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Biomedical subjects

T Juvonen

Publications and source records attributed to T Juvonen.

At least 91 records · Page 5Linked to original sources
PubMed1994

Segmental mediolytic arteritis--electronmicroscopic and immunohistochemical study.

We examined specimens of human gastroepiploic artery aneurysm from a patient having several visceral aneurysms using electronmicroscopic and immunohistochemical techniques. The histopathological and ultrastructural findings confirmed the diagnosis of segmental mediolytic arteritis. Arterial smooth muscle cells from the gastroepiploic artery contained cytoplasmic vacuoles, media was thin and the internal elastic membrane showed distortion. X-ray microanalysis revealed calcium deposits in the medial extracellular space. Antigenic determinants of human immunoglobulins, fibrinogen, complement C3a and factor VIII were demonstrated in the injured artery wall, suggesting that immunocomplexes deposited in the artery wall may be associated with local injury. These findings support the role of autoimmune disorders in the pathogenesis of segmental mediolytic arteritis.

Aged↗
PubMed1994

Spontaneous intraabdominal haemorrhage caused by segmental mediolytic arteritis in a patient with systemic lupus erythematosus--an underestimated entity of autoimmune origin?

We describe the sixth known case of segmental mediolytic arteritis and the third in a survivor. A 70-year-old woman had intraabdominal bleeding due to a ruptured aneurysm of the omental artery. Interestingly, this patient also had a systemic lupus erythematosus. This report gives further support to the role of immune abnormalities underlying segmental mediolytic arteritis.

Aged↗
PubMed1994

Distribution of the carbonic anhydrase isoenzymes I, II, and VI in the human alimentary tract.

The distribution of carbonic anhydrase isoenzymes I, II, and VI was studied in the human alimentary tract using specific antibodies to human isoenzymes in conjunction with the immunoperoxidase technique to elucidate the physiological role and possible functional interplay of carbonic anhydrases (CAs) in alimentary canal functions. From the isoenzymes studied, CA II was found to be the most widely distributed in the various epithelia throughout the alimentary canal. In addition to the acinar cells of the parotid and submandibular glands and the duodenal Brunner's glands, it was present in the mucosal epithelium of the oesophagus, stomach, duodenum, and colon. The epithelial cells of the hepatic bile ducts, gall bladder, and pancreatic ducts also contained CA II in abundance. In contrast, CA VI was present only in the serous acinar and ductal cells of the parotid and submandibular glands, and CA I in the mucosal epithelium of the colon and the A cells of the pancreatic Langerhans's islets. These results suggest that CA II as a widely distributed isoenzyme in the epithelia of the alimentary canal and CA VI as secreted into saliva, may form a mutually complementary system protecting oesophageal, gastric, and intestinal mucosa from acidity.

Carbonic Anhydrases↗
PubMed1994

Acute phase response in patients with uncomplicated and complicated endoscopic retrogradic cholangiopancreaticography.

Acute phase response after endoscopic retrogradic cholangiopancreaticography (ERCP) was studied in 42 patients with suspected pancreatic or biliary diseases. In uncomplicated cases acute phase response determined by serum C-reactive protein levels was rare and did not parallel the serum amylase or lipase levels. In three of the these 42 patients, post-ERCP pancreatitis developed and CRP levels elevated sharply and paralleled the degree of pancreatitis. Six additional patients outside of this prospective study with post-ERCP-pancreatitis and daily CRP determinations were used to determine the CRP-response curve in post-ERCP pancreatitis.

Acute-Phase Reaction↗
PubMed1994

High-activity carbonic anhydrase isoenzyme (CA II) in human gallbladder epithelium.

