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Biomedical subjects

E Pesonen

Publications and source records attributed to E Pesonen.

At least 55 records · Page 3Linked to original sources
PubMed1994

Nutritional and genetic contributions to serum cholesterol concentration in a children's follow-up study.

In the Finnish multicentre study of cardiovascular risk in young Finns in 1980, 1983 and 1986, 2429, 2052 and 1841 9 to 18-year-old children and adolescents participated. In 1980, subjects of eastern origin living in the west had, despite their western diet, higher serum cholesterol concentrations than subjects both residing in and originating from the west. In males, eastern origin increased the east/west difference in serum cholesterol concentrations. Between 1980 and 1986 the mean serum total cholesterol of the study cohorts decreased by 5.5% and simultaneously the east/west differences in serum cholesterol concentrations disappeared in boys. The study suggests that genetic background is a separate factor determining serum total cholesterol level, but with declining serum cholesterol concentrations the effect of the genetic factor does not become manifest.

Adolescent↗
PubMed1994

Prognostic studies in breast cancer. Multivariate combination of nodal status, proliferation index, tumor size, and DNA ploidy.

We studied histological samples and clinical data from 111 breast carcinoma patients originally treated in 1975-1977 who did not have distant metastases at the time of diagnosis. A multivariate survival analysis using the Cox model selected the studied variables in the following order according to their prognostic association (breast cancer deaths, or deaths from any cause): axillary lymph node status, tumor size, mitotic index, and DNA ploidy status. The association of the different variables to the prognosis in respect to breast cancer deaths was evaluated 1-10 years after treatment by stepwise logistic regression. Lymph node status, tumor size, mitotic index, and DNA ploidy all showed significant relation to the prognosis but this association varied considerably with time of observation.

Adult↗
PubMed1994

Parameters for a knowledge base for acute appendicitis.

Acute appendicitis is the most common cause of acute abdomen requiring surgical intervention. The clinical diagnosis of acute appendicitis is not always easy due to variable symptomatology, particularly at the onset. The contributions of history-taking and physical examination in the diagnosis of acute appendicitis was studied in connection with the Research Committee of the World Organization of Gastroenterology (OMGE) survey of acute abdominal pain. Especially the suitability of diagnostic parameters in the construction of an expert system for automatic decision making was studied. The results clearly show that it is possible to construct an expert system for automatic decision making in the diagnosis of acute appendicitis.

Abdomen, Acute↗
PubMed1994

Effects of bone marrow transplantation on myocardial function in children.

Of 41 pediatric patients currently alive after total body irradiation (TBI) and bone marrow transplantation (BMT), 30 (allogeneic 20, autologous 10) participated in the study. Pre-transplant therapy included high-dose cyclophosphamide (CY) and TBI (n = 12), high-dose CY alone (n = 4), high-dose Ara C and TBI (n = 5), cisplatinum, high-dose melphalan, VP-16 and TBI (n = 9). Acute cardiotoxicity was suggested by a > 15% decrease in the QRS voltage sum of the limb leads in all patients. Late cardiotoxicity was evaluated 0.5-10 years (median 5 years) post-transplant by ECG, chest radiograph, radionuclide cineangiography (RNCA) and echocardiography (ECHO). Six patients had a persistent decrease in the QRS amplitudes. They were all asymptomatic but had abnormal systolic function at the time of the study. BMT patients differed from their controls in the mean values of both the systolic and diastolic indices of myocardial function shown by RNCA and ECHO. Treatment was associated with decreased myocardial contractility. Isovolumic relaxation time and deceleration time were longer in BMT patients than in controls. Myocardial damage seemed to be worst after CY while high-dose Ara C was tolerated best. We conclude that both acute and late cardiotoxicity may occur after BMT, calling for long-term cardiac follow-up.

Adolescent↗
PubMed1993

The effect of antenatal dexamethasone administration on the fetal and neonatal ductus arteriosus. A randomized double-blind study.

