Search PubMed⌕ Search

Biomedical subjects

M Hakala

Publications and source records attributed to M Hakala.

At least 37 records · Page 2Linked to original sources
PubMed2001

Magnetic resonance imaging and magnetic resonance sialography of parotid glands in primary Sjogren's syndrome.

OBJECTIVE: To look for structural parotid gland changes on magnetic resonance (MR) imaging and MR sialography of primary Sjögren's syndrome (SS) patients and healthy control subjects and to compare these methods with each other. METHODS: MR imaging and MR sialography of both parotid glands were performed on 26 patients and 7 healthy controls. Bilateral surface coils were used to obtain high spatial resolution. RESULTS: Twenty-two of the 26 patients had abnormalities on MR imaging. Twenty-one had a nodular or dendritic parenchymal pattern, 5 had cavities, and 6 had duct dilatations. On MR sialography, 25 of the 26 patients had abnormalities of the ducts, and 16 of them also had cavities. One patient and all 7 controls had normal results with both methods. The structural appearance of the parotid glands on MR images had marginal linear association with the duct system changes but no correlation with the cavitary changes seen on MR sialography. Furthermore, duct system abnormalities did not correlate with cavitary changes. Both parenchymal and sialographic abnormalities were associated with the presence of Ro/SSA antibodies but not with age of the patient, disease duration, salivary flow rate, or the presence of hypergammaglobulinemia or extraglandular manifestations. CONCLUSION: MR imaging and MR sialography are noninvasive methods that provide definitive information of morphologic changes in parotid glands and can be used as diagnostic indicators of primary SS. Because these methods give information on different aspects of glandular pathology, both should be performed when evaluating parotid glands of SS patients. MR sialography is more sensitive, but conventional MR imaging gives complementary information on the progressive pathologic changes of glandular parenchyma.

Adult↗
PubMed2001

Process control of apple winemaking by low-resolution gas-phase Fourier-transform infrared spectroscopy.

Four apple wine fermentation processes have been observed by means of direct-inlet gas-phase FTIR spectroscopy. The apple juice concentrates were each fermented by two species of Saccharomyces cerevisiae starters, and the experiment was repeated. The development of the concentrations of 1-propanol, 4-methylpyridine, acetaldehyde, acetic acid, and ethyl acetate was monitored. Two different sampling methods were used--static headspace and direct injection of the must. The performance of the FTIR method is limited by the high ethanol concentration. It can be mathematically proven that the amount of sample can be selected so that any distortion due to ethanol is minimized. Headspace GC-MS was used for preliminary compound identification.

1-Propanol↗
PubMed2001

Low-resolution gas-phase FT-IR method for the determination of the limonene/carvone ratio in supercritical CO2-extracted caraway fruit oils.

A low-resolution gas-phase FT-IR method for the fast analysis of supercritical CO2-extracted caraway fruit oils has been developed. The limonene/carvone ratio of extraction product was determined within seconds, yielding a coefficient of variation of <5% (n = 10). A selection of experimental parameters is discussed on the basis of the analysis of 52 extracted samples. GC-FID was used as a reference method. A correlation of 0.983 (n = 24) between the two methods was observed. This method is suitable for the analysis of a large number of caraway fruit extracts due to its speed, repeatability, and minimum sample preparation.

Carbon Dioxide↗
PubMed2001

Differences between female and male patients with familial rheumatoid arthritis.

OBJECTIVE: To determine whether there are genetic differences between female and male patients with familial rheumatoid arthritis (RA). METHODS: 45 men and 119 women from 78 families with RA who all had at least one first degree relative with RA were compared. HLA-DRB1 alleles were analysed, including DRB1*04 subtypes and associations of DRB1*04 haplotypes with DQB1*0301 or DQB1*0302 alleles, the age of the patients at disease onset, the presence of rheumatoid factor (RF), joint erosions, and rheumatoid nodules. RESULTS: HLA-DRB1*13 allele (the subtype allele of DR6, reported to be protective against the development of RA) was found in 14/119 (12%) of female but in none of the male patients (p=0.036). The HLA-DR4 allele was found slightly more often in men than women patients with familial RA (31/45 (69%) v 75/119 (63%), NS). Men were also more often RF positive than women (44/45 (98%) v 98/117 (84%); p=0.031). On the other hand, the mean age at onset of RA was significantly lower in the female group (40.4 years) than in men (46.6 years, p=0.0044). CONCLUSION: The results indicate that there is stronger genetic background in familial male than female patients with RA in the genetic susceptibility defined by the studied HLA antigens. However, the earlier age of onset of the disease in female group and the increased proportion of women with RA indicate that there are additional sex related predisposing factors enhanced in familial cases.

