[Lung volume reduction procedure in the treatment of severe emphysema].
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Adult↗
Biomedical subjects
J Laitinen
Publications and source records attributed to J Laitinen.
Endotoxins and IgG antibodies as indicators of occupational exposure to the microbial contaminants of metal-working fluids.
OBJECTIVES: The aim of this study was to evaluate workers' exposure to microbes and bacterial endotoxins during the use of metal-working fluids (MWF). METHODS: Air and bulk sampling with biomonitoring of workers' serum IgG antibodies were used to estimate the exposure to biological agents at 18 workplaces. The types of emulsified MWF used were synthetic fluid, mineral oil or rape seed oil, in grinding, turning and drilling work. RESULTS: The endotoxin concentrations in the air ranged from 0.04 to 600 ng/m(3) when the endotoxin levels in MWF were 0.03-25,000 ng/ml. A high correlation was found between the endotoxin levels and the bacterial counts from MWF, as well as between the total culturable bacteria and the gram-negative bacteria concentrations in the air. Comamonas testosteroni and C. acidovorans were the most common strains in the samples but also colonies of Ochrobactrum anthropi, Pantoea agglomerans and Stenotrophomonas maltophilia were isolated from the workplaces. Fungi like Aspergillus, Cladosporium and Penicillium species were identified in the air but only rarely in the MWF. Positive IgG antibodies were found in the sera of 22 of the 25 MWF workers examined. Antibodies against S. maltophilia, P. agglomerans and C. acidovorans were the most common, appearing in 72%, 64% and 64%, respectively, of the cases. The MWF workers showed significantly higher IgG antibody responses to bacterial antigens than did the controls. CONCLUSIONS: The results clearly proved that in occupational hygiene measurements, endotoxins serve as excellent indicators of exposure to the microbial contaminants of MWF. IgG antibodies against antigens identified from workplace samples could be a practical tool for occupational health physicians.
Air Microbiology↗
Associations between dental occlusion and misarticulations of Finnish dental consonants in cleft lip/palate children.
The purpose of this study was to examine whether malocclusions in terms of crossbites, large maxillary overjet, and deep bite are related to the articulatory problems with the Finnish dental consonants /r/, /s/ and /l/ in different cleft types and gender. The subjects were 260 (108 girls, 152 boys) 6-yr-old Finnish-speaking non-syndromic children with isolated cleft palate (CP, n = 79), cleft lip/alveolus (CL(A), n = 76), unilateral (UCLP, n = 78), and bilateral (BCLP, n = 27) cleft lip and palate. Occlusal anomalies were evaluated from dental plaster casts, and speech was analyzed by two speech pathologists with a high reliability. Altogether, 43% of patients misarticulated at least one of the studied sounds, and had crossbites significantly more often (73%) than subjects with correct /r/, /s/ and /l/ production (45%). Posterior crossbites were significantly associated with defective articulation, whereas anterior crossbite alone, large maxillary overjet, or deep bite were not. It was concluded that occlusal abnormalities in terms of posterior crossbites should be considered as a risk factor for correct dental consonant articulation in cleft-affected subjects.
Articulation Disorders↗
Blood pressure and hormonal responses to short whole body cold exposure in subjects with high dietary salt intake.
