Biomedical subjects

R Tuimala

Publications and source records attributed to R Tuimala.

At least 91 records · Page 5Linked to original sources

PubMed1982

Placental transfer of clenbuterol early in human pregnancy.

After administration of clenbuterol 80 microgram p.o., a beta-adrenoceptor agonist, the concentrations of (14C-labelled) clenbuterol in fetus, placenta and maternal plasma in 9 patients at 9-12 weeks gestation were measured during therapeutic abortion. The time interval between the administration and abortion ranged from 120 to 280 min. The mean concentrations of clenbuterol in maternal plasma, fetus and placenta were 0.37 (range 0.22-0.56), 0.32 (0.14-0.48) and 0.91 (0.12-1.73) ng equivalents per ml or per gram of tissue wet weight. The mean concentration ratio of clenbuterol between fetus and maternal plasma was 0.84 (6 cases); it did not vary with time. The concentration of clenbuterol in three amniotic fluid samples ranged from 0.06 to 0.16 ng/ml (mean 0.11). Maternal plasma concentrations showed wide variability of the pharmacokinetic phase at the time of abortion. The studies indicate that clenbuterol crosses the placenta early in human pregnancy and that it accumulates in the placenta.

Adolescent↗

PubMed1982

Peripheral venous concentrations of oestrogens in postmenopausal women with ovarian cancer.

Serum concentrations of oestrone, oestradiol and oestriol were measured in 23 postmenopausal women, 12 with ovarian cancer and 11 with genital prolapse. Oestrone (387.6 pmol/l) and oestradiol (72.7 pmol/l) levels were higher in the cancer group than those in the control group (159.8 and 27.5 pmol/l respectively), while oestriol levels did not differ (434.5-270.8 pmol/l). The results indicate abnormal ovarian function in postmenopausal patients with ovarian cancer.

Aged↗

PubMed1982

Pituitary-adrenal and testicular function in preterm infants after prenatal dexamethasone treatment.

Pituitary-adrenal and testicular function was monitored by plasma ACTH and testosterone (T) measurements in preterm newborns (gestational age below 36 weeks), exposed in utero to dexamethasone treatment for prevention of respiratory distress syndrome. A group of age-matched premature newborns and full-term infants served as controls. The cord-blood ACTH level was high in each group (logarithmic means 65-75 ng/l), but decreased within the first 2 days of life to mean levels between 20-30 ng/l on days 3 to 10 inclusive. Dexamethasone treatment had no effect on the postnatal ACTH concentrations when compared with preterm or full-term controls. Similarly, no difference in plasma ACTH were found between untreated preterm and full-term infants during the first 10 days of life. T levels in mixed cord blood were on average 2-3 nmol/l in the preterm male infants. An increase to a mean level of 10 nmol/l was seen in 1 h and 1 d samples. Thereafter, the concentration of T decreased to 2-3 nmol/l on days 3-10 postnatally. No effect of dexamethasone treatment was seen on the postnatal pattern of plasma T. When preterm male and full-term male infants were compared, no difference was seen in the T peak in the first day of life. However, the 1-3, and 60-90 days concentrations of T were 2-fold (p less than 0.01-0.05) higher in the preterm group. It is concluded that prenatal dexamethasone treatment of the mother does not influence the postnatal pituitary-adrenal function as monitored by ACTH measurements. Likewise, no effect of this treatment was observed on the postnatal testicular activity of preterm male infants. The immediate postnatal peak in plasma T levels persisted longer in the preterm than in the full-term male infants.

Adrenocorticotropic Hormone↗

PubMed1982

Amniotic fluid beta-2-microglobulin in normal and complicated pregnancies. Correlation with gestational age, creatinine concentration and L/S ratio.

The beta-2-microglobulin concentrations in 127 aminotic fluid samples, obtained during weeks 32-42 of normal pregnancies (n = 58) and complicated pregnancies (n = 69), were measured and correlated with gestational weeks, amniotic fluid creatinine concentrations and L/S ratios. A significant (p less than 0.001) decrease of beta-2-microglobulin concentration occurred from week 32 to 34 of normal pregnancies, after which the beta-2-microglobulin level was unchanged. There were no significant correlations between beta-2-microglobulin concentrations and amniotic fluid creatinine concentrations of LK/S ratios. The beta-2-microglobulin content was elevated in samples obtained from diabetic and toxemic pregnancies. Measurement of beta-2-microglobulin in amniotic fluid seems to be of limited value for determining fetal age, but it may be useful in estimating fetal renal maturity.

Amniotic Fluid↗

PubMed1982

Fetal adrenocorticotropic hormone and prolactin at delivery.

