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Biomedical subjects

P Summanen

Publications and source records attributed to P Summanen.

At least 73 records · Page 4Linked to original sources

Bilophila wadsworthia isolates from clinical specimens.

Bilophila wadsworthia is an anaerobic, gram-negative, asaccharolytic, bile-resistant, catalase-positive bacillus that is usually urease positive and was originally recognized in specimens of peritoneal fluid and tissue from patients with appendicitis. Additional isolations from clinical specimens, including a scrotal abscess, mandibular osteomyelitis, axillary hidradenitis suppurativa, pleural fluid, joint fluid, and blood, are described here.

Adult↗

Retinal pigment epithelial cells secrete urokinase-type plasminogen activator and its inhibitor PAI-1.

Secretion of plasminogen activators and their inhibitors was examined in cultures of human retinal pigment epithelial (RPE) cells. The methods employed were zymography and reverse zymography, solid-phase immunocapture assay, metabolic labeling followed by immunoprecipitation, and immunofluorescence. The results showed that these cells produce urokinase-type plasminogen activator (u-PA) and a plasminogen activator inhibitor (PAI) which is immunologically and biochemically similar to PAI-1. Tissue-type plasminogen activator activity (t-PA) was not detected, but we detected small amounts of t-PA in an inactive complex with inhibitor in RPE cell-conditioned media. We conclude that RPE cells have the potential to utilize u-PA-catalyzed plasminogen activation which is subject to regulation by PAI-1. These results may have a bearing on the pathogenesis of proliferative retinal diseases.

Antibodies, Monoclonal↗

An immunohistochemical and prognostic analysis of cytokeratin expression in malignant uveal melanoma.

A group of 52 patients with malignant uveal melanoma treated by primary enucleation in 1977-1979 was studied to determine the frequency of immunoreactivity for cytokeratins (CK) in primary and metastatic melanoma, the CK types present, and the prognostic significance of CK expression. By immunohistochemistry, monoclonal antibody (MAb) V9 to vimentin reacted with all 52 formalin-fixed, paraffin-embedded primary tumors and all 31 metastases from 11 patients. MAb CAM 5.2 to CK 8 and 18 reacted with 20 and MAb CY-90 to CK 18 with 25 primary melanomas, whereas MAb KS-B17.2 and MAb CK5 to CK 18 labeled 8 and 6 tumors, respectively. Antibodies to CK 13 and CK 19 each labeled single cells in one specimen, and other CK types were not detected. In 6 primary melanomas, only a few tumor cells were immunopositive for CK 8 and 18, but in 17 cases up to one quarter, and in 2 tumors more than one quarter, of them were labeled. The positive cells were spindle, epithelioid, or intermediate in shape, and tended to be more frequent in mixed than in spindle cell melanomas. MAbs CAM 5.2 and CY-90 did not react with any of the 16 liver metastases, but labeled 7 of 15 other metastases. Metastases were somewhat more common when the primary tumor was immunoreactive for CK 8 and 18, apparently because CKs were more frequent in mixed cell melanomas. Although CK expression is of diagnostic significance and can denote low levels of epithelioid differentiation, it is not an independent prognostic factor in malignant uveal melanoma.

Adolescent↗

Propionibacterium acnes-enhanced lens-induced granulomatous uveitis in the rat.

Propionibacterium acnes (Corynebacterium parvum) is being implicated more frequently as a cause of intraocular inflammation following cataract surgery. In addition to its role as an infectious agent, P. acnes also may possess adjuvant-like or adjuvant-enhancing properties. The presence of this organism in an eye with residual lens material after extracapsular cataract surgery could augment inflammation resulting from a phacoantigenic (phacoanaphylactic) response. We have modified an established rat model of lens-induced granulomatous uveitis (LIGU) to examine the adjuvant properties of P. acnes. Our results suggest that P. acnes effectively potentiates LIGU.

Adjuvants, Immunologic↗

Are certain oral pathogens part of normal oral flora in denture-wearing edentulous subjects?

A complete loss of teeth may eliminate some pathogenic bacteria for lack of a suitable habitat for colonization. The occurrence of Actinobacillus actinomycetemcomitans, black-pigmented Bacteroides, mutans streptococci, lactobacilli and yeasts was investigated in 51 edentulous subjects with complete denture(s); mean age 74 years (range 44-92 years). None of the subjects had received antibiotics during the preceding 6 months. Four swab samples per subject were taken from the fitting surface of the upper denture, from the palate, buccal mucosae and dorsum of the tongue. At least 0.5 ml of stimulated saliva was collected into a sterile tube. The samples were cultivated aerobically and anaerobically using nonselective and selective media. A. actinomycetemcomitans was not found in any of the samples. Black-pigmented Bacteroides were found in 49 (96%) and yeasts in 25 (49%) of the subjects. Of the 49 saliva samples, 41 (84%) yielded mutans streptococci and 45 (92%) lactobacilli. In contrast to black-pigmented Bacteroides, mutans streptococci and lactobacilli, A. actinomycetemcomitans may not belong to the normal oral flora of edentulous subjects wearing dentures.

