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J Mattila

Publications and source records attributed to J Mattila.

At least 19 recordsLinked to original sources
PubMed2004

Age-dependent accuracy of Helicobacter pylori antibody assays for adults, with special emphasis on atrophic gastritis.

The accuracy of Helicobacter pylori antibody assays for 561 consecutive adult outpatients who had undergone gastroscopy was studied. The sensitivity of an immunoglobulin G test was 99 to 100% for all age groups, but the specificity declined by age group, from 99% for those aged 15 to 49 years to 75% for those aged > or =65 years. The exclusion of false-positive results for patients with atrophic gastritis improved the specificity to 93 to 97% for the older age groups.

Adolescent↗
PubMed2002

Bile flow to the duodenum is reduced in hypothyreosis and enhanced in hyperthyreosis.

Disturbances in sphincter of Oddi (SO) function may prevent normal bile flow and thus enhance probability of common bile duct stone (CBDS) formation. We have previously shown increased prevalence of diagnosed hypothyroidism in CBDS patients, which may be explained by thyroxine-induced inhibition of SO contractility, in addition to previously suggested changes in bile composition and hepatocytic excretion. The aim of this study was to investigate biliary dynamics in relation to altered thyroid gland function in rat, a rodent without a gallbladder. Euthyroid, hypothyroid or hyperthyroid Spraque-Dawley rats were anaesthetized with i.p. urethane, and exsanguinated at 15, 45, or 60 min after intravenous 99mTc HIDA injection. At these timepoints, the bile flow to intestine was determined by measuring the relative intestine vs. liver radioactivity. At 45 min this was 44% lower in hypothyroid rats and at 60 min 73% higher in hyperthyroid rats compared to euthyroid rats, while hepatic radioactivity at 15 min and blood pressure at injection were similar in the groups. We conclude that the bile flow to duodenum is reduced in hypothyreosis and enhanced in hyperthyreosis.

Animals↗
PubMed2001

Development of progressive pulmonary interstitial and intra-alveolar cholesterol granulomas (PICG) associated with therapy-resistant chronic systemic juvenile arthritis (CJA).

A girl aged 5 years with therapy-resistant chronic systemic juvenile arthritis (CJA) developed progressive fibrosing lung disease. Histology of an open lung biopsy revealed pulmonary interstitial and intra-alveolar cholesterol granulomas (PICG). Since treatment with steroids and immunosuppressive drugs did not prevent progression of lung fibrosis, an experimental treatment with a tumor necrosis factor alpha (TNF alpha) antagonist etanercept was started. Although development of chronic changes in the lung parenchyma could not be prevented, this treatment brought considerable relief and markedly improved the child's physical capacity. By ruling out other causes for development of PICG, we concluded that the primary disease had caused the development of cholesterol granulomata by macrophage activation. We suggest, therefore, that a trial with etanercept in children with otherwise therapy-resistant CJA should be considered, especially if pulmonary complications have developed.

Arthritis, Juvenile↗
PubMed2001

Changes in zoobenthic community structure after pollution abatement from fish farms in the Archipelago Sea (N. Baltic Sea).

Long-term changes in sediment macrofauna communities at two sites affected by fish farming in the Archipelago Sea, south-west Finland have been investigated. Sampling stations in the Särkänsalmi Strait and Kaukolanlahti Bay, previously investigated 1982-1991, were revisited in 1994, 1995 and 1998 to detect signs of recovery following a decrease in organic load since 1990 and 1991, respectively. The results indicate a partial recovery in Särkänsalmi during post-pollution years, whereas no improvement has taken place in Kaukolanlahti. The improvement in Särkänsalmi is shown by a significant increase in the number of species and total abundance, and by the community structures becoming more similar over time. On the other hand, a significantly decreased number of species, abundance and biomass values over time as well as the occurrence of defaunated anoxic sediments, are clear signs of continued deterioration in Kaukolanlahti. Differences in the recovery potential of the two water areas are interpreted as consequences of topography and water exchange patterns causing differences in oxygen saturation.

Animals↗
PubMed2001

Histological and macroscopic changes in the pelvic pouch: long-term follow up after restorative proctocolectomy for ulcerative colitis (UC).

