Biomedical subjects

E Pesonen

Publications and source records attributed to E Pesonen.

At least 73 records · Page 4Linked to original sources

PubMed1991

Blood pressure in children, adolescents and young adults.

The question of whether blood pressure is one of the main risk factors for cardiovascular diseases in childhood has been evaluated in a Study of Cardiovascular Risk in Young Finns. In the second follow-up study, carried out in 1986, blood pressure was successfully measured in 2500 individuals aged nine to 24 years using a random zero sphygmomanometer. The mean systolic blood pressure in girls rose from 102 mmHg (95th percentile 119 mmHg) at age nine to 116 mmHg (138 mmHg) at age 24 and that in boys from 102 mmHg (95th percentile 121 mmHg) to 128 mmHg (148 mmHg). Diastolic blood pressure was more often measurable using Korotkoff's 5th than the 4th phase. The values observed were similar to those reported by the Second Task Force on Blood Pressure Control in Children, but owing to differences in the methods used to measure blood pressure it cannot be reliably concluded that the blood pressures were similar in the two series. Even in childhood blood pressure measurement is important, and since it changes with the physical size of the child, observations should be compared with normal values such as those reported here. No data are yet available to suggest that children with blood pressure values in the high normal range would benefit from interventions. Thus normal blood pressure value curves should be applied with caution when assessing children.

Adolescent↗

PubMed1991

Composition of the diet of young Finns in 1986.

The aim was to describe the energy intake and composition of the diet of 1200 9-, 12-, 15-, 18-, 21- and 24-year-old Finns in 1986 and changes in their diet from 1980 to 1986. Data on food consumption were collected using the 48 h recall method. In 1980 protein accounted for 14%, fat for 38% and carbohydrates for 48% of total energy intake, and in 1986 for 15%, 38% and 47%, respectively. The mean P/S ratio increased from 0.24 to 0.31 while the regional differences in the intakes of fatty acids remained unchanged, the P/S ratio being higher in urban than in rural areas and higher in western than in eastern Finland. In 1986 the diet of 15-, 18- and 24-year-old males contained more fat, saturated fatty acids and monounsaturated fatty acids but less sucrose than that of females. The difference in the diet between young men and women, if continued, might increase the male/female ratio at risk for coronary heart disease, which is already pronounced in Finland.

Adolescent↗

PubMed1991

Dimensions of the coronary arteries in children.

The extent of narrowing of the coronary arteries was measured in a series of 106 children who died accidentally. The outer radius of left main stem coronary artery increases from 1.06 mm at the age of 1 to 1.67 mm at 15. The left anterior descending branch increased with age from 0.70 to 1.35 mm and the inner radius from 0.55 to 1.10 mm. The mean thickness of the media and intima also increased with age; the correlation between thickness and weight was less pronounced. The coronary arteries thickened concomitantly with the size of the artery but that was due mainly to thickening of the intima. Substantial narrowing was found in the youngest age groups and the extent did not correlate with age but with the size of the vessel. The greatest narrowing was 57% of the arterial lumen. The measured dimensions will serve as normal values for the coronary arteries in Finnish children at autopsy.

Adolescent↗

PubMed1991

Tumour ploidy, morphometry, histological grading and clinical features in ovarian carcinoma: mutual relations.

The relationship between tumour ploidy and qualitative and quantitative histopathology was assessed in a series of 95 ovarian carcinomas. 67% of the tumours were non-diploid (DNA aneuploid). 56% of the early stage (I-II) tumours were non-diploid and 81% of the tumours in advanced (III-IV) stages were aneuploid. Histological grading failed to show a clear relationship between increasing malignancy grade and ploidy. There was a close association between DNA ploidy and nuclear perimeter, area and shortest and longest nuclear diameter: the nuclei of non-diploid tumours were generally larger. Also the number of mitotic figures per square millimeter of epithelium in the microscope image (volume-corrected mitotic index, M/V-index) differed significantly between near-diploid and non-diploid tumours. Discriminant analysis showed that 74% of the learning-set tumours (67% of the test set tumours) could be correctly classified in low-ploidy and high-ploidy categories with morphometric features (nuclear perimeter, M/V-index and volume percentage of epithelium). Characteristic features of non-diploid ovarian tumours--rapid proliferation and large nuclear size--could be assessed with morphometric methods which allowed a relatively large aneuploid tumour group to be distinguished.

