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Biomedical subjects

M Perkkiö

Publications and source records attributed to M Perkkiö.

48 records · Page 3Linked to original sources
PubMed1983

Iron deficiency anaemia with hypoproteinaemia.

Forty two children were admitted to this hospital between 1975 and 1980 with severe iron deficiency anaemia and 8 of them also had oedema caused by a low concentration of serum proteins. These 8 patients, aged 8-24 months, and 13 age matched controls were investigated. The patients had excessive faecal loss of 59FeCl or 51Cr-albumin, or both; their jejunal biopsy specimens showed little decrease in the ratio of villous height to crypt depth; and they had fewer intraepithelial lymphocytes and cells containing IgA than controls. They were all treated with an oral ferrous iron preparation and the oedema, hypoproteinaemia, and low haemoglobin concentrations rapidly resolved. These results show that immunologically mediated hypersensitivity is not implicated in iron deficiency anaemia associated with hypoproteinaemia.

Anemia, Hypochromic↗
PubMed1981

Morphometric and immunohistochemical study of jejunal biopsies from children with intestinal soy allergy.

A morphometric and immunohistochemical restudy was made of jejunal biopsy specimens from 5 patients with soy allergy and the results obtained were compared to those from specimens taken before soy feeding and to those at a later time. All the patients had had previous cow's milk allergy with malabsorption. Gastrointestinal symptoms presented within two weeks of starting the soy based formula but in two patients the symptoms were mild and these patients were able to continue soy feeding. Jejunal biopsy specimens taken within 3 days from the reaction to soy showed villous atrophy associated with crypt hyperplasia and an increased cell renewal rate. Also, these specimens showed an inflammatory reaction in the lamina propria and in the epithelium, and the numbers of IgA- and IgM-containing cells were increased. Later, when the soy proteins were eliminated, the morphology of the jejunum improved and the cell numbers were reduced to normal. The intestinal damage and the local immune reaction caused by soy proteins are similar to those seen in cow's milk allergy with malabsorption. The immunological mechanisms operating in these diseases are thought to be the cause of these changes.

Atrophy↗
PubMed1981

Semi-quantitative analysis of immunoglobulins and complement fractions 3 and 4 in the jejunal mucosa in coeliac disease and in food allergy in childhood. Immunohistochemical study by light and electron microscopy.

Immunoglobulins A, M, G and E and complement fractions 3 and 4 in jejunal biopsy specimens of 14 children were stained by the peroxidase-labelled antibody technique and studied in light and electron microscopy. In addition, cryostat sections were stained with FITC-conjugated anti-C3,-C4 and -IgE sera. Five patients had coeliac disease, three intestinal cow's milk or rye allergy, three eczema due to food allergy, and in three patients, who served as controls, intestinal and immunological diseases were excluded. This study showed that increased amounts of IgA and IgM both in coeliac disease and in food allergy are produced by the plasma cells in the lamina propria of the jejunum and are secreted into the gut through the epithelial cells in a similar manner as in the morphologically normal intestine. The amount of IgG produced locally or derived from serum, was increased in coeliac disease. IgE-producing cells were rare in all patients. No deposits of complement were seen in the basement membranes or epithelial cells.

Animals↗
PubMed1980

Morphology of the jejunum in children with eczema due to food allergy.

We report the results of a morphometric study of jejunal biopsy specimens from 18 children with eczema due to food allergy. The measurements were compared with those for 13 age-matched children without gastrointestinal or immunological diseases. The patients' ages ranged from 2 months to 4 years. In 14 the food responsible for the symptoms was cow's milk. During the challenge tests with suspected foods 10 children had skin symptoms only (group I) and eight had gastrointestinal symptoms in addition (group II). Both groups showed a significant decrease in the villus/crypt ratio, mostly due to an increase in crypt depth. The counts of lymphocytes and plasma cells in the lamina propria and of intraepithelial lymphocytes did not differ from those seen in the controls. Four patients had increased counts of jejunal eosinophils, but the mean count for the whole group was not significantly increased. Considered nine measurements only five of the patients had moderate changes in jejunal morphology.

Biopsy↗
PubMed1980

Immunohistochemical study of intestinal biopsies from children with atopic eczema due to food allergy.

In 18 patients with skin reactions after food challenge and in controls the numbers of immunoglobulin-containing cells in the intestinal mucosa were studied by the direct immunoperoxidase technique; IgE and C3 were studied by FITC-conjugated sera also. Serum immunoglobulins, complement fractions 3 and 4, and reaginic antibodies to the foods were measured during the provocation. None of the patients had any deficiency in the numbers of immunoglobulin-containing cells in the intestinal mucosa or in the serum immunoglobulin concentrations. The numbers of IgM- and IgA-containing cells were higher in the patients than in the controls. But patients and controls had equally low numbers of IgE-containing cells. No deposits of C3 were seen in any of the biopsy specimens. Serum IgE was increased in 13 cases. The presence of reaginic antibodies to cow's milk and cereals correlated well with the clinical reaction (12/15 and 5/7 of the cases). There was a negative correlation between the logarithm of serum IgE and the number of IgA-containing cells in the jejunal mucosa (P less than 0.01). High prechallenge counts of blood eosinophils were seen in seven cases and these showed a close correlation with the eosinophils in the jejunal mucosa (P less than 0.001).