OBJECTIVE: Our aim was to evaluate macroscopic and histological (inflammatory) changes in ileal pouch mucosa after restorative proctocolectomy with J-pouch-ileoanal anastomosis for UC during long-term follow up. PATIENTS AND METHODS: Thirty-six (56%) out of 64 consecutive patients operated at our Institute during 1985-90 underwent endoscopy of the reservoir in the years 1994 and 1998. Functional outcome and macroscopic changes were recorded and histological samples taken from the three levels of the pelvic pouch. Acute and chronic inflammation were graded in accordance with a well-established histopathologic scoring system. RESULTS: The functional outcome was unchanged in 26 (72%), became worse in eight (22%) and better in two (6%) cases during follow up. The number of macroscopic changes increased during follow up and there was a tendency for them to become more common in the distal pouch. Microscopic acute and chronic inflammation decreased during follow up. There were more severe inflammatory changes in the distal pouch. Both acute and chronic inflammatory scores were higher through the reservoir in the cases of chronic pouchitis. Chronic pouchitis occurred more often in males. CONCLUSION: Macroscopic and inflammatory changes in the pelvic pouch seem to have separate progress during long-term follow up. In chronic pouchitis both acute and chronic inflammation are pronounced and spread over the entire pelvic pouch mucosa.

Journal Article↗
PubMed2000

Hot spots, indicator taxa, complementarity and optimal networks of taiga.

If hot spots for different taxa coincide, priority-setting surveys in a region could be carried out more cheaply by focusing on indicator taxa. Several previous studies show that hot spots of different taxa rarely coincide. However, in tropical areas indicator taxa may be used in selecting complementary networks to represent biodiversity as a whole. We studied beetles (Coleoptera), Heteroptera, polypores or bracket fungi (Polyporaceae) and vascular plants of old growth boreal taiga forests. Optimal networks for Heteroptera maximized the high overall species richness of beetles and vascular plants, but these networks were least favourable options for polypores. Polypores are an important group indicating the conservation value of old growth taiga forests. Random selection provided a better option. Thus, certain groups may function as good indicators for maximizing the overall species richness of some taxonomic groups, but all taxa should be examined separately.

Animals↗
PubMed2000

Atypical bronchopulmonary carcinoids show a tendency toward increased apoptotic and proliferative activity.

BACKGROUND: Bronchopulmonary carcinoid tumors can be divided into typical and atypical carcinoids according to their histologic and clinical features. Atypical carcinoids tend to have less predictable biologic behavior and are associated with a worse prognosis than typical carcinoids. The authors examined apoptosis and the expression of apoptosis regulating proteins Bcl-2, Bax, Bak, and Mcl-1 in 21 typical and 10 atypical bronchopulmonary carcinoid tumors. To find features distinguishing the growth of these types of tumors, the expression of p53 protein and the proliferation marker Ki-67 were also investigated. Finally, the parameters were compared with clinical follow-up data. METHODS: Thirty-one bronchopulmonary carcinoid tumors were examined by using in situ 3'-end labeling of DNA (TUNEL) for apoptosis and immunohistochemical staining methods for Bcl-2, Bax, Bak, Mcl-1, p53, and Ki-67 in formalin fixed, paraffin embedded tissue specimens. RESULTS: The apoptotic indices (AIs) were low in general (mean 0.18%), but higher AIs (> 0.5%) were observed significantly more often in atypical than in typical carcinoids (P < 0.008) in association with shortened survival (P < 0. 008). No relation between apoptosis and Bcl-2, Bax, Bak, or Mcl-1 expression was found. Expression of p53 protein was detected in only three atypical carcinoids, which also had significantly higher AIs than p53 negative tumors (P < 0.03). Proliferation rates measured by Ki-67 index were unusually low; the highest proliferation rates were observed in atypical carcinoids. There was a positive correlation between AI and Ki-67 indices (P < 0.01). CONCLUSIONS: This study suggests that the extent of apoptosis in bronchopulmonary carcinoid tumors is low. This, together with a low proliferation rate and an apparent absence of p53 mutation, enables a benign growth pattern. Some atypical carcinoids with enhanced apoptosis are associated with shortened survival, clearly deviating from typical carcinoids.

