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Biomedical subjects

T Kurki

Publications and source records attributed to T Kurki.

At least 55 records · Page 3Linked to original sources
PubMed1995

Head and neck cancer: detection of recurrence with PET and 2-[F-18]fluoro-2-deoxy-D-glucose.

PURPOSE: To evaluate positron emission tomography (PET) with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) in detection of suspected recurrence of head and neck cancer, and to compare visual, static, and kinetic analyses of the tracer uptake. MATERIALS AND METHODS: Seventeen dynamic FDG PET studies were performed in 15 patients. The images were interpreted visually, and the uptake was quantitated as the standardized uptake value (SUV) and as the regional FDG metabolic rate. RESULTS: Sensitivity of blinded visual interpretation of the PET images for the presence of malignancy was 88% and specificity was 86%. Malignant lesions accumulated significantly more FDG than benign lesions (P = .008 for SUVs, P = .002 for regional metabolic rates). When maximum uptake of FDG in the benign lesions was used as a threshold, the sensitivity of SUV analysis for malignancy was 75% and that of regional metabolic rates was 86%. CONCLUSION: Detection of recurrent head and neck cancer is feasible with FDG PET. Quantitation of FDG uptake assists in correct interpretation of the PET images.

Deoxyglucose↗
PubMed1995

Father's heart beat responds to the birth of his child.

We monitored the electrocardiogram of 20 fathers while their child was born. Paternal heart rate rose on average by 53% during delivery from the starting point frequency (72 beats/min.) to the maximum (115 beats/min.) just before the birth of the child. Judging from the heart rate variation, paternal sympathetic activity increased by 25% and vagal tone decreased by 22% during delivery. No derangements in cardiac function were encountered, not even in the man who fainted.

Adult↗
PubMed1994

Increased incidence of bronchopulmonary dysplasia after antenatal administration of indomethacin to prevent preterm labor.

The aim of this randomized study was to compare the neonatal outcome in infants who have been exposed in utero to indomethacin with that in infants exposed to a beta-adrenergic agonist, nylidrin hydrochloride. Eighty pregnant women threatened with preterm labor between 24 and 34 weeks of gestation were enrolled in the study. An intravenous infusion of nylidrin or enterally administered indomethacin was given for a maximum of 72 hours. If preterm labor recurred, all parturient patients were treated with nylidrin. Indomethacin prolonged gestation significantly more than the beta-adrenergic agonist (6.6 weeks vs 4.5 weeks; p = 0.04). Ten of the forty-two infants exposed to indomethacin and 2 of the 45 infants exposed to nylidrin had bronchopulmonary dysplasia (24% vs 5%; p = 0.02). Among the 28 infants delivered within 120 hours after the start of treatment, the incidences of respiratory distress syndrome (82% vs 29%; p = 0.02), bronchopulmonary dysplasia (73% vs 6%; p = 0.0006), and necrotizing enterocolitis or focal intestinal perforation (27% vs 0%; p = 0.03) were higher among those exposed to indomethacin than among those exposed to nylidrin. We infer that administration of indomethacin to pregnant women threatened with premature labor is associated with an increased risk of bronchopulmonary dysplasia in their infants if delivery occurs early.

Adult↗
PubMed1994

MR of intracranial tumors: combined use of gadolinium and magnetization transfer.

PURPOSE: To study the potential combined application of gadolinium and magnetization transfer in the MR imaging of intracranial tumors. METHODS: Twenty-two patients were imaged at low field strength (0.1 T). Corresponding gradient-echo partial saturation images without and with magnetization transfer pulse were produced. Images with intermediate repetition times were obtained in 18 cases; five different sequences were produced in 4 cases. Gadopentetate dimeglumine was used at a dose of 0.1 mmol/kg. RESULTS: Magnetization transfer effect increased the contrast between enhancing lesion and normal brain and the contrast between edema and normal brain; the contrast between enhancing lesion and edema was not significantly changed. On intermediate-repetition-time magnetization transfer images the contrast between enhancing tumor and normal brain and the contrast between edema and normal brain were superior to short-repetition-time magnetization transfer images, but the differentiation between enhancing tumor and edema was poorer. CONCLUSION: Magnetization transfer can be used to improve contrast in Gd-enhanced MR imaging. Combining magnetization transfer with an intermediate-repetition-time image provides the possibility for displaying both enhancing and nonenhancing lesions on a single MR image.