The objective of the present study was to test a hypothesis that a high dietary salt intake potentiates a cold induced increase in blood pressure in normotensive men. Male subjects (n = 12) were given 7 g day-1 sodium chloride during the cold months of the year, divided in 3-4 doses per day and dissolved in water, for 14 days additional to their normal diet which contained on the average 9.7 g sodium chloride per day. The same subjects, having their normal diet, served as controls. The resting blood pressure was measured on the fourteenth day seven times at the intervals of five minutes in a climatic chamber in thermoneutral conditions. Then the subjects, wearing a three-layer winter clothing, moved into a wind tunnel (-15 degrees C, air velocity 3.5 ms-1) in which they stayed for fifteen minutes and the blood pressure was recorded at the intervals of three minutes. After the cold exposure, the subjects moved back into the climatic chamber for 30 min and the blood pressure was measured as before the cold exposure. Blood samples were drawn before and after the experiment for ion and hormone measurements. A 12 h urine sample was collected just prior to the cold exposure. A significant difference both in systolic (7 mmHg) and in diastolic (7 mmHg) blood pressure was found between a salt load group and control group under thermoneutral conditions, repeatedly measured over 30 min (paired Student's t-test; p < 0.05). During the whole body cold exposure, blood pressure significantly increased both with and without the extra salt load (repeated measures ANOVA, Student-Newman-Keuls; p < 0.05). The level to which the mean arterial pressure increased during the exposure was independent of the salt intake and the profile of the mean arterial pressure curve was similar in both groups. The systolic pressure increased by a 25 mmHg in both groups during the cold exposure. The increase in the diastolic pressure was significantly (paired Student's t-test, p < 0.05) higher in the high salt group (18 +/- 4 mmHg) than in the control group (12 +/- 3 mmHg) thus supporting partly our hypothesis. After the two-week high salt intake, serum Na+, K+, Cl-, Hct, and plasma Hb were at the similar level as before the extra salt intake. Plasma renin activity, NT-proANP, ANP, and serum aldosterone were not different between the groups, both before and after the cold exposure. The main findings are: 1) the mean arterial pressure increases to the same level and in the same manner independent of the salt load during a short whole body cold exposure and 2) in cold the diastolic blood pressure increases significantly more in people under a very high salt diet.
Adult↗
Polyamines may regulate S-phase progression but not the dynamic changes of chromatin during the cell cycle.
Several studies suggest that polyamines may stabilize chromatin and play a role in its structural alterations. In line with this idea, we found here by chromatin precipitation and micrococcal nuclease (MNase) digestion analyses, that spermidine and spermine stabilize or condense the nucleosomal organization of chromatin in vitro. We then investigated the possible physiological role of polyamines in the nucleosomal organization of chromatin during the cell cycle in Chinese hamster ovary (CHO) cells deficient in ornithine decarboxylase (ODC) activity. An extended polyamine deprivation (for 4 days) was found to arrest 70% of the odc- cells in S phase. MNase digestion analyses revealed that these cells have a highly loosened and destabilized nucleosomal organization. However, no marked difference in the chromatin structure was detected between the control and polyamine-depleted cells following the synchronization of the cells at the S-phase. We also show in synchronized cells that polyamine deprivation retards the traverse of the cells through the S phase already in the first cell cycle. Depletion of polyamines had no significant effect on the nucleosomal organization of chromatin in G1-early S. The polyamine-deprived cells were also capable of condensing the nucleosomal organization of chromatin in the S/G2 phase of the cell cycle. These data indicate that polyamines do not regulate the chromatin condensation state during the cell cycle, although they might have some stabilizing effect on the chromatin structure. Polyamines may, however, play an important role in the control of S-phase progression.
Animals↗
Correspondence between occupational exposure limit and biological action level values for alkoxyethanols and their acetates.
