Biomedical subjects

J Hietanen

Publications and source records attributed to J Hietanen.

At least 19 recordsLinked to original sources

PubMed1992

The histologic pattern of bone invasion by squamous cell carcinoma of the mandibular region.

Surgical specimens from 16 nonirradiated patients with carcinoma of the mandibular region who had undergone resection of the mandible were investigated histologically to evaluate the presence, pattern and extent of bone involvement. Thirteen of the 16 carcinomas had invaded the mandibular bone. Two main patterns of growth were identified: seven carcinomas had infiltrated nonuniformly into the bone and six tumours had advanced as a compact front. Direct invasion from the oral mucosal tumour could be verified in 12 cases. Extension of four of these 12 tumours in bone clearly exceeded their dimension in the overlying mucosa. Carcinoma tissue in the mandibular canal, at a distance from the major tumour extension, was seen in two cases, whereas the periodontal ligament spaces were invaded only when there was a direct contiguous invasion by the tumour. The grade of histologic differentiation of the carcinoma did not definitely correlate with the frequency, pattern or extension of bone involvement. The results indicate that large tumour size, location on the mandibular alveolar ridge and clinical fixation to the mandibular bone predispose to, but are not prerequisites for bone invasion. Taken together, this study has shown that prediction of the presence and extent of bone involvement of the carcinoma located in the mandibular region is difficult on clinical grounds.

Adult↗

PubMed1992

Exfoliation syndrome in patients scheduled for cataract surgery.

A series of 305 consecutive patients 30 years of age or older scheduled for cataract surgery was examined to find out the frequency of exfoliation syndrome, the predominant type of cataract, and the intraocular pressure status. The mean age of 222 (72.8%) females and 83 (27.2%) males was 71.7 (+/- 11.1) years (range 32 to 91 years). Exfoliation was detected in 77 (25.2%) patients. It was unilateral in 37 (48.0%) patients, the affected eye being in 29 (78.4%) cases scheduled for cataract surgery, and bilateral in 40 (52.0%) patients. Exfoliation was increased steadily with age. It was most often seen on the anterior lens capsule (88.9%). Krukenberg's spindle was seen in 31 (20.4%) eyes of patients with and in 12 (2.6%) eyes of patients without exfoliation (p less than 0.001). Nuclear sclerosis predominated in eyes with (83.8%) as compared to those without (61.9%) exfoliation (p less than 0.01). Posterior subcapsular cataract was less common in eyes with exfoliation (1.5%) than in eyes (21.1%) without it (p less than 0.001). A tendency to slightly higher preoperative intraocular pressure was measured in eyes with exfoliation as compared to those without it, and glaucoma occurred much more frequently (33.8% vs 10.8%) in the former group (p less than 0.001). Exfoliation and capsular glaucoma, which must be promptly detected to avoid surgical complications, are frequent in patients scheduled for cataract surgery.

Adult↗

PubMed1991

Three main arteries of the face and their tortuosity.

The anatomy of the facial, transverse facial and infraorbital arteries and their tortuosity was studied in 69 human cadavers (age range 18-95 years). The types of facial vascularisation were divided into four categories according to the gradually diminishing relative dominance of the facial artery. Type A, in which the facial artery was dominant, comprised 22% of the cases; type B 49%; type C 20%; and the variant of the hypoplastic facial artery, type D, 9% of the cases. The type of vascularisation was not dependent on age or sex. The tortuosity of all three arteries showed a statistically significant increase with age. A weak correlation was found between the relative dominance and the tortuosity of the facial artery.

Adolescent↗

PubMed1991

Immune-inflammatory cells in recurrent oral ulcers (ROU).

Tissue lesions from eight patients with recurrent oral ulcers (ROU) were subjected to detailed immunohistopathologic studies. In five patients, a specimen of an unaffected area from the opposite site was obtained. The main inflammatory cells in situ were CD3 positive T lymphocytes, with CD4 cells forming approximately half (range 30-60%) and CD8 cells 20% (range 10-30%) of all cells. CD19 positive B lymphocytes formed 5-12% of all cells. Furthermore, 45% (range 15-65%) of all lymphoid cells had signs of previous antigenous contact and had helper/inducer CDw29 type. Suppressor/inducer CD45R cells formed only about 20% (range 7-50%) of all cells. Although this observation suggests involvement of antigen as a causative and/or triggering stimulus, elements of a non-specific inflammatory response were observed as well. Endogenous peroxidase-positive neutrophils were present at the ulcer site, and were occasionally observed intravascularly and in the extracellular matrix in areas characterized by inflammatory mononuclear cell infiltrates. Although the proportion of endogenous peroxidase-positive, recently recruited monocytes was low, CD11b and nonspecific esterase-positive mature tissue macrophages formed about 14% (range 5-35%) of all inflammatory cells in situ, particularly at the periphery of the lymphoid cell infiltrates. Mast cells were also observed in all samples studied, forming 2-5% of inflammatory cells in the richly vascularized connective tissue beneath the basement membrane. In the specimens from clinically unaffected areas, inflammatory cells were rare. Our observations stress the multifaceted nature and participation of multiple effector systems in the local tissue pathogenesis of ROU.

