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Biomedical subjects

S Renvall

Publications and source records attributed to S Renvall.

At least 19 recordsLinked to original sources
PubMed2001

Burst abdomen. Local synthesis of nucleic acids, glycosaminoglycans, proteins and collagen in wounds.

BACKGROUND AND AIMS: Abdominal wound dehiscence and evisceration is a surgical emergency. The general phenomena leading to this complication are for the most part known. However, the local biochemical events of different layers of the abdominal wall in wound dehiscence have not been studied. The purpose of the present study was to analyze the synthesis and contents of DNA, RNA, proteins and collagen in fascial, subcutaneous and skin layers in burst abdomen. MATERIAL AND METHODS: The material consisted of 10 controls and 12 patients divided into two groups. Group A consisted of 7 patients with acute free or covered perforation of the gastrointestinal tract and group B consisted of 5 critically ill patients at admission. RESULTS: In group A, higher amounts of specific isotopes were accumulated into DNA, proteins and collagen in fascial and subcutaneous wound layers than in those of the controls. However, in critically ill patients the corresponding accumulation was lower than in controls. On the other hand, in both group A and B, the content of hydroxyproline (collagen) was below the control level in fascial and subcutaneous layers of the abdominal wound. CONCLUSIONS: The results indicate that the degradation of collage exceeds the synthesis of collagen in wounds of patients with burst abdomen. Probably this increased degradation of collagen in wounds partly explains the higher wound disruption rate in these patients.

Abdomen↗
PubMed2001

Burst abdomen. Local synthesis of nucleic acids, glycosaminoglycans, proteins and collagen in wounds.

BACKGROUND AND AIMS: Abdominal wound dehiscence and evisceration is a surgical emergency. The general phenomena leading to this complication are for the most part known. However, the local biochemical events of different layers of the abdominal wall in wound dehiscence have not been studied. The purpose of the present study was to analyze the synthesis and contents of DNA, RNA, proteins and collagen in fascial, subcutaneous and skin layers in burst abdomen. MATERIAL AND METHODS: The material consisted of 10 controls and 12 patients divided into two groups. Group A consisted of 7 patients with acute free or covered perforation of the gastrointestinal tract and group B consisted of 5 critically ill patients at admission. RESULTS: In group A, higher amounts of specific isotopes were accumulated into DNA, proteins and collagen in fascial and subcutaneous wound layers than in those of the controls. However, in critically ill patients the corresponding accumulation was lower than in controls. On the other hand, in both group A and B, the content of hydroxyproline (collagen) was below the control level in fascial and subcutaneous layers of the abdominal wound. CONCLUSIONS: The results indicate that the degradation of collagen exceeds the synthesis of collagen in wounds of patients with burst abdomen. Probably this increased degradation of collagen in wounds partly explains the higher wound disruption rate in these patients.

Abdomen, Acute↗
PubMed1991

Fibronectin and collagen gene expression in healing experimental colonic anastomoses.

The temporal and spatial expression of fibronectin and type I and III collagen genes were studied 1-14 days after surgery in the healing rat colonic anastomosis using recombinant deoxyribonucleic acid techniques. Messenger ribonucleic acids (mRNAs) coding for fibronectin and type III collagen synthesis increased from the first day after operation and type I collagen synthesis increased from the second day after operation, as demonstrated by Northern hybridizations. Maximal mRNA production for fibronectin and collagens was seen at 2 and 7 days, respectively, after anastomosis. Activation of type I and III collagen genes in the anastomotic area was confined to tissues developing in the anastomotic line, the serosal surface and the submucosal layer. Strong fibronectin expression was observed in the same areas. The results suggest that genetic events leading to collagen synthesis in the anastomotic area start immediately after surgery. Maximal gene expression is not reached until 1 week after surgery.

Anastomosis, Surgical↗
PubMed1991

Formation of granulation tissue in intra-abdominal viscose cellulose sponges. An experimental study in rats.

Formation of intra-abdominal granulation tissue was studied in 32 rats 2, 4, 7 or 21 days after implantation of viscose cellulose sponges. The concentrations of DNA, RNA-ribose, uronic acids, hexosamines, nitrogen and collagen were then measured in the sponges. The rats' body weight fell by 10-15% in the first week, but was regained within 3 weeks. The sponges induced dense intra-abdominal adhesions, reflected in highly active connective tissue formation. This process seemed analogous to that seen in granuloma formation in subcutaneous tissue or wound healing, but the synthesis of macromolecules was especially pronounced in the peritoneal cavity. The experimental model offers a new means for studying intra-abdominal adhesions and permits evaluation of factors claimed to have stimulating, inhibiting or no effect on intra-abdominal adhesion formation.

