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Biomedical subjects

M Lempinen

Publications and source records attributed to M Lempinen.

At least 91 records · Page 5Linked to original sources
PubMed1980

Serum phospholipase A2 in human acute pancreatitis.

The main problem in the diagnosis of acute pancreatitis is the early detection of the fulminant forms. So far, there is no single laboratory test that affords an unequivocal measure of the severity of the disease. We have studied the serum phospholipase A2 concentrations of 66 consecutive patients with acute or chronic relapsing pancreatitis. Fifty-two patients had a mild spontaneously healing form of the disease, whereas eight patients developed a pseudocyst or an abscess. Six patients had operatively established haemorrhagic pancreatitis. The serum phospholipase A2 concentrations were significantly higher in the patients with haemorrhagic pancreatitis than in those with a spontaneously healing disease. Moreover, in the patients with a milder form of the disease the serum phospholipase A2 concentrations correlated with prognostic signs suggested by others. The results suggest that the assaying of serum phospholipase A2 might be a valuable tool in the diagnosis and follow-up study of patients with acute pancreatitis.

Acute Disease↗
PubMed1980

The effect of zinc-protamine-glucagon in acute pancreatitis.

A double blind study testing the effect of long-acting zinc-protamine-glucagon (7.5 mg every 12 hours for 4--5 days) was carried out in acute pancreatitis. There were 32 patients in ZP-glucagon- and 39 patients in the placebo group. The results show that glucagon had a slightly favourable effect on the general clinical course of the disease but they do not give enough evidence for routine use of glucagon in pancreatitis.

Acute Disease↗
PubMed1979

Selective measurement of triacylglycerol lipase activities in pig post-heparin plasma.

Immunochemical methods for the selective measurement of pig post-heparin plasma lipoprotein lipase and hepatic lipase are described and validated. A simple two step purification method for porcine hepatic lipase from hepatic perfusate based on affinity chromatography and gel filtration is reported. The activity of the post-heparin plasma lipoprotein lipase and hepatic lipase in swine is reported. It is demonstrated that fasting decreases the activity of post-heparin plasma lipoprotein lipase activity more than two-fold while it does not affect the hepatic lipase activity significantly.

Animals↗
PubMed1979

Results of hepatic lobectomy for primary epithelial cancer in 31 adults.

Hepatic lobectomy for primary epithelial cancer was performed in 31 adults from 1964 through 1977 in the surgical departments of six Scandinavian hospitals. Twenty-three patients were discharged and had a 2 year survival rate of 62 per cent and a 5 year survival rate of 16 per cent. Alternatives to surgery have not yet emerged. Further progress requires centralization.

Adenoma, Bile Duct↗
PubMed1979

Phospholipase A2 in serum and ascitic exudate in experimental acute haemorrhagic pancreatitis in pigs.

We have developed a model of experimental haemorrhagic pancreatitis in pigs with a 100% mortality within 24 h without treatment. In this model we have studied the production of peritioneal exudate and compared the concentrations of amylase, lipase and phospholipase A2 in the ascitic exudate and serum. The results suggest that the determination of phospholipase A2 might be important in the diagnosis and follow-up of acute pancreatitis.

Acute Disease↗
PubMed1979

Bleeding oesophageal varices caused by the Budd-Chiari syndrome treated by the Warren shunt.

A previously healthy nonalcoholic 21-year old man was admitted to the hospital for further investigation because of previous severe haematemesis. Oesophageal varices proved to be the origin of the bleeding. The underlying cause for portal hypertension was total obstruction of the left and 70% obstruction of the right hepatic veins (chronic Budd-Chiari syndrome). Portal flow to the liver was almost normal due to well developed collaterals to the azygos vein and the patient's liver function was good. Distal splenorenal shunt (Warren shunt) was performed to decompress the varices. Postoperative recovery was uneventful and 10 months later the patient's general condition was excellent. Varices had disappeared and there was also improvement in his haematological status.

Adult↗
PubMed1978

Xylocaine treatment in experimental pancreatitis in pigs.

Experimental haemorrhagic pancreatitis was induced in 12 piglets by infusing Nataurocholate trypsin into the pancreatic duct with simultaneous intravenous secretin stimulation. Within some minutes after the infusion all animals developed severe pancreatitis accompanied by the production of bloody ascites. Unless given specific treatment the pigs died within 24 h. Of the animals treated with xylocaine infusion (50 microgram/kg/min for 24 h) one died within 24 h, one during the second day, and four lived for over a week, at which time they were killed. Although xylocaine treatment signficantly improved the survival of the animals, it did not seem to influence the local damage of the pancreatic tissue. Xylocaine has been shown to inhibit phospholipase-A in vitro. It is possible that xylocaine also acts in vivo by inhibiting phospholipase-A, thus preventing lethal tissue damages at an early stage of pancreatitis.

Acute Disease↗
PubMed1977

Cholestyramine and ileal by-pass in the treatment of familial hypercholesterolaemia.