Aged↗

The microbiology of chronic sinus disease in children with respiratory allergy.

Chronic maxillary sinusitis is common in children with respiratory allergy and is associated with increased morbidity. The bacteriology of chronic sinus disease in these children has not been adequately evaluated. Between May 1987 and January 1988, 12 children (aged 3 to 9 years), all with documented respiratory allergy and chronic respiratory symptoms consistent with chronic sinusitis (greater than 30 days), were fully evaluated. History, physical examination, complete blood count, nasal smear, and Waters x-ray were done. All patients had opacification of one or both maxillary sinuses, failed to respond to multiple courses of antibiotics, and subsequently underwent maxillary sinus aspiration and irrigation. Specimens were cultured for aerobic and anaerobic organisms with standard technique, and sensitivities were obtained. Culture results revealed a single organism (Moraxella [Branhamella] catarrhalis) in five patients, one patient yielded M. catarrhalis plus Streptococcus species, three were negative, and three patients grew multiple organisms (two with multiple aerobic streptococcal species and one patient with aerobic streptococci and Peptostreptococcus). All children received appropriate culture-directed antimicrobial therapy. Sequential biweekly follow-up revealed progressive radiographic clearing and significant symptomatic improvement. M. catarrhalis is a common pathogen, whereas anaerobic organisms are unusual as a cause of chronic maxillary sinusitis in allergic children. Some children, despite negative cultures, may benefit from maxillary sinus irrigation.

Child↗

The bacteriology of gangrenous and perforated appendicitis--revisited.

By using optimum sampling, transport, and culture techniques in patients with gangrenous or perforated appendicitis, we recovered than has previously been reported. Thirty patients older than 12 years with histologically documented gangrenous or perforated appendicitis had peritoneal fluid, appendiceal tissue, and abscess contents (if present) cultured. Appendiceal tissue was obtained so as to exclude the lumen. A total of 223 anaerobes and 82 aerobic or faculatative bacteria were recovered, an average of 10.2 different organisms per specimen. Twenty-one different genera and more than 40 species were encountered. Bacteroides fragilis group and Escherichia coli were isolated from almost all specimens. Within the B. fragilis group, eight species were represented. Other frequent isolates included Peptostreptococcus (80%), Pseudomonas (40% [P. aeruginosa, 23.3%, other Pseudomonas spp., 16.7%]), B. splanchnicus (40%), B. intermedius (36.7%), and Lactobacillus (36.7%). Interestingly a previously undescribed fastidious gram-negative anaerobic bacillus was isolated from nearly one half of all patients. This organism was found to have low DNA homology (by dot blot) with the known organisms most closely resembling it.

Adolescent↗

Selective medium for isolation of Bacteroides gracilis.

A new medium selective for Bacteroides gracilis was developed. The medium is tryptic soy agar (Difco Laboratories, Detroit, Mich.) containing nalidixic acid, teicoplanin, sodium formate, sodium fumarate, and potassium nitrate. All 18 strains of B. gracilis tested grew with only minimal inhibition. Most of the other 214 organisms tested, including most Bacteroides species, other anaerobes, and a substantial number of facultative anaerobes, were significantly inhibited by the medium. In a diagnostic study of 49 clinical specimens (28 patients with intra-abdominal infection, mostly gangrenous or perforated appendicitis), four strains of B. gracilis were isolated (from 4 different patients) on B. gracilis selective agar but were not detected on standard media.

Agar↗

Peripheral retinal angiomalike lesion and macular pucker.

We interpreted clinical data on five eyes with preretinal macular fibrosis (macular pucker) in association with a solitary angiomalike lesion in the peripheral retina. One angioma was associated with von Hippel-Lindau disease, and the others were regarded as acquired sporadic angiomas occurring in otherwise healthy persons. Regression of the vascular mass occurred as a result of transscleral cryopexy in four eyes and by argon laser in one eye. After treatment, the macular pucker was stabilized, but regression of the preretinal membrane did not occur. The visual acuity improved after cryotherapy in one eye, and in two eyes visual improvement occurred after vitrectomy and membrane removal.

Adult↗

Significance of various systemic and ocular parameters in the long-term prognosis after diabetic vitrectomy.

