Healing of subcapital femoral osteotomies fixed with self-reinforced poly-L-lactide screws: an experimental long-term study in sheep

Subcapital femoral osteotomies of ten young adult sheep were fixed with two bioabsorbable, self-reinforced, poly- L-lactide (SR-PLLA) lag screws of 4.5 mm in diameter. At 3 weeks radiographs were taken to check the reduction and fixation achieved. After follow-up periods of 12 weeks, 1 year and 3 years with three sheep in each group, and of 7 years and 4 months with one sheep, the sheep were killed, and the healing of the osteotomies, degradation and tissue response of the implants were examined radiographically, histologically and microradiographically. All osteotomies healed with a firm bony union. There was no dislocation or wound infection. Histologically, there was no marked tissue response in the bone tissue. At 12 weeks the implants were grossly intact, at 1 year granulation tissue and new bone formation had started to penetrate into the implant, and at 3 years the implant area was mostly replaced by connective tissue and new bone, but implant material was still seen as little islands surrounded by some lymphocytes. At 7 years and 4 months, the implant material had been degraded and replaced by tight bone. Self-reinforced poly- L-lactide lag screws seem to possess adequate mechanical properties and good biocompatibility for this demanding fixation.     

Integrated regional services: are working process changes desirable and achievable?

In the hospital district of Helsinki and Uusimaa, 32 municipalities with one or more health centres provide primary care to their residents. Legal and organizational barriers between primary care and hospital care impede the continuity of patient care. Integrating primary and secondary care with the aid of information technology may facilitate a virtual electronic patient record, in which the viewing of images and other patient data is possible regardless of the organization that produced them. For example, in one trial, diabetic patients sent their home blood glucose measurements by modem to their health centre. Preliminary observations suggest that they could increase their glucose testing largely because they were able to transmit the results to the database and receive teleconsultations. Also, a picture archiving and communication system (PACS) has been in operation in two clinics of the Helsinki University Central Hospital for over two years and seven hospitals had become filmless by the end of 2001. A regional PACS is planned to be completed by the year 2004.     

Genetic boundaries of the schizophrenia spectrum: evidence from the Finnish Adoptive Family Study of Schizophrenia

OBJECTIVE: Identification of the genetically related disorders in the putative schizophrenia spectrum is an unresolved problem. Data from the Finnish Adoptive Family Study of Schizophrenia, which was designed to disentangle genetic and environmental factors influencing risk for schizophrenia, were used to examine clinical phenotypes of schizophrenia spectrum disorders in adopted-away offspring of mothers with schizophrenia spectrum disorders. METHOD: Subjects were 190 adoptees at broadly defined genetic high risk who had biological mothers with schizophrenia spectrum disorders, including a subgroup of 137 adoptees at narrowly defined high risk whose mothers had DSM-III-R schizophrenia. These high-risk groups, followed to a median age of 44 years, were compared diagnostically with 192 low-risk adoptees whose biological mothers had either a non-schizophrenia-spectrum diagnosis or no lifetime psychiatric diagnosis. RESULTS: In adoptees whose mothers had schizophrenia, the mean lifetime, age-corrected morbid risk for narrowly defined schizophrenia was 5.34% (SE=1.97%), compared to 1.74% (SE=1.00%) for low-risk adoptees, a marginally nonsignificant difference. In adoptees whose mothers had schizophrenia spectrum disorders, the mean age-corrected morbid risk for a schizophrenia spectrum disorder was 22.46% (SE=3.56%), compared with 4.36% (SE=1.51%) for low-risk adoptees, a significant difference. Within the comprehensive array of schizophrenia spectrum disorders, schizotypal personality disorder was found significantly more often in high-risk than in low-risk adoptees. The frequency of the group of nonschizophrenic nonaffective psychoses collectively differentiated high-risk and low-risk adoptees, but the frequencies of the separate disorders within this category did not. The two groups were not differentiated by the prevalence of paranoid personality disorder and of affective disorders with psychotic features. CONCLUSIONS: In adopted-away offspring of mothers with schizophrenia spectrum disorders, the genetic liability for schizophrenia-related illness (with the rearing contributions of the biological mothers disentangled) is broadly dispersed. Genetically oriented studies of schizophrenia-related disorders and studies of genotype-environment interaction should consider not only narrowly defined, typical schizophrenia but also schizotypal and schizoid personality disorders and nonschizophrenic nonaffective psychoses.     

