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Biomedical subjects

A Penttilä

Publications and source records attributed to A Penttilä.

At least 73 records · Page 4Linked to original sources
PubMed1996

Moderate alcohol consumption and disorders of human spermatogenesis.

Environmental factors are suspected to be responsible in part for the deterioration in semen quality observed worldwide during the recent few decades. Alcohol might be one factor, considering the frequent changes in testicular function associated with heavy drinking. The dose-dependent effects of alcohol on human spermatogenesis are, however, not well known. We analyzed spermatogenesis and testicular tissue morphology of 195 men, aged 35-69 years, with computer-assisted microscopy in this autopsy study. The men were categorized into controls and four "consumption groups" according to the average daily alcohol consumption, which was determined on the basis of blind interviews with relatives and acquaintances. When the average daily alcohol consumption was 40 g or less, 59 (66%) of the 90 men showed normal spermatogenesis, whereas 31 (34%) had partial spermatogenic arrest (SA). Of the 31 men with average daily intake between 40 and 80 g, 17 (54%) showed normal spermatogenesis, 13 (42%) had partial or complete SA, and 1 man exhibited more severe testicular damage-"Sertoli cell only" (SCO) syndrome. Among men with daily intake between 80 and 160 g, only 13 of 35 men showed normal spermatogenesis (37%), 19 (54%) had partial or complete SA (odds ratio = 2.92), and 3 (9%) had the SCO syndrome (odds ratio = 16.85). The frequencies of spermatogenic disorders were similar in men drinking in excess of 160 g. Both SA and the SCO syndrome showed a clear dependence on daily dose; p < 0.0001 and p < 0.0004, respectively. We conclude that long-term average daily consumption of < 40 g of alcohol seems not to be associated with disorders of spermatogenesis. Consumption of moderate amounts of alcohol may affect semen quality more often than previously thought, whereas high alcohol consumption may even be associated with serious disorders of spermatogenesis.

Adult↗
PubMed1995

Early perivenular fibrogenesis--precirrhotic lesions among moderate alcohol consumers and chronic alcoholics.

Cirrhosis is believed to be preceded by "precirrhotic" lesions indicating initial fibrogenesis in the perivenular area. We investigated three previously described markers of early perivenular fibrogenesis: the thickness of the rim of the terminal hepatic venule, perivenular fibrosis and perivenular fibronectin deposition. The frequencies of these features were evaluated and compared to long-term daily alcohol intake in autopsy series of 120 males comprising abstainers, moderate alcohol consumers and chronic heavy alcohol consumers. Thickening of the rim of the terminal hepatic venule showed no correlation to the long-term daily ethanol intake. In contrast, compared to abstainers, daily alcohol intake between 40 and 80 g for an average of 25 years was associated in an increased number of subjects with perivenular fibrosis (13.3% vs 38.9%, p < 0.05), and with perivenular fibronectin deposition (13.3% vs 44.4%, p < 0.025). Similarly, daily intake exceeding 80 g was associated in an increased number of subjects with perivenular fibrosis (56.1%, p < 0.001) and with perivenular fibronectin deposition (56.1%, p < 0.001). A daily intake exceeding 80 g (110 g/d vs 240 g/d) did not, however, further increase the occurrence of these lesions. A daily intake below 40 g of absolute alcohol was not associated with signs of early perivenular fibrogenesis. In this study, the frequencies of subjects with perivenular fibrosis and perivenular fibronectin deposition correlated with the amount of daily alcohol intake. A daily intake between 40 and 80 g was associated with approximately a three-fold and a daily intake exceeding 80 g with approximately a five-fold increase in the risk of these features. This could suggest that daily intake between 40 and 80 g represents a "threshold" level, beyond which the risk of alcoholic liver fibrosis increases significantly. The majority (50-70%) of chronic heavy alcohol consumers presented signs of early perivenular fibrogenesis, whereas cirrhosis was found in only 20% of heavy consumers. This could suggest that alcohol-induced fibrotic lesions of the liver may develop in the majority of people, but factors other than cumulative alcohol consumpation may have a critical impact on the progression of early liver fibrosis to cirrhosis.