The concentrations of adrenocorticotropic hormone (ACTH) and prolactin in fetal scalp and umbilical cord blood were measured in 49 full-term fetuses, 25 of whom were delivered spontaneously, 10 of whom underwent induced vaginal delivery, and 14 of whom underwent elective cesarean section. Serial fetal scalp blood samples taken during the 35 vaginal deliveries showed no change in concentration of these hormones. The mean (+/- SD) plasma level of ACTH in cord artery blood after vaginal delivery (315 +/- 249 ng/liter) was significantly higher (P less than .05) than after cesarean section (184 +/- 201 ng/liter), indicating that the fetal anterior pituitary is capable of responding to partal stress.

Adrenocorticotropic Hormone↗

PubMed1981

Postmenopausal hormone replacement therapy with estrogen periodically supplemented with antiestrogen.

To inhibit endometrial stimulation during postmenopausal estrogen therapy, 25 women with climacteric symptoms were treated with a daily dose of 1.25 mg of conjugated estrogens for 7 weeks followed by a period of 10 days with clomiphene citrate administration (50 mg per day). This combination was repeated three times during the 6-month trial. The marked relief of climacteric symptoms with estrogen was slightly less during clomiphene treatment. Uterine bleeding occurred five times during estrogen treatment periods but never during or after clomiphene supplementation. Histologic examination revealed endometrial atrophy in 41% of the samples after the first estrogen treatment, whereas after the first and third clomiphene periods this was increased to 77% and 73%, respectively. The first clomiphene treatment significantly decreased the concentrations of cytosol estrogen and progestin receptors in endometrium, as compared with the levels recorded at the end of the preceding estrogen therapy. The depression in the cytosol estrogen receptor concentration was persistent, whereas cytosol progestin receptor concentration tended to increase during the subsequent estrogen-plus-clomiphene treatment. Estrogen declined serum concentration of follicle-stimulating hormone (FSH), whereas the concentration of luteinizing hormone (LH) and prolactin remained unchanged. Clomiphene did not change the levels of these hormones from those observed during the estrogen treatment. The concentration of free fatty acids in serum was increased during the estrogen and clomiphene treatments, whereas the levels of cholesterol and high-density lipoprotein--cholesterol did not change. Our results suggest that this treatment regimen relieves climacteric symptoms without endometrial stimulation or other adverse effects. Thus, clomiphene appears to be a practical alternative to progestin for interruption of the postmenopausal endometrial effect of estrogen.

Clomiphene↗

PubMed1981

Pregnancy and delivery at the age of forty and over.

One hundred and eighty-six deliveries from mothers of age 40 and over at Oulu University Central Hospital during 1975-77 are summarized. The commonest maternal complications were pre-eclampsia (25.8%) and pathological glucose tolerance (7.0%). The cesarean section rate of the whole group was 126.7%, and for the primiparas, 47%. Placental complications were slightly but not significantly more common among parturients over 40 compared with our general obstetric population. The pregnancies did not adversely affect the mothers' health despite commonly occurring maternal diseases. The commonest pathological findings among the newborns were hyperbilirubinemia (7.9%), neonatal infections (4.2%), clavicular fractures (3.2%) and postpartum asphyxia (2.6%). Congenital anomalies occurred in 2.6% of the children and were the main cause of the perinatal mortality, which was 5/189 (2.6%). Prematurity and low birth weight were not increased.

Adult↗

PubMed1981

A relationship between cord blood and maternal blood lymphocytes and term placenta in the induction of aryl hydrocarbon hydroxylase activity.

Correlations between lymphocyte aryl hydrocarbon hydroxylase (AHH) inducibility in cord blood and maternal lymphocytes and placental AHH activity were studied in 15 smokers and 11 non-smokers. Placental AHH activity was extremely low in the non-smokers regardless of the lymphocyte AHH induction ratio, but was elevated to a variable extent in the smokers, in whom it showed a statistically significant correlation (r = 0.75, P less than 0.01) with cord blood lymphocyte AHH inducibility. The correlation between maternal lymphocyte AHH inducibility and placental AHH activity was poor (r = 0.04, not significant). These findings suggest that AHH induction in man may be 'systematically' regulated and that the genetic background will determine the extent of induction at a given level of exposure to polycyclic aromatic hydrocarbons.

Adolescent↗

PubMed1981

Maternal, fetal and aminiotic fluid ACTH, cortisol and prolactin in association with medical beta-adrenergic stimulation.

In view of observations indicating accelerated fetal pulmonary maturation after tocolytic therapy with beta-adrenergic agonists, this study was undertaken to determine whether the phenomenon is related to enhanced maternal or fetal ACTH, cortisol or prolactin secretion. The concentrations of ACTH, cortisol and prolactin in maternal venous blood, umbilical arterial and venous blood, and amniotic fluid were similar after short-term maternal intravenous infusion of isoxsuprine, fenoterol or isotonic saline, and they did not increase in the maternal venous blood during these treatments or during long-term treatment with intravenous ritodrine. These results suggest that the accelerated fetal pulmonary maturation induced by beta-adrenergic stimulation is not mediated by ACTH, cortisol or prolactin.

