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Biomedical subjects

J Eklund

Publications and source records attributed to J Eklund.

At least 19 recordsLinked to original sources

Head posture measurements among work vehicle drivers and implications for work and workplace design.

An increased risk of musculoskeletal disorders, e.g. from the neck region, has been found among professional drivers of work vehicles. The purpose of this study was to identify causes of postural load and implications for vehicle design and work tasks. A second purpose was to develop the methods for measurement and analysis of head postures. Field measurements of head postures for drivers of fork lift trucks, forestry machines, and cranes were carried out. The equipment used was an electric goniometer measurement system, containing a mechanical transmission between the head and the upper trunk. Methods for data presentation and quantification were developed. The results showed that rotatable and movable driver cabins improved head postures and viewing angles substantially. Narrow window frame structures and large, optimally-placed windows were also advantageous. The steering wheel, controls, and a high backrest restricted shoulder rotation, which increased head rotation in unfavourable viewing angles. Improved workspace layouts and work organization factors such as job enlargement decreased the influence of strenuous postures. The results also showed that head postures should be analysed in two or three dimensions simultaneously, otherwise the postures taken will be underestimated in relation to the maximal voluntary movement.

Adult

MAR, a novel high-incidence Rh antigen revealing the existence of an allelic sub-system including Cw (Rh8) and Cx (Rh9) with exceptional distribution in the Finnish population.

We present new genetic evidence obtained from population studies on Finns and from the studies on Finnish blood donors as well as their selected families using an antibody that defines a novel high-incidence Rh antigen MAR. Anti-MAR antibody shows an antithetical relationship to both anti-Cw and anti-Cx. The Rh antigens Cw (RH8) and, more strikingly, Cx (RH9) have each an exceptionally high frequency in Finns. Our studies on their genetic relationship indicate that the three antigens Cw, Cx and MAR behave as if being determined by alleles of the same Rh sub-system. Furthermore, we conclude that this sub-system manifests an inheritance pattern that is distinct from but analogous to that of the two well-known allelic sub-systems of C/c and E/e antigens.

Adult

[Transfusion medicine--Scandinavian recommendations].

At the 14th Nordic Congress on Transfusion Medicine, held in Reykjavik in 1993, it was recommended that every blood bank should have an established programme for the management of screening-positive donors and blood components deriving from them. Other topics discussed at the congress were the education of registrars in transfusion medicine, new screening methods and questions of quality assurance.

Antibodies, Viral

Serum steroids and prolactin during and after major surgical trauma.

Serum levels of cortisol, dehydroepiandrosterone (DHA) and its sulfate (DHAS), 4-androstene-3,17-dione (A-4), 17-alfa-hydroxy-progesterone (17 OHP), testosterone (T, only in males), unconjugated (E1) and total estrone (tE1 greater than 85% estrone sulfate) were studied in six male and two female patients before, during and up to 30 days after aortic graft surgery. All steroids except 17 OHP decreased following induction of anesthesia but, except for testosterone, rose again during surgery to preoperative levels or slightly above. Extremely high peak values for E1 and tE1 and a less pronounced peak for cortisol were noted on postoperative day 2; after that, the levels of these steroids returned to normal. The levels of 17-OHP, DHA and DHAS decreased after surgery and were below preoperative values from postoperative day 4 to day 16 or (DHAS) day 30. In males, 17 OHP showed a pronounced peak 30 min after initiation of surgery, but decreased after that to below preoperative values. Testosterone levels decreased further during surgery and remained very low until postoperative day 16. Major surgical trauma has a rapid, profound and long-lasting effect on gonadal activity, as judged from decreased testosterone levels, while the effect on adrenal steroids is less pronounced. Adrenal delta 4 and delta 5-steroids showed different patterns in the postoperative period, indicating differences in their regulation. The highly elevated estrogen levels on postoperative day 2 probably reflect either transiently elevated peripheral aromatization or decreased estrogen metabolism rather than increased levels of substrate steroids (A-4). The biological significance of this remains to be elucidated.

17-alpha-Hydroxyprogesterone

[Scandinavian recommendations for transfusion medicine].

A central issue at the 13th Scandinavian Congress on Blood Transfusion Medicine was national self-sufficiency in plasma and plasma products, as outlined in the resolution adopted by the Council of Europe in 1990. Delegates also discussed the serological screening of donors to prevent the transmission of infection, new developments in the production of blood components, leukocyte filtration and serological technology.

Blood Banks

Uteroplacental blood flow measured by placental scintigraphy during epidural anaesthesia for caesarean section.

The uteroplacental blood flow was measured before and during epidural anaesthesia for caesarean section in 11 women. The blood flow was measured with dynamic placental scintigraphy. After an i.v. injection of indium-113m chloride, the gamma radiation over the placenta was recorded with a computer-linked scintillation camera. The uteroplacental blood flow could be calculated from the isotope accumulation curve. The anaesthesia was performed with bupivacaine plain 0.5%, 18-22 ml and a preload of a balanced electrolyte solution 10 ml/kg b.w. was given. The placental blood flow decreased in eight patients and increased in three with a median change of -21%, not being statistically significant. No correlation between maternal blood pressure and placental blood flow was found.

