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Biomedical subjects

A Kivelä

Publications and source records attributed to A Kivelä.

At least 19 recordsLinked to original sources
PubMed1998

Combined laboratory and diary method for objective assessment of menstrual blood loss.

BACKGROUND: To develop an objective measurement system for menstrual blood loss applicable in clinical practice. METHODS: One hundred and fifty-six patients were enrolled in a randomized trial of the treatment of menorrhagia in all five gynecology departments of the university teaching hospitals in Finland. Correlation between venous blood hemoglobin concentration (Hb) and absorbance at 564 nm (A564) was investigated in experiments with blood samples. Amount of collected menstrual blood and menstrual diary data were analyzed. RESULT: Hb concentration and A564 of the blood were linearly correlated (r=0.99). One hundred and fifty-four women (99%) returned used sanitary protection and menstrual diaries. On average, 12% (range 0-57%) of menstrual blood was lost during collection. The median amount of blood recovered from sanitary protection was 89 ml (range 14-724 ml), with 58% (n=90) of the women exceeding 80 ml per cycle. When the spilled blood was taken into account, the corresponding figures were 104 ml (range 15-724 ml) and 66% (n= 101). CONCLUSIONS: The spectrophotometric measurement of venous blood in the conventional alkaline hematin method can be replaced by measurement of Hb concentration. All blood incompletely collected should be recorded. Objective measurement of menstrual blood loss can be applied in routine clinical practice.

Adult↗
PubMed1997

Comparison of a 10-mg controlled release oxybutynin tablet with a 5-mg oxybutynin tablet in urge incontinent patients.

Oxybutynin has long been used for the treatment of patients with detrusor overactivity and urinary urge incontinence. The short half-life of oxybutynin administered as a conventional tablet formulation or syrup requires 2-3 times daily dosage to be effective. A new controlled release (CR) tablet for once-daily administration has been developed. The efficacy and tolerability of this new controlled release tablet was compared to that of a 5-mg conventional oxybutynin tablet administered twice daily. Seventeen female incontinent patients were studied in a double-dummy crossover trial. Efficacy and tolerability were assessed by using a voiding diary, pad-weighing test, visual-analogue scale (VAS), and questionnaire. Adverse events were recorded spontaneously on a questionnaire by the patients themselves throughout the study. Serum concentrations of oxybutynin and its active metabolite N-desethyloxybutynin were studied after both a single dose and multiple dosage. There was no difference in efficacy between the two formulations. Depending on the parameters tested, the change from baseline values in a positive direction ranged from 15 to 53%. The incidence of adverse events was similar with both formulations. Oxybutynin or its metabolite showed no cumulation during the multiple dosage with a 10-mg CR tablet. The controlled release tablet formulation is as effective and as well-tolerated as the conventional one, but has the advantage of only once-a-day dosage, enhancing treatment compliance.

Adult↗
PubMed1997

The clinical significance of an absent end-diastolic velocity in the umbilical artery detected before the 34th week of pregnancy.

BACKGROUND: The aim of this study was to evaluate the clinical significance of absent or reversed (ARED) flow detected in the late second or early third trimester in the umbilical artery in high-risk pregnancies. METHODS: Eighty-three women with hypertensive disorders of pregnancy, gestational diabetes or a suspected disorder of the fetus (e.g. small-for-gestational age) were included in this retrospective study. A constant finding of ARED flow in the umbilical artery was registered with the pulsed Doppler method between the 23+/-0 and 33+/-6 gestational weeks. Perinatal mortality (PNM) rates, Apgar scores and arterial umbilical pH values, birth weights, the frequency of SGA, gestational ages at birth, NICU (=neonatal intensive care unit) days, anomalic fetuses and the mode of delivery were registered. Mann-Whitney U-test and chi-squared test were used for statistical analysis. RESULTS: The PNM in the entire group under study was 19.3% (16 infants/fetuses). The rate of structurally or chromosomally abnormal fetuses was 15.7% (13 infants/fetuses). When anomalic fetuses were excluded the PNM was 18.6%. No non-anomalic fetuses/newborns were lost in cases in which ARED was detected after the 30th week. No statistically significant difference was observed in PNM and SGA frequencies when comparing AEDV (absent end-diastolic velocity) fetuses with those who had REDV (reversed end-diastolic velocity). When anomalic fetuses were excluded the PNM rate in the AEDV group was 8.9% compared with the PNM rate of 35.7% in the REDV group; (p=0.03). CONCLUSIONS: An early ARED finding (before the 34th week) in the umbilical artery signifies a marked warning signal of fetal distress. In these cases the rates of perinatal morbidity and mortality are very high, which is a reflection of the severity of the condition. The majority of fetuses can, however, be saved.

Blood Flow Velocity↗
PubMed1996

Decrease in melatonin precedes follicle-stimulating hormone increase during perimenopause.

