Search PubMed⌕ Search

Biomedical subjects

M Hakala

Publications and source records attributed to M Hakala.

At least 91 records · Page 5Linked to original sources
PubMed1991

B27-bearing HLA haplotypes in rheumatoid arthritis: characterization in Finnish patients.

The frequency of human leukocyte antigen (HLA)-B27 has been found to be increased in rheumatoid arthritis (RA) in Finland and marginally also in some other populations. In the present study HLA-B27-bearing haplotypes in RA patients were found to carry DR1 and DR4 genes more often than do B27 haplotypes in control population. B27;DR4,DW14;DQw7 was a typical B27-DR4 haplotype whereas DR4 in the majority of other haplotypes occurs with Dw4 and DQw8 genes. The result indicates that the B27 association with RA is not independent of DR1 and DR4, but whether the B27;DR4;DQw7 haplotype subjects a person to a higher disease risk than do other DR4 haplotypes, or is associated with a more severe course of the disease, remains to be investigated.

Arthritis, Rheumatoid↗
PubMed1990

Open lung biopsy of patients with rheumatoid arthritis.

In order to shed light on the histological changes occurring in the lungs of patients with rheumatoid arthritis (RA), we scrutinized an open lung biopsy file of 199 patients and selected the patients with RA. The histopathological patterns observed were: pulmonary rheumatoid nodules (4 cases, including one with rheumatoid pneumoconiosis); usual interstitial pneumonia (UIP) (2 cases); desquamative interstitial pneumonia (2 cases); bronchiolitis obliterans with patchy organizing pneumonia (2 cases); follicular bronchiolitis (1 case); organizing pneumonia always associated with bronchiolitis (3 cases); granulomatous reaction (3 cases); obliterating vasculitis (3 cases); granulomatous vasculitis (1 case); lymphoid hyperplasia (2 cases); and localized pulmonary fibrosis (1 case). The clinical data and laboratory findings for the histopathological groups overlapped and did not properly predict the anatomical picture. Both patients with UIP died of lung disease. Otherwise the prognosis in the series was good.

Arthritis, Rheumatoid↗
PubMed1990

Simultaneous presentation of upper lobe fibrobullous disease and spinal pseudarthrosis in a patient with ankylosing spondylitis.

A 51 year old man with a 20 year history of ankylosing spondylitis and pronounced thoracic gibbus presented with two simultaneous complications of longstanding ankylosing spondylitis, upper lobe fibrobullous disease, and spinal pseudarthrosis. No neurological sequelae developed and treatment was conservative. Both these lesions mimic tuberculosis, and so it is important to determine them accurately to avoid unnecessary antituberculosis treatment. Both of these complications are reported to occur in longstanding ankylosing spondylitis and their simultaneous presentation may be more common than is realised. This case is believed to be the first such report of their association.

Bone Resorption↗
PubMed1988

Bronchiolo-alveolitis with pulmonary basal lamina injury in a rheumatoid patient during gold treatment.

A 47-year-old housewife presented with nonproductive cough, progressive breathlessness and intermittent fever during gold treatment, originally prescribed for seropositive polyarthritis, which later fulfilled the criteria for systemic lupus erythematosus (SLE). An open lung biopsy showed abundant interstitial edema with mononuclear inflammatory cells and some eosinophils, and slight bronchiolitis. The picture was nonspecific but suggestive of hypersensitivity pneumonitis. Electron microscopy revealed splitting and local disappearance of the basal laminae of the alveolar capillaries, venules and alveolar epithelium. This injury was confirmed by immunohistochemical staining for type IV collagen and laminin, the major components of basal laminae. In most macrophages there was lysosomal electron dense granular material, i.e. aurosomes, which gave the spectrum of gold in electron microprobe analysis. After the gold treatment was stopped the pulmonary symptoms gradually decreased during several months and no permanent lung disease remained. Whereas the pulmonary manifestation could have been due to her underlying disease we discuss in this study the possibility of its being gold induced.

