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J Tölli

Publications and source records attributed to J Tölli.

16 recordsLinked to original sources
PubMed2004

Effect of carcinomatosis and intraperitoneal 5-fluorouracil on peritoneal blood flow modulated by vasopressin in the rat as measured with the 133Xe-clearance technique.

PURPOSE: Intraperitoneal administration of 5-fluorouracil for the treatment of gastrointestinal malignancies results in a greater total drug exposure in the peritoneal fluid than in plasma. Drugs are eliminated from the peritoneal cavity mainly by capillaries leading to the portal venous system and to a lesser extent by lymphatics. The drug itself and the presence of peritoneal carcinomatosis may affect elimination of the drug. The 133Xe-clearance technique allows the influence of a vasoactive agent on the peritoneal blood flow to be estimated with minimal invasiveness. The aim of the present study was to explore whether intraperitoneal 5-FU or peritoneal carcinomatosis affects the peritoneal blood flow and its reactivity to intravenous vasopressin, as measured indirectly with the 133Xe-clearance technique. METHODS: The animals used in this study were 63 Wistar-Fu (W-Fu) rats and 67 Lister-Hooded (LH) rats. On day 0, either 5-FU at 25 mg/kg body weight in 25 ml/kg isotonic saline was instilled intraperitoneally, or 1 x 10(5) syngeneic tumour cells were inoculated intraperitoneally. On days 1, 2 and 3 in the 5-FU-treated rats, and on days 12-16 in rats inoculated with tumour cells, peritoneal blood flow was analysed with the 133Xe-clearance technique, before and during intravenous infusion of vasopressin at 0.07 IU/min/kg body weight. RESULTS: The basal 133Xe-clearance before administration of vasopressin was similar in all groups except in the LH rats treated with 5-FU in which it was significantly lower. Infusion of vasopressin induced a significant decrease in 133Xe-clearance of the same magnitude in controls and in tumour-bearing rats. In the rats given intraperitoneal 5-FU, vasopressin did not reduce the 133Xe-clearance the first day after administration of 5-FU. CONCLUSIONS: Intravenous vasopressin at 0.07 IU/min/kg decreased peritoneal blood flow as measured indirectly with the 133Xe-clearance method. Intraperitoneal 5-FU abrogated the reduction in peritoneal blood flow with intravenous vasopressin the first day after treatment. In contrast, the presence of peritoneal carcinomatosis did not influence peritoneal blood flow, nor the effect of vasopressin

Animals↗
PubMed2000

Loss of total body potassium during rapid weight loss does not depend on the decrease of potassium concentration in muscles. Different methods to evaluate body composition during a low energy diet.

OBJECTIVE: The aim of the study was to elucidate whether combustion of skeletal muscle glycogen during a very low calorie diet (VLCD) was associated with decreased muscle potassium content. A comparison between different methods was also performed to evaluate body composition during a VLCD and a low calorie diet (LCD). DESIGN: Dietary treatment of obese women by VLCD and LCD. Measurements after 1 and 2 weeks of VLCD and 6 months of LCD. SUBJECTS: Fifteen perimenopausal obese women aged 46.5+/-1.3 y and 15 of 48.0+/-0.7 y of age. MEASUREMENTS: Skeletal muscle biopsies under local anaesthesia. Body composition measurements by means of deal-energy X-ray absorptiometry (DEXA), and measurements of total body potassium (40K) and total body nitrogen (TBN). Measurements of electrolytes and glycogen concentration in muscle samples. RESULTS: In the first study (1 week of VLCD) skeletal muscle glycogen decreased (P<0.01), but muscle potassium increased (P<0.01). Muscle sodium decreased (P<0.01), while muscle magnesium was unaltered. Body weight decreased by 2.9+/-0.5 kg and 40K decreased. Fat-free mass (FFM) calculated from 40K and DEXA decreased by 2.7 vs 1.9 kg (P<0.001). Body fat measured with DEXA decreased by 1.1 kg (P<0.01), but not body fat calculated from 40K. TBN decreased by 0.03+/-0.01 kg (P<0.05) and FFM calculated from TBN by 2.9+/-0.5 kg (P<0.002). In the second study, 6 months on the LCD resulted in 17.0+/-2.0 kg weight reduction and this was mainly due to reduced body fat, 14. 0+/-2.0 kg measured with DEXA and from 40K (P<0.001). The decrease in FFM was slight. CONCLUSION: One week of VLCD resulted in muscle glycogen depletion but increased muscle potassium content in spite of decreased total body potassium. FFM contributed to the main part of body weight loss during short periods of severe energy restriction, but remained unchanged during long-term dietary treatment. Body fat became mostly responsible for the body weight loss during long-term LCD. Calculations of changes of FFM from 40K and TBN seem to overestimate the FFM decrease associated with short-term VLCD. International Journal of Obesity (2000)24, 101-107

Absorptiometry, Photon↗
PubMed1996

Comparison of methods to estimate body fat in growth hormone deficient adults.