Adult↗

PubMed1991

Regional distribution of mast cells and peptide containing nerves in normal and adjuvant arthritic rat synovium.

Simultaneous visualization of nerves and mast cells in the rat synovium was possible with double staining. Thus, a direct comparison could be made of nerves and mast cells in the ankle joints of healthy rats and in those with severe adjuvant induced polyarthritis. Nerves were studied with avidin-biotin-peroxidase complex (ABC) immunostaining, using heterologous antisera to protein gene product 9.5 (PGP 9.5), a recently discovered neural protein, and the neuropeptides substance P and calcitonin gene related peptide (CGRP). Mast cells were visualized by metachromatic staining of granule heparin. With double staining of sections, a parallel distribution of mast cells and nerves in all parts of the normal synovium was noted. In rats with adjuvant induced arthritis, a near total parallel disappearance of mast cells and nerves in the synovium occurred. In the arthritic rat such mast cell/nerve "units" were only present in the region where synovium attaches to bone. The observed regional depletion of both nerves and mast cells in arthritis may be of importance in the pathophysiology of arthritis.

Animals↗

PubMed1990

Contiguous enlarged dental follicles with histologic features resembling the WHO type of odontogenic fibroma.

Defective odontogenesis and/or retarded eruption of teeth can be associated with histologic features akin to odontogenic fibroma in the dental follicles. Unerupted mandibular premolar and molar teeth of a 24-year-old man were surgically exposed, yet the teeth failed to erupt. About a year and a half later, radiographs indicated further enlargement of the follicle of the premolar, and both teeth were subsequently surgically removed. Histologically, the follicles were composed of mature collagenous tissue among which epithelial islands and numerous clusters of calcified bodies were present. Indirect immunofluorescence showed positive staining for type I and type III collagen, which exhibited a sparse distribution, but not for the aminoterminal propeptide of type III procollagen. The hamartomatous nature of the lesions is discussed with emphasis on their histologic resemblance to the WHO type of odontogenic fibroma.

Adult↗

PubMed1990

Benign osteoblastoma of the mandible.

Benign osteoblastoma is a rare osteoblastic tumour with osteoid and bone deposition. A rapidly growing osteoblastoma involving the area of the mandibular first and second molar of a 20-year-old female is described. Investigation of the collagenous components of the tumour by immunofluorescence was suggestive of a normal collagen synthesis by the tumour osteoblasts. The lesion is discussed with particular emphasis on its differential diagnosis and matrix constituents.

Adult↗

PubMed1990

The mandibular infected buccal cyst (paradental cyst). A radiographic and histological study.

Mandibular infected buccal cysts occur on the buccal and distal aspects of the roots of partly or fully erupted mandibular molars with vital pulps. In the present investigation six cases associated with mandibular first and second molars were studied. The cysts were lined with a non-keratinised squamous epithelium with a mixed inflammatory cell infiltrate in the connective tissue. The clinical and microscopic features were similar to those of previously reported paradental cysts. The inflammation always present in these cysts may have an important role in their pathogenesis. It may induce periodontal pocketing, which may lead to hyperplasia and cyst formation in adjacent odontogenic epithelium, which may be either remnants of the reduced enamel epithelium or cell rests of Malassez.

Adolescent↗

PubMed1990

Bone scanning for evaluating mandibular bone extension of oral squamous cell carcinoma.

Inability to control the primary tumor in oral cancer, leading to local recurrence, results in low survival rates. The extent of bone involvement is therefore a critical factor in planning treatment. To evaluate whether uptake of 99mTc-DPC (dicarboxypropane-diphosphate) was reliable in demonstrating the extent of mandibular involvement, 13 consecutive patients with squamous cell carcinoma of the mandibular gingiva, floor of the mouth, and lower buccal sulcus were studied. Bone involvement, as judged from preoperative radiographs and bone scans, was compared with that determined through careful analysis of histologic sections of jaw specimens. The bone scan findings corresponded well with the histologic findings in 10 cases. In contrast to earlier studies, there were no false-positive findings. False-negative bone scans were seen in three cases in which there was infiltration of the upper cortex of the mandible. A negative bone scan, therefore, cannot guarantee absence of bone involvement. Nevertheless, bone scanning seems to provide valuable information for preoperative evaluation of evident tumor infiltration of bone.

