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Biomedical subjects

J Savola

Publications and source records attributed to J Savola.

At least 19 recordsLinked to original sources

Atipamezole, an imidazoline-type alpha(2)-adrenoceptor inhibitor, binds to human platelets and inhibits their adrenaline-induced aggregation more effectively than yohimbine.

To investigate the usefulness of atipamezole [MPV-1248, 4-(2-ethyl-2, 3-dihydro-1H-inden-2-yl)-1H-imidazole], a novel alpha(2)-adrenoceptor-specific antagonist, as a tool in platelet studies, the ability of this antagonist: (1) to bind to platelet alpha(2)-adrenoceptors, and (2) to inhibit adrenaline-induced platelet aggregation was compared to that of yohimbine, another commonly used alpha(2)-adrenoceptor antagonist. It was found that atipamezole binds to platelet alpha(2)-adrenoceptors more effectively than yohimbine: [3H]atipamezole has more than three times higher alpha(2)-adrenoceptor binding affinity in intact gel-filtered human platelets (equilibrium dissociation constant (K(d)) 0.7+/-0.21 vs. 2.9+/-0.77 nM, p<0.05), but only one-third of the binding capacity of [3H]yohimbine (B(max) 27.0+/-3.8 vs. 100+/-19 pM/10(5) cells, p<0.01). Functionally, in comparison with yohimbine, an almost threefold lower concentration of atipamezole inhibited adrenaline (5 microM)-induced platelet aggregation. A concentration of atipamezole, which inhibited this aggregation by 50% (IC(50)), was 0.37+/-0.07 microM, whereas IC(50) for yohimbine was 0.98+/-0.12 microM, p<0.0001. Thus, atipamezole represents a functionally undisputed alpha(2)-adrenoceptor antagonist, more effective than yohimbine. Its distinct binding profile as a radioligand also suggests the presence of imidazol(in)e binding sites in platelets.

Adrenergic alpha-Agonists↗

Life-threatening Mycoplasma hominis mediastinitis.

Mycoplasma hominis infections are easily missed because conventional methods for bacterial detection may fail. Here, 8 cases of septic mediastinitis due to M. hominis are reported and reviewed in the context of previously reported cases of mediastinitis, sternum wound infection, pleuritis, or pericarditis caused by M. hominis. All 8 patients had a predisposing initial condition related to poor cardiorespiratory function, aspiration, or complications related to coronary artery surgery or other thoracic surgeries. Mediastinitis was associated with purulent pleural effusion and acute septic symptoms requiring inotropic medication and ventilatory support. Later, the patients had a tendency for indolent chronic courses with pleuritis, pericarditis, or open sternal wounds that lasted for several months. M. hominis infections may also present as mild sternum wound infection or as chronic local pericarditis or pleuritis without septic mediastinitis. Treatment includes surgical drainage and debridement. Antibiotics effective against M. hominis should be considered when treating mediastinitis of unknown etiology.

Adult↗

Selective assessment of single-lung graft function with 133Xe radiospirometry in acute rejection and infection.

In single-lung transplant recipients, the usefulness of spirometric indexes in detecting acute events involving the lung graft is limited due to the bias caused by the native lung. Selective functional monitoring is needed for the proper evaluation of complications after transplantation, but thus far, to our knowledge, no clinically feasible methods for selective graft-function assessment have been presented. In ten single-lung recipients, of whom six had a parenchymal lung disease and four had pulmonary hypertension, the relative ventilation (Vtx), perfusion (Qtx), and ventilation/perfusion ratio of the transplanted lung (V/Qtx) were determined with multidetector 133Xe radiospirometry. Additionally, the fractions of FEV1, FVC, and diffusing capacity for carbon monoxide (Dco) of the transplant (FEV1tx, FVCtx, Dcotx, respectively) were determined by using corresponding radiospirometric parameters for the calculation of their distribution between the lungs. The analysis included seven episodes of acute rejection and nine episodes of infection. The Qtx decreased during acute rejection but did not change during infection (p=0.001). Compared with the figures during infection, the V/Qtx increased during acute rejection significantly (p<0.05) in patients with underlying fibrosis or emphysema, but not in those with pulmonary hypertension. In detection of acute events, the sensitivity of the selective parameters, ie, FEV1tx (86%) and FVCtx (73%), was higher than that of the sum-function parameters, FEV1 (66%) and FVC (40%). Moreover, the sensitivity of Dcotx (80%) was higher than that of Dco (60%) in detecting acute rejection. The findings indicate that, in single-lung recipients with a parenchymal lung disease, the assessment of Qtx, V/Qtx, and Dcotx with a radioactive tracer can help to distinguish acute rejection from infection. The graft-selective parameters, ie, FEV1tx, FVCtx, and Dcotx, tended to be more sensitive than the corresponding sum-function parameters in detecting acute events, thus providing a more accurate functional profile of the single-lung graft.