Apoptosis↗
PubMed2000

Liver involvement in patients operated for ulcerative colitis, with special reference to the association of cholangitis with colorectal dysplasia and carcinoma.

This study classified liver changes found in patients undergoing proctocolectomy for ulcerative colitis and examined whether patients with cholangitis have an increased risk of colorectal dysplasia and carcinoma. The patients were 152 who underwent liver biopsy during surgery for ulcerative colitis. Prior surveillance colonoscopy specimens and operative liver and proctocolectomy specimens were examined histologically. Patients with dysplasia or carcinoma in colorectal specimens were pair-matched to patients without such neoplasia. Sixteen (10.5%) patients had histological features consistent with small-duct primary sclerosing cholangitis on liver biopsy, five of them showing normal liver function values. Of the 152 patients 4 were found to have colon carcinoma (2.6%) and another 4 low-grade dysplasia (2.6%) either upon colonoscopy or in colectomy specimens. The median duration of the colitis in the 8 patients with colorectal neoplasia was 12 years (range 2-29) and in the other 142 patients 4 years (0.1-33; P=0.007). The prevalence of primary sclerosing cholangitis (PSC) or cholangitis was 50% in cases with colorectal neoplasia and 13% in pair-matched controls without colorectal neoplasia. In this selected group of patients operated on for ulcerative colitis the prevalence of histological cholangitis was thus higher than that of PSC in previous epidemiological studies. In addition, the prevalence of PSC or cholangitis was much higher in cases with colorectal neoplasia than in pair-matched controls without colorectal neoplasia. Our results support the view that cholangitis constitutes an additional risk factor underlying colorectal dysplasia or carcinoma.

Adolescent↗
PubMed1999

DNA flow cytometry in surgically treated lung cancer--prognostic significance.

Although DNA aneuploidy and high proliferative activity (S-phase fraction, SPF) of tumour cells, measured by flow cytometry, have proved to be indicators of poor prognosis in most solid tumours, there have been conflicting results in lung cancer studies. During a four-year period we studied the prognostic significance of DNA ploidy and SPF in 99 surgically treated lung cancer patients. Flow cytometric analysis was done from archival, formalin-fixed, paraffin-embedded tumour specimens. DNA index and SPF were determined, using MultiCycle software with sliced nuclear correction to compensate for debris. There were 61 DNA diploid and 38 DNA aneuploid tumours. The median SPF was 10.2%. Neither ploidy nor SPF was associated with previously known prognostic factors. Survival was poorer in patients with aneuploid tumours than in the other patients, but the difference was not statistically significant. DNA ploidy and SPF thus do not seem to be useful prognostic indicators in surgically treated lung cancer.

Aged↗
PubMed1999

Prognosis of surgically treated lung cancer.

BACKGROUND AND AIMS: This retrospective study clarifies the prognosis of surgically treated lung cancer in a teaching university hospital. MATERIAL AND METHODS: During a four year period 141 patients were operated for lung cancer in a teaching university hospital. After five years follow up the case records were analysed. The operative and microscopical findings were classified using the AJC pTNM staging system and WHO's histologic classification of lung tumours. There were 120 (85 %) male and 21 (15 %) female. The median age for males was 62 years and females 64 years; range was 29 to 76 years for both sexes. RESULTS AND CONCLUSIONS: The perioperative mortality of all patients was 5,0 %, of 84 patients operated with lobectomy 2.4 %, of 32 patients operated with pneumectomy 15,6 %, and of 25 patients operated with explorative thoracotomy 0 %, respectively. The five year survival of all patients was 33 % including perioperative mortality. The survival was significantly better for 83 patients with stage I disease (49 %) than 17 stage II (6 %), 24 stage IIIa (20.8 %), and 17 stage IIIb or IV disease (0 %). The survival was significantly better after lobectomy (44.1 %) than after pneumectomy (25.0 %) or explorative thoracotomy (8.0 %). Our study shows the good effect of surgery in stage I, and confirms it's usefulness in stage IIIa lung cancer. The histologic types of tumours did not affect survival.

