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Biomedical subjects

M Siurala

Publications and source records attributed to M Siurala.

At least 73 records · Page 4Linked to original sources
PubMed1979

Gastric morphology, function, and immunology in first-degree relatives of probands with pernicious anemia and controls.

Gastric morphology, function, and immunology was studied in 68 patients with pernicious anemia (PA), 183 of their first-degree relatives, and 354 control subjects. The PA relatives and controls were comparable in age and sex distribution. In both groups, mean gastric acid output decreased and mean fasting serum gastrin levels and the prevalence of atrophic gastritis increased with age. The total prevalence of chronic gastritis was similar in the two groups, but severe atrophic gastritis of the body of the stomach (AGB), achlorhydria, parietal cell antibodies, and a raised fasting serum gastrin level were significantly more common in PA relatives than in controls. Of the PA relatives 23 had severe AGB which was indistinguishable from the gastric mucosal lesion found in PA probands and was, as a rule, accompanied by several other characteristics of type A gastritis. These included a normal antrum (78%), slight or absent inflammatory cell infiltration in the gastric mucosa (70%), achlorhydria (91%), high fasting serum gastrin level (83%), parietal cell antibodies (65%), and intrinsic factor antibodies (22%). The mean age and the proportion of subjects with slight and moderate AGB of all AGB subjects was significantly lower in PA relatives than in controls. This suggests an early onset and a rapid progression from mild to severe AGB in PA relatives. Thus, the PA relatives appear to consist of two populations, one with a high and one with little or no proneness to severe AGB. This bimodal distribution suggests the participation of a single major factor, probably genetic, in the pathogenesis of severe AGB in PA relatives.

Adolescent↗
PubMed1979

Morphological, functional and immunological state of the gastric mucosa in gastric carcinoma families. Comparison with a computer-matched family sample.

Three hundred and one first-degree relatives (series) of 73 gastric carcinoma patients and 358 control relatives (controls) of 73 computer-matched probands from a general population were studied by direct-vision gastric biopsy and functional and immunological examinations. The controls were representative of the series with respect to age, sex, birth and dwelling place, and relationship of the relatives. Series and controls behaved similarly as to total prevalence of gastritis, age and sex distribution of gastritis, serum gastrin level, and circulating gastric antibodies. On the other hand, the total prevalence of hyperplastic polyps, atrophic gastritis of the body and antrum, severe atrophic gastritis of the body, intestinal metaplasia, epithelial atypia, and achlorhydria was significantly higher in the series than in the controls. In subjects below 50 years of age the prevalence of severe atrophic gastritis of the body, intestinal metaplasia, and epithelial atypia was also significantly higher in the series. In addition, the mean age of the subjects with atrophic gastritis, intestinal metaplasia, epithelial atypia, and achlorhydria was lower in the series than in controls; however, significant differences were found only in female subjects with epithelial atypia and atrophic gastritis of the body. The results suggest that the prevalence of signs often considered premalignant is significantly higher in carcinoma relatives than in controls and that these signs show a trend to occur at an earlier age in carcinoma relatives. This could explain the significantly higher than expected death rate from gastric carcinoma in close relatives with this disease, found in the present and in other series.

ABO Blood-Group System↗
PubMed1979

Morphometric analysis of the loss of chief and parietal cells after partial gastrectomy for duodenal ulcer.

Relative chief and parietal cell volume densities were estimated morphometrically in the remnant mucosa of 98 male patients ("series"), operated on for duodenal ulcer by the Billroth II, and in the body mucosa of 55 subjects, age and sex matched, from a random series of a Finnish population ("controls"). The relative volumes of chief and parietal cells were significantly lower in the series than in the controls. The mean chief cell: parietal cell ratio was significantly higher in the series than in the controls. In the controls the ratio decreased with increasing loss of normal tubules. However, no such decrease was discernable in the series, owing to wide scatter of the individual ratios. High ratios (greater than or equal 2.0) were found in 17 cases of the series and in one of the controls. These 17 patients with high ratios had a significantly higher mean length of the foveoles and a significantly lower mean score of the round cell infiltration than the operated patients with lower ratios.

