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Biomedical subjects

S L Karonen

Publications and source records attributed to S L Karonen.

At least 91 records · Page 5Linked to original sources

Glycogen depletion during prolonged exercise: influence of glucose, fructose, or placebo.

We examined the influence of various carbohydrates of fuel homeostasis and glycogen utilization during prolonged exercise. Seventy-five grams of glucose, fructose, or placebo were given orally to eight healthy males 45 min before ergometer exercise performed for 2 h at 55% of maximal aerobic power (VO2max). After glucose ingestion, the rises in plasma glucose (P less than 0.01) and insulin (P less than 0.001) were 2.4- and 5.8-fold greater than when fructose was consumed. After 30 min of exercise following glucose ingestion, the plasma glucose concentration had declined to a nadir of 3.9 +/- 0.3 mmol/l, and plasma insulin had returned to basal levels. The fall in plasma glucose was closely related to the preexercise glucose (r = 0.98, P less than 0.001) and insulin (r = 0.66, P less than 0.05) levels. The rate of endogenous glucose production and utilization rose similarly by 2.8-fold during exercise in fructose group and were 10-15% higher than in placebo group (P less than 0.05). Serum free fatty acid levels were 1.5- to 2-fold higher (P less than 0.01) after placebo than carbohydrate ingestion. Muscle glycogen concentration in the quadriceps femoris fell in all three groups by 60-65% (P less than 0.001) during exercise. These data indicate that fructose ingestion, though causing smaller perturbations in plasma glucose, insulin, and gastrointestinal polypeptide (GIP) levels than glucose ingestion, was no more effective than glucose or placebo in sparing glycogen during a long-term exercise.

Adult↗

Pancreatic blood flow and contrast enhancement in computed tomography during experimental pancreatitis.

The pancreatic blood flow and contrast enhancement in computed tomography (CT) were studied in 10 piglets weighing 17-25 kg with experimental pancreatitis. Each animal served as its own control. CT and blood flow measurements were made both before induction of pancreatitis and 5-6 h after the onset of the disease. Cardiac output was measured by thermodilution, and was kept constant throughout the study by infusion of dextran and saline. Although the pancreatic blood flow remained constant in this experiment, CT showed a significant decrease in contrast enhancement.

Animals↗

The effect of renal transplantation on gastric acid secretion and on the serum levels of gastrin and group I pepsinogens.

To gain further understanding of the peptic complications encountered in renal transplant surgery, 84 patients (19 with chronic renal failure on dietary treatment, 29 on regular dialysis treatment, 36 with a well-functioning renal transplant) were studied with regard to gastric acid secretion capacity and serum concentrations of gastrin and group I pepsinogens (PG I). The mean duration of preoperative dialysis treatment of the dialysed patients was 13.7 months. The mean length of postoperative follow-up of the transplant patients was 10.1 months. There was no significant difference between the mean gastric acid secretion of the three groups of patients. All the means were within the reported reference interval for healthy controls. However, 26% of the non-dialysed, 17% of the dialysed and 28% of the transplant patients had gastric hyposecretion. The mean serum concentration of gastrin was elevated in all patient groups and unaffected by normalization of renal function through transplantation, unlike PG I, which was normalized by the procedure. Thus, in the present era of treatment of chronic renal failure with a relatively short period of dialysis treatment, the frequent gastric hypoacidity, which is known to be peculiar to non-dialysed uraemic patients, seems also to characterize dialysis and transplant patients.

Adult↗

Glycemic control and serum lipoproteins after total pancreatectomy.

Carbohydrate and lipid metabolism were studied in 10 patients who had undergone total pancreatectomy. The results were compared with Type I diabetic patients and normal subjects, all of whom were matched for age, sex and weight. At the same level of glycemic control, the daily need for insulin was significantly lower in the patients with pancreatogenic diabetes than in those with Type I diabetes. Concentrations of serum total VLDL and HDL triglyceride were higher in the pancreatectomized patients than in the diabetic or normal controls, whereas concentrations of serum total and LDL cholesterol were significantly lower. The composition of the VLDL, LDL and HDL particles was abnormal in the totally pancreatectomized patients as all three lipoprotein fractions were enriched in triglyceride. HDL2 cholesterol was similar in the totally pancreatectomized patients to that in the other two groups but HDL3 cholesterol was lower. Postheparin plasma lipoprotein lipase and hepatic lipase activities were normal. It is concluded that in totally pancreatectomized patients the changes in the lipoprotein profile on reflect more the action of various confounding factors, i.e. malabsorption, continuance of alcohol abuse and dietary changes than the impact of the diabetes itself.

Adult↗

Remissions in newly diagnosed type 1 (insulin-dependent) diabetes: influence of interferon as an adjunct to insulin therapy.

