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Biomedical subjects

S Sutinen

Publications and source records attributed to S Sutinen.

At least 55 records · Page 3Linked to original sources
PubMed1983

Treatment of noninsulin-dependent diabetes mellitus with enzyme inducers.

Although treated adequately with antidiabetic drugs, diet, exercise, and education, patients with noninsulin-dependent diabetes mellitus (NIDDM) may develop resistance to treatment. In NIDDM hepatic microsomal enzyme activity is reduced and since postreceptional glucose metabolism is influenced by these enzymes, we treated the subjects with enzyme-inducing drugs. These inducers (phenobarbital and medroxyprogesterone acetate) when added as adjuvant therapy to sulfonyl urea regimen, reduced blood glucose and plasma insulin, and increased microsomal enzyme activity (as indicated by increased antipyrine metabolism). A trial with placebo did not alter serum glucose levels. Body weight fell and serum aminotransferase levels were normalized. These changes were reflected by reduction of liver fat content (determined by light microscopy), by increased surface density of smooth endoplasmic reticulum, and by repairation of the plasma cell membrane of hepatocytes, as seen in electron micrographs. Activation of postreceptional events in hepatocytes may thus be a new approach in the treatment of therapy-resistant type II diabetes.

Aged↗
PubMed1983

Liver damage in nurses handling cytostatic agents.

Three consecutive head nurses developed liver injury after years of handling cytostatic drugs. They had neurological symptoms associated with elevated serum alanine amino-transferase (ALAT) and alkaline phosphatase (ALP) levels. Liver histology showed portal hepatitis with piecemeal necrosis in one of them, the others had hepatic fibrosis and fat accumulation. The subjects' livers were metabolically active as reflected by adaptive and toxic changes in cellular ultrastructure. After withdrawal of the drugs, serum ALAT and ALP values fluctuated between normal and 2-3 times elevated. Follow-up biopsies demonstrated an increase in collagen fibres and a decrease in microsomal enzyme activity, as reflected by arylhydrocarbon hydroxylase activity in vitro. The findings suggest that handling of cytostatic drugs may insidiously damage the liver, which, with time, seems to lead to irreversible fibrosis.

Adult↗
PubMed1983

Histological subtypes or grading of pulmonary adenocarcinoma. A histochemical and electron microscopic study.

To reveal whether the different histological subtypes of pulmonary adenocarcinoma are composed of different types of cells, we analyzed basic mucus histochemistry and ultrastructural features in a series of 61 adenocarcinomas correlating the findings with four ways of histological classification and grading. 82% of the tumours were composed of a single and 18% of two or more cell types. The original WHO classification had no association with the histochemical or ultrastructural features studied. A modified WHO classification, however, based on the prevailing subtype, had significant associations with five, a classification based on prevailing growth pattern with four, and histological grading with eight histochemical and electron microscopic features. The results suggest that it is more important to classify pulmonary adenocarcinomas by histological grades than by subtypes.

Adenocarcinoma↗
PubMed1983

The value of roentgenologic screening in lung cancer.

A series of 446 patients with lung cancer were followed for 5 yr or until death to find out whether the mode of detection of the cancer affected their prognosis. The patients were divided into 2 groups. Group A: patients whose cancer was diagnosed in mass radiography, or some other health examination, or in an examination for another disease. Group B: patients who had consulted a doctor on account of their symptoms. Of the patients in Group A, 50% were alive 1 yr after diagnosis and 5% after 5 yr. The corresponding figures in Group B were 24% and 4%. In 127 patients, an abnormal shadow could already be seen in roentgenograms taken 6 months or more before diagnosis. These patients survived longer than the others, 9% being alive 5 yr after diagnosis. The results do not suggest that roentgenologic screening improves the prognosis for lung cancer.

Adenocarcinoma↗
PubMed1983

Does the location of lung cancer affect its prognosis?

A series of 446 patients with lung cancer, comprising all the patients in a defined population who had lung cancer diagnosed over 4 years, were prospectively studied and followed up for 5 years or until death. Epidermoid carcinoma was relatively more common among the central tumours, and adenocarcinoma among the peripheral tumors; 79% of adenocarcinomas, but only 36% of epidermoid carcinomas being peripheral. The survival rate was significantly worse for the patients with central rather than peripheral tumours, although even so, only 3% of the former and 7% of the latter were alive 5 years after diagnosis. The patients with a tumour extending to the main bronchi had a poor prognosis. There was no consistent difference in the lobar distribution of the various histological types, and the prognosis was similar irrespective of the lobar location of the tumour. Unless located in the main bronchi, the site of lung cancer may be of little importance to the prognosis.