Animals↗
PubMed1991

Internal hernias after gastric operations.

From a total of 2,146 oesophagojejunal and gastrojejunal anastomoses done between 1969 and June 1990, 7 patients (0.3%) were operated on for internal hernias. Six had developed their hernias after Billroth II gastrectomy with antecolic gastrojejunostomy and enteroanastomosis, and one patient after retrocolic Roux-en-Y reconstruction. The patients were operated on 5 days-27 years after their first operations. No patients developed internal hernias after simple gastrojejunostomy or after operations for malignant disease. Two patients died (29%) and three others developed complications. Five patients were thin. Treatment was delayed in most cases because of the nonspecific presentation of the condition. The diagnosis of internal hernia should be borne in mind in patients who develop abdominal pain with persistent nausea or vomiting after operation, so that prompt treatment may be instituted.

Aged↗
PubMed1991

Expression of epidermal growth factor and epidermal growth factor receptor genes in healing colonic anastomoses in rats.

This study uses complementary DNA probes to find out if epidermal growth factor (EGF) and EGF receptor genes are activated in healing colonic anastomoses in rats. 35 rats had a colocolonic anastomosis which was removed for study 1, 2, 3, 5, 7, or 14 days after operation. Six animals without surgery served as controls. The specimens were examined by northern blotting, in situ hybridisation, and conventional microscopy. Microscopic healing progressed normally. The expression of the EGF gene was minimal and surgery did not activate it. However, surgical trauma did increase the expression of the EGF receptor gene by 2.2 times when compared to day one. In situ hybridisations localised a strong EGF receptor expression in mucosal epithelial cells in all specimens, and a moderate reaction in fibroblasts in the repair tissue in the anastomotic line. The enhanced EGF receptor gene expression suggests that anastomotic healing is associated with the presence of EGF or an EGF-like substance and its activity increases during the first postoperative week.

Anastomosis, Surgical↗
PubMed1991

Bone cement and wound healing. An experimental study in the rat.

The local effect of methyl methacrylate on wound healing was studied in rats using viscose cellulose sponges. A 7 mm diameter cylindrical section was removed from the sponges, filled with freshly prepared bone cement or left empty in controls. Two sponges were implanted subcutaneously into each rat. The concentrations of DNA, RNA-ribose, nitrogen, hydroxyproline, uronic acids and hexosamines of the sponges were determined 5, 10 and 21 days postoperatively. The concentrations of collagen and glycosaminoglycans were similar in experimental and control samples and only small differences were detected in the amounts of DNA. It was concluded that methyl methacrylate bone cement did not have any practical harmful effects on wound healing.

Animals↗
PubMed1990

Fibronectin, laminin, and collagen types I, III, IV and V in the healing rat colon anastomosis.

The purpose of this work was to study normal anastomotic healing in the rat colon. The unprepared sigmoid colon was divided and a colo-colostomy performed using a one-layer inverting technique. Frozen sections were taken and studied immunohistologically with specific antibodies to fibronectin, laminin and collagen types I, III, IV and V. From day one onwards a strong fibronectin reaction was observed in the anastomosis, reaching maximum staining intensity on postoperative day five. Type III collagen and pericellular type V collagen were at first detected in the anastomosis on day two. From day three onwards all collagens studied and laminin were present in the repair tissue (laminin and type IV and V collagen in the regenerating capillary walls). Maximum immunofluorescence was observed on day seven and it remained on a high level throughout the study, except for fibronectin, which weakened gradually after the fifth postoperative day. The results indicate that healing of the colon anastomosis occurs by rapid accumulation of connective tissue components between the inverted leaves of the colonic wall, as also new capillaries consisting of the basement membrane components, type IV and V collagen as well as laminin, are formed.

Anastomosis, Surgical↗
PubMed1990

Local energy metabolism in healing colon anastomosis. An enzyme-histochemical study in rats.

