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Biomedical subjects

J Heikkilä

Publications and source records attributed to J Heikkilä.

At least 19 recordsLinked to original sources
PubMed1979

Systemic availability of ergotamine tartrate after oral, rectal and intramuscular administration.

Plasma ergotamine levels were measured in 33 volunteers (subgroups 11, 12 and 10) after a single dose of ergotamine administered by various routes. Ergotamine tartrate was given in doses normally used in the treatment of acute migraine--2.0 mg orally, 2.0 mg combined with 100 mg caffeine rectally and 0.5 mg i.m. Plasma ergotamine concentrations were determined by radioimmunoassay. The highest and longest lasting levels were found after i.m. administration, the peak concentration being 1.94 +/- 0.34 (SEM) ng/ml at 1/2 h. The corresponding maximum concentrations after oral and rectal administration were 0.36 +/- 0.08 ng/ml at 2 h and 0.42 +/- 0.09 ng/ml at 1 h. In most of the subjects the plasma ergotamine level began to rise again at 24 to 48 h. The cause of the elevation is not known but it might favour possible accumulation of the drug. Absorption from suppositories was at least as good as after oral administration and the former route may therefore be advantageous for migraine patients in whom nausea and vomiting during an attack may prevent efficient oral medication.

Administration, Oral↗
PubMed1979

Accuracy and usefulness of echoventriculography in acute myocardial infarction.

Echoventriculography is a noninvasive and three-dimensional ultrasonic technique capable to assess in detail the regional performance of the left ventricle. Therefore the mechanical performance of the left ventricle after myocardial infarction is informatively assessed by the composite contributions made by infarcted and noninfarcted segments. Its reliability has been confirmed by direct cineangiographic and autopsy correlations. In clinical decision making such direct information is of great value both for diagnosis and therapeutic selection. In the coronary care unit echoventriculography provides most information obtained by the less feasible invasive cineangiographic examinations.

Acute Disease↗
PubMed1979

Detached pacing electrode tip as a pulmonary embolus.

Forceful extraction of an Elema unipolar endocardial pacing electrode caused accidental detachment of the electrode tip. The tip migrated from the jugular vein into the central venous circulation and after some delay finally passes during the night into a pulmonary artery branch. Transient pleural irritation was the only sequel.

Cardiac Pacing, Artificial↗
PubMed1979

Microdosimetric measurements of ionization by some radioisotopes.

Microdosimetry has been a fast growing field in dosimetry during the last years. We have measured and calculated microdosimetric quantities which are important in correlation between the energy deposited in microscopic volumes and the biological effect. We have measured the energy distribution spectra in volumes with diameters of 1 and 2 mum and calculated the dose mean of specific energy and the mean event number per unit absorbed dose for the radioisotopes: 60Co, 137Cs, 99Tcm, 125J and the beta emitter 90Sr.

Cesium Radioisotopes↗
PubMed1978

Frequent users of doctor services in a small rural community.

Thirty-six per cent of the visits to doctors in a small rural community were made by the 6% of the population having the most diseases or symptoms. About 90% of the population accounted for about one-half of the medical services provided by the Kuusamo doctors; the other half was taken up by the 10% of the inhabitants in greatest need of medical attention. Adults consulted a doctor 2.1 times a year on the average. The most common reasons for consultations were respiratory diseases (23%), diseases of the genito-urinary system (16%) and accidents (14%).

Adult↗
PubMed1978

Failure of methylprednisolone to protect acutely ischemic myocardium: a contrast with subsequent beta-adrenergic blockade in man.

Two grams of methylprednisolone was administratered to ten patients with acute myocardial infarction at an average of 13 hours from the onset of symptoms; pain in the chest was not relieved in six of the ten patients. In one hour, no significant improvement was noted in the function of the ischemic segments (examined using a multiaxis echocardiographic method) or in the S-T segments of the 12-lead electrocardiogram. Left ventricular filling pressure soon increased by an average of 4 mm Hg (P less than 0.005), without ventricular dilatation or a Frank-Starling response, suggesting a decrease (ischemic?) in myocardial compliance. Cardiac output by Swan-Ganz thermodilution later increased by 21 percent (P less than 0.01) when a decrease in peripheral vasoconstriction was evident. In contrast, small-dose beta-adrenergic blockade using 0.2 mg of pindolol intravenously after administration of methylprednisolone immediately relieved pain in the chest in all six patients. Elevation of the S-T segments was reduced by 34 percent (P less than 0.05) within 15 minutes, and the contractile function of the ischemic segments improved markedly, by 3 mm or to 34 percent of normal, from the 4 percent of normal before administration of pindolol (P less than 0.005). Hemodynamic function did not deteriorate in the eight patients with uncomplicated infarction or moderate left ventricular failure. Therapy with pindolol thus reduced clinical, electrocardiographic, and myocardial mechanical signs of acute ischemia safely, while administration of methylprednisolone had no short-term protective effect.

Acute Disease↗
PubMed1978

Loss of apical left ventricular contraction after closed mitral valve surgery.

28 patients with advanced mitral valve restenosis were studied by cardiac catherization on an average of 7.2 years after previous closed mitral valvotomy, performed using the Tubbs dilator technique. Loss of left ventricular apical contraction was noted in 17 of 31 left ventricular cineangiograms. In the other regions, only 2 cases of local anterior wall akinesia and 1 of posterobasal akinesia was observed. The extent of akinesia was rather small: from 4 to 21%, a mean of 10.1% of the left ventricular circumference. Though ejection fractions remained 21% smaller in those with regional left ventricular dysfunction than in those with normal contraction (p less than 0.005), no other clinical haemodynamic consequences were found. The mechanical trauma caused by insertion of the dilator seems to result frequently in focal contraction abnormalities of the left ventricle, but these are of minor degree.