Adenocarcinoma↗
PubMed1983

Pulmonary fibrosis, with sarcoid granulomas and angiitis, associated with handling of mouldy lichen.

We report a case of extrinsic allergic bronchiolo-alveolitis associated with handling of mouldy lichen. The patient had periodic dyspnoea, cough and mucoid sputum, and a micronodular infiltration of both lungs with slight restrictive ventilatory insufficiency. An open lung biopsy showed interstitial inflammation and fibrosis with sarcoid granulomas and angiitis. The symptoms disappeared during long term corticosteroid therapy, but reappeared every year when the patient participated in the handling of lichen (Cladonia alpestris). Precipitating antibodies against Aspergillus fumigatus, A. umbrosus, and Thermoactinomyces vulgaris, were detected in the patient's serum, and against a mixture of fungi including A. terreus, Rhizopus spp., Cladosporium spp., and Penicillium spp., isolated from mouldy lichen storage boxes. After she retired, her symptoms disappeared and the lung function tests showed a slight improvement. In Northern Finland, farmers generally participate in lichen collection. Antigens from mouldy hay and from mouldy lichen may represent a double occupational hazard for them.

Adult↗
PubMed1983

Extrinsic allergic bronchiolo-alveolitis: serology and biopsy findings.

Because the diagnosis of extrinsic allergic bronchiolo-alveolitis is usually on a clinical and serologic basis, recent histopathologic descriptions of the syndrome are rare. As the etiology may vary in different countries, so perhaps may the histopathology? Clinical and serological examination was combined with histopathology of open lung biopsy from 14 northern Finnish patients. All of them, after exposure to mouldy dust, had a typical clinical syndrome with cough and/or dyspnoea, some radiographic changes, and a reduced VC and/or DCO. Precipitating antibodies were demonstrated in 11 patients. Histopathologically, oedema, macrophages and granulomas were found in all patients, as were lymphocytic and plasmocytic infiltrates. Inflammatory changes were alveolar, interstitial and bronchiolar, including bronchiolar granulomas in all but one case. None of the patients had severe fibrosis or emphysema. There were no examples of clear-cut acute or chronic stages as described in previous studies. Instead, most of our specimens represented an "intermediate" stage, indicating differences in exposure or susceptibility of the population compared with other countries.

Alveolitis, Extrinsic Allergic↗
PubMed1982

Liver injury in subjects occupationally exposed to chemicals in low doses.

The hepatic injury developing during occupational exposure to chemicals was investigated in 23 male patients, aged 23-49 years, by comparing case histories, liver function tests, hepatic microsomal enzyme activities in vivo and in vitro with histology. The subjects, 15 chemical industry workers and 8 painters, had disturbed liver tests after years of exposure to solvents, paints and lacquers. Characteristic for the patients was a 2-4-fold increase in serum aminotransferases associated with normal liver or reactive hepatitis with or without fatty liver. All patients, except subjects with fatty change, had metabolically active liver which was reflected as adaptive and toxic changes in cellular ultrastructure. The biochemical liver tests normalized within 3-6 weeks after cessation of the exposure. The findings demonstrate that occupational exposure to chemical solvents may insidiously damage the liver. The injury is detectable by biochemical, metabolic and histological investigations in the early phase.

Adult↗
PubMed1982

A scanning and transmission electron microscopic study of pulmonary adenocarcinoma with histological correlation.

