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Biomedical subjects

J Rapola

Publications and source records attributed to J Rapola.

At least 109 records · Page 6Linked to original sources
PubMed1986

Presence of apocrine epithelial antigen (AEA) in type II pneumocytes and in hyaline membranes of neonatal RDS.

We have investigated the distribution of an apocrine membrane antigen (AEA) in pulmonary tissue using a rabbit antiserum raised against fat globule glycoproteins isolated from human milk. In indirect immunostaining (PAP, IF) of sections from normal lung tissue, the membranes facing the alveolar lumen of cells corresponding to the type II pneumocytes in the alveolar walls were decorated. The selective distribution of AEA to the membranes of type II pneumocytes was confirmed in double immunostaining by identification of these cells with rat antibodies against surfactant apoprotein. In fetal lung tissue, the AEA antigen was detected by the 9th week of gestation. In lung samples from newborns which had died of respiratory distress syndrome (RDS) the intra-alveolar hyaline membranes stained for the AEA antigen. SDS-PAGE of the immunoprecipitate obtained with anti-AEA serum from radiolabelled glycoprotein fraction of normal lung tissue revealed a single band of 79,000 dalton apparent molecular weight. These findings indicate that the AEA constitutes a membrane marker of the type II pneumocytes and might be involved in the secretory process of surfactant. Immunohistological evidence for the presence of AEA in the hyaline membranes of neonatal RDS is also presented.

Antigens↗
PubMed1986

Production of basement membrane laminin and type IV collagen by tumors of striated muscle: an immunohistochemical study of rhabdomyosarcomas of different histologic types and a benign vaginal rhabdomyoma.

Immunohistochemical methods were used to demonstrate the distribution of basement membrane laminin and type IV collagen in eight tumors derived from striated muscle (three botryoid, two alveolar, and two adult-type rhabdomyosarcomas; one benign vaginal rhabdomyoma). All of the tumors produced significant amounts of both basement membrane components. Stainings clearly revealed the alveolar nature of the rhabdomyosarcomas, with the alveolar spaces surrounded by distinct basement membranes. Different stages of cellular development were identified in the botryoid sarcomas, with the most immature cells of the cambium layer devoid of external basement membrane around the tumor cells, although the stroma contained finely dispersed basement membrane material and some cells contained intracytoplasmic laminin or type IV collagen, indicative of the synthesis of these proteins. The more mature cells, which had abundant granular cytoplasm, were enveloped by distinct basement membranes and seemed to have coalesced, forming structures resembling myotubes. The adult-type rhabdomyosarcomas were composed of large pleomorphic cells that were surrounded by basement membranes, either individually or in small groups. Some giant cells contained intracytoplasmic laminin. The vaginal rhabdomyoma was composed of round rhabdoblastic cells or elongated strap cells with cross-striations. Cells of both of these types were surrounded by thin but distinct basement membranes. The results suggest that demonstration of basement membranes would be helpful in the diagnosis of tumors derived from striated muscle. The findings concerning different stages of maturation of tumor cells are in accordance with previous in vitro observations of myoblastic cells.

Adult↗
PubMed1986

Salla disease variants. Sialoylaciduric encephalopathy with increased sialidase activity in two non-Finnish children.

The case reports of two Swedish girls with initially pseudostationary clinical pictures, one simulating ataxic and the other dyskinetic cerebral palsy, are presented. It was eventually revealed that they had a slowly progressive encephalopathy with pronounced gross motor disability and signs of severe dyskinesia, but only mild intellectual delay. Electron microscopy of skin biopsies showed a picture identical to that in Salla disease. They had a moderately increased 5-10 fold urinary free sialic acid excretion, increased sialidase activity in lymphocytes but normal activity in cultured fibroblasts. These two Swedish cases represent variants of Salla disease, a group of conditions with probable genetic heterogeneity.

Carbohydrate Metabolism, Inborn Errors↗
PubMed1986

Inevitable and avoidable deaths in childhood ALL.

