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Biomedical subjects

E Pesonen

Publications and source records attributed to E Pesonen.

143 records · Page 8Linked to original sources
PubMed1980

Fibromuscular dysplasia in a child: a generalized arterial disease.

After slight prodromal symptoms a fourteen-year-old girl had epileptic convulsions followed by a right-sided hemiplegia. Carotid angiogram showed almost total occlusion of the left arteria cerebri media. Six weeks later she developed elevated blood pressure followed by convulsions and lowered consciousness. Abdominal aortic angiogram showed total occlusion of the left renal artery at its origin. After nephrectomy, the blood pressure returned to normal. Histological examination of the main branches of the renal artery revealed fibromuscular dysplastic changes. Renovascular hypertension and childhood idiopathic cerebral arterial disease might represent different aspects of the same process.

Adolescent↗
PubMed1977

Coronary artery changes in newborn babies. A histological and electron microscopical study.

The main branch of the left coronary artery of 14 autopsied newborn babies was studied both in light and electron microscopy. Intimal and medial changes of varying severity were found in most cases. The lesions show edema and suggest insudation of the blood solutes into the vessel wall. The edematic phase is followed by proliferation of smooth-muscle and undifferentiated cells, leading to a thickening of the arterial wall. The structure of the lesions resembles the so-called preatherosclerotic changes found frequently in adults. The relationship of the neonatal coronary changes to arteriosclerosis is discussed.

Arteries↗
PubMed1977

Double outlet right ventricle with extreme hypertrophy of muscle bundles associated with crista supraventricularis. A heart with three ventricles.

A baby born with cardiac, cerebral, ocular, palatal, renal and pulmonary anomalies died four hours after birth. The cardiac anomaly consisted of a double outlet right ventricle with extreme hypertrophy of the muscle bundles associated with the crista supraventricularis. The hypertrophic muscle mass divided the right ventricle into two parts, one of them corresponding to the outflow tract of the pulmonary artery. The other part received blood from the left ventricle through a septal defect and led the flow into the aorta. The two compartments were connected by a narrow canal at the apex of the right ventricle. Blood flow into the pulmonary artery was strictly dependent on the patency of the ductus arteriosus. Signs of closure could be found on the inner surface of the duct.

Abnormalities, Multiple↗
PubMed1975

Thickenings in the coronary arteries in infancy as an indication of genetic factors in coronary heart disease.

In Finland, mortality from coronary heart disease is high, and much higher in the eastern than in the western countries. Both left and right coronary arteries of 141 children who died under one year of age at the Children's Hospital, University of Helsinki, were investigated. Thirty-two of these children formed a western and 41 an eastern group according to the birthplaces of their grandparents in Finland. Correlations were tested between this geographical distribution and some dimensions of the coronary arteries, as well as other clinical variables. The inner vascular layers of the left coronary arteries were found to be thicker in the eastern group (P less than 0.05 in analysis of variance and P less than 0.01 in regression analysis). No other significant correlations were observed. This association of infants having thick inner vascular layers in the coronary artery with a population group where mortality from coronary heart disease (CHD) is very high supports the hypothesis that the thickenings are prearteriosclerotic. The difference found between the arteries of the western and eastern groups might be due to a difference in the vulnerability of the inner vascular wall to extrinsic deleterious factors. The association substantiates the existence of a genetic component in the etiology of CHD and supports the theory that two separate groups of settlers originally colonized Finland.

Age Factors↗
PubMedDate not supplied

Later potentials on signal-averaged electrocardiograms in children after right ventriculotomy.

After corrective surgery for congenital heart defects, scars may create fractionation and delay of the electrical signals in the heart muscle, providing a substrate for arrhythmias. Signal-averaged electrocardiograms (SAECGs) were obtained from 33 children after right ventriculotomy, on average 6 years after surgery, and from 38 healthy controls of the same age. The duration of the filtered QRS complex (fQRS), the duration of the low amplitude signal (< 40 microV) in the terminal QRS complex (LAS40), and the root mean square amplitude of the terminal 40 ms of the QRS complex (RMS40) were determined. The values of fQRS > or = 117 ms, RMS40 < or = 25 microV, and LAS40 > or = 35 ms, which were beyond the mean +/- 2 SD of the healthy controls, were considered abnormal. Most patients had right bundle branch block and therefore a prolonged fQRS. Late potentials were defined as present if both the RMS40 and LAS40 were abnormal. Altogether nine patients (27%) had late potentials. In the patients with late potentials the incidence of serious ventricular arrhythmias was 44% (4 of 9) and in the patients without late potentials 0% (0 of 24). In seven patients with enlargement of the right ventricle, the incidence of arrhythmias was 57% (4 of 7) when late potentials were present and 0% (0 of 7) when they were absent. In the present study late potentials were associated with a history of arrhythmias, especially when the right ventricle was enlarged. Therefore the SAECG may be useful for determining the risk of serious arrhythmia events in children operated for congenital heart defects.