A comparison was made of the therapeutic effectiveness of cholestyramine and an ileal by-pass operation as hypocholesterolaemic measures in thirteen patients with familial xanthomatotic type II hypercholesterolaemia. Serum cholesterol and faecal steroids were measured before and at the end of a 10 day course of cholestyramine (32 g/day), and subsequently after an ileal by-pass operation. The mean decrease in serum cholesterol caused by cholestyramine (-17%) was significantly less than that caused by the surgical procedure (-33%). The increase in faecal steroid excretion, mainly as bile acids, was lower with cholestyramine (1.261 g/day) than after the ileal exclusion (2.176 g/day) and a positive correlation was found between the decrease in serum cholesterol and the increase in the faecal elimination of steroids of cholesterol origin. However, even though the increase in faecal steroids with cholestyramine was positively correlated with that resulting from ileal by-pass, the correlation between the corresponding changes in serum cholesterol level was not significant. The findings indicate that ileal by-pass decreases serum cholesterol and increases faecal elimination of cholesterol more effectively than cholestyramine, and that the decrease in the serum cholesterol level induced by ileal exclusion is not consistently predictable by the serum cholesterol response to the preceding cholestyramine treatment.

Adult↗
PubMed1977

Ultrastructural changes in the gastric mucosa following hemorrhagic shock in pigs.

Ultrastructural changes in the gastric mucosa of 14 piglets subjected to transient hemorrhagic shock (3 hr duration; mean arterial pressure 40 mmHg) are described. After 30 min there was mucosal edema and extravasation of red blood cells. Microthrombi with degranulating thrombocytes and fibrin strands were seen in the capillaries. These changes were also seen in the antral mucosa where no subsequent ulceration usually occurs. At this stage the cells of the neck region of the gastric glands showed mitochondrial dilatation and their apical parts were seen to bulge into the lumen of the gastric glands. Other cell types were affected later and necrosis progressed from the surface into deeper parts of the mucosa. Mast cells and mucosal endocrine cells were relatively resistant, being mostly undamaged at the end of the shock period and later. The findings suggest that, during the shock, local formation of thrombi contributes to mucosal ischemia and ulcer formation, and that the cells at the neck region of the gastric glands form the locus of limited resistance to ulcerogenic effects.

Animals↗
PubMed1976

Ganglioside pattern and neuraminic acid content of human gastric and colonic carcinoma.

Twenty-five human gastric and 11 human colonic adenocarcinomas were analysed for their ganglioside pattern and for their content of lipid-bound and protein-bound neuraminic acid. In most carcinomas the content of both lipid-bound and protein-bound neuraminic acid was increased by an average of four- and two-fold, respectively. The ganglioside pattern of all the carcinomas resembled that of normal tissue. In six gastric carcinomas the content of lipid-bound neuraminic acid and the ratio of lipid-bound neuraminic acid to protein-bound neuraminic acid (L/P ratio) were lower than those of normal gastric mucosa. These carcinomas were significantly larger than the rest of the tumours.

Adenocarcinoma↗
PubMed1976

Modification of procine stress ulceration by methylprednisolone, vitaminA and methysergide treatment.

Using a swine shock ulcer model, three pharmacological agents, methylprednisolone, vitamin A and methysergide were evaluated, as they protect gastric mucosa against acute ulceration. Following haemorrhagic shock (3 h duration; mean arterial pressure 40 mm Hg) nine of the ten control animals (90%) developed gastric ulceration. Of the six test animals treated with intravenous methylprednisolone during the shock, only one (17%) developed gastric lesions (p less than 0.02; x2 = 5.76). Of the ten test animals pretreated with massive doses of parenteral vitamin A, only three (30%) developed lesions (p less than 0.05; x2 = 5.21). In contrast to this, treatment with methysergide, a serotonin antagonist, did not significantly effect the ulceration rate, since four of the six test animals (67%) had gastric lesions. The results suggest that methylprednisolone and vitamin A do protect the gastric mucosa from experiment stress ulceration, but their mechanism of action remain obscure and further investigation is needed to judge their value in clinical use.

Animals↗
PubMed1976

A benign hepatocellular adenoma treated by extended right lobectomy.

A 19-YEAR-OLD WOMAN WITH A LARGE BENIGN HEPATOCELLULAR ADENOMA IS PRESENTED. The initial symptom was continuous anaemia demanding transfusions twice a month. Coeliac angiography revealed the hepatic tumour, which was thought to be malignant. Angiography produced permanent paraplegia as a complication. The tumour was radically removed by an extended right lobectomy. The weight of the operation specimen was 2200 g. Histologically the differential diagnosis layed between benign hepatocellular adenoma and hepatocellular carcinoma. Postoperative stricture of the common duct developed as a complication of T-tube and was successfully treated at reoperation. Liver function became totally restored after the operation and after 5 years' follow-up there has been no tumour recurrence. The very rare benign hepatocellular adenomas are discussed.