Adult↗

PubMed1990

An electron microscopic study of oral lesions in erythema multiforme.

The ultrastructure of oral lesions in 6 patients with erythema multiforme (EM) and of one apparently clinically healthy oral mucosa in one patient with recurrent EM during remission is described. Alterations were observed in epithelium, basal lamina and lamina propria. Both intercellular and intracellular oedema, intracellular vacuolization, decreased numbers of desmosomes, and also loss of cytoplasmic organelles and occasional nuclei were noted in the epithelium. Inflammatory cells--mainly lymphocytes--were found intra-epithelially. Several discontinuities together with some evidence of duplication of the basal lamina were seen in five of the six lesional mucosa specimens. The inflammatory infiltrate in the lamina propria consisted mainly of lymphocytes, although plasma cells, neutrophilic and eosinophilic leukocytes, macrophages and mast cells were also found. Some of the mast cells were partly degranulated. The apparently clinically healthy oral mucosa in the patient with EM in remission showed mild inflammatory changes. The changes observed in the lesional mucosa in EM are thus according to our study mostly non-specific inflammatory alterations and are not pathognomonic for EM.

Adolescent↗

PubMed1990

Herpes simplex virus antigens and inflammatory cells in oral lesions in recurrent erythema multiforme. Immunoperoxidase and autoradiographic studies.

Herpes simplex virus (HSV) antigens were sought in 15 biopsy specimens from both lesional mucosa and clinically healthy looking oral mucosa between attacks in patients with erythema multiforme (EM). Four of the eight biopsy specimens obtained from lesional EM mucosa stained positively with HSV-1-and/or HSV-2-specific antisera applied in direct immunoperoxidase staining. Of the 16 tissue specimens used as controls, two displayed positive staining with HSV-1 and/or HSV-2. Five of the seven biopsy specimens from macroscopically healthy oral mucosa obtained between attacks from patients with recurrent EM stained positively with HSV-1 and/or HSV-2. Of the six tissue specimens used as controls, three stained positively. Most of the local inflammatory mononuclear cells belonged to the T cell series, mainly to the CD-4 subset. A small proportion of the local T cells were blast transformed as assessed by CD-25 expression and [3H]thymidine incorporation. This, together with the findings showing a lower degree of activation in the biopsy from macroscopically healthy looking mucosa between attacks suggest an active role of the cell-mediated immune response in the genesis of oral lesions in EM. The persistence of HSV antigens, and the well-established role of HSV as a precipitating factor in recurrent EM, suggest that HSV may be involved, but since HSV seems to be present in other mucosal lesions as well as in clinically healthy mucosa, quite frequently an additional, hitherto unknown factor must be present in order that EM may occur.

Antigens, Viral↗

PubMed1989

A radiological study of degenerative vascular changes in the external carotid region and carotid bifurcation.

In a series of 79 autopsies performed on subjects aged from 18 to 95 years occlusions in the external carotid, maxillary and inferior alveolar arteries were rare: only two cases were found in the maxillary and one in the inferior alveolar arteries. Tortuosity of the arteries increased with age, being most extensive in the external carotid and least in the inferior alveolar artery. Variations in the diameter of the maxillary artery occurred in 11 persons (14%), the incidence increasing with age. The youngest person showing such changes was aged 55 years. The average diameter of the arterial lumen of the inferior alveolar artery decreased with advancing age. This narrowing of the lumen also correlated with the loss of teeth. Calcified atherosclerotic plaques in the carotid bifurcation were present in 59% of the cases studied. In persons aged over 60 years a correlation was found between the carotid calcifications and coronary artery disease.

Adolescent↗

PubMed1989

Florid cemento-osseous dysplasia (gigantiform cementoma) in a Caucasian woman.

The present study reports a case of an uncomplicated florid cemento-osseous dysplasia in a 39-year-old Caucasian woman. The extensive dysplastic lesions affected all jaw quadrants and both radio-opaque and lytic lesions were demonstrated radiographically. Histopathological studies revealed calcified, partly acellular cementum-like tissue. All clinical, radiographic, biochemical and histological features were suggestive of the diagnosis of florid cemento-osseous dysplasia.

Adult↗

PubMed1989

Verapamil-induced gingival overgrowth: a clinical, histologic, and biochemic approach.

Verapamil-induced overgrowth was most prominent in the anterior regions and interproximal areas associated with plaque retention. Despite periodontal therapy, overgrowths recurred 1 month after gingivectomy. Discontinuation of the drug resulted in regression of the overgrowths. Histologic findings showed inflamed connective tissue covered by an acanthotic, thickened oral epithelium with long rete pegs containing dyskeratotic pearls. The proliferation rate and protein and collagen production of fibroblasts from the overgrowth sites were markedly lower than in the control cells cultured from healthy gingiva. Incubation of fibroblasts in the presence of verapamil reduced protein and collagen synthesis.

