Biomedical subjects
A Kahri
Publications and source records attributed to A Kahri.
Regeneration after physeal distraction of the radius in sheep.
In 18 sheep, gradual physeal distraction of the distal radius was performed by external fixation. Separation of the physis from the metaphysis occurred in all the sheep. Prior to bone formation, collagen fibers were organized according to the direction of the distraction, and lamellar bone was formed if the collagen bundles were lineally organized. In the area where the collagen was disorganized, and also near the periosteum, woven bone was first formed, which was then remodeled into lamellar bone. In some sheep separate groups of chondrocytes were isolated in the metaphyseal area after the distraction. In 2 animals a double physis was formed in the metaphyseal area. This was obviously due to the separation of proliferative chondrocytes in the metaphysis as a result of distraction. After consolidation of the distraction area, this zone of chondrocytes, located in the metaphysis, was still producing new bone 20 weeks postoperatively.
Long-term results of adrenal surgery in patients with Cushing's syndrome due to adrenocortical adenoma.
Fourteen of 16 patients with Cushing's syndrome due to adrenal adenoma who had undergone adrenal surgery in the period 1967-1981 participated in a follow-up study 1 to 15 (mean 4.5) years after the operation. There were 14 unilateral and two bilateral adenomas. Two patients have died: one from postoperative complications, the other by suicide 10 years after surgery. None of the patients relapsed and none showed clinical features of Cushing's syndrome. However, five patients remained obese and four hypertensive. Furthermore, in the female patients the bone mineral density was lower than in age-matched controls. The function of the pituitary-adrenal axis recovered slowly. Postoperative replacement therapy was withdrawn 3 to 28 (mean 11.8) months after surgery in all but one patient. The function of the remaining adrenal gland was completely normal in 10 patients. In two patients the plasma cortisol response to ACTH-stimulation was still blunted and associated with elevated plasma ACTH-levels. The plasma ACTH-level was low in the only patient having persistent hypocortisolism. In conclusion, the results show that most patients with Cushing's syndrome due to adrenal adenoma recover fully after surgery. In some patients, however, the suppressed pituitary and/or adrenal fail to resume normal function.
Hyperparathyroidism with hypercalciuria and urolithiasis: long-term effects of parathyroid surgery and postoperative thiazide therapy.
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Neurofilaments in adrenal and extra-adrenal pheochromocytoma. Demonstration using immunofluorescence microscopy.
Three cases of pheochromocytomas (two adrenal and one retroperitoneal) were studied immunohistologically, using specific antibodies against different types of intermediate filaments. A strong positive reaction was seen in immunofluorescence microscopy with antineurofilament antibodies, while no staining of tumor cells was observed with antikeratin, antivimentin, or antidesmin antibodies. The results are in accordance with the neuroepithelial derivation of adrenal medulla and paraganglia and suggest that antineurofilament antibodies can be used as an adjunct aid in identifying pheochromocytomas.
Parathyroidectomy in chronic renal failure.
During the period 1971-1976, subtotal parathyroidectomy was performed on 34 patients with chronic renal failure, representing 8% of all uraemic patients treated on the Renal Ward. Preoperative treatment of renal failure was conservative therapy in 6, haemodialysis in 20 and renal transplantation in 8 patients. The operation was indicated by grave clinical symptoms (pruritus, bone pains and mental disturbances), gastric ulcer and radiological abnormalities (osteoporosis, fractures, subperiosteal resorption and metastatic calcifications). The serum immunoreactive parathyroid hormone was determined in 13 cases, and the value was elevated in all. The serum calcium level was elevated in 8 out of 34 cases. Less than 500 mg of parathyroid tissue was removed in 12 cases, between 500 and 6000 mg in 19 and over 6000 mg in 3. Nodular hyperplasia was present in 11 patients, diffuse hyperplasia in 23. Postoperatively marked falls in serum parathyroid hormone and serum calcium values were observed. The bone pains, pruritus and mental disturbances were alleviated, and the general condition was favourably influenced. The operation had a lesser and more retarded effect on the radiological changes. Complete recovery was only achieved with successful renal transplant. Parathyroidectomy often had a favourable effect on the grave symptoms and may, therefore, be considered in some cases of severe hyperparathyroidism secondary to chronic renal failure.
