Biomedical subjects

A Reinilä

Publications and source records attributed to A Reinilä.

At least 19 recordsLinked to original sources

PubMed1997

Salivary carbonic anhydrase protects gastroesophageal mucosa from acid injury.

Saliva contains several factors that protect the alimentary canal mucosa against acidity. We measured the secretory carbonic anhydrase (CA VI) levels in the saliva of patients with gastrointestinal disorders using a time-resolved immunofluorometric assay. The mean enzyme concentrations were found to be lower in patients with verified esophagitis, gastric ulcer, or duodenal ulcer than in control patients with nonacid peptic diseases. The biochemical data from the enzyme activity assays and western blots of the human gastric mucosa and gastric juice samples indicated that the swallowed CA VI probably retains its activity in the harsh environment of the gastric lumen. In the upper alimentary canal, CA VI may neutralize the acid by catalyzing the formation of carbon dioxide and water. The present findings suggest that drugs supplemented with CA VI may prove beneficial in treating acid-peptic diseases.

Blotting, Western↗

PubMed1997

The rupture type determines the outcome for ruptured abdominal aortic aneurysm patients.

BACKGROUND: The treatment of patients with ruptured abdominal aortic aneurysm (RAAA) poses a significant surgical challenge. To achieve improvement in survival, factors influencing case fatality must be identified and modified. The aim of the present survey was to determine the contribution of preoperative, perioperative and postoperative events in predicting the mortality among AAA patients undergoing an emergency operation. MATERIAL AND METHODS: Fifty-one consecutive patients with ruptured infrarenal abdominal aortic aneurysm and twenty-six patients with 'expanding symptomatic aneurysms' (EAAA) were reviewed retrospectively to determine the relative contributions of preoperative, perioperative and postoperative factors on mortality. RESULTS AND CONCLUSIONS: The 30-day mortality was 47% in the RAAA group and 12% in the EAAA group. The rupture type was the main predictor of the outcome for the RAAA patients, the mortalities being 88% and 29% among patients with free (n = 16) and contained (n = 35) ruptures, respectively. In conclusion, the best way of avoiding poor results in cases of emergency aneurysm repair is to aim at elective operations. After the rupture, the clinical course is mainly determined by the rupture type, which is unfortunately beyond the surgeon's control. Surgical expertise and the avoidance of technical error can significantly affect the survival.

Adult↗

PubMed1996

Outcome of elective infrarenal abdominal aortic aneurysm repair--an analysis of 174 consecutive patients.

The aim of the study was to assess the surgical outcome of elective infrarenal abdominal aortic aneurysm (AAA) repair and the clinical and surgical factors that may predict this outcome. The series comprises 174 consecutive patients who underwent elective surgery for infrarenal AAA. Factors found to be predictive of early hospital death (4.5%) were aneurysm size (> 5 cm), ischaemic heart disease, chronic obstructive pulmonary disease (COPD), preoperatively elevated C-reactive protein (CRP) and a history of aneurysm-related pain preoperatively. The outcome was also very poor if the bacterial culture from the aneurysm sac was positive. On the whole, the abdominal aortic aneurysm operation effectively controls the disease and can be safely employed electively.

Adult↗

PubMed1995

[Tailgut cyst].

Explore the source record for details and available documents.

Adult↗

PubMed1994

Segmental mediolytic arteritis--electronmicroscopic and immunohistochemical study.

We examined specimens of human gastroepiploic artery aneurysm from a patient having several visceral aneurysms using electronmicroscopic and immunohistochemical techniques. The histopathological and ultrastructural findings confirmed the diagnosis of segmental mediolytic arteritis. Arterial smooth muscle cells from the gastroepiploic artery contained cytoplasmic vacuoles, media was thin and the internal elastic membrane showed distortion. X-ray microanalysis revealed calcium deposits in the medial extracellular space. Antigenic determinants of human immunoglobulins, fibrinogen, complement C3a and factor VIII were demonstrated in the injured artery wall, suggesting that immunocomplexes deposited in the artery wall may be associated with local injury. These findings support the role of autoimmune disorders in the pathogenesis of segmental mediolytic arteritis.

Aged↗

PubMed1994

Spontaneous intraabdominal haemorrhage caused by segmental mediolytic arteritis in a patient with systemic lupus erythematosus--an underestimated entity of autoimmune origin?

We describe the sixth known case of segmental mediolytic arteritis and the third in a survivor. A 70-year-old woman had intraabdominal bleeding due to a ruptured aneurysm of the omental artery. Interestingly, this patient also had a systemic lupus erythematosus. This report gives further support to the role of immune abnormalities underlying segmental mediolytic arteritis.

