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Biomedical subjects

T Koivula

Publications and source records attributed to T Koivula.

At least 127 records · Page 7Linked to original sources
PubMed1990

Finnish recommendation for methods used in urinalysis: results for five-year period.

A recommendation concerning basic urine examinations and bacteriological cultures was published in 1983 in Finland including three clinical indication groups with different screening strategies. Close cooperation between laboratory experts and clinicians as well as much training in urine sediment cytology were essential before the new principle became widely accepted. Decreased workload in laboratories in clinically less significant cases was shown with the use of the full capacity and qualities of complete urinalysis when needed. Standardized test procedures combined with sediment staining improved the clinical efficiency of urine microscopy.

Finland↗
PubMed1990

The effect of elective surgery on serum N-acetyl-beta-D-glucosaminidase activity.

N-acetyl-beta-D-glucosaminidase (NAG; EC 3.2.1.30) activity was measured in sera of 23 patients admitted for elective surgery. Cholecystectomy increased serum NAG activity (by 62%) (p less than 0.004), whereas other types of operations (minor or major abdominal surgery, inguinal hernias and leg varices) had no regular effect. In cholecystectomy patients, the increase of serum NAG activity was associated with parallel changes in liver enzymes suggesting that manipulation of liver may liberate NAG into the circulation. Surgical trauma per se does not provoke any significant liberation of NAG.

Acetylglucosaminidase↗
PubMed1989

Primary invasive and in situ vaginal carcinoma. Flow cytometric analysis of DNA aneuploidy and cell proliferation from archival paraffin-embedded tissue.

Eleven invasive and five non-invasive primary vaginal carcinomas were studied by DNA flow cytometry using archival paraffin-embedded tissue as starting material. Overall frequency of DNA aneuploidy in the invasive carcinomas was 8/11 (73%). DNA aneuploidy occurred in all four advanced stage (III-IV) and in 4/7 (57%) of the early stage (I-II) carcinomas. Among the squamous cell carcinomas aneuploid DNA content was also associated with non-keratinizing tumor type. Invasive vaginal carcinomas showed a high median S-phase fraction (SPF) (18.4%, range 6.9-31.8%). High SPF values were associated with advanced stage and non-keratinizing tumors. Corrected 5-year survival rate in invasive vaginal cancer was 44%, with no significant relation to DNA ploidy or SPF. In situ carcinomas were almost as often DNA-aneuploid (3/5, 60%) as the invasive carcinomas and had comparable median SPF value (13.4%, range 5.5-24.6). One in situ carcinoma with a high DNA-index and SPF relapsed, but overall 5-year survival rate was 100%. In conclusion, both invasive and in situ vaginal carcinomas frequently contain DNA-aneuploid stemlines and show a high SPF. Although DNA aneuploidy and high SPF correlate with advanced stage and non-keratinizing tumor type, they do not have much prognostic relevance in vaginal neoplasia.

Aneuploidy↗
PubMed1989

Intestinal permeability changes in acute gastroenteritis: effects of clinical factors and nutritional management.

The effects of early home management of acute diarrhea followed by rapid in-hospital realimentation on intestinal permeability were studied in 41 children aged 3-25 months with acute gastroenteritis (73% rotavirus). After oral rehydration, a 100 ml oral load containing 4 g of lactulose and 0.8 g of mannitol was administered, and an aliquot of urine excreted in the subsequent 5 h was analyzed with gas-liquid chromatography. The mean lactulose/mannitol recovery ratio was significantly higher than in 28 nondiarrheal controls, which was due to decreased mannitol excretion. The gastroenteritis patients who had received uninterrupted feeding in addition to adequate fluid replacement before hospitalization had a normal urinary lactulose/mannitol ratio, with a mean of 0.04, and a 95% confidence interval (CI) of [0.03, 0.07], whereas in fasted children with inadequate or adequate fluid replacement, the respective mean ratios were 0.24, 95% CI of [0.14, 0.43], and 0.14, 95% CI of [0.09, 0.20] (F = 12.63, p less than 0.001). The fasting-associated rise was caused by increased lactulose excretion. At retesting of gastroenteritis patients after 2 days of in-hospital realimentation, the lactulose/mannitol ratios did not differ significantly from the level on admission. The study indicated that fasting maintains the increased intestinal permeability associated with acute gastroenteritis whereas early feeding at home may promote reduction of permeability and hasten recovery.

Acute Disease↗
PubMed1989

Human pancreatic phospholipase A2 in acute necrotizing pancreatitis.

