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S Sutinen

Publications and source records attributed to S Sutinen.

At least 37 records · Page 2Linked to original sources
PubMed1986

Tularemia in otolaryngologic practice. An analysis of 127 cases.

Ulceroglandular, glandular, and oropharyngeal forms of tularemia may occur in otolaryngologic patients, frequently causing diagnostic difficulties. A retrospective analysis of 127 patients with serologically proved tularemia in the head and neck region is presented with special reference to diagnostic difficulties. Short case reports of six patients are included. Difficulties seemed to appear especially in the diagnosis of glandular tularemia. Oropharyngeal tularemia is easily confused with infectious mononucleosis. A high degree of suspicion of tularemia is recommended in endemic areas.

Adolescent↗
PubMed1986

Ultrastructure of extrinsic allergic bronchiolo-alveolitis.

Electron microscopic findings in open lung biopsies of 13 patients with extrinsic allergic bronchiolo-alveolitis (EABA) were studied. Eleven of the patients had farmer's lung and two had been exposed to other mouldy dust. Numerous lymphocytes, macrophages and giant cells were found both in the alveolar and bronchiolar lumina. Bronchiolar changes included loss of microvilli on the ciliated cells, granulomas, detachment of basal cells from each other, as well as disintegration of the basement membrane. In the alveoles hyperplasia and hypertrophy of type II (granular) pneumocytes often loosely connected with the basement membrane, were frequently demonstrated. Disintegration of the basement membrane accompanied by detachment of the pneumocytes occurred occasionally. In the interstitium lymphocytes, mast cells and plasma cells predominated. The size and shape of lymphocytes were variable. In addition, some lymphocytes with pseudopods were detected both in alveolar lumen and in the interstitium. Mast cells were found in close connection with plasma cells occasionally. Granulomas consisting of these cells and giant cells were usually present. Foreign material resembling hyphal fragments was found in the giant cells of two patients. The present series emphasizes the role of lymphocytes, macrophages, giant cells and mast cells, in the pathogenesis of EABA. The presence of numerous plasma cells in the lung parenchyma suggests the possibility of local antibody response caused by exposure to inhaled antigens.

Alveolitis, Extrinsic Allergic↗
PubMed1986

Bronchial changes in airborne tularemia.

We describe seven typhoidal tularemia patients without ulcers or lymphadenopathy, who underwent diagnostic bronchoscopy. Four patients had had obvious airborne exposure to F. tularensis during farming activities, and the remaining three had respiratory symptoms also. Bronchoscopical findings were pathological in all cases, varying from local to diffuse haemorrhagic inflammation; in one case a granulomatous tumour was seen. Early histopathological changes in three biopsies consisted of haemorrhagic oedema progressing to a non-specific inflammatory reaction, which could still be found 45 days after the onset of symptoms. Granulomatous inflammation, indistinguishable from tuberculosis or sarcoidosis, was seen in four biopsies from two patients, three to seven months after the onset. Most patients had radiographic hilar enlargement. We conclude that transmission of typhoid tularemia usually occurs through inhalation leading to bronchial changes, which correspond skin ulcerations in ulcero-glandular tularemia, the hilar enlargement corresponding to the lymph node component. We emphasize that usage of the term 'typhoidal' tularemia should be discontinued. Instead, tularemia transmitted through inhalation should be called pulmonary or respiratory.

Adult↗
PubMed1986

Association of bronchiolitis with connective tissue disorders.

Among 173 consecutive open lung biopsies, nine gave a histopathological diagnosis of bronchiolitis. Seven of these patients had some connective tissue disorder (CTD), six of whom are presented in this report; two had classical and one possible rheumatoid arthritis (RA), one ankylosing spondylitis, one scleroderma, and one developed classical RA four years after biopsy. Four of the patients were smokers, most suffered from breathlessness and cough. In terms of lung function three patients had obstruction, one both restriction and obstruction and three a decreased diffusion capacity. For control purposes peripheral lung tissue was studied histologically from 24 consecutive smoking patients without CTD who underwent a lobectomy for cancer. Intraluminal plugs and mucosal lymphoplasmocytic infiltration of the bronchiolar walls were more prevalent and abundant in the CTD patients than in the controls (p less than 0.02 and p less than 0.001 respectively). Two CTD patients also showed some obliterative bronchiolitis. Corticosteroids were effective in one out of four patients treated. One patient improved and the others did not show any progression during the follow up. The results suggest that smoking alone does not explain the lesions of the small airways found in CTD patients, and that bronchiolitis may be specifically associated with the basic disorder in such cases.