The causes of 37 deaths among 100 Finnish children with ALL were analyzed after a median follow-up of 5 years. Five children died during primary induction, 9 in complete remission, and 23 in hematological relapse. Infections were responsible for 17 deaths, and four deaths were due to toxicity of chemotherapy. In 16 cases ALL relapse was the major cause of death. Ten of the deaths were defined as "avoidable" because they occurred in potentially curable children, i.e., during induction or primary remission. Critical analysis revealed that 5 out of the 10 "avoidable" deaths might indeed have been prevented by appropriate diagnosis and therapy. We want to emphasize the need for continuous education of all pediatricians involved in the care of ALL patients, as well as the importance of best available clinical expertise and centralization of medical therapy in the efforts to diminish the mortality in childhood ALL.

Adolescent↗
PubMed1986

Disturbed calcium and phosphate homeostasis during treatment with ACTH of infantile spasms.

Kidney histology of five infants who died during or immediately after treatment with adrenocorticotrophic hormone (ACTH) showed severe tubular and interstitial calcinosis. We therefore studied serum concentrations of calcium, inorganic phosphate, and parathormone, serum activities of alkaline phosphatase, and urinary excretion of calcium, inorganic phosphate, and cyclic adenosine monophosphate (cAMP) in 16 other children with infantile spasms before, during, and after 6 weeks of treatment with ACTH. During the treatment the following observations were made: hypocalcaemia developed in three infants; the mean daily urinary excretion of calcium in the group increased threefold and seven infants had hypercalciuria; the excretion of phosphate increased but its tubular reabsorption remained stable; and in most infants serum parathormone and urinary cAMP excretion increased, and in four infants they increased to supranormal concentrations. These biochemical changes were reversible in most infants. Radiographs suggested loss of bone mass by 3-4 weeks of treatment, with rapid recovery after treatment. We conclude that infants treated with ACTH for infantile spasms are at risk of suffering disturbance in calcium and phosphate homeostasis, which leads to nephrocalcinosis.

Adrenocorticotropic Hormone↗
PubMed1986

C-reactive protein compared with white blood cell count and erythrocyte sedimentation rate in the diagnosis of acute appendicitis in children.

Acute abdominal symptoms in 162 children were investigated with rapidly quantified C-reactive protein (CRP), white blood cell (WBC) count and erythrocyte sedimentation rate (ESR) as laboratory parameters. When the symptoms had been present for at least 12 hours, the CRP level was greater than 10 mg/l in 72% of cases with histologic evidence of appendicitis, while leukocytosis (WBC greater than 15 000/mm3) and raised ESR (greater than 20 mm/l h) were found in 58% and 51%, respectively. If appendicitis had progressed to gangrenous stage, however, CRP alone was capable of identifying 83% of cases, while 76% had leukocytosis and 60% elevated ESR. When perforation had occurred there was greatly increased CRP and invariably leukocytosis, but elevated ESR in only 60%. With the combination CRP and WBC count (using rise in one or both), 88% of all appendicitis cases could be identified, and at least 96% of those with gangrene or perforation. The predictive value of combined positive CRP and WBC tests was not less than 93%.

Acute Disease↗
PubMed1985

t(11;19)(q23;p11) in a child with acute T-cell leukemia.

A translocation, t(11;19)(q23;p11), is reported in a child with T-cell leukemia. Our case indicates that the t(11;19) may not be restricted to the monocytic leukemias, as earlier reported, but may occur in other malignancies.

Bone Marrow↗
PubMed1985

Visceral anomalies in the Meckel syndrome.

The visceral abnormalities of 32 autopsied Meckel's syndrome cases were analysed macroscopically and histologically in order to observe the distribution and spectrum of internal abnormalities in this hereditary malformation syndrome. All cases showed the classical triad of central nervous system anomaly, postaxial polydactyly, and cystic kidneys. Five cases were midterm fetuses and 27 cases were perinatal deaths. The kidneys were grossly enlarged in almost all of the cases (29) and showed a uniform histological pattern of fibrocystic proliferation, which is considered characteristic of MS. Fibrosis and proliferation of the bile ducts in the hepatic portal tracts were found in each case. Severe hypoplasia of the male genitalia associated with cryptorchidism was the third consistent anomaly. Derivatives of the müllerian ducts were present in four males, and the initial sex determination of the male infants was sometimes difficult. Epididymal cysts (39%) and ductal dilatation as well as fibrosis of the pancreas (31%) were further common anomalies. This series showed that a number of gross and microscopic abnormalities are consistently present in MS and that histological investigation is invaluable in defining the syndrome in doubtful cases.