We studied the effect of interferon as an adjunct to conventional insulin therapy on the early course of Type 1 diabetes in 43 newly diagnosed patients. Compared with conventional therapy, interferon administration slightly delayed the improvement of glucose homeostasis and the rise of high density lipoprotein cholesterol, while C-peptide secretion was unaffected. Independent of the type of therapy, 18 patients (42%) entered partial remission. The remission began 2.0 +/- 0.6 months (mean +/- SEM) from the start of therapy and lasted for 4.1 +/- 1.1 months. Seven patients (16%) were still in remission 1 year after diagnosis. The patients who entered remission had higher initial C-peptide secretion, lower glycosylated haemoglobin levels and better initial control than patients without remission. Thus, interferon provided no benefits as an adjunct to conventional insulin therapy in unselected patients with newly diagnosed Type 1 diabetes. An important factor for the development of remission was the presence of C-peptide secretion at the time of diagnosis.

Adolescent↗

Extremely high concentration of serum prostate-specific acid phosphatase in an untreated prostatic cancer patient.

We report a patient having advanced prostatic cancer and serum immunoreactive prostate-specific acid phosphatase concentrations of up to 8.9 mg/l, which is more than 3000 times the upper limit of our health-associated reference interval. following orchiectomy, the enzyme concentration decreased to 1.5 mg/l in 5 days, and to 3.6 micrograms/l within 1.5 months and to 1.4 micrograms/l within 6 months.

Acid Phosphatase↗

Serum pepsinogen I and the state of gastric mucosa in an Estonian population sample.

Seventy-seven adult subjects from a rural population were examined by gastroscopic biopsy and serum pepsinogen I (PG I) determination. A new radioimmunoassay method for PG I determination, based on enzymatic iodination and the double antibody solid-phase technique, was used. A highly significant correlation (r = 0.488, p less than 0.001) between the state of the fundal mucosa and the PG I level was observed. In persons with severe or moderate forms of atrophic fundal gastritis the PG I values were notably lower than those of the other groups. Good differentiation of persons with normal fundal mucosa and with severe fundal gastritis was obtained. In subjects with a normal fundal mucosa the PG I values were significantly higher in men (130 +/- 48 micrograms/l) than in women (87 +/- 17 micrograms/l). A decline in serum PG I level with age was observed. In patchy gastritis the PG I value is helpful in assessing the state of the fundal mucosa.

Adult↗

Ischemic pain nonsegmentally produces a predominant reduction of pain and thermal sensitivity in man: a selective role for endogenous opioids.

Ischemic pain was produced by a blood pressure cuff placed to the arm of healthy human subjects for 15 min which produced a mean pain score of 59% (visual analogue scale). Ischemia induced a significant dental pain threshold elevation (mean 67%) and 2 mg of naloxone did not reduce it. Thermal sensitivity of the upper lip had a tendency to reduction during ischemia and 2 mg of naloxone reduced this effect. Tactile thresholds in the forehead or in the contralateral arm were not markedly elevated. Neither ACTH nor prolactin level in the plasma was related to the dental pain threshold elevation during ischemia. The findings of the present study suggest that ischemic pain nonsegmentally produces a predominant inhibition of responses to thin afferents. Endogenous opioids may markedly contribute to the reduction of thermal sensitivity induced by ischemia, but their contribution to dental pain threshold elevations seems to be less important. Stress or other adenohypophyseal mechanisms involving the release of ACTH or prolactin do not explain the effects of ischemia found in the present study.

Adrenocorticotropic Hormone↗

Seasonal variation of urinary calcium and oxalate excretion, serum 25(OH)D3 and albumin level in relation to renal stone formation.

Seasonal variations in urinary calcium and oxalate excretion, serum 25(OH)D3 and albumin level were studied in 11 normo- and 11 hypercalciuric renal stone-formers, in 10 healthy subjects and in 14 long-stay hospital patients during one year. Serum albumin levels increased significantly during May--October in all four groups, whereas no significant changes occurred in serum calcium values when adjusted for differences in serum albumin concentration. Serum 25(OH)D3 level, urinary calcium and oxalate excretion were significantly higher during May--October than November--April in all except the long-stay hospital patients, whose corresponding values showed no seasonal changes and whose serum 25(OH)D3 levels as well as urinary calcium excretion were significantly lower than in the other three groups. The serum 25(OH)D3 level was significantly higher throughout the year in hypercalciuric than normocalciuric stone-formers. The hypercalciuric patients also passed more stones than the normocalciuric patients during a period of 9 years. There was a positive correlation between serum 25(OH)D3 and urinary calcium, between serum 25(OH)D3 and stone episodes and between urinary calcium and stone episodes. Because of this positive correlation, it might be useful to concentrate preventive therapy for recurrent renal stones to the light period only.

