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Biomedical subjects

A Koskimies

Publications and source records attributed to A Koskimies.

At least 19 recordsLinked to original sources
PubMed1996

The utilization rate and pregnancy outcome of multifetal pregnancy reduction in the Nordic countries.

OBJECTIVE: To review the utilization rate and pregnancy outcome of multifetal pregnancy reductions (MFR) in the Nordic countries during the period January 1986-June 1992. STUDY DESIGN: All centers offering assisted conception in Denmark, Finland, Norway and Sweden were retrospectively surveyed by means of a questionnaire with regard to the number and methods used for MFR, pregnancy loss and the outcomes of the pregnancies. The response rate was 100%. RESULTS: During the period studied, 185 births of triplets or higher multiples occurred in Sweden, 120 in Finland and 102 in Denmark. MFR was performed in 42 women (Sweden 26, Finland 10, Denmark 6) but not in Norway at all. This gives an estimated average utilization rate of 1/7 multiple births of three or more in Sweden, 1/17 in Denmark and 1/12 in Finland. The most frequently used method was intracardiac or intrathoracic injection of a potassium chloride solution in gestational weeks 9-12. One pregnancy was reduced from seven to four fetuses, two from five to three, 10 from five to two, one from four to three, 17 from four to two, one from four to one, five from three to two, four from three to one and one from two to one. Nine (21%) pregnancies terminated in a spontaneous abortion within one week (n = 2) to several weeks (n = 7) after the procedure. Of the remaining 33 (79%) pregnancies which continued to delivery, two fetuses died in utero in the second trimester, three infants died perinatally and one child had transverse limb reduction defects. A successful pregnancy defined by the discharge home of at least one infant occurred in 79% of the cases. CONCLUSION: This study gives national estimates on the utilization rate of MFR. Although MFR is performed more frequently in Sweden than in Denmark and Finland, the overall figures remain low in the Nordic countries. The incidence of pregnancy loss in this study is somewhat higher than in several larger reported series, probably reflecting the learning curve of the procedure. It seems reasonable that MFR should be performed in only a few centers in the Nordic countries.

Female↗
PubMed1991

Conservative treatment of ectopic pregnancy.

As a conservative nonsurgical treatment of an early ectopic pregnancy, local prostaglandin, parenteral or local methotrexate, local hyperosmolar glucose, and also expectant management have been used successfully in selected cases. The success rate of conservative treatment has been 71%-100% and that of tubal patency after different kinds of conservative treatment 72-93% of patients. In the present study of expectant management in early ectopic pregnancy in patients with decreasing serum hCG levels, spontaneous resolution was observed in 64.6% of patients and in the total series of 207 ectopic pregnancies in 15.0% of patients. Expectant management of early ectopic pregnancy is recommended when emergency surgery is not needed on admission and the serum hCG level is decreasing as noted in two consecutive estimations with an interval of 1-2 days.

Adnexa Uteri↗
PubMed1990

Testicular function after chemotherapy for osteosarcoma.

Testicular volume, sperm count and four hormones were measured in 18 patients 1-13 years after chemotherapy for osteosarcoma. The testicles were small in 13 patients. 17 patients gave semen samples: 10 were azoospermic and 2 were oligozoospermic. Testicular volume and sperm count were possibly associated with the type of chemotherapy. Of the 7 patients who had received cisplatin-containing chemotherapy, 6 had small testes and azoospermia; 1 was oligozoospermic with normal-sized testes. In 3 of the 11 patients whose chemotherapy had not included cisplatin, testicular size and sperm count were normal.

Adolescent↗
PubMed1989

Efficacy of gonadotropin-releasing hormone agonist (buserelin) in the treatment of endometriosis.

In a multicenter study, the efficacy of and tolerance of 6 months' intranasal gonadotropin-releasing hormone agonist (buserelin) treatment (300 micrograms x 3/day) on laparoscopically verified endometriosis was evaluated in 25 patients. At second-look laparoscopy at the end of medication, the mean endometriosis score had fallen by 82.2%. All endometriosis-associated symptoms and physical findings decreased or almost disappeared during buserelin administration. After discontinuing therapy, they showed a tendency to reappear, but nevertheless they were milder after one year of follow-up, than before treatment. Seven (54%) of the 13 women wishing pregnancy actually conceived. Vaginal irregular spotting bleedings during the first 2 months occurred in 7 patients. No patient withdrew from the trial because of side effects, although almost all women developed symptoms of estrogen deficiency (serum estradiol concentrations fell to menopausal levels).

