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Biomedical subjects

M O Pulkkinen

Publications and source records attributed to M O Pulkkinen.

At least 37 records · Page 2Linked to original sources
PubMed1985

Acute urinary bladder tamponade with hypovolemic shock due to placenta percreta with bladder invasion. Case report.

A rare case with residual tissue of placenta previa invading posterior parts of the bladder as placenta percreta complicated by massive late hematuria with hypovolemic shock two months after gynecologic-obstetric operation is presented. The patient was finally treated by emergency bladder resection. If a grand multipara with a history of hysterotomies, such as cesarean sections, presents lower abdominal pain involving hematuria during pregnancy, placental invasion of the bladder may be suspected. The primary treatment by hysterectomy should be complemented by bladder resection. This placental type may have high steroidogenesis.

Acute Disease↗
PubMed1985

Induction of human labor at term: uterine activity, inducibility, duration and neonatal jaundice.

A total of 821 patients, 39-40 weeks pregnant, was obstetrically normal at admission. In 212 of them intra-uterine pressure (IUP) was monitored before and during inducing labor by oxytocin, in 212 patients delivery was also induced by oxytocin but not monitored, in 197 by combining oxytocin and amniotomy, and 200 had spontaneous delivery. Inducibility could be predicted by uterine baseline activity and a 50 mu i.v. shot of oxytocin, together with determination of cervical status and placental location. The duration of labour induction was affected by parity, placental location and cervical status, but was predicted only to a minor degree by baseline activity and uterine oxytocin sensitivity. Amniotomy did not affect caesarean, section rate. The newborn child benefited from IUP monitoring: fewer transfers to pediatrics were necessary, there was less neonatal jaundice and fewer blood exchanges. It is assumed that if labor is not monitored through IUP, oxytocin may cause neonatal hyperbilirubinaemia through episodes of increased uterine resting pressure.

Female↗
PubMed1984

Collagen types and fibronectin in the uterine muscle of normal and hypertensive pregnant patients.

Specimens from the uterine wall were obtained from 16 patients at 31 to 40 weeks of pregnancy: 10 underwent surgical procedures for a hypertensive disorder and six for abnormality of the birth canal or faulty presentation. Collagen types I, III, and V and fibronectin antibodies were used for immunohistologic studies. Collagen types I and V were located mainly around single cells, but type III and fibronectin were found mainly around cell bundles. Collagenous structures in the uterine muscle of patients with hypertensive disorder in pregnancy were torn. Abundant fibronectin fluorescence was detected in the lobuli within the disrupted tissue. Disruption of the uterine structure correlated with the amount of urinary protein excreted.

Adult↗
PubMed1984

Myoelectrical activity in the human oviduct with tubal pregnancy.

Myoelectrical activity and progesterone (P) and 17 beta-estradiol (E2) concentrations were measured in 12 human oviducts with tubal pregnancy. Spikes were frequently superimposed on a single, smooth, slow wave. The region above a large conceptus (P dominance) was inactive in eight of 10 oviducts. The myoelectrical activity spread toward these conceptuses from both sides, apparently holding the conceptus in place. In three cases with small placentas, the spread of weak activity tended to push the conceptus out of the oviduct. A steep decline of P and E2 levels distally in both directions from the conceptus was coincident with frequency of peaks.

Adult↗
PubMed1984

Norethisterone acetate and ethinylestradiol in early human pregnancy.

In a double-blind randomized trial, 25 women (8-9 weeks pregnant) received 20 mg norethisterone acetate (NET-AC) and 0.04 mg ethinylestradiol (EE2), 25 women receiving placebo. The patients were followed by ultrasound and the products at curettage studied macroscopically and microscopically. In an open trial, ten patients (5-9 weeks pregnant) received NET-AC + EE2, 11 serving as controls. The concentrations of plasma progesterone, estradiol-17 beta, 17 alpha-hydroxyprogesterone, norethisterone, and FSH were followed. The frequency of intrauterine hemorrhage in early pregnancy was not affected by NET-AC + EE2. Ultrasound was not reliable when studying the occurrence of decidual hemorrhages during early pregnancy. The pharmacokinetics and bioavailability of NET remain unchanged during early pregnancy. The treatment with NET-AC + EE2 had no effect on the heights and the time courses of the mean plasma values of progesterone, estradiol-17 beta, 17 alpha-hydroxyprogesterone, and FSH. No differences were found between treated and nontreated patients in the pathology of the placenta or decidua as determined by both macroscopic and microscopic examinations. The hypothesis of Papp and Gardo, that decidual hemorrhages may be induced in early pregnancy as a consequence of a "withdrawal effect" of hormonal pregnancy tests, is not supported by the results of this investigation.

