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Biomedical subjects

T Laine

Publications and source records attributed to T Laine.

At least 37 records · Page 2Linked to original sources
PubMed1998

Lumbar spinal stenosis: assessment of long-term outcome 12 years after operative and conservative treatment.

The present study focuses on the long-term prognosis of radiographically verified stenosis of the lower lumbar spine. The purpose here was to describe the outcome 12 years after radiographic diagnosis of spinal stenosis and to identify factors predicting disability after operative or conservative treatment. Data were compiled on 75 patients (43 men and 32 women) with changes in functional myelography diagnostic for spinal stenosis. Their mean age at the interview 12 years later was 61 years. The sagittal diameter of the dural sac was measured from baseline myelographs at all intervertebral levels and was corrected for magnification. In the interview, subjective outcome assessment was obtained with a structured questionnaire, and the low-back disorder was scored using the Oswestry disability index. The sagittal diameter of the dural sac was severely stenotic (<7.0 mm) in 32 patients (26 operated), and moderately stenotic (7.0-10.5 mm) in 43 patients (31 operated). The severity of the stenosis significantly predicted disability, even when the effects of age, sex, therapy regimen, and body mass index were adjusted for. For moderate and severe stenosis, the adjusted mean Oswestry indices were 28.4 and 39.1, respectively (p = 0.01). Therapy as such (operative versus nonoperative) did not significantly correlate with later disability. The radiographic severity of lumbar spinal stenosis predicts disability independently of therapy regimen. Randomized clinical trials are needed to establish the indications for surgical and conservative treatment. Radiographic severity of the stenosis should be considered as an effect-modifying or confounding factor in clinical trials and other studies focusing on the outcome of lumbar spinal stenosis.

Aged↗
PubMed1997

Improved accuracy of pedicle screw insertion with computer-assisted surgery. A prospective clinical trial of 30 patients.

STUDY DESIGN: A prospective clinical trial was done to study the accuracy of pedicle screw placement in 30 consecutive computer-assisted orthopedic surgeries. OBJECTIVES: To determine the accuracy and clinical applicability of this new method for pedicle screw insertion. SUMMARY OF BACKGROUND DATA: Conventional screw insertion techniques have been associated with high pedicle screw malplacement rates in cadaver studies and clinical studies with postoperative computed tomography evaluation. METHODS: Thirty transpedicular, low-back, titanium instrumentations were performed with computer-assisted orthopedic surgery. The accuracy of screw placement was evaluated using a sophisticated computed tomography protocol. RESULTS: The total number of pedicle screws was 174. Of these, 139 (79.9%) could be inserted with computer-assisted orthopedic surgery. The malplacement rate of computer-assisted orthopedic surgery screws was 4.3%. In screws that were not inserted by computer-assisted orthopedic surgery, the malplacement rate was 14.3%. One malplaced screw that had not been inserted with computer-assisted orthopedic surgery caused L4 root paresis. CONCLUSIONS: The accuracy of pedicle screw placement using computer-assisted surgery proved to be superior to the accuracy obtained when using conventional techniques.

Bone Screws↗
PubMed1997

Accuracy of pedicle screw insertion: a prospective CT study in 30 low back patients.

A prospective study of the accuracy of titanium pedicle screw placement in 30 low back operations was performed. The postoperative plain radiographs and CT reformation images were evaluated by two independent radiologists. Thirty-two out of 152 screws (21%) perforated the pedicle cortex. One-tenth of the perforations was detected with conventional radiography. In ten patients (33%) all the screws were located within the pedicle. The clinical significance of this study lies in the finding that pedicle perforations are more frequent than is generally believed and that, in spite of the many malplacements, no screw that perforated by less than 4.0 mm caused neurological problems. Only one nerve root lesion was detected.

Adult↗
PubMed1997

Steady-state pharmacokinetics of oestradiol gel in post-menopausal women: effects of application area and washing.

OBJECTIVE: To investigate the effect of cutaneous application area on oestradiol absorption using an oestradiol gel for transdermal use. Furthermore, the effect of washing of the application site on oestradiol pharmacokinetics was studied. DESIGN: Open-label, randomised, three-way cross-over study. SETTING: A clinical pharmacokinetic research unit. SUBJECTS: Sixteen healthy postmenopausal volunteers. INTERVENTIONS: During three treatment periods, subjects were treated with 1 mg oestradiol (1.0 g Divigel/Sandrena 0.1% gel), applied on the thigh to a skin area of 200 cm2, 400 cm2, or on an area 'as large as possible'. Blood samples were drawn during steady-state (on days 14-15) immediately before application and at regular time intervals thereafter. MAIN OUTCOME MEASURES: Serum oestradiol levels were measured for determination of peak concentration (Cmax), time to peak concentration (tmax) and bioavailability using the area under the time concentration curve (AUC0-24). RESULTS: Bioavailability from a 200 cm2 area was 2-fold higher than that from the largest possible area (P < 0.05). Oestradiol peak plasma concentration from a 200 cm2 area was higher than from the two larger areas (P < 0.05), which did not differ significantly from each other. Washing of the application site 30 min after application reduced the bioavailability from both the 200 cm2 and 400 cm2 application areas (P < 0.01), but peak plasma concentration from the 200 cm2 area only (P < 0.01). Time to reach peak plasma concentrations was significantly reduced with all three application areas by washing. CONCLUSION: A higher oestradiol absorption was achieved from a smaller application area. No marked differences were observed in the pharmacokinetics between 200 cm2 and 400 cm2 application areas, which are those recommended for this oestradiol gel preparation.