Adenoma↗
PubMed1976

A benign hepatocellular adenoma treated by extended right lobectomy.

A 19-year-old woman with a large benign hepatocellular adenoma is presented. The initial symptom was continuous anaemia demanding transfusions twice a month. Coeliac angiography revealed the hepatic tumour, which was thought to be malignant. Angiography produced permanent paraplegia as a complication. The tumour was radically removed by an extended right lobectomy. The weight of the operation specimen was 2200 g. Histologically the differential diagnosis layed between benign hepatocellular adenoma and hepatocellular carcinoma. Postoperative stricture of the common duct developed as a complication of T-tube and was successfully treated at reoperation. Liver function became totally restored after the operation and after 5 years' follow-up there has been no tumour recurrence. The very rare benign hepatocellular adenomas are discussed.

Adult↗
PubMed1976

Duodenogastric reflux of lysolecithin in the pathogenesis of experimental porcine stress ulceration.

The role of duodenogastric reflux of lysolecithin, a normal constituent of duodenal juice, in the pathogenesis of gastric stress ulcerations was investigated with a swine shock-ulcer model. Twenty-seven piglets, weighing 8 to 12 kilograms, were used. In an intact animal, the average concentration of intragastric lysolecithin before shock was 138 mug per milliliter (median, N = 6). At the end of the shock period, the average concentration of lysolecithin was 540 mug per milliliter and the over-all amount in the gastric juice was 14.3 mg. (median, N = 6). Following hemorrhagic shock (3 hours duration; mean arterial pressure, 40 mm. Hg), all six control animals with normal gastroduodenal continuity got gastric ulcerations. Interruption of duodenogastric reflux by duodenal exclusion and gastrojejunostomy completely abolished the development of these ulcerations in six test animals. When the interrupted duodenogastric reflux was replaced artificially by intragastric instillation of lysolecithin (500 mug per milliliter; 25 ml.), all six animals developed lesions. Intragastric lysolecithin without shock had no effect. The results provide further support to the concept that regurgitation of duodenal juice into the stomach is an essential factor in the pathogenesis of gastric stress ulceration. The results also suggest that, in this respect, one of the active components in duodenal juice is lysolecithin.

Animals↗
PubMed1975

Role of pyloric reflux in experimental stress ulceration during haemorrhagic shock.

The significance of pyloric reflux of bile and duodenal juice in experimental gastric stress ulceration was studied using a swine shock ulcer model. Following a haemorrhagic shock of 3 h duration, nine of the ten control piglets (90%) with normal bile flow have gastric mucosal lesions. None of the five piglets with permanent bile diversion (ligation of common bile duct; cholecystojejunostomy) has gastric lesions. Intragastric instillation of pure bile prior to the shock in piglets with permanent bile diversion induced gastric lesions in only one of the five test animals (20%). If duodenal juice was used instead, four of the six test animals (67%) have lesions. The results indicate that, in the pig, an uninterrupted flow of bile into the duodenum is a prerequisite for the development of gastric mucosal lesions following haemorrhagic shock. They also suggest that duodenal juice containing both bile and pancreatic juice has a stronger ulcerogenic influence on shocked porcine gastric mucosa than bile alone.

Animals↗
PubMed1975

Ulcer simulating gastric carcinoma. I. Diagnostic considerations and treatment.

Small ulcer-simulating carcinomas accounted for 3.9% (48 cases) of the 1324 patients with carcinoma of the stomach treated at the Second Department of Surgery, University Centtive of a malignant ulcer in 52% of the cases whereas gastroscopy combined with exfoliative gastric cytology gave 73% correct results. In spite of preoperative suspicion of malignancy most patients were operated on as for a benign ulcer. Partial distal gastrectomy without splenectomy was performed in 93% of the patients. There was no hospital mortality. The 5-year survival rate by the actuarial method was 63%.

Adult↗
PubMed1975

Surface electron microscopical changes of the gastric mucosa in experimental porcine stress ulceration.

Gastric mucosal changes in 8 piglets subjected to a transient hypovolaemic shock were studied using scanning electron microscopy (SEM). The mucosal lesions during the shock were characterized by progressive degenerative changes in the mucous membrane of the stomach. These surface changes included flattening or swelling of the individual cells. The flattening of the mucous membrane was later connected with red cell diapedesis through it. These changes were most typical in the areas of haemorrhagic gastritis and preceded the ulcer formation. Following retransfusion, the affected epithelial lining appeared greatly distended over the oedematous lamina propria, with almost complete loss of structural detail. Masses of red blood cells were seen to emerge through the epithelium as an indication of subepithelial haemorrhage. It is possible that the injured epithelium is actually broken down by the pressure of the underlying mucosal haemorrhage and oedema. At later stages, the ulcerated areas showed complete loss of epithelial cells and thus the underlying structureless lamina propria, covered by necrotic cell remnants, blood cells and fibrin, was denuded.

Animals↗