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Biomedical subjects

P Kujala

Publications and source records attributed to P Kujala.

26 records · Page 2Linked to original sources

Airborne transmission of tularemia in farmers.

In a tularemia epidemic during 1982 in northern Finland, 53 patients showed no peripheral portal of entry for infection or associated lymphadenopathy. Respiratory symptoms were observed in 72% of the patients. 26/38 cases had abnormal chest films. Hilar adenopathy was the most common finding (36%). Four patients did not receive antibiotics; 43 received tetracyclines, 5 streptomycin and 1 cefuroxime and amoxycillin. All patients recovered. 50 patients acquired the infection during common farming activities, such as making fresh hay with a hay-cutter, handling dry hay, threshing, etc. Thus, airborne transmission may be an important source of infection in normal farming activities in endemic areas of tularemia.

Agriculture↗

Amenorrhea with low normal thyroid function and thyroxine treatment.

The effect of thyroxine treatment in cases of functional amenorrhea accompanied by low normally thyroid function was studied. During six months of follow-up, regular or single menstrual cycles were restored in ten of the 17 patients with thyroxine treatment and in four of the 11 patients without thyroxine treatment. During thyroxine treatment, thyroxine and free thyroxine index levels were elevated and serum testosterone levels decreased, but no significant changes were observed in serum estradiol, prolactin, follicle-stimulating hormone or luteinizing hormone levels. In the thyroid-releasing hormone/luteinizing-releasing hormone test, the thyroid-stimulating hormone response was markedly suppressed, but there were no changes in follicle-stimulating hormone, luteinizing hormone or prolactin responses. In one patient with primary hypothyroidism, regular menstrual cycles were restored and serum prolactin and thyroid-stimulating hormone levels normalized during thyroxine treatment. Thyroxine treatment seems to have benefits in some amenorrheic patients with low normal thyroid function.

Adult↗

Guillain-Barré syndrome and tularemia pleuritis with high adenosine deaminase activity in pleural fluid.

A 56-year-old man suffered from prolonged fever, sore throat and cough, followed by pleural effusion and reversible progressive ascending muscle weakness. The condition fulfilled the diagnostic criteria of Guillain-Barré syndrome. Tuberculosis was initially suspected because of lymphocyte predominance and high adenosine deaminase activity in the pleural fluid. Later, an agglutination titer of 10,240 to Francisella tularensis antigen was found and an infected hare exposure could be identified. Thus, the activity of adenosine deaminase may be high also in tularemia pleuritis.

Adenosine Deaminase↗

Aurothiomalate and hydroxychloroquine inhibit nitric oxide production in chondrocytes and in human osteoarthritic cartilage.

OBJECTIVES: Nitric oxide (NO) is a destructive mediator produced by activated chondrocytes. The aim of the present study was to investigate the effect of disease-modifying anti-rheumatic drugs (DMARDs) on interleukin-1beta (IL-1beta)-induced NO production in chondrocyte cultures, and in human osteoarthritic cartilage. RESULTS: Aurothiomalate, hydroxychloroquine, methotrexate and leflunomide inhibited IL-1beta-induced inducible NO synthase (iNOS) expression and NO production in immortalized H4 chondrocytes, while penicillamine and sulfasalazine had no effect. This can be explained by the fact that the four effective DMARDs also suppressed IL-1beta-induced activation of nuclear factor kappa B (NF-kappaB), which is a crucial transcription factor for iNOS. Aurothiomalate and hydroxychloroquine also inhibited IL-1beta-induced NO production in OA cartilage whereas methotrexate and leflunomide had no effect. CONCLUSION: Aurothiomalate and hydroxychloroquine suppressed IL-1beta-induced NO production in chondrocyte cultures and in OA cartilage. The results suggest an additional anti-inflammatory mechanism for aurothiomalate and hydroxychloroquine and indicates their possible therapeutic value in the treatment of osteoarthritis (OA).

Analysis of Variance↗

Candida immunity in patients undergoing surgical treatment for heart valve disease.

The appearance of Candida antigen (Latex agglutination method), Candida antibodies (indirect immunofluorescence) and positive fungal cultures as well as the lymphocyte transformation response to Candida antigen "in vitro" was studied in a series of 37 successive patients before and after heart valve replacement. The Candida antigen test was positive preoperatively in 11/36 (31%) and postoperatively in 14/36 (39%) of the patients and in 2/200 (1%) of the controls (blood donors). The differences in the frequencies of positive tests between the patient group and the control group are significant (p less than 0.001). The lymphocyte response to Oidiomycin (Candida albicans) preoperatively was greater than the mean control value in 6/11 (54.5%) of the patients showing a positive Candida antigen test, but only in 4/25 (16.0%) of the patients who were Candida antigen negative. The total number of lymphocytes and the number of ANAE positive (T) cells as well as the lymphocyte response to Oidiomycin (OID), tuberculoprotein (PPD) and phytohaemagglutinin (PHA) decreased markedly postoperatively. Candida antibody titres were positive (greater than or equal to 1:128) in 3/37 (8%) of the postoperative patients and in 2/84 (2.4%) of the controls. This difference is not significant. Positive Candida antibody titres were found postoperatively in 15/37 (41%) of the patients, which is a significantly higher frequency than that seen preoperatively (p less than 0.005). More positive fungal cultures from throat specimens (p less than 0.005) were found in the patient group before surgery than in the control group (hospital personnel). After surgery the number of positive fungal cultures in these cases decreased (p less than 0.001) due to the use of oral antifungal prophylaxis with nystatin tablets.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