Adrenergic beta-Agonists↗

PubMed1981

The lack of significant change in plasma progesterone and estradiol-17 beta levels before the onset of human labor.

Maternal plasma levels of progesterone and estradiol-17 beta were measured weekly by radioimmunoassay in 15 healthy women during the last trimester of normal pregnancy. There was a large individual variation for both hormones. The mean concentrations rose slightly with advancing gestational age but the ratio of progesterone to estradiol did not change. It is apparent that the onset of spontaneous labor cannot be predicted by measuring the levels of progesterone and estradiol-17 beta in maternal peripheral plasma.

Adolescent↗

PubMed1981

Aryl hydrocarbon hydroxylase induction in maternal and cord blood mitrogen-treated lymphocytes.

The inducibility of aryl hydrocarbon hydroxylase was measured in mitrogen-activated peripheral lymphocytes from smoking and nonsmoking mothers and their newborn infants (cord blood). The mean inducibility ratio in lymphocytes from smoking women was 4.02 and that for nonsmokers 2.87. Benz(a)anthracene-induced and noninduced AHH activities were 3-6 times higher in the lymphocytes from the cord blood than in those from the mothers. The inducibility ratio in the cord blood lymphocytes from the smoking mothers was 3.65 and did not differ significantly from that for the nonsmokers, 3.54. There was a significant correlation in the induction ratio between maternal and cord blood lymphocytes from the nonsmokers, but not in the smokers. Thymidine incorporation was about twice as high on average in the cord blood lymphocytes as in the maternal lymphocytes. The results demonstrate that the extent and distribution of inducibility were very similar in the maternal and cord blood lymphocytes.

Adolescent↗

PubMed1980

Suppression of threatened premature labor by administration of cortisol and 17 alpha-hydroxyprogesterone caproate: a comparison with ritodrine.

A shift in progesterone-to-estradiol balance to estradiol dominance is assumed to be a prerequisite for regular uterine contractions. To antagonize this effect in premature labor 24 consecutive women were treated with intravenous cortisol for 3 days and with weekly intramuscular injections of 17 alpha-hydroxyprogesterone caproate (17 OHP-C). Twenty-four similar patients treated with ritodrine served as a reference group. The delivery was postponed by at least 1 week in 21 patients (87.5%) in the steroid treatment group and in 18 patients (75%) in the ritodrine group. The premature labor lasted for 5.1 +/- 0.4 hours (mean +/- SEM) with steroid therapy and for 2.2 +/- 0.3 hours with ritodrine. In singleton pregnancies the gestational length and birth weight of the newborn infants were greater in the steroid treatment group (N = 23, 39.1 +/- 0.3 weeks, 3,460 +/- 119 gm) than in the ritodrine group (N = 24, 37.7 +/- 0.4 weeks, 3,106 +/- 118 gm). Steroid treatment suppressed serum estradiol concentrations (maximally by 60%) and, to a lesser extent, testosterone, estriol, and progresterone levels (maximally by 30%).

17 alpha-Hydroxyprogesterone Caproate↗

PubMed1980

Serum progesterone, estradiol, and estriol before and during induced labor.

To investigate the association of serum levels of progesterone (P), estradiol (E2), and estriol (E3) with the initiation of regular contractions, venous blood samples were taken prior to and 3 hours after the successful induction of labor in 83 parturients by means of low amniotomy and intravenous oxytocin infusion. The serum P level and P/E2 ratio decreased and serum E2 level increased after induction in healthy primigravidas and in parturients with an initial P dominance (serum P/E2 ratio more than 5). There was also a decrease in the serum P level and P/E2 ratio in postterm patients and parturients with a ripe cervical state. Cholestasis of pregnancy was associated with a rise in the serum level of E2 and a decrease in the P/E2 ratio. In an unfavorable cervical state there was a rise in the serum E2 level; patients with an initial E2 dominance (serum P/E2 ratio 5 or less) showed a rise in the serum P level and P/E2 ratio. Healthy multigravidas and patients with pre-eclampsia did not show any hormonal changes. The onset of induced labor seems to be associated with a rise in serum E2 concentration and/or with a drop in P concentration. The increase in serum E2 level is thought to be due to the activation of the anterior pituitary--adrenal axis. The lower P level is supposedly a result of diminished uteroplacental circulation.

Cervix Uteri↗

PubMed1980

Conversion of dehydroepiandrosterone sulphate to oestrogens in intraphepatic cholestasis and other complications of pregnancy.