Adult↗
PubMed2001

Type I collagen degradation does not diminish with RA disease duration.

OBJECTIVE: To assess the relation between type I collagen degradation and the duration of rheumatoid arthritis (RA). METHODS: The serum concentrations of cross linked carboxyterminal telopeptide of type I collagen (ICTP) measured earlier in a community based series (90 patients) and a hospital based series (59 patients) were re-evaluated with reference to the duration of RA. RESULTS: The serum ICTP showed a positive correlation with the duration of the disease in the hospital based series (r(s)=0.40, p<0.01) but not in the community based one (r(s)=0.18, p=0.10). CONCLUSIONS: Type I collagen degradation predominantly reflecting pathological bone destruction does not seem to diminish in longlasting RA.

Arthritis, Rheumatoid↗
PubMed2000

Arthritis impact measurement scales in a community-based rheumatoid arthritis population.

The objective of this study was to use the Arthritis Impact Measurement Scales (AIMS) in a community-based rheumatoid arthritis (RA) population to describe the patient population, analyse health status changes and predict survival. The AIMS was assessed in 91 RA patients in a community-based RA population in Kuusamo, Northern Finland. A 5-year follow-up study was performed. The mean AIMS scores in this series of RA patients were comparable to those reported in previous studies. Dexterity correlated with disease duration. Lower extremity function was well preserved and only slightly dependent on disease duration. The AIMS scores changed for the worse in all the subscales over the follow-up period. Of all the AIMS subscale scores, poor functional status, as measured by the AIMS lower extremity function and social activity subscales, best predicted mortality.

Arthritis, Rheumatoid↗
PubMed2000

Anxiety and depression in a community-based rheumatoid arthritis population.

OBJECTIVE: To assess anxiety and depression and their explanatory factors in rheumatoid arthritis (RA) in a community-based population. METHODS: The subscales of the Arthritis Impact Measurement Scales (AIMS) for anxiety and depression were used, and the Health Assessment Questionnaire (HAQ) was used for the assessment of disability. Cross-tabulation and multivariate logistic regression analysis were used to evaluate which variables best describe the patients with either high or low depression and anxiety scores. RESULTS: Nearly 20% of our patients had probable depression (AIMS depression subscale score > or =4), a figure comparable to earlier hospital-based series. Most of the AIMS anxiety subscale variability was explained by poor physical function and the male sex, while the AIMS depression subscale variability was mostly explained by poor physical function, comorbidities, and social inactivity. CONCLUSION: In our cross-sectional, community-based RA series, depression was equal to the figures previously reported from hospital-based series. Poor physical function was a powerful explanatory factor of both depression and anxiety.

Anxiety↗
PubMed2000

Prediction of disease progression in early rheumatoid arthritis by ICTP, RF and CRP. A comparative 3-year follow-up study.

OBJECTIVE: To test the predictive value of the cross-linked carboxyterminal telopeptide of type I collagen (ICTP; a marker of type I collagen degradation), rheumatoid factor (RF) and C-reactive protein (CRP) for disease progression in patients with early rheumatoid arthritis (RA) METHOD: We tested the value of baseline values of RF, CRP and ICTP for the prediction of radiological joint progression over 3 yr in 63 consecutive patients with early RA who were treated with the 'saw-tooth strategy'. RESULTS: Age- and sex-adjusted risks as odds ratios (95% confidence intervals) of elevated serum ICTP, RF positivity and increased CRP for progressive joint disease (defined as an increase of > 20 in Larsen's index on radiographs of the hands and feet) were 3.9 (1.3, 11.9), 3.9 (1.0, 15.5) and 2.6 (0.9, 7.5), respectively. Better prediction was achieved when the tests were used in combination, and where there was both elevated ICTP and positive RF the odds ratio was 9.1 (2.5, 32.9). This test combination showed good sensitivity and specificity (71 and 77%, respectively), with a positive predictive value of 65% and a likelihood ratio of 3.1. CONCLUSION: This kind of risk profile, in which the tests used reflect different aspects of the disease process, may be useful in early disease assessment to find patients who will need the most active drug therapy.

Adolescent↗
PubMed2000

Reduced incidence of alcohol related deaths in subjects with rheumatoid arthritis.