Adult↗

Use of hormone receptors in scintigraphy of the ovaries.

Based on the mechanism of hormone receptors, luteinizing hormone (LH) labelled with 123-iodine was used as tracer in scintigraphy of rabbit ovaries. The ovaries were visualized in static pictures 6-15 min after injection except in the case where the rabbit was pre-injected with 10 micrograms of cold LH. 3.1% of the injected activity was found in the ovaries 14 h after injection.

Animals↗

Pituitary function in prolactinoma. Effect of surgery and postoperative bromocriptine therapy.

Forty-five women and fifteen men with prolactinomas have been treated surgically. Patients with large tumours received pituitary irradiation and postoperative hyperprolactinaemia was treated with bromocriptine. The patients have been followed-up for 6-36 months following the operation. The tumours were larger and the levels of production higher in men as compared with women. All women had amenorrhoea. Galactorrhoea was present in forty-three women but not in the men. After surgery serum prolactin levels fell significantly in all women but remained above normal in thirty-six; prolactin remained high in twelve men. Bromocriptine effectively decreased the postoperative hyperprolactinaemia. The surgical complications were oculomotor nerve paresis in one woman and one man. After surgery six (23%) women developed impaired GH secretion, six (15%) impaired thyroid function, eight (18%) impaired cortisol secretion and five (17%) impaired LH secretion in isolation or combination which had not been present preoperatively. Three patients relapsed. Fifteen women menstruated after surgery and ten began to do so during the subsequent bromocriptine treatment. Thus, menstruation was restored in all six women with microadenomas in sixteen of twenty patients with intrasellar macroadenomas and three of nineteen patients with suprasellar adenomas. The preoperative LH-reserve proved to be an important prognostic indicator. Nine patients, i.e. 50% of patients desiring fertility became pregnant. In the men gonadal function deteriorated in four patients and did not improve in any without testosterone treatment.

Adenoma↗

Carbohydrate ingestion before exercise: comparison of glucose, fructose, and sweet placebo.

To examine the effect of various carbohydrates on the metabolic and hormonal response to exercise, 75 g glucose, fructose, or placebo were given to nine well-trained males (VO2 max 60 +/- 1 ml . kg-1 . min-1) 45 min before cycle ergometer exercise performed at 75% VO2 max for 30 min. After glucose ingestion, the rise in plasma glucose was 3-fold (P less than 0.005) in plasma insulin 2.5-fold (P less than 0.01) greater than after fructose. During exercise, after glucose administration plasma glucose fell from 5.3 +/- 0.3 to 2.5 +/- 0.2 mmol/l (P less than 0.001) and after fructose from 4.5 +/- 0.1 to 3.9 +/- 0.3 mmol/l (P less than 0.05). The fall in plasma glucose was closely related to the preexercise levels of plasma insulin (r = 0.82, P less than 0.001) and glucose (r = 0.81, P less than 0.001). Both glucose and fructose ingestion decreased the FFA levels by 40-50% (P less than 0.005) and during exercise they remained 30-40% lower after carbohydrate than placebo administration (P less than 0.02). This study suggests that glucose ingestion prior to exercise results in hypoglycemia during vigorous exercise, this rapid fall in plasma glucose is mediated, at least in part, by hyperinsulinemia, and fructose ingestion is associated with a modest rise in plasma insulin and does not result in hypoglycemia during exercise.

Administration, Oral↗

Plasma insulin, C-peptide, and blood glucose in portal, hepatic and peripheral veins in liver cirrhosis. Effect of intravenous tolbutamide.

The responses of portal, hepatic and peripheral venous blood glucose (BG), plasma insulin (IRI) and C-peptide (IRC) levels to iv tolbutamide (200 mg) have been determined in 9 non-diabetic patients with liver cirrhosis and in 6 control subjects. The basal levels of plasma IRI and IRC were similar in patients and controls as were the portal and peripheral BG levels. In the hepatic vein, however, the BG-levels were higher in cirrhotic patients than in controls. After tolbutamide administration the BG-levels were unchanged in the cirrhotic patients but a significant fall in hepatic vein BG was observed in controls. In both groups of subjects the highest post-tolbutamide IRI-levels were found in the portal vein whereas the corresponding IRC-levels were as high in the hepatic as in the portal vein. The increments of portal venous IRI and IRC were significantly higher in controls as compared to the cirrhotic patients. Nevertheless, in the peripheral veins the increments of IRI and IRC were very similar in both groups of subjects or even less in the control subjects. The results suggest that in patient with liver cirrhosis the secretion of insulin is not increased but slightly decreased. The production of glucose by the liver also seems to be increased either due to insulin resistance or portal venous shunting of insulin.

