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Biomedical subjects

J Salo

Publications and source records attributed to J Salo.

At least 55 records · Page 3Linked to original sources
PubMed1997

Testosterone regulates apoptosis in adult human seminiferous tubules in vitro.

In the present study an in vitro model was developed and characterized for evaluation of the role of apoptosis in adult human testes. The samples came from adult men undergoing orchidectomy for prostate or testicular cancer. Segments of seminiferous tubules were isolated and incubated under serum-free conditions in the absence or presence of testosterone. Apoptosis was assessed by low mol wt DNA fragmentation (185-bp multiples) by use of 3'-end-labeled DNA, in situ end labeling, and morphological detection under light and electron microscopy. During the 4-h incubation, a 15-fold increase was seen in apoptotic DNA fragmentation. The extent of low mol wt DNA showed a time-dependent increase and reached a 20-fold intensity in 24 h of incubation compared to the level at 0 h. Apoptosis was significantly suppressed by testosterone concentrations of 10(-7) and 10(-6) mol/L during the first 4 h of incubation. Apoptotic cells were identified mainly as spermatocytes and occasionally as spermatids. We conclude that apoptosis is induced in human seminiferous tubules under serum-free conditions in vitro. That this apoptosis is suppressed by testosterone indicates that testosterone in the human male is a critical germ cell survival factor. The model created in the present study provides a valuable tool for further investigation of hormonal and gene regulation of human germ cell death and survival.

Adult↗
PubMed1997

Multiple forms of messenger ribonucleic acid encoding glycodelin in male genital tract.

Glycodelin-A is a human endometrium-derived glycoprotein with contraceptive and immunosuppressive activities. Recently, we found that seminal plasma contains immunoreactive glycodelin (GdS) that is differentially glycosylated and has no contraceptive activity. We now report localization and variant forms of GdS in the male genital tract. Northern blot and reverse transcription-PCR analyses showed that GdS mRNA is expressed in the seminal vesicles and ampulla of the vas deferens. Immunohistochemical staining localized GdS to the epithelial cells and lumen of glands in the seminal vesicles and ampullary part of the vas deferens. The same tissues and cells contained glycodelin mRNA as localized by in situ hybridization. Whereas the major reverse transcription-PCR products were identical to the glycodelin-A cDNA from decidual expression library, there were also several splicing variants of GdS mRNA. Seminal plasma also contained smaller immunoreactive forms of the GdS protein. Some of them were posttranslational cleavage products of GdS, because incubation of 125I-labeled GdS in seminal plasma resulted in smaller molecular weight cleavage products. Based on these results, we concluded that multiple forms of glycodelin mRNA are expressed in the male genital tract, including those lacking the coding sequences for the glycosylation sites, and that seminal plasma has proteolytic activity that cleaves GdS.

Aged↗
PubMed1997

The role of bronchoplasty in the treatment of lung cancer.

Over a half of the patients with lung cancer have inoperable disease on diagnosis. Limited respiratory reserve due to chronic pulmonary disease can preclude patients from pneumonectomy. A bronchoplastic resection can be used to circumvent pneumonectomy in selected cases. Its applicability in lung cancer was investigated by following up a total of 28 patients who underwent this procedure for lung cancer between 1973 and 1993 in our institution. This was only approximately 1.4% of all our lung cancer operations. The actuarial five-year survival probability was 40%, and the complication rate was 16%. These values are comparable to those reported in the literature and to those of pneumonectomy. It appears that the ideal cases with a proximal tumour but limited disease are rare.

Actuarial Analysis↗
PubMed1997

Surgical treatment of acute myocardial ischaemia related to coronary angioplasty with special reference to use of perfusion balloon catheter and long-term outcome.