Astrocytoma↗
PubMed1994

High-resolution CT of the lung in asbestos-exposed subjects. Comparison of low-dose and high-dose HRCT.

The lowest possible mAs settings for high-resolution CT (HRCT) were studied on 45 individuals with suspected asbestos-related lung disease. All patients were investigated with 5 to 6 high-dose HRCT images (120 kVp/160 mA/2 s) at 3-cm intervals. At a selected level 4 additional low-dose images were obtained on each patient with lower mAs settings (100 mA/2 s, 80 mA/2 s, 60 mA/2 s, 30 mA/2 s). Thirty-seven subjects out of 45 had HRCT lesions compatible with asbestosis. HRCT images obtained with as low as 60 mA/2 s settings clearly showed pleural tractions and thickenings, parenchymal bands, honeycombing and subpleural curvilinear shadows, whereas in the evaluation of subpleural short lines and ground glass findings 80 mA/2 s were required. The lowest setting, 30 mA/2 s, was sufficient only in detecting and evaluating pleural tractions and thickenings. We conclude that 160 mAs yield good quality HRCT images, with substantial decrease of radiation dose, for the evaluation of asbestos-related lesions.

Adult↗
PubMed1993

Coitus during pregnancy is not related to bacterial vaginosis or preterm birth.

OBJECTIVE: Our goal was to assess the relationship between bacterial vaginosis and sexual intercourse and the impact of both on preterm birth. STUDY DESIGN: The presence of bacterial vaginosis was assessed in 790 healthy nulliparous women between 8 and 17 weeks' gestation, and they were then asked to record weekly the number of occasions of sexual intercourse from registration to term. The end point for each was the occurrence of preterm uterine contractions, preterm birth, or preterm rupture of the membranes. RESULTS: A total of 407 women returned the specific follow-up charts on vaginal intercourse. Bacterial vaginosis was detected at registration in 93 of the 407 subjects (22.9%), but the presence or absence of bacterial vaginosis had no predictive value as regards the frequency of subsequent intercourse. Of the 39 women (9.6%) who experienced threatened preterm labor, 16 were delivered before 37 weeks of gestation. In addition, premature rupture of membranes occurred in 48 women (9 preterm and 39 term). The 95% confidence interval for the weekly frequency of intercourse was calculated for those women delivered at term; a larger (p < 0.05) proportion of women delivered preterm, with (6/9, 66.7%) or without (13/16, 81.3%) premature rupture of membranes, had frequencies less than the 95% confidence interval during the second trimester of pregnancy; the respective proportions were 75.0% (6/8) and 78.6% (11/14) during the third trimester. Furthermore, among those women who had stopped having sexual intercourse in the last trimester, a larger (p < 0.05) proportion was delivered preterm (57.1%), with or without premature rupture of membranes, than was delivered at term (13.6%). In addition, only three women (18.8%) delivered preterm, with (two women) or without (one woman) premature rupture of membranes, reported having intercourse within 1 week before the onset of complications. CONCLUSION: For healthy nulliparous women, coitus during pregnancy is not related to bacterial vaginosis and does not predispose to preterm birth.

Coitus↗
PubMed1993

Relationship between vascular factors and white matter low attenuation of the brain.

To study the relationship between vascular factors and white matter low attenuation of the brain (WMLA), computer tomography findings of 251 patients were re-interpreted. Clinical data on patients were collected from the hospital records. It was possible to obtain sufficient clinical data on 204 patients who were included in the study. WMLA changes, on computer tomography, were found in 51.5% of patients. WMLA was most commonly present in patients with vascular (69.8%) and combined (69.2%) dementia. The occurrence of WMLA did not differ between patients with Alzheimer's disease (26.7%) and those without dementia (35.9%). Arterial hypertension, coronary heart disease, or diabetes were not associated with WMLA. Heart failure and orthostatic hypotension, were found to be more commonly present in patients with than in those without WMLA (34.0% vs 14.3%, p = 0.0012; 10.0% vs 2.0%, p = 0.036). Both systolic and diastolic low blood pressure values were associated with WMLA unlike hypertensive blood pressure values. Atrial fibrillation in electrocardiography was associated with WMLA, while neither left ventricular hypertrophy nor myocardial infarction was. When several explanatory variables were adjusted by logistic regression analysis, age, heart failure, and systolic blood pressure below 130 predicted WMLA. In conclusion, the association between WMLA and vascular factors with hemodynamic significance suggests that cerebral hypoperfusion may contribute to the genesis of WMLA.