Adult↗
PubMed1978

Myocardial complications of immunisations.

Immunisation may induce myocardial complications. In this pilot study clinical, electrocardiographic, chemical and immunological findings have been studied during a six weeks' follow-up after routine immunisation (mumps, polio, tetanus, smallpox, diphtheria and type A meningococcal disease) among 234 Finnish conscripts at the beginning of their military service. Serial pattern of ECG changes suggestive of myocarditis was recorded in eight of the 234 conscripts one to two weeks after vaccination against smallpox and diphtheria. Changes were mainly minor ST segment elevations and T wave inversions and usually they disappeared in a few weeks. The ECG positives more often had a history of atopy, and their mean body temperatures and heart rates after the vaccinations were higher than among the other subjects (p less than 0.01). However, clinical myocarditis was never noted, nor were immunological or enzymological changes different among the ECG positives. Thus in 3% of the study population, evidence of postvaccinal myocarditis was noted, based on serial ECG patterns, but without any other evidence of cardiac disease.

Adult↗
PubMed1976

Echoventriculography in acute myocardial infarction. III. Clinical correlations and implication of the noninfarcted myocardium.

Echoventriculography permits detection of regional abnormalities of left ventricular wall motion in acute myocardial infarction. Overall and regional performance of the left ventricle was related to the prognosis and clinical severity of acute transmural myocardial infarction in 30 patients. Although values for left ventricular size, ejection fraction and modified mean circumferential fiber shortening velocity were all abnormal (P less than 0.005), they did not differ among 8 patients with uncomplicated infarction, 12 with moderate left ventricular failure and 10 with pulmonary edema or shock. In contrast, magnitude of the summed wall motion amplitudes from seven standards regions around the left ventricle decreased in parallel with ejection fraction (P less than 0.001) and with clinical severity of infarction (r = -0.79, P less than 0.001). Function of the healthy myocardium with hypercontractile in 40 percent of patients, but this occurred only in patients with uncomplicated or moderately severe infarction. In patients with severe pump failure the "uninvolved" myocardium did not manifest a hypercontractile or even normal response despite infusion of catecholamines (-21 percent; r = -0.76, P less than 0.001). Four nonsurviving patients had the poorest ventricular function (as low as 10 percent of normal) as assessed by several segmental echocardiographic performance indexes. Performance of the noninfarcted myocardium therefore seems to have a role in deterioration of left ventricular pump function in acute myocardial infarction

Adult↗
PubMed1976

Comparison of haemodynamic effects of pethidine and anileridine in patients with coronary-artery disease.

The circulatory effects of anileridine, a derivative of pethidine, have been little studied. Therefore we compared the haemodynamic effects of equianalgesic doses of pethidine (1 mg/kg i.v.) and anileridine (0.25 mg/kg) in matched patients requiring myocardial revascularization. Cardiac output was significantly increased 5 min after the administration of pethidine, mainly due to an increase in heart rate. A transient rise in the systolic pulmonary-arterial pressure was found after anileridine. No remarkable changes were found in systemic arterial pressures, central venous pressure, balloon-occluded pulmonary-arterial pressure, stoke volume, systemic or pulmonary vascular resistances and derived oxygen consumption. Further, 20 min after drug administration, there were no significant differences in any circulatory parameters between the two groups. One patient developed acute cardiac failure after anileridine, though as he had very severe coronary heart disease it remains an open question whether this was spontaneous or drug-induced. Since the rate-pressure product tended to increase after pethidine, this drug may not be considered an ideal analgesic for patients with ischaemic heart disease. Anileridine had less influence on this variable. Since the circulatory effects of pethidine seem to depend on the haemodynamic status of the patient, the haemodynamic properties of anileridine may also deserve further investigation.

Adult↗
PubMed1976

Echoventriculography in acute myocardial infarction. II: Monitoring of left ventricular performance.

In acute myocardial infarction the overall left ventricular pump function and the regional performance of the infarcted and non-infarcted myocardial segments were studied serially by echocardiographic techniques in 24 patients during the first week of their illness. Left ventricular cavity sizes were acutely increased in 62 per cent of the patients (P less than 0-005). The end-systolic diameter in anterior infarcts increased to the greatest extent, +44 per cent, the end-diastolic diameter by +27 per cent, giving a volume of 246+/-25 ml. In the anterior myocardial infarcts all the function parameters deteriorated more than in the posteroinferior ones. Ejection fraction was subnormal (P less than 0-005) in every patient, and mean circumferential fibre shortening (Vcf) was slowed by about 30 per cent (P less than 0-005). Regionally, contraction of the infarcted area of the ventricle was asynergic in every instance, and its function was almost totally lost (P less than 0-001). Systolic paradoxical motion was a constant and stable finding in the anterior infarctions but not so in the posterior ones. While this asynergic systolic contraction may distort echocardiographic measurement of the end-systolic left vlic phase. The serial deviations from normal in the amplitude or velocity of the uninvolved segments were small, but in the case of clearly enlarged end-diastolic volumes these figures in fact indicate supernormal, compensating function. Both overall and regional performance were worst within the first 3 days of infarction, improving thereafter. The patient with a fatal course showed, instead, progressive deterioration. This noninvasive left ventriculogram by ultrasound gives valuable insight into overall pump function and ventricular volumes, little studied so far in acute infarction, and it may serially quantify the segmental function of both the infarcted and uninvolved regions.

Acute Disease↗