Monitoring microvascular free flaps with tissue oxygen measurement and pet

Snoring occurs as a major symptom in patients with sleep disordered breathing (SDB). The aetiology of snoring remains still unclear despite various attempts to localize snoring. The correlation between different snoring sounds and the severity of SDB has not yet been investigated in a larger population. The aim of this study was to record and analyse snoring sounds and to correlate the obtained data with clinical and polysomnographical parameters. Sixty male patients with suspected SDB and reported snoring underwent a clinical examination and night time polysomnography. The parallel digitally recorded snoring sounds were analysed by fast fourier transformation (FFT). Peak intensity was determined from the power spectrum. The periodicity of snoring was classified into rhythmic and non-rhythmic snoring according to the presence of air flow interruptions due to obstructive apneas. Patients with primary snoring revealed peak intensities between 100 and 300 Hz. Patients with an obstructive sleep apnea syndrome (OSAS) revealed peak intensities above 1,000 Hz. Polysomnographical data (AHI, mean and minimum SpO₂) as well as body mass index (BMI) correlated with peak intensity of the power spectrum. None of the parameters of the clinical examination correlated with peak intensity. Frequency analysis of snoring sounds provides a useful diagnostic tool to distinguish between different patterns of snoring and respective SDB. The topodiagnosis of snoring is not possible by means of frequency analysis or clinical examination alone. Acoustical analysis of snoring sounds seems a promising additional diagnostic tool to verify different types of SDB in snoring patients.     

Liposomal Targeting of Bcl-2 Antisense Oligonucleotides with Enhanced Stability into Human Myeloma Cell Lines

Cationic liposomes improve the delivery of antisense oligonucleotides (ODNs) into cells. However, there is marked variability in the cellular uptake of ODNs into different cell lines. We used liposomes containing dimethyloctadecylammonium bromide (DDAB) and dioleoylphosphatidylethanolamine (DOPE) to increase the delivery of phosphodiester ODNs into four different myeloma cell lines. The delivery by cationic liposomes increased the delivery of bcl-2 antisense ODNs by a factor of 9 to 45 as compared to plain ODNs. The stability of ODNs was increased with liposomes both in the culture medium and within the cells. Intact liposomal ODNs were detected inside the cells up to 24 hours with gel electrophoresis and phosphor imager analysis. Antisense ODNs had no effect on bcl-2 mRNA levels. Also the proliferation of myeloma cells remained unchanged during the 3-day incubation period. Our study shows that liposomal antisense ODNs targeting bcl-2 of human myeloma cells result in increased stability of ODNs with minimal toxicity. However, further modifications are needed to gain biological effects of antisense ODNs on human myeloma cells.     

The Moore vitallium femoral-head prosthesis in fractures of the femoral neck.

A follow-up is given of early and late results in 109 arthroplasties with the self-locking Austin T. Moore vitallium femoral head prosthesis in fractures of the femoral neck on 106 patients. Operative indication was usually fresh medical fracture of the femoral neck in an elderly woman, or its late complication. The surgery was performed in a unit for general surgery also engaged in pre- and postgraduate teaching activities. Many operations were performed by residents engaged in general surgery or orthopaedics. Point scores according to a modification of Merle D'Aubigné's classification showed excellent or at least good results in 81 per cent of the 69 mobile patients. Because of deteriorated general physical condition 11 patients were chronically bed-ridden. Five patients could not be reached. In three instances the prosthesis was removed. 21 patients died, three during the stay in hospital and 18 later for reasons not connected with the operative procedure. The mortality during 40 months of observation corresponded fairly well to that expected in the age group for the population as a whole.     