Administration, Intranasal↗
PubMed1988

A short luteal phase in cycles stimulated with clomiphene and human menopausal gonadotropin for in vitro fertilization.

Of 70 cycles stimulated with clomiphene and human menopausal gonadotropin (hMG) for an in vitro fertilization-embryo transfer (IVF-ET) program, a short luteal phase of 11 days or less was found in 18. In this group the mean estradiol and progesterone levels were elevated in the early luteal phase. Despite the elevated initial values, progesterone levels fell rapidly at the mid luteal phase as a sign of premature luteolysis. The mean total amount of gonadotropin administered and the mean number of follicles punctured and of oocytes recovered did not show any significant difference between the groups of normal and short luteal phases. The present findings support the theory that hyperestrogenism in the early luteal phase may initiate the premature luteolysis observed in clomiphene-menopausal gonadotropin-stimulated cycles.

Clomiphene↗
PubMed1988

Choriogonadotropin and its beta subunit separated by hydrophobic-interaction chromatography and quantified in serum during pregnancy by time-resolved immunofluorometric assays.

Concentrations of human choriogonadotropin (hCG) and its free beta subunit (beta hCG) were measured in serum by highly sensitive and specific time-resolved immunofluorometric assays (IFMAS). The results were confirmed by completely separating beta hCG and hCG by a novel method based on hydrophobic-interaction chromatography. We used three monoclonal antibodies in two different combinations. In both assays an antibody reacting with both free beta hCG and with intact hCG was immobilized onto the wall of a microtiter strip well. For assay of intact hCG we used as the indicator antibody an antibody against the alpha subunit, labeled with a europium chelate. For assay of beta hCG we used an indicator antibody that reacted only with the free beta subunit. hCG cross-reacted in the assay of beta hCG by 0.6%. Quantifying hCG in serum after in vitro fertilization showed that, seven to eight days after embryo transfer, the hCG concentration started to increase, thereafter increasing with a doubling time of 1.9 days during the following three weeks. hCG concentrations in serum peaked six to 10 weeks later, corresponding to eight to 12 weeks after the last menstrual period. Throughout pregnancy, measurable amounts of beta hCG were present in serum. The highest beta hCG/hCG ratio (maximum 7.3%, median 3.0%) was observed during early gestation. During the fourth to 13th weeks after the last menstrual period the ratio of beta hCG/hCG decreased gradually, being 1.0% during the second and third trimesters.

Chorionic Gonadotropin↗
PubMed1987

Size heterogeneity of epidermal growth factor in human body fluids.

We measured the concentration of immunoreactive (IR) hEGF in various body fluids by radioimmunoassay (RIA) and evaluated its size heterogeneity by size exclusion high performance liquid chromatography combined with RIA or with time-resolved immunofluorometric assay (TR-IFMA). Mean concentration was 80 ng/ml in urine, 65 ng/ml in milk, 50 ng/ml in seminal plasma, 25 ng/ml in armpit sweat, 1 ng/ml in breast sweat, 0.3 ng/ml in third-trimester amniotic fluid, 3 ng/ml in saliva, 1.5 ng/ml in tears and 0.3 ng/ml in gastric juice. All the fluids except armpit sweat and gastric juice contained two to five molecular sizes of IR-hEGF. As well as the 6200-dalton (6.2 kDa) hEGF we found at least four other different molecular sizes with approximate weights of greater than or equal to 300, 150, 70 and 20 kDa. The authentic 6.2 kDa form made up greater than 90% of the total IR-hEGF in all except the amniotic fluid where its proportion was 71%, and the seminal plasma where the proportion could not be determined.

Amniotic Fluid↗
PubMed1986

In vitro recovery of human chorionic gonadotropin-stimulated cyclic adenosine 3',5'-monophosphate production in desensitized human granulosa-luteal cells.