Twenty of 569 consecutive patients (3.5%) undergoing percutaneous transluminal coronary angioplasty required emergency coronary artery bypass grafting for acute closure of the dilated vessel. In seven patients an intracoronary autoperfusion balloon catheter was inserted to ensure antegrade blood flow across the injured zone of the coronary artery. The time needed for completion of the bypass grafts ranged from 100 to 399 minutes (mean 180 minutes). An average of 1.9 coronary artery bypasses was inserted. In total, 11 of the 20 patients (55%) developed new Q waves and had elevated CK-MB levels. However, the myocardial infarction rate was only 14% in those with a perfusion balloon catheter as against 77% in those without one. The insertion of a ball-out catheter permitted greater utilization of the internal mammary artery as a bypass graft. Angiographic follow-up was conducted after a mean of 28 months (19 patients). The patency rate of the bypass grafts placed in the emergency setting was relatively good (91%). Thallium tomography revealed a scar of variable size in all 17 patients studied and a reversible exercise perfusion defect requiring coronary reangioplasty in three patients. In conclusion, the insertion of a perfusion balloon catheter after abrupt coronary occlusion during coronary angioplasty solved the problems of acute myocardial ischemia and markedly lowered the definite myocardial infarction rate. This technique ensures favourable haemodynamic conditions for emergency myocardial revascularization.

Angioplasty, Balloon, Coronary↗
PubMed1997

Heart transplantation in Finland 1985-1995.

BACKGROUND AND AIMS: Since improved immunosuppression in the 1980's, heart transplantation is a well established procedure to treat patients with end-stage heart failure. The first heart transplantation in Finland was performed in 1985. Since then the activity has gradually increased to a level of about 25 annual transplants. The aim of this report is to sum up the clinical experience during the first 11 years. MATERIALS AND METHODS: From February 1985 till the end of 1995, 190 heart transplantations were performed in our institution. There were 176 males and 14 females ranging from 15 to 62 (mean 42.2) years of age. End-stage preoperative cardiac disease was dilating cardiomyopathy in 108 cases, coronary artery disease in 65 cases, valvular disease in 12 cases and congenital heart disease in five cases. RESULTS: The 30-day hospital mortality was 29 out of 190 (15.2%). The actuarial survival was 77% at one year, 75% at two years and 73% at 10 years. The most common causes of death were rejection (11 cases), graft failure (11 cases), abdominal complications (six cases) and cytomegalovirus (CMV) infection (four cases). A total of 87 rejection episodes occurred in 53 patients consisting 28 per cent of patients. 44 rejections occurred within three months post transplantation. Significant infections were noted in 198 instances in 97 patients. These were of bacterial origin in 92, viral in 48, fungal in 12 and protozoal in 10 cases, and 36 such infections which responded to antibiotics favourably but in which the microbe remained unidentified. 138 infections (i.e. 80%) occurred within 6 months post transplantation. In viral infections cytomegalovirus (CMV) predominated (29 out of 48). The CMV infection was significantly milder in patients who were seropositive preoperatively than in preoperatively seronegative patients with seropositive donors. CMV infection was associated with increased risk of post-transplant coronary artery disease. Three years after transplantation some restoration of sympathetic nervous response was observed at orthostatic test in heart rate and blood pressure. CONCLUSIONS: It can be concluded that 1) if a patient survives the three immediate postoperative months, his prognosis is good for the forthcoming years, 2) clinically significant rejections occur in less than one third of the patients, 3) cytomegalovirus is the most harmful agent post transplantation and a risk factor for post-transplant coronary artery disease and that 4) some restoration of sympathetic nervous control of the heart occurs within three years after transplantation.

Adult↗
PubMed1996

Bone-resorbing osteoclasts reveal a dynamic division of basal plasma membrane into two different domains.

Bone-resorbing multinucleate osteoclasts exhibit a ruffled border membrane apposing the bone and a basal membrane contacting the circulation. A junctional complex called the sealing zone separates these two membrane domains, but the defined nature of these membrane domains has remained obscure. We now show, using enveloped viral glycoproteins and lectins as tools, that osteoclasts exhibit a novel membrane domain in the basal surface when they are polarized for resorption. Influenza haemagglutinin, which is apically targeted in epithelial cells, is targeted to a restricted area at the top of the basal surface, while vesicular stomatitis virus G-protein which is basolaterally targeted in epithelia, occupies the rest of the basal surface. Neither of these viral glycoproteins is gathered to the ruffled border nor sealing zone area, but they share in a specific way the basal surface. To show that the division of basal membrane into two different domains also occurs in non-infected cells, we have analyzed the distribution of receptors for these viruses and binding sites of some lectins. Both of these methods show that also some endogenous proteins are located in different domains in the basal surface in active osteoclasts. We also show that these two different membrane domains can be distinguished in scanning electron microscopy level due to the villus appearance of the central basal domain.

Animals↗
PubMed1995

Regulation of intracellular pH in isolated Necturus gastric mucosa during short-term exposure to luminal acid.