Chromosomes↗

PubMed1990

Quantitation of autoradiographic grains in different zones of articular cartilage with image analyzer.

A novel method is introduced for the estimation of grain numbers in autoradiographic sections of articular cartilage with an image analyzer. It is based on separation of grains from the underlying structures by gray level thresholding and determination of the percentage of total area occupied by grains in a relatively large measuring field. The mean grain size is used as a reference to calculate grain numbers per cell profile and per unit area of tissue in various zones of bovine articular cartilage labelled with 35S-sulphate in tissue culture. The results demonstrate considerable zonal differences as well as site related topographic variation in the rate of 35S-sulphate incorporation. The largest site-related variation in the grain counts was observed in the superficial zone, suggesting a delicate control of proteoglycan synthesis in this zone.

Animals↗

PubMed1990

Intimal thickening in the coronary arteries of infants and children as an indicator of risk factors for coronary heart disease.

Narrowings of the coronary arteries were measured in 94 infants aged less than 1 year who died in hospital and 102 1- to 16-year-old children who died accidentally. The arteries were transformed mathematically to circles. The degree of narrowing caused by intimal thickening was determined as the ratio of intimal area to the original luminal area. This ratio was further transformed to percentage. The degree of narrowing varied between 0 and 58% (mean 20%). The mean degree of narrowing in the left coronary artery during the first year of life was 17% and, between 12 and 15 years, 34%. Narrowing was greater in males (P = 0.02), when all the 333 coronary samples were included in the analysis. The birthplaces of the subjects' grandparents were traced from population registers and it was found that narrowing in the left coronary artery of infants was greater in those descended from grandparents from eastern Finland, an area of high mortality from coronary heart disease (CHD). Intimal thickening in infants and children seems to be a morphological manifestation of hereditary predisposition to CHD.

Adolescent↗

PubMed1990

Consistency of quantitative methods in ovarian tumor histopathology.

Two mitotic activity indices, volume fraction of neoplastic epithelium, nuclear area, nuclear perimeter, and shortest nuclear axis were estimated in 46 ovarian tumors by three observers in two independent laboratories. The mitotic activity index, the volume corrected mitotic index (M/V index) and subjective volume fraction estimates showed a very good correlation from the same fields by two observers in the same laboratory (r = .999, .995, .950). Repeat estimates from different fields by the same observer showed coefficient values of .949, .939, and .813, and estimates by two different observers within one laboratory values of .949, .936, and .789, respectively. The correlation between two independent observers in different laboratories was also good (r = .894, .834, .834, respectively). Grading based on morphometric measurements was uniformly performed in 90-100% of cases in an interfield interobserver intralaboratory situation, and in 79-97% (M/V index) or 76-93% (mitotic activity index) in an interlaboratory situation. Because the cases near the grade limits were more often differently graded than other cases, the methods allowed the pathologist to locate the probably incorrectly graded cases. Morphometry of ovarian tumors was shown to be easy, which makes morphometric malignancy grading systems potentially able to support diagnostic and therapeutic decisions in practice.

Cell Nucleus↗

PubMed1990

Prognostic value of ovarian carcinoma grading methods--a method comparison study.

The prognostic value of subjective histological and morphometric grading was studied in 75 primary ovarian carcinomas. Histological grading methods recommended by Czernobilsky and by Russell and the morphometric method of Baak and co-workers were compared in a two-observer system. The 5-year survival could be correctly predicted in about two-thirds of the patients with all three methods. When mitotic counting (volume corrected mitotic index, M/V-index) was compared with the above grading methods by using a receiver operating characteristic curve) the M/V-index was generally superior in its prognostic power regardless of the sensitivity/specificity level chosen. The morphometric grading method and the grading method based on the M/V index were also shown to be readily reproducible.

Carcinoma↗

PubMed1990

Comparison of morphometry and DNA flow cytometry with standard prognostic factors in bladder cancer.