Human granulosa-luteal cell production of cyclic adenosine 3',5'-monophosphate (cAMP) and progesterone (P) were studied in response to purified human chorionic gonadotropin (hCG) in cultured cells from hyperstimulated follicles of in vitro fertilized patients. The hCG injection given to the patients 36 hours before laparoscopy caused partial desensitization of adenylate cyclase of these cells to gonadotropins. Preincubation of the cells in hormone free medium for 2 to 3 days significantly increased their cAMP responsiveness to hCG. P production was stimulated initially by hCG and showed no desensitization. In the cells preincubated for 72 hours without hCG, a subsequent stimulus of 50 ng/ml of hCG elicited maximal cAMP response, whereas 1 ng/ml of hCG was sufficient to bring about maximal P secretion. Time-course studies indicated that maximal cAMP response to hCG was obtained in 1 to 3 hours. Both basal and hCG-stimulated P accumulation continued to rise for up to 24 hours. Preincubation of granulosa-luteal cells from hyperstimulated follicles improves the cells' cAMP responsiveness to hCG, whereas P response remains unaltered.

Chorionic Gonadotropin↗
PubMed1986

Activation of protein kinase-C stimulates human granulosa-luteal cell prostacyclin production.

To study the production of prostacyclin (PGI2) by human granulosa-luteal cells in vitro, individual follicles from clomiphene/human menopausal gonadotropin-stimulated cycles of patients undergoing in vitro fertilization were aspirated 36 h after the administration of hCG. Granulosa cells were isolated and cultured for 48 h to regain responsiveness to hCG. The cells were then recultured for 3 days in the presence of a protein kinase-C activator, 12-O-tetradecanoylphorbol-13-acetate (TPA), hCG, cholera toxin, and indomethacin. The media were assayed for 6-keto-prostaglandin F1 alpha (PGF1 alpha), a stable hydration product of PGI2. TPA increased granulosa cell PGI2 production 20-fold. The increase in PG synthesis was detectable at 12 h, was maximal at 72 h, and was prevented by indomethacin. The increase in PG production was specific to TPA and did not occur when an inactive phorbol ester, 4 alpha-phorbol-12,13-didecanoate, was used. hCG and cholera toxin stimulated granulosa cell cAMP production, but not PGI2 synthesis. Thus, human granulosa cells produce PGI2 by protein kinase-C-mediated mechanisms.

6-Ketoprostaglandin F1 alpha↗
PubMed1985

Distribution of placental protein 14 in tissues and body fluids during pregnancy.

Placental protein 14 (PP14) levels were measured in serum samples from non-pregnant and pregnant women, amniotic fluid, cord blood, and extracts of placenta, decidua and fetal membranes. The levels were low (15-40 micrograms/l) in serum of non-pregnant women. In four pregnancies following in-vitro fertilization, the serum PP14 levels started to rise 2-12 days after embryo replacement. In normal pregnancy, the highest serum PP14 concentrations (up to 2200 micrograms/l) were detected between 6 and 12 weeks. After 16 weeks the level decreased and plateaued at 24 weeks to around 200 micrograms/l. In amniotic fluid, the highest PP14 levels (232 mg/l) were found between 12 and 20 weeks, being considerably higher than those in maternal serum throughout pregnancy. In cord blood, the levels were low (15-22 micrograms/l) or undetectable. In early pregnancy decidua, the PP14 content was higher (41-160 mg/g total protein) than in late pregnancy decidua (60-2700 micrograms/g total protein). In amnion and chorion laeve, the PP14 concentration varied from 50 to 750 and 50 to 1000 micrograms/g protein, respectively. Early pregnancy placenta contained 0.25-15 mg/g and late pregnancy placenta 3-430 micrograms/g protein of PP14. These results show that the levels of PP14 in pregnancy serum have a similar profile to hCG, but in contrast to other placental proteins, the amniotic fluid PP14 levels are remarkably high. This may be explained by suggesting that decidua is a source of PP14.

Amniotic Fluid↗
PubMed1985

Monitoring the LH surge by ultrarapid and highly sensitive immunofluorometric assay.