Adult↗
PubMed1995

Extracellular mast cell granules carry apolipoprotein B-100-containing lipoproteins into phagocytes in human arterial intima. Functional coupling of exocytosis and phagodytosis in neighboring cells.

In experimental studies in vitro, mast cells have induced uptake of apolipoprotein B-100 (apoB-100)-containing low-density lipoproteins by macrophages, with the subsequent formation of foam cells, the hallmarks of atherosclerosis. Recently, increased numbers of activated, ie, degranulated, mast cells were found to be present in human coronary fatty streaks and atheromas. We therefore sought evidence of a connection between mast cells and foam cell formation in vivo. In electron microscopic studies of human aortic and coronary fatty streaks and atheromas, exocytosed cytoplasmic secretory granules of mast cells were detected in the vicinity of their parent cells. These exocytosed granules had bound apoB-100-containing lipoproteins, as indicated by their positive staining with MB 47, a monoclonal antibody against apoB-100. A smooth muscle cell was observed to be in the process of phagocytosing one such exocytosed granule, and in the vicinity of a degranulated mast cell a foam cell contained an ingested mast cell granule. Therefore, the micrographs show that exocytosed granules of intimal mast cells may contribute to intimal foam cell formation and suggest a role for mast cells in human atherogenesis. More generally, the findings provide evidence that phagocytosis of apoB-100-carrying particles is one mechanism by which lipoproteins enter human arterial intimal cells.

Adult↗
PubMed1994

Lumbar disc degeneration and atherosclerosis of the abdominal aorta.

STUDY DESIGN: This study analyzed the relationship of disc degeneration to atherosclerotic changes in the abdominal aorta and stenosis of the ostia of the lumbar and middle sacral arteries, 86 plain radiographs of lumbosacral spines, and the corresponding abdominal aortas were evaluated in connection with routine autopsy. RESULTS: Disc degeneration, advanced atherosclerotic manifestations, and stenosis of the ostia of the lumbar and middle sacral arteries all increased with age (P < 0.001). After partial rank correlation analysis, keeping the effect of age constant, there was still a statistically significant association between the grade of disc degeneration and stenosis of the ostia of the arteries supplying the disc. The association was stronger at upper lumbar levels (0.001 < P < 0.01) than at lower ones (0.01 < P < 0.05). Furthermore, with complicated lesions in the abdominal aorta, disc degeneration at all lumbar levels increased. CONCLUSIONS: Atherosclerosis in the abdominal aorta and especially stenosis of the ostia of segmental arteries may play a part in lumbar disc degeneration.

Aging↗
PubMed1994

Abuse of alcohol in sudden out-of-hospital deaths in Finland.

Alcoholism is known to be greatly underdiagnosed in death certificates, a fact that biases in estimates of alcohol-related mortality. An autopsy series of 1658 cases (920 with natural cause of death and 738 nonnatural) was reviewed to evaluate the extent of this bias, and also to see how well different sources of information served as indicators of alcoholism when alcohol-related disease diagnosed at autopsy was considered as a gold standard. A stepwise logistic regression model adjusted by age and sex showed police reports of individual's alcohol usage and blood alcohol concentration (BAC) of > 2.9/1000 at autopsy to be the two most significant predictors of chronic alcohol abuse (p < 0.0001). The specificities of these two parameters as predictors of chronic alcohol abuse were generally high and sensitivities low. The authors see high BAC (> 2.9/1000), due to its high specificity, as particularly suggestive of chronic heavy drinking. However, it is wise to use these parameters only as an aid in decision-making, not as sole indicators of alcoholism. Deaths associated with chronic heavy drinking were frequent, 50.5% of the total series (male 56.4%, female 37.1%). For all but one age-group (male 45-64 years), however, death certificates mentioned alcohol-related diseases in less than half of these cases. Especially evident underdiagnosis was found for female and males 65 years and older. These results indicate that alcoholism is frequent in such a highly selected population as a series of forensic autopsies and suggest that estimates of prevalence of alcoholism based only on review of death certificates are to be considered with great caution.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents↗
PubMed1994

Cytokeratin inclusions in alcoholic liver disease and their relation to the amount of alcohol intake.

