vitamin D reduced osteomalacia, slightly increased the serum 1,25-dihydroxyvitamin D3 concentration and decreased serum levels of parathyroid hormone. Both treatments gave a similar slight decrease in serum calcitonin concentrations. A mechanism of action for the treatments is suggested.

Aged↗

PubMedDate not supplied

Ovarian cancer and gonadotropins in vitro: new evidence in favor of independence.

BACKGROUND: The aim of this study was to investigate whether newly established epithelial ovarian carcinoma cell lines secrete inhibins, and whether their proliferative and secretory activity can be regulated by gonadotropins. MATERIALS AND METHODS: Three recently characterized human epithelial ovarian carcinoma cell lines were exposed to human choriongonadotropin hCG and follicle stimulating hormone FSH. Cell proliferation was determined by counting. Secretory activity of the cell lines was studied by analyzing inhibin A, inhibin B, inhibin pro-aC, estradiol, progesterone, testosterone, and CA 125 concentrations from the medium. The expression of gonadotropin receptors was studied by RT-PCR. RESULTS: None of the cell lines were found to secrete any of the inhibins, progesterone or testosterone. Only UT-OC-4 cells secreted low levels of estradiol. Gonadotropin receptors were not expressed by any of the cell lines, and accordingly neither FSH nor hCG stimulated the growth of these cells. However, hCG had some dose dependent growth inhibitory effect on UT-OC-3. Passage 42 cells of UT-OC-3 secreted significantly more CA 125 than passages 8 cells (P = 0.000). CONCLUSIONS: The present results suggest that the carcinomatous epithelial cells of the ovary do not secrete inhibins. The serum inhibin levels previously detected in patients with epithelial ovarian carcinoma may therefore reflect an ovarian stromal response to carcinoma. The findings are also in favor of an independence of ovarian cancer of gonadotropins.

CA-125 Antigen↗

PubMedDate not supplied

Serologic evidence for the role of Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma hominis in the etiology of tubal factor infertility and ectopic pregnancy.

The authors used enzyme immunoassay to determine the prevalence of serum antibodies to the sexually transmitted disease (STD) organisms Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma hominis among 104 infertile women undergoing in vitro fertilization. Altogether, 55 (72%) out of 76 women with tubal abnormalities tested positive for one or more STD organisms, compared with only 6 (21%) out of 28 infertile women with normal tubes (P less than .001). The authors obtained positive test results for C. trachomatis, N. gonorrhoeae, and M. hominis in 40%, 14%, and 37% of the patients with tubal abnormalities, respectively; of women without tubal abnormalities, the test results were 7%, 0%, and 14%, respectively. Out of 20 patients with a history of ectopic pregnancy, the authors obtained positive findings for C. trachomatis, N. gonorrhoeae, and M. hominis in 8 (40%), 1 (5%), and 7 (35%), respectively. These results indicate an independent role for all three STD organisms in the etiology of tubal factor infertility and ectopic pregnancy following both symptomatic and asymptomatic pelvic inflammatory disease (PID). The correlation between positive mycoplasmal serology and secondary infertility and tubal abnormalities may suggest a link between M. hominis infections during pregnancy and delivery complications and consequent development of tubal factor infertility.

Chlamydia Infections↗

PubMedDate not supplied

Reproductive outcome after multiple ectopic pregnancies.

Seventy-six patients with two or more ectopic pregnancies treated at the Department of Obstetrics and Gynecology, University Central Hospital, Tampere, Finland over a period of 14 years (1972-1985) were retrospectively analyzed. Conservative tubal surgery had originally been performed in 57% of patients with a repeat tubal pregnancy, and in 41% of control patients with a single tubal pregnancy. After two ectopic pregnancies, 53 patients were actively trying to conceive. Of these patients, 25% achieved delivery, 40% had a third ectopic pregnancy, and 35% did not conceive. Ipsilateral tubal pregnancy occurred in 83% after salpingotomy, in 88% after fimbrial evacuation, and in 47% after tubal resection. Conservative surgery was performed in 16 patients with only one tube where an ectopic pregnancy occurred; 25% had a term delivery, 25% had a repeat ectopic pregnancy, and 50% did not conceive. Follow-up of 19 patients after three tubal pregnancies showed that 16% delivered, 26% had a repeat tubal pregnancy, and 58% did not conceive. There was no significant difference between fertility results after salpingectomy and those after conservative surgery.