OBJECTIVES: The Finnish occupational exposure limit (OEL) values for alkoxyethanols and their acetates were lowered in 1996. A reevaluation of the correspondence between the new OEL value and the biological action level (BAL) was thus needed. This study was conducted in silkscreen printing enterprises, where 2-alkoxyethanols and their acetates are mainly used as solvents. The air/urine correlations between 2-methoxyethylacetate, 2-ethoxyethylacetate, 2-butoxyethanol, 2-butoxyethylacetate, and 2-methoxyacetic (MAA), 2-ethoxyacetic (EAA), and 2-butoxyacetic acid (BAA) were evaluated on an individual and time-related basis at four different enterprises. METHODS: Inhalation exposure to alkoxyalcohols and their acetates was monitored with diffusion badges (n = 38) for an entire work week. Urinary excretion of alkoxyacetic acids immediatley after the shift and at 14-16 h after exposure (n = 112) was analyzed by a gas chromatograph equipped with a flame-ionization detector. RESULTS: Inhalation exposure to 2-methoxyethylacetate at 0.5 cm3/m3 corresponded to MAA excretion of 3 mmol/mol creatinine in urine at 14 to 16 hours after exposure. The next-morning urinary EAA excretion of 37 mmol/mol creatinine corresponded to an 8-h 2-ethoxyethylacetate exposure of 2 cm3/m3 when all collected data were included. This average EAA excretion was 69% of the German BAT value and only 34% of the American biological exposure index (BEI) value. Urinary EAA excretion was 30-40% lower at the beginning of the work week than at the end of the work week. On the other hand, EAA excretion was 10-20% higher than that measured at 14-16 h after exposure. Urinary BAA excretion of 75 mmol/mol creatinine in postshift urine corresponded to an 8-h 2-butoxyethanol and 2-butoxyethylacetate exposure of 5 cm3/m3. This BAA excretion was 87% of the German BAT value. CONCLUSION: According to these results, it seems that the BAL for MAA and EAA should be 3 and 50 mmol/mol creatinine as measured at 14-16 h after exposure, respectively. The BAL value for BAA seems to be 70 mmol/mol creatinine in postshift samples. These recommendations are valid only if samples are collected at the end of the work week.
Acetates↗
Outcome of patients operated on for esophageal atresia: 30 years' experience.
PURPOSE: The aim of this study was to evaluate the outcome and late sequelae of patients with esophageal atresia or tracheoesophageal fistula. METHODS: Sixty patients with esophageal atresia or tracheoesophageal fistula (EA-TEF) were treated in Tampere University Hospital in the years 1963 through 1993. Long-term outcome was evaluated with a questionnaire, pulmonary and esophageal function test results, 24-hour pH level monitoring, tracheobronchoscopy findings, and esophagogastroscopy with biopsy sections and samples for bacterial cultures. RESULTS: One third of the respondents reported having impaired quality of life because of respiratory infections, dyspnea, and difficulties in swallowing and coughing at night. Eighteen percent had gastroesophageal reflux (GER) symptoms. The rate of symptoms decreased with age. Impaired pulmonary function, GER, abnormal esophageal peristalsis, and transit time were registered. Tracheobronchoscopy showed tracheal narrowing and inflammation in one third; in histopathologic analysis, however, the rate of inflammation was more than doubled. Histologically, esophageal inflammation was found in 51%, Barrett's esophagus in 6%, and a Helicobacter pylori infection in 21% of cases. The severity of GER, esophageal peristaltic abnormality, tracheal inflammation, and impairment of pulmonary function seems to be alleviated with age. CONCLUSIONS: Although the long-term outcome of EA-TEF patients seems to be favorable, respiratory and gastrointestinal symptoms as well as functional abnormalities remain frequent. Gastric metaplasia in the esophagus and the high rate of tracheal, esophageal, and gastric inflammation indicate a need for long-term follow-up.
Adolescent↗
The association between dental arch dimensions and occurrence of Finnish dental consonant misarticulations in cleft lip/palate children.
The aim of this study was to examine whether maxillary and mandibular dental arch width, length, and palatal height dimensions are associated with the occurrence of misarticulations (phonetic or phonologic errors) in the dental consonants /r/, /s/, and /1/ in different cleft types and sexes. The subjects were 263 (109 girls, 154 boys) 6-year-old Finnish-speaking non-syndromic children with isolated cleft palate (CP, n=79), deft lip/alveolus (CL(A), n=77), unilateral (UCLP, n=80), and bilateral (BCLP, n=27) cleft lip and palate. Dental plaster casts were measured by two authors using the technique of Moorrees, and auditive speech was analyzed with high reliability by two speech pathologists. The results showed that the occurrence of misarticulations increased and dental arch dimensions decreased with the severity of the cleft. Narrower and shorter maxillary arches as well as shallower palates were related to problems with the studied dental consonants. Mandibular arch dimensions were not related to the misarticulations. However, statistical analysis did not reveal significant differences in dental arch dimensions between subjects with and without misarticulations when they were compared separately for different cleft types. The etiology of clefting per se--isolated deft palate versus cleft lip with or without deft palate--did not seem to explain the associations between dental arch dimensions and the studied misarticulations.