Local energy metabolism in healing colonic anastomosis was studied in rats. A one-layer, inverting colo-colostomy was performed and frozen sections from the anastomotic area were enzyme-histochemically stained for key enzymes in energy metabolism. Anaerobic metabolism prevailed in the anastomotic area during the first postoperative week. The repair tissue between the inverted colonic leaves showed the first sign of aerobic glycolysis 1 week postoperatively. Increasing lactate dehydrogenase activity, however, was seen from day 3 onwards (simultaneously with revascularization), and indicators for amino acid metabolism, lysosomal activity and metabolism via the pentose phosphate shunt were present even earlier--from day 1 onwards. Anastomotic surgery was followed by severe reduction of metabolism in all layers of the colonic wall 0-5 mm from the anastomotic line. Normal metabolism was not restored until postoperative day 21. These findings should be considered in surgical techniques and post-operative management.

Anastomosis, Surgical↗
PubMed1990

Girdlestone operation. An acceptable alternative in the case of unreconstructable hip arthroplasty.

Between 1970 and 1984, 1250 total hip arthroplasties using methylmethacrylate bone cement were performed at the Department of Surgery, University of Turku, Finland. Girdlestone arthroplasty was performed in nine women and one man in ten cases of failed arthroplasty. In general, the results were evaluated as good. The patients were satisfied, and they had no pain or only slight or occasional pain on weight bearing. Nine of ten patients could walk, two of them without any walking aids. In conclusion, the Girdlestone operation can offer an acceptable functional result when reconstruction of the hip joint is not possible.

Aged↗
PubMed1989

Rupture of the urinary bladder, a potentially serious condition.

During the years 1969 to 1983, 61 patients with rupture of the urinary bladder were treated at the Department of Surgery, University of Turku, Finland. The etiology of the injury was accident trauma in 48%, iatrogenic trauma in 28%, minor trauma in association with misuse of alcohol in 21% and other causes in 3% of the cases. In the first three groups the most reliable signs for diagnosing rupture were abdominal pain and tenderness, together with macroscopic or microscopic haematuria. In some cases cystography was of decisive importance in making the diagnosis. The prognosis for this condition, especially when it was associated with other injuries, was serious. Nine patients (14.8%) died and 35 patients (57.3%) had postoperative complications, for the most part infection-related. Fifty-nine patients underwent operative exploration and repair of the bladder, followed by urethral catheter drainage. Two patients were treated conservatively, with an indwelling urinary catheter only.

Adult↗
PubMed1989

Changes in the connective tissue composition of the submucosal layer of colonic anastomosis. An immunohistologic study in rats.

Submucosal healing of colonic anastomosis was studied in rats. The unprepared sigmoid colon was divided and colo-colostomy performed, using a one-layer inverting technique. Frozen sections were studied immunohistologically with specific antibodies to fibronectin, laminin and collagen types I, III, IV and V. From the first to the fifth postoperative day the submucosa was highly oedematous. A clear fibronectin reaction was observed in the submucosa, reaching maximum on postoperative day 5. From day 3 onwards the fluorescence intensities of types I and III collagen in the young granulation tissue and of types IV and V collagen and laminin in the regenerating capillaries rapidly increased, with maximum on day 7. The striking changes in the submucosa indicate that the healing process involves not only the actual area of the anastomosis, but also widely the submucosal layer of the adjacent intestine.

Anastomosis, Surgical↗
PubMed1988

Cellular differentiation and expression of matrix genes in type 1 neurofibromatosis.

The cellular heterogeneity of cutaneous tumors from nine patients with type 1 (von Recklinghausen's) neurofibromatosis was studied using several antigenic markers with special reference to focal heterotopic differentiation and interindividual variation. Furthermore, cells which actively express the genes for type I and III collagens and fibronectin, the major components of the abundant extracellular matrix of neurofibromas, were localized using in situ hybridizations. In eight of nine cases, the S-100 protein positive cells, i.e. Schwann-like cells, composed 60 to 80% of the total cell population. However, in one case, only about 40% of the cells were S-100 protein positive. The latter tumor was studied with respect to perineurial cell differentiation and stained with a mixture of two antibodies, directed against the S-100 protein and type IV collagen. In Schwann cells, the staining reaction for S-100 protein was observed in the nuclear region, whereas the staining reaction for type IV collagen was located peripherally, corresponding to the basement membrane zone covering the cells. The stromal cells which showed only the peripheral staining profile were considered to be neoplastic perineurial cells. Distinct structures with epithelial, endothelial, or smooth muscle cell differentiation were present within the benign tumors, as detected by immunostaining for cytokeratin, epithelial membrane antigen, factor VIII-related antigen and desmin, respectively. In situ hybridizations revealed a clearly detectable expression of type I procollagen genes in less than 10% and type III procollagen gene in less than 5% of the total cell population. Active synthesis of fibronectin was limited to the vascular walls, when examined by in situ hybridization, and antibodies to cellular fibronectin localized to the same areas. However, antibodies to plasma fibronectin produced a uniform staining reaction throughout the tumors suggesting that most of the fibronectin in neurofibromas is plasma-derived. The latter observation suggests that neurofibroma cells are freely accessible to various plasma proteins, including growth factors, which may influence the growth characteristics of these lesions.