Aged↗

PubMed1992

Reversibility of hypertensive vascular changes after coarctation repair in dogs.

A silk ligature was tied around the aorta at the site of the ligamentum arteriosum in beagle puppies aged 8 wk, and the aortic coarctation was corrected 8 mo later, when the aortic peak-to-peak systolic pressure gradient was 6.0 (SD 0.7) kPa. Similar thoracotomy was performed as a sham operation on the control animals on both occasions. One y after the coarctation repair, there was practically no systolic pressure gradient across the aortoplasty site at rest [0.5 (1.0) kPa]. Histologic examination 12 mo after the correction operation showed the medial and intimal layers of the aortic arch in the aortoplasty group (n = 8) were significantly thicker than those in the control group (n = 7) [media 1.86 (0.06) versus 1.78 (0.08) mm and intima 53.2 (13.3) versus 38.3 (10.9) microns, respectively, p less than 0.05 for both]. The thicknesses of both intima and media of the left anterior descending and circumflexing coronary arteries and descending aorta distal to the aortoplasty site were similar in both groups. The increased vascular wall thickness may cause reduced compliance of the vascular bed above the coarctation site and hypertension after correction of the coarctation. Our results support the finding that patients with repaired aortic coarctation have an increased risk of permanent vascular changes.

Animals↗

PubMed1985

Cellular breakdown within muscular arteries in hypercholesterolemic rats.

Adult male rats were fed a high-fat cholesterol, thyroid-suppressive diet for three months, after which the structure of the muscular arteries (coronary and tarsal pedis) was examined by transmission electron microscopy. The plasma cholesterol concentration was elevated when the animals were killed and a distinct ultrastructural finding was the presence of necrotic cells in the media of both the coronary and the tarsal pedis arteries. Medial smooth muscle cells contained multivesicular membranous bodies, and membranous material accumulated in the intercellular space of the arterial media. It is proposed that the membrane changes and cellular death within muscular arteries may primarily be due to the increased membrane cholesterol concentration of smooth muscle cells during hypercholesterolemia. Dietary saturated fatty acids may have a contributing effect on smooth muscle cell injury in the hypercholesterolemic state.

Animals↗

PubMed1984

Ultrastructure of heart muscle in short-term diabetic rats: influence of insulin treatment.

The ultrastructure of myocardium was examined in short-term diabetic rats. Morphometric analysis showed the volume of myocytic mitochondria, sarcoplasmic reticulum and lipid droplets to be significantly increased compared with those of control animals. Further measurements of mitochondria and sarcoplasmic reticulum indicated that the augmentation of these compartments was accountable by the enlargement of pre-existing mitochondria, which were swollen, and of pre-existing tubules of sarcoplasmic reticulum, the lumen of which was dilated. After insulin treatment the morphological changes were returned to normal which indicates that they were not due to the toxic effect of streptozotocin but were caused by the diabetic state per se. This suggestion is further supported by the finding that experimentally induced metabolic acidosis without diabetes did not cause any morphologically detectable changes in the heart muscle. It is concluded that short-term diabetes in the rat causes mitochondrial swelling, dilatation of sarcoplasmic reticulum and accumulation of lipid in cardiac myocytes, and that these changes are preventable with insulin treatment. We suggest that insulin may have an important role in the maintenance of metabolism in heart muscle.

Acidosis↗

PubMed1984

Uptake of plasma triacylglycerol by a muscular artery in the rat: an ultrastructural study.

The uptake of plasma triacylglycerol by the dorsalis pedis artery in the rat was studied using intravenous infusion of an emulsion of triacylglycerol at a rate of 2.3 mumol per min for 1.5 or 5 h. Electron microscopy revealed lipid droplets in the arterial lumen near the endothelium and in the medial smooth muscle cells (SMC), but not in the endothelial cells or in the extracellular space. Lamellar structures with a periodicity of 40 A developed in the arterial tissue when glutaraldehyde-fixed specimens were incubated at +25 degrees C before postfixation in osmium. Lamellae were present at the luminal and basal surfaces and within endothelial cells, and also in the medial extracellular space associated with the plasma membrane of SMC, in the intracellular channels and near and inside the mitochondria of the medial SMC. No lipid droplets or lamellae were found in the arterial tissue of the control rats. The findings indicate that plasma triacylglycerol is not taken up by the arterial tissue as intact lipid particles, but that these are hydrolyzed at the luminal surface of the endothelium, the lipolytic products then being transferred to the medial SMC for re-esterification and storage in the form of triacylglycerol. The lamellar structures found in the fixed and incubated arterial tissue are thought to represent fatty acids produced by the lipolysis of triacylglycerol during incubation, and we suggest that the transport of fatty acids from the arterial lumen to the medial SMC occurs by lateral movement in a continuum of cell membranes.