Bronchitis↗
PubMed1986

Post-mortem bacterial culture of bronchial mucus and heart blood in hospital and non-hospital autopsies: effect of morgue time and length of hospitalization.

We studied cultures of 109 bronchial mucus and 67 heart blood specimens from unselected hospital autopsies and 40 bronchial mucus and heart blood specimens from unselected non-hospital (forensic) autopsies, performed 1-11 days after death. The most prevalent bacterium was Streptococcus viridans. No association was found between morgue time and the number of species isolated from each bronchial mucus or heart blood specimen in either hospital or non-hospital autopsies, nor between morgue time and the number of occasions different species were isolated from the bronchial mucus or heart blood specimens in either series. Bronchial mucus and heart blood cultures from the hospital autopsies gave more often gram negative rods and less often other microbes in result than those from the non-hospital autopsies (p less than 0.05 and p less than 0.025 respectively). There was a highly significant association between the length of hospitalization and the occurrence of gram negative rods both in the bronchial mucus and heart blood (p less than 0.001 and p less than 0.0001 respectively), a result which probably reflects the ante-mortem colonization of the respiratory tract with gram negative bacilli among hospitalized patients.

Adolescent↗
PubMed1986

Histopathology of human lymph node tularemia caused by Francisella tularensis var palaearctica.

Histopathology of tularemia, caused by type-B strain, tuberculosis, and sarcoidosis were compared in lymph node biopsy specimens from ten patients with tularemia, 26 with tuberculosis, and 14 with sarcoidosis. In very early tularemia there were only reactive changes without necrosis. Abscess necrosis with or without epithelioid cell reaction was observed during the second week and caseous necrosis during the fourth week. Argyrophil fibers were absent from necrotic lesions in tularemia, but, often, also in tuberculosis. In most cases of tularemia and in half the cases of tuberculosis, the inflammatory process extended beyond the capsule of the lymph node. In some cases, tularemia could not be histologically differentiated from tuberculosis, but tularemia was always differentiated from sarcoidosis. Our series of lymph node tularemia seems to represent a milder disease than those cases published earlier. Tularemia should be considered in the differential diagnosis with tuberculosis, toxoplasmosis, and cat-scratch disease.

Epithelium↗
PubMed1986

Hard metal lung disease: a clinical, histological, ultrastructural and X-ray microanalytical study.

Four employees occupied in hard metal grinding work at the same machine shop developed interstitial lung disease after 2-7 years of working. Open lung biopsies from two of them showed giant cell interstitial pneumonia with bronchiolitis. The multinucleate giant cells were shown by electron microscopy to include both pneumocytes and macrophages. The giant pneumocytes were severely damaged, the endoplasmic reticulum being swollen and the few lamellar bodies being small, and some mitoses were visible in the pneumocytes. No mitoses were found in the giant macrophages. Pulmonary dust particles were studied in situ by scanning transmission electron microscopy and energy-dispersive spectrometry. Cobalt was no longer found in most of the pulmonary hard metal particles, but it was regularly detected in grinding dust particles in air samples studied by scanning electron microscopy and energy-dispersive spectrometry.

Adult↗
PubMed1985

Weights of the body and cardiac ventricles in pulmonary emphysema.

We analysed statistically the association of emphysema, determined on inflation fixed specimens, with the weights of the body and heart, and of the cardiac ventricles, weighed separately, in 170 male and 86 female adult autopsies. The cases were grouped according to the cause of death into cardiovascular, cancer and other deaths. In men the body weight was inversely proportional to the severity of emphysema, but no association existed between the body weight and the cause of death. In male cardiovascular deaths the total heart weight, total ventricular weight and the weight of the left ventricle with the septum were also inversely proportional to the severity of emphysema while this was not true in the other deaths. In male cardiovascular deaths a decrease, and in the other deaths an increase, of the weight of the free wall of the right ventricle was associated with an increasing severity of emphysema. In all male deaths, however, the left to right ratio decreased with an increasing severity of emphysema. Thus, pulmonary emphysema is associated both with a general atrophy, including the myocardium, and a mainly relative right ventricular hypertrophy. An absolute right ventricular hypertrophy, however, seems to accompany emphysema only in the absence of other major cardiovascular diseases.