Articulation Disorders↗
Urinary NAG and GAG as biomarkers of renal effects in exposure to 2-alkoxyalcohols and their acetates.
Many sensitive biomarkers are available for the surveillance of the early health effects of chemicals on humans. This study was conducted to evaluate the usefulness of glycosaminoglycans (GAG) as biomarkers of early kidney effects in exposure to 2-alkoxyethanols and their acetates. GAG were compared with effects on the urinary beta-N-acetylglycosaminidase activity (NAG). According to the results of the present study, the excretion rate of GAG was higher among women than men. On the other hand, the excretion rate of GAG was lower among exposed subjects than among the controls, and the level was decreased at the tested levels of exposure. The NAG activity was higher in most of the exposed groups than in the controls. The data indicated that an appropriate urinary limit value for ethoxyacetic acid was 30 mmol/mol creatinine in postshift samples and that this value corresponded to an 8-hour exposure level of 2 cm3/m3 2-ethoxyethylacetate. Urinary butoxyacetic acid excretion of 60 mmol/mol creatinine corresponded to the inhalation exposure level of 5 cm3/m3 2-butoxyethanol and its acetate in postshift samples.
Acetates↗
Occurrence of dental consonant misarticulations in different cleft types.
To study the occurrence and type of misarticulations in dental consonants /r/, /s/ and /l/ 280 (115 girls, 165 boys) 6-year-old cleft children were examined by 1 of the 2 experienced speech pathologists of the cleft team. The patients included 82 children with isolated cleft palate (CP), 82 with cleft lip with (34) or without (48) cleft alveolus [CL(A)], 85 with unilateral cleft lip and palate (UCLP) and 31 with bilateral cleft lip and palate (BCLP). CP children were first divided into subgroups; there were 17 children with soft palate cleft, 49 with partial and 16 with complete hard palate cleft. All patients were native Finnish speakers, and had normal hearing, no known syndrome or associated anomalies possibly affecting speech or psychomotor retardation. The results showed that the occurrence and severity as well as the number of errors of all studied sounds separately or grouped increased with the severity of the cleft being constantly greatest in the BCLP group and lowest in the CL(A) group. Altogether 44% of the patients misarticulated at least one studied sound; 41% distorted and 5% substituted, and 2% both distorted and substituted. The /r/ sound was misarticulated by 36%, the /s/ sound by 23%, and the /l/ sound by 18% of the patients. Boys tend to have more problems in producing the studied sounds correctly.
Articulation Disorders↗
Digital wireless radiology consultations with a portable computer.
A wireless system for radiological subspecialist consultation based on a portable personal computer and a GSM cellular phone was tested. A link with secure access to the hospital image network was built. A total of 68 emergency computerized tomography (CT) examinations were transmitted. Transmission time via GSM for a single CT image was 1 min and for a complete head scan was 18 min. The transmitted images were acceptable for final diagnosis in 72% of the cases, the rest being acceptable for preliminary diagnosis. The diagnosis from the transmitted images did not change after a later review of the original images in 97% of cases. The wireless link saved a hospital visit by the senior radiologist in 24% of cases. The results show that a remote consultation link can be built with readily available technology and that the technique is useful in radiological subspecialist consultations for CT images.
Adolescent↗
Obesity is a health problem.