Abnormalities, Multiple↗
PubMed1985

Improved technique for the expression of fragile-X in cultured amniotic fluid cells.

An improved technique for inducing fra(X) expression in cultured cells was obtained by using diazepam for mitotic arrest and 5-fluorodeoxyuridine (FUdR) for the induction of fra(X) expression. The method was developed using cultured fibroblast and urinary cells from fra(X) patients. Prenatal studies were performed on cultured amniotic fluid cells in five pregnancies at risk for fra(X). In two cases the cultured cells showed a 46,XY, fra(X) karyotype. One of the pregnancies was terminated and the diagnosis was confirmed by chromosome studies on several fetal tissues including chorionic villi and by histopathologic changes in the lymphatic vessels of the fetal testes. The fra(X) was also demonstrated in chorionic villi in a case in which amniotic fluid cells were not studied. Chorionic villi were isolated after a spontaneous abortion, the cultured cells had a 45,X karyotype and in addition 5% of the cells were fra(X) positive.

Adult↗
PubMed1985

Gyrate atrophy of the choroid and retina. A five-year follow-up of creatine supplementation.

Gyrate atrophy of the choroid and retina (GA) is an autosomal recessive chorioretinal degeneration with a 10-20-fold elevation of plasma ornithine due to deficient activity of ornithine aminotransferase. Type II fibres of the skeletal muscle are atrophic and contain tubular aggregates in electron microscopy. Deficient creatine and creatine phosphate formation have been postulated to be involved in the pathogenesis of GA. The five-year follow-up results of oral creatine supplementation in 13 patients are presented. Visual function tests and fundus photographs showed progression of GA during the treatment. The velocity of the progression varied considerably between individuals. Generally, the progression was rapid in the young patients and slow in the more advanced stages. Abnormalities in the skeletal muscle decreased or disappeared rapidly. They reappeared in the few patients who discontinued the medication. The difference in the therapeutic effect on the skeletal muscle and eye is discussed.

Adolescent↗
PubMed1985

Accumulation of laminin and type IV collagen in the kidney in congenital nephrosis.

The aim of this study was to evaluate qualitatively the occurrence of the basement membrane proteins laminin and type IV collagen in the kidneys of ten infants with congenital nephrotic syndrome of the Finnish type (CNF) aged from 3 to 23 months and to compare the results with those for age-matched controls. A slow accumulation of basement membrane (BM) material occurred in the glomerular mesangium, the peripheral capillaries, around atrophied tubules, and the renal vessels in the course of the disease. The staining pattern of accumulated material depended on the duration of the disease and subsequent renal parenchymal damage. Young CNF patients with slight morphological changes in the kidney had only focal and minimal increases in the amounts of mesangial matrix, but as the disease advanced, so the BMs of the glomerular capillaries, renal arteries, and atrophied tubules also became involved and were thicker than normal. The staining reaction was in all patients similar with antibodies against the fragment P1 of laminin and the 7-S domain of type IV collagen. The accumulation of BM material in CNF kidneys is regarded as a secondary phenomenon induced by an unknown pathogenetic defect in the metabolism of some BM component.

Basement Membrane↗
PubMed1985

Fibrosarcoma in a girl with celiac disease and IgA deficiency.

A case of abdominal wall fibrosarcoma in a 17-year-old girl with celiac disease and IgA deficiency is described. Celiac disease was putatively diagnosed with intestinal biopsy at the age of 15 years when she came for hospital investigations because of IgA deficiency and recurrent respiratory infections. The tumor occurred at the age of 17 years during the gluten challenge performed for final diagnosis of celiac disease. Surgical excision, irradiation, and chemotherapy were initially successful. After 7 months, however, the tumor recurred. Reoperation and a new course of irradiation therapy coinciding with the reinstitution of a gluten-free diet proved to be effective in tumor eradication. Nine years after the cessation of cancer treatment she is well and has two healthy children.

Abdominal Muscles↗
PubMed1985

Duchenne-like muscular dystrophy in two sisters with normal karyotypes: evidence for autosomal recessive inheritance.