OBJECTIVE: To determine whether antenatal dexamethasone sodium phosphate administration constricts the fetal ductus arteriosus or improves spontaneous closure of the ductus in premature infants. DESIGN: A randomized double-blind study. SETTING: University hospital of Helsinki, Finland. PARTICIPANTS: Sixty-one pregnant women with threatened preterm delivery between 24 and 31.9 weeks' gestation and 57 of their offspring (28 in the dexamethasone and 29 in the placebo group), born at 24 to 34.9 weeks' gestation, were studied using Doppler echocardiography. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Between the dexamethasone and placebo groups, there were no significant differences in systolic or diastolic flow velocity values in the fetal ductus arteriosus. Of the 29 infants with respiratory distress syndrome, 26 (90%) had hemodynamically significant patent ductus arteriosus and received indomethacin sodium: 12 (92%) of 13 dexamethasone-treated infants and 14 (88%) of 16 placebo-treated infants. One placebo-treated infant was ligated. Of the 28 infants without respiratory distress syndrome, only four (14%) had hemodynamically significant patent ductus arteriosus. In infants born at or before 30 weeks' gestation, spontaneous closure of the ductus occurred more frequently after administration of prenatal dexamethasone (in six of 17 infants; 35%) than placebo (in none of 10 infants; P < .05). CONCLUSIONS: Our data indicate that antenatal dexamethasone administration had no constrictive effect on the ductus arteriosus of the fetus between 24 and 31 weeks' gestation. However, antenatal dexamethasone had a beneficial effect on ductal closure in very premature infants.

Adult↗
PubMed1993

Atrial natriuretic factor and pulmonary status in premature infants with respiratory distress syndrome: preliminary investigation.

We studied the correlation of atrial natriuretic factor (ANF) with lung compliance in a series of 16 premature infants with respiratory distress syndrome (RDS). The infants were followed during the first week of life by sequential Doppler echocardiography, lung compliance, and ANF measurements. Plasma ANF concentration varied between 38 and 2220 pg/mL; mean concentrations of 393 and 123 pg/mL with the ductus open and with it closed, respectively (P < 0.01). The arteriolar/alveolar oxygen-tension ratio showed an inverse correlation with the logarithm (In) of the ANF concentration (r = -0.55, P = 0.0002). Both mean airway pressure and In ANF showed an inverse correlation with the arteriolar/alveolar oxygen tension ratio (R = -0.77, F = 20.5 and 13.8, respectively). Plasma ANF was inversely correlated to lung compliance (r = -0.64, P < 0.0001). In infants with RDS, plasma ANF concentrations increase with the severity of respiratory distress. Because ANF increases endothelial permeability, in this preliminary investigation lead to the hypothesis that it may contribute to respiratory distress by causing extravasation of fluid from the pulmonary circulation in these patients.

Atrial Natriuretic Factor↗
PubMed1993

Value of absent or retrograde end-diastolic flow in fetal aorta and umbilical artery as a predictor of perinatal outcome in pregnancy-induced hypertension.

There is insufficient data on the value of absent or retrograde end-diastolic flow (AREDF) in the fetal umbilical artery, descending aorta and aortic arch to predict perinatal outcome. In this prospective investigation, 65 pregnant women between 24 and 34 weeks' gestation with pregnancy-induced hypertension were studied by color Doppler echocardiography. Pregnancies leading to birth at or before 34.0 gestational weeks (23 with and 19 without AREDF) were included in the outcome analysis. Fetuses with AREDF were delivered at earlier gestational ages (p = 0.006). They had a higher incidence of gastrointestinal complications (p = 0.01), bronchopulmonary dysplasia (p = 0.03), intraventricular hemorrhage (p = 0.03) and vascular hypotension (p = 0.03) than those without AREDF. The presence of AREDF was associated with a mortality rate of 30%, whereas in fetuses without AREDF there was no mortality (p = 0.01). Using logistic regression and taking into consideration various perinatal factors, the presence of AREDF (p = 0.03) and early gestational age (p = 0.0001) were associated with serious neonatal diseases or death. A reverse diastolic flow in the aortic isthmus was registered in five fetuses; three died during the perinatal period and one was severely damaged. According to our results, AREDF, particularly with the appearance of reverse diastolic flow in the isthmus of the aortic arch, is a predictor of poor neonatal outcome.

Adult↗
PubMed1993

Intimal thickening of the coronary arteries in infants in relation to family history of coronary artery disease.