OBJECTIVE: All of the presently used methods for in-vivo determination of body composition have inherent methodological errors and depend on various assumptions. We have therefore compared several different methods used to measure body fat in adult GH deficiency during GH treatment. DESIGN: Comparison of body composition data from a two-phase trial with an initial placebo-controlled, double-blind 6-month period, followed by open treatment with GH until all patients had received GH for 12 months. PATIENTS: Twenty-five patients with known GH deficiency entered the study. Baseline examinations were complete in 23 patients, and 22 patients (16 males, 6 females) completed all examinations after treatment. MEASUREMENTS: Body fat calculated from total body potassium (TBK) by whole-body 40K counting, total body water (TBW) by tritium dilution, total body nitrogen (TBN) by neutron activation, and bioelectric impedance (BIA) measurements were compared to body fat determinations by dual-energy X-ray absorptiometry (DEXA) in two-compartment and multicompartment body composition models. RESULTS: At baseline, DEXA fat mass agreed well at group level with measurements based on TBW or TBK alone, in a four-compartment model based on TBK and TBW, and a multicompartment model based on bone mineral (by DEXA), TBN and TBW. Body fat by BIA agreed less well. After 12 months of GH treatment, body fat decreased by all methods used. This decrease was smaller by DEXA than by the other methods. The four-compartment model based on TBK and TBW, and TBW alone, showed the best agreement with changes in DEXA fat. CONCLUSION: All methods showed a decrease of body fat with GH treatment, but variation between methods was considerable.

Absorptiometry, Photon↗
PubMed1995

Exercise capacity in patients undergoing proctocolectomy and small bowel resection for Crohn's disease.

The effect of proctocolectomy and small bowel resection on working capacity has not been assessed objectively in previous research. Twenty-nine patients with Crohn's disease were investigated with cycle ergometry and a questionnaire, following proctocolectomy with and without small bowel resection. Maximal exercise load is known to correspond well with working capacity, particularly when account is taken of body composition and metabolic variables. Maximal exercise load was reduced marginally (by 9 per cent) in patients without small bowel resection and by 22 per cent in patients with moderate small bowel resection (15-30 per cent resection). Patients with extensive bowel resection (more than 50 per cent) had a 40 per cent reduction in the maximal exercise load. This reduction in maximal exercise load was greater than predicted when accounting for reduction in muscle mass. All patients had a normal oxygen uptake including resting energy expenditure. Urinary sodium and magnesium excretion was low in the group with moderate bowel resection, whereas the extensively resected patients were malnourished and had a reduced body cell mass. The authors conclude that the significantly reduced working capacity was of multifactorial origin secondary to malabsorption. However, the patients seemed unaware of the degree of their diminished working capacity. This reduced capacity makes it unlikely that they would be able to perform any labour involving high energy consumption at the level of 500-700 W, and this inability was reflected by a high rate of unemployment among the patients.

Adult↗
PubMed1995

Effects of recombinant human growth hormone on basal metabolic rate in adults with pituitary deficiency.

The effect of recombinant human growth hormone (rhGH) on basal metabolic rate (BMR) was studied in a placebo-controlled, double-blind, crossover trial. Ten patients with a history of complete pituitary insufficiency were randomized for 26 weeks in each period. Three patients were excluded due to withdrawal, fever, and claustrophobia, respectively. All patients had received adrenal, thyroid, and gonadal substitution therapy for at least 1 year before the study. The dose of rhGH was 0.25 to 0.5 U/kg/wk, administered subcutaneously once a day in the evening. BMR was determined by indirect calorimetry in a computerized ventilated open-hood system. Body composition was examined using four different methods--computed tomography (CT), tritium dilution, 40K determinations, and total body nitrogen (TBN) measured with neutron activation. The body composition data have previously been reported. Fat-free mass (FFM) increased and body fat (BF) decreased during the first 6 weeks of rhGH treatment, but no further changes in body composition occurred between 6 and 26 weeks. Baseline BMRs in GH-deficient (GHD) patients were in the lower part of the reference range, but BMR and the ratio between BMR and FFM (BMR/FFM) were not significantly lower than in a carefully selected control group. BMR increased between 0 and 6 weeks (mean +/- SD: from 6.68 +/- 1.55 to 7.75 +/- 1.35 MJ/24 h, P < .001) and then remained unchanged between 6 and 26 weeks. The increase in BMR was closely related to the increase in FFM (r = .91, P < .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Absorption, gastrointestinal transit, and tablet erosion of felodipine extended-release (ER) tablets.