Adult↗
PubMed1985

Detection of antigens in lung biopsies by immunoperoxidase staining in extrinsic allergic bronchiolo-alveolitis (EABA).

Open lung biopsy specimens of 14 patients with extrinsic allergic bronchiolo-alveolitis (EABA) were studied by immunoperoxidase staining with avidin-biotin-complex method using nonconjugated antisera to Micropolyspora faeni, Thermoactinomyces vulgaris, Aspergillus fumigatus, and Aspergillus umbrosus. Antigenic intracellular material was found in macrophages and giant cells of granulomas in the lung tissue of 8 patients. This finding supports the hypothesis which suggests that macrophages and T-lymphocytes contribute to the tissue injury in EABA.

Alveolitis, Extrinsic Allergic↗
PubMed1985

A necropsy study of Pi phenotypes, emphysema, and smoking.

Pi phenotypes, determined post mortem by isoelectric focusing and immunofixation, emphysema, assessed from inflation fixed specimens and smoking history were correlated in 186 hospital necropsies. It was possible to determine Pi phenotype in 98.4% of the specimens. Phenotype M occurred in 87.5%, MZ in a 8.1%, MS in 2.1% and FM in 0.5%. An expected association was found between smoking and emphysema but not between the Pi phenotypes and emphysema. Thus, while smoking is a major aetiological factor, the Pi MZ heterozygous state does not seem to predispose to structural emphysema. However, the small number of cases did not allow an estimation of the risk of smoking in Pi MZ heterozygous persons compared to those with the normal Pi phenotype.

Adult↗
PubMed1984

Immunohistochemical identification of Aspergillus fumigatus in farmer's lung.

Fragments of fungi in a granuloma were demonstrated in lung biopsy specimens of two patients with farmer's lung by using an avidin-biotin-complex method with non-conjugated rabbit antiserum to Aspergillus fumigatus. Our findings suggest that the type IV or cell-mediated immunity at least partly explains the pathogenesis of farmer's lung.

Antigens, Fungal↗
PubMed1984

Diagnosis of emphysema on chest radiographs.

To evaluate how well pulmonary emphysema could be diagnosed on routine chest radiographs by using generally known criteria, a radio-pathologic correlative study was performed in 88 unselected patients with post-mortem verification of emphysema. The signs used were: I. Signs of overinflation as (a) blunting of the costophrenic sinuses and/or depression of the dome of the right diaphragm, (b) widening of the retrosternal airspace and (c) a right or obtuse sternodiaphragmatic angle, II. Irregular radiolucencies. III. Arterial deficiency. If two or more of the above signs were present, a total accuracy of 77% in detecting emphysema was achieved. The irregular radiolucency and arterial deficiency signs were sensitive but less accurate than those of overinflation.

Adult↗
PubMed1984

Hepatic glucose-6-phosphatase activity in non-insulin dependent diabetics. Effect of enzyme-inducing drugs.

The role of glucose-6-phosphatase (G6Pase) in postreceptional glucose handling in non-insulin dependent diabetics ( NIDDs ) was in investigated by comparing the enzyme values in diagnostic liver biopsy samples with fasting blood glucose (BG), immunoreactive insulin (IRI) and plasma antipyrine half-life (T/2). The NIDDs , treated with sulphonylureas, had elevated serum aminotransferase and alkaline phosphatase values associated with fatty liver with or without fibrosis. G6Pase activity was reduced in the NIDDs compared with subjects who had undergone gallstone surgery (p less than 0.001), insulin dependent diabetics (p less than 0.001), and age- and sex-matched non-diabetics (p less than 0.001). G6Pase was inversely related to BG and antipyrine T/2, but not to IRI or conventional liver function tests. Therapy with phenobarbital and medroxyprogesterone acetate, known inducers, increased G6Pase activity, shortened antipyrine T/2, reduced BG and did not alter IRI, in four NIDDs . Low liver G6Pase activity in NIDDs may hence be one factor underlying the impaired glycemic control.