In the present study, the frequency and the distribution pattern of immunoreactive hepatocytic cytokeratin (CK) inclusions was investigated using the monoclonal antibody (MAb) CAM 5.2 detecting CKs 8, 18 and 19. The CK antigenicity of the inclusions was confirmed on frozen sections with MAbs for the CKs 7, 8, 17, 18 and 19. The frequency of hepatocytic CK aggregates was compared to the presence of non-alcoholic and alcoholic liver disease (ALD) as well as to the average all-year daily ethanol intake of 195 consecutive males subjected to medico-legal autopsy. Hepatocytic CK inclusions were infrequent in patients with normal liver histology, portal fibrosis and/or portal inflammation. In ALD, however, inclusions were observed in 35.6% of patients with fatty liver, in 63.2% of patients with alcoholic hepatitis, in 30.8% of patients with bridging fibrosis and in 60.0% of patients with liver cirrhosis. In all specimens studied, the inclusions were reactive only for CKs 8 and 18, CKs 7, 17, and 19 being unreactive. The frequency of inclusion bodies increased, paralleling increasing average all-year daily alcohol consumption. Compared to non-drinkers, a daily intake of between 40 and 80 g of absolute alcohol was associated with a statistically significantly (relative risk, RR = 6.6) increased risk of formation of aggregates. Similarly, daily consumption exceeding 80 g was related to increased (RR = 6.0) frequency of CK aggregates. The frequency of full-blown "classical" Mallory bodies (MBs) was, however, increased (RR = 8.9) only in patients with a daily intake exceeding 160 g.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Postmortem angiographic study of degenerative vascular changes in arteries supplying the cervicobrachial region.

OBJECTIVES: To study the prevalence of degenerative changes in the arteries supplying the cervicobrachial region, and their relation to cervical disc degeneration. METHODS: Fifty postmortem aortic arch angiographies were evaluated for occlusions and variations in the diameter of the vertebral arteries and thyro- and costocervical trunks, as well as for tortuosity, average diameter and the highest cervical level to which the ascending cervical artery, an upward continuation of the thyrocervical trunk, and the deep cervical artery, an upward continuation of the costocervical trunk, ascended. RESULTS: Localised segmental narrowings, usually situated close to the ostia of the arteries, were common, whereas total occlusions were rare. Thirty (60%) of the subjects showed a segmental narrowing at least in one of the six arteries analysed, while only two (4%) showed an occluded artery, which in both the cases was the thyrocervical trunk. Narrowings were most common in vertebral arteries, followed by costocervical and thyrocervical trunks. Segmental narrowings, as well as general tortuosity of the arteries, increased with age. It was also found that ascending and deep cervical arteries did not run as high up in the posterior neck muscles in older people as in younger ones. Twenty three subjects with marked cervical disc degeneration showed on average 2.3 arteries with segmental narrowings, while the corresponding figure for twenty seven subjects without disc degeneration was 0.6. Both the segmental narrowings and the disc degeneration, however, were strongly associated with age, and thus the causality between the former two remained unclear. CONCLUSION: The study showed that degenerative changes are common in the arteries supplying the cervicobrachial area, indicating that impaired blood flow might play a part in some cervicobrachial disorders.

Adolescent↗
PubMed1994

Pleural plaques and exposure to mineral fibres in a male urban necropsy population.