Alveolitis, Extrinsic Allergic↗
PubMed1988

Poor prognosis in patients with rheumatoid arthritis hospitalized for interstitial lung fibrosis.

Fifty-seven patients with rheumatoid arthritis (RA) were treated in hospital for diffuse interstitial lung fibrosis. Although interstitial fibrosis (either on the basis of lung function tests or chest roentgenograms or both) is fairly common among patients with RA, according to this study interstitial fibrosis of sufficient extent or severity to warrant hospitalization was rare: incidence of hospitalization due to the lung disease in RA patients was one case per 3,500 patient-years. Eight patients had a largely reversible lung disease associated with drug treatment (gold, D-penicillamine or nitrofurantoin.) The remaining 49 had interstitial fibrosis of unknown cause. Causes for hospitalization were respiratory and general symptoms in 38, but infiltrations on routine chest roentgenographic examinations alone in eleven patients. Forty-five out of the 49 patients had crackles on auscultation. The most typical findings in lung function tests were restriction and a decreased diffusion capacity. These 49 patients showed a poor prognosis, with a median survival of 3.5 years and a five-year survival rate of 39 percent.

Arthritis, Rheumatoid↗
PubMed1987

Serum copper, zinc and ceruloplasmin concentrations in patients with lung cancer.

Serum copper (SCu), zinc (SZn) and ceruloplasmin (SCP) concentrations were measured in 199 patients with lung cancer and 81 with nonmalignant lung disease. No significant differences were detected between these groups in the mean concentrations or in the SCu:SZn ratio, nor was any correlation found between the histological type or clinical extent of the tumor and the level of SCu, SZn or SCP. SCu and SCP increased significantly in accordance with the symptomatic stages of Feinstein, and in a parallel manner. These measures were also significantly higher in the patients who died within 4 months of diagnosis than in those who lived for 4 months or longer. SZn was similar throughout and was not predictive of the prognosis. It is concluded that SCu, SZn and SCP determinations are of no help in distinguishing malignant from nonmalignant lung disease and are only of limited importance for estimating the extent of the disease or the prognosis of a patient with lung cancer.

Adenocarcinoma↗
PubMed1987

Patients with rheumatoid arthritis and gold-induced pneumonitis express two high-risk major histocompatibility complex patterns.

Gold salt therapy-induced pneumonitis is a rare complication in patients with rheumatoid arthritis (RA). We studied HLA-A, B, C, D/DR, and complement factor B (Bf) and C4 alleles in 17 patients with RA and gold-induced pneumonitis and found that these patients had strikingly homogeneous major histocompatibility complex (MHC) markers. Eight of them (47 percent) had the alleles HLA-A3 B35 Dwl BfF C4A3,2 (BO), which were shown by family studies of some patients to be inherited as an extended MHC-haplotype with an apparent gene duplication in the C4A locus. The other high-risk phenotype, HLA-B40 with a C4 null allele, was found in eight patients (47 percent). All but three of the 17 patients had at least one of the two high-risk markers, the frequency of these combinations being clearly higher than in the two control groups: patients with RA but with no gold-induced side effects and healthy individuals. Our study shows that use of several MHC markers together results in a strong association between the markers and the disease.

Adult↗
PubMed1986

Association of different HLA antigens with various toxic effects of gold salts in rheumatoid arthritis.

An association of gold induced proteinuria with HLA-D(R)3 has been reported. To investigate other possible relationships between gold toxicity and HLA antigens we studied 85 patients with rheumatoid arthritis (RA) divided into four subgroups: patients with gold induced interstitial pneumonitis, mucocutaneous lesions, proteinuria, and patients without gold toxicity. The HLA frequencies in patient groups and 283 healthy controls were compared in different pairwise combinations. Gold induced pneumonitis was associated with HLA-B40 and Dw1. An association between gold induced proteinuria and HLA-Dw3 was also seen. The increased prevalence of Dw4 in RA was observed only in the control patient group without gold induced side effects. The frequencies of HLA-B7 and Dw2 were decreased in all patient groups compared with the control population. These results further support the view of the heterogeneity of RA as manifested by the unique HLA associations with resistance and susceptibility to gold induced side effects characterising different subgroups.