Aged↗
PubMed1984

Postmortem radiographic, histological and bacteriological studies of terminal respiratory infections and other pulmonary lesions in hospital and non-hospital necropsies.

One lung from 109 unselected hospital and 43 unselected non-hospital necropsies was studied using postmortem radiography with histological verification. Signs of acute bacterial infection, including bronchiolitis or bronchopneumonia, were present in 42.2% of the hospital necropsies and infection was the immediate cause of death in 8.3%. There was only one case of incipient bronchopneumonia among the non-hospital necropsies. Emphysema was the most common other pulmonary lesion in both groups. Gram negative bacteria were found significantly more often in the bronchial mucus of lungs with any pulmonary lesion, particularly those with signs of bacterial infection, than in the bronchial mucus of morphologically normal lungs in both groups of patients. In addition, the frequency of infections was associated with length of stay in hospital. This may reflect the prevalence of Gram negative infections in hospitals.

Adolescent↗
PubMed1984

Quantitative x ray microanalysis of pulmonary mineral particles in a patient with pneumoconiosis and two primary lung tumours.

The right upper lung lobe of a 74 year old man was resected for a central tumour. Two primary cancers were found; a central small cell carcinoma and a peripheral squamous cell carcinoma. In addition, the peripheral lung tissue showed generalised peribronchiolar fibrosis extending from the non-respiratory bronchioles to the level of the alveolar ducts. Abundant asbestos bodies and large amounts of black dust were seen around the bronchioles. Pulmonary mineral particles were studied by quantitative energy dispersive x ray microanalysis (EDS) using scanning transmission electron microscopy (STEM). The x ray spectra for mineral particles were measured in thin sections, and the characteristic peak intensities of the elements were converted to weight fractions (in oxides). The results enabled the minerals present to be identified and their presence confirmed by calculating the mineral formula. These originated from nine natural minerals, anthophyllite and chrysotile asbestos, talc, and quartz, feldspars, and muscovite, which are components of sand, and also from two artificial mullites used in fire clay. The exposure history of the patient explained the most likely origins of the minerals detected. The patient had been a mason for 23 years, repairing and demolishing stoves and fireplaces and using asbestos for insulation work.

Aged↗
PubMed1984

Lysosomal gold accumulations in pulmonary macrophages.

Although soluble gold has been widely used in the treatment of rheumatoid arthritis, little is known about the distribution of gold deposits in extra-articular tissues. In the synovial lining cells and articular cartilage, the morphology of lysosomes containing gold, the aurosomes, is well documented. Because gold may cause pulmonary injury, the morphology and distribution of gold deposits in pulmonary tissue should be recognized. We found morphologically typical aurosomes with electron-dense membranes and granules, giving the spectrum of gold in electron microprobe analysis, in the interstitial and alveolar macrophages in the open lung biopsies of 3 patients who had received gold treatment but not in 12 patients who had not received gold treatment. In contrast to previous studies, aurosomes were not found in the endothelial cells.

Arthritis, Rheumatoid↗
PubMed1984

Rheumatoid pneumoconiosis in a dolomite worker: a light and electron microscopic, and X-ray microanalytical study.

A 46-year-old woman suffering from rheumatoid arthritis developed numerous round opacities at the apex of the right lung 11 years after an exposure to dolomite . Resected lung showed discrete nodules, 0.8-2 cm in diameter, with central necrosis surrounded by palisading fibroblasts and a prominent inflammatory zone. A large number of birefringent dust particles were seen in the necrotic centres and around the nodules. By electron microscopy the particles were dense, mostly elongated and lamellar, varying from 0.005 to 3 microns in width, and from 0.1 to 6.5 microns in length. Energy dispersive x-ray microanalysis of the dust particles gave elemental spectra with high spikes of silicon, aluminium and potassium, and minimal magnesium, calcium, iron and titanium. According to chemical analysis, the original dolomite consisted almost entirely of magnesium and calcium carbonates and only of traces of silicon, aluminium and potassium. Apparently the human organism can better eliminate calcium and magnesium carbonates than silicon, aluminium and potassium.

Calcium Carbonate↗