The activity and the content of phospholipase A2 (PLA2), a potential 'toxin' in pancreatitis, were determined separately by respective methods in pancreatic tissue resected from 22 patients treated for acute necrotizing pancreatitis. Correspondent enzyme assays were analyzed in the serum of 6 last patients. In cases with total necrosis in the tissue resected, the pancreatic PLA2 activity, but not the content, was almost totally lost. Serum PLA2 activity slightly decreased within the extension of pancreatic necrosis. The timing of sampling, number of positive Ranson signs or the course of the disease had no influence on the tissue PLA2 results. Serum PLA2 activity showed a correlation with tissue PLA2 activity.

Acute Disease↗
PubMed1989

Prognostic assessment in stage I ovarian cancer using a discriminant analysis with clinicopathological and DNA flow cytometric data.

We have previously defined three types of tumor DNA histograms, which are associated with favourable, intermediate and poor prognosis of patients with ovarian cancer. In the present study we evaluated the value of DNA histogram type combined with clinicopathological data in predicting long-term clinical outcome in stage I ovarian cancer. A stepwise discriminant analysis was done to find out the best combination of prognostic parameters in the distinction of two groups of stage I ovarian cancer patients; those with less than 5-year overall survival (22 cases) and those with longer than 5-year recurrence-free survival (47 cases). DNA histogram and histological type as well as FIGO stage in that order proved to be the most discriminating parameters and their combination allowed the correct prediction of clinical outcome in 78% of stage I ovarian cancer patients. In stage Ia the proportion of correctly classified cases based on DNA histogram and histological type was 82%. If DNA histogram was omitted from the discriminant analysis, the combination stage and histological type correctly classified a significantly lower percentage (68%) of patients. DNA flow cytometry thus improved the prognostic evaluation in stage I ovarian cancer, but even when combined with conventional clinicopathological factors failed to give correct prognostic assessment in about 20% of patients with stage I ovarian cancer.

Aged↗
PubMed1989

Urinary citrate excretion in patients with urolithiasis and normal subjects.

Citrate is a normal constituent of urine which combines with calcium to form a soluble salt. Urinary citrate excretion was examined in patients with urolithiasis and normal subjects by a specific enzymatic technique. There was a considerable overlap in the urinary citrate excretion between normal subjects and stone-formers, but the citrate-creatinine ratio, the citrate-calcium ratio and the citrate-magnesium-calcium ratio, which were all highly significantly lower (p less than 0.001) in stone-formers than in controls, proved most reliable in discriminating between these groups.

Calcium↗
PubMed1989

Effect of one haemodialysis treatment on the plasma concentrations of intact parathyroid hormone and ionised calcium: usefulness of end-dialysis values in evaluating the suppressibility of hyperparathyroidism.

We studied the effect of one haemodialysis treatment on the plasma concentrations of intact parathyroid hormone (PTH), total immunoreactive PTH (determined with an antibody against the mid-molecular part of the hormone), and ionised calcium in 25 patients on maintenance dialysis for chronic renal failure. During dialysis the calcium concentration in the external fluid was 1.75 mmol/l, which led to an increase in the plasma ionised calcium concentration from 1.23 +/- 0.07 mmol/l (mean +/- SD) at commencement of dialysis to a final 1.35 +/- 0.07 mmol/l (P less than 0.001). The plasma concentration of intact PTH decreased from 27.4 +/- 26.3 pmol/l to 13.0 +/- 19.1 pmol/l (P less than 0.001) during the treatment. Total immunoreactive PTH did not change, reflecting poor dialysability of PTH and PTH fragments. We also compared the dialysis-induced changes in the plasma concentrations of intact PTH and ionised calcium with those induced by a calcium infusion test. We conclude that in the majority of dialysis patients, one haemodialysis treatment with a relatively high external fluid calcium concentration can be used to assess the suppressibility of secondary hyperparathyroidism.

Adult↗
PubMed1988

Improving the prognostic value of DNA flow cytometry in breast cancer by combining DNA index and S-phase fraction. A proposed classification of DNA histograms in breast cancer.