OBJECTIVES: The study aimed to evaluate the risk of pleural plaques according to the degree of past exposure to asbestos, type of amphibole asbestos, and smoking, as well as to estimate the aetiologic fraction of asbestos as a cause of plaques among urban men. METHODS: The occurrence and extent of pleural plaques were recorded at necropsies of 288 urban men aged 33 to 69 years. The pulmonary concentration of asbestos and other mineral fibres was analysed with scanning electron microscopy. The probability of past exposure was estimated from the last occupation. RESULTS: Pleural plaques were detected in 58% of the cases and their frequency increased with age, probability of past occupational exposure to asbestos, pulmonary concentration of asbestos fibres, and smoking. The risk of both moderate and widespread plaques was raised among asbestos exposed cases, and the risk estimates were higher for widespread plaques than for moderate plaques. The age adjusted risk was higher for high concentrations of crocidolite/amosite fibres than for anthophyllite fibres. The aetiologic fraction of pulmonary concentration of asbestos fibres exceeding 0.1 million fibres/g was 43% for widespread plaques and 24% for all plaques. The median pulmonary concentrations of asbestos fibres were about threefold greater among cases with widespread plaques than among those without plaques. No increased risk of pleural plaques was associated with raised total concentrations of non-asbestos fibres. CONCLUSION: The occurrence of pleural plaques correlated closely with past exposure to asbestos. The risk was dependent on the intensity of exposure. Due to methodological difficulties in detecting past exposures to chrysotile and such low exposures that may still pose a risk of plaques, the aetiologic fractions calculated in the study probably underestimate the role of asbestos.

Adult↗
PubMed1994

Mast cells of two types differing in neutral protease composition in the human aortic intima. Demonstration of tryptase- and tryptase/chymase-containing mast cells in normal intimas, fatty streaks, and the shoulder region of atheromas.

Biochemical studies in vitro have demonstrated that stimulated mast cells induce macrophage foam cell formation through the synergistic action of mast cell granule neutral proteases and proteoglycans. To determine the presence and number of mast cells in human arterial intima, the site of atherogenesis, specimens of normal and atherosclerotic human aortic intima from 35 autopsies of persons ranging from 13 to 67 years old were stained with monoclonal antibodies against the two major proteases of mast cells, tryptase and chymase. All mast cells present were found to contain tryptase, and an average of 40% contained chymase as well. In sections of normal intimas, fatty streaks, and atheromas, the mast cells had average densities of 15/mm2, 15/mm2, and 3/mm2, respectively. In contrast to the normal intimas and fatty streaks, however, the atheromas had mast cells distributed unevenly in a typical pattern: 8/mm2 in the shoulder region, 1/mm2 in the fibrous cap, and none in the core region. In normal intimas, fatty streaks, and the shoulder region of atheromas, the mast cells amounted to 3% of all nucleated cells. The ratios of mast cells to T lymphocytes and to macrophages, respectively, were 2:1 and 1:4 in normal intimas, 1:3 and 1:10 in fatty streaks, and 1:5 and 1:20 in the shoulder region of atheromas. Thus, among the blood-borne cells in the human aortic intima, mast cells compose a significant cell population, and in terms of their protease content, these intimal mast cells are heterogeneous.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Accumulation of activated mast cells in the shoulder region of human coronary atheroma, the predilection site of atheromatous rupture.

BACKGROUND: Rupture in the shoulder region of a coronary atheroma is considered to be a sequel to local extracellular matrix degradation in this highly vulnerable site. Such degradation could be triggered by mast cells, which are filled with neutral proteases and are present in coronary atheromas. However, the distribution and phenotype of mast cells within coronary atheromas have not been studied. METHODS AND RESULTS: Specimens of normal and atherosclerotic human coronary intima from 32 autopsy cases with ages ranging from 13 to 67 years were stained with monoclonal antibodies against the two major proteases of mast cells, tryptase and chymase. Of the tryptase-containing mast cells, a variable proportion (average, 40%; range, 0% to 100%) also contained chymase. In the normal coronary intimas, mast cells amounted to 0.1% of all nucleated cells. In the fatty streaks, this proportion was higher by 9-fold, and in the cap, core, and shoulder regions of atheromas by 5-, 5-, and 10-fold, respectively. Electron and light microscopic studies of mast cells in the shoulder region of atheromas revealed degranulation of mast cells, a sign of their activation, and moreover, that the proportion of activated mast cells was much higher (85%) in this region than in the normal intima (18%). CONCLUSIONS: The far higher proportion (50-fold) of activated mast cells in the shoulder region of atheromas supports the hypothesis that mast cells, a cell type capable of triggering matrix degradation, actively participate in the destabilization and ensuing rupture of coronary atheromas and thus may trigger an acute coronary event.