Adult↗
PubMed1986

Association of bronchiolitis with connective tissue disorders.

Among 173 consecutive open lung biopsies, nine gave a histopathological diagnosis of bronchiolitis. Seven of these patients had some connective tissue disorder (CTD), six of whom are presented in this report; two had classical and one possible rheumatoid arthritis (RA), one ankylosing spondylitis, one scleroderma, and one developed classical RA four years after biopsy. Four of the patients were smokers, most suffered from breathlessness and cough. In terms of lung function three patients had obstruction, one both restriction and obstruction and three a decreased diffusion capacity. For control purposes peripheral lung tissue was studied histologically from 24 consecutive smoking patients without CTD who underwent a lobectomy for cancer. Intraluminal plugs and mucosal lymphoplasmocytic infiltration of the bronchiolar walls were more prevalent and abundant in the CTD patients than in the controls (p less than 0.02 and p less than 0.001 respectively). Two CTD patients also showed some obliterative bronchiolitis. Corticosteroids were effective in one out of four patients treated. One patient improved and the others did not show any progression during the follow up. The results suggest that smoking alone does not explain the lesions of the small airways found in CTD patients, and that bronchiolitis may be specifically associated with the basic disorder in such cases.

Bronchitis↗
PubMed1986

Rheumatoid arthritis with pleural effusion includes a subgroup with autoimmune features and HLA-B8, Dw3 association.

Twenty-eight patients with rheumatoid pleural effusion were investigated to examine the frequency of HLA antigens as compared with 56 rheumatoid arthritis (RA) patients without this intrathoracic manifestation of RA and with 283 healthy controls. HLA-B8 was strongly associated with the presence of pleural effusion (PE) in RA patients. A high prevalence (71%) of B8/Dw3 was found among male RA patients of the PE group in whom the joint disease had begun at an age over 50 years and who also had besides pleuritis other intrathoracic manifestations of RA associated with high rheumatoid factor titres and low complement (C4) levels in sera. Actually, the HLA-B8 association was not seen in the rest of the PE group. The finding may be related to the heterogeneity of RA, a male subgroup of the disease being characterized by multiple intrathoracic manifestations and genetically associated with the large group of autoimmune disorders, such as SLE, characterized by high prevalences of HLA-B8 and D(R)3.

Adult↗
PubMed1986

Diffuse interstitial lung disease in rheumatoid arthritis. Views on immunological and HLA findings.

Immunological parameters including HLA typing were studied in 32 patients with rheumatoid arthritis (RA) associated diffuse interstitial lung disease (DILD) and in 32 age- and sex-matched RA control patients. The male RA patient group with DILD also included patients with other intrathoracic manifestations and had a higher prevalence of HLA-B8 and Dw3 than did healthy controls, thus agreeing with our earlier results that RA patients with this antigen combination are prone to multiple intrathoracic complications. Patients with DILD had higher titres of rheumatoid factor (RF) and lower complement (C4) levels than matched RA controls. The RF titre was in inverse correlation with C3 and C4 levels, suggesting that RF immune complexes may also promote rheumatoid lung disease via activation of the classical pathway of complement.

Aged↗
PubMed1984

Botulism revisited. A case report.

Two cases of food-borne botulism following consumption of commercially canned German-made liver sausage are presented. The more serious case involved respiratory paralysis for 15 days, the milder one only muscle weakness in the area of the cranial nerves. Both of the patients recovered well and returned to their jobs half a year after the onset of the illness.

Adult↗