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Biomedical subjects

M Suurküla

Publications and source records attributed to M Suurküla.

At least 19 recordsLinked to original sources

Regional distribution of melanocytic naevi in relation to sun exposure, and site-specific counts predicting total number of naevi.

The role of exposure to ultraviolet light in the formation of melanocytic naevi was analysed by investigating the regional naevus distribution in 310 subjects (30-50 years) from a Swedish census file. The lateral aspect of the arms and the back had the largest concentration of naevi. The mean naevus count per unit surface area was higher in intermittently exposed than in rarely exposed skin (p less than 0.001), while the lowest mean count was found in chronically exposed skin. These results support the idea that intermittent exposure to ultraviolet light has a "naevogenic" effect while chronic exposure might be protective. Dysplastic naevi had a distribution pattern quite different from common naevi. Considering the distribution pattern solely, dysplastic naevi seem to develop independently of exposure to ultraviolet light. The numbers of naevi in different skin areas were tested for their power in predicting the total body naevus count. The strongest correlations were found between total counts and counts on the anterior surface of the thighs and the lateral aspect of the arms. Counts from any of these areas will provide a practical and satisfactory estimate of the total number of naevi.

Adult

Prevalence of common and dysplastic naevi in a Swedish population.

The naevus profile was examined in a Swedish population that was randomly selected from a census file. The participation rate was considered high at 82%. The number of common naevi (CN) and the prevalence of dysplastic naevi (DN) were investigated in 379 subjects (aged 30-50 years). The mean total body count of CN greater than or equal to 2 mm was 67 (range 1-300). As many as 22% of the population had 100 naevi or more and only 18% had less than 25. The counts were not influenced by age or sex. DN were diagnosed clinically in 18% (CI 14-22%) of the subjects and histologically in 8% (CI 5-11%). Subjects with dysplastic naevi had a significantly larger number of common naevi and a more sun-sensitive skin type than subjects without DN, P less than 0.001.

Adult

Ultrasound measurement of wall thickness in the carotid artery: fundamental principles and description of a computerized analysing system.

A B-mode [two-dimensional (2D)] image from the carotid artery may be described as containing seven echo zones. The aim of the present work is to discuss how lumen diameter and wall thickness can be measured from these zones, and to review some of the basic principles of ultrasound physics and imaging. Simple experiments were performed to identify the echoes defining intima-lumen interfaces. The results showed that: (1) The intima-media thickness of the near wall cannot be measured in a valid way. (2) The lumen diameter of a blood vessel is defined by the distance from the leading edge of the intima-lumen interface of the near wall (echo zone 3) to the leading edge of the lumen-intima interface of the fall wall (echo zone 5). (3) Previously published studies have validated the intima-media complex of the far wall as the distance from the leading edge of the lumen-intima interface of the far wall to the leading edge of the media-adventitia interface of the far wall (echo zone 7). We suggest that if measurements on the near wall are performed, measurements from the far wall should also be presented separately, and if lumen diameter is measured, that this measurement is carried out according to the leading edge principle. We describe a computerized analysing system for the measurement of wall thickness and plaque area on the carotid and femoral arteries. The system is based on a low-cost PC and a frame grabber board and calculates minimum, maximum and mean values of lumen diameter and wall thickness from a section of the artery.

Carotid Arteries

Melanocytic naevi in sun-exposed and protected skin in melanoma patients and controls.

The possible link between exposure to ultraviolet light and naevus development was studied in 121 melanoma patients and 310 controls by comparing the number of naevi in a sun-exposed area on the back with that in a sun-protected area on the buttocks. Both patients and controls had a four-fold increase in the number of naevi in the exposed compared with the protected area, p less than 0.001. The difference in naevus count between the exposed and the protected area was larger in patients than in controls, p less than 0.001. Subjects with dysplastic naevi, melanoma patients as well as controls, had a larger difference in the number of naevi between the two areas than subjects without dysplastic naevi, p less than 0.001. These results support the idea that sunlight plays an important role in naevus development and may explain why a high naevus count is a risk marker for malignant melanoma.

Adult

Common and dysplastic naevi as risk factors for cutaneous malignant melanoma in a Swedish population.

Common naevi, dysplastic naevi (DN) and other phenotypic features were evaluated as melanoma risk factors in a Swedish case-control study. One-hundred and twenty-one prevalent melanoma cases and 378 randomly selected controls participated. The mean total body naevus count was 115 in the cases and 67 in the controls. Fifty-six per cent of the cases and 18% of the controls had clinical DN. The corresponding figures for histologically diagnosed DN were 40% and 8% respectively. Clinical DN was as good as histologically diagnosed DN in identifying individuals at risk for melanoma. Subjects with sun-sensitive skin, greater than or equal to 150 naevi and presence of DN have 50 times higher melanoma risk than those without these characteristics.

Adult

UVB-induced melanocyte proliferation and 5-S-cysteinyldopa excretion in dysplastic nevus syndrome.

This is the first in vivo study of the effects of UV on the epidermal melanocytes in dysplastic nevus syndrome (DNS). Eleven DNS patients and 22 healthy subjects were given total body UVB irradiation 8 times during 17 days and the melanocyte population was estimated in biopsies from shielded and irradiated skin. There was a doubling of the melanocyte counts in irradiated skin and a less pronounced but significant increase in the shielded skin area. The urinary excretion of 5-S-cysteinyldopa (5-S-CD) was measured before, during and after the irradiation period. The 5-S-CD excretion reached a maximum after 2 weeks of irradiation and returned towards the basal value after the irradiation period. We were not able to document any abnormal melanocytic UV response in DNS patients before, during or after the irradiation.