Adult↗
PubMed1978

Long-term observation of subjects with normal mucosa and with superficial gastritis: results of 23--27 years' follow-up examinations.

261 subjects with a normal body mucosa or with superficial gastritis used as controls for an atrophic gastritis series have been followed up for 23--27 years. Of them, 41 died during the earlier and 63 during the present follow-up period. In all, 141 subjects were reexamined in 1976--1977 and 16 answered a questionnaire. None of the subjects had gastric carcinoma or an adenomatous polyp. One patient diagnosed and reported earlier had died of gastric carcinoma during the present period of observation. Of the subjects with normal body mucosa 58% had developed superficial and 14% atrophic gastritis. Of those with superficial body gastritis 42% had developed atrophic gastritis and 18% showed an improvement of the gastritic changes. It should be noted, however, that earlier examinations were performed with blind biopsy and the present with direct vision gastroscopic biopsy. The state of the antral and body mucosa was similar in 53%, antral changes dominated in 33% and the changes in the body in 14%. Intestinal metaplasia was found in 36%, atypical epithelium in 6%, parietal cell antibodies in 0.5% and intrinsic factor antibodies in 0.5%. The fasting serum gastrin level was above 100 ng/ml in 10%. Only 2 cases fulfilled the morphological, functional and immunological criteria of type A gastritis. The present controls differed from the atrophic gastritis series in that the topography of gastritis was different and in that the incidence of metaplasia, atypia, gastric antibodies and high serum gastrin levels was markedly lower.

Antibodies↗
PubMed1978

Gastric lesion and pernicious anemia: a family study.

34 subjects including 5 probands with pernicious anemia, 3 probands with severe atriphic body gastritis and 26 of their first-degree relatives were studied gastroscopically, bioptically, functionally and immunologically. In general, members of the same family revealed a trend to behave similarly with respect to the parameters studied. Signs of A-gastritis (severe atrophy of gastric body glands with a normal or almost normal antrum, achlorhydria, hypergastrinemia and parietal cell antibodies), with intrinsic factor antibodies in the gastric juice and diminished intrinsic factor secretion without anemia were found both in families of probands with atrophic gastritis and pernicious anemia. This suggests a close etiopathogenetic relation of this type of mucosal lesion to overt pernicious anemia. Determination of HCl output and serum gastrin level enabled us to distinguish two differently behaving subgroups in the series, one of them with characteristics of overt adult pernicious anemia. Very low intrinsic factor secretion was found almost exclusively in connection with the presence of intrinsic factor antibodies in the gastric juice and always with severe atrophy of gastric body glands.

Anemia, Pernicious↗
PubMed1978

Cystic "hamartomatous" epithelial polyps of the stomach.

Nine cases of cystic polyps were found among 15,000 routine gastroscopies. All but one of the subjects were women. The polyps were found only in the body of the stomach. They were less than 5 mm in size and in most cases multiple. Endoscopically they were verruca-like lesions and appeared to be loosely attached to the mucosal membrane. They consisted of mucosal cysts lined with normal but irregularly arranged epithelial cells of the body mucosa. No inflammatory reaction or metaplasia was seen in the polyps or outside them. These characteristics suggested the hamartomatous nature of these polyps.

Adult↗
PubMed1977

Dynamics of antral and fundal gastritis in an Estonian rural population sample.

The random population sample collected from an Estonian rural district, and in which antral and fundal gastritis was studied by means of direct vision biopsy technique, was subjected to stochastic analysis identical to that performed earlier on a Finnish representative population sample. Antral gastritis started at an earlier age than fundal gastritis. The antral and fundal age-dependent score lines, which illustrate the dynamic behaviour of each population sample as a whole, nearly meet at later age, indicating that the progression of fundal gastritis is more rapid than that of antral gastritis. The prevalence of fundal gastritis was somewhat lower in this material than in the Finnish rural population sample. However, the age-adjusted score values did not significantly differ in these population samples.