BACKGROUND/AIMS: Continuous exposure to gastric acid implies efficient control mechanisms of intracellular pH (pHi) in the gastric epithelium. This study assessed the roles of Na+, H+, and HCO3- transport mechanisms in controlling pHi during short-term exposure of the gastric epithelium to luminal acid. METHODS: pHi and Na+ activity (aiNa) were measured with liquid sensor microelectrodes in isolated Necturus antral mucosa, modulating ion transport mechanisms by ion removal and pharmacological inhibition. RESULTS: Short-term exposure to luminal acid (pH 2.3) acidified pHi by 0.3 pH units, whereafter pHi stabilized. This was associated with transient increase in aiNa. Blocking of Na+/H+ exchange (in the presence of HCO3-/CO2) by removal of Na+ or addition of amiloride eliminated the increase in aiNa and resulted in uncontrolled acidification of pHi. Similarly, blocking of HCO3- transport (in the presence of Na+) by removal of HCO3-/CO2 or addition of 4-acetamido-4-isothiocyanatostilbene-2,2-disulfonic acid resulted in uncontrolled acidification of pHi despite increase in aiNa. Blocking of Na+/K+ exchange with ouabain eliminated the recovery of aiNa and also resulted in uncontrolled acidification of pHi. CONCLUSIONS: The data indicate that during short-term exposure of the gastric mucosa to luminal acid, both Na+/H+ antiport and HCO3- transport are needed to control pHi and maintain it within physiological ranges.

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗
PubMed1995

Complications of negative laparotomy for truncal stab wounds.

In a retrospective study of 459 patients undergoing mandatory explorative laparotomy for truncal stab wounds, 172 (37%) negative laparotomies were identified, divided in two groups: group I (n = 147) without, and group II (n = 25) with associated extra-abdominal injuries or surgical procedures other than laparotomy. One patient (0.6%) died of associated mediastinal vascular injuries. The overall postoperative morbidity rate was 21%, 17% in group I, and 44% in group II (p < 0.001). The excess morbidity in group II was caused by pulmonary complications associated with a thoracic injury or procedure. In group I, the complications were not severe, prolonging the mean hospital stay by 4.6 days. It is concluded that mandatory laparotomy for truncal stab wounds leads to an unnecessary operation in about 40% of cases, with a 20% morbidity rate associated with the laparotomy itself. Although the complications are not severe, the results should be assessed against the safety and accuracy of the selective management of abdominal stab wounds.

Abdominal Injuries↗
PubMed1995

Differential expression of laminin chains and their integrin receptors in human gastric mucosa.

The proliferating cells of the gastric mucosa are found among the pit and mucous neck cells. These cells migrate upward to renew the surface epithelium and downward to restitute the glandular cells. As the epithelial basement membranes (BMs) function as substrate for cell adhesion and migration as well as signals for their differentiation, we studied, by indirect immunofluorescence microscopy, the distribution of different laminin chains and their integrin receptors in adult human stomach. The immunoreactivity for laminin alpha 2 chain localized to the BMs of glands and the lower parts of the gastric pits whereas the laminin alpha 3 chain (laminin-5/kalinin) immunoreactivity was strictly confined to BMs underneath the surface epithelium and the upper parts of the pits. Proliferating mucosal epithelial cells, identified by Ki-67 antibodies, were confined to the areas containing both alpha 2 and alpha 3 laminin chains. The alpha 1, beta 1, and gamma 1 laminin chains were found in all BMs of the mucosa whereas the beta 2 chain was prominent in mucosal blood vessels and also detectable in some glands. Among the laminin integrin receptors, the alpha 3 and beta 4 subunits were seen to be expressed in cells along the BMs with the alpha 3 laminin chain. The alpha 6 integrin, on the other hand, was seen in all gastric epithelia. The present results demonstrate that in the adult human stomach laminin alpha 2 and alpha 3 chains show zonal distribution in BM underlying gastric mucosal epithelium whereas other laminin chains show a more general distribution.

Adult↗
PubMed1995

Residual stones after percutaneous nephrolithotomy; sensitivities of different imaging methods in renal stone detection.