Adult

Biochemical characterization and tissue distribution of the scleredema in a case of Buschke's disease.

Biopsies from a patient with a longstanding form of scleredema adultorum Buschke were analysed for morphological and biochemical changes in the dermal connective tissue. By light microscopy the tissue changes were located to the deep part of the reticular dermis. Therefore dermal tissue was separated into a superficial and a deep part and analysed biochemically. By this procedure it was possible to show that the concentration of hyaluronan in the deep part of the dermis was increased. The urinary excretion of methylimidazole acetic acid, an indicator of the mast cell mass in the body, was also elevated.

Diabetes Mellitus, Type 2

Toxic epidermal necrolysis with extensive mucosal erosions of the gastrointestinal and respiratory tracts.

Toxic epidermal necrolysis with epidermal shedding over almost the entire body occurred in a patient with classical rheumatoid arthritis treated with sulindac, penicillamine and a combination analgesic containing paracetamol and chlormezanone. Erosions in the lower respiratory tract and the intestine contributed to a lethal outcome of the disease and showed a microscopical picture similar to that of the skin involved. The histopathological picture of these extracutaneous lesions have been only briefly reported previously.

Acetaminophen

Absent latissimus dorsi muscle and anhidrotic axilla in Poland's syndrome. Case report.

The case of an 18-year-old female with absence of the right breast, sternocostal part of the major pectoral muscle and total absence of the minor pectoral muscle and the latissimus dorsi muscle, is presented. She also had decreased sweating capacity and absence of terminal hairs in the central part of her right axilla. Histological examination of skin specimens from this area of the axilla demonstrated hypoplasia of the apocrine sweat glands, but normal eccrine sweat glands, indicating an apocrine dependent axillary sweating function. The breast was constructed using a direct subcutaneous prosthesis implant, giving a final result that was good in regard to shape and softness. This provides grounds for reconsidering the use of the latissimus dorsi muscle flap in breast constructions in Poland's syndrome.

Adolescent

Ceftazidime and renal function.

Glomerular filtration rate (GFR) as measured by 51Chrome-EDTA clearance, decreased with a mean of 10 ml/min during therapy with ceftazidime 2 g bid in 16 patients with initial GFR of 30 to 110 ml/min. A significant increase in the excretion of urinary alanine aminopeptidase was also found. In another three patients with initial GFR of 17-22 ml/min increases in serum creatinine during therapy were noted. These observations indicate that ceftazidime should be used with caution in patients with impaired renal function and not be combined with nephrotoxic drugs until the safety of such combinations has been studied.

Adult

Acute radiorenography during attacks of renal colic.

Acute radiorenography was compared to emergency excretory urography to evaluate its diagnostic accuracy in 22 patients with clinical signs of renal colic, including erythrocytes in the urinalysis. All 16 patients with delayed excretion and/or dilated renal pelves on excretory urography had delayed excretion of radioactivity on renography. Furthermore, 6 patients with reduced renal function judged by renography had marked or slight delay in excretion on excretory urography. Small stones not causing stasis were found on excretory urography in 2 patients with normal renograms. It is concluded that acute radiorenography is simple, rapid and safe, and identifies accurately patients with abnormal renal function during attacks of colic, with less risks than excretory urography of causing renal damage or aggravating the pain of renal colic.

Adult

Bone scintigraphy in the diagnosis of skeletal involvement and metastatic calcification in multiple myeloma.

The contribution of bone scintigraphy to the diagnosis of skeletal involvement in multiple myeloma was evaluated in a consecutive, unselected series of 25 previously untreated patients. Definite scintigraphic abnormalities were found in 11 patients (localized in 4, generalized in 7) (44%). In the majority of patients the clinical value of the information gained from scintigraphy was roughly equal to that found by radiography. However, 2 patients with normal and 2 with questionable bone scans had X-ray evidence of skeletal involvement, and the extent of bone destruction in 4 cases was seriously underestimated in the bone scans. Small osteolytic lesions were as a rule not detected by scintigraphy. On the other hand, in 8 patients the bone scan added information of involvement of ribs, pelvis and vertebrae, not clearly visualized by X-ray. In 2 patients, both with IgA myeloma, hypercalcemia and uremia, a massive extraskeletal uptake of the bone-seeking isotope was observed. Autopsy verified in one case the presence of a disseminated metastatic calcification.

Adult

Penile blood pressure in erectile impotence following cystectomy.

Penile systolic blood pressure and systolic and diastolic brachial blood pressure were measured in 17 men who had undergone cystectomy and prostatectomy for cancer of the bladder. After the operation, 13 patients reported erectile impotence, while 4 retained sexual potency. Comparisons were made with 7 healthy, potent controls. The systolic penile blood pressure was significantly lower and the systolic pressure gradient between brachial and penile pressure was significantly higher in the men with erectile impotence than in the potent men. Reduced penile blood pressure after such operations may arise from vascular trauma. A surgical technique that protects penile blood vessels may conceivably reduce the risk of erectile impotence following cystectomy.

Adult

Basal cell carcinoma in children. Case report.

Clinical and pathoanatomic features of two children with basal cell carcinoma, an extremely uncommon disease in childhood, are reported. Clinically these lesions had a benign appearance, similar to a foreign body granuloma and an intradermal naevus, respectively, but histological examination showed a picture typical of basal cell carcinoma. The tumours were radically treated and no recurrence occurred during an observation time of 12 and 42 months, respectively.

Adolescent