OBJECTIVES: It has previously been shown that people with ankylosing spondylitis have an increased incidence of alcohol related deaths from accidents and violence. This study investigated alcohol related deaths in subjects with rheumatoid arthritis (RA). METHODS: The study covered the subjects, 1666 in number, who had died in 1989 and had been entitled under the nationwide sickness insurance scheme to receive specially reimbursed medication for RA. RESULTS: There were eight alcohol related deaths among the 480 men and three deaths among the 1186 women with RA. The standardised mortality ratios and their 95% confidence intervals (CI) were 0.40 (95% CI 0.20, 0.80) and 0.40 (95% CI 0.13, 1.26), respectively. CONCLUSION: Alcohol either protects from RA or, subjects with RA curtail their drinking after the manifestation of RA.

Adolescent↗
PubMed2000

Motor performance of the hand in patients with rheumatoid arthritis.

OBJECTIVES: To examine the motor performance of the hand in a sample of patients with rheumatoid arthritis (RA). SUBJECTS: The patient group comprised 21 (two men, 19 women) patients with RA. Twenty one control subjects matched for age and sex were selected from a larger reference group, which had been drawn from the local population. METHODS: The measured motor performance aspects were simple reaction time, choice reaction time, speed of movement, finger tapping speed, and coordination (that is, speed of movement/accuracy). Results were compared for age and sex matched pairs. The measurements were made with the Human Performance Measurement/Basic Elements of Performance system, which is a multifunctional system designed to measure different motor aspects of the hands, including reaction time, movement speed, tapping speed, and coordination. RESULTS: A comparison of the results for the patient and control groups indicated that the motor functions of patients with RA were impaired in all the measured aspects (with the exception of the index finger tapping test). The difference between the groups varied between 11% and 21% for the reaction time tasks, between 12% and 18% for the speed of movement tasks, and between 15% and 17% for the coordination task. CONCLUSION: Based on the results of our research, it seems that RA decreases some motor performance functions of the hand expressed as simple reaction time, choice reaction time, speed of movement, and coordination. The changes were emphasised in movements performed with several joints.

Adult↗
PubMed2000

Immunogenetic differences between patients with familial and non-familial rheumatoid arthritis.

OBJECTIVE: To search for possible immunogenetic differencies between the patients with familial and non-familial rheumatoid arthritis (RA). METHODS: The study compared 129 familial RA patients with 217 non-familial patients for the frequencies of HLA-DR antigens including DR4 subtypes, DR4-DQB1*0301 and DR4-DQB1*0302 haplotypes and HLA-B27 antigen as well as the age of disease onset and existence of rheumatoid factor or joint erosions. RESULTS: Two major differences between familial and non-familial groups were found: firstly, familial RA patients had increased frequency of HLA-DR4 as compared with the non-familial RA group (68.2 v. 54.8%; p = 0.019). Secondly, the mean age at onset of RA was significantly lower in the familial than in the sporadic RA patients (42.0 v. 46.5 years; p = 0.0020) and the difference still remained when the DR4 positive and negative subgroups were compared separately. CONCLUSION: These results confirm the more prominent association with HLA-DR4 in familial than in the non-familial cases and suggest that accumulation of HLA risk genes may, at least partly, explain the familial occurrence of the disease. Other susceptibility genes may also be concentrated in multiplex case families as suggested by an earlier age at the onset of RA in both HLA-DR4 positive and negative familial patients.

Adolescent↗
PubMed2000

No signs of autonomic nervous system dysfunction in primary Sjörgen's syndrome evaluated by 24 hour heart rate variability.

OBJECTIVE: Autonomic neuropathy is associated with increased mortality. In patients with primary Sjögren's syndrome (SS), disturbances in the autonomic nervous system have been described using conventional cardiovascular reflex tests. Heart rate variability (HRV) measured from Holter recording has proved to be a reliable and sensitive method in assessing autonomic function and prognosis. We evaluated cardiovascular autonomic function based on HRV in patients with primary SS compared to the general population. METHODS: We analyzed HRV from 24 h electrocardiography recordings in 28 patients with primary SS and 28 healthy age and sex-matched population-based controls. RESULTS: There were no significant differences in time or frequency domains or nonlinear measures of HRV between the groups. CONCLUSION: The prevalence of autonomic disturbances is not increased in patients with primary SS compared to the general population.

Adult↗
PubMed1999

Comparison of combination therapy with single-drug therapy in early rheumatoid arthritis: a randomised trial. FIN-RACo trial group.