Adult↗
PubMed1992

Urinary excretion of prostacyclin and thromboxane metabolites in threatened preterm labor: effect of indomethacin and nylidrin.

OBJECTIVE: We studied the role of smooth muscle-relaxing prostacyclin and its endogenous antagonist, thromboxane A2, in preterm labor by assessing the urinary output of the breakdown products of prostacyclin (6-keto-prostaglandin F1 alpha and 2,3-dinor-6-keto-prostaglandin F1 alpha) and those of thromboxane A2 (thromboxane B2, 2,3-dinor-thromboxane B2). STUDY DESIGN: Thirty-three women in preterm labor between 25 and 34 weeks of gestation were studied before, during, and after treatment with indomethacin (n = 16) or nylidrin (n = 17). Urinary prostanoid levels were determined by high-performance liquid chromatography followed by radioimmunoassay, and the excretion was expressed as nanograms of prostanoids per millimole of creatinine. Statistical analyses were done by paired and unpaired Student t test, by Spearman's correlation, and by Wilcoxon signed-rank test. RESULTS: Preterm labor was accompanied by a median 32% higher output of prostacyclin and thromboxane A2 metabolites as compared with those in 25 controls. At 8 hours after the start of treatment indomethacin induced maximal drops in 6-keto-prostaglandin F1 alpha (70%), in dinor-6-keto-prostaglandin F1 alpha (60%), in thromboxane B2 (85%), and in dinor-thromboxane B2 (95%) excretion. Within 1 week after the cessation of indomethacin, output of prostacyclin metabolites had recovered to pretreatment values, whereas output of thromboxane A2 metabolites was yet lower than the pretreatment value. Nylidrin induced no change in the output of prostacyclin and thromboxane A2 metabolites. CONCLUSION: Threatened preterm labor is associated with a rise in prostacyclin and thromboxane A2 synthesis. Indomethacin inhibits more thromboxane A2 than does prostacyclin synthesis. These findings may explain the fetal vascular changes during maternal indomethacin treatment.

6-Ketoprostaglandin F1 alpha↗
PubMed1992

Premature rupture of the membranes: effect of penicillin prophylaxis and long-term outcome of the children.

To assess the value of prophylaxis with penicillin in women with premature rupture of membranes (PROM) and the long-term outcome of children born after prolonged PROM, we studied 221 women with this condition. Penicillin (5 mu twice, 6 hours apart) was given intravenously to 50 women and placebo to 51 women, whereas 76 comparable patients were treated without penicillin or placebo. The time interval between PROM and delivery ranged from 14 hours to 56 days. Chorioamnionitis occurred more frequently (p less than 0.05) among patients with placebo (14%) than among those treated with penicillin (2%). One puerperal endometritis appeared in the placebo group compared with none in the penicillin group. One newborn (1.7%) born to a mother with placebo prophylaxis developed septicemia, compared with none in the penicillin group. The outcomes of pregnancies complicated with PROM treated without penicillin or placebo were comparable with those in the placebo group. In addition, we compared somatic and psychomotor development of 159 children born to mothers with prolonged PROM (more than 12 hours; mean, 5.6 days; range, 14 to 1344 hours) with those of 43 children born at similar gestational age within 5 hours after PROM. No pulmonary sequelae could be linked to the long time period between PROM and delivery, but infants born soon after PROM more often (p less than 0.05) had cerebral palsy (8 of 43, 18.6%) than did infants born after prolonged PROM (7 of 159; 4.4%). We conclude that, in cases with PROM, penicillin prophylaxis decreases maternal and neonatal infectious morbidity and that the long interval between PROM and delivery does not impair the long-term outcome for these children.

Adult↗
PubMed1992

T1 in subacute and chronic brain infarctions. Time-dependent development.