Obesity is a very common and an increasing nutritional problem in Finland and in other western countries and also in circumpolar areas. Dietary factors like high intakes of fat and alcohol, and physical inactivity predispose to obesity. Childhood obesity increases the risk of obesity in adulthood. Obesity is associated with cardiovascular diseases, non-insulin-dependent diabetes mellitus and musculoskeletal disorders which cause work disability. Prevention of obesity should be more focused because treatment of obesity is difficult and the long-term result generally poor. Multidisciplinary co-work is needed to find out how the factors of childhood are related to obesity in adulthood.
Adolescent↗
Work ability of young adults.
This paper reviews the themes related to work ability of young adults. Premature working discapacity causes significant economical and social costs in Finland compared to other Nordic countries and has for that reason been studied most intensively there. Work ability is an interaction of social, environmental and individual factors such as physical fitness, coping skills, social support behaviour and health behaviour. Environmental factors influencing work ability can be concrete, like physical and chemical exposures or more abstract like unemployment. The work ability of ageing people has been studied intensively, while work ability of young adults has not been properly evaluated so far. The worsened economic situation in Finland has meant an excessive work load for those who still have work. At the same time the risk of permanent unemployment is increasing. This polarizationing affects especially the young because they may fail to enter the working life. Also factors related to childhood may affect and even determine work ability in adulthood.
Adolescent↗
Biomonitoring of technical grade 1-alkoxy-2-propanol acetates by analysing urinary 2-alkoxypropionic acids.
Today commercially available 1-alkoxy-2-propanol acetates contain a harmful isomer 2-alkoxy-1-propanol acetates, which makes up less than 20% of the commercial product. This harmful isomer provides a means with which to study the toxicity and exposure to alkoxypropanols. Assessing exposure to technical grade 1-alkoxy-2-propanol acetates through the biological monitoring of urinary 2-alkoxypropionic acids has been found to be the most accurate method. The method developed in this study provides a procedure for the simultaneous urinalysis of methoxyacetic acid (MAA), ethoxyacetic acid (EAA), butoxyacetic acid (BAA), oxalic acid (OA), 2-methoxypropionic acid (2-MPA) and 2-ethoxypropionic acid (2-EPA). This possibility is very valuable in workplaces where workers are exposed simultaneously to different glycol ethers. This study was conducted among 54 silkscreen printers, who gave a urine sample to be analysed using a capillary gas chromatograph for 2-MPA and 2-EPA. The mean urinary concentrations of 2-MPA and 2-EPA were 1.27 (S.D. = 1.60) nmol/mol creatinine (median = 0.53, n = 26) and 1.23 (S.D. = 2.31) mmol/mol creatinine (median = 0.26, n = 39), respectively. The urinary excretion of 2-MPA and 2-EPA immediately after shift was linearly dependent on the preceding technical grade 1-methoxy-2-proponol acetate (7 = 0.16x + 0.26, n = 26 R2 = 0.78) and technical grade 1-ethoxy-2-propanol acetate (y = 2.05x - 0.09, n = 39, R2 = 0.68) respective exposure, as measured in the workers' breathing zone. According to the results of this study it is possible to monitor exposure to the technical grade 1-methoxy-2-propanol acetate and technical grade 1-ethoxy-2-propanol acetate through urinalysis of 2-MPA and 2-EPA.
Acetates↗
Biological monitoring of occupational exposure to 1-methoxy-2-propanol.
At the end of a workweek 23 silkscreen printers gave a urine sample for capillary gas chromatographic analysis for 1,2-propanediol. The mean concentration was 2.52 (S.D. 2.01) mmol mol creatinine(-1) (median=1.76, n=23). The urinary excretion of 1,2-propanediol was linearly dependent on the preceding 1-methoxy-2-propanol exposure measured in the worker's breathing zone [y=0.99+0.28x, n=23, r=0.67, where y is the urinary 1,2-propanediol concentration, in mmol mol creatinine(-1) and x is the concentration, in cm3 m(-3), of 1-methoxy-2-propanol (90.2%), 1-ethoxy-2-propyl acetate (5.8%), 1-methoxy-2-propyl acetate (2.1%) and 1-ethoxy-2-propanol (1.9%) in the air].