Adolescent↗
PubMed1994

Asbestos exposure and pulmonary fiber concentrations of 300 Finnish urban men.

OBJECTIVES: The aim of the study was to determine the pulmonary concentrations of mineral fibers in the Finnish male urban population and to evaluate the analysis of pulmonary fiber burden by scanning electron microscopy (SEM) as an indicator of past fiber exposure. METHODS: The pulmonary concentration of mineral fibers was determined by SEM and compared with occupational history for a series of 300 autopsies of urban men aged 33 to 69 years. RESULTS: The concentration of fibers (f) longer than 1 micron ranged from < 0.3 to 163.10(6) per gram of dry tissue (f.g-1). Asbestos fiber concentrations exceeding 1.10(6) f.g-1 were observed in 33% of the cases with probable occupational exposure to asbestos and 1% of the cases with unlikely occupational exposure. Even asbestos fiber concentrations of 0.3 to 1.10(6) f.g-1, especially of crocidolite-amosite fibers, were rare among the men with unlikely occupational exposure. Fiber concentrations exceeding or equaling 1.10(6) f.g-1 were 10 times more frequent among the men more than 60 years of age as compared with those less than 40 years of age. Inorganic fibers other than asbestos had a weaker correlation with occupational history and age. Smoking habits had no significant effect on the pulmonary fiber counts. CONCLUSIONS: Asbestos fiber concentrations exceeding 1.10(6) f.g-1 are highly indicative of past occupational exposure to asbestos. The distribution of fiber concentrations in the different age groups of this study indicated decreasing asbestos exposure in Finland since the 1970s.

Adult↗
PubMed1993

Alcohol consumption and alcoholic liver disease: evidence of a threshold level of effects of ethanol.

The effects of long-term moderate or "social" alcohol consumption (10-80 g daily intake) on the incidence of features of alcoholic liver disease (ALD) were delineated in a consecutive autopsy series of 210 males. The subjects' daily intake, as well as duration of alcohol consumption, was determined by an interview with the spouse or a close acquaintance and compared with semiquantitative histological scores for stage of ALD. No significant increase in the incidence of features of ALD could be related to all-year daily intake of ethanol below 40 g (40 g equals 1.1 liter of beer, 0.44 liter of wine, and 0.11 liter of spirits). However, daily intake between 40-80 g increased relative liver weight on average 3.1 g/kg of body weight (p < 0.02), the frequency of fatty liver from 11.7 to 47.2% [relative risk (RR) = 4.4], and the frequency of mainly slight alcoholic hepatitis up to 16.7% (RR = 7.5). The incidence of both bridging fibrosis and liver cirrhosis increased significantly (RR = 8.8) only when daily intake exceeded 80 g. Amounts of ethanol exceeding 80 g did not relate to further increases in incidence of bridging fibrosis or liver cirrhosis. These findings suggest that, in males, daily ingestion of ethanol below 40 g for a period of 25 years does not increase the risk of alcohol-related liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Delayed increases in liver cirrhosis mortality and frequency of alcoholic liver cirrhosis following an increment and redistribution of alcohol consumption in Finland: evidence from mortality statistics and autopsy survey covering 8533 cases in 1968-1988.