Kidneys of 35 renal stone patients treated with percutaneous nephrolithotomy (PNL) were examined at 12-36 months (mean 23 months) after the procedure by plain radiography (PR), conventional linear tomography (LT), computed tomography (CT), and ultrasonography (US) to find out the long-term stone-free rate as well as the accuracy of these imaging methods to detect residual or recurrent renal stones. The present series included 36 kidneys with a 56% postoperative stone-free status examined by plain radiography and a 58% one examined by linear tomography at 12-36 months. CT showed 47% and US 72% of the kidneys to be stone-free, respectively. The sensitivity of CT was superior to plain radiography (P < 0.05), linear tomography (P < 0.05) or US (P < 0.001) in the detection of residual or recurrent stones after percutaneous nephrolithotomy analyzed statistically by McNemar's test. In the same group of 35 patients, which consisted of the above 36 postoperative kidneys together with 19 contralateral kidneys, a total of 55 kidneys were evaluated by the above methods, revealing 56 stones in 31 kidneys. Of these stones 95% were detected by CT, 70% by plain radiography, 68% by linear tomography, and 32% by renal US. Of the 55 kidneys, 14 contained 20 stone fragments smaller than 3 mm, and 26 kidneys carried 43 concrements smaller than 6 mm. The sensitivities of the four imaging methods in the detection of these small fragments were as follows: plain radiography 60% and 60%, linear tomography 55% and 58%, CT 95% and 93%, and US 15% and 26%.(ABSTRACT TRUNCATED AT 250 WORDS)

Follow-Up Studies↗
PubMed1994

Imaging in the diagnosis and assessment of prognosis in localized prostate cancer. Consensus Conference on Diagnosis and Prognostic Parameters in Localized Prostate Cancer. Stockholm, Sweden, May 12-13, 1993.

As part of a WHO consensus conference on diagnosis and prognostic parameters in localized prostate cancer, a working group of experts discussed the role of various modern imaging techniques. Special attention was focused on transrectal ultrasound (TRUS) in combination with biopsies, magnetic resonance imaging (MRI) using endorectal coil and recent advances in these techniques. Some experimental techniques, especially hormone receptor scintigraphy and positron emission tomography were also discussed and new results were presented. We concluded that MRI seems to be superior to other imaging techniques in the preoperative assessment of local tumor stage. TRUS defends its place in the diagnostic armament; it is easily combined with multiple biopsies, the results of which are important in the assessment of the biological aggressiveness of prostate cancer. The present development in the field of nuclear medicine may result in techniques for in vivo characterization of tumors and will most certainly have important implications for diagnosis of prostate cancer in the future.

Animals↗
PubMed1994

Laparoscopic gastro-oesophageal antireflux surgery.

Recent improvement in the understanding of gastro-oesophageal antireflux mechanisms and the pathophysiology of the gastro-oesophageal reflux disease (GERD) has warranted the concept that antireflux surgery provides a valid, and sometimes superior, alternative to medical therapy in selected patients. The main indications for surgical treatment of symptomatic GERD are: failure of medical therapy to heal ulcerative oesophagitis or to prevent recurrence of stricture or other complications, and the development of aspiration pneumonia or other airway complications. The Belsey and Nissen fundoplication and the Hill posterior gastropexy are the three most widely used surgical procedures to control reflux. The success rate of these operations, performed openly, in relieving symptoms and healing the lesions is 80-90%. The laparoscopic approach provides an interesting alternative in antireflux surgery. It affords a potential to reduce some inherent complications of conventional surgery, provided the operator is technically experienced and well aware of the pathophysiological principles of this disease. It is also superbly convenient to the patient. The currently published short-term results of laparoscopic antireflux surgery are comparable to those of open surgery, but the technique is still young, and its final evaluation is not possible until long-term results are available.

Female↗
PubMed1993

Effect of advanced brain atrophy and vitamin deficiency on cognitive functions in non-demented subjects.

The relationship between the cognitive functions, structural changes of the brain and vitamin levels was evaluated in 36 non-demented subjects with advanced brain atrophy, and 57 age- and sex-matched healthy controls. In the control subjects ageing was associated with mild decline of cognitive skills, but the cognitive changes were not linked to the structural changes of the brain. In contrast, advanced brain atrophy and vitamin deficiency was related to the decline of complex cognitive functions in the atrophy group. Our results indicate that there are limits of normal age-related changes of the brain structure, and advanced brain atrophy on CT scans increase the probability of mild deficits of the cognitive skills.

Aged↗
PubMed1993

Treatment of urinary stones by extracorporeal shock wave lithotripsy.