17-alpha-Hydroxyprogesterone↗
PubMed1984

Studies on the role of intestinal bacteria in metabolism of synthetic and natural steroid hormones.

Administration of antimicrobial agents to subjects taking oral contraceptives has been reported to lead to contraceptive failure and subsequent pregnancy. In women taking oral contraceptives antimicrobial agents could have an effect on both endogenous hormone levels and on the metabolism of the exogenously administered steroids. To investigate these possibilities, antimicrobial agents were administered for short periods to normal women taking various steroid drugs: Megestrol acetate (MA), medroxyprogesterone acetate (MPA), norethisterone (NET), a combination of NET and ethinylestradiol (EE) or a combination of lynestrenol and EE. During ampicillin administration the 24-h morning plasma concentrations of MA, MPA and NET were increased compared to the control values. In the MA and MPA experiments the afternoon values were determined and also found to be increased. In the subjects taking oral contraceptives plasma EE concentration showed a tendency to decrease during ampicillin administration on the third, fourth or fifth morning of ampicillin administration, but was never lower than the pretreatment values. In other experiments plasma estrone (E1) and estradiol (E2), urinary total E1, E2 and estriol (E3) and fecal unconjugated and conjugated E1, E2 or E3 were determined by RIA before, during and after administration of oxytetracycline (2 X 500 mg/day for 5 days) to 5 young male subjects. Furthermore urinary and fecal estrogens were determined in 1 male subject after administration of erythromycin for 6 days and in 2 normally menstruating women after tetracycline and trimethoprim administration, respectively. During treatment with antimicrobial drugs an increase in the excretion of fecal conjugated and, with the exception of the oxytetracycline experiments, also of unconjugated estrogens paralleled a decrease in urinary estrogen excretion, especially for E2 and E3. In both urine and feces the E1/E2 and E1 + E2/E3 ratios increased due to diminished reductive metabolism of estrogens in the gut. No significant effects on plasma unconjugated estrogen concentrations were observed. The results suggest that the intestinal bacterial flora plays a significant role in estrogen metabolism. However, further studies are necessary, because our results do not explain why administration of antibiotics may cause contraceptive failure.

Adult↗
PubMed1984

Electrical activity in the human oviduct after the menopause.

Electrical activity was recorded in 18 morphologically normal human oviducts excised from 17 women during hysterectomy. All women were in the first five years after menopause. The first part of the oviduct to become inactive after menopause was the isthmus near the uterus or the ampullary-isthmic junction. The region which exhibited electrical activity last was the ovarian end of the tube. The typical wave-form of electrical activity in post-menopausal oviducts resembled that recorded during the follicular phase in fertile women: a single smooth wave lasting 3-5s. In three cases, over a bulbous swelling of the ampulla, this typical activity was replaced in continuous, high frequency activity. A hypothesis is provided that the observed changes in electrical activity may be related to certain clinical phenomena such as the increased incidence of tubal pregnancy in the pre-menopause.

Electrodes↗
PubMed1983

Decrease in serum testosterone concentration during treatment with tetracycline.

Serum concentrations of testosterone and the binding capacity of sex hormone binding globulin (SHBG) were measured on days 2 days immediately preceding tetracycline treatment, on 3 days of treatment and on 2 days immediately after cessation of treatment. On the treatment days serum mean testosterone concentrations were significantly lower than on the control days (17 +/- 0.9 vs 21 +/- 0.8 nmol/l, P less than 0.01). There were no differences in the SHBG. The 'free testosterone index' behaved like the total testosterone.

