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Biomedical subjects

R Sorva

Publications and source records attributed to R Sorva.

At least 37 records · Page 2Linked to original sources
PubMed1994

Frequency distribution of breath sounds as an indicator of bronchoconstriction during histamine challenge test in asthmatic children.

In order to study changes in respiratory sounds associated with acute bronchoconstriction and -dilatation, breath sounds of 11 children with asthma (age range, 10-14 years) were recorded at the chest and at the trachea during histamine challenge test and after subsequent bronchodilatation. The changes in frequency spectra of breath sounds were compared with simultaneous changes in forced expiratory volume in 1 second (FEV1). In seven children who responded to histamine with a decrease in FEV1 of more than 15%, there was a significant relationship between percentage change in FEV1 (delta FEV1) and percentage change in median frequency (delta F50) of expiratory breath sounds recorded at the chest (r = 0.865; beta = -0.706, P = 0.0001) and at the trachea (r = 0.888; beta = -1.12, P = 0.0001). The association between breath sound intensity and FEV1 was weaker. Based on ANOVA, the increase of F50 during the challenge test was significantly larger in children who responded to histamine than in those who were non-responsive (P = 0.0016). At the chest, a decrease of 15% in FEV1 corresponded to an increase of 8% in expiratory F50. The provocative dose of histamine inducing a decrease of 15% in FEV1 (PD15FEV1) and the provocative dose causing an increase of 8% in F50 (PD8F50) were significantly related (r = 0.927, P = 0.003). We conclude that spectral analysis of breath sounds can be used to indicate airway obstruction during bronchial challenge tests in children, and may be adapted for tests in pre-school children. The results suggest that the same mechanisms that induce airflow limitation due to inhaled histamine may generate an increase in frequency content of breath sounds in children with asthma.

Adolescent↗
PubMed1994

Beta-lactoglobulin secretion in human milk varies widely after cow's milk ingestion in mothers of infants with cow's milk allergy.

BACKGROUND: Cow's milk proteins secreted in human milk may cause cow's milk allergy (CMA) even during exclusive breast-feeding. We studied beta-lactoglobulin levels in human milk of mothers of infants with CMA. We also studied intestinal absorption of macromolecules in the same mothers to see whether it is related to the secretion of beta-lactoglobulin in human milk. METHODS: CMA was verified with oral challenge in 46 of 55 infants assessed. beta-Lactoglobulin levels were assessed in human milk from 53 of 55 mothers of the infants before (basal sample) and 1 and 2 hours after an oral cow's milk load, which was given after a 24-hour milk-free diet. beta-Lactoglobulin was determined by an ELISA with a detection limit of 0.002 microgram/L. The 6-hour urine recovery of a high-molecular-weight polyethylene glycol (PEG) 3000 was assessed after an oral load of PEG in 45 of 55 mothers. RESULTS: beta-Lactoglobulin was found in the 1- or 2-hour samples in 75% of the mothers. beta-Lactoglobulin levels were increased in the 1- or 2-hour samples as compared with the basal levels in about half of the mothers. The respective levels were decreased in one third of the mothers whose basal beta-lactoglobulin levels were higher than in the others. beta-Lactoglobulin was found in none of the three human milk samples in 15% of the mothers. After an oral load of a high-molecular-weight PEG 3000, the 6-hour urine recovery of PEG was similar in the mothers of the infants with CMA and the mothers of infants without CMA. Neither was the urinary recovery of PEG related to the beta-lactoglobulin levels in human milk. CONCLUSIONS: The results support the view that beta-lactoglobulin in human milk may contribute to, but does not alone explain, the development of CMA in breast-fed infants.

Animals↗
PubMed1994

Familial high serum concentrations of the carboxyl-terminal propeptide of type I procollagen.

We describe a family with an apparently autosomal-dominant trait that caused extremely high circulating concentrations of the carboxyl-terminal propeptide of type I procollagen (PICP). All family members examined had normal values for other biochemical markers of bone formation and degradation and no related clinical abnormalities. Furthermore, their serum concentrations of the amino-terminal propeptide of type I procollagen (PINP) were normal. Although PINP and PICP are released from the same precursor molecule, PINP is cleared from the circulation via the scavenger receptor in liver endothelial cells, whereas PICP is cleared via the mannose receptor of these cells. We thus hypothesize that the clearance of circulating PICP is compromised in the affected subjects of this family, the result of either a defective mannose receptor function or an abnormal molecular structure of their PICP.

Adolescent↗
PubMed1993

Serum eosinophil cationic protein during treatment of asthma in children.