A total of 1641 ESWL-treatments were performed in 948 patients at Helsinki University Central Hospital between June 1989 and December 1991. In a series of 816 patients and 1287 treatments with data available 681 (76.4%) stones were located in the kidney, 208 (23.3%) in the ureter, and three (0.3%) in the urinary bladder. Auxiliary procedures were performed in 156 (19.1%) and repeated treatments in 300 (36.8%) patients. The most common complication was intensive pain during the procedure in 138 (16.9%) patients. The first 139 patients were followed until six months after their last ESWL-procedure. The six-month stone-free rates of renal and ureteric stones of these patients were 67.4% and 86.7%, respectively. The overall six-month clearance rate was 72.4%.

Age Distribution↗
PubMed1992

Time-resolved fluorescence imaging of europium chelate label in immunohistochemistry and in situ hybridization.

Fluorescent lanthanide chelates with long decay times allow the suppression of the fast decaying autofluorescence in biological specimens. This property makes lanthanide chelates attractive as labels for fluorescence microscopy. As a consequence of the suppression of the background fluorescence the sensitivity can be increased. We modified a standard epifluorescence microscope for time-resolved fluorescence imaging by adding a pulsed light source and a chopper in the narrow aperture plane. A cooled CCD-camera was used for detection and the images were digitally processed. A fluorescent europium chelate was conjugated to antisera and to streptavidin. These conjugates were used for the localization of tumor associated antigen C242 in the malignant mucosa of human colon, for the localization of type II collagen mRNA in developing human cartilaginary growth plates, and for the detection of HPV type specific gene sequences in the squamous epithelium of human cervix. The specific slowly decaying fluorescence of the europium label could be effectively separated from the fast decaying background fluorescence. It was possible to use the europium label at the cell and tissue level and the autofluorescence was effectively suppressed in in situ hybridization and immunohistochemical reactions in both frozen and formaldehyde-fixed, wax-embedded specimens.

Alkaline Phosphatase↗
PubMed1992

IV diclofenac in post-thoracotomy pain.

We have studied the efficacy of a continuous i.v. infusion of diclofenac 2 mg kg-1/24 h given for 2 days after major thoracic surgery in 30 patients in a double-blind, placebo-controlled, parallel-group design. The patients were able to obtain additional pain relief as on demand morphine boluses. In the diclofenac group, the consumption of morphine was reduced by 60% during the first and by 76% during the second day after operation compared with the control group. Overall, analgesia was also superior in the diclofenac group. Arterial oxygenation was significantly greater and the arterial PCO2 increased less during the first day after operation in the diclofenac group compared with the control group. Diclofenac had no significant effect compared with placebo on blood loss or on any bleeding or platelet test. Urine output was significantly less during the first day after operation in the diclofenac group compared with the control group, but was normal on the second day after operation; plasma creatinine concentrations were unchanged. I.v. diclofenac infusion combined with opioids delivered via a patient-controlled analgesia device seems a valuable method of pain relief after thoracic surgery in patients in whom more invasive techniques, such as extradural local anaesthetics and opioids, cannot be used. However, non-steroidal anti-inflammatory drugs should be used cautiously, if at all, in patients who are at risk of acute renal failure.

Adult↗
PubMed1992

Influence of topical steroid treatment on maxillary sinusitis.

The clinical efficacy and adverse effects of budesonide administered as a nasal aerosol in addition to sinus washings and erythromycin therapy was assessed by comparison with placebo in a randomized, double-blind study of 40 patients with chronic or recurrent maxillary sinusitis. Most of the patients had been referred for operative treatment. Corticosteroid therapy, 400 micrograms daily, or placebo was continued for 3 months. Budesonide and antral irrigations reduced nasal symptoms more effectively than placebo, and there was a significantly greater reduction in facial pain and sensitivity in the budesonide group than in the placebo group. During the treatment period, mucosal thickening as evaluated by radiology decreased more clearly in the budesonide group than in the placebo group, but the difference did not reach statistical significance. The most frequently isolated bacteria were Staphylococcus aureus, Staphylococcus epidermidis and Haemophilus influenzae. Only 2 of 20 Haemophilus strains were beta-lactamase producers. The cellular picture was dominated by neutrophils in all secretions. There was no significant difference in clinical outcome between the two groups. Topical steroid therapy did not cause any adverse effects.

Administration, Topical↗