Animals↗

PubMed1984

Ultrastructure of arteries in rats fed a high-fat cholesterol diet. Intimal thickening of a small muscular artery.

Focal nodular intimal thickening developed in a small muscular artery (tarsal pedis) of rats fed a diet containing 28% neutral fat and 2% cholesterol for three months. Examination by electron microscopy showed the main cellular component of these intimal lesions to be a smooth muscle cell. Single unidentified cells were present in the subendothelial region. The internal elastic membrane was fragmented and a few smooth muscle cells were seen between the fragments, extending from the media into the intima. Numerous vesicles were present in the intercellular space, a cluster being enclosed within a basement membrane in places. No lipid accumulation was found. The findings point to an important role for smooth muscle cells in the initiation of atherosclerosis, and suggest that lipid accumulation is a secondary event in the development of this process in muscular arteries in this animal model.

Animals↗

PubMed1983

Does the location of lung cancer affect its prognosis?

A series of 446 patients with lung cancer, comprising all the patients in a defined population who had lung cancer diagnosed over 4 years, were prospectively studied and followed up for 5 years or until death. Epidermoid carcinoma was relatively more common among the central tumours, and adenocarcinoma among the peripheral tumors; 79% of adenocarcinomas, but only 36% of epidermoid carcinomas being peripheral. The survival rate was significantly worse for the patients with central rather than peripheral tumours, although even so, only 3% of the former and 7% of the latter were alive 5 years after diagnosis. The patients with a tumour extending to the main bronchi had a poor prognosis. There was no consistent difference in the lobar distribution of the various histological types, and the prognosis was similar irrespective of the lobar location of the tumour. Unless located in the main bronchi, the site of lung cancer may be of little importance to the prognosis.

Adenocarcinoma↗

PubMed1983

Prevention of morphological changes of great arteries in coarctation of the aorta with antihypertensive therapy.

The possibility of preventing morphological changes in arterial walls in coarctation of the thoracic aorta with antihypertensive therapy was evaluated in an experimental study on dogs. Seven mongrel dogs weighing 2350-2980 g were operated upon at the age of 2 months. Antihypertensive therapy with a diuretic (hydrocholothiazide 25 mg/day), beta-blocker (propranolol and 80 mg/day) and vasodilatator (prazosin ad 40 mg/day) was started 1 month after the experimental coarctation was produced in the animals. Blood pressure decreased significantly, although not to the level of the control group. Seven months after the coarctation a perfusion fixation was done. Morphometrical light microscopic analysis was performed on the coronary and cerebral arteries. The histochemical findings in the aorta were analysed qualitatively, as was the amount of lipid in the coronary and the middle cerebral arteries. Electron microscopic studies were performed on the coronary artery. The findings were compared to the control and coarctated (non-treated) groups studied earlier (Uhari et al., 1982). Active antihypertensive therapy prevented all the major morphological changes previously reported to occur in coarctation. We suggest that active antihypertensive therapy started immediately after the diagnosis of coarctation might improve the prognosis of the patients with aortic coarctation by preventing morphological changes in the great arteries.

Animals↗

PubMed1982

Morphology of the great arteries in chronic experimental coarctation in dogs.

Vascular changes of the great arteries could be one explanation for the serious complications and persistent hypertension after coarcectomy among patients with coarctation. This possibility was studied by evaluating the morphology of the coronary artery, aorta and middle cerebral artery in 7 experimental 9-month-old dogs in which a coarctation of the thoracic aorta had been made at the age of 2 months. A classical coarctation syndrome with high blood pressure and intense collateral circulation developed during growth. Five sham-operated dogs living in the same laboratory environment served as a control group. Morphometric measurements showed medial thickening of the coronary artery wall in the coarctated dogs (135 vs 103 microns, P less than 0.05). The relative amount of glycosaminoglycans of the media was also greater in the study group (14.8% vs 8.1%, P less than 0.02). The relative number of medial nuclei was significantly greater in the coarctated dogs (P less than 0.025), reflecting medial hyperplasia. Vacuolated smooth muscle cells and fragmented elastic membranes were found in the media of the aortas of coarctated animals. No significant differences between the groups were found in the cerebral arteries. It is suggested that re-evaluation of the optimal age of patients with coarctation for surgical repair is obviously necessary.

