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Biomedical subjects

M Hakala

Publications and source records attributed to M Hakala.

102 records · Page 6Linked to original sources
PubMed1984

Lysosomal gold accumulations in pulmonary macrophages.

Although soluble gold has been widely used in the treatment of rheumatoid arthritis, little is known about the distribution of gold deposits in extra-articular tissues. In the synovial lining cells and articular cartilage, the morphology of lysosomes containing gold, the aurosomes, is well documented. Because gold may cause pulmonary injury, the morphology and distribution of gold deposits in pulmonary tissue should be recognized. We found morphologically typical aurosomes with electron-dense membranes and granules, giving the spectrum of gold in electron microprobe analysis, in the interstitial and alveolar macrophages in the open lung biopsies of 3 patients who had received gold treatment but not in 12 patients who had not received gold treatment. In contrast to previous studies, aurosomes were not found in the endothelial cells.

Arthritis, Rheumatoid↗
PubMed1984

Hypertension after clonidine overdose. A case report.

A hypertensive reaction is described in a 28-year-old woman with renal failure who took 30-70 clonidine tablets (150 micrograms each) with suicidal intent. She became increasingly drowsy. Her blood pressure on admission was 210/150 mmHg and gradually fell to 140/100 mmHg during the next 16 hours, at which time her plasma clonidine concentration was 4.7 ng/ml. This interesting hypertensive reaction was probably due to excessive stimulation of peripheral postsynaptic alpha-adrenoceptors.

Adult↗
PubMed1977

Kyphosis in the paralytic spine.

The paralytic spine without supplementary support is unstable and susceptible to axial collapse. The biomechanical factors responsible for spinal stability should be considered in any treatment regimen for paralytic spines. If posterior fusion is elected as the treatment, kyphosis must be corrected so that the eccentric loading and kyphotic bending moment is very small. When this is done, posterior fusion alone is adequate to give spinal stability and increased function to the individual.

Adolescent↗
PubMedDate not supplied

Non-union of the clavicle in a child. A case report.

A case of symptomatic non-union of the clavicle occurred in a 12-year-old boy. Differential diagnosis roentgenographic and histologic observations, including the results of resection of the non-union site and stablization of the proximal clavicle using the coraco-acromial ligament demonstrated that this rare condition can be restored to full asymptomatic function without any internal metallic fixation devices.

Child↗
PubMedDate not supplied

The coach's finger.

Explore the source record for details and available documents.

Athletic Injuries↗
PubMedDate not supplied

Good results from combining etanercept to prevailing DMARD therapy in refractory juvenile idiopathic arthritis.

OBJECTIVE: To assess the effect of etanercept added to prevailing drug therapy in patients with juvenile idiopathic arthritis (JIA) whose disease was refractory to conventional disease-modifying antirheumatic drug (DMARD) treatment, including combinations of different DMARDs. METHODS: Data on 31 JIA patients with a disease resistant to conventional DMARD treatment were retrospectively collected from medical records and assessed for a one-year period after the introduction of etanercept or to the time of cessation of the drug due to a lack of efficacy or side effects. Efficacy was assessed based on the normal laboratory indexes of inflammation and changes in the following parametres: number of DMARDs used and intraarticular (i.a.) glucocorticoid injections. The numbers of inpatient days needed were also recorded. RESULTS: Etanercept was well tolerated. Only two patients stopped discontinued the treatment because of allergic rash, after 3 weeks of treatment in one case and after 4 months in another. In two cases the treatment was discontinued because of a lack of efficacy. During the treatment, there was a significant decrease in the number of DMARDs used and the i.a. glucocorticoid injections needed as well as in the dose of per oral glucocorticoids. The laboratory parameters also improved. In addition, there was a significant decrease in the number of inpatient days per 3-month period before and during the etanercept treatment. CONCLUSION: The addition of etanercept to conventional DMARD therapy in children with the most severe cases of JIA leads to an excellent clinical response during the first 12 months. The tolerability of the drug is good in combination therapy with various DMARDs.

Adolescent↗
PubMedDate not supplied

Increased type I collagen degradation correlates with disease activity in reactive arthritis.

OBJECTIVE: The assay for the cross-linked carboxyterminal telopeptide of type I collagen (ICTP) has been shown to reflect increased type I collagen degradation in patients with rheumatoid arthritis. To look for increased collagen degradation in other inflammatory rheumatic diseases, we studied plasma ICTP in patients with reactive arthritis (ReA). METHODS: ICTP was determined by radioimmunoassay from 69 ReA patients. ICTP data on 56 patients aged > or = 20 years were compared with normal ICTP values available for that age group. RESULTS: The median (range) plasma ICTP concentration of the patients > or = 20 years of age was 3.9 (2.1-9.6) micrograms/l, and in 13 (23%) of them the value was elevated if compared with the normal upper reference limit (mean + 2SD), 5.2 micrograms/l, given by the manufacturer. The mean (SD) duration of joint symptoms was 76 (61) days in patients with ReA. Modest albeit statistically significant correlations were noted between the plasma ICTP and the erythrocyte sedimentation rate, C-reactive protein and the Lansbury articular index (Spearman's r 0.39, 0.37 and 0.29, respectively). The median values for all of the above mentioned parametres were at least twice as high in the group of patients with elevated ICTP compared with those in patients with normal values (p < 0.05). No statistically significant correlation was detected between the plasma ICTP and the duration of joint symptoms. CONCLUSION: Increased type I collagen degradation can take place in ReA, and this process seems to correlate with the extent and activity of the joint disease.

Adult↗
PubMedDate not supplied

Association of tumour necrosis factor a, b and c microsatellite polymorphisms with clinical disease activity and induction of remission in early rheumatoid arthritis.

OBJECTIVE: To study the associations of tumor necrosis factor (TNF) a, b and c microsatellite markers with 1) the clinical disease activity and 2) the induction of remissions in patients with early rheumatoid arthritis (RA) treated with two treatment strategies. METHODS: In the FIN-RACo (FINnish Rheumatoid Arthritis Combination therapy) trial of two years, 195 patients with recent-onset RA were randomly assigned to receive either a combination (COMBI) (sulphasalazine, methotrexate, hydroxychloroquine, and prednisolone) or a single (SINGLE) (initially sulphasalazine with or without prednisolone) disease modifying antirheumatic drug (DMARD) therapy. TNF a, b and c microsatellite and HLA-DRB1 typings were carried out in 165 (79 COMBI; 86 SINGLE) study completers. RESULTS: At baseline the 28 joint disease activity scores (DAS28) of the patients positive for TNFa2, a13 or b1 microsatellite markers were significantly higher than in the other patients. In the SINGLE patients the DAS28 improved comparably in patients with (n = 31) or without (n = 53) the TNFb1 marker (NS), while the DAS28 of the TNFb1-positive COMBI patients (n = 22) improved significantly more than that of the TNFb1-negative cases (n = 57) (p = 0.014). Respective 31.8% (7/22) and 28.1% (16/57) of the COMBI patients with or without TNFb1 allele achieved remission at one year. The corresponding figure in SINGLE patients were 0% (0/31) and 20.8% (11/53) (p = 0.006). At two years the remission frequencies in the TNFb1+/TNFb1- patients in the COMBI and SINGLE were 50.0%/38.6% and 9.7%/22.6%, respectively. CONCLUSION: Early TNFb1+ RA patients have more active disease but respond more favourably to COMBI treatment than the patients without this microsatellite allele. The finding may be of clinical relevance for the choice of DMARDs in early RA.

Adolescent↗