The gastrointestinal transit and tablet erosion of felodipine extended release (ER) tablets 10 mg were studied by gamma scintigraphy in eight healthy young males after administration under fasting and nonfasting conditions. Plasma concentrations of felodipine were also measured. Gastric emptying after administration together with food (mean, 3.2 hr) was slower in all subjects compared to emptying under fasting conditions (mean, 0.6 hr). The mean small intestinal transit times for the two study conditions did not differ significantly (5.1 and 4.7 hr, respectively). Tablets did not leave the colon in any subject within 14 hr after administration. Felodipine was shown to be absorbed in the colon, although the major part of the dose was absorbed in the small intestine. The absorption rate of felodipine was related to erosion of the hydrophilic matrix tablet. Tablet erosion and hence drug absorption were slower in the more distal parts of the gastrointestinal tract. Administration together with food did not significantly affect tablet erosion.

Adult↗
PubMed1993

Increased body fat mass and decreased extracellular fluid volume in adults with growth hormone deficiency.

OBJECTIVE: Growth hormone deficiency in adults with hypopituitarism has previously received little attention. Recent data, however, suggest that GH deficiency might be essential for the long-term prognosis of these patients. Earlier studies have documented that GH regulates body composition; in this, body composition in adult patients with hypopituitarism including GH deficiency was studied. DESIGN: A follow-up study of patients with hypopituitarism on routine replacement therapy with L-thyroxine, cortisone acetate and sex steroids. PATIENTS: One hundred and six patients (69 males, mean age 52.5 years and 37 females, mean age 53.4 years) diagnosed as having growth hormone deficiency on the basis of low IGF-I concentration or a maximum GH-response less than 5 mU/l after an insulin/glucagon tolerance test. MEASUREMENTS: Body composition was estimated from body weight, total body water and total body potassium and the results were compared with values predicted from height, weight, age and sex, using data from a large number of healthy subjects. RESULTS: The total body water was significantly lower than that predicted from the observed body weight (P < 0.001), as was the extracellular water (P < 0.001) and the extracellular/intracellular water quotient (P < 0.001). On average, the body cell mass was similar to the predicted value, but the observed/predicted body cell mass ratio correlated positively with age at follow-up. The body cell mass was lower than predicted in subjects below the age of 50 years (P < 0.01). The body fat was higher than predicted (P < 0.001); the increases was also noted in lean subjects. The observed body weight in male subjects was 7.5 kg higher (P < 0.001) than that predicted from healthy subjects of the same body height, a difference explained by an average increase of 6.6 kg in the body fat (P < 0.001) and 1.6 kg in the body cell mass, with a simultaneous reduction of 0.7 kg in the extracellular water (NS). Male patients suffering from untreated androgen deficiency had lower body cell mass than those on androgen treatment. Female subjects weighed 3.6 kg (NS) more on average than healthy women, a difference explained by an increase in the body fat of 6.0 kg (P < 0.001) with a simultaneous decrease of 2.4 kg in the extracellular water (P < 0.001). The body cell mass was similar to that seen in the controls. CONCLUSIONS: Adult patients with growth hormone deficiency have an increased body weight compared to normals of the same age, sex and height, due to an increment of the body fat with a simultaneous reduction in the total body water.

Adolescent↗
PubMed1993

Treatment of adults with growth hormone (GH) deficiency with recombinant human GH.

