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Biomedical subjects

H Alaranta

Publications and source records attributed to H Alaranta.

106 records · Page 6Linked to original sources
PubMed1984

Invalidity pension after lumbar disc operation.

A total of 753 patients (328 women, 425 men) below 65 years of age and without previous pension living in the South-West of Finland, were operated on for the first time for lumbar disc herniation during the period 1975-1979. The frequency of a new invalidity pension was observed during a follow up period of two years. Of the 753 patients there were 100 new invalidity pensioners (13%) during one year and 133 (18%) during two years after the first operation. According to a statistical model for the impact of age and nature of work on invalidity pension the greatest risk of pensioning for women was associated with age, pensioning being more than five times higher in the age group 45-54 years than below 35 years. Moderate and heavy work by women constituted a minor risk factor, increasing the risk by less than two times compared with light work. In men the risk correlated clearly to both age and nature of work. Moderate and heavy work increased the risk nearly three times compared with light work. The frequency of pensions among 45-64 year old men was even 6-8 times higher, than the risk for men below 35 years. A second operation increased the risk on average two to three times. Cauda equina syndrome was not a risk factor for receiving an invalidity pension. The primary diagnosis for an invalidity pension was something other than lumbar disc herniation in 20%. Patients with unsatisfactory results after lumbar disc operations account for about 10% of all the new invalidity pensions due to some form of back disease in Finland.

Adult↗
PubMed1983

Performance capacity of trunk muscles in ankylosing spondylitis.

The comparative results of four tests (a dynamometer, a single and a repetitive dynamic and a static test) to determine the performance capacity of trunk muscles in ankylosing spondylitis are reported. Seventeen men and four women, aged 31 to 35 yrs, were examined. Trunk muscle performance was compared with the flexion mobility of the spine and ESR. The best correlation between muscle capacity of trunk extensors and spinal mobility was seen in the static trunk extensor test. The best correlation between muscle capacity of trunk flexors and spinal mobility was seen in the single dynamic test. Because the comprehensive exercise therapy including muscle strengthening is supported by our results and there is no generally recommended test for evaluating the performance capacity of trunk muscles, it seems reasonable to develop such tests of trunk muscles for clinical assessment of ankylosing spondylitis. Clinical trials to ensure the positive effect of well trained trunk muscles in ankylosing spondylitis are still lacking.

Abdominal Muscles↗
PubMed1983

Prolactin and cortisol in cerebrospinal fluid: sex-related associations with clinical and psychological characteristics of patients with low back pain.

Clinical and psychological characteristics of 33 patients with low back pain were correlated with prolactin and cortisol concentrations in cerebrospinal fluid (CSF). A significant sex difference was found in CSF prolactin levels: women secreted more prolactin into the CSF than did men. High CSF cortisol levels were associated with a rhizographically-demonstrable abnormality, suggesting a relationship between cortisol and an 'organic' origin of pain symptoms. Impairment-disability indices also were associated with CSF hormone levels. Moreover, the two hormones had dissociated psychological correlates. Prolactin was related to depression and anxiety, whereas cortisol was related to somatization. Sex differences were observed in the cortisol response to the symptoms of chronic low back pain, especially in the presence of anxiety and somatization. The sex differences in psychoneuroendocrine and emotional responses suggest that male and female pain patients have different coping mechanisms.

Adult↗
PubMed1983

Fibrillation potentials, positive sharp waves and fasciculation in the intrinsic muscles of the foot in healthy subjects.

The extensor digitorum brevis and abductor digiti minimi muscles were examined bilaterally with electromyography in 53 healthy subjects. In 72% of the subjects either fibrillation potentials, positive sharp waves or fasciculation was seen in at least one muscle examined. These slight, usually symmetric neuropathic signs are believed to be associated with normal aging and to some extent also with external trauma to the nerves and muscles in the distal parts of the foot.

Adolescent↗
PubMed1983

Operated lumbar disc herniation: epidemiological aspects.

A total of 1011 operations for lumbar disc herniation were carried out in South-West Finland during the period 1975-1979. Of these operations 907 were first and 104 reoperations. Eleven patients had cauda equina symptoms. There were 856 operations performed on patients living in the area served by Turku University Central Hospital, an area with 455 000 inhabitants. Operations on 778 patients (342 women and 436 men, mean age 41.6 years) were first and operations on 78 patients (36 women and 42 men, mean age 42.7 years) were reoperations (9.1%). Nearly 90% of the patients were between 25 and 54 years of age. Neither heavy nor light work was more common among the first operated or reoperated patients than in the population at large. The monthly variation in the number of operations had no statistical significance. The incidence of operation for first lumbar disc herniation varied yearly from 31 to 36 per 10(5) persons living in the Turku University Central Hospital area.