Acidification of bile is one of the factors that prevents calcium precipitation and thereby gallstone formation. Carbonic anhydrase II (CA II) has previously been shown to be one of the key factors in the human alimentary tract that regulates the acid-base balance. We demonstrated CA II expression in the human gallbladder epithelium using immunohistochemical techniques, elucidated the CA II content of the epithelium by digital image analysis of the immunohistochemically stained enzyme in samples from 16 patients undergoing cholecystectomy, and correlated the results with the calcium content of the gallstones. Nine patients had symptomatic gallstone disease and seven an acalculous, histologically normal gallbladder. The patients were classified into two groups on the basis of the calcium content of their gallstones: no gallstones or gallstones containing no calcium (Group 1) and gallstones with 2-87% calcium by weight (Group 2). The immunohistochemical techniques showed distinct epithelial CA II-positive staining in most of the gallbladder samples, but digital image analysis revealed distinct variations in staining intensity among them. The median staining intensity index was significantly higher in Group 1 (0.4463) than in Group 2 (0.2376; p = 0.0262). The results suggest that CA II is abundantly expressed in the normal gallbladder epithelium and that decreased expression may be associated with the formation of calcified gallstones. These findings are relevant to the pathogenesis of gallstone disease.

Adult↗
PubMed1994

Long-term outcome after renovascular surgery. Comparison between thoracoretroperitoneal/saphenous vein and transabdominal/Dacron prosthesis bypass grafting.

The outcomes of 16 patients operated on for renovascular hypertension (RH) are analyzed. Eight had undergone surgery by the thoracoretroperitoneal approach with saphenous vein bypass grafting, and 8 by the transabdominal approach with a Dacron prosthesis. Distinct differences in favour of the former group were found after an average of 6 years of follow-up.

Abdomen↗
PubMed1994

Acute type A aortic dissection--diagnostic aspects and surgical experience.

Acute type A aortic dissection was surgically treated in 33 patients aged 20-65 years, all critically ill on admission to hospital. Transthoracic echocardiography revealed pericardiac tamponade in eight cases of extreme emergency, indicating surgery without need of additional imaging. Transesophageal echocardiography provided a definitive diagnosis in 16 cases, with excellent reliability and no false positive findings. Composite graft replacement with button technique was used in 24 patients and other methods of repair in nine. The perioperative mortality was 12% (4/33) and the late mortality 7% (2/29). The actuarial 5-year survival rate was 73%. No aortic root reoperation was required during follow-up for a mean of 4 years. Transesophageal echocardiography proved to be an accurate tool for speedy diagnosis of acute type A aortic dissection and open composite graft replacement with button technique highly satisfactory treatment, avoiding late aortic root problems.

Acute Disease↗
PubMed1994

Demonstration of a bioactive elastin-derived peptide (Val-Gly-Val-Ala-Pro-Gly) in vascular lesions characterised by the segmental destruction of media.

An antibody to elastin-derived chemotactic peptide Val-Gly-Val-Ala-Pro-Gly was used to study human artery samples from 18 patients with various vascular lesions, such as aneurysms or occlusive arteriopathy. The antibody recognised epitopes in two artery specimens, one occlusive arteriopathy and one aneurysm, and both specimens were also characterised by a segmental destruction of media. The positive staining for the peptide was located in the elastic membranes and endothelial cells that were also stained with antibodies to IgG. This study suggests that elastin-derived chemotactic peptides may have a role in vascular lesions characterised by a destruction of media and a formation of aneurysm. Since elastin-derived chemotactic peptides are more chemotactic to monocytes than to neutrophils, it is possible that mononuclear phagocytes are involved in the segmental destruction of elastin.

Adult↗
PubMed1994

Characteristics of symptomatic gallbladder disease in patients with either solitary or multiple cholesterol gallstones.

Recent studies have indicated that solitary or multiple gallstones may differ with respect to the conditions favoring their formation, such as nucleation time. We examined the clinical, histological and laboratory characteristics of symptomatic gallstone disease in a series of 125 consecutive patients with either solitary (n = 33) or multiple (n = 92) cholesterol gallstones undergoing cholecystectomy. The nature of biliary pain was found to differ in the two groups. Histological diagnoses of acute cholecystitis and gallbladder cancer was more frequent in the patients with multiple stones, and cholesterolosis in those with solitary stones. Furthermore, the stone cholesterol content was higher in the solitary stone group than in the multiple stone group. Morbid complications such as cholangitis and pancreatitis were rare and occurred only in the multiple stone group. The results support the view that gallbladder disease presents histological evidence of biliary complications more often in patients with multiple cholesterol stones than in those with solitary stones.