Administration, Cutaneous↗
PubMed1995

Associations among different orofacial dysfunctions in 9-11-year-olds.

This study is the second part of a longitudinal investigation on different orofacial dysfunctions in growing individuals. The aim of the present report was to determine, in 219 children with and without articulatory speech disorders, whether certain associations among misarticulations of speech, craniomandibular disorders (CMD), and problems in oral motor skills still were found at the age of 9-11 years, as they had been in these children at the age of 6-8 years. Multiple logistic regression models showed that certain aspects of dental malocclusion such as large overjet, anterior open bite and lateral cross-bite, and certain signs of CMD such as palpatory tenderness of the TMJ, jaw deviation on opening and bruxism were related to misarticulations of speech. Children with sounds produced too far posteriorly seemed to have a smaller maximal opening but larger laterotrusive and protrusive movement capacities of the mandible than children with correct speech articulation. Despite maturation of the oral motor skills with age, among 9-11-year-olds various orofacial dysfunctions still seemed to be associated with each other. This probably indicates fixation of certain speech misarticulations rather than immaturity of the fine motor control.

Articulation Disorders↗
PubMed1995

The influence of incisal malocclusion on the social attractiveness of young adults in Finland.

The aim of this study was to investigate the importance of dentofacial appearance on the perceived social attractiveness of young adults in Finland. The dental arrangements studied were incisal crowding, median diastema, protruding incisors, and ideal incisal occlusion. Facial photographs of six young adults were obtained and modified, so that for each face, four different dental arrangements could be portrayed. The photographs were shown to 1007 Finnish students to estimate social and personal characteristics of the person in the photograph. Dental arrangement had a significant influence on the perceived beauty and success of the persons. Test faces with incisal crowding and median diastema were ranked as significantly less intelligent, beautiful and sexually attractive, and judged to belong to lower social class than the same faces with ideal occlusion. Protruded incisors did not affect the ratings compared to ideal occlusion. On the average, female test faces were judged more favourably than the male ones. The results indicate that among Finnish students conspicuous incisal crowding or spacing represent a social disadvantage compared to normal or protruded incisors.

Adolescent↗
PubMed1993

Palatal and mandibular arch morphology in 47,XYY men and in other sex-chromosome anomalies.

Dimensions of the maxilla and mandible were studied in 47,XYY men and their first-degree male relatives, and the results compared with similar studies of other sex-chromosome anomalies. An extra Y chromosome in 47,XYY men caused an increase in palatal growth transversely and anteroposteriorly and in mandibular arch length anteroposteriorly compared to normal men. Palatal height and mandibular width were smaller with this chromosome pattern. Increase in the number of sex chromosomes is associated with changes in palatal and mandibular arch dimensions, more often an increase than a decrease. The findings support earlier observations that the palate becomes shallower with the addition of an X chromosome. It is also apparent that the influence of X and Y chromosomes differs, at least regarding the magnitude of metric changes.

Adolescent↗
PubMed1993

Spondylodesis augmented by transpedicular fixation in the treatment of olisthetic and degenerative conditions of the lumbar spine.

Fifty-one patients having lumbar or lumbosacral posterolateral fusion with pedicle screw internal fixation were reviewed retrospectively two years after the fusion by an independent observer. In 44 patients, the underlying condition was lytic or degenerative spondylolisthesis. The internal device was removed one year after the fusion. The fusion rate was 94%. The subjective disability was assessed using the Oswestry disability index. The mean Oswestry score was 38% preoperatively, and 24% two years after the fusion. Preoperatively, only every fifth patient was able to work; two years postoperatively, almost 60% held jobs. Complications due to internal fixation were recorded in 57% of the cases. Most of these, such as screw breakage and screw loosening in the sacrum, were of no clinical importance. The use of internal fixation seems to enhance the fusion rate but is associated with more complications than posterolateral fusion without implants.

Adult↗
PubMed1993

Palatal and alveolar arch dimensions in 47,XXY (Klinefelter syndrome) men.

Men with one extra X chromosome (47,XXY; Klinefelter syndrome) show a tendency to have a shallower but longer palate than normal (46,XY) men. The palate is also narrower than in 46,XY men. The mandible is clearly narrower but sagittally longer compared with the mandibles of 46,XY men. The present results indicate that the presence of one extra X chromosome in 47,XXY men is reflected in decreased growth of the maxilla transversely and vertically and of the mandible transversely. Increased length of the alveolar arches might be partly a compensation for the decreased width of the alveolar arch. This change might be associated with larger tooth sizes in 47,XXY men. Unbalanced appositional growth rather than disturbances in other orofacial growth mechanisms might be associated with the XXY sex chromosome pattern.

Adolescent↗
PubMed1992

Occlusion in 47,XXY (Klinefelter syndrome) men.

Occlusal morphology of permanent dentitions in 29 men with a 47,XXY chromosome complement (Klinefelter syndrome) was determined from dental casts. The results showed that a relatively frequent occlusal anomaly was mesial molar occlusion. Incisal open bite was also more common than in controls. Based on the present and previous observations of occlusal anomalies in various sex chromosome anomaly groups and normal controls, it is suggested that the presence of the Y chromosome in the genome is at least as important as the X chromosome for the development of harmonious occlusal morphology. The tendency towards sexual dimorphism in occlusal phenotype might result from a differential effect of the X and Y chromosomes on cellular activity which leads to different growth patterns.

Adolescent↗