In a double blind, cross-over placebo-controlled trial, we studied the effects of 26 weeks of replacement therapy with recombinant human GH on body composition, metabolic parameters, and well-being in 10 patients with adult-onset GH deficiency (GHD). All patients received appropriate thyroid, adrenal, and gonadal replacement therapy. The dose of recombinant human GH was 0.25-0.5 U/kg.week (0.013-0.026 mg/kg.day) and was administered sc daily at bedtime. One patient was withdrawn from the study because of edema and atrial fibrillation. Body composition was estimated with three independent methods: computed tomography, bioelectric impedance, and total body potassium combined with total body water assessments. The Comprehensive Psychological Rating Scale and the Symptom Check List-90 were used to assess any change in psychopathology. After 26 weeks of treatment, adipose tissue (AT) mass decreased 4.7 kg (P < 0.001). Subcutaneous AT decreased by an average of 13%, whereas visceral AT was reduced by 30%. Muscle volume increased by 2.5 kg (5%; P < 0.05). According to the four-compartment model derived from assessments of total body potassium and total body water, body cell mass and extracellular fluid volume increased significantly by 1.6 and 3.0 kg, whereas body fat decreased by 6.1 kg. Results obtained by the bioelectric impedance technique were similar. The mean (+/- SD) concentrations of insulin-like growth factor-I increased from 0.26 (0.06) at baseline to 2.56 (1.55) and 2.09 (1.03) kU/L after 6 and 26 weeks of treatment. Calcium and serum phosphate, osteocalcin, and procollagen-III concentrations were significantly higher, and intact PTH concentrations were reduced after 6 and 26 weeks of treatment, respectively. Total and free T3 concentrations were significantly increased after 6 and 26 weeks of treatment, whereas free T4 concentrations were reduced at 6 weeks, but after 26 weeks, free T4 concentrations had returned to pretreatment values. Finally, after 26 weeks of treatment, there was a decrease in the Comprehensive Psychological Rating Scale score (P < 0.05). The results show that GH replacement in GHD adults results in marked alterations in body composition, fat distribution, and bone and mineral metabolism and reduces psychiatric symptoms. Finally, we conclude that the observed beneficial effects of replacement therapy with GH are of sufficient magnitude to consider treatment of GHD adults.

Adipose Tissue↗
PubMed1991

A small dose of soluble alginate-fiber affects postprandial glycemia and gastric emptying in humans with diabetes.

Seven men with well-controlled, noninsulin-dependent (type 2) diabetes ingested on two different mornings, in random order, meals with or without a 5.0-g sodium alginate supplement (algae-isolate, 75% soluble fiber). The meals contained similar amounts of digestible carbohydrates, fat and protein. The gastric emptying rate of the meal containing sodium alginate, measured by detection of 51Cr mixed into the meals, was significantly slower than that of the fiber-free meal. Sodium alginate also induced significantly lower postprandial rises in blood glucose, serum insulin and plasma C-peptide. The diminished glucose response after the addition of sodium alginate could be correlated to the delayed gastric emptying rate induced by the fiber (rs = 0.92, P less than 0.01).

Adult↗
PubMed1991

The effect on body composition and exercise performance of home parenteral nutrition when given as adjunct to chemotherapy of testicular carcinoma.

This study has evaluated whether long-term and permanent total parenteral nutrition (TPN) can protect body composition and exercise capacity during iterated courses of chemotherapy (PVB) in men with testicular carcinoma. Thirty-three men were randomly allocated by means of a computer based algorithm to receive either TPN (at hospital and home) during the entire chemotherapy period or to rely on spontaneous oral intake only. Nutrition status was assessed by measurements of whole body nitrogen (neutron activation), total body potassium, body water, urine creatinine excretion, loco-regional body nutrition indexes (AMC, TSF) and biochemical plasma concentrations (albumin, thyroid hormones). Whole body respiratory gas exchanges were measured during resting, submaximal and maximal exercise. TPN was prescribed on an individual basis in all study patients to cover 150% of their measured caloric need; nitrogen was given as 0.2 g N kg-1 day. All individuals were allowed to eat freely throughout the study. TPN patients were in overall positive energy balance (+850 Kcal day-1), while the control group was in negative balance (-532 Kcal day-1). This led to weight gain in the TPN group (+2.2 +/- 1.0 kg) while the control group lost significant weight (-4.2 +/- 1.1 kg). The average spontaneous oral caloric intake was 1014 +/- 153 Kcal day-1 in the TPN group and 1484 +/- 200 Kcal day-1 in the control group; total protein intake corresponded to 1.5 g protein kg day-1 in the TPN group and 0.7 kg day-1 in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Experiences in the field of elemental analysis in vivo.

In this paper some radioanalytical methods will be described for assessing the contents of various elements in the human body. In vivo methods are necessary for this problem. Protein content can be estimated by means of in vivo measurements of nitrogen, bone minerals by means of the total body content of calcium. Fat contains a high concentration of carbon. Carbon in fat can be estimated and from this the total body fat can be calculated. Toxic elements such as lead, cadmium and mercury are assessed by in vivo measurements, both related to occupationally exposed workers and to members of the public.

Body Composition↗
PubMed1989

Gastric emptying and glycemic response after ingestion of mashed bean or potato flakes in composite meals.