BACKGROUND: Intimal thickenings of the coronary arteries of newborn children are composed mainly of smooth muscle cell proliferations. To investigate whether thickening of the intima in infants is associated with a family history of coronary artery disease (CAD), we studied the relation of coronary death of grandparents to intimal thickening of 136 infants. METHODS AND RESULTS: The length of internal elastic lamina of the artery and the areas of arterial layers in cross section were measured, and the arteries were transformed to idealized round circles. Intimal thickening was assessed as the degree of luminal narrowing (ratio of intimal area to the area on the luminal side of the arterial media). Among 136 infants, luminal narrowing varied between 0% and 58%. CAD deaths accounted for 108 of the total 281 deaths among the grandparents of the infants. Family history of CAD (defined as at least one CAD death among the four grandparents) was positive for 77 infants. Family history of CAD was significantly more common in the infants with luminal narrowing of both the left and right coronary arteries compared with the infants with no narrowing in at least one artery (odds ratio adjusted for sex, infection status, and age of infant, 5.69; 95% confidence interval, 1.46-22.2). After adjustment for sex and age, infants with both a positive family history and presence of infection had an increased degree of luminal narrowing compared with infants with a negative family history and no infection. CONCLUSIONS: The association of coronary artery intimal thickening in infancy with family history of CAD suggests that intimal thickening is a morphological manifestation of predisposition to CAD.

Aged↗
PubMed1993

Altered serum lipid profile after systemic infection in children: risk factor for CHD?

Systemic infections may thicken the intima of coronary arteries and modify the serum lipid profile. Infants and children are particularly susceptible to such intimal thickening, the signs of which are more pronounced in infants who have evidence of infection at death. The topography of the thickenings, their greater size in males, and in families with a history of coronary heart disease favours the idea that the thickenings are pre-atherosclerotic. Infections modify the serum lipid pattern: serum high density lipoprotein (HDL) cholesterol concentration decreases and stays low during convalescence. Thus repeated infections might prove to be a risk factor for atherosclerosis via their effect on HDL concentration.

Adolescent↗
PubMed1992

Echocardiographic study of the morphology and growth of the aortic arch in the human fetus. Observations related to the prenatal diagnosis of coarctation.

BACKGROUND: In a study of normal and abnormal growth of the aorta before birth, high-resolution echocardiographic imaging of the aortic arch in 92 normal fetuses aged 16-38 weeks was used to establish normal values for aortic arch dimensions at varying gestational ages. METHODS AND RESULTS: From long-axis views of the aortic arch, the internal diameter of the aortic root, ascending aorta, transverse aortic arch, aortic isthmus, proximal descending thoracic aorta, and left common carotid artery were measured. Correlation coefficients for the diameter of each aortic arch segment when related to gestational age varied from r = 0.87 to r = 0.94 (p less than 0.001 for each), and growth curves were derived from the third and 97th percentiles around each linear regression analysis. In most of the fetuses, there was progressive tapering of the aortic arch, with the smallest diameter being at the isthmus. The ratio of the transverse aorta, isthmus, descending aorta, and aortic root to the ascending aorta remained relatively constant with gestational age, with mean values of 0.94, 0.81, 0.96, and 1.13, respectively. In five fetuses in whom a prenatal diagnosis of aortic coarctation was confirmed postnatally, transverse aortic and isthmic measurements fell on or below the third percentile for gestational age from the above data. In each case, the ratio of left common carotid artery to transverse aorta was greater than or equal to 0.73 compared with less than or equal to 0.62 for the 92 normal fetuses (mean ratios, 0.77 +/- 0.05 [SD] for coarctation versus 0.48 +/- 0.08 for normal fetuses; p less than or equal to 0.001). CONCLUSIONS: Use of normal growth curves for the developing aortic arch should facilitate the prenatal diagnosis of left heart and aortic arch abnormalities, particularly aortic coarctation, which until recently has been a difficult prenatal diagnosis to make with certainty.

Aorta, Thoracic↗
PubMed1992

Relationships between myocardial macrominerals and trace elements and luminal narrowing of coronary arteries in Finnish children.