In 83 bladder cancer patients with adequate follow-up (mean 13 years, range 9-22) the prognostic value of morphometric, DNA flow cytometric and clinical parameters was assessed. Paraffin embedded material was used in flow cytometry. Univariate life-table analysis showed the statistically significant relation of clinical stage, histological grade, mean nuclear area, the Standard Deviation (SD) of nuclear area, mean maximal nuclear diameter, mean nuclear perimeter and the volume corrected mitotic index (M/V index) to survival when bladder cancer deaths alone were used in the analysis. The recurrence of bladder cancer could be predicted with the M/V index. Survival analysis with Cox's regression model pointed to primary tumour clinical stage as the most important prognostic factor of crude survival. Histologically, grade and the SD of nuclear area were the best prognostic factors. Primary tumour stage and histological grade were the best predictors of death from bladder cancer. In Cox's model, histoquantitative methods are almost as good as clinical staging in predicting prognosis. DNA flow cytometry of paraffin embedded material offered no advantage over clinical stage, histological grade or morphology in assessing prognosis.

Adult↗

PubMed1990

Histological and histochemical studies on local coronary wall thickenings (cushions) in Finnish children who died violently. Cardiovascular risk in young Finns?

Coronary arteries of 93 clinically healthy Finnish children of both sexes were collected from successive, medicolegal autopsies of victims of violent death. In the histological and histochemical study, local, cushion-type thickenings of the coronary walls were demonstrable in 47, i.e. 50 per cent, of the children, the occurrence increasing with age. The most prominent change was the splitting of the internal elastic membrane and the accumulation of smooth muscle cells, forming a new, musculo-elastic layer. Glycosaminoglycans appeared in the luminal parts of the thickenings. There was an average decrease in the succinate dehydrogenase reaction in the cushion area, implying a degenerative process. The increase in the reaction of "injury markers", acid phosphatase and esterase based on the increase of cells rich in these enzymes, indicated pathologic process. It was concluded that change of this kind, demonstrable early in childhood, may dispose coronary arteries to atherosclerosis.

Acid Phosphatase↗

PubMed1990

DNA ploidy and S phase fraction in human bladder cancer. Relation to survival and histological grade (WHO).

The nuclear DNA content of archival paraffin-embedded bladder cancer samples (70 patients) of WHO grades I-III has been measured by flow cytometry. The female/male ratio was 15/55. The mean follow-up time was 13 years (range 9.6-22.0 years). 37 of 70 (53%) patients had DNA index 1.0 (diploid DNA content), and the remaining 33 (47%) patients had an aneuploid tumor. There was no significant difference in the age (mean +/- SD) of the patients having a diploid (66 +/- 9 years) or an aneuploid tumor (68 +/- 11 years) at the time of diagnosis. 47 deaths occurred during the follow-up period; 24 (51%) of these were due to bladder cancer (12 diploid, 12 aneuploid tumors). No significant difference was found after radical treatment during the disease-free interval (mean +/- SD) between diploid (48 +/- 45 months) and aneuploid (35.5 +/- 35 months) groups of patients. Recurrences during the follow-up period were equally common among aneuploid and diploid tumors. A statistically significant relation between histological grade and survival could be demonstrated, but DNA ploidy and S phase fraction had little prognostic value in this respect. There was no statistically significant difference in survival between aneuploid (30%) and diploid (35%) groups of tumors during the follow-up period. The study suggests that flow cytometric determination of nuclear DNA ploidy from paraffin-embedded samples in bladder tumors does not add to the prognostic power of subjective histological grading.

Aged↗

PubMed1990

Correlation of patent ductus arteriosus shunting with plasma atrial natriuretic factor concentration in preterm infants with respiratory distress syndrome.

The concentration of plasma atrial natriuretic factor (ANF) and the mechanism for its secretion were investigated in 17 preterm infants with respiratory distress. Their mean gestational age was 29 wk and wt 1250 g. The infants were followed during the first week of life by sequential Doppler ultrasound studies. Ductal openness versus closure and amount of ductal flow were correlated with plasma ANF concentrations. In a subset of 10 infants, sequential Doppler color flow mapping was used to quantify the ductal flow. During the first 72 h, plasma ANF was high, 361 pg/mL; it decreased to 96 pg/mL by the end of the 1st wk. The ANF level was significantly higher when the ductus was open than closed (393 versus 123 pg/mL, p less than 0.05). In patients with open ductus and bidirectional foramen ovale shunting (n = 3) ANF was 567 pg/mL and in those with left-to-right shunt 355 pg/mL (n 15, NS). The left atrial size, i.e. the left atrial to aortic root ratio, correlated with the amount of ductal shunting (r = 0.63, p less than 0.01) and with ANF concentration (r = 0.46, p less than 0.02). The correlation of ANF values and the magnitude of left-to-right ductal shunting assessed by color flow mapping was highly significant (r = 0.66, p less than 0.001). In these patients, the elevation of ANF is reflective of ductal flow.