Adult

The effect on uteroplacental blood flow of epidural anaesthesia containing adrenaline for caesarean section.

The effect on uteroplacental blood flow of an epidural anaesthesia containing adrenaline for caesarean section was investigated in ten healthy women using dynamic placental scintigraphy with indium-113m and a computer-linked gamma camera. The epidural anaesthesia was performed with 18-22 ml bupivacaine 5 mg/ml with adrenaline 2.5 micrograms/ml followed by an i.v. balanced electrolyte infusion of 10 ml/kg b.w. A significant median decrease in the total maternal placental blood flow of 34% was found (P less than 0.01). There was also a significant decrease in maternal mean blood pressure of 3 mmHg (0.4 kPa) (P less than 0.05) and a significant negative correlation between the change in maternal blood pressure and the change in uteroplacental blood flow (r = -0.69, P less than 0.05).

Adult

Impressions for prosthodontic restorations reproducing narrow spaces and severe undercuts.

Distortion of an impression material may occur in special clinical situations in which the material's elastic limit is exceeded. Impressions were made of a master model designed to test such situations. Three different hydrocolloids and an addition silicone were used in the experiment. An extended setting time had to be used for one material, to prevent it from tearing. When this extended time was used, this material was the dimensionally most accurate material in the test. All materials were accurate in reproducing normally positioned abutments, while some of the impressions failed to reproduce adjacent abutments with particularly narrow interspaces; narrow passages may therefore require further tooth preparation. In the most severely undercut area differences existed among the materials, and sometimes tears occurred. When the papilla is missing, the undercut area should be blocked out to prevent plastic deformation of the impression material, causing inaccurate restorations.

Agar

Perinatal mortality from Rh(D) hemolytic disease in Finland, 1975-1984.

Analysis of 41 deaths from Rh(D) hemolytic disease (HDN) in Finland in the past 10 years revealed that 17 occurred in mothers immunized before anti-D IgG was available and three in mothers immunized by blood transfusion in earlier years. Nine deaths were related to loopholes in the anti-D program and could presumably have been prevented by ensuring that all eligible Rh-negative women received anti-D IgG after delivery and abortion. Six deaths were due to immunization during a first pregnancy after the 28th week and three to maternal immunization despite anti-D IgG. Immunization from these sources can only be reduced by anti-D IgG injected antenatally as well as postnatally, though the complete eradication of HDN seems to be beyond our grasp. Giving anti-D IgG to Rh-negative women after the birth of a Rh-positive infant or after an abortion has been common practice in Finland, the former since 1969 and the latter since 1971. Although anti-D prophylaxis has been very effective in reducing the incidence of Rh(D) hemolytic disease, new cases continue to occur. Since the prophylaxis fails to prevent perinatal mortality, we decided to discover how the mothers whose infants died from HDN had become immunized in the past 10 years.

Blood Transfusion

Phosphate supplementation in parenteral nutrition.

Pronounced serum phosphate deficiency has been shown to be deleterious when starting parenteral nutrition in severely malnourished patients. The consequences of phosphate deficiency and the need for phosphate supplementation in critically ill patients are not well known. Thirty ICU patients randomized into two groups were studied. The patients received complete parenteral nutrition with and without addition of extra phosphate. The low phosphate group got 7.5 mmol phosphate (from the phospholipids in the fat emulsion) and the high phosphate group got 60-80 mmol phosphate/day. There were no significant differences in serum phosphate or calcium levels between the groups. In the high phosphate group the phosphate balance was positive and calcium balance zero while in the low phosphate group both phosphate and calcium balances were negative. The phosphate content in a standard nutrition programme is not sufficient to create a positive phosphate balance. With the addition of 80 mmol phosphate/day a positive balance was achieved. It is hard to establish guidelines for the administration of phosphate in ICU patients. 20-40 mmol may normally be satisfactory but we have shown that ICU patients may need and can tolerate up to 80 mmol/day.

Adult

Quantitation of immunoglobulin classes and subclasses in anti-Rh (D) antibodies.

The isotype profiles of anti-Rh (D) antibodies were measured from 16 serum samples with a solid-phase radioimmunoassay that employed monoclonal anti-isotype antibodies. These antibodies had been standardized in another solid-phase system with the aid of monoisotypic antibodies (e.g., anti-tetanus toxoid of isotype IgG4), and this permitted calculations of the relative concentrations of different isotypes in each anti-D population. Of the heavy-chain isotypes, only IgG1 and IgG3 were found in anti-Rh (D) antibodies. The share of IgG1 varied from 100% (2 sera) to 0% (1 serum) of detected units, and the mean proportion was 73.8%. The remainder was IgG3 (mean share 26.2%). The proportions of kappa and lambda immunoglobulins varied greatly in individual sera, in three sera only kappa Ig and in one serum only lambda Ig could be detected.

Humans