Carcinoma, Non-Small-Cell Lung↗
PubMed1998

Chronic inflammatory changes in the pouch mucosa are associated with cholangitis found on peroperative liver biopsy specimens at restorative proctocolectomy for ulcerative colitis.

BACKGROUND: The clinical syndrome of primary sclerosing cholangitis (PSC), diagnosed in about 5% of patients with ulcerative colitis (UC), has been shown to be associated with pouchitis after ileal pouch-anal anastomosis. The aim of this study was to ascertain whether UC patients with cholangitis on liver biopsy at proctocolectomy, with or without the clinical syndrome of PSC, have an increased risk of inflammatory changes in the ileal reservoir mucosa and clinical pouchitis. METHODS: Of the consecutive 81 UC patients treated with restorative proctocolectomy with ileal J reservoir at Tampere University Hospital between 1985 and 1991, 73 with peroperative liver biopsy were included. A peroperative liver biopsy was obtained during proctocolectomy. After a median follow up of 64 months, pouch biopsy specimens were obtained. Periods of clinical pouchitis were diagnosed by means of clinical criteria alone or by clinical criteria combined with the results of previous pouch endoscopies in all patients. RESULTS: Ten patients (14%) showed histologic features consistent with small-duct PSC on liver biopsy. Endoscopic retrograde cholangiography had previously been performed on four of these patients, and all four had large-duct PSC. Patients with cholangitis had significantly more severe chronic, but not acute, inflammation in the pouch mucosa than patients without cholangitis. At least one episode of pouchitis occurred in 30% of the patients without cholangitis as compared with 90% of the patients with cholangitis. Chronic pouchitis was more frequent in the group with cholangitis than in the group without it (70% versus 11%). CONCLUSIONS: The only means of detecting all UC patients with cholangitis is a liver biopsy. Cholangitis, either with the clinical syndrome of PSC or found on liver biopsy, seems to be a risk factor for chronic-type inflammatory changes in the pouch mucosa and for the development of pouchitis.

Adult↗
PubMed1998

Antibodies to pyruvate dehydrogenase in primary biliary cirrhosis: correlation with histology.

Antimitochondrial antibodies to pyruvate dehydrogenase are the hallmark of primary biliary cirrhosis. Their pathogenic role has not been proven, although antibodies to pyruvate dehydrogenase are bound to biliary epithelium. The aim of this study was to characterize serum IgA antibodies to pyruvate dehydrogenase and to evaluate their response to different treatment regimens. We also compared the level of antibodies with severity of histological lesions and the data of biochemical liver tests. Serum samples were collected at baseline and after 24 months from 61 primary biliary cirrhosis patients, whereas 23 patients were treated with ursodeoxycholic acid, 20 with colchicine, and 18 with placebo. ELISA was used to detect antibodies to pyruvate dehydrogenase. IgA and IgG were separated with jacalin and protein-A, respectively. Capacity of immunoglobulins to inhibit enzymatic activity was detected by spectrophotometric observation of the rate of enzyme reaction. 49 (80.3%) of the 61 patients possessed IgA antibodies to pyruvate dehydrogenase. Significant decrease in IgA antibodies was observed only in the ursodeoxycholic acid group (p<0.05). 15 of 18 IgA preparations and all 24 IgG preparations of patients' sera were inhibitory towards pyruvate dehydrogenase (mean inhibitory percent +/-SD: 42+/-33.4% and 79+/-22.4%, respectively, at a protein concentration of 100 microg/ml). The level of serum antibodies to pyruvate dehydrogenase correlated with several histological parameters (fibrosis, inflammatory infiltrate), but not with biochemical parameters. Our data reveal that IgA antibodies to pyruvate dehydrogenase inhibit enzyme function. The correlation between antibodies to pyruvate dehydrogenase and histological parameters might suggest the pathogenic role of these antibodies.

Adult↗
PubMed1997

Expression and therapeutic response related to apolipoprotein E polymorphism in primary biliary cirrhosis.