Age Factors↗

PubMed1990

Volume corrected mitotic index (M/V index) in human bladder cancer; relation to histological grade (WHO), clinical stage (UICC) and prognosis.

A retrospective study was performed on 83 bladder cancer patients diagnosed at the Department of Surgery, Kuopio University Central Hospital, during the years 1965-1987. The follow-up time was 22 years, and the mean follow-up time of individual patients was 13 years (range 9.4-22 years). Histological grade (WHO), volume corrected mitotic index (M/V index) and clinical stage (UICC) were correlated to the survival of patients. Histological grade, M/V index and clinical stage were associated with crude survival (all causes of death included) with little predictive power. The recurrence of the disease could be predicted by the M/V index, but not by histological grade or clinical stage. When bladder cancer deaths only were included, histological grade (chi 2 = 26.6, p less than 0.001), M/V index (chi 2 = 6.6, p = 0.042) and clinical stage (chi 2 = 31.7, p less than 0.001) were clearly associated with prognosis. Also the metastasizing potential of bladder carcinomas could be predicted by the M/V index and by the histological grade at the time of primary diagnosis. Histological grade and M/V index were positively correlated (chi 2 = 16.7, p = 0.002, r = 0.47). In multivariate analysis clinical stage, histological grade and M/V index predicted prognosis in the order of importance.

Aged↗

PubMed1990

An improved prognostic index of axillary node involvement in breast cancer incorporating DNA ploidy and tumour size.

A multivariate prognostic index based on clinical data and the results of flow cytometry for the grading of breast cancer was evaluated in 117 patients whose disease had been detected and treated by mastectomy with axillary clearance between 1974 and 1976. Survival analysis with Cox's regression model pointed to three important prognostic factors: lymph node involvement (p less than 0.001), DNA ploidy (p less than 0.01) and tumour size (p less than 0.01). These factors were incorporated into a prognostic index, in which the lymph node involvement, DNA ploidy, and tumour size contributed to the index in that order. Logistic discriminant analysis with five year follow-up as the fixed end point (70 alive, 47 dead) gave the same result; lymph node involvement, tumour size, and DNA ploidy were the best prognostic indicators of survival. The result showed that our multivariate prognostic index was more powerful than lymph node involvement alone. The use of this prognostic index is recommended for selecting patients for different treatments.

Adult↗

PubMed1990

Morphometry in human transitional cell bladder cancer. Nuclear area and standard deviation of nuclear area--relation to tumor grade (WHO) and prognosis.

A retrospective follow-up (range 9.4-22 years, mean 13 years) study of 83 patients with grade I-III (WHO) bladder carcinomas was performed. Nuclear area (mean +/- SD 59.7 +/- 18.7 microns2) and the SD of nuclear area (mean +/- SD 19.7 +/- 13.4 microns2) were determined by using morphometric methods. The SD of nuclear area and histopathological grade exhibited a clearly significant relation, the relation between grade and nuclear area was weaker. The number of recurrences in the bladder and the recurrence-free period were not significantly related to histopathological grade, mean nuclear area or SD of nuclear area. The progress in nodal or metastatic stage could be predicted by histopathological grade, mean nuclear area and SD of the nuclear area. Prediction of crude survival, however, was not efficient. When only bladder cancer deaths were included in the analysis, histopathological grade (p less than 0.001), mean nuclear area (p = 0.011) and SD of the nuclear area (p = 0.001) showed a significant relation to survival. Grade II tumors could be divided into two prognostically different groups using nuclear area and SD of the nuclear area as classifiers. The results suggest that morphometric parameters are as good as histopathological grade in predicting long-term prognosis of bladder carcinomas, and better than the histopathological grade in predicting progress in nodal (N) or metastatic (M) stage.

Aged↗

PubMed1990

Factors associated with risk of breast cancer and persistence of symptoms in women with breast problems.

