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Biomedical subjects

P Sipponen

Publications and source records attributed to P Sipponen.

At least 235 records · Page 13Linked to original sources

Relative risk of stump cancer following partial gastrectomy.

The relative risk of stump cancer following partial gastrectomy for a benign gastroduodenal condition was estimated using an individually matched retrospective study design based on autopsy material. Data on all patients dying with gastric cancer and autopsied at the Central Laboratory of Pathology, University Central Hospital, Helsinki, during 1961-75 were collected. Matched pairs of the same sex and age were used as controls. Of the 464 patients dying with gastric cancer, 9 had undergone previous partial gastrectomy, while the respective number among the controls was 5. This result suggests that the risk of cancer in the gastric stump was not significantly increased as compared to the normal unoperated population.

Aged↗

A gastroscopic and histological double-blind study of the effects of diclofenac sodium and naproxen on the human gastric mucosa.

The effects of diclofenac sodium and naproxen on the gastric mucosa were studied in a double-blind trial by gastroscopy, gastrophotography and histological examination of the mucosa in six healthy volunteers. Detectable lesions were evident in the mucosa of four subjects after administration of both drugs, and the lesions were more extensive after the ingestion of naproxen than after diclofenac sodium in all of these cases. The most serious lesions verified by both gastroscopy and histology always occurred after exposure to naproxen. The histology of the gastric mucosa of two subjects with severe lesions showed spotty to moderate chronic superficial gastritis, whereas the overall histological appearance of the mucosa was normal in subjects with slight or moderate lesions after drug administration. The maximal acid output was positively correlated with the severity of the lesions. Subjective symptoms occurred in one person during diclofenac sodium and in three during naproxen administration.

Adult↗

Demonstration of an intracellular copper-binding protein by orcein staining in long-standing cholestatic liver diseases.

Liver biopsies from eight patients with primary biliary cirrhosis, two with chronic active hepatitis of a cholestatic form, three with long-standing alcoholic liver cirrhosis, and one with extrahepatic biliary obstruction were studied. In each case dark brown cytoplasmic material was seen after staining of the tissue sections with Shikata's orcein method. In exactly the same cellular and subcellular locations as the orcein-positive material, and with morphologically equal granules, two different ordinary staining methods for copper (rubeanic acid and Mallory-Parker's haematoxylin) gave positive reactions. The earlier histochemical findings have revealed the protein nature and high sulphydryl content of the orcein-positive material. Its close association with copper in liver sections suggests its copper-binding nature and indicates that a common copper-protein complex accumulates in the cytoplasm of liver cells during longstanding cholestasis in biliary diseases of various pathogenetic origin.

Cholestasis↗

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↗

Immunological parameters, viral antibodies, and biochemical and histological findings in relatives of patients with chronic active hepatitis and primary biliary cirrhosis.

The familial occurrence of immunological, virological, biochemical and histopathological abnormalities has been studied in 39 first degree relatives of patients with primary biliary cirrhosis (PBC) and in 58 first degree relatives of patients with chronic active hepatitis (CAH). Tissue antibodies were more frequent in relatives than in age- and sex-matched controls. Abnormal immunoglobulin levels were demonstrated in about half of the relatives. Very high antibody titres to measles and rubella occurred only in the relatives of the patients with CAH. Moreover the raised titres tended to be clustered in a few families in which also the propositi had very high viral antibody titres. Liver biopsy was performed only on the relatives with biochemical abnormalities. Unspecific inflammatory changes were observed in 5 relatives of the patients with CAH and in 4 relatives of the patients with PBC. An active liver disease was detected in two relatives of the PBC-group and in one of the CAH-group. A marked accumulation of various immunological and histopathological abnormalities in four families was observed.

Adolescent↗

Orcein positive hepatocellular material in long-standing biliary diseases. I. Histochemical characteristics.

Orcein positive material, which accumulates in liver cells in long-standing biliary diseases, was studied histochemically in 5 patients with primary biliary cirrhosis. The material was highly basophilic after previous oxidation of tissue sections and could be demonstrated by orcein at pH 2, alcian blue at pH 0.2, and toluidine blue at pH 2.5. The comparative experiments suggested that sulphonic acid residues in orcein positive material after the oxidation were responsible for the staining reactions. In addition, the staining characteristics indicated the protein nature of the material. The staining reactions suggested that orcein positive material is associated with copper in liver cells and indicated the presence of a copper-protein complex. In contrast to orcein and alcian blue reactions, the oxidation of tissue sections abolished the positive histochemical reaction for copper. This was considered to indicate a dissociation of the copper-protein complex and an oxidation of the liberated sulphydryl groups to sulphonic acid residues, which are probably responsible for the basophilic staining reactions.

Alcian Blue↗

Orcein positive hepatocellular material in long-standing biliary diseases. II. Ultrastructural studies.

An ultrastructural study of liver cells was performed on 4 patients with primary biliary cirrhosis (PBC) and on 3 patients with chronic active hepatitis (CAH). In liver cells of PBC patients large (ad 2-3 mu in diameter) particles were seen, which morphologically resembed autophagic vacuoles or large secondary lysosymes. The morphology, size, location, and quantity of these particles corresponded to the orcein positive material seen in light microscopy of adjacent sections in specimens from PBC patients. These large particles were not seen in liver cells of CAH patients, which also lacked the orcein positive material in light microscopy. The author suggests that the observed particles indicate the activation of lysosomal compartment in liver cells in PBC, and that the orcein positive material (copper-protein complex accumulating in liver cells in chronic cholestasis) is taken into the phagolysosomal metabolism and processing in liver cells, and possibly resembles in this respect the intracellular metabolism of iron-compounds.