Adolescent↗

PubMedDate not supplied

Follicular fluid cyclic nucleotides, prostaglandin E2, leukotriene B4, oestradiol, progesterone and luteinizing hormone in women stimulated by clomiphene and gonadotropins.

The concentrations of cyclic AMP, cyclic GMP, prostaglandin E2 (PGE2), leukotriene B4 (LTB4) oestradiol, progesterone and luteinizing hormone (LH) were determined in 30 follicular fluid samples from 25 women in an IVF programme. Multiple follicular development was induced by clomiphene citrate and human menopausal gonadotropin. Laparoscopic aspiration of follicular fluid was performed 36 hours after injection of human chorionic gonadotropin. The mean concentration of LH was significantly lower (p less than 0.05) in the follicular fluid with ova developing to embryos that cleaved than in those without cleavage. The mean concentrations of cAMP, cGMP, PGE2, LTB4, oestradiol and progesterone were not significantly different. PGE2 and LH concentrations in the follicular fluids showed significant correlation (r = 0.56; p = 0.004). Significant correlation was also seen between cAMP and progesterone concentrations (r = 0.50; p = 0.006). The presence of cyclic nucleotides, PGE2 and LTB4 in human follicular fluid suggests that these factors may have a role in the function of the follicular fluid.

Adult↗

PubMedDate not supplied

Inflammatory etiology of salpingitis isthmica nodosa: a clinical, histological and ultrastructural study.

Fifteen patients with obstructive salpingitis isthmica nodosa were studied. Histologically the tubal lumen was narrowed in all cases and in five patients the central tubal lumen could not be detected at all. In all cases an at least slight inflammatory response was found, consisting of lymphocytes and slight fibrosis. Seven of the patients had high serum chlamydial antibody titers (greater than 128). Ultrastructurally the epithelium lining the gland-like structure was similar to normal tubal epithelium. Inflammation may be a chronic irritant, leading to tubal spasm, muscular hypertrophy and eventually to salpingitis isthmica nodosa.

Epithelium↗

PubMedDate not supplied

Estrogen in the treatment of abnormal cervical mucus infertility.

The effects of intravaginal estrogen treatment on the cervical mucus and PCT were investigated in ten primarily infertile patients. The abnormal cervical mucus was the only demonstrable factor of their infertility. The duration of the infertility had ranged from 5-10 years. In four cases the percentual and progressive motilities of the spermatozoa improved and the number of spermatozoa rose in the PCT. Three of the patients conceived during the test cycle. In addition the effects of intramuscular estradiol-benzoate on the cervical mucus and PCT were investigated in clomiphene-treated patients. No differences were found between the test and the control cycle.

Administration, Topical↗

PubMedDate not supplied

Isthmic tubal occlusion: etiology and histology.

Twenty five patients were operated on for isthmic tubal occlusion. In 15 cases (60%) the etiology of this lesion was salpingitis isthmica nodosa. Of the other 10 cases, three showed tubal endometriosis and another three isthmic fibrosis. In two patients the histologic examination showed chronic inflammation. In one case etiology was tubal tuberculosis and in one case a cyst of calcified Gartner 's duct was seen. Inflammatory etiology seems to be important in isthmic tubal occlusion. In many cases chlamydial infection may be the chronic irritant which also cause the muscular hypertrophy leading to salpingitis isthmica nodosa.

Calcinosis↗