BACKGROUND: The treatment of rheumatoid arthritis should aim at clinical remission. This multicentre, randomised trial with 2-year follow-up sought evidence on the efficacy and tolerability of combination therapy (sulphasalazine, methotrexate, hydroxychloroquine, and prednisolone) compared with treatment with a single disease-modifying antirheumatic drug, with or without prednisolone, in the treatment of early rheumatoid arthritis. METHODS: 199 patients were randomly assigned to two treatment groups. 195 started the treatment (97 received combination and 98 single drug therapy). Single-drug therapy in all patients started with sulphasalazine; in 51 patients methotrexate was later substituted. Oral prednisolone was required by 63 patients. The primary outcome measure was induction of remission. Analyses were intention to treat. FINDINGS: 87 patients in the combination group and 91 in the single-therapy group completed the trial. After a year, remission was achieved in 24 of 97 patients with combination therapy, and 11 of 98 with single-drug therapy (p=0.011). The remission frequencies at 2 years were 36 of 97 and 18 of 98 (p=0.003). Clinical improvement (American College of Rheumatology criteria of 50% clinical response) was achieved after 1 year in 68 (75%) patients with combination therapy, and in 56 (60%) using single-drug therapy (p=0.028), while at the 2-year visit 69 and 57 respectively (71% vs 58%, p=0.058) had clinically improved. The frequencies of adverse events were similar in both treatment groups. INTERPRETATION: Combination therapy was better and not more hazardous than single treatment in induction of remission in early rheumatoid arthritis. The combination strategy as an initial therapy seems to increase the efficacy of the treatment in at least a proportion of patients with early rheumatoid arthritis.

Adult↗
PubMed1999

Primary Sjögren's syndrome with severe central nervous system disease.

OBJECTIVE: Central nervous system (CNS) involvement in primary Sjögren's syndrome (pSS) is controversial with regard to frequency, significance, and etiology. METHODS: We describe a young woman with pSS and severe CNS disease and review the literature on the pathophysiology, clinical significance, symptoms, diagnostic examinations, and treatment of CNS disease with concomitant pSS (CNS-SS). RESULTS: Our patient with pSS had a 5-month history of benign lymphadenopathy and myositis, after which she developed severe CNS disease, vasculitic lesions on her hands, and a neurogenic bladder attributable to spinal cord involvement. The diagnosis was based on the clinical picture and the results of a brain magnetic resonance imaging (MRI) scan, electroencephalography (EEG), and cerebrospinal fluid (CSF) analysis. The disease did not respond to corticosteroids, but the administration of cyclophosphamide resulted in recovery. In the literature, the incidence of CNS-SS varies widely, from rare to incidence rates of 20% to 25%. The clinical picture is diverse, ranging from mild cognitive symptoms to fatal cerebrovascular accidents. The pathophysiology of CNS-SS is unclear, specific diagnostic methods are not available, and diagnosis is based on the clinical picture and a combination of examinations. MRI is the most sensitive test and cerebral angiography the most specific. CSF reflects involvement of the leptomeninges, and EEG is nonspecific. There are no controlled studies of the treatment of CNS-SS. Regimens for vasculitis are commonly used. CONCLUSIONS: CNS-SS is uncommonly recognized and difficult to diagnose. Increasingly accurate and available diagnostic examinations will yield more information about the association of CNS disease with pSS.

Adult↗
PubMed1999

T(H)1 cytokines are produced in labial salivary glands in Sjögren's syndrome, but also in healthy individuals.

The aim of the present study was to assess the T cell cytokines IFN-gamma, IL-2, IL-4 and IL-5 in labial salivary glands (LSG) in Sjögren's syndrome (SS) and healthy controls using RT-PCR and immunohistochemistry. IFN-gamma is always or almost always produced in SS and in healthy controls. IL-2 was also found in some samples, but IL-4 and IL-5 were not. Less than 2% of all inflammatory mononuclear cells contained immuoreactive IFN-gamma or IL-2. Cytokine mRNA profile in LSGs in SS is skewed towards a T(H)1 pattern. The classical T(H)1 cytokines are also produced in normal glands, even in the absence of foci. T(H)1 type response may play an active role as part of the mucosal associated lymphoid tissue/responses, perhaps in prevention of reactivation of latent viruses. This may also make the exocrine glands a locus minoris resistentiae when the self tolerance is broken.

Antisense Elements (Genetics)↗