Melatonin, the hormone of the pineal gland, which in animal studies has been found to inhibit aging processes, is secreted in smaller amounts towards senescence. Menopause, an aging process in women, is known to be associated with typical changes in gonadotropin and sex steroid secretion. Our main objective was to study the possible role of melatonin in the hormonal regulation of menopause. This study focused on detailed changes in melatonin and follicle-stimulating hormone (FSH) secretion cross-sectionally in pre- to postmenopausal females. Special attention was paid to females aged around 50 years, which is the mean menopausal age. Seventy-seven healthy female volunteers aged 30-75 years were the subjects of this study. Melatonin was measured radioimmunologically from nocturnal urine collected between 20.00 and 08.00 h, and FSH and melatonin from blood samples taken at 0.900 h. Nocturnal urinary excretion of melatonin was found to decline significantly from premenopause to postmenopause. The youngest premenopausal women (age group 30-39 years) excreted the highest amounts of melatonin (21.2 +/- 2.2 pmol/h, mean +/- SEM, N = 17). In the age group 40-44 years the excretion declined by 41% (p < 0.05). The second significant decline (35%, p < 0.05) took place between the age groups 50-54 years and 55-59 years. A declining trend as a function of age was also seen in morning serum melatonin. Serum FSH rose sharply to high levels before the age of 50 (p < 0.01) and remained at a high level thereafter. Urinary melatonin correlated negatively with serum FSH (r = -0.32, p < 0.05). In conclusion, the inverse changes in melatonin and FSH secretion during the perimenopausal years, with the sharpest decline in nocturnal excretion of melatonin far before menopause, suggest that melatonin may be permissively linked to the initiation of menopause.

Adult↗
PubMed1991

A new PstI restriction fragment length polymorphism (RFLP) of placental alkaline phosphatase. RFLP haplotypes and correlation with electrophoretic types.

A new PstI restriction fragment length polymorphism (RFLP) of placental alkaline phosphatase (PLAP) was discovered in a study of a Finnish population sample and designated PstI(b)1 or Pst(b)2 depending on the presence or absence of the cleavage site. The frequency of the PstI(b)2 allele was 0.24. This allele showed a positive (p = 3 x 10(-6) association with the electrophoretic allele 2(F) and a negative association (2 x 10(-7) with the electrophoretic allele 1(S). The previously described PstI RFLP [PstI(a)] was also found to be associated with electrophoretic types; the PstI(a)1 allele (presence of site) was associated with the electrophoretic type 2 (p = 0.023). Haplotype frequencies and disequilibria were calculated between PstI(a), PstI(b) and RsaI RFLPs. A complete disequilibrium (p = 1 x 10(-6) was found between PstI(a) and RsaI, whereas there was no significant disequilibrium between PstI(b) and RsaI. There was no strict correlation between the distances between the RFLP loci and the degree of linkage disequilibrium. The allele controlling the electrophoretic variant PLAP 18 (D) was found in polymorphic frequency (0.024) in the Finnish population.

Alkaline Phosphatase↗
PubMed1991

Serum melatonin during human pregnancy.

Serum melatonin concentrations from 55 pregnant healthy women (13 during the first, 18 during the second and 24 during the third trimester) and 11 non-pregnant control women were measured radioimmunologically at 11.00 h (Study A). In addition, serum melatonin concentrations from 12 women in early and 11 women in late pregnancy were measured every four hours throughout the day (Study B). Serum melatonin levels during the third trimester of pregnancy (76.5 +/- 38.3 pmol/l) were significantly (p less than 0.01) higher than those during the first (29.7 +/- 9.9 pmol/l) and the second trimester (39.1 +/- 11.2 pmol/l) and those of non-pregnant control women (41.7 +/- 15.5 pmol/l) and there was a positive correlation between the week of gestation and serum melatonin at 11.00 h (Study A). A clear diurnal rhythm in serum melatonin concentrations was found both in early and in late pregnancy (Study B). The amplitude and duration of the nocturnal rise of melatonin were higher during late pregnancy, but there was no clear phase shift. Increased serum concentration of melatonin in late pregnancy may be due to increased synthesis and secretion or retarded metabolism of melatonin during late pregnancy.

Circadian Rhythm↗
PubMed1990

Melatonin in infants and mothers at delivery and in infants during the first week of life.