Acute Disease↗

Value of high-resolution computed tomography in routine evaluation of lung transplantation recipients during development of bronchiolitis obliterans syndrome.

BACKGROUND: Chronic rejection is a major long-term complication after lung transplantation. The purpose of our study was to evaluate the role of repeated high-resolution computed tomographic examinations in monitoring the development of bronchiolitis obliterans syndrome after lung transplantation. METHODS: A total of 126 high-resolution computed tomographic examination in 13 lung transplant recipients was analyzed. During a mean follow-up period of 23 months, bronchiolitis obliterans syndrome developed in eight of the patients. A scoring system from 0 to 10 based on the number of chronic changes on high-resolution computed tomography was developed, and the score of each patient was compared with decline in the forced expiratory volume in 1 second and maximal forced expiratory flow rate of 50% of the forced vital capacity. RESULTS: The score of chronic changes, measured at 1 year after transplantation, correlated inversely with the values of forced expiratory volume in 1 second and maximal forced expiratory flow rate at 50% of the forced vital capacity (p < 0.05). Stage I bronchiolitis obliterans syndrome was associated with scores of 4 to 6 (mean 5.0), stage 2 with scores of 6 to 9 (mean 7.0), and stage 3 with scores of 6 to 9 (mean 7.7). The sensitivity of high-resolution computed tomography was 93% and its specificity was 92% when five chronic changes were used as a cutoff level. CONCLUSIONS: The progress of chronic changes on high-resolution computed tomography occurs concurrently with the development of bronchiolitis obliterans syndrome. High-resolution computed tomography may provide additional morphologic information for noninvasive evaluation of chronic lung rejection.

Adult↗

Aneurysm of the iliac artery in Marfan's syndrome.

There appears to be an association between iliac artery aneurysm and Marfan's syndrome. A case of iliac artery aneurysm in a young male with the disorder is presented. The iliac aneurysm was successfully managed by arterial reconstruction with a prosthesis. Patients with Marfan's syndrome should be followed for signs of weakness of the peripheral arterial system.

Adult↗

Diseases and drugs causing prolongation of the QT interval.

The prolonged QT interval and its association with diseases and drugs was studied on the basis of computerized electrocardiograms recorded in the region of the Kuopio University Central Hospital, East Finland. Altogether, 33,655 persons in whom at least 1 electrocardiogram was recorded from 1975 to 1983 were found. The study population consisted of 183 persons with prolonged QT intervals (at least 470 ms) and 187 with normal QTc intervals (440 ms or less), aged 45 to 64 years. These subjects were selected from 14,990 persons eligible. No difference in the prevalence of diseases affecting the QTc interval was found between those with long QTc intervals and those with normal QTc intervals. No difference between the groups was found in use of quinidine, procainamide or disopyramide. When the comparison was made on the basis of all group 1A antiarrhythmic drugs (quinidine, procainamide and disopyramide combined), persons with prolonged QTc intervals used these drugs more often than did those with normal QTc intervals (p = 0.031). Use of sotalol was significantly more common (p less than 0.001) in subjects with long QTc intervals. The mortality rate was also higher in persons with prolonged QTc interval (p less than 0.001), and most deaths during follow-up were due to coronary artery disease.

Anti-Arrhythmia Agents↗

Clinical and serological diagnosis of Nephropathia epidemica, the mild type of haemorrhagic fever with renal syndrome.

The serological diagnosis of Nephropathia epidemica (NE), the mild European type of haemorrhagic fever with renal syndrome (HFRS), was studied by means of an indirect immunofluorescent antibody technique (IFAT) in a large outbreak in Finland (morbidity 1.4/1000 population). Acetone-fixed sections of lung of bank voles (Clethrionomys glareolus) naturally infected with Puumala virus served as antigen. Altogether 65 patients were followed serologically for up to 20 months. Serological results obtained by NE-IFAT were compared with the clinical diagnosis of NE. Of the 41 clinically accepted NE cases 40 were serologically positive. Use of the NE-IFAT serological test allowed the diagnosis to be made in seven patients for whom the clinical data were not sufficient for diagnosing NE. The antibody response in NE often appears to be slower than that against Hantaan virus. Practical recommendations are given for the clinical and serological diagnosis of the milder forms of HFRS.

Adolescent↗