Adult↗
PubMed1993

Carbonic anhydrase isoenzymes II and I are present in the zona glomerulosa cells of the human adrenal gland.

Human carbonic anhydrase isoenzymes I and II (HCA I and II) were purified from human erythrocytes by inhibitor affinity chromatography and ion-exchange chromatography. These isoenzymes were then located in the human adrenal gland using specific polyclonal antisera raised in rabbits and specific detection by immunohistochemical techniques. Both HCA II and I were located in the zona glomerulosa cells, although the staining for HCA I was faint. The cells of the zona fasciculata and the zona reticularis failed to stain with either antiserum. Control stainings with preimmune or anti-HCA VI sera were negative. The presence of HCA II and I in the zona glomerulosa cells may be linked to regulation of the biosynthesis or secretion of mineralocorticoids.

Antibody Specificity↗
PubMed1993

Gallstone cholesterol content is related to apolipoprotein E polymorphism.

BACKGROUND: The genetically determined phenotypes of apolipoprotein E are related to variations in lipoprotein levels and in the enterohepatic metabolism of cholesterol and bile acids. The present study was designed to elucidate the role of apolipoprotein E polymorphism in gallstone formation. METHODS: Apolipoprotein E phenotype was determined in 169 consecutive cholecystectomy patients and in 200 controls. The cholesterol content of the gallstones (n = 169), the presence of cholesterol monohydrate crystals of fresh gallbladder bile (n = 142), and the nucleation time (n = 35) were also analyzed. RESULTS: The median cholesterol content of the gallstones was higher in the apolipoprotein E4 category (phenotypes E4/4 and E4/3, 97%) than in the E3 (E3/3, 78%) and E2 patients (E2/2 and E2/3, 76%, P = 0.0003). In E4 patients, cholesterol crystals were found immediately after surgery in 27 of 40 (68%), whereas in E3 and E2 groups in 36 of 88 (41%), and 4 of 14 (29%) of the patients (P = 0.0001). The median nucleation time in E4 patients (2.5 days) was shorter than in patients with E3 (5.5 days) or E2 (6.0 days) (P = 0.0016). CONCLUSIONS: These data indicate that apolipoprotein E polymorphism affects cholesterol content of cholelithiasis. We suggest that this phenomenon is mediated by the altered formation of cholesterol monohydrate crystals in different apolipoprotein E phenotypes.

Adult↗
PubMed1993

Extracellular matrix proteins in bile and serum of patients with gallstone disease.

The relationship of basement membrane to interstitial collagen-related protein metabolism was investigated in a sample of 100 consecutive patients undergoing surgery for gallstone disease. The measurements were performed on both sera and bile specimens using specific radioimmunoassays for type IV collagen, laminin, endogenous intact human type III collagen aminopropeptide and its degradation product, Col. 1. While basement membrane related proteins, type IV collagen and laminin were dominant in the bile, type III collagen related proteins were lower than in the corresponding serum samples. Both the intact type III procollagen peptide and its Col. 1 fragment were, however, found in the bile. The highest bile laminin concentrations were observed in patients with gallbladder fibrosis, whereas type III aminopropeptides were elevated not only in fibrosis and cancer but, most markedly, in acute inflammation of the gallbladder. Bile type IV collagen concentration was also found to vary according to the cholesterol content of gallstones. The results point to differences in the metabolism of various extracellular matrix proteins during the development of gallstone disease. The association between such proteins, the histological alterations in the gallbladder wall and the cholesterol content of gallstones may have implications for the pathogenesis of gallstone disease.

Adolescent↗
PubMed1992

Mediastinal window: a cause of simultaneous bilateral spontaneous pneumothorax.

A case of bilateral spontaneous pneumothorax with critical collapse of both lungs in a previously healthy 19-year-old woman is described. A congenital defect of mediastinal septum was suspected on the basis of roentgenographic findings and confirmed by right-sided thoracotomy. This mediastinal window between the pleural spaces allowed air leaking from a ruptured right lung apical bulla to collapse not only the right lung but also the left. Apical TA stapler resection and right-sided parietal pleurectomy was performed to prevent recurrence.

Adult↗