The three-dimensional growth pattern and cell shape and surface of 26 adenocarcinomas of the lung were studied by scanning electron microscopy. The prevailing subtype according to the WHO histological classification, grade of differentiation and secretion of mucosubstances were determined by light microscopy, the tumour cells being further characterized by transmission electron microscopy. The series included 5 acinar, 12 papillary, 1 bronchiolo-alveolar and 8 solid subtypes of adenocarcinoma. Out of these 5 acinar, 9 papillary and 1 bronchiolo-alveolar carcinomas were well or moderately, and 1 solid carcinoma was moderately differentiated. One acinar, 2 papillary and 7 solid carcinomas were poorly differentiated. All tumours secreted mucosubstances, which in the solid carcinomas occurred as intracytoplasmic vacuoles. In acinar adenocarcinomas there were columnar tumour cells surrounded by fibrotic stroma. In the papillary and bronchiolo-alveolar subtypes the tumour cells formed papillary nodules along the alveolar walls while the solid subtype showed no organized structures. The tumour cells were mostly cylindrical or club-shaped in well and moderately differentiated and spherical in less differentiated neoplasms. In well differentiated papillary carcinomas the tumour cells were tightly attached to each other, whereas many moderately and all poorly differentiated carcinomas had broad intercellular spaces. Tumour cells with microvilli occurred more often in the acinar, papillary and bronchiolo-alveolar subtypes, which were mostly well or moderately differentiated, than in the mostly poorly differentiated solid subtype of pulmonary adenocarcinoma, which often had a rough apical surface with microridges. In conclusion the three-dimensional growth pattern corresponded fairly well with the prevailing histological subtype and the surface structure of cancer cells seemed to reflect the grade of differentiation in pulmonary adenocarcinomas.

Adenocarcinoma↗
PubMed1982

Accuracy of postmortem radiography of excised air-inflated human lungs in assessment of pulmonary emphysema.

The accuracy of radiography of excised air-inflated lungs in assessing pulmonary emphysema at necropsy was evaluated in a series of 107 adults who had died in hospital by reading the radiographs and examining the pathological specimens independently. The radiographic and pathological assessments of the severity of emphysema correlated significantly (r = 0.87, p less than 0.0001). Mild emphysema was recognised radiographically in 88.7% and moderate in 94.9% of the lungs. One of 16 normal lungs (6.3%) was radiographically diagnosed as showing mild emphysema. Six out of 53 lungs (11.3%) with mild emphysema were radiographically assessed as normal. The correct radiographic recognition of the type of emphysema was possible in 86% of lungs with mild and 97.4% with moderate centrilobular emphysema and in 81.8% and 87.5% respectively of the lungs with mild and moderate paracicatricial emphysema, but in only 25.0% and 28.6% of the lungs with mild and moderate panlobular emphysema. Radiographical diagnosis of centrilobular and paracicatricial emphysema was verified pathologically in all lungs showing mild emphysema, but that of panlobular emphysema in only 66.7%. Radiography of excised air-inflated lungs is a rapid, convenient, and reliable method of recognising and assessing the severity of appreciable degrees of centrilobular and paracicatricial emphysema, but less reliable in recognising panlobular emphysema. After the procedure the specimen remains available for almost any other technique.

Adult↗
PubMed1981

Survival among patients with lung cancer. An epidemiologic study.

A series of 446 patients with lung cancer, comprising all cases diagnosed in a defined population of approximately 300,000 persons during a period of 4 yr, were studied prospectively and followed for 5 yr or until death. Histologic or cytologic confirmation of the diagnosis was achieved in 431 cases (97%). Only 140 patients (31%) were alive 1 yr after diagnosis, and only 19 patients (4%) were alive after 5 yr, with no significant difference between the men and women. The 5-yr. survival rates among patients with epidermoid. small-cell anaplastic, and adenocarcinoma were 6, 2, and 4%, respectively. The patients could also be divided into prognostically meaningful groups according to the symptomatic staging proposed by Feinstein. Of the 427 patients who had died within 5 yr, 410 (96%) had died of lung cancer and only 17 (4%) had died of other diseases.

Adenocarcinoma↗
PubMed1981

Pattern recognition in radiographs of excised air-inflated human lungs. I. Circulatory disorders in non-emphysematous lungs.