The presence or absence of retinal detachment, especially detachment of the macula, was the most critical parameter predicting visual outcome, and long duration of detachment worsened the prognosis (P = 0.0084). In contrast, the time interval from vitreous haemorrhage to surgery did not associate with the long-term visual outcome. Pre-operative visual acuity of counting fingers 1 m or better was associated with favourable visual outcome (P = 0.0032). Other pre- or per-operative parameters (e.g. aphakia, iris rubeosis, extent of photocoagulation, retinal breaks) did not associate with visual prognosis significantly. Significant association between general parameters and visual outcome was found only in the group of traction retinal detachment where loss of vision was related to shorter duration of diabetes (P = 0.0213), and shorter duration of background retinopathy (P = 0.0300), and proliferative retinopathy (P = 0.0072).

Adult↗

Bilophila wadsworthia, gen. nov. and sp. nov., a unique gram-negative anaerobic rod recovered from appendicitis specimens and human faeces.

Strongly catalase-positive Gram-negative anaerobic rods were isolated from approximately half of all intra-abdominal specimens received from patients with gangrenous and perforated appendicitis, and subsequently also from normal faecal specimens. The organism was originally detected on Bacteroides-bile-aesculin (BBE) agar, and grew slowly on non-selective anaerobic media containing blood. It was stimulated by bile and differed from other known genera by being urease- and catalase-positive, and by reducing nitrate. It did not reduce sulphate. Other anaerobic Gram-negative rods showed no homology by DNA dot-blot hybridization. The thermal melting profile of chromosomal DNA showed 39-40 mol% G + C. The whole-cell fatty acid methyl ester profile included cyclic and branched long-chain acids, and differed from those of all other anaerobes that have been tested. beta-Lactamase was not detected. The name Bilophila wadsworthia gen. nov., sp. nov. is proposed for this organism.

Appendicitis↗

Subgingival microflora, dental and periodontal conditions in patients with hereditary fructose intolerance.

Hereditary fructose intolerance (HFI) is a rare autosomally recessive disease which leads to severe hypoglycemia. The fructose-free diet of these patients apparently influences dental health. Half of the patients are free of caries, but there are no reports on their periodontal condition nor on the composition of their subgingival microflora. Therefore 18 patient with HFI were examined for the following parameters: radiographic bone loss, caries rate, gingival bleeding, occurrence of calculus, pocket depths, salivary flow rate, buffer capacity and pH from paraffin wax-stimulated saliva. Salivary S. mutans and lactobacilli were also enumerated. Specific antibody titers from whole saliva and serum to Actinobacillus actinomycetemcomitans gamma 4, Bacteroides gingivalis, and Capnocytophaga ochracea were determined with ELISA. Finally the subgingival plaque was analyzed by culture. Altogether 196 anaerobic or microaerophilic isolates representing 29 different species were obtained from the HFI patients and 164 isolates of 26 species from the controls. The frequency of Actinomyces odontolyticus, Veillonella parvula, and Wolinella recta in the HFI patients was significantly high The DMF-induces were lower in the study group than in the controls and so was the occurrence of S. mutans and lactobacilli in the saliva. Of the periodontal parameters examined, the only difference found was an increased incidence of gingival bleeding and calculus formation in the HFI patients. The results suggest that in the HFI patients the common gingival bleeding is associated with the more frequent occurrence of Actinomyces odontolyticus, Veillonella parvula, and Wolinella recta.

Adolescent↗

Long-term visual results of vitreous surgery in diabetic eye disease.

Long-term visual results in the first 124 consecutively vitrectomized eyes of 105 diabetic patients in our department were evaluated. The indications for vitrectomy were unresorbable vitreous haemorrhage (77 eyes, 62%) (group A), central traction retinal detachment (21 eyes, 17%) (group B), and a combination of both (26 eyes, 21%) (group C). Initially visual acuity (VA) improved at least by one category in 83 eyes (67%). The latest postoperative VA after the mean follow-up of 3.7 +/- 0.2 years was greater than = 0.3 in 36 eyes (29%), 0.1-0.25 in 15 eyes (12%), 0.05-0.08 in 9 eyes (7%), counting fingers (CF) 1-less than 3 m in 13 eyes (11%), and less than CF 1 m in 51 eyes (41%). The latest VA of 0.3 or better was significantly more common in group A (40%) than in group B (10%) or group C (12%) (P = 0.0087 and 0.0076, respectively). The most common causes of visual failure (VA less than C F 1m) were neovascular glaucoma and/or retinal detachment. At the latest follow-up visit 50% of the patients had VA of 0.3 or better, 16% were in the low-vision category, and 34% were blind (VA less than 0.05).

Adolescent↗

Vitrectomy for diabetic eye disease. The prognostic value of pre-operative electroretinography and visual evoked cortical potentials.