Adult↗

The occurrence of orcein-positive hepatocellular material in various liver diseases.

Liver specimens from 103 patients with various hepatic diseases and from 297 consecutive liver biopsies examined routinely were stained with orcein after oxidation of the tissue sections with potassium permanganate. Orcein-positive dark brown cytoplasmic material could be demonstrated in 27 cases with long-standing cholestasis. These patients had either primary biliary cirrhosis, the cholestatic liver disease of ulcerative colitis or chronic active hepatitis, advanced alcoholic cirrhosis or secondary biliary cirrhosis due to extrahepatic biliary obstruction. Orcein-positive material could not be demonstrated in congenital disorders of bilirubin metabolism or in hemochromatosis. Similarly, it could not be found in acute, toxic, alcoholic or chronic persistent hepatitis.

Adult↗

Histological characteristics of chronic hepatides and primary biliary cirrhosis with special reference to orcein positive hepatocellular accumulations.

The histological criteria of chronic hepatides (chronic persistent and aggressive hepatitis) and primary biliary cirrhosis are well characterized and documented in the literature. Histology forms the diagnostic basis for chronic hepatides. Diagnostic changes are seen, however, only in some cases of primary biliary cirrhosis (PBC) and only in the early stages of the disease. Difficulties are met especially in differentiating PBC from chronic aggressive hepatitis (CAH). There is a considerable histological overlap and mixed forms occur. Orcein-positive material, which is a copper-binding protein with high content of sulphydryl groups, accumulates in liver cells in long standing cholestatic liver diseases and can be demonstrated histochemically in routine biopsy specimens. It is seen in PBC in at least 70% of biopsy specimens which confirms the biliary nature of the disease. In CAH orcein positive material can be demonstrated in 20% of specimens but only from patients who also have features of PBC. This group of patients may therefore have both biliary disease are hepatocellular damage, and can be separated from CAH by the orcein method.

Chronic Disease↗

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↗

The effect of hepatic dearterialization and re-dearterialization on carcinoid liver metastases.

A 48-year-old woman with severe carcinoid syndrome caused by multiple liver metastases was treated by hepatic dearterialization. After the operation, urinary 5-HIAA excretion fell transiently to normal levels and the patient was symptom-free for six months. After one year the symptoms of carcinoid syndrome had recurred and a re-dearterialization was performed. A favourable clinical effect was again achieved, but the relief of symptoms lasted only six months. The changes in urinary 5-HIAA excretion and SGOT, SGPT, bilirubin, alkaline phosphatase, cholesterol, PP activity as well as serum protein levels were uniform after both operations to an astonishing degree. Histological specimens taken at reoperation showed that the carcinoid metastases in the anterior parts of the liver were largely necrotic. The necrotic areas has peculiar features, e.g. the necrosis was partly incomplete and ghost like carcinoid structures could be seen.

Alanine Transaminase↗

Heterogeneity in susceptibility to chronic gastritis in relatives of gastric cancer patients with different histology of carcinoma.

The morphological state of gastric body mucosa was examined in 269 first-degree relatives of 64 index patients with gastric carcinoma and in 142 subjects selected at random. Gastric carcinoma was divided into three groups according to histological properties: carcinoma mucocellulare, carcinoma adenomatosum, and carcinoma anaplasticum. The state of gastric body mucosa was divided into five stages: normal, superficial gastritis, slight moderate, and severe atrophic gastritis. The results were subjected to the numerical analysis based on the stochastic theory. The term 'age-adjusted score' (AAS) employed therein defines the individual susceptiability to chronic gastritis. In terms of AAS, the material could be divided into 'high' and 'low' gastritis risk families. It appeared that the subjects belonging to carcinoma mucocellulare index patient families had a significantly higher susceptibility to chronic gastritis than the other relatives examined. These families were also significantly concentrated in the group of 'high risk' families. The heterogeneity of the relatives of gastric cancer patients as regards their gastritis risk should obviously be taken into account in future epidemiological studies. These findings constitute further justification of the genetic approach in studies concerning gastritis-gastric cancer relationship.

Adolescent↗

Ulcer simulating gastric carcinoma. II. Histopathology and survival.

Forty eight benign-ulcer-simulating gastric carcinomas treated at the Second Departmxamined histologically. Twenty two cases (46%) were classified as adenocarcinomas, 15 (31%) were mucocellular and 11 (23%) were anaplastic poorly differentiated forms. Invasion was limited in the histological specimens to the mucosa or submucosa in 20 cases (43%) which also fulfilled the criterias for early gastric carcinoma. The five year survival rate, by the actuarial method, was 63%, which is good if compared with that of all gastric carcinomas. The good prognosis can mainly be explained by the high percentage of early carcinoma for which the 5 year survival rate was 77%.

Adenocarcinoma↗

Orcein positive hepatocellular material in histological diagnosis of primary biliary cirrhosis.

Liver biopsies from 18 patients with primary biliary cirrhosis (PBC) and from 25 patients with chronic active hepatitis (CAH) were stained by orcein after oxidation of the tissue sections with potassium permanganate. In 15 out of the 18 cases which could be classified on clinical, biochemical and immunological basis as PBC, the hepatocytes, usually periportally, contained cytoplasmic stainable material. 5 out of the 25 CAH patients contained the same material, but four of these patients were clinically atypical and showed features of cholestatic form of CAH and features crosslinking with PBC. All patients in both groups were serologically hepatitis-B antigen negative. The orcein staining method seems to be a reliable addition to differentiating histologically between PBC and CAH.

Adult↗