The aim of the present study was to determine whether pregnancy complications themselves influence the conversion rate of dehydroepiandrosterone sulphate (DHAS) to oestrogens during pregnancy. 100 mg DHAS was given intravenously to seven women with intrahepatic cholestasis of pregnancy, nine women with preeclampsia, nine diabetics, ten with twins and eight women with normal pregnancy between 31--40 weeks of gestation. Serum oestradiol (E2) and oestriol (E3) were measured with specific radioimmunoassays before and 1--5 h after DHAS injections. A significant oestradiol elevation following DHAS was similar in each group. By contrast there was an oestriol elevation (P less than 0.05) only in intrahepatic cholestasis of pregnancy. The results indicate that: (1) pregnancy complication itself does not effect the conversion rate of DHAS to oestradiol, (2) in patients with intrahepatic cholestasis there is a disturbed E3 metabolism which may be due to an increased placental permeability to exogenous DHAS or to a decreased metabolism of E3 by maternal liver.

Cholestasis, Intrahepatic↗

PubMed1980

Intra-amniotic or intravenous injection of dehydroepiandrosterone sulphate: simultaneous changes in steroid levels in amniotic fluid and maternal serum.

Levels of unconjugated oestradiol-17 beta (E2) and testosterone (T) and total oestriol (E3) were measured hourly to 6 h after intra-amniotic (i.a.) (100--200 mg) or intravenous (i.v.) (100 mg) injection of dehydroepiandrosterone sulphate (DHEA-S) in a series of twenty-six women with mid-trimester abortion. Amniotic fluid E2 and T levels were elevated significantly 1--6 h after the i.a. injection of DHEA-S, while the E3 level in amniotic fluid did not change. The i.a. administration also induced significant rises in serum E2 and T levels between 1 and 6 h and in the serum E3 level between 2--6 h. The i.v. injection of DHEA-S was accompanied by significantly elevated serum levels of E2 and T, while the E3 concentration remained unchanged. It appears that following maternal i.v. administration or an amniotic fluid injection, DHEA-S is rapidly converted to E2 and T, and these accumulate in both the maternal circulation and the amniotic fluid. E3, however, is formed only after i.a. administration of DHEA-S, and is selectively transported to the maternal blood.

Amnion↗

PubMed1980

Congenital chloride diarrhea: possibility for prenatal diagnosis.

Two pregnancies, which resulted in the births of infants affected by congenital chloride diarrhea (C.C.D.) are presented. No method is available for prenatal diagnosis of this disorder. In this paper the intrauterine onset of diarrhea is confirmed by amniofoetography and high bilirubin values in amniotic fluid. In the second case the amniotic fluid alpha-fetoprotein (A.F.P.) was detected to be abnormally high at the 29th gestational week.

Adult↗

PubMed1980

Maternal, fetal and neonatal effects of beta-adrenergic stimulation in connection with cesarean section.

To investigate the combined metabolic effects of beta-mimetic therapy and general anesthesia on maternal and fetal/neonatal metabolism, 14 patients were treated with isotonic saline, 11 with intravenous fenoterol (3 microgram/min) and 9 with intravenous isoxsuprine (150 microgram/min) for 30 minutes prior to cesarean section. The maternal heart rate and blood pressure as well as the maternal and fetal acid-base balance were followed. The neonatal glucose level was monitored for 36 hours after delivery. The heart rate and the diastolic and systolic blood pressure values increased during the operation in each group, without any marked differences between the groups. At delivery, the mean maternal BD (base-deficit) value was higher in the fenoterol patients than in the control patients, indicating a trend towards metabolic acidosis. The other values of acid-base balance in the maternal and umbilical arterial and venous blood did not reveal any differences between the groups. The neonatal glucose level at 2 hours after delivery was higher in the fenoterol group than in the control group. The other values recorded during 36 hours revealed no differences between the groups. Beta-mimetic treatment preceding general anesthesia in cesarean section does not have unfavorable effects on the mother, the fetus or the newborn. Such therapy thus does not seem contraindicated when uterine contractions should be rapidly suppressed in cases of fetal distress before operation.

Acid-Base Equilibrium↗

PubMed1980

Decreased intervillous and unchanged myometrial blood flow in supine recumbency.

The supine position in late pregnancy is associated with many hemodynamic changes caused by compression of the inferior vena cava and a resulting fall in cardiac output. To investigate the effect of this position on uteroplacental blood flow, 22 women with normal (N = 12) or hypertensive (N = 10) pregnancy were investigated using the intravenous 133Xe washout method, in both the supine and left-tilted (45-degree) lateral positions. The intervillous blood flow (113 +/- 48 ml/min/dl) was lower in the supine position than in the left-tilted position (141 +/- 48 ml/min/dl) (P less than 0.01), while the myometrial blood flow was similar in both (9.0 +/- 3.3 ml/min/100 g in supine and 8.7 +/- 2.7 ml/min/100 g in left-tilted position). The results suggest that the autoregulation system for uteroplacental circulation is operative only in the nonplacental component of the pregnant uterus.

Adolescent↗