Adult↗

Hormonal pattern in prostatic cancer. I. Correlation with local extent of tumour, presence of metastases and grade of differentiation.

In 32 subjects with histologically and/or cytologically verified prostatic cancer the hormonal pattern was studied by assaying 18 plasma and urinary hormones or groups of hormones. The tumours were classified according to the UICC classification system and the hormone values were correlated to the local extent of the tumour (T classification), the presence of metastases (M classification) and the differentiation of grade (G classification). It was found that patients with metastases had significantly higher plasma oestradiol and lower testosterone/oestradiol and testosterone/oestrone plus oestradiol ratios as compared to those subjects without metastases. In subjects with moderately or poorly differentiated tumours plasma oestrone + oestradiol was significantly higher and the testosterone/oestrone + oestradiol ratio was significantly lower than in the subjects with well differentiated tumours. In the various TNM classification groups no obvious trends were found with regard to urinary hormones and no significant differences between the groups for plasma FSH, LH, prolactin, progesterone and cortisol were observed. It is concluded that in more advanced cases with metastatic cancer and when tumours are less well differentiated the androgen/oestrogen ratio may be decreased. These alterations have no diagnostic significance because of greater overlapping of individual results between the various groups of patients.

Age Factors↗

Hormonal pattern in prostatic cancer. II. Correlation with primary response to endocrine treatment.

In 32 subjects with histologically and/or cytologically verified prostatic cancer the hormonal pattern was studied by assaying 18 plasma and urinary hormones or groups of hormones and relating the values to the response to endocrine treatment. Total orchidectomy (orchiepididymectomy) was performed on 9 patients, subcapsular orchidectomy on 13 patients and oestrogen therapy with Estradurin was given in 4 patients. Six patients had total orchidectomy followed by estrogen therapy. With few exceptions all values were within the normal range. The only significant exceptions were the high urinary oestrogen values and the low urinary oestrone + oestradiol/oestriol ratio observed as compared to healthy males working in a factory. No urinary hormone values or ratios of hormone values could be used for the prediction of prognosis in prostatic carcinoma patients. However, the ratios of plasma testosterone/oestradiol (T/Oe2) and testosterone/prolactin (T/Prl) were found to give good information with regard to the response to endocrine treatment. High values for one or both of these ratios meant a good response to treatment in all subjects without exception in this material. Subjects with both ratios low had a good response to endocrine treatment in 50% of the cases. No other plasma hormones measured were of any help prognostically. It is concluded that by measuring the T/Oe2 and T/Prl ratios it seems possible to select a group of patients with favourable primary response to endocrine treatment.

Aged↗

Bomocriptine treatment of patients with acromegaly resistant to conventional therapy.

Eleven patients with active acromegaly resistant to conventional therapy were treated with bromocriptine for 15 (12--22) months by increasing the daily dose stepwise from 5 to 10--60 mg. A satisfactory response was achieved in all but one of the eight patients, in whom the mean diurnal level of serum GH was less than 50 ng/ml, whereas patients with grossly elevated serum GH levels responded poorly. In the longterm, no overall effects on glucose tolerance or plasma insulin (IRI) levels were observed but the chemical diabetes of three patients ameliorated in two. On the other hand, a dose-dependent acute suppressive effect of bromocriptine on plasma IRI response to oral glucose was observed, suggesting a direct effect of bromocriptine on the release of insulin from beta cells. Bromocriptine seems to be a good alternative in the treatment of patients with acromegaly who have not responded to conventional therapy.

Acromegaly↗

Thyroid hormones and TSH, prolactin and LH responses to repeated TRH and LRH injections in depressed patients.

Twelve patients with unipolar depressive disorders received 600 microgram of synthetic TRH or LRH, in a random order, for 3 days each. Placebo injections were given as two 3-day courses prior to and between the active treatments. Serum TSH, prolactin (Prl) and LH were measured by radioimmunoassays prior to the experiment as well as immediately before and 20 min after each injection. Serum T4 and T3 were determined by radioimmunoassays before the treatments and 24 h after the first two TRH injections. Serum T4 level in depressed patients did not differ from controls. Serum T3 level in depressed patients was significantly below, and the reverse T3 level was slightly above the normal mean. However, the latter difference was not statistically significant due to the large variation of rT3 levels among the depressed patients. The TSH responses did not differ from that of controls after the first injection but the responses after the second injection were lower than in a control study. The Prl responses to TRH were sub-normal in seven out of eight patients. Blunted LH responses to LRH were seen in three patients.

Adult↗