To optimize the prognostic value of DNA flow cytometry in breast cancer the authors calculated several parameters from the DNA histogram, including the DNA index, the size and number of aneuploid peaks as well as S-phase and G2/M-phase cell cycle fractions. Of these, DNA index and S-phase fraction (SPF) proved to be the most valuable prognostic indices. DNA aneuploidy was associated with a three-fold risk of death as compared to DNA diploidy (P less than 0.0001). The highest risk of death was associated with hypertetraploid (greater than 2.20) DNA index, whereas a tetraploid DNA index (1.80-2.20) was associated with a relatively low risk. The SPF had significant additional prognostic value in both DNA diploid (P = 0.0002) and DNA aneuploid (P = 0.02) tumors. By combining DNA index and SPF the authors defined three types of DNA histograms, which were associated with favorable, intermediate, and poor prognosis of the patients. DNA diploidy together with low (less than 7%) SPF (type I DNA histogram) was associated with very favorable prognosis, whereas DNA aneuploidy with high DNA index (greater than 2.20) or high (greater than 12%) SPF (type III DNA histogram) was related to the worst prognosis with approximately eight-fold relative risk of death. In a Cox multivariate regression analysis the type of DNA histogram was an independent and most powerful prognostic indicator in breast cancer. The other independent factors in the Cox analysis were primary tumor size, nodal status, and progesterone receptor status.

Aged↗
PubMed1988

DNA flow cytometric analysis indicates that many breast cancers detected in the first round of mammographic screening have a low malignant potential.

An organized mammographic screening program covered 8,690 women from selected birth cohorts (aged 50-59) in the Tampere University Central Hospital district. Forty-four breast cancer cases were detected in the first round of mammographic screening, which is 3.7 times the expected annual number of new cases in this population. To evaluate the proliferative kinetics and biological properties of these cancers, DNA flow cytometric analysis was carried out in 37 of the screen detected cancers (SDCs) using 60 clinically detected stage I-II cancers and 30 screen-detected benign lesions as reference. DNA aneuploidy was observed in 17/37 (46%) of the SDCs as compared to 41/60 (68%) in the clinical controls (p less than 0.05), while all the benign lesions were DNA-diploid. The median S-phase fraction (SPF) in the SDCs was significantly (p less than 0.001) lower (3.5%) than in the clinical controls (9.6%). Differences in SPF persisted in subgroups defined by DNA ploidy and histological type. In stage-I SDCs the median SPF value (2.5%) approached that of benign tumors (1.9%). Our epidemiological and biological data indicate that the first round of mammography predominantly detects prevalent preclinical lesions, some of which are of very low malignant potential. At present such patients may often receive too extensive treatment. DNA flow cytometry could help in the identification of cases which could be treated, for example, by breast-conserving methods.

Aneuploidy↗
PubMed1988

Prognostic significance of DNA index, multiploidy, and S-phase fraction in ovarian cancer.

Paraffin-embedded tumor samples from 157 ovarian cancer patients were analyzed by DNA flow cytometry. Tumor ploidy had prognostic significance in both early and advanced ovarian cancer. After adjusting for stage, residual tumor mass, histopathologic type, treatment, and age of patient in a Cox regression analysis, the relative risk of death was two-fold higher in single DNA-aneuploid and sixfold higher in DNA-multiploid tumors as compared to DNA-diploid tumors (P less than 0.0001). A tetraploid DNA index was associated with a relatively low risk ratio, whereas hypertetraploid tumors were highly malignant. S-phase fraction (SPF) had prognostic value especially in DNA-diploid tumors. The simultaneous evaluation of DNA index, the number of aneuploid cell clones, and SPF gave more prognostic information than the determination of tumor ploidy alone. On the basis of these parameters we have developed a classification of tumor DNA histograms for better prognostic assessment of ovarian cancer.

Aged↗
PubMed1988

Hormonal activity of epithelial ovarian tumours in post-menopausal women.

Concentrations of progesterone and oestradiol in peripheral serum and tumour cyst fluid were measured in 42 post-menopausal women with epithelial ovarian tumours (17 cancer, 6 borderline malignant, 19 benign tumours) and in 19 post-menopausal women without ovarian neoplasms. The hormonal response of the endometrium was assessed, progestogen and oestrogen receptor content in the tumour tissue case recorded, and tumour deoxyribonucleic acid (DNA) ploidy was measured by flow cytometry. No significant differences were found between the mean serum steroid levels in patients with malignant, borderline or benign tumours, but the mean serum levels of oestradiol in patients with malignant or benign ovarian tumours were higher than those in the controls. Endometrial hormonal activity was seen in 19% of the samples studied. Malignant and benign mucinous epithelial tumours were the types most frequently associated with hormonal activity. Increased levels of sex steroids were seen in the cyst fluid of serous malignant and borderline malignant tumours, while benign tumours were inactive. The steroid receptor content of the various tumour types did not vary significantly. Ten (59%) out of 17 ovarian carcinomas were found to be aneuploid and 41% diploid as measured by flow cytometry. No significant differences in serum levels of progesterone and oestradiol were found between aneuploid and diploid ovarian carcinomas. These results contribute to our knowledge of the hormonal activity of epithelial ovarian tumours in post-menopausal women.

Adenocarcinoma↗