Changes in the legal restrictions for alcohol consumption in 1969 liberated purchasing and marketing of low-alcohol beer. Subsequently, within the space of 5 years, the per capita consumption of absolute alcohol increased from 4.2 to 6.5 liters. To evaluate the possible effects of this change upon liver cirrhosis mortality as well as prevalence of liver cirrhosis in autopsy series, we surveyed mortality statistics and data from 8,533 medicolegal autopsies in 1968 through 1988. Liver cirrhosis mortality statistics revealed a highly significant (p less than 0.001) increase from 6.4 to 13.7 per 100,000 during the period, and similarly, the prevalence of liver cirrhosis in the autopsy series showed a highly significant (p less than 0.001) increase from 3.0% to 6.1%. More specifically, this increase was attributable to a highly significantly (Chi-square 15.4, p less than 0.001) increased proportion of alcoholic liver cirrhosis occurring at a younger age and almost exclusively in males. The stepwise mode of increase as well as the changes in sex and age distribution of cirrhosis since 1969 could be interpreted as an effect of distribution of consumption to a new generation of consumers. The forensic autopsy series seemed to reflect changes in per capita consumption with a shorter time lag than with mortality statistics. Additionally, only 7% of the 448 cirrhotics singled out from this material exhibited liver cirrhosis as a cause of death and were thus also included in the official mortality statistics, suggesting the greater accuracy of our forensic autopsy series.

Adult↗
PubMed1991

Sudden death and sleeping history among Finnish men.

An autopsy was performed in 460 consecutive cases of sudden death among 35- to 76-year-old men. The closest cohabiting individual known to each decreased subject was interviewed. Snoring history was obtained in 321 of the 371 interviews. In 86 cases there was a history of 'habitual' (almost always or always) snoring, and 88 men snored 'often'. The mean age of subjects was 55.4 years. The mean body mass index (BMI) was 26.3 kg m-2. Among the obese snorers (n = 82), apnoeas had been observed 'occasionally', 'often', or 'habitually' in 49 cases. Death was classified as cardiovascular in 186 (40.4%) cases. Cardiovascular cause of death was more common among those who snored habitually or often than among those who snored occasionally or never (P less than 0.05). 'Habitual' snorers died more often while sleeping (P less than 0.05). Habitual snoring was found to be a risk factor for morning death (P less than 0.01). The possibility of obstructive sleep apnoea as a cause of sudden death should at least be considered if the decreased is known to have been a habitual snorer.

Alcoholism↗
PubMed1991

Pitfalls in the diagnosis of drug smuggler's abdomen.

Narcotics "body packing" can be detected in abdominal X-rays by the ring shadow caused by air trapped in the packs. In a series of 82 cases admitted for abdominal X-ray in Helsinki, Finland, in 1982 through 1988, we encountered 9 (11.0%) true positives, 3 (3.6%) false positives, and 1 (1.2%) false negative. The false positives were due to the constipation often associated with the narcotics abuse. The false negative X-ray diagnosis was attributable to an inexperienced radiologist. False negatives may also be associated with packets containing marijuana, packs with few wrappings, aluminum-foil coated packs, and machine-packed narcotics. Searching for trapped air in radiographs, repeated X-raying by an experienced radiologist, use of computed tomography, or combined urinary drug screening may be applied to diminish false findings and to avoid unnecessary arrest for the purpose of fecal screening over several days.

Adult↗
PubMed1990

Alcohol screening with the Alcoscan test strip in forensic praxis.

The Alcoscan test strip was applied as an assay for the screening of alcohol in vitreous humor and urine samples in autopsy cases and in saliva from drunken drivers. The method gives instant and reliable semi-quantitative information on the presence of alcohol and is valuable when considering the necessity of chemical sampling especially during autopsy.

Alcohol Drinking↗
PubMed1990

Vertebral artery rupture in traumatic subarachnoid haemorrhage detected by postmortem angiography.

A fatal subarachnoid haemorrhage from a ruptured normal intracranial vertebral artery in a 49-year-old male, following a blow to the head, was revealed by a postmortem angiographic technique using radiopaque silicone rubber as a contrast medium vulcanizing at room temperature. No fracture of the atlas or connection between intracranial vessels and extracranial soft tissue haematoma could be visualized. We advocate the use of postmortem angiography in the diagnosis of suspected head trauma sustained in fights.

Carotid Artery, Internal↗