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Biomedical subjects

J Raekallio

Publications and source records attributed to J Raekallio.

At least 19 recordsLinked to original sources

Intimal thickening in the coronary arteries of infants and children as an indicator of risk factors for coronary heart disease.

Narrowings of the coronary arteries were measured in 94 infants aged less than 1 year who died in hospital and 102 1- to 16-year-old children who died accidentally. The arteries were transformed mathematically to circles. The degree of narrowing caused by intimal thickening was determined as the ratio of intimal area to the original luminal area. This ratio was further transformed to percentage. The degree of narrowing varied between 0 and 58% (mean 20%). The mean degree of narrowing in the left coronary artery during the first year of life was 17% and, between 12 and 15 years, 34%. Narrowing was greater in males (P = 0.02), when all the 333 coronary samples were included in the analysis. The birthplaces of the subjects' grandparents were traced from population registers and it was found that narrowing in the left coronary artery of infants was greater in those descended from grandparents from eastern Finland, an area of high mortality from coronary heart disease (CHD). Intimal thickening in infants and children seems to be a morphological manifestation of hereditary predisposition to CHD.

Adolescent↗

Histological and histochemical studies on local coronary wall thickenings (cushions) in Finnish children who died violently. Cardiovascular risk in young Finns?

Coronary arteries of 93 clinically healthy Finnish children of both sexes were collected from successive, medicolegal autopsies of victims of violent death. In the histological and histochemical study, local, cushion-type thickenings of the coronary walls were demonstrable in 47, i.e. 50 per cent, of the children, the occurrence increasing with age. The most prominent change was the splitting of the internal elastic membrane and the accumulation of smooth muscle cells, forming a new, musculo-elastic layer. Glycosaminoglycans appeared in the luminal parts of the thickenings. There was an average decrease in the succinate dehydrogenase reaction in the cushion area, implying a degenerative process. The increase in the reaction of "injury markers", acid phosphatase and esterase based on the increase of cells rich in these enzymes, indicated pathologic process. It was concluded that change of this kind, demonstrable early in childhood, may dispose coronary arteries to atherosclerosis.

Acid Phosphatase↗

Histochemical examination of energy metabolism in aortic vein grafts in rats.

The duration of the presumed metabolic depression of syngeneic vena cava to aorta transplants was determined in rats and the site and type of energy metabolism in the vein grafts assessed. The aerobic metabolic activity was measured from the histochemical reactivity of the enzymes, succinate dehydrogenase and cytochrome oxidase, and the anaerobic activity by staining with lactate dehydrogenase. The activity of the hexose-monophosphate shunt was assessed by the histochemical demonstration of glucose-6-phosphate dehydrogenase. Sixteen hours after grafting a pronounced metabolic depression was noted. Recovery occurred 24 hours after transplantation. The most intense staining was from lactate dehydrogenase in the vein grafts and in the non-transplanted veins. At the end of the observation period of four months the grafts were definitely more strongly stained than the non-transplanted veins, with most of the activity in the thickened intima. This layer had a metabolic profile resembling that of the media of the adjacent aorta.

Animals↗

Coronary intimal thickenings and lipids in Finnish children who died violently.

Intimal thickenings of the coronary arteries were found in healthy children who died violently, of both sexes even in children under 5 years of age. The average incidence was 53 % of the 75 cases. Splitting of the internal elastic lamina was the primary finding, followed by local increase in smooth muscle cells. The thickening could occupy 50 % of the coronary lumen. The accumulation of esterified cholesterol in the coronary arteries began before the age of 10 years. The fatty acid composition of the cholesterol esters suggests that they are derived from the blood. The question whether the thickenings are precursors of forthcoming coronary atheromas needs further detailed studies, especially in young adults.

Adolescent↗

Timing of wounds--an introductory review.

The cause of death is sometimes less important than the reconstruction of events. Reconstruction becomes possible a) with careful examination of wounds and b) with their proper timing. The biochemical timing of injuries is now accurate enough to distinguish whether a wound was inflicted less than 5 minutes, 5-15 minutes or 15 minutes to several hours before death. The distinction between antemortem and postmortem wounds is possible, by using biochemical serotonin and histamine methods, after a survival time of as little as a few seconds or minutes. The methods of enzyme histochemistry act as a supplementary guide to the timing of wounds, especially of those inflicted 1-8 hours before death. Wounds inflicted 8 hours or more before death may be timed histologically. The histological examination of wounds is still absolutely indispensable in spite of the use of the sophisticated methods. In addition to histology and enzyme histochemistry, the biochemical determinations of histamine and serotonin are applicable to forensic autopsy material. This will be illustrated by several cases of homicide and road death.

Enzymes↗

Ultrastructural characteristics of cells in human wound collected by Cellstic device.

The differentiating human wound cells and intercellular matrix was studied by electron microscopy. The cells were collected with a special wound drain containing a piece of cellulose sponge. Although fibroblastic cells could be detected as early as 20 hr after operation, the main cell population consisted of inflammatory cells. The fibroblastic cells were classified into three types according to the stage of ultrastructural differentiation. Some cells of different types were in close contact by membrane apposition to each other and to the sponge material. However, no specialized junctions were seen. Organized collagen fibers were not seen during the observation period despite the well developed organelles for protein synthesis in the fibroblastic cells. The close contacts of normal cells with the sponge pore walls indicated good compatibility with human tissue and safe use for clinical experiments in routine operations.

Adolescent↗

Signs of capillary formation in the early phase of wound healing in children.