RATIONALE AND OBJECTIVES: Time-dependent behavior of T1 in brain infarcts and in brain tissue of the contralateral hemisphere was studied in the subacute and early chronic stages of stroke. METHODS: T1 was measured from magnetic resonance images (MRIs) of 29 patients as a function of infarct location and age. Another group of 11 patients was studied with consecutive MRI studies during the first 5 weeks after the onset of infarct, and the distribution of T1 in the infarctions was analyzed from T1 maps using a histographic method. RESULTS: During the first 2 months after a stroke, T1 was longer in the infarcted gray matter than in the infarcted white matter (P = .002), and prolonged linearly in both. The histographic analysis showed a component arising from tissue breakdown products that could be identified for up to 5 weeks. A transient lengthening in T1 of the contralateral hemisphere, reaching a maximum at 3 weeks, also was observed. CONCLUSIONS: These characteristics of recent infarctions differentiate them from older, gliotic lesions. The lengthening of T1 in the contralateral hemisphere may reflect remote flow and metabolic effects of brain infarctions.

Acute Disease↗
PubMed1992

Bacterial vaginosis in early pregnancy and pregnancy outcome.

OBJECTIVE: We assessed the association between bacterial vaginosis in early pregnancy and adverse pregnancy outcome. METHODS: Vaginal swabs for bacterial culture, Gram stain, and Papanicolaou stain were taken at the first prenatal visit between 8-17 weeks' gestation in 790 healthy nulliparous women. RESULTS: Culture-proven bacterial vaginosis was detected in 169 of 790 women (21.4%), 167 (98.8%) of whom could also be identified by Gram stain. Papanicolaou smears were available from 299 women, among whom 101 had bacterial vaginosis on culture; of these 101, 78 (77.2%) could be detected by Papanicolaou stain. Of the 751 women whose clinical follow-up was completed, 42 had been treated for preterm uterine contractions (preterm labor), but only 17 delivered between 20-36 weeks' gestation (preterm birth). Premature rupture of membranes (PROM) occurred more than 6 hours before delivery in 80 cases (nine preterm and 71 term). Bacterial vaginosis in early pregnancy predicted preterm labor, preterm birth, or preterm PROM with a sensitivity of 41-67%, specificity of 79%, and negative predictive value of 96-99%, but the positive predictive value was low at 4-11%. However, bacterial vaginosis was associated with a 2.6-fold risk (95% confidence interval [CI] 1.3-4.9) for preterm labor, a 6.9-fold risk (95% CI 2.5-18.8) for preterm birth, and a 7.3-fold risk (95% CI 1.8-29.4) for preterm PROM. CONCLUSIONS: Bacterial vaginosis in early pregnancy can be detected reliably by Gram stain and, in most cases, by Papanicolaou smear. Although bacterial vaginosis is associated with preterm labor, preterm birth, and preterm PROM, the clinical usefulness of its assessment is limited because of the high rate of false-positive findings.

Adult↗
PubMed1991

The effects of indomethacin and a beta-sympathomimetic agent on the fetal ductus arteriosus during treatment of premature labor: a randomized double-blind study.

To study the effect of maternal indomethacin or nylidrine hydrochloride treatment on the fetus ductus arteriosus and the pulmonary artery, 27 women with threatened preterm labor between 24 and 34 weeks' gestation were studied by echocardiography. Fourteen women were treated with indomethacin and 13 with nylidrin. Both systolic and diastolic velocities in the ductus increased after administration of indomethacin indicating constriction in nine fetuses, and exceeded the corresponding velocities in the fetuses of the nylidrin group (p = 0.001). However, there were no changes in pulmonary artery flow velocities (p greater than 0.5). In the indomethacin group, there was a significant linear positive relationship between the gestational age and the change in ductal flow velocity. Three of the nine patients with ductal constriction also had tricuspid regurgitation. These findings indicate that indomethacin, not nylidrin, causes transient constriction of the ductus arteriosus and the constrictive response increases with the gestational age. We recommend echocardiographic surveillance of fetal hemodynamics when prostaglandin synthesis inhibitors are used in the treatment of spontaneous preterm labor.

Blood Flow Velocity↗
PubMed1991

Maternal plasma corticotrophin-releasing hormone--elevated in preterm labour but unaffected by indomethacin or nylidrin.