Chromatography, Gas↗
Pituitary size and function in children and adolescents with shunted hydrocephalus.
OBJECTIVE: Most previous reports of endocrine disorders in children with shunted hydrocephalus have been case reports and there is a lack of systematic information on pituitary anatomy and function among these children. We have obtained these data in a large group of individuals with shunted hydrocephalus. DESIGN: A controlled cross-sectional study. PATIENTS: Fifty-four children and adolescents with shunted hydrocephalus were studied for pituitary anatomy and function. They had 54 age- and sex-matched controls (group I). The mean age of the patients and controls was 12.6 years and the mean shunting period 10.6 years. There was a second control group (II) for the magnetic resonance imaging (MRI) and a third control group (III) for the radiography of the sella turcica. MEASUREMENTS: The anatomy was visualized by MRI of the pituitary gland and by radiography of the sella turcica. The functional evaluation included an arginine-insulin test and a combined stimulation test with corticotrophin releasing factor (CRF), GnRH and TRH. RESULTS: The patients were shorter (height 148.4 cm vs 153.7 cm, P < 0.05 and relative height -0.5 SDS vs 0.4 SDS, P < 0.05) and had a higher BMI than the control group I (20.6 kg/m2 vs 18.0 kg/m2, P < 0.001). They had also a greater pituitary height than the control group II (5.8 mm vs 5.1 mm, P < 0.01). The patients had significantly lower basal GH levels (P < 0.001) than controls I. Sixteen patients (30%) had a poor GH response (< 20 mU/l) in the arginine-insulin test. Pituitary height was significantly lower among these patients than in those with a normal response (4.7 mm vs 6.3 mm, P < 0.01), who had an increased pituitary height compared to controls II (5.1 mm, P < 0.01). The area under the curve (AUC) for GH correlated with the pituitary volume (r = 0.50, P < 0.001). The patients had higher basal FSH and LH concentrations than controls I (P < 0.001). The peak to basal ratios of FSH and LH were increased in the prepubertal patients and that of LH at Tanner pubertal stage II in the females. The basal FSH and LH levels correlated with the pituitary volume (r = 0.50 and r = 0.54, P < 0.001 for), as did FSH AUC and LH AUC (r = 0.48 and r = 0.75, P < 0.001 for both). CONCLUSIONS: These observations indicate that children with shunted hydrocephalus have an increased pituitary size on average. About one-third of these patients had signs of reduced GH secretion and significantly lower pituitary height, which probably contributes to their poor linear growth. Increased pituitary size was associated with enhanced gonadotrophin secretion, which may result in early puberty in children with shunted hydrocephalus.
Adolescent↗
Computed tomography data based rapid prototyping model of the temporal bone before cochlear implant surgery.
Rapid prototyping (RP) technique allows automatic fabrication of 3D model parts. This method was applied to make a temporal bone model before cochlear implant surgery. A helical CT scan is used to acquire high resolution data from the middle and the inner ear of the patient. From the scanning data bone structures and soft tissues can be separated because their different grayscale pixel values. By using a guided image processing tool the desired parts of the anatomy can be extracted and 3D data created. The segmented data are processed to the form suitable for creating a high accuracy RP model. The RP model is made in the stereolithography (SLA) process by means of a computer guided HeCd laser beam inducing polymerisation of acrylic solution as it passes layer by layer over the surface of the polymer solution. In this prototype model the anatomy of the temporal bone can be clearly visualised, including, e.g., mastoid cells, tympanic cavity, bony canal of facial nerve, and round and oval windows. The inner ear spaces including vestibule, semicircular canals and cochlear turn are also shaped. The transparent acrylic material allows bonelike mechanical handling. The RP model can be dissected and used in individual surgical planning and simulation prior to cochlear implantation.
Cochlear Implants↗
[X-linked adrenoleukodystrophy--an explanation for school problems of boys,walking problems of men and Addison disease].
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Addison Disease↗