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Biomedical subjects

K Setälä

Publications and source records attributed to K Setälä.

At least 55 records · Page 3Linked to original sources
PubMed1986

Intraocular lens implantation in exfoliation syndrome and capsular glaucoma.

The intra-operative difficulties and post-operative complications after posterior chamber lens implantation are described in 30 eyes with exfoliation syndrome (including 19 eyes with capsular glaucoma (CG), 30 age- and sex-matched patients with non-exfoliative eyes comprised a comparison group. Three eyes of the control group had simple glaucoma. The highest risk rate for intra-operative difficulties and post-operative complications was found in the CG group. 8/19 eyes had intra-operative difficulties and 7/19 post-operative complications corresponding 3/11 eyes and 2/11 eyes, respectively, in the exfoliation (E) group. Eyes in the control group had a low rate of complications, 3/30 intra-operatively and 2/30 post-operatively. In 63% of the CG and E eyes the visual acuity was 0.5-1.0 1 month post-operatively compared with 70% in the control group. Exfoliation syndrome is not a contraindication for posterior chamber lens implantation. Special attention should be paid to IOL selection. Complications due to insufficient mydriasis, weak zonules and possible undiagnosed lens subluxation, should be taken into account on planning the operation.

Eye Diseases↗
PubMed1986

Trabeculectomy with the use of sodium hyaluronate. A prospective study.

The effect of sodium hyaluronate (Healon) on the post-operative course and IOP 1 week and 1 month after trabeculectomy is reported. Twenty-nine eyes of 23 patients with open-angle glaucoma (10 simple, 11 capsular and 8 secondary glaucoma) were operated with the use of sodium hyaluronate. The study was prospective. For comparison, 29 eyes of 21 age- and sex-matched patients with glaucoma, operated during the pre-Healon period were selected. Patients in the study group were operated by the same surgeon and in the control group by different senior staff members. The method for trabeculectomy is described. IOP decrease was 56 and 54% in the H- and control group. No differences in post-operative pressure level existed between the different types of glaucoma. Shallow or flat chamber occurred frequently in both groups, but had a greater incidence in the control group. Sodium hyaluronate seems to prevent early excessive filtration. In five eyes of both groups choroidal detachment was simultaneously present. The incidence of choroidal detachment was the same as the overall incidence of this complication in this clinic. Post-operative pressure rise of greater than 30 mmHg after restoration of a flat chamber was more frequent in the control series. Sodium hyaluronate is useful in trabeculectomy. It prevents collapse of the anterior chamber and hyphema during the operation, it stabilizes early post-operative pressure and prevents excessive filtration combined with shallow or flat anterior chamber. It does not prevent choroidal detachment after trabeculectomy.

Adult↗
PubMed1984

Carcinogenesis--devolution towards an ancient nucleated pre-eukaryotic level.

Because the mitochondria and the cells housing them are obligatory symbionts, the evolutionary history of cells forms the locus minoris resistentiae which is the prerequisite for the carcinogenetic process. During carcinogenesis, the cells devolve towards an ancient anaerobic nucleated pre-eukaryotic level. True carcinogens cause an accumulation of inclusion bodies in the inner, bacterial, mitochondrial membrane. The mitochondrial damage which is detectable only in the early pretumorous stages, results in the respiratory surface with its enzymes being specifically changed, the mitochondrial and nuclear cycles no longer coinciding, the energy generation being forced to reuse the latent, "prehistoric", mode of respiration and the mitochondrial enzyme systems of soil bacterial origin becoming adapted to use other and more versatile metabolic pathways with a wider variety of end-products than classical glycolysis which produces lactate only. Neither external carcinogens nor oncogens are necessary. An increased, prolonged cell replication activity of physiological type is sufficient to initiate and maintain the process in animals with an inherited neoplastic disposition located in the inner mitochondrial membrane. The neoplastic disposition is inherited maternally: in fertilization the ovum does not receive mitochondria from the spermatocyte. The final results are an overall retardation of cell processes and instability in its structural and functional repertoire, the cytoskeleton (differentiation organelle) of the malignant cell manifesting special patterns. The proposed devolutionary mechanism is feasible as DNA packages are physiological components of soil bacterial membrane and can remain dormant (repressed) for years, or for ever, but under suitable conditions can generate seemingly new species, and particularly because enzyme adaptability is the unique privilege of soil bacteria.

Animals↗
PubMed1982

A new suggestion of the design of rational anticancer therapy: experimental studies in mice.

In attempts to develop a rational anticancer strategy the same homologous tissue in 3 conditions were used side by side as targets: normal epidermis of the mouse back. Tween 60R-provoked benign epidermal hyperplasia, and carcinogen-provoked malignant condition. In contrast to the highest tolerated doses of the cytostatics conventionally used, the dose was stepwise decreased towards the subthreshold level. Then the smallest dose that caused the slightest detectable injury to the malignant cells was employed. The results show that the dose of the cytostatics (colchicine, and vinblastine sulfate) can be reduced to 1/12 if the drug is linked to dimethyl-sulfoxide (DMSO), a compound with unique hydrating and oxido-reducing properties. The cytostatic-DMSO complex acts selectively, sparing the viability of the normal and hyperplastic cells, but at the same time increasing the vulnerability of the malignant cells. The specific target for cytostatic-DMSO complex is the 3-dimensional cytoskeleton (the differentiation organelle) which is deranged in malignant cells. The measure causes a morbid swelling (20-fold, or more) of the cytoplasm which leads to collapse of the cytoskeleton, so that the marginal quantities of the cytostatics can exert their effects in the highly re-hydrated water matrix of the malignant cells. It is, moreover, probable that the doses of the cytostatic in DMSO could be further reduced to 1/100, or even to 1/1,000. The polarization microscopic technique reveals events down to the (sub)-molecular level. The cytological material comprises 930,000 karyokinetic assemblies and 14,522,600 corresponding nucleated non-dividing cells in various cutaneous conditions of 1,860 mice. The conclusions were drawn only when the differences between corresponding parameter pairs were statistically highly significant (P less than 0.001).