Child, Preschool↗
PubMed1980

Time of appearance of immunoglobulin-containing cells in the mucosa of the neonatal intestine.

In 46 intestinal specimens from infants 2 hr to 6 months old, the numbers of immunoglobulin-containing cells were counted by the direct immunofluorescent or direct immunoperoxidase technique. A restudy was made of biopsy specimens taken for diagnostic purposes, 34 from the rectum and 3 from the transverse colon of 30 infants at the Children's Hospital, Helsinki in 1971-1977, and in addition, of autopsy material recently collected from the intestines of 9 infants. Up to the age of 12 days, no immunoglobulin-containing cells were seen. A small number (1 to 2) of IgM-containing cells was seen in the lymph nodes of the 2 earlier specimens taken at the ages of 6 and 12 days. A rectal specimen from a 12-day-old infant showed 24 IgA- and 60 IgM-containing cells/mm2. In rectal specimens of infants less than 1 month old, the mean number of IgM-containing cells (26/mm2) was higher than that of IgA-containing cells (14/mm2), but older infants had a significantly higher mean number of IgA-containing cells (P < 0.01). The mean number of IgM-containing cells was the same in children 1 to 3 months (53 cells/mm2) and 3 to 6 months of age (59 cells/mm2), whereas the mean number of IgA-containing cells increased with age up to 6 months (112 and 163 cells/mm2). The youngest infant who had IgG-containing cells was 13 days old, although positive staining of intercellular spaces in the lamina propria and of the capillary endothelium by anti-IgG serum was observed in all specimens. The mean number of IgG-containing cells was low (5 cells/mm2) in all age groups. Sparse IgE-containing cells (less than 12 /mm2) were seen in 4 of the 46 specimens. In 5 patients, 2 or 3 consecutive specimens were available for the study; in these, the increase in the numbers of IgA- and IgM-containing cells was similar to the mean increase in cell numbers for the series as a whole.

Age Factors↗
PubMedDate not supplied

Changing pattern of treatment policies invalidates the use of C-reactive protein level and hyponatremia as indicators of sepsis in children with malignancies.

We evaluated serum C-reactive protein (CRP) level and serum sodium concentration as early indicators of bacteremia in neutropenic children in two different series in 1983-1984 (49 bacteremias) and 1989-1990 (29 bacteremias). During the earlier period, the goal was to avoid unnecessary antimicrobial therapy. Currently a neutropenic patient is placed on antimicrobial therapy at the first sign of fever. In 1983-1984 the serum CRP concentration was elevated in every case, whereas in 1989-1990 it was normal in 34% cases (P = .0001). Hyponatremia was detected on admission in 84% and 52% cases (P = .0001). The urinary sodium concentration was elevated in most cases. The mortality in bacteremia was 22% in 1983-1984 compared to 3% (P = .025) in 1989-1990. Prompt initiation of empirical antimicrobial therapy in children with fever and neutropenia invalidates the use of hyponatremia and an elevated CRP level as early indicators of sepsis.

Adolescent↗
PubMedDate not supplied

Chemotherapy with the "8 in 1" protocol for malignant brain tumors in children: a population-based study in Finland.

We evaluated the outcome of 68 children with malignant brain tumors treated with the "8 in 1" chemotherapy protocol in Finland from 1986 to 1993, comparing 5-year survival rates with those for a historical control group (from 1975 to 1985). For all malignant brain tumors, overall survival was 43% (vs 28% in the control group; P <0.05), and progression-free survival (PFS) was 43% (vs 23%; P <0.05). For medulloblastoma and primitive neuroectodermal tumor, survival was 63% (vs 35%; P <0.05), and the corresponding PFS was 59% (vs 35%; P = 0.15). For high-grade glioma, both the survival rate and the PFS were 27% (vs 17%; P = NS). Thus the outcome was significantly better for our "8 in 1" -treated patients than for the historical controls, especially among the children with primitive neuroectodermal tumor and medulloblastoma. In contrast, those with high-grade gliomas and brain stem tumors seem to have received little benefit; different, more effective treatments are needed for these patients.

Adolescent↗
PubMedDate not supplied

Infections occurring during the courses of anticancer chemotherapy in children with ALL: a retrospective analysis of 59 patients.

In a retrospective analysis we evaluated the occurrence of infections in 59 children with acute lymphoblastic leukemia (ALL) during the entire duration of their anticancer chemotherapy. We recorded a total of 245 infection episodes, 118 (50%) being during neutropenia and 119 (50%) during nonneutropenia. The infections most commonly detected during neutropenia were fevers of undetermined origin (36%), clinically or microbiologically defined focal infections (33%), and bacteremias (28%). During nonneutropenia, upper respiratory tract infections (55%) were the most common. Patients needed hospitalization for infections for a total of 1951 days (i.e., a mean of 33 days per patient) and the mean number of infection episodes was 4.2 per patient. Recurrent fever developed in 21% of the children with bacteremia. Mortality caused by bacteremias was 10%. Infections during the chemotherapy of ALL were a significant cause of morbidity in children, but mortality was low.

Adolescent↗