Adolescent↗
PubMed1977

Neuropathy and the automatic analysis of electromyographic signals from vibration exposed workers.

An automatic analysis of the electromyographic activity of the extensor digitorum communis, first dorsal interosseus and opponens pollicis muscles was performed, and both motor and sensory conduction velocities of the median and ulnar nerves were measured in the study of neuropathic changes that occur in traumatic vasospastic disease. Twenty-eight forest workers and 10 pneumatic-tool operators, all with a long occupational exposure to local vibration of the hands, were studied with these neurophysiological methods and general clinical and roentgenological examinations. Twenty male manual workers with a similar age distribution served as the comparison group. The most sensitive measures which separated the subjects with traumatic vasospastic disease from the nonexposed workers were the conduction velocity of the slower motor fibers of the ulnar nerve, the distal sensory conduction velocity and the motor distal latency of the median nerve. The duration and rise time of the averaged muscular potentials of intrinsic hand muscles correlated especially with those nerve conduction velocities which were the most sensitive in exhibiting neuropathic changes.

Adult↗
PubMedDate not supplied

Accuracy of the Jamar dynamometer.

The purpose of the study was to check the calibrations of six Jamar dynamometers. Five handle positions were tested for each instrument, with the application of seven different external forces, from 5 kg to 60 kg. Between two testers the repeatability was also evaluated. Major differences in testing accuracies were not found according to different breadths of grip. The repeatability of testing accuracy among the two examiners was rather good, varying in average from only 1.2 kg to 1.4 kg per handle position. The error of absolute kilograms increased relating to heavier loads, but the percentage error decreased when the load increased. The accuracy of the older dynamometers was poorer than the accuracy of the newer ones. The normative values of hand grip related to different handle positions are reviewed.

Calibration↗
PubMedDate not supplied

A prospective 5-year follow-up study of 276 patients hospitalized because of suspected lumbar disc herniation.

The study consists of 276 patients who were hospitalized between 1980 and 1982 because of suspected lumbar disc herniation. Treatment choice was based on clinical indications only; no randomization was used. A total of 179 patients were treated surgically and 97 had continued conservative treatment. Both groups were followed-up 1 and 5 years later. Five-year follow-up results showed that 68% of operated patients still had pain in sciatic distribution and 21% were retired. Re-operation frequency was 13.8%. Of non-operated patients, 82% still had sciatica and 26% were retired. Reasons for outcome differences between the study groups are discussed.

Adult↗
PubMedDate not supplied

Clinical, social, and psychological factors and outcome in a 5-year follow-up study of 276 patients hospitalized because of suspected lumbar disc herniation.

The study consisted of 276 patients who were hospitalized between 1980 and 1982 because of suspected lumbar disc herniation. No randomization of treatment was used. On the basis of clinical indications 179 patients were operated on and 97 had further conservative treatment. Results of physical, social, and psychological examinations performed after 1 year were related to the 5-year outcome defined by occupation handicap of the WHO system. For operated patients, subjective working incapacity, sensory deficit of leg, tightness of hamstrings, age, and pain in lumbar extension predicted a poor outcome. Predictive factors for non-operated patients were increased occurrence of occupational hazards and co-morbidity.

Adult↗
PubMedDate not supplied

Cathepsin G in degenerating and healthy discal tissue.

OBJECTIVES: To assess the eventual presence, tissue localization, molecular forms, amount and activity of cathepsin G in the annulus fibrosus. METHODS: Normal non-autolytic disc tissue was collected from cadavers within six hours after death. Degenerate disc samples were collected from low back pain patients undergoing anterior interbody fusion due to severe, discographically verified and painful disc degeneration, and from the posterior parts of intervertebral discs from 10 patients undergoing microscopic discoidectomy because of intervertebral herniation. Avidin-biotinperxidase complex staining of cathepsin G was quantitated by morphometry. Cellular localization was analyzed using double immunofluorescence staining of cathepsin G and CD68, proline 4-hydroxylase or von Willebrand factor. Neutral salt extracts were analyzed by using synthetic cathepsin G substrate in spectrophotometry, dot-immunoblotting and Western blotting. RESULTS: Histological and morphometric image analysis showed increased cellularity, increased numbers of cathepsin G positive cells and neovascularization in degenerated discs compared to control discs. Neutral salt extract of disc tissue, degenerated or normal, in contrast to control material from synovial capsular tissue, did not contain measurable cathepsin G activity, although immunoreactive enzyme was detected in dot-immunoblotting. Western blotting demonstrated that the discal cathepsin G had an apparent molecular weight of 27 kDa. CONCLUSION: Due to its properties and localization in normal and pathologically altered tissue, cathepsin G probably plays both a direct and an indirect role in extracellular matrix degradation in the annulus fibrosus. Extracted cationic cathepsin G was immunoreactive, but was functionally inhibited by serpins or, more likely, by polyanionic proteoglycans and saccharins derived from the connective tissue matrix of the annulus fibrosus.