Two sisters, products of a consanguineous marriage (with a total of 12 children) showed muscle weakness at ages 7 and 6 yrs, respectively. The symptoms progressed rapidly and the patients were confined to wheelchairs at ages of 12 and 11 yrs, respectively. They had mild facial weakness and pseudohypertrophy of the calves, but neither cardiomyopathy nor mental retardation. Serum CK activities exceeded upper normal limit by 70 to 85-fold. Muscle biopsies were compatible with muscular dystrophy. Both girls had a normal karyotype. The healthy mother had mild CK elevations in two out of three occasions, but the muscle biopsy was normal. Three out of the six unaffected sibs had mild CK elevations. The findings support the concept of severe progressive muscular dystrophy with autosomal recessive inheritance. The condition is clinically indistinguishable from Duchenne muscular dystrophy.

Creatine Kinase↗
PubMed1985

Antioxidant treatment in Spielmeyer-Sjögren's disease.

The data for 125 patients with Spielmeyer-Sjögren's disease is presented. Antioxidant therapy was given to 49. 27 received a combination of vitamin E, vitamin C, methionine and BHT. As the disease began to progress, the treatment was changed to a combination of sodium selenite and vitamin E in 14 of the 27 patients. The same therapy was also given to 22 children who had not received previous antioxidant supplementation. The number of positive and negative responses was nearly equal in the 2 treatment groups. However, the quality of the response was better in the selenite group and it has been possible in some cases to stop for several years, at least, the deterioration which began during the original therapy.

Adolescent↗
PubMed1985

Particulate fraction in amniotic fluid at second trimester.

Amniotic fluid at 15-20 weeks contains high concentrations of microvillar enzymes which serve as markers for the prenatal diagnosis of cystic fibrosis. We found that these enzymes were mostly bound to amniotic fluid particulate fraction which eluted in the void volume on Sepharose 6B chromatography and precipitated in ultracentrifugation at 100,000g. Electron microscopy showed that the particulate fraction comprised membrane fragments and small vesicles. It represented less than 1% of the total protein in cell free amniotic fluid. Sorbitol gradient centrifugation showed heterogeneity in the particulate fraction. The enzyme patterns of amniotic fluid and meconium particulate fractions resembled each other. Antiserum against particulate fraction in amniotic fluid strongly reacted with early meconium and fetal small intestine in immunodiffusion, enzyme immunoassay, and staining with immunoperoxidase. The results suggest that most of the enzyme rich particulate fraction in early amniotic fluid originates in the fetal intestine.

Alkaline Phosphatase↗
PubMed1985

Extracellular matrix and epithelial differentiation of Wilms' tumor.

Different histologic types of 82 Wilms' tumors were graded on the basis of the histologic pattern. Representative tumors of each group were analyzed by the immunoperoxidase method for evaluation of the histogenesis of Wilms' tumor and the value of antibodies against extracellular matrix (ECM) components (collagens I and III, laminin, fibronectin) in differential diagnosis of different types of Wilms' tumors. The tubules of classic Wilms' tumor expressed laminin, which could be seen also in and around some blastemal cells. Blastema and tubules were negative for interstitial collagens, but Type I and III collagen were prominent in the fibrovascular stroma. The monomorphous tubular, psammomatous and rosetting tumors expressed laminin, but no interstitial collagens. In sarcomas, only the blastemal variant of spindle-cell sarcomas was negative for interstitial collagens, which were abundantly seen in all other sarcomas. While spindle-cell sarcomas were devoid of laminin, the highly malignant rhabdoid and clear-cell sarcomas expressed laminin in a characteristic dotted fashion. Staining for fibronectin gave varying results and had therefore only a limited value in distinguishing different types of Wilms' tumors. However, the antibodies against interstitial collagens and against the basement membrane glycoprotein laminin turned out to be a useful adjunct in differential diagnosis and classification, especially of sarcomatoid Wilms' tumors. The basement membrane of normal nephrons is similar to that in tubules of triphasic Wilms' tumor, but the ECM of blastemas is different. This transformed phenotype might represent a maturation arrest of the blastemal cell when compared with the expression of proteins during normal nephrogenesis.

Adenocarcinoma↗