BACKGROUND: Serum eosinophil cationic protein (ECP) is suggested to reflect the degree of bronchial inflammation and hyperreactivity in patients with asthma. We measured serum ECP levels before and 1 and 5 months after treatment with inhaled budesonide (n = 10) or sodium cromoglycate (SCG) (n = 7) in children with asthma. METHODS: The daily dose of budesonide was 800 micrograms/m2 during the first month and 400 micrograms/m2 during the next 4 months. ECP levels were determined by radioimmunoassay. RESULTS: ECP decreased during the 5 months of treatment (p = 0.020 for treatment groups combined; p = 0.049 for the budesonide group; p = NS for the SCG group). The higher the serum ECP level at entry, the more it decreased during treatment, both in the budesonide group (r = -0.697, p < 0.05) and in the SCG group (r = -0.893, p < 0.05). No correlation was found between the ECP level and the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1%) or between changes in these. However, basal pulmonary function was reduced in 8 of 16 subjects only, and FEV1% did not change significantly in either group. Thus the absence of a correlation is understandable. CONCLUSIONS: The clinical value of the sensitive decrease in serum ECP remains to be established.

Administration, Inhalation↗
PubMed1993

Bovine beta-lactoglobulin levels in hydrolysed protein formulas for infant feeding.

A bovine milk protein, beta-lactoglobulin (beta LG), was measured by an enzyme-linked immunosorbent assay (ELISA) in seven different infant formulas based on protein hydrolysates from cows' milk whey or casein, and from bovine collagen and soy. beta LG levels in the formulas were 1/100 to 1/4,800,000 lower than in cows' milk (CM). There was a great difference in the beta LG level between the partly and the extensively hydrolysed formulas; the amount of beta LG was 40,000-fold higher in the partial hydrolysates vs the extensively hydrolysed formulas. Residual beta LG may have been responsible for the allergic reactions described in some children with cows' milk allergy (CMA) receiving these formulas.

Animals↗
PubMed1992

Effects of inhaled budesonide on serum markers of bone metabolism in children with asthma.

The effects of inhaled glucocorticoids on serum markers of bone formation were evaluated in asthmatic children. Serum total alkaline phosphatase (AP), bone alkaline phosphatase (BAP), osteocalcin, and the novel marker of bone formation, carboxypropeptide of type I procollagen (PICP), were measured. In the cross-sectional part, long-term glucocorticoid users were compared with sodium cromoglycate (SCG) users. In the boys (n = 16), but not in the girls (n = 11), PICP was significantly lower in the glucocorticoid users than in the SCG users. PICP correlated positively with BAP (n = 54; groups combined, r = 0.29, p < 0.05). In the longitudinal part, the effects of inhaled budesonide or SCG, both used for the first time, were evaluated before and after 1 and 5 months of treatment. The budesonide dose was 800 micrograms/m2/day for 1 month and thereafter half of that. The SCG dose was 30 mg/day throughout the study. Only during budesonide use did osteocalcin and PICP decrease, the median osteocalcin by 8% at 1 month (p < 0.05) and by 6% at 5 months (n = 15), and PICP by 5% at 1 month (p < 0.05) and by 28% at 5 months (n = 7, p < 0.01). AP and BAP did not change significantly. Decreased PICP suggests decreased bone formation rate. PICP might be clinically useful as a marker of early adverse effects of glucocorticoids on bone.

Administration, Inhalation↗
PubMed1991

Changes in carbohydrate and lipid metabolism in children with asthma inhaling budesonide.

In a longitudinal study, antiasthmatic and metabolic effects of budesonide inhalations in initially high (800 micrograms/m2/day for 1 month) and subsequently lower (400 micrograms/m2/day for 4 months) dosage were evaluated in nine children with asthma, aged 5 to 10 years. The FEV1 increased significantly after high dosage (median, 96.5% versus 105.5%; p = 0.0339). After lower dosage, FEV1 was still higher than at the baseline (106% versus 96.5%; p = 0.0339). Clinically, no additional beta2-agonist was needed after 2 weeks of treatment. Serum high-density lipoprotein cholesterol increased significantly by 22% after high dosage (medians, 1.18 versus 1.44 mmol/L). A significant decline to 1.31 mmol/L was observed when the dose was reduced (overall, p = 0.0319). The treatment had no significant effect on serum total cholesterol, on serum triglycerides, on the ratio of high-density lipoprotein to total cholesterol, on the body mass index, or on glucose tolerance. The high dosage increased significantly the ratio of serum insulin to blood glucose, calculated from the areas under the incremental 2-hour curves in the glucose tolerance test (medians, 17.3 versus 23.2 mU/mmol). After lower dosage, the ratio declined significantly to 13.5 mU/mmol (overall, p = 0.0164). No significant changes were observed in plasma cortisol in the 2-hour adrenocorticotropic hormone test. The antiasthmatic effect of budesonide inhalations in a dose of 800 micrograms/m2/day for 1 month was accompanied by detectable changes in lipid and carbohydrate metabolism. These metabolic changes were reversible, and the antiasthmatic effect could be maintained by a dose of 400 micrograms/m2 for 4 months without significant systemic effects. This dose is safe and efficient in the maintenance treatment of childhood asthma.