Adolescent↗
PubMedDate not supplied

Ketone bodies maintain normal cardiac function and myocardial high energy phosphates during insulin-induced hypoglycemia in vivo.

It has been suggested that myocardial utilization of ketone bodies might cause deterioration of cardiac function. Therefore, the influence of ketonemia (mean: 1.3 and 3.3 mM) in the presence of hypoglycemia (mean: 33 mg/dl) on cardiac function, substrate utilization and myocardial high energy phosphate levels was studied in 10 mongrel dogs. Hypoglycemia alone led to a significant increase of mean aortic pressure, total peripheral resistance and myocardial oxygen consumption, but other hemodynamic parameters and regional myocardial function were not changed. Additional infusion of 3-hydroxybutyrate did not affect hemodynamic variables significantly. During both metabolic interventions in vivo phosphorus-31 nuclear magnetic resonance (NMR) spectroscopy showed stable levels of myocardial Pi, PCr, ATP, as well as PCr/Pi (3.2-3.4) and PCr/ATP (3.0-3.2) ratios. Biochemical measurements revealed that ketonemia led to significant alterations in arterial concentrations and arterio-coronary venous differences of selected citric acid cycle intermediates, thus confirming previous reports which suggested a blockade of the 2-oxoglutarate-dehydrogenase reaction induced by ketone body oxidation. However, despite this blockade, the energy supply to the heart was not impaired as shown by normal NMR spectroscopy and cardiac performance. It is speculated that the blockade might be due to an enhanced NADH/NAD ratio.

3-Hydroxybutyric Acid↗
PubMedDate not supplied

Prostacyclin treatment for persistent pulmonary hypertension of the newborn.

To study the effect of prostacyclin treatment on pulmonary arterial pressure (PAP), systolic pressure (BP), and systemic oxygenation, eight infants with persistent pulmonary hypertension of the newborn (PPHN) born between 34 and 42 weeks' gestation and having a birth weight of 2540-4130 g were studied using Doppler echocardiography. At a mean age of 19 hours (range 3-32 hours), despite maximal ventilator therapy and an FIO2 of 1.0, the mean PaO2/PAO2 was 0.07 (range 0.04-0.09) and the AaDO2 was 616 mmHg (range 521-654 mmHg). After volume correction and during inotropic medication with dopamine and dobutamine, the mean PAP by echocardiography was 68.6 +/- 6.5 mmHg and the mean BP 59.8 +/- 4.8 mmHg. Prostacyclin infusion was then started at a dose of 20 ng/kg/min and increased stepwise to a mean dose of 60 ng/kg/min (range 30-120 ng/kg/min) over 4-12 hours, at which time PAP decreased to 49.2 +/- 3.5 mmHg (p = 0.0005) and BP to 53.2 +/- 9.1 mmHg (p = 0.17); the PAP thereafter remained below the BP. After 72 hours of prostacyclin infusion, PAP was 49.6 +/- 18 mmHg, BP 66.1 +/- 5.4 mmHg, PaO2/PAO2 0.14 +/- 0.12, and AaDO2 428 +/- 189 mmHg at FIO2 0.65. The median duration of prostacyclin infusion was 3.6 days and of respirator treatment 7.0 days. All patients survived without extracorporeal membrane oxygenation. At 6-12 months, none of the patients had severe central nervous system complications, but two had bronchopulmonary dysplasia. These findings indicate that prostacyclin is able to reverse the right-to-left shunt in PPHN by decreasing PAP, and that systemic hypotension can be prevented with adequate volume correction and inotropic medication.

Apgar Score↗
PubMedDate not supplied

Endothelial cell damage in piglet coronary artery after intravenous administration of E. coli endotoxin. A scanning and transmission electron-microscopic study.

E. Coli endotoxin was administered to 6 piglets from a litter of 10. Three days after the endotoxin stimulus 3 piglets showed definitive morphological evidence of endothelial damage to their left coronary artery. The proximal parts of the coronary artery were severely damaged. In scanning electron microscopy, the changes varied from disappearance of the microvilli to complete exfoliation of the endothelial cells. In cases of severe endothelial cell damage transmission electron microscopy revealed severe changes or even signs of cell death in the inner medial smooth muscle cells. Only of the piglets died prematurely. We are sufficiently encouraged to continue testing the theory that repeated endothelial cell damage initiates stenosing lesions in the coronary arteries.

Animals↗
PubMedDate not supplied

Nutrient intake and blood lipids in children.