BACKGROUND/AIMS/METHODS: Apolipoprotein E polymorphism, affecting intestinal absorption and biliary secretion of bile acids, might also contribute to the variable course and response to drug treatment of primary biliary cirrhosis. To test this possibility, we studied the apo E gene frequency, and the expression and response to drug therapy in different apo E isoforms of 88 patients with primary biliary cirrhosis, randomized to ursodeoxycholic acid, colchicine or placebo treatments for 2 years. RESULTS: The frequency of the epsilon2 allele was 2.4 times higher (p<0.01) in the patients with primary biliary cirrhosis compared with the Finnish population. At entry the patients with the epsilon4 allele were significantly younger (p<0.01) than those with other epsilon alleles, while the severity of primary biliary cirrhosis was similar in the three apolipoprotein E phenotypes. Liver enzymes, acute hepatic inflammation, serum total and low density lipoprotein cholesterol were decreased by ursodeoxycholic acid only in the patients with the epsilon4 and homozygous epsilon3 alleles, but not in those with the epsilon2 allele. Improvements of liver enzyme tests by ursodeoxycholic acid were more marked in the patients with the epsilon4 than other epsilon alleles. CONCLUSIONS: The present data show that in primary biliary cirrhosis the epsilon2 allele is overrepresented, and suggest that the expression of primary biliary cirrhosis and response of the disease to ursodeoxycholic acid treatment are closely related to the apo E polymorphism.

Adult↗
PubMed1996

The use of tissue plasminogen activator in post-traumatic total hyphaema.

BACKGROUND: We wanted to evaluate whether intracameral injection of tissue plasminogen activator (tPA) is useful in managing traumatic hyphaema. METHODS: Two eyes with total hyphaema after a severe penetrating injury were treated with a single intracameral injection of 25 micrograms of tPA 5 and 14 days after the injury, respectively. RESULTS: Most of the blood coagulum dissolved within 24 h, and in one of the two eyes the intraocular pressure decreased from 45 to 8 mmHg. The other eye was hypotonic. No re-bleeding or complications related to the use of tPA were noticed. CONCLUSION: The results in these two cases suggest that tPA is a useful adjunct in managing total hyphaema.

Adult↗
PubMed1996

Clinical assessment compared with cyst fluid analysis in the differential diagnosis of cystic lesions in the pancreas.

BACKGROUND: In adults 80% to 90% of cystic lesions in the pancreas are pseudocysts and the remainder are mostly neoplastic cysts. To choose optimal treatment for an individual patient, exact nonoperative diagnosis would be preferable. This study was done to assess the value of cyst fluid analysis, compared with clinical and radiologic findings, in the differential diagnosis of pancreatic cystic lesions. METHODS: Twenty-two patients with a cystic lesion in the pancreas underwent operation, cyst wall biopsy, and aspiration of cyst fluid. Carcinoembryonic antigen (CEA), CA 19-9, pancreatitis-associated protein (PAP), and total protein concentration, amylase activity, and cytologic findings were studied. Final diagnosis was pseudocyst in 14 patients, serous cystadenoma in two, mucinous cystadenoma in two, and mucinous cystadenocarcinoma in four patients. RESULTS: Clinical and radiologic judgment correctly differentiated pseudocysts and neoplastic cysts. Cyst fluid aspiration did not succeed in two patients with mucinous cystadenocarcinomas because of the high fluid viscosity. Cyst fluid amylase activity was high (greater than 16,000 IU/ml) in all but one pseudocyst and low (less than 83 IU/ml) in all but one neoplastic cyst. CEA level was lower in pseudocysts than in neoplastic cysts, but with an overlapping value between the groups. Mean CA 19-9 concentration was higher in pseudocysts than in neoplastic cysts, but with wide overlap between the groups. Pancreatitis-associated protein and total protein concentration and cystic fluid cytologic findings did not differ between various types of cysts. CONCLUSIONS: Clinical judgment including careful history and radiologic studies seems to be the most reliable method of differentiating neoplastic pancreatic cysts from pseudocysts. Amylase and CEA levels give suggestive information, but cyst fluid analysis may be misleading in an individual patient.

Adult↗