To evaluate the possible effect of the extreme and permanent changes in the hormonal milieu and in the lighting conditions at birth on the pineal hormone, melatonin (MT), we measured maternal vein and umbilical artery concentrations of MT in 19 parturients, post-partum urinary concentrations of MT in 14 mothers and their infants, and daytime (0800-2000 h) and night-time (2000-0800 h) urinary concentrations of MT and 6-sulphatoxymelatonin in 22 infants during the first 8 days of life. The mean MT concentrations in maternal venous blood and umbilical arterial blood did not differ significantly from each other and there was a positive correlation between them. The same was true for postpartum urinary MT of the mothers and their infants. There was no diurnal rhythm of MT during the first week of life. MT excretion in neonates was 2-5 pmol/12 h (only 1-5% in comparison with adults) and that of 6-sulphatoxymelatonin 150-300 pmol/12 h. In reverse phase high pressure liquid chromatography (HPLC) studies, 84-100% of total MT immunoreactivity was eluted at the same position as synthetic MT, and a small amount of hydrophobic MT-like immunoreactive material was also detected in five of the 10 urine extracts studied. This material (perhaps a novel neonatal metabolite of MT) may be indicative of immaturity of neonatal metabolism of MT although 6-hydroxylation is also functional in neonates. Although infant MT immediately after delivery at least partly reflects maternal MT secretion, our results show that the pineal gland is capable of producing MT at this time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Does ephedrine influence newborn neurobehavioural responses and spectral EEG when used to prevent maternal hypotension during caesarean section?

The recovery of 16 infants born by elective caesarean section with spinal anaesthesia, in which either ephedrine or fluid load was used to prevent maternal hypotension, were studied using Scanlon's neurobehavioural tests and a computerized EEG. Neurobehavioural testing showed no differences between the ephedrine and the non-ephedrine groups of infants at ages of 3 h, 1 day, 2 days and 4-5 days, whereas the spectral EEG showed significant differences between the two groups during the first 2 h after delivery, which had disappeared 24 h later. It is suggested that small doses of ephedrine given to the mother i.v. to prevent hypotension during spinal anaesthesia have short-lived effects on the neonate's central nervous system, which will be detected in the spectral EEG, but not in neurobehavioural tests.

Adult↗
PubMed1989

Serum and amniotic fluid melatonin during human labor.

The serum and amniotic fluid concentrations of melatonin (MT) were measured by RIA during human labor in different conditions related to the type of delivery and the time of the day of delivery. Serum MT concentrations displayed a normal diurnal rhythm, resembling that of nongravid women; the mean concentration [163.8 +/- 149.6 (+/- SD) pmol/L] at night was significantly (P less than 0.001) higher than that during the day (31.4 +/- 16.3 pmol/L). The amniotic fluid MT concentration, which showed a significant positive correlation to the serum MT concentration (r = 0.625; P less than 0.01), also showed an obvious diurnal rhythm; the mean MT concentration was significantly (P less than 0.01) higher during the night [99.3 +/- 59.3 (+/- SD) pmol/L] than during the day (58.9 +/- 33.5 pmol/L). Reverse phase high pressure liquid chromatography confirmed that the amniotic fluid MT immunoreactivity eluated as synthetic MT. During the night the mean amniotic fluid MT concentration [99.3 +/- 59.3 (+/- SD) pmol/L] was significantly (P less than 0.01) lower than that in serum (178.9 +/- 189.6 pmol/L). The progress of delivery, estimated by cervical dilatation, did not affect serum MT concentrations. Induction of delivery by amniotomy and/or oxytocin, and operative delivery by cesarean section had no effect on serum MT concentrations. Human MT secretion does not seem to be influenced by the physical stress of labor or endocrine changes associated with parturition. The single factor regulating MT secretion during human delivery appears to be the time of day.

Adult↗
PubMed1988

Seasonal, menstrual and circadian secretions of melatonin, gonadotropins and prolactin in women.

In order to evaluate the role of the pineal gland in human reproduction, day- and night-time concentrations of serum melatonin, FSH, LH and prolactin were measured by radioimmunoassays on various days of the menstrual cycle during summer (average daylight 22 h) and winter (daylight 5 h) in healthy females (n = 12) from northern Finland (65 degrees N). A multifactorial analysis of variance showed that, in addition to the well-established increases of gonadotropins at midcycle and melatonin and prolactin at night, there was a significant effect of season on the serum levels of melatonin and LH. Night-time serum melatonin levels on cycle days 2 and 10 were 27% and 49% (P less than 0.05 and less than 0.01) higher in winter than in summer. Night-time serum LH levels at midcycle were 76% (P less than 0.05) higher in summer than in winter. There were no significant effects of season on the serum levels of FSH, prolactin, day-time melatonin or LH outside the mid-cycle. Neither were there any significant effects of the day of the menstrual cycle on the serum melatonin levels. It is possible that in winter the high levels of melatonin in the follicular phase have an inhibitory effect on the serum LH levels. In summer the melatonin levels are lower and perhaps less inhibitory on the secretion of LH, resulting in the stimulation of the reproductive competence in human females.

Adult↗
PubMed1987

Inverse seasonal relationship between melatonin and ovarian activity in humans in a region with a strong seasonal contrast in luminosity.