Antibodies, Monoclonal↗
PubMed1987

Development of peritoneal fibrosis occurs under the mesothelial cell layer.

This study was carried out in order to find out which part of the peritoneal wall reacts toward silica and produces peritoneal fibrosis. Colloidal silica was injected into the peritoneal cavity of rats to induce chemical peritonitis and frozen sections of the peritoneal wall were stained with specific antibodies toward type I and III collagens and fibronectin. A massive proliferation of granulation tissue was observed between the submesothelial and muscular layers within 48 hr visualized by prominent fibronectin staining. Type III collagen formed lamellar-like structures in the newly formed granulation tissue. The connective tissue reaction was extended into the underlying muscular tissue. Three weeks after silica injection the reactive granulation tissue exceeded the original peritoneum three- to fourfold in thickness. At this stage it contained extended fibrillar structures oriented perpendicular to the surface or muscular layers of the peritoneum. Type I collagen antibody was bound to the superficial cell layer in the control samples and in the early peritonitis whereas the entire granulation tissue was evenly stained at 3 weeks. Type III collagen antibody was bound to the surface layer of the peritoneum, granulation tissue, and perimysial connective tissue throughout the healing period. The results indicate that the peritoneal fibrotic process occurs under the thin peritoneal lining cell layer and on the surface of the muscle layer.

Animals↗
PubMed1987

Factors contributing to subphrenic abscess.

Between 1969 and 1982 11 primary (without previous surgery) and 38 secondary (postoperative) subphrenic abscesses were treated out of total 20800 operations. The patients had on an average more than 4 risk factors. Causes contributing to the formation of secondary abscesses were a difficult operation in 42%, deficiencies in surgical technique in 26%, operative contamination in 21% and peritonitis in 13% of the cases. Clear problems in the primary operation were found in 23 of 38 patients and in 6 of 7 patients who died with a later secondary abscess. It seems probable that subphrenic abscesses are more likely to develop in high risk patients after a difficult and/or contaminated operation.

Adult↗
PubMed1986

Effect of a hexosylceramide fraction of the hemodialysate Solcoseryl on experimental granulation tissue.

This work was carried out to study the effects of a hexosylceramide fraction (Hex-Cer) of the hemodialysate Solcoseryl on developing granulation tissue in rats. Subcutaneously implanted cylindrical hollow viscose-cellulose sponges were used as an inductive matrix for the growth of granulation tissue. In the control animals, the implants were treated daily by withdrawing 1 ml of wound fluid from the central dead space of the implant and by injecting back 1 ml of physiological saline. In the experimental animals, the aspirated wound fluid was replaced by a corresponding volume of a solution containing 0.08 microgram of Hex-Cer in physiological saline. Analyses of the wound fluid and granulation tissue were carried out 4, 10 and 21 days after the implantation. Statistically significant increases in the mean amounts of granulation tissue DNA and RNA were observed in the Hex-Cer group as compared with the controls, indicating an augmented cellularity. Concurrently, the mean amounts of collagen hydroxyproline in the Hex-Cer group were significantly higher than the respective control values. Similarly, on days 4 and 10, the amounts of uronic acids were higher in the Hex-Cer group than in the controls, reflecting an enhanced accumulation of glycosaminoglycans. The tissue hemoglobin reflecting the degree of vascularization rose gradually as the healing progressed, the mean amounts being generally higher in the Hex-Cer group than in the controls. Wound fluid pO2, pCO2 and pH as well as wound fluid hemoglobin and lactate concentrations showed no essential differences between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Actihaemyl↗
PubMed1985

Immediate enteral feeding after abdominal surgery.

Enteral feeding by nasoenteral tube was begun immediately after surgery of the alimentary tract in 120 patients. In 37 cases the feeding was delivered proximally to a fresh anastomosis or enterotomy. Immediate enteral feeding was well tolerated even after major elective surgery of the gastrointestinal tract. The feeding promoted recovery of bowel function and evoked no major complications. Abdominal discomfort and diarrhea were the most common side effects. The response was less favorable after nonelective surgery associated with intraabdominal or systemic sepsis.

Enteral Nutrition↗