Administration, Inhalation↗
PubMed1990

Variation of growth in length and weight of children. I. Years 1 and 2.

As part of our work aiming at facilitation of growth screening, we analyzed the growth of 741 healthy infants from birth to 2 years of age. We 1) show that weight depends on length rather than age, 2) present new growth standards in a format which allows direct reading of relative length and relative weight, and 3) define the normal variation of changes over different periods in terms of relative length (SD score, SDS) and relative weight (deviation of weight from the median weight for length and sex, %DW). The group mean values for changes in length SDS and %DW were zero, but there were wide individual variations, which decreased with age and length. We present curves defining these variations for use in growth screening.

Age Factors↗
PubMed1990

Variation of growth in height and weight of children. II. After infancy.

To provide for early detection of abnormal changes in growth, we propose the monitoring of all children for changes in relative height and relative weight as indirect indicators of growth velocity. To this end we analyzed the growth of 2,156 children, as recorded by the child health surveillance services at ages 2 to 19 years. From their data we constructed growth standards on charts of a novel type, which allow direct reading of relative height (SD score, SDS) and relative weight (percentage deviation of weight from median weight for height and sex, %DW). Variation in height explained most (mean 60%) of the variation in weight, and age did not contribute significantly. Hence, our weight charts are height-based. Next, we defined the variations of changes in (delta) SDS and %DW during the different periods of growth. The group means of changes in each period were zero. Variation in delta SDS is widest at the earliest ages, then decreases until year 9-10 (girls) and 10-11 (boys), and again increases. For delta %DW the picture is similar. We present these variations as diagrams for use in growth screening.

Adolescent↗
PubMed1989

Growth evaluation: parent and child specific height standards.

Data on the growth of 1063 children and their parents were analysed. Of the variation in height at prepuberty about 20%, and of the final height 30-46%, were explained by the variation in parental heights; the children's own height at the age of 1.0 year increased the proportion explained to half. Two equations were developed for increasing the accuracy of the evaluation of growth. One defines parent specific mean height standard deviation score, and the other includes the parents' heights and the child's height at the age of 1.0 year and defines expected standard deviation score for height. These equations are easy to use if they are converted to nomograms.

Aging↗
PubMed1988

Craniopharyngioma surgery in children: endocrine and visual outcome.

Twenty-two children with craniopharyngioma were operated on in our Department of Neurosurgery from 1970 to 1981. Removal was total in 11 patients. There was one surgical death, but no recurrences in this group. Only partial removal could be performed in 10 children, followed by stereotactic radiotherapy in one. Recurrences have occurred in 4 of these children and 2 of them have died. In 1 child a biopsy was performed, followed by insertion of a shunt and stereotactic radiotherapy. Nine years after treatment there have still been no recurrences. Visual acuity was unchanged after the procedure in 17/21 survivors, improved in 1, and deteriorated in 3. The visual fields remained unchanged in 11, improved in 3, and deteriorated in 7. The visual fields and visual acuity were normal postoperatively in 5 patients. Hypopituitarism was more extensive after the procedure. We recommended an attempt at total removal whenever possible.

Child↗
PubMed1988

Testosterone substitution increases the activity of lipoprotein lipase and hepatic lipase in hypogonadal males.

We studied the effects of testosterone substitution on serum concentrations of lipids, lipoproteins, apoproteins and on the activity of hepatic lipase (HL) and lipoprotein lipase (LPL) in postheparin plasma and on the activity of LPL in adipose tissue (AT-LPL) in 13 male hypopituitary patients. The activities of LPL and HL in postheparin plasma were markedly increased by 1 week after a testosterone enanthate injection (P less than 0.001). The HL activity remained elevated (P less than 0.05) after 1 month's treatment, but the LPL activity declined to presubstitution levels. The prolonged substitution decreased serum apoproteins A-I and A-II (P less than 0.05). The changes of apo A-I and A-II correlated inversely with those of the free testosterone index (FTI) (r = -0.74, r = -0.67, P less than 0.05). Serum HDL-cholesterol level decreased slightly by 1 week and it correlated inversely with the increase in testosterone and the FTI (r = -0.67, r = -0.85, P less than 0.05). The results suggest that testosterone increases the activity of both lipolytic enzymes in postheparin plasma. The effect on HL appears to be more persistent than that on LPL. The data support a role for androgens in the regulation of serum lipoprotein and HDL-cholesterol levels.

Adipose Tissue↗
PubMed1988

Elevated adipose tissue lipoprotein lipase activity in craniopharyngioma patients.