Adolescent↗
PubMed1983

Prostaglandins and the non-pregnant uterus. The pathophysiology of primary dysmenorrhea.

The biochemical background of primary dysmenorrhea is characterized by high uterine prostaglandin levels, high levels of blood arginine vasopressin and of estradiol in the late cycle. In dysmenorrheic patients the progesterone level is slightly higher when bleeding starts, than in eumenorrheic patients, but is normal during the late cycle. Biochemical actions pass through free 'activator' calcium, and this, together with possible micro-anatomic changes (like increased frequency of gap junctions), explains the smooth-muscle dysfunction. The uterine activity is characterized by high conduction velocity (as indicated by the high rate of rise in active pressure) and by high resting pressure. The pathophysiology of primary dysmenorrhea includes diminished uterine blood flow and anoxic pain, which result from the constriction of the uterine arteries and/or from the contracture on the uterine muscle itself.

Calcium↗
PubMed1982

Electrical activity in the human oviduct during the menstrual cycle.

Electrical activity in 25 isolated human oviducts on different days of the menstrual cycle was recorded with six simultaneous suction electrodes in at least 18 locations. During the follicular phase, electrical activity consisted of a smooth, single slow spike that lasted 3 to 6 seconds, and on which was superimposed a fast spike(s) in the ampulla immediately after menstruation. The shape of this activity changed at midcycle, first in the ampulla and later in the isthmus, to a burst of potentials; in the ampulla it sometimes changed to a slow wave on which was superimposed a series of fast spikes. The pacemakers were stable and their number few. The electrical activity spread with a velocity of 1 to 3 mm/sec. The probability of spread toward the uterus varied with the location in the oviduct and with the day of the cycle. After menstruation, electrical activity spread in the uterine direction. On cycle day 12, activity spread toward the ampullary-isthmic junction (AIJ) from both ends of the oviduct. On days 14 and 15, it spread a short distance from the ampulla to the isthmus, through the AIJ. On cycle day 18, spread toward the uterus covered the uterine half of the ampulla. AIJ, and the isthmus. Two to 5 days later, no constant features could be detected in the spread. These findings suggest that the human oviduct functions like the oviducts of other mammalian species, with the spread of electrical activity and the transport of ova being related.

Action Potentials↗
PubMed1981

Treatment of primary dysmenorrhea with diclofenac sodium.

The efficacy of diclofenac sodium was investigated in the painful symptoms of primary dysmenorrhea and in reducing menstrual bleeding. Thirty-five nulliparous women (17-28 yr of age) were included in a double-blind cross-over study for four menstrual periods, two periods with diclofenac sodium and two periods with placebo. The diclofenac sodium treatment (total of 58 periods) reduced the pain significantly in comparison with placebo (57 periods), as evaluated by subjective rating (P less than 0.001) and by a 6-point scale of pain intensity (P less than 0.05). Also the amount of menstrual bleeding was significantly reduced as measured by subjective rating (P less than 0.001) and by counting the number of sanitary pads used (P less than 0.05). The results indicate that diclofenac sodium in low dose (about 75 mg daily) is effective not only in reducing the pain at menstruation, but also the bleeding.

Adult↗
PubMed1981

Lung tissue progesterone in the human fetus and neonate.

During fetal life human lungs have a high progesterone concentration (average 380 ng/g at 14 weeks of gestation and 635 ng/g at 32 weeks). At 30 h of age, this concentration had decreased to 185 ng/g. During the first 72 h of life, some infants with respiratory distress syndrome (RDS) had a higher amount of progesterone in their lungs than infants with diseases other than RDS. In newborns with RDS, serum transcortin (binding progesterone) was close to the normal value, but serum progesterone concentration 57% below normal. The hypothesis that, in addition to surfactant, lung tissue smooth muscle (regulated among other things by progesterone and prostaglandins) may control lung function at birth is strengthened by the fact that RDS can be provoked by progesterone in the rabbit and that fatty acids and prostaglandins are abnormal in human RDS.

Female↗