Two meals of mashed-bean or potato flakes and meat were served in random order to six healthy male subjects to determine effects on gastric emptying and glycemic reactions. The meals had comparable physical appearance and contained similar amounts of digestible carbohydrate, fat, and protein. No difference in gastric emptying, recorded by gamma camera after mixing 51Cr with the meals, was found between the meals. The bean-flakes meal gave significantly lower blood glucose (p less than 0.01) and serum insulin (p less than 0.05) concentrations than did the potato-flakes meal. The overall blood glucose response, calculated as incremental area under the curves for 2 h, also differed between the meals (p less than 0.05) whereas the overall insulin response did not differ significantly. The low glycemic response after bean flakes could not be explained by the gastric emptying rate, which provides additional evidence for the slow digestion of bean starch in the small intestine.

Adult↗
PubMedDate not supplied

A comparison of different methods to measure body composition in patients.

A comparison of different methods to measure body composition in growth hormone deficient patients is presented. The technical limitations of the available methods are discussed. The techniques used to measure body composition and fat free mass has been by total body water, total body potassium, dual energy X-ray absorptiometry, bioelectrical impedance and total body nitrogen.

Absorptiometry, Photon↗
PubMedDate not supplied

Blood flow in liver tumors--effects of vasoactive drugs estimated with xenon (133Xe) clearance.

BACKGROUND/AIMS: The aim of the present study was to identify in a standardized experimental rat liver tumor system the drugs which are most appropriate in influencing the relationship between liver tumor and normal liver parenchyma blood flow as estimated with 133Xe washout clearance method, and thereby positively influencing the kinetics of chemotherapeutic drugs. A battery of vasoactive drugs, which according to a literature review were considered to be active, were tested. METHODOLOGY: Twelve drugs were administered intravenously on 113 Wistar-Fu rats with an experimental adenocarcinoma in the liver (weight 0.62 g). 133Xe was applied in the tumor and in normal parenchyma with and without administration of a vasoactive drug. The pulses were registered with a NaI (Tl)-scintillation detector connected to a multichannel analyzer. The disappearance rate of the isotope was calculated according to a single compartment model. Four recordings were performed in each rat randomly in tumor and liver parenchyma with and without a drug (series A) and one series twice in tumor and twice in parenchyma with a drug (series B). RESULTS: In unaffected animals the tumor to liver quotient was 0.57+/-0.35. This quotient was higher in tumors less than 0.53 g. Angiotensin-II 8 mg i.v. increased the quotient to 0.95+/-0.20. No other drug significantly influenced the quotient. CONCLUSIONS: In an experimental adenocarcinoma in the liver this study has investigated the possibility of increasing the tumor to normal liver parenchyma blood flow quotient by a variety of vasoactive substances for the beneficial modification of tumor blood flow. Angiotensin II 8 mg i.v. was the only drug, which increased the quotient. None of the other tested drugs were supporting previous presented results on influencing tumor blood flow.

Animals↗
PubMedDate not supplied

133Xe clearance estimates the effect of vasopressin on peritoneal blood flow in rats.

BACKGROUND/AIMS: When assessing the peritoneal microcirculation with invasive methods, interference with the mechanisms of vaso-regulation may occur. The 133Xe clearance technique renders the possibility, by minimal invasiveness, to estimate the influence of a vasoactive agent on the peritoneal microcirculation. METHODOLOGY: Ten to 15MBq of 133Xe were injected in the abdominal cavity in thirty-eight Wistar-FU (W-FU) rats and 35 Lister-Hooded (LH) rats. A NaI (Tl)-scintillation detector registered activity before and during vasopressin infusion. Gamma camera imaging confirmed the washout from the abdominal cavity. The laser Doppler flowmetry technique was used as a comparison. RESULTS: Vasopressin at 0.07 IU/kg/min IV significantly reduced 133Xe-clearance by 37% (p = 0.029) and 52% (p=0.036) and laser Doppler flowmetry by 69% (p=0.0019) and 44% (p=0.0039) in W-FU and LH rats, respectively. A linear correlation between dose of vasopressin and relative decrease in 133Xe clearance was demonstrated in the W-FU rat model (r2=0.98, p=0.023). The 133Xe clearance from the abdominal cavity in rat using a single-compartment model or the slow compartment in a double-compartment model gave reproducible information. CONCLUSIONS: The usefulness of this mini-invasive technique for sequential measurements before and during intervention will render the 133Xe clearance suitable for assessment of blood flow changes in the abdominal cavity.

Animals↗