Animals↗

PubMed1981

Long-term effects of untreated diabetes on the arterial wall in rat. An ultrastructural study.

Arterial ultrastructure was examined in twelve untreated streptozotocin-diabetic rats. Five showed severe changes in muscular (coronary, tibial, pulmonary) arteries two months after induction of diabetes. The basement membrane of smooth muscle cells was patchily thickened in these arteries. No similar changes were seen in muscular arteries of the other seven diabetic rats or in 10 control rats. No lesions were found in elastic arteries (aorta, main pulmonary artery) of any diabetic or control animals. Plasma non-esterified fatty acids, total ketone bodies, and glucose levels were higher in the diabetic rats with arterial changes (p less than 0.01) than in the diabetic animals without such changes. The molar ratio of non-esterified fatty acid to albumin in plasma ranged between 2.3-3.3 in the diabetic rats with arterial lesions, 1.4-1.8 in those without such features, and 0.6-1.1 in the controls. The excess of non-esterified fatty acid in plasma during insulin deficiency could be an important factor in the initiation of arterial changes in this model of experimental diabetes.

Animals↗

PubMed1980

Accumulation of lipid in muscular arteries of short-term diabetic rats. An electron microscope study.

Lipid accumulation in muscular (pulmonary, coronary and tibial) arteries and elastic (aorta and pulmonary) arteries of streptozotocin diabetic (65 mg/kg) rats was studied with an electron microscope. Arterial tissue specimens taken 4 days after the induction of diabetes showed lipid deposits in smooth muscle cells in the muscular arteries of 9 out of 24 diabetic rats, but in none of the 17 control rats. Histochemically the lipid was identified as triacylglycerol. Lipid accumulation was not seen in the elastic arteries of either diabetic or control rat. The diabetic animals with lipid deposits had slightly but significantly higher plasma glucose concentrations (p < 0.02), higher non-esterified fatty acids levels (p < 0.01), and lower concentrations of plasma insulin (p < 0.02) than those without arterial deposits. The amount of lipid deposited in the arteries was closely related to the plasma non-esterified fatty acid level, which was in the ranges 0.8-1.1 mmol/l in diabetic rats without deposits, and 1.1-2.4 mmol/l in those with deposits. The findings suggest that lipid accumulations in smooth muscle cells of muscular arteries during acute diabetes could result from the high plasma non-esterified fatty acid concentrations.

Animals↗

PubMed1980

Lung cancer in a defined geographical area: history and histological types.

Lung cancer was diagnosed in 446 patients during four years in a population living in a defined geographical area in northern Finland. The series comprised 420 men and 26 women, with a male/female ratio of 16.6:1. The diagnosis was confirmed histologically or cytologically in 431 cases (97%). Epidermoid carcinoma was the most common histological type of tumour in the men, followed by small cell anaplastic and adenocarcinoma, whereas in the women all these types were of equal frequency. Almost all the men, but only about half of the women, were smokers or ex-smokers. The amount smoked daily had no correlation with the histological type of cancer, whereas those patients who had started smoking early had relatively more Kreyberg group I tumours (epidermoid, small cell, and large cell carcinoma) than those who had started smoking late. Cancer was usually detected on the basis of symptoms, but 17% emerged from mass radiography or some health examination, and 12% from examinations for another disease. Fifteen per cent of the patients had no symptoms at the time of diagnosis, this being more common among the patients with epidermoid or adenocarcinoma than among those with anaplastic forms.

Adenocarcinoma↗

PubMed1979

The influence of insulin on the lipids in the pulmonary artery and the lungs of severely diabetic rats. A histochemical and chemical study.

The effect of insulin on the triglyceride deposits found in the pulmonary artery branches of streptozotocin-diabetic rats was investigated by treating the animals for two, five, nine or 14 days with insulin (3--8 units/day). Histochemical analysis showed that the triglyceride deposits in the pulmonary artery developed within three to four days after the induction of diabetes, but were not present in any animals five days from the initiation of insulin therapy. Plasma triglycerides, non-esterified fatty acids, phospholipid and total cholesterol concentrations were within the normal range within two days of the inception of insulin therapy and random plasma glucose levels were normal within five days. Analysis of lung lipids showed that after 14 days of insulin treatment the decreased content of phospholipids and the increased content of non-esterified fatty acids found in diabetic rats were also normalized. These findings suggest that insulin has an important role in the regulation of lipid metabolism in the pulmonary artery and lung tissue in the diabetic state.

Animals↗