Nutrient intake and serum total cholesterol (C T), serum high density lipoprotein cholesterol (HLD), triglycerides (TG) and fatty acids were evaluated from 692 3-year, 8-year and 12-year-old children in different areas in Finland. Serum/plasma TC concentrations varied from 4.8 to 5.0 mmol/l, HDL from 1.3 to 1.5 mmol/l and TG from 0.70 to 0.87 mmol/l. 12-year-old boys consumed significantly more energy than girls at the same age. In the 8-year-old boys the quality of fat used on the bread and quality of milk drunk influenced on the serum fatty acid composition, the proportion of linoleic acid being greater in those children who used margarine and/or low fat milk. The 3-year-old children at the highest quartiles of TC concentration used less wheat products and their intake of riboflavin was less than children in the lowest quartile. HDL concentration was associated with the intake of thiamine. The 12-year-old children having their TC concentrations in the highest quartile used more saturated fats and got more saturated fatty acids than children in the lowest quartile. The higher the sugar consumption and sucrose intake were, the lower was the HDL concentration. The prevalence of obesity increased with the age, being 0.5%, 5.0% and 8.5% in the 3-year, 8-year and 12-year-old children respectively. Urban children were more commonly obese than rural children, the prevalence being 8.0% versus 2.2% (p less than 0.01).

Child↗
PubMedDate not supplied

Biochemical composition of coronary arteries in Finnish children.

To study the early features of atherosclerosis, we analyzed coronary artery intima medias from 63 boys and 30 girls who were newborn to 15 years old at the time of accidental death. Fatty streaks were found in five boys and one girl and, with one exception, were not present until the second decade of life. From birth there was a continuous increase in esterified cholesterol (EC) and a two- to threefold rise in free cholesterol and phospholipid. DNA, total protein, and collagen tended to rise after the first decade. The content of hyaluronic acid remained fairly constant, but sulphated glycosaminoglycans (GAGs) rose during the second decade; the highest increases were in dermatan and chondroitin sulphates. The content of arterial EC showed significant positive correlations with those of GAGs, but associations with the contents of DNA, total protein, and collagen were not significant. As judged by the observed gradual increase in arterial EC and a change in its fatty acid composition, there is a continuous increase with age in LDL-derived EC in the arterial wall. The mechanism of this accumulation is unknown, but the findings provide circumstantial evidence to support the concept that arterial GAGs may cause retention of plasma-derived lipids, which may subsequently be altered and internalized by the intimal cells.

Adolescent↗
PubMedDate not supplied

Glycosaminoglycans and apolipoproteins B and A-I in human aortas. Chemical and immunological analysis of lesion-free aortas from children and adults.

To study changes in the contents of plasma lipoproteins in human arteries with age and the relationship of lipoproteins with other arterial constituents, we analyzed the contents of apolipoproteins B (apo B) and A-I (apo A-I), free and esterified cholesterol, and glycosaminoglycans (GAG) in lesion-free aortic intimas of 30 children and adults. The content of apo B increased significantly with age, whereas that of apo A-I remained relatively constant. Apo B and apo A-I had significant positive correlations with the content of chondroitin sulphates A + C (CS A + C), which comprised 35% to 47% of the aortic GAG. The correlations remained significant after correction for the effect of age. Aortic apo B, but not apo A-I, also showed significant positive correlations with the contents of intimal free and esterified cholesterol. The results indicate that: considerable amounts of apo B and apo A-I can be found in lesion-free aortic intimas; there is an age-related rise in the content of apo B and a fall in the ratio of apo A-I to apo B, which are unfavorable developments in the light of current views on atherogenesis; the contents of the apolipoproteins are proportional to that of CS A + C, which might have a role in the retention of lipoproteins in the arteries.

Adolescent↗
PubMedDate not supplied

Prediction of survival in breast cancer: evaluation of different multivariate models.

BACKGROUND: We compared the performance of multivariate models based on mitotic activity index, lymph node status, and tumor size in the prognostication of breast cancer. MATERIAL AND METHODS: Cox and discriminant models for survival were created for two patient groups: a) 120 breast cancer patients, and b) 86 patients with ductal infiltrating carcinoma. The models were compared with the model of Baak et al (1985). RESULTS: The models distinguished between dying and surviving patients with an efficiency of 70.9-77.9% in mutual tests. With a single cutoff the model of Baak et al was less efficient (50.8-65.8%). If a region of uncertainty was allowed between two cutpoints, the efficiencies below and above the cutpoints increased. When the uncertain region included a third of the patients, the efficiency varied between 73.8 and 84.7%. CONCLUSION: Multivariate models seem to need a region of uncertainty between two discriminating cutpoints. These models resulted in the correct prediction of prognosis in about 75% and more of patients. With different materials the models differed in efficiency. With a region of uncertainty the model of Baak et al performed well with completely independent material.

Adult↗