In addition to the traditional risk factors for cardiovascular diseases it has been hypothesized that a suboptimal intake of macrominerals and trace elements plays a role in the etiology of such diseases. We studied the possible correlation between preatherosclerotic changes in the coronary arteries and the myocardial concentration of K, Ca, Mg, Fe, Zn, Cu and Se in an autopsy series of children who had died mainly from accidental causes (n = 58). The concentrations of myocardial elements were comparable to values published elsewhere except for a slightly higher Cu concentration. The myocardial Se concentration indicated an adequate Se status. Narrowing of the coronary artery lumen was not correlated with myocardial element concentration except in the case of Se, for which a positive correlation was found (r = 0.23, p less than 0.04). Myocardial K was positively correlated with myocardial Mg (r = 0.65, p less than 0.001) and inversely correlated with Ca (r = -0.50, p less than 0.001). The intake of saturated vs. unsaturated fats was associated with myocardial Cu and Ca concentrations. Our results suggest that myocardial macrominerals and trace elements do not play a role in juvenile preatherosclerotic changes of the arteries.

Adolescent↗
PubMed1991

The effects of indomethacin and a beta-sympathomimetic agent on the fetal ductus arteriosus during treatment of premature labor: a randomized double-blind study.

To study the effect of maternal indomethacin or nylidrine hydrochloride treatment on the fetus ductus arteriosus and the pulmonary artery, 27 women with threatened preterm labor between 24 and 34 weeks' gestation were studied by echocardiography. Fourteen women were treated with indomethacin and 13 with nylidrin. Both systolic and diastolic velocities in the ductus increased after administration of indomethacin indicating constriction in nine fetuses, and exceeded the corresponding velocities in the fetuses of the nylidrin group (p = 0.001). However, there were no changes in pulmonary artery flow velocities (p greater than 0.5). In the indomethacin group, there was a significant linear positive relationship between the gestational age and the change in ductal flow velocity. Three of the nine patients with ductal constriction also had tricuspid regurgitation. These findings indicate that indomethacin, not nylidrin, causes transient constriction of the ductus arteriosus and the constrictive response increases with the gestational age. We recommend echocardiographic surveillance of fetal hemodynamics when prostaglandin synthesis inhibitors are used in the treatment of spontaneous preterm labor.

Blood Flow Velocity↗
PubMed1991

Serum cholesterol levels during and after Kawasaki disease.

Serum total cholesterol and high-density lipoprotein (HDL) cholesterol concentrations were studied in paired sera from 23 patients (16 boys) with Kawasaki disease (KD) during acute illness and in 35 patients (21 boys) 5.4 to 7.7 years after KD. Total cholesterol and HDL cholesterol concentrations were significantly lower (paired t test, p = 0.0001) in samples taken within 30 days of the onset of illness (3.32 +/- 0.85 mmol/L (128 +/- 33 mg/dl) and 0.54 +/- 0.25 mmol/L (20.8 +/- 9.7 mg/dl) than in the second samples taken 2 to 16 months after onset of disease (4.16 +/- 0.93 mmol/L (161 +/- 35 mg/dl) and 1.24 +/- 0.35 mmol/L (47.2 +/- 13.9 mg/dl). The lowest total cholesterol levels were observed in samples taken 6 to 9 days after the onset of KD (p = 0.019). No correlations were seen between the highest erythrocyte sedimentation rate, C-reactive protein, or thrombocyte counts and the acute or convalescent cholesterol levels. In patients studied 5.4 to 7.7 years after recovery from KD, the mean total cholesterol concentrations were still lower than in healthy Finnish children. In girls the HDL cholesterol concentrations were similar, whereas 3 of the 18 boys studied had HDL cholesterol values more than 2 SDs below the mean for healthy boys. There was no correlation between the serum cholesterol concentrations and coronary artery abnormalities. These data lead us to infer that KD does not cause such permanent changes in cholesterol metabolism as to be considered a risk factor for atherosclerosis beyond that caused by the disease itself.

Child↗
PubMed1991

Prognosis of transitional cell bladder cancer: a multivariate prognostic score for improved prediction.