A novel time-resolved immunofluorometric method is described for the estimation of human luteinizing hormone (LH) in serum and urine. The method utilizes two monoclonal antibodies: one reacting with the beta-subunit is adsorbed to the wall of a microtiter well, and the other is labeled with a fluorescent europium chelate and reacts with the alpha-subunit. The method is ultrarapid (15-30 min) and highly sensitive (1 IU/L). A large linear measuring range allows measurement of LH levels from 1 to 250 IU/L. For the monitoring of urinary LH, IFMA gives the same information as the Hi-Gonavis assay, but it has the advantages of greater sensitivity and a shorter assay time. For the determination of serum LH levels, an acceptable correlation was observed between radioimmunoassay and IFMA. Furthermore, IFMA has a greater sensitivity, and is more rapid and not dependent on the handling of radioactive materials.

Antibodies, Monoclonal↗
PubMed1984

Characterization of fibronectin on human spermatozoa.

Ejaculated human spermatozoa were shown to have fibronectin polypeptides on their surface. Immunofluorescence studies revealed fibronectin as a belt-like fluorescent band on the post-acrosomal area of sperm heads, whereas none was found in sperm tails. The location of the fluorescent band corresponded to the equatorial segment of the spermatozoon. Fibronectin polypeptides were heterogeneous with Mr ranging from 35000 to 210000, as revealed by immunoblotting and by immunoprecipitation of detergent extracts from surface-radioiodinated spermatozoa.

Electrophoresis, Polyacrylamide Gel↗
PubMed1984

Peritoneal fluid prostaglandins in endometriosis, tubal disorders, and unexplained infertility.

To elucidate the roles of prostaglandins in peritoneal fluid and sex steroids in patients with endometriosis (N = 29), tubal disorders (N = 15), and unexplained infertility (N = 13), assays were performed using 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) (a metabolite of prostacyclin), thromboxane B2 (a metabolite of thromboxane A2), estradiol, and progesterone. Women with normal pelvic anatomy (N = 25) served as controls. Peritoneal fluid 6-keto-PGF1 alpha concentrations in patients with endometriosis (742 +/- 104 pg/ml, mean +/- SE), tubal disorders (987 +/- 211 pg/ml), and unexplained infertility (1659 +/- 770 pg/ml) were higher than those in the control women (515 +/- 77 pg/ml). The thromboxane B2 levels in the peritoneal fluid in endometriosis (554 +/- 73 pg/ml), tubal disorders (614 +/- 107 pg/ml), and unexplained infertility (668 +/- 161 pg/ml) were higher than the levels in the control subjects (333 +/- 23 pg/ml). There was no relationship between 6-keto-PGF1 alpha/thromboxane B2 in peritoneal fluid and day of menstrual cycle. The concentrations of estradiol and progesterone were normal in all patient groups and were not related to the 6-keto-PGF1 alpha and thromboxane B2 levels. The authors suggest that these prostanoids, which may contribute to infertility, may originate mainly from the peritoneum as a result of irritation by endometriotic implants, tubal adhesions, and scarring.

Adult↗
PubMed1984

Detection and localization of placental protein 14-like protein in human seminal plasma and in the male genital tract.

The concentration of PP14 in seminal plasma was determined by radioimmunoassay. The levels were 13-362 mg/liter in normospermic specimens (n = 36), 10-252 mg/liter in samples from 46 infertile men (oligo-, astheno-, terato- or necrospermia), and 30-233 mg/liter in 7 vasectomized men. No significant difference was found in the PP14 levels in the groups examined. Low PP14 levels (13-25 micrograms/liter) were detected in male sera. In RIA, serial dilutions of seminal plasma and purified PP14 gave parallel dose-response curves. In tandem-crossed immunoelectrophoresis, seminal plasma PP14 showed a reaction of identity with PP14 purified from human term placenta. The isoelectric point of seminal plasma PP14 was 5.2-5.4 and that of early maternal serum PP14 was 4.8-4.9. In the normospermic group a moderate negative correlation (p less than 0.05) was found between the volume of seminal plasma and the PP14 level, whereas the correlation was positive (p less than 0.05) in the infertile group. There also was a negative correlation (p less than 0.05) between the percentage of motile spermatozoa and PP14 concentration. No correlation was observed between the sperm count or age of men and PP14 level in seminal plasma. The origin of seminal plasma PP14 is not from the testes, as the levels in vasectomized and nonvasectomized men were similar. By immunoperoxidase staining, PP14 was detected in the epithelium of seminal vesicles but not in the testis.

Adult↗