The activity of lipoprotein lipase (LPL) was measured in adipose tissue (AT-LPL) and postheparin plasma (PH-LPL) of 13 obese patients (aged 11 to 31 years) who had surgery for craniopharyngioma 1 to 13 years earlier. AT-LPL activity (mean +/- SEM) was higher in them than in subjects matched with respect to age, sex, and relative body weight (4.6 +/- 1.1 v 2.1 +/- 0.4 mumol free fatty acids (FFA).h-1.g-1, P less than .05). The activity was also higher when expressed per fat cell.

Adipose Tissue↗
PubMed1988

Postoperative computed tomographic control of 38 patients with craniopharyngioma.

Computed tomography scanning was performed on 38 patients 1-12 years after surgery for craniopharyngioma. Recurrence of the tumor had appeared in nine patients. Thirteen patients had a residual tumor, and 16 were tumor-free after primary surgery. In addition, one patient became tumor-free after total removal of the recurrent tumor. After partial removal, the rate of recurrence was high and the quality of life was impaired.

Adolescent↗
PubMed1988

Children with craniopharyngioma. Early growth failure and rapid postoperative weight gain.

Pre- and postoperative growth was analyzed in 22 children with craniopharyngioma. In 19 children a growth failure preceded the diagnosis by a mean of 4 years. Six children were obese preoperatively. During the first 3 postoperative months relative weight increased greater than 10% in 14/21 children (there was one surgical death). One year after surgery 13/21 were obese. Neither the size of the tumor nor the mode of surgery was decisive in the development of the obesity. Serum insulin and insulin-like growth factor I (IGF-I) were assessed in four children with growth hormone deficiency (GHD) who, after surgery for craniopharyngioma, were growing normally without GH substitution. One of them was normal in weight and had normal insulin and IGF-I levels; the others were obese and had supranormal insulin and subnormal IGF-I levels. One of the four and two other children with unsubstituted GHD reached final height SDS -0.8, -2.0 and -2.4. One child with normal postoperative GH response reached final height SDS -0.7. Final height SDS greater than or equal to -2.5 was gained with GH substitution by 6/11 children. It was greater than 2.0 SD below the height SDS expected from the heights of the parents in 7/11. An adequate monitoring of children's growth would lead to earlier diagnosis and probably better outcome.

Adolescent↗
PubMed1988

Effects of endogenous sex steroids on serum lipoproteins and postheparin plasma lipolytic enzymes.

Sex steroids influence serum high density cholesterol (HDL) concentrations through their effects on postheparin plasma hepatic lipase activity. This enzyme is remarkably sex steroid sensitive; its activity is increased by treatment with androgens and androgenic progestins but decreased by estrogens. Hepatic lipase also is regulated by endogenous estradiol, but less is known about its regulation by endogenous androgens. We measured serum lipoproteins and postheparin plasma hepatic lipase and lipoprotein lipase activities in relation to sex steroids in 13 boys in whom testicular sex steroid production was stimulated by 4 injections of hCG given at 3-day intervals. Serum testosterone, but not estradiol, concentrations increased in 8 boys (group I, prepubertal and early pubertal boys), whereas in 5 boys both testosterone and estrogen concentrations increased concomitantly (group II, pubertal boys). Postheparin plasma hepatic lipase activity increased by 34% (P less than 0.001) in group I, but did not change in group II. Serum HDL cholesterol concentrations did not change during hCG stimulation. However, postheparin plasma hepatic lipase activity correlated inversely with serum HDL (r = -0.34; P less than 0.05) and HDL2 cholesterol levels (r = -0.51; P less than 0.001), and the changes in HDL2 levels and hepatic lipase activity were inversely related (r = -0.63; P less than 0.05). Postheparin plasma lipoprotein lipase activity decreased during hCG stimulation. Its activity was positively related to HDL (r = 0.47; P less than 0.05) and HDL2 cholesterol levels (r = 0.54; P less than 0.001). These results suggest that endogenous androgens and estrogens are involved in the regulation of postheparin plasma lipase activities and serum HDL cholesterol concentrations.

Adolescent↗
PubMed1987

Craniopharyngioma in children and adults. Correlations between radiological and clinical manifestations.

We studied the radiological and clinical manifestations of craniopharyngioma in 22 children and 29 adults. The tumours tended to be smaller in adults than in children, and non-calcified, more often solid than cystic and suprasellar than suprasellar-intrasellar. Small tumours were associated with symptoms which had long been overlooked. The size of the tumour did not influence the results of surgery in children, but in adults total removal was more often successful for small tumours. In the children total removal was achieved least often with calcified and suprasellar-intrasellar tumours. Pre-operative skull radiography was abnormal in all except one of the children but in only half of the adults. Sclerosis of the sella floor and erosion of the dorsum sellae are early signs which are easily overlooked.

Adult↗