An investigation was carried out into the prognostic value of standard flash electroretinography (ERG) and visual-evoked cortical potentials (VECP) recorded for 87 diabetic eyes prior to vitrectomy. 95% of the eyes with a recordable ERG b-wave achieved a post-operative visual acuity (VA) of 0.05 or better (positive predictive value), but only 35% of the eyes with a good post-operative VA had a recordable b-wave (sensitivity). The corresponding values for the ERG a-wave were 67 and 72%, and for the VECP 77 and 69%, respectively. A non-recordable b-wave in the ERG was associated with a poor visual outcome (VA less than 0.05) in 45% of cases (negative predictive value), and 97% of the eyes with a poor visual outcome had a nonrecordable b-wave (specificity). The corresponding values for the ERG a-wave were 42 and 37%, and for the VECP 53 and 63%, respectively. Consequently, the odds ratio for an unfavourable visual outcome (VA less than 0.05) was greater for a non-recordable b-wave (15.7) than for a nonrecordable VECP (3.8) or a non-recordable a-wave (1.5). Recordability of the b-wave gave the best prediction for attached macula. Extensive photocoagulation diminished all ERG and VECP amplitudes. Vitreous opacities had no significant effect on the ERG or VECP.

Adolescent↗

Minocycline effects in patients with active trachoma.

Minocycline has a unique solubility in lipids and may reach therapeutic concentrations in tears and saliva. In two consecutive prospective double-masked clinical trials that were carried out in two villages in Saudi Arabia, we assessed the effects of oral minocycline in the treatment of trachoma and compared its effects with those of topical tetracycline ointment in the first study and to tetracycline ointment and placebo in the second study. A total of 178 eyes in 96 patients were included. The age range was 7 to 14 years, with a mean age of 9 years. All patients underwent complete ophthalmologic evaluation. School children were divided into two groups in a double-masked fashion. The first group received either oral minocycline or topical tetracycline 1% ointment and the second group was divided into three subgroups, each receiving one of the following therapeutic modalities: oral minocycline, topical tetracycline ointment, or placebo ointment. All patients were evaluated before initiation of therapy, at three weeks and at 12 months following treatment. Therapy was continued for a period of five weeks. These two double-masked field-based clinical trials have shown both minocycline given orally and tetracycline ointment given topically were effective in decreasing the intensity of inflammation due to trachoma. Oral minocycline was found to be equally effective as topical tetracycline ointment in the treatment of trachoma at three weeks. Minocycline, however, was found to be superior to topical tetracycline when patients were evaluated one year after therapy (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Comparative evaluation of RapID ANA and API 20 A for identification of anaerobic bacteria.

This study evaluated RapID ANA and API 20 A systems for identification of anaerobic gram-positive and gram-negative bacteria isolated from oral and non-oral infections using standard reference methods. A total of 480 isolates were tested in both systems. The RapID ANA system correctly identified 74% of the strains to species level and 17.5% to genus level; 5% were misidentified. The API 20 A system correctly identified 50% of the strains to species level and 24.5% to genus level; 8% were misidentified and 17.5% could not be identified by the API 20 A system.

Bacteria, Anaerobic↗

Exfoliation syndrome among Saudis.

The prevalence of exfoliation syndrome among Saudis was determined during the National Survey of Blindness and Eye Disease in 1984 in Kingdom of Saudi Arabia. The subsample of this study consists of 376 persons aged 40 years or more from 50 different locations examined under mydriasis by the authors using Kowa hand-held microscope. There were 192 men and 184 women with the mean age of 56.0 +/- 1.2 years (median 53.5 years, range 40-95 years). The overall prevalence of exfoliation syndrome was 9.3%: in the age group 40 to 49 years 1.6%, 50 to 59 years 7.8%, 60 to 69 years 8.9%, and 26.5% in persons 70 years of age and over. No significant association was found between exfoliation syndrome and sex or parental kinship. In 16 persons the exfoliation syndrome was unilateral, and in 19 persons bilateral. In 24 eyes the phenomenon could not be evaluated due to the anterior segment pathology. Exfoliation syndrome was associated with higher intraocular pressure (20 +/- 3 mmHg (n = 49) vs. 17 +/- 0.4 mmHg (n = 601), P less than 0.05), and more cataract changes (P less than 0.001) than eyes without. These eyes were also associated with poorer visual acuity than the eyes without exfoliation syndrome: in 26 of 35 persons with exfoliation syndrome, the affected eye was the better eye but in 35% the vision was less than 0.05 (less than 3/60) i.e. the person was blind, compared to 6% of persons whose better eye did not have exfoliation syndrome (P less than 0.001).

Adult↗