Secondary hyperparathyroidism and parathyroidectomy in terminal chronic renal failure.
Subtotal parathyroidectomy was performed on 34 patients with severe renal insufficiency. The indications were grave clinical symptoms (pruritus, bone pains and mental disturbances), gastric ulcer and radiological abnormalities (metastatic calcifications, osteoporosis, fractures and subperiostal resorption). The serum calcium level was elevated in eight cases. The serum parathormone value was determined in 13 cases, it was elevated in all cases. Less than 500 mg tissue was removed in 12, between 500 and 6000 mg in 19 and over 6000 mg in 3 cases. Nodular hyperplasia was demonstrated in 11 and diffuse hyperplasia in 23 patients. The serum calcium and parathormone levels fell markedly after the operation, and pruritus, bone pains and mental disturbances were markedly alleviated. Complete recovery was achieved only by a successful renal transplantation, but the operation had often a favourable effect on the grave symptoms.
Transport of 22Na and 86Rb tracer ions in isolated contracting heart cells exposed to lignocaine.
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Inductive transformation as a basic phenomenon in the genesis of cells of the zona fasciculata and reticularis of the adrenal cortex.
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Histochemical and electron microscopic studies on the cells of the rat adrenal cortex in tissue culture.
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Recurrent adrenal cortical carcinoma with Cushing's syndrome: twenty-five-year follow-up of a patient.
A 43-year-old female patient is currently being treated by us for a recurrence of adrenal cortical carcinoma associated with Cushing's syndrome and virilization. Despite many relapses of metastatic spread she has not only survived for 25 yr after the removal of the primary tumor but also until now preserved her ability to work in a textile factory.
Hemorrhagic gastropathy in epidemic nephropathy.
A patient with epidemic nephropathy (NE) and with gastrointestinal symptoms and hemorrhagic gastropathy prompted us to study further 10 consecutive patients with NE. Gastroscopy was carried out within 1 to 4 weeks after the beginning of the symptoms, and in every case a hemorrhagic gastropathy was observed. Hemorrhagic lesions were more marked, the shorter the elapsed time interval from the beginning of symptoms. Hemorrhagic changes were always more prominent in the proximal than in the distal part of the stomach. In 7 of 10 patients lesions were also observed in the duodenum. Colonoscopy was done in one patient and it showed similar spotty hemorrhages, suggesting that hemorrhagic lesions were not limited to the gastroduodenal mucosa only. Histological studies disclosed that the hemorrhagic lesions were associated with edema in the lamina propria, but without inflammatory changes. Follow-up gastroscopy in three patients 3 to 8 weeks later showed disappearance of hemorrhagic lesions in every patient. Thus, these results show for the first time that hemorrhagic gastropathy is a common finding in NE, and it may explain the abdominal symptoms and gastrointestinal bleeding in some of these patients. However, the mechanism of the hemorrhagic lesions needs further exploration.
Expression of inhibin alpha in the human adrenal gland and adrenocortical tumors.
We studied the expression of inhibin alpha-subunit in normal and hyperplastic adrenal glands, as well as in various adrenocortical tumors. The protein expression of inhibin alpha was performed by immunohistochemistry. Virilizing adenomas showed strong immunoreactivity against monoclonal inhibin alpha-subunit antibody, whereas other adenomas were only weakly positive or completely negative. In the adrenal cortex no inhibin alpha immunoreactivity was detected in the zona glomerulosa. Zona fasciculata showed weak staining for inhibin alpha, however, strong immunostaining was detected in zona reticularis both in normal and hyperplastic adrenal glands. Adrenal medulla was negative for inhibin alpha. In conclusion, we show high expression of inhibin alpha subunit in zona reticularis of normal and hyperplastic adrenal glands as well as strong expression in virilizing adenomas.