Clinical and histological prognostic factors were evaluated by means of Cox's analysis in 265 bladder cancer patients with a mean followup of 10 years. The parameters studied were obtained from the primary biopsies, which included clinical stage, World Health Organization grade, papillary status, morphometrically measured mean nuclear area, standard deviation of nuclear area, mean nuclear area of the 10 largest nuclei, mitotic activity index and volume corrected mitotic index. In univariate survival analysis all of the parameters predicted survival (p less than 0.001). In Cox's analysis the clinical stage was the most important prognosticator (p less than 0.001) followed by papillary status (p less than 0.001), volume corrected mitotic index (p = 0.011) and nuclear area of the 10 largest nuclei (p = 0.091). In stages Ta to T2, grades 1 to 2 tumors the papillary status (p = 0.001), mitotic activity index (p = 0.021) and T category (p = 0.029) showed independent prognostic value. Among the stages Ta to T1 tumors the papillary status included all of the available prognostic information (p = 0.001). In a separate analysis of histological features in all papillary tumors histological grade (p less than 0.001) and mitotic activity index (p = 0.021) were related independently to survival in Cox's analysis. In papillary stages Ta to T2, grades 1 to 2 tumors (mitotic activity index, p = 0.029) and in papillary stages Ta to T1 tumors (volume corrected mitotic index, p = 0.054) mitotic indexes showed independent prognostic value. In grade 2 tumors the papillary status p = 0.004) and mitotic activity index (p = 0.090) had independent prognostic value. The mitotic indexes predicted progression among stages Ta to T1 tumors (p less than 0.001) and within World Health Organization grades significantly. The combination of prognostic parameters into prognostic scores gave a more accurate estimate of survival than the single parameter approach. The results suggest morphometric grading of bladder tumors. However, papillary and nonpapillary tumors require different grade limits.

Aged↗
PubMed1991

Histoquantitative study of inflamed tongue mucosa.

A quantitative, semiautomatic analysis of histologic features of the specific inflammatory changes occurring on the dorsum of human tongue was made for 37 tongues. Well-documented histologic differences between clinically normal appearing tongue (control), atrophic, geographic and fissured tongue were shown quantitatively. The epithelium of atrophic tongue was thinner compared to the controls. Reduction of the thickness was due to the shortened or totally missing rete pegs. Epithelium of geographic and fissured tongue showed irregular rete pegs. In fissured tongue heavy inflammation seemed to shorten the rete pegs. In atrophic tongue the connective tissue was thicker compared to the controls. This could be due to mild, chronic inflammation causing loose connective tissue described in atrophic tongue. Muscle cells of geographic tongue appeared to be as in the controls, whereas in atrophic and fissured tongue the uppermost muscle cells were small and separated compared to the controls.

Adult↗
PubMed1991

Cardiovascular risk in young Finns.

This report describes the general outline and progress of a multicentre study on risk factors of coronary heart disease and their determinants in children and adolescents. "Cardiovascular Risk in Young Finns" comprises a cross-sectional study of 3 to 18-year old subjects in 1980, and follow-up studies in 1983 and 1986 in various parts of Finland, and in 1989 in one of the study areas (Turku). The number of participants in 1980 was 3596 (83.1%) of those invited. In 1983 and 1986 83.2% and 77.8% of them, respectively, participated. The study programme has comprised questionnaire data on, for example, general health and living conditions, physical activity, eating habits, smoking, and psychological variables. The physical examination covered height, weight, skinfold thickness, pubertal stages and blood pressure. Blood specimens were obtained to assess concentrations of serum lipids and insulin, and in 1986 also for possible genetic markers of hypercholesterolemia. A 48 hour recall on nutrient intake was obtained from some of the subjects. The follow-up studies have enabled a study of the tracking phenomenon. Other important questions under study include, for example, the possible clustering of risk factors and their determinants. The cohorts studied provide a valuable research basis for the future, with emphasis on enabling a long-term follow-up of the subjects.

Adolescent↗
PubMed1991

Obesity in children, adolescents and young adults.

The prevalence of obesity in Finnish children, adolescents and young adults aged three to 24 years was estimated in three surveys performed within the multicentre project, "Cardiovascular Risk in Young Finns" (1980, 1983, 1986). Obesity was defined as either body mass index (weight/height) or skinfold thickness (triceps or subscapular) or both greater than 90th percentiles of age and sex-specific reference data for white children. Its mean prevalences among 9- to 18-year old boys and girls in three surveys (95% confidence limits) were 3.6% (3.1-4.2) and 2.1% (1.7-2.6) as estimated in terms of body mass index and triceps skinfold thickness or 4.3% (3.9-4.9) and 2.6% (2.2-3.1) according to body mass index and subscapular skinfold thickness. Thus the 9- to 18-year old boys were on average more often obese than the girls, but no statistically significant changes in the prevalence of obesity were observed over the period 1980-1986. Body mass index and triceps or subscapular skinfold thicknesses vary in sensitivity as indicators of obesity.

Adolescent↗