Small silicone rubber tubes containing a standard size viscose cellulose sponge (Cellstic) were implanted in wounds of 23 children at the end of routine surgery. The Cellstics were drawn out of the wounds 1-4 days after implantation. Single cells and cell aggregates, called cell aggregation centers (CAC), were washed out of the Cellstic sponges by the retrograde injection technique, centrifuged, studied histologically and histochemically for cytochrome oxidase activity. Small leukocytic CACs and solitary cells, also including some macrophages and a few endothelial cells, were observed on the first postoperative day. On the second postoperative day and thereafter 2-4 endothelial cells were attached to each other surrounding a lumen. These capillary segment-looking formations (CSF) resembled capillary segments and they were seen both inside and outside the (now larger) CACs. Outside the CACs solitary endothelial cells occasionally exhibited ring-like formations. High cytochrome oxidase activity was observed especially in many CSFs but the solitary and the ring-shaped endothelial cells, in- and outside the CACs, also showed intense oxidative metabolism.

Capillaries↗

Effect of intrauterine thymectomy on granulation tissue formation. An experimental study.

Intrauterine thymectomy was successfully performed on 9 guinea pig foetuses at the gestational age of 36-48 days. This resulted in a significant suppression of the phytohemagglutinin (PHA) response of the whole blood lymphocytes at the age of 3 mth. The in utero-thymectomized guinea pigs and their littermate non-thymectomized controls were operated on by making 4 symmetrical dorsal skin incisions and by subcutaneously implanting 8 standardized pieces of viscose cellulose sponge. On the 1st, 3rd, 5th and 10th days the tensile strength of the wounds was determined and the implants were analysed histologically and enzymehistochemically. At the time of incipient fibroplasia on the 5th post-operative day, the tensile strength of the wounds, the number of fibroblasts and the activities of aminopeptidase and succinate dehydrogenase were clearly less in the guinea pigs which had been thymectomized in utero. These findings indicate that adequate thymic function was necessary for normal fibroblast proliferation, since intrauterine thymectomy led to a temporary delay in the beginning of the fibroblastic phase in wound healing.

Animals↗

A new method for the induction of therapeutic amenorrhea: low dose endometrial afterloading irradiation. Clinical and hormonal studies.

The authors present a new method for the induction of therapeutic amenorrhea: low dose endometrial afterloading irradiation. The problem with this method has been how to inactivate the endometrium while maintaining the physiological function of the ovaries. In 5/29 young patients regular or irregular bleedings occurred after an endometrial dose of 11 +/- 1 Gy. These subjects were given a repeat low dose intrauterine irradiation. Thereafter no bleedings were found in four out of five patients. Two to 9 years after the repeat irradiation the plasma levels of E1, E2, FSH and LH corresponded closely to those of healthy women in reproductive age in three out of five patients; some high plasma P levels indicated ovulation. In two patients the E1, E2 and P values were more likely postmenopausal but, on the other hand, FSH and LH values reproductive ones. The endocrinological studies after one irradiation [5] and the medico-legal [15] and neuropsychiatric [17] aspects relevant to the method are presented elsewhere.

Adolescent↗

Therapeutic amenorrhoea induced by endometrial irradiation technique in mentally retarded women: neuropsychiatric aspects.

Menstruation may cause many difficulties in the care of mentally retarded women. We have applied the low-dose endometrial after-loading irradiation method for the termination of menstruation of such persons. So far, we have studied 29 women during the period 1970-1978. Twenty-two of them had earlier received gestagen treatment for the same purpose. The radiation dose was chosen in such a way that the dose in the endometrium was 14 Gy, giving an ovarian dose of about 4 Gy. One treatment gave a cessation of menstruation in 22 patients and two had minor flow with no clinical inconvenience, but five required a repeated irradiation. The hormonal changes after radiotherapy were found to be minor. The need for tranquilizers did not change. There were some changes in the frequency of epileptic seizures, possibly due to the termination of gestagen treatment, which has antiepileptic effects. The care of four of the 21 in-patients became so much easier after radiotherapy that they could be transferred to home care.

Adolescent↗

Morphometry of coronary arteries: its use in children 1 year of age or older.

Coronary arteries from 52 children were cross-sectioned semiserially at 0.2-mm intervals. The sections that showed the greatest intimal thickening were chosen for morphometric analysis, which was performed with the aid of a coordinate digitizer. The size of the arteries, the thickness of the arterial media and intima, and the cross-sectional areas of the arterial layers correlated closely with the patient's age with various body measurements, and with the anatomic dimensions of the arteries. The variation in the cross-sectional area of the media in the left anterior descending branch was almost completely explained by a stepwise regression model; the fraction explained by the model (ie, multiple correlations squared) was 0.96, which means that very little variability was due to other factors, eg, methodologic errors. This suggests that the method is reliable. With an exact method, a smaller sample is adequate, which will ease obtaining normal growth curves for coronary arteries.

Adolescent↗

Pituitary-ovarian hormones after low-dose endometrial afterloading irradiation.

Low-dose endometrial after loading irradiation was used in 19 mentally retarded women for the induction of therapeutic amenorrhea. They were divided into two subgroups on the basis of age: 13 young patients (mean age 17 years, range 13-26 years) and six patients of middle age (mean age 42 years, range 34-44 years). In the young patients, during the 10-month follow-up period, the plasma E2 levels did not decrease. However, the FSH concentration increased. Late on, 2-9 years after treatment, the E2 levels were significantly higher than those of healthy postmenopausal women and did not differ from the values of healthy women in the sixth to seventh days of the menstrual cycle. At that time the FSH and LH levels were similar to reference values in reproductive age. The E2/E1 ratio was significantly higher than that of healthy women in the sixth to seventh days of the cycle and that of postmenopausal women. Most of the menstrual cycles were anovulatory but some ovulatory also occurred. The testosterone concentrations did not differ from reference values. The ovaries of the middle age patients were more sensitive to irradiation than those of the younger patients.

Adolescent↗