The effects of season on the activity of the pituitary-ovarian axis and the pineal gland were studied in 11 women by serum and urinary melatonin determinations and in 21 women by measurements of the serum concentrations of anterior pituitary and ovarian hormones during the dark and light seasons. A melatonin index was determined by integration of the area below the curve of serum melatonin concentrations during 24-h periods in both seasons. During the dark season, the daytime 12-h melatonin index and daytime urinary melatonin excretion were significantly higher than during the light season. In addition, the duration of the nocturnal melatonin pulse (serum melatonin levels, greater than 65 pmol/L) was lengthened during this season, whereas the mean serum estradiol concentration was significantly decreased at the time of ovulation and during the luteal phase of the cycle, indicating lowered ovarian activity. Luteal phase gonadotropin concentrations were increased during the dark season, which was also characterized by increased sex hormone-binding globulin (SHBG) and decreased free testosterone concentrations and free androgen indices (ratio of testosterone to SHBG X 700) throughout the menstrual cycle. The dark season was thus characterized by increased melatonin secretion and decreased ovarian and androgenic activities. In summary, we characterized two season-dependent hormonal phenomena. Although we did not prove any cause and effect association between melatonin and anterior pituitary-ovarian hormones, the inverse seasonal relationship in pineal gland and ovarian secretion suggests that melatonin is causally related to reproduction in humans.

Adult↗
PubMed1980

Serum progesterone, estradiol, and estriol before and during induced labor.

To investigate the association of serum levels of progesterone (P), estradiol (E2), and estriol (E3) with the initiation of regular contractions, venous blood samples were taken prior to and 3 hours after the successful induction of labor in 83 parturients by means of low amniotomy and intravenous oxytocin infusion. The serum P level and P/E2 ratio decreased and serum E2 level increased after induction in healthy primigravidas and in parturients with an initial P dominance (serum P/E2 ratio more than 5). There was also a decrease in the serum P level and P/E2 ratio in postterm patients and parturients with a ripe cervical state. Cholestasis of pregnancy was associated with a rise in the serum level of E2 and a decrease in the P/E2 ratio. In an unfavorable cervical state there was a rise in the serum E2 level; patients with an initial E2 dominance (serum P/E2 ratio 5 or less) showed a rise in the serum P level and P/E2 ratio. Healthy multigravidas and patients with pre-eclampsia did not show any hormonal changes. The onset of induced labor seems to be associated with a rise in serum E2 concentration and/or with a drop in P concentration. The increase in serum E2 level is thought to be due to the activation of the anterior pituitary--adrenal axis. The lower P level is supposedly a result of diminished uteroplacental circulation.

Cervix Uteri↗
PubMedDate not supplied

Ethnic differences in enzyme and DNA polymorphisms of human tissue-specific alkaline phosphatases.

Enzyme and DNA polymorphisms and haplotypes of tissue-specific alkaline phosphatase genes were studied in Finns, Saamis and Swedes. In placental alkaline phosphatase (PLAP) restriction fragment length polymorphisms (RFLPs), found after digestion with RsaI and PstI, no significant population differences were observed. The PstI RFLP of the germ cell alkaline phosphatase (GCAP) locus showed significant allele frequency variations between Finns and Swedes (p = 0.014) and between Saamis and Swedes (p = 1 x 10(-4)). Electrophoretic enzyme variants of PLAP were studied in Finns and Swedes. The PLAP variant 18 (D in older nomenclature) was found at a polymorphic frequency in the Finnish sample. In all populations, strong linkage disequilibria were found between the RFLPs and between RFLPs and electrophoretic PLAP types. There was, however, one notable exception: between the RsaI RFLP of PLAP and the PstI RFLP of GCAP no linkage disequilibrium was found. Two new RFLPs were observed in the Finnish population sample, a RsaI mutant site in PLAP with a frequency of 0.02 and a KpnI mutant site outside and upstream of the PLAP gene with a frequency of 0.036. In accordance with findings in previous studies at the enzyme level, PLAP also appeared to be more polymorphic than GCAP and intestinal alkaline phosphatase at the DNA level.

Alkaline Phosphatase↗
PubMedDate not supplied

Is p53 polymorphism maintained by natural selection?

We present here a new interesting feature of the human tumor suppressor gene p53: a very pronounced ethnic and clinal variation of polymorphic codon 72 alleles. The frequency of the A1 (Pro) allele showed a north-south cline from 17% in Swedish Saamis to 63% in African Blacks (Nigerians), and there was a significant (p < 0.001) correlation (r = 0.95) between the A2 frequency and latitude. In the Finnish and Swedish populations no significant differences were found with respect to the genotype and allele distributions in spontaneously aborted fetuses and liveborn children, which makes differential intrauterine selection unlikely. However, the ethnic and clinal variations suggest that the codon 72 polymorphism is balanced and maintained by natural selection.

Alleles↗