The role of corticotrophin-releasing hormone (CRH) in preterm labour was studied in 23 women in preterm labour at between 26 and 33 weeks gestation who were randomly allocated to receive treatment with indomethacin (n = 11) or with nylidrin a beta-sympathomimetic agent (n = 12). Maternal plasma CRH in the preterm group (median 70, range 9-597 pmol/l) before therapy was higher (P less than 0.05) than that in 23 control pregnancies, without uterine contractions, matched for gestational age (median 51, range 4-127 pmol/l). CHR levels determined after 3 and 24 h of treatment showed a 10% decrease in the indomethacin group and 10-20% decrease in the nylidrin group, but these changes were not statistically significant. After cessation of uterine contractions during tocolysis, 12 women proceeded to give birth preterm (less than 37 weeks) and their pretreatment CRH levels (median 195, range 9-597 pmol/l) were higher (P less than 0.05) than those in women whose pregnancy proceeded to term (median 52, range 16-207 pmol/l). In another group of women, full-term labour was not accompanied by any changes in maternal CRH levels. Umbilical plasma CRH levels were 1.1-9.8% of the paired maternal levels and did not rise with advancing gestational age. Nor had the type of delivery (elective caesarean section before labour, or preterm or term vaginal delivery) any effect on fetal CRH levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Catechol-O-methyltransferase activity in red blood cells in threatened preterm labor; effect of indomethacin and nylidrin.

Catecholamines that are released in excess during human labor are inactivated mainly by catechol-O-methyltransferase (COMT). To ascertain whether uterine contractions are associated with changes in COMT activity in red blood cells (RBCs), we studied 25 women with established threat of preterm labor between 25 and 33 weeks of gestation, 25 gestational age-matched control women not experiencing uterine contractions, 25 women who were in term labor, and 25 non-pregnant healthy women. COMT activity in pregnant women without uterine contractions (median 0.3, range 0.1-0.8 pmol/mg/min) was lower (p less than 0.05) than that in non-pregnant control series (median 0.5, range 0.3-0.7 pmol/mg/min). RBCs' COMT activity in women with preterm labor (median 0.6, range 0.2-1.1 pmol/mg/min) was greater (p less than 0.05) than that in pregnant and non-pregnant control women, but similar to that during term labor (median 0.5, range 0.2-1.7 pmol/mg/min). Women with preterm labor were treated with indomethacin (12 women) or nylidrin (13 women). Nylidrin treatment was accompanied by a 35% rise in COMT activity 3 h later, whereas indomethacin caused no significant change. Apart from cessation of uterine contractions during tocolysis, 13 women went into labor before the 37th gestational week, but their pretreatment COMT activity (median 0.7, range 0.2-1.1 pmol/mg/min) did not differ from COMT activity in women whose pregnancy proceeded to term (median 0.5, range 0.3-1.0 pmol/mg/min).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

A randomized double-dummy comparison between indomethacin and nylidrin in threatened preterm labor.

We compared the tocolytic effect of indomethacin and nylidrin in a prospective double-blind trial in which the appearance of the tocolytic treatment (always intravenous infusion and rectal suppositories/oral capsules) was identical to the subjects. Sixty healthy women in imminent preterm labor between 25-34 weeks of singleton gestation were included. Thirty of these women received indomethacin (concomitantly with placebo infusion), with doses as follows: day 1, 100-mg rectal suppository followed by two oral capsules (50 mg) at 8-hour intervals; days 2 and 3, three 50-mg oral capsules each day. Thirty women received intravenous nylidrin (concomitantly with rectal/oral placebo), initiated with the dose of 50 micrograms/minute and continued at the dose of 100-150 micrograms/minute for a maximum of 3 days. Preterm labor was arrested for 24, 48, and 72 hours in 100, 96, and 90%, respectively, of subjects in the indomethacin group, compared with 100, 76, and 73% of women in the nylidrin group; the difference was significant (P less than .05) at 48 hours. Women progressed beyond 37 gestational weeks more commonly (P less than .05) with indomethacin (21 of 30, 70%) than with nylidrin (13 of 30, 43%). Indomethacin treatment was accompanied by maternal side effects 20% of the time, significantly less commonly (P less than .001) than with nylidrin (83%). The neonatal outcome was similar in the two study groups. We conclude from this double-dummy technique trial that indomethacin is more effective and better tolerated than nylidrin in arresting imminent preterm labor.

Adult↗