Biomedical subjects
Publications and source records attributed to M Saari.
A family study on the inheritance of HL-A antigens and susceptibility to acute anterior uveitis is reported. In the 4 families examined, the antigen 27 (haplotype 2.27) occurred in all of the 7 patients with acute anterior uveitis and in 22 of the 33 healthy family members examined. It is suggested that in Finns the haplotype 2,27 is linked with genes predisposing the carrier to acute anterior uveitis.
A patient developed an acquired toxoplasmic chorioretinitis 11 days after exposure to infected animals. As systemic manifestations of the disease, the patient had rhinitis, sore throat, muscular pains, fatigue, cervical lymphadenopathy, and cardiac symptoms, with highly elevated Toxoplasma antibody titers. During treatment with prednisone, the chorioretinal lesion progressed to the macular area, but improvement was seen when pyrimethamine and sulfonamide therapy was started. The importance of this case relates to the unusual occurrence of acquired infection with systemic manifestations in toxoplasmic chorioretinitis and to the possibility of the transmission of toxoplasmosis by trophozoites in excretions.
It has generally been assumed that the trophozoites of Toxoplasma gondii cannot survive long outside the body and they cannot resist even small changes in osmotic pressure, and that toxoplasmosis is transmitted by transplacental infection, cysts and oocysts. In an attempt to demonstrate that trophozoites can resist changes in osmotic pressure, some were preserved in ascitic fluid made hypertonic with 1%, 2%, 5%, and 10% salt excess of sodium chloride and in ascitic fluid made hypotonic by mixing it in the ratio 3 : 7, 1 : 9 and 1 : 49 with distilled water. The trophozoites remained infectious in 1% salt excess for 29 days, in 2% for 15 days, in 5% for 5 days and in 10% salt excess for 2 days and in ascitic fluid diluted 3 : 7 with distilled water for 15 days and in ascitic fluid diluted 1 : 9 with distilled water for 3 days. We suggest that trophozoites, being resistant to changes in osmotic pressure, may survive outside the body long enough to transmit the disease.
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The ultrastructure of the microvessels of the guinea pig, rat, rabbit and cat was studied in an effort to discover the morphological basis of the permeability of the iris vessels. The microvessels of the iris revealed a non-fenestrated endothelium. A relatively wide intercellular space and macula occludens were seen at the intercellular junctions of the endothelial cells in the capillaries and postcapillary venules. It is concluded that these intercellular spaces may form the small pore system which makes the diffusion through the iris vessels possible. Transcapillary exchange of high molecular substances is made possible by the vesicular transport system of the micropinocytosis vesicles.
In order to study the morphological basis of the increased permeability of the capillaries of the iris in neuroparalytic keratitis the ophthalmic division of the trigeminal nerve in the cat was denervated using a stereotactic method. The homolateral iris was studied by electron microscopy three days after denervation. Abnormally large pinocytotic vacuoles were observed in the endothelial cells of the iris capillaries and the intercellular junctions of the endothelial cells showed widened inter-cellular space and macula occludens. These ultrastructural changes may explain the protein leakage into the anterior chamber in neuroparalytic keratitis.
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As remnants of pupillary membrane, some albino rat eyes revealed vascular loops starting from arteriovenous bridges near the pupillary margin and crossing the pupil. These vascular loops bend in miosis and straighten in mydriasis, which prevents them from being broken during pupillary movement. The vessel wall reveals endothelial cells and pericytes. The lumen contains red blood cells, which means that they are functional vessels. They may function as vascular shunts between opposite sides of the albino rat iris.
In order to determine the distribution of etiologic and diagnostic categories of uveitis at the Oulu University Eye Hospital, 653 patients with uveitis treated during the years 1964-1974 were reviewed. Of the 653 patients, 321 were men and 332 women; 547 had anterior, 64 posterior and 42 generalzied uveitis; 524 unilateral and 129 bilateral; 570 acute and 83 chronic; and 446 single and 207 recurrent. The etiologic factors were distributed into rheumatoid (7.2%), streptococcal (4.1%), tuberculosis (3.7%), toxoplasmosis (3.3%), varicella-zoster (1.7%), sarcoidosis (1.4%), staphylococcal (1.1%), leptospirosis (0.6%), lymphatic leucemia (0.5%), herpes simplex (0.5%), yersinosis (0.1%) and undetermined cases (75.8%). There were no cases of syphilis. Most of the cases in this series were anterior and acute uveitis occurring mainly in the age group 20-59 years.
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