Adolescent↗
PubMedDate not supplied

Traumatic spinal cord injury as a complication to ankylosing spondylitis. An extended report.

OBJECTIVE: Käpylä Rehabilitation Centre is in Finland the only unit taking care of the subacute rehabilitation activities of patients with spinal cord injury (SCI). The annual incidence of new patients with SCI is 55 (1.1 per 100,000 inhabitants). The ankylosed spine (AS) is reported to be at greater risk for fracture and SCI. The aim of the study was to clarify if this higher risk of ankylosing spondylitis (AS) could also be detected among patients with traumatic SCI rehabilitated at Käpylä Rehabilitation Centre. Further, the aim was to evaluate the characteristics of patients with traumatic SCI as a complication to AS in order to develop prevention of SCI in patients with AS. METHODS: Patient data was gathered from the patient register covering all Finnish patients with traumatic SCI (n = 1,103) rehabilitated at Käpylä Rehabilitation Centre from the year 1979 to 1998. The patient journals were subjected to a detailed and systematic analysis. Data about patients with a history of AS (n = 19; 18 men, 1 woman) was then compared to the data about all the patients with SCI (n = 1,103; 902 men, 201 women). RESULTS: Based on the national prevalence data, the incidence rate of patients with AS for traumatic SCI was found to be 11.4 times greater than expected for the population at large. The mean age of the patients with AS was clearly higher (55.3 yrs) than the mean age of the whole group of patients (36.4 yrs) with traumatic SCI. The neurologic injury was at the cervical level in 84% of the patients with AS, but only in 48% of the patients with traumatic SCI in general. Among the patients with AS, the SCI was caused by slipping in 53% of the cases, whereas slipping was the reason for SCI only in 7% of the cases in general. CONCLUSION: Patients with AS seem to run a higher risk of traumatic SCI than the people at large, and the injury levels are higher. In particular, male patients with advanced AS should be instructed to install preventive devices such as night lights and handrails, supports or head rests when driving a car, and they should avoid walking on slippery surfaces, loose carpets etc. They also should be encouraged to avoid excessive use of alcohol and activities involving the risk of physical injury such as contact sports.

Accidental Falls↗
PubMedDate not supplied

Lumbar spinal canal size of sciatica patients.

Seven measures at the three lowest lumbar interspaces were recorded from conventional radiographs of the lumbar spines of 160 consecutive patients with low back pain and sciatica admitted for myelography and possible surgery. Eighty-eight patients were operated upon for disc herniation, and of the conservatively-treated 72 patients, 18 had a pathologic and 54 a normal myelogram. The results were evaluated after one year using the occupational handicap scales of WHO. Correlations of radiographic measures to stature were moderate and to age small. After adjusting for stature and age, only the male interpedicular distances and the antero-posterior diameter of intervertebral foramen at L3 were greater than those of females. The males with a pathologic myelogram had smaller posterior disc height at L3 and a smaller interarticular distance at L3 and L4 than those with normal myelogram, likewise the midsagittal diameter at L3 and L4 in females. In all patients other measures besides posterior disc height were smaller than those for low back pain patients (p less than 0.001) or for cadavers (p less than 0.001). The only correlation between measures and clinical manifestations was between pedicular length at L3 and limited straight leg raising. Where the disc material had been extruded into the spinal canal, the interpedicular distance was significantly wider. Only anterior disc height at L3 revealed differences between good and poor outcome one year after surgery, as did the interarticular distance at S1 in patients with normal myelogram after conservative treatment.

Adolescent↗
PubMedDate not supplied

Prognostic value of EMG in patients with lumbar disc herniation--a five year follow up.

The prognostic value of EMG in patients treated for lumbar disc herniation was evaluated in 80 patients, 55 were operated and 25 treated conservatively. All patients had an EMG examination before the initial hospitalization or operation. The patients were followed up one year and five years later. The outcome of the treatment was evaluated using a modified WHO handicap classification. The initial EMG finding had no prognostic significance in determining the outcome five years later. A normal EMG finding both at the one year and five year follow-ups was related to a good outcome. Signs of old neuropathy, large motor unit potentials and reduced interference pattern muscles were related to a poor outcome. The EMG findings predict the outcome for these patients only to a limited extent. The overall outcome seems to be influenced to a greater extent by psycho-social aspects than by qualitative aspects of the nerve root lesion detected by the EMG.

Action Potentials↗