Risk factors in breast cancer were analysed in a series of 293 women who were first seen at the Surgical Outpatient Department of Savonlinna Central Hospital in 1982-1983 for breast problems and were alive and willing to participate in a control examination and interview 4-5 years later. In 1986 and 1987 the patients were examined clinically and underwent mammography and interview. They were divided into three groups: 1) 49 patients with breast cancer in 1982 and 1983, 2) 49 with breast symptoms after primary treatment of benign disease, and 3) 195 patients without breast symptoms after primary treatment of benign disease. The groups were compared in terms of 18 suggested risk factors for breast cancer. Two factors were significantly associated with breast cancer (compared with all benign breast diseases): higher age of the patient and higher age at first delivery. Use of contraceptives was significantly associated with the presence of breast symptoms after treatment of benign breast disease (as compared with the absence of symptoms) (RR = 1.70 P less than 0.001). Hysterectomy and/or oophorectomy was significantly associated with the absence of breast symptoms among patients with benign breast disease (RR = 0.76, P less than 0.05). Our results suggest that symptoms after treatment of benign breast disease are associated with the levels of female sex hormones.

Breast Diseases↗

PubMed1989

Relationship between DNA ploidy and survival in patients with primary breast cancer.

The DNA ploidy of breast cancer tissue from paraffin blocks was measured by flow cytometry in 117 patients whose disease had been detected and treated with surgery between 1974 and 1976. Patients with aneuploid tumours had positive axillary nodes and distant metastases more often than those with diploid tumours. Aneuploid tumours were more common in postmenopausal than premenopausal women. The S-phase fraction (SPF) was significantly higher in aneuploid than in diploid tumours and positive axillary lymph nodes were found in 26 per cent of the patients who had a tumour with a SPF below the median (4.8 per cent) and in 48 per cent of those with tumours with SPF values above the median. At the primary clinical investigation 2 per cent of the patients with diploid tumours and 6 per cent of those with aneuploid tumours had distant metastases. During the follow-up, the proportion of patients with distant metastases increased to 42 and 72 per cent, respectively. With a follow-up of 11.5 years, the DNA aneuploidy of the tumour showed a significant association with decreased survival. Thirty-three per cent of patients with diploid and 65 per cent of patients with aneuploid tumours had died from breast cancer during the follow-up (P less than 0.001). All patients with hypertetraploid or multiploid tumours died from breast cancer. High SPF values were associated more closely with distant metastases or death during the follow-up than low SPF values. Our results suggest that DNA ploidy measured by flow cytometry from paraffin embedded tissue blocks of human breast cancer can be used to predict the aggressiveness of the tumour and the survival of the patients.

Aged↗

PubMed1989

Experimental ductus arteriosus: the relationships of atrial pressure, dilatation and flow with ANF secretion.

The design of the study was to determine whether an increased blood flow as seen in shunt lesions could serve as a stimulus for the secretion of atrial natriuretic factor (ANF). Since atrial pressure, flow, and dilatation are closely related, an experimental ductus arteriosus model was utilized, in which acute changes of flow are assumed not to dilate the left atrium. In six dogs, a Dacron graft was constructed between the main pulmonary artery and the innominate artery. Constricting and releasing the tape around the graft adjusted the amount of "ductal" shunting. The total pulmonary flow and the shunt flow were measured by electromagnetic-flow transducers around the aortic root and around the graft. Plasma ANF concentration was measured from both cardiac atria. The size of the left atrium was determined from echocardiographic measurements made from a short-axis view. The total pulmonary flow varied between 1.2 and 5.8 1/min. The highest measured ANF was 396 pg/ml, and this was from the left atrium when the pressure was 18 mmHg, the highest left atrial pressure recorded. The highest right atrial pressure (5 mmHg) also correlated with the highest right-atrial level of ANF (366 pg/ml). The right atrial pressure had a significant correlation with plasma ANF concentration (R = 0.43, p less than 0.05). Pulmonary flow and plasma ANF concentration did not correlate; neither did left atrial size and ANF levels in 16 flow states where the size was measured. In the absence of atrial dilatation there was minimal stimulus for ANF secretion. A transient increase of left atrial pressure, without a concomitant significant atrial dilatation, did not serve as a significant stimulus for ANF secretion.

Animals↗