Adolescent↗
PubMed1976

Selective loss of parietal cells in the gastric remnant following antral resection.

The mucosa of the gastric remnant of 41 subjects who had been operated upon 17-18 years earlier for peptic ulcer was studied histologically. The histological changes were classified as follows: 1) normal mucosa, 1; 2) simple gastritis, superficial or atrophic, 27; and 3) "selective loss of parietal cells", 13 subjects. The latter type was characterized by marked loss of parietal cells without corresponding loss of other epithelial elements and without an inflammatory reaction. These changes were thought to reflect a lack of a trophic action on parietal cells exerted by gastrointestinal hormones, as e.g. gastrins.

Aged↗
PubMed1976

Clinical correlations and significance of orceinpositivity in chronic active hepatitis and primary biliary cirrhosis.

Clinical, biochemical and immunological variables were analyzed in 30 patients with orcein-negative (ON) chronic active hepatitis (CAH), 4 patients with ON primary biliary cirrhosis (PBC), 8 patients with orcein-positive (OP; intracellular copper-binding protein seen histologically in liver biopsy specimens) CAH and 15 patients with OP-PBC. A marked elevation of serum bile acids, alkaline phosphatase, leusine aminopeptidase, gammaglutamyl transpeptidase and cholesterol concentrations, and highly pathological BSP Tm values were characteristic for OP-cases. In addition the faecal fat level was increased and bile acids decreased in OP-cases. Serum levels of IgG or IgM and the occurrence of smooth muscle, mitochondrial or glomerular antibodies were identical in ON- and OP-CAH as well as also in ON- and OP-PBC. 49 patients were treated with a combination of prednisone and azathioprine from 4 to 72 months (mean 22). 26 patients with ON-CAH responded biochemically and morphologically to the treatment. No treatment failures were found in ON-CAH. In contrast treatment failure was confirmed in every treated OP-PBC or OP-CAH. The results suggest that orcein-positivity indicates a poor response to prednisone-azathioprine treatment of CAH.

Adult↗
PubMed1976

The possible precancerous significance of abnormal cells in gastric cytology specimens: a follow-up study of 545 patients.

In a series of 545 patients without roentgenological and gastroscopical signs of gastric malignancy, the cytological finding was interpreted as normal (Papanicolaou I) in 351 patients and abnormal (Papanicolaou II-III) in 194 patients. In the abnormal group were included 48 patients with large nuclei and 11 patients with cytologically wrong positive smears (Papanicolaou IV-V), in whom x-ray examination, gastroscopy, and a follow-up study did not reveal any signs of gastric carcinoma. The two groups were collected under uniform principles and studied by the same methods. They were also comparable as to age and sex distribution. In a 15-year follow-up study it was found that 2 patients (0.6%) in the cytologically normal group and 5 (2.6%) in the abnormal group had died of gastric carcinoma. The difference was statistically significant. The 15-year death rate from gastric carcinoma in the cytologically abnormal group was statistically significantly higher than in the expected death rate in the general population of corresponding age and sex distribution.

Adult↗
PubMed1976

Dynamics of atrophic gastritis in male and female subjects after partial gastric resection -- an evaluation by stochastic analysis.

Forty-two subjects (33 male and 9 female) were examined 17 to 18 years after partial gastrectomy due to gastric or duodenal ulcer, with regard to morphological state of gastric body mucosa, specimens obtained by direct gastroscopy technique being evaluated by our scoring system. Our stochastic analysis was applied to the findings to obtain the "age-adjusted score' (AAS), representing the degree of progression of chronic gastritis with reference to a random population, independent of the subject's age. Higher susceptibility of males than females to progressing chronic gastritis, and higher than that of both males and females of the random population, was noted. The atrophic changes in males after gastrectomy showed no dependence on age.

Adult↗