To evaluate the patterns of normal lung tissue, alveolar and interstitial oedema, macrophage collections, haemorrhage and infarction in radiographs of excised air-inflated lungs at autopsy, the distribution of these findings in 89 lungs was determined histologically on 441 sections sampled from 59 lungs selected to represent unequivocally the features in question. Normal lung tissue appeared as branching blood vessels with a delicate net-like background. Alveolar oedema gave a fine punctate opacity distributed evenly, and interstitial oedema showed as either short lines perpendicular to the pleural surface, as a network of branching narrow lines, or as long non-branching lines. Macrophage collections associated with chronic congestion showed as a coarsely punctate opacity, but this was often inconspicuous or similar to the pattern of slight alveolar oedema or slight haemorrhage. Massive haemorrhage appeared as a finely macular opacity. Fresh infarction gave a dense wedge-shaped opacity with pleural retraction and a rounded top. An older infarction was less homogeneous with more indistinct borders. The demonstration of thromboemboli without infarction was not possible.

Adult↗
PubMed1981

Pattern recognition in radiographs of excised air-inflated human lungs. II. Acute inflammation in non-emphysematous lungs.

To evaluate the patterns of bronchiolitis, alveolar pneumonia, usual interstitial pneumonia, and local interstitial inflammation in radiographs of excised air-inflated lungs at autopsy the distribution of these findings in 89 lungs was determined histologically on 441 sections sampled systematically. Pathologic-radiologic correlations were then studied on the basis of 33 sections from 24 lungs selected to represent unequivocally the features in question. Discrete alveolar pneumonic infiltrates measuring 2 mm or more in diameter appeared as coarse unhomogeneous macular opacities exhibiting indistinct borders and often following bronchi or bronchioli. Smaller infiltrates or pure bronchiolitis were not distinguishable radiographically. Infiltrates measuring more than 1 cm in diameter appeared confluent with a dense homogeneous centre and indistinct borders. In the midst of the opacities air-bronchograms were often and abscess cavities sometimes visible. Fulminant acute interstitial pneumonia of the usual type showed centrally a dense opacity with air-bronchograms and peripherally trabecular densities distributed non-anatomically. Between the trabecular densities there were uneven punctate opacities and expansion by air-inflation was incomplete. Local interstitial inflammation that caused thickening of the alveolar walls up to 4 time of normal was not distinguishable radiographically.

Adult↗
PubMed1981

Pattern recognition in radiographs of excised air-inflated human lungs. IV Emphysema alone and with other common lesions.

To evaluate at autopsy the radiographic pattern of emphysema alone and with alveolar oedema, haemorrhage or pneumonia in excised air-inflated lungs the distribution of these findings in 89 lungs was determined histologically on 441 sections sampled systematically. Pathologic-radiologic correlations were studied on the basis of 58 sections from 30 lung selected to represent most clearly the features in question. In mild centrilobular emphysema (CLE) the number and calibre of small blood vessels was often reduced. Small translucencies could appear. In moderate CLE vascular changes were always visible and unevenly distributed translucencies in most cases. Some lungs looked slightly rounded. In severe CLE the number of blood vessels was greatly reduced, they were displayed between extensive tissue defects, and the lung looked always rounded. Only mild panlobular emphysema occurred in the material. This was difficult to distinguish radiologically but could show up as a coarse reticular background with a reduced number of blood vessels, and the lung could look rounded. Paracicatricial emphysema appeared as translucent areas around scars. Simultaneous alveolar processes often obscured the blood vessel changes of CLE and could accentuate or hide the tissue defect translucencies. The same alveolar processes were more unevenly distributed in emphysematous than in non-emphysematous lungs.

Adult↗
PubMed1980

Lung cancer in a defined geographical area: history and histological types.

Lung cancer was diagnosed in 446 patients during four years in a population living in a defined geographical area in northern Finland. The series comprised 420 men and 26 women, with a male/female ratio of 16.6:1. The diagnosis was confirmed histologically or cytologically in 431 cases (97%). Epidermoid carcinoma was the most common histological type of tumour in the men, followed by small cell anaplastic and adenocarcinoma, whereas in the women all these types were of equal frequency. Almost all the men, but only about half of the women, were smokers or ex-smokers. The amount smoked daily had no correlation with the histological type of cancer, whereas those patients who had started smoking early had relatively more Kreyberg group I tumours (epidermoid, small cell, and large cell carcinoma) than those who had started smoking late. Cancer was usually detected on the basis of symptoms, but 17% emerged from mass radiography or some health examination, and 12% from examinations for another disease. Fifteen per cent of the patients had no symptoms at the time of diagnosis, this being more common among the patients with epidermoid or adenocarcinoma than among those with anaplastic forms.

Adenocarcinoma↗