Animals↗
PubMed1980

Endothelial cells in dominant cornea guttata.

A family with autosomal dominant cornea guttata in three generations is described. The investigated pedigree consisting of 25 healthy patients and 6 patients with cornea guttata. A few guttata were already present at an early age and very pronounced corneal endothelial guttata appeared in the middle-aged patients. No other ocular pathology was associated with this condition and the endothelial cell counts were not affected by guttata excrescences. The corneal thickness was normal in the affected and non-affected members of the family while bullous keratopathy did not seem to be associated with dominant cornea guttata in this family.

Adolescent↗
PubMed1979

Corneal endothelial cell density in iridocyclitis.

The endothelial cells of both eyes of 60 unilateral iridocyclitic patients were photographed with a specular microscope to establish the possible effect of iridocyclitis on corneal endothelial cells. Chronic severe iridocyclitis with mutton-fat keratic precipitates (KP) lowered the central endothelial cell count. Five patients out of the seven with mutton-fat KPs had a distinctly lower central cell density in the affected eye. In the remaining patients, no significant difference in cell densities could be demonstrated between affected and healthy eyes. Neither the inflammatory process itself nor the round white KPs had a deleterious effect on the central corneal endothelial cell densities.

Adolescent↗
PubMed1979

Corneal endothelial cell density after an attack of acute glaucoma.

The corneal endothelial cells of 25 patients with unilateral acute glaucoma were photographed with a clinical specular microscope. Photography was performed as soon as (average 6-12 h) the IOP had been lowered with iv Acetazolamide and/or Mannitol and topical Pilocarpine therapy, and the corneas had become clear. Peripheral iridectomy was performed on the affected eye and prophylactically on the fellow eye in most of these patients. The follow-up endothelial photographs were taken 6-24 months postoperatively. High intraocular pressure lasting 3 days or more lowered the central endothelial cell density. But a rise in pressure lasting from only a few hours to 2 days did not affect the endothelial cell count. Operative glaucoma procedures caused a loss of central endothelial cells of approximately 4.8% in the series. There was a clear correlation between the duration of elevated pressure and the number of central corneal endothelial cells lost.

Acute Disease↗
PubMed1979

Corneal endothelial cells in essential iris atrophy. A specular microscipic study.

The specular microscope was used to study the corneal endothelium in three patients with essential iris atrophy and three patients with anterior mesodermal disorders with uncertain diagnose. Pleomorphic and enlarged endothelial cells were found to be typical for essential iris atrophy. The changes were also present in one eye with normal pressure. In the patients with other types of iridal disorder the endothelial cells were normal in form. In one of these patients high intraocular pressure and surgery had seemingly led to enlargement of the endothelial cells. According to our findings, the specular microscope is a useful aid differentiating essential iris atrophy from other disorders of the iris.

Adult↗
PubMed1978

Bacterial enzymes in uremia management.

The theoretical background for a conservative therapeutic treatment of uremia is described, with illustrative results from preliminary clinical trials in 10 patients and 10 normal reference subjects. The proposed treatment focuses upon the patient's gastrointestinal tract--the normal site for metabolism of both exogenous (dietary) and endogenous (recycled) protein--enabling it to behave like the rumen of the cow. The objective is to induce the uremic's organism to utilize its own "waste" substances. The patient swallows enterosoluble capsules containing specifically adapted enzymes (immobilized or free) from apathogenic soil microorganisms. These are pre-adapted to convert urea, creatinine, uric acid, guanidino derivatives, and other nonprotein nitrogen compounds (NPN). The enzymes utilize many other substances, in particular ammonia, potassium, phosphorus, and several other factors potentially dangerous for the uremic. The enzymes apparently cleave vasoconstrictatory peptides in the intestines. In the course of the therapy, renoparenchymal hypertension decreased significantly, and increased again when the regimen was interrupted. The results from the present studies are in full accord with the information published in the relevant fields. The time appears ripe for large-scale trials of the therapeutic regimen outlined, especially as many commercial microbial enzymes already have a long history of safe use in food processing.

Animals↗
PubMed1978

Endothelial cells in the glaucomato-cyclitic crisis.

In 21 patients with unilateral glaucomatocyclitic crisis (Posner-Schlossman syndrome) the central corneal endothelium was photographed with a clinical specular microscope. In each patient the endothelial cell density was determined in both the affected and the contralateral healthy eye. In patients who had had several attacks of P-S the endothelial cell density was lower in the affected eye than in the healthy eye (16 cases). 4 patients seen after the first attack and 1 of 3 patients after the second attack had the same cell density in both eyes. Thus, loss of endothelial cells seems to be due mainly to the recurrent attacks of elevated pressure. The role of the inflammatory changes occurring in eyes with the P-S syndrome, especially keratic precipitates, is discussed.

Adult↗