Adult↗

PubMed1989

Glycoconjugates in exfoliation syndrome. A lectin histochemical study of the ciliary body and lens.

The binding of ten biotin-coupled lectins with different carbohydrate specificities to exfoliative material and neighbouring tissues was studied in 16 formalin-fixed and paraffin-embedded human eyes. Eight of the eyes were exfoliation positive while the rest were exfoliation negative. Exfoliative material reacted intensely with Lens culinaris (LCA), Canavalia ensiformis (ConA) and Ricinus communis (RCA-I) agglutinins. Positive reaction was also seen with wheat germ (WGA), peanut (PNA) and soybean (SBA) agglutinins. The superficial zonular lamella, zonular fibers and the non-pigmented epithelium of the ciliary body had a rather similar lectin-binding profile to exfoliative material. The lens capsule was essentially unreactive with all the lectins used. The lens epithelium reacted faintly with ConA, LCA, WGA and RCA-I. Pre-treatment with neuraminidase to remove sialic acid resulted in increased binding of PNA and SBA to exfoliative material, zonular fibers and the zonular lamella, and in decreased binding of WGA to the non-pigmented epithelium of the ciliary body, zonular fibers and the zonular lamella. The results indicate that alpha-mannosyl, beta-galactosyl, N-acetyl-D-glucosaminyl and N-acetylneuraminic acid residues are present in glycoconjugates of exfoliative material and neighbouring tissues.

Aged↗

PubMed1989

Plasmin and plasminogen activator activities in tear fluid during corneal wound healing after anterior keratectomy.

Plasmin can degrade fibronectin and laminin, two important components of the extracellular matrix facilitating cell sliding and healing following a wound. In this study we investigated the relationship between the tear fluid level of plasmin and plasminogen activator and the healing of a corneal wound. Anterior keratectomy (AKE) was performed for seven rabbits (11 eyes). Eight eyes were rewounded after re-epithelialization. Tear fluid samples were collected with capillaries before wounding and during wound healing. Plasmin and plasminogen activator (PA) activities were determined using radial caseinolysis procedures. After AKE the plasmin concentrations increased rapidly, from a mean (+/- SEM) of 3.9 +/- 0.9 micrograms/ml to a mean of 37.9 +/- 7.8 micrograms/ml (p less than 0.01), and decreased during wound healing. Rewounding also resulted in an increase in plasmin concentration in the tear fluid (from a mean of 2.9 +/- 0.6 micrograms/ml to a mean of 5.0 +/- 1.1 micrograms/ml; p greater than 0.05). The PA activity showed an inverse trend as it decreased after AKE from a mean of 2.0 +/- 0.6 IU/ml to a mean of 0.3 +/- 0.1 IU/ml (p less than 0.001). During wound healing and re-epithelialization, the PA activity increased again, to 2.1 +/- 0.3 IU/ml (p less than 0.001). Abrasion of the newly grown epithelium in eight eyes caused a second elevation of PA activity which was not significant. This study demonstrates a close association between the healing of corneal wounds and changes in the plasmin and PA activities in tear fluid. Determination of the activity of these enzymes may therefore be useful for monitoring corneal wound healing.

Animals↗

PubMed1989

Mast cells and their mediators.

Mast cells (MC) are the most important cells in hypersensitivity reactions. Their functions in other pathological conditions are, however, not completely understood. At least two different MC subtypes have been isolated and it seems that due to environmental changes further differences in the morphology and functions of MC:s exist. The activation of MC:s can be both due to immunological and non-immunological factors and results in a release of different mediators and production of so called newly generated MC mediators. The functions following mediator release are complicated and several other inflammatory cells are involved in these reactions. Due to the more slowly effect of the newly generated mediators and the interaction of different cell types the effects of these reactions are often spread over a long time. It seems that MC:s may play an important part not only in hypersensitivity reactions but also in other pathological conditions as in inflammatory disorders.

Humans↗

PubMed1988

Topical treatment of oral leukoplakia with bleomycin.

Ten patients with oral leukoplakia were treated topically with bleomycin. We found the method convenient but only successful where sufficient attention was paid to the activity of the bleomycin-dimethylsulphoxide solution. The initial epithelial dysplasia disappeared completely in five of the 10 patients, while in the remainder the dysplastic grade remained the same. Following treatment the thickness of the keratotic layer increased in four patients, became thinner in five and remained unchanged in one. Although clinically the results of treatment only appear some 3 months after bleomycin application, once the lesions are cured their recurrence seems to be slower than after surgery. Nevertheless we strongly emphasise that 3-monthly follow-ups are mandatory for patients with oral leukoplakias whether or not they have been treated successfully.

Administration, Topical↗