Fetal but not adult Leydig cells are susceptible to adenoma formation in response to persistently high hCG level: a study on hCG overexpressing transgenic mice

We have previously demonstrated that male transgenic (TG) mice overexpressing human chorionic gonadotropin (hCG+) develop reproductive organ defects, but no tumors, in adult age. In this study, the effects of persistently elevated hCG were followed in TG males between day 5 postpartum and adulthood. Leydig cell (LC) adenomas were found in prepubertal mice, most prominently at the age of 10 days, but not in adult age. Serum testosterone concentrations were significantly increased in TG males at all ages studied. The phenotype of the prepubertal hCG+ males resembled that found in boys upon expression of constitutively activating luteinizing hormone (LH) receptor mutations. The temporal expression patterns of the fetal LC marker gene, thrombospondin 2, and those of adult LCs, hydroxysteroid dehydrogenase-6, delta5-3-beta and prostaglandin D synthase, were similar in wild-type and hCG+ males. Hence, the postnatal adenomas resemble functionally fetal LCs, and only these cells are susceptible to hCG-induced tumorigenesis. Our findings demonstrate a novel intriguing difference between the fetal and adult LC populations and provide further insight into the potential tumorigenic effects of gonadotropins.     

The associations of emotion regulation and dysregulation with the metabolic syndrome factor

OBJECTIVE: Emotion regulation has been associated with good, and dysregulation with poor subjective health; but it is unclear if emotion regulation is related to metabolic syndrome. METHODS: Associations between the metabolic syndrome factor (systolic and diastolic blood pressure, waist circumference, high-density lipoprotein, triglycerides, and glucose), emotion regulation (the strategies of repair and maintenance, self-perceived emotion regulation) and dysregulation (emotional ambivalence); and subjective health (self-rated health and psychosomatic symptoms) were studied using a structural equation modelling (SEM) approach. The participants (96 women, 85 men) were drawn from the Jyv?skyl? Longitudinal Study of Personality and Social Development (JYLS). RESULTS: High repair was associated directly to the low metabolic syndrome factor, while high maintenance, high self-perceived emotion regulation, and low emotional ambivalence were related indirectly to the low metabolic syndrome factor through good subjective health. CONCLUSIONS: Successful emotion regulation may have an association not only with the subjective experience of health, but also with physiological regulation systems, leading to a reduced risk for metabolic syndrome.     

Absence of the genetic variant Val79Met in human chorionic gonadotropin-beta gene 5 in five European populations

Chorionic gonadotropin (CG) is an essential signal in establishment and maintenance of pregnancy in humans and higher primates. A G-to-A transition in exon 3 of human CGbeta gene 5, changing the naturally occurring valine residue to methionine in codon 79 (Val(79)Met) has been reported at carrier frequency 4.2% in a random population from the Midwest of the United States. The biological activity of the variant hCG was similar to that of wild-type (WT) hCG. However, the Val(79)Met beta-subunit displayed impaired ability to assemble with alpha-subunit, and the amount of hCG alpha/beta heterodimers formed and secreted by transfected cells was seriously impaired in the previous study. Because of these functional implications we found it important to study the occurrence of the Val(79)Met hCGbeta variant in other populations. By using a PCR-RFLP method, a search for the Val(79)Met hCGbeta variant was carried out on a total of 580 DNA samples from five European populations (Finland, Denmark, Greece, Germany and the UK). The results demonstrated an absence of the polymorphism in these populations. Hence, the naturally occurring variant (Val(79)Met) of the hCGbeta gene 5, found previously at high frequency in the US, is clearly less common, or absent, in the European populations studied.