Lack of fibronectin-binding plasma membrane proteins may explain defective pericellular matrix formation in transformed fibroblasts and fibrosarcoma cells

Affinity of iodinated fibronectin (Fn) and its defined proteolytic fragments to electrophoretically separated polypeptides of normal and malignant cells was studied in an overlay assay. Cellular 125I-Fn and a major 125I-Fn fragment (Mr 120,000-140,000), containing the cell-binding site, revealed in fibroblasts Mr 170,000, Mr 140,000, and Mr 47,000 Fn-binding polypeptides of which the first two could also be found in the plasma membrane preparations. Binding of 125I-Fns to Mr 170,000 and Mr 140,000 polypeptides was inhibited by the synthetic peptide Arg-Gly-Asp-Ser and to all 3 polypeptides by Fns and Mr 120,000-140,000 fibronectin fragment. Both fibrosarcoma cells and SV40-virus-transformed fibroblasts appeared to lack the Mr 140,000 Fn-binding polypeptide. Binding was similar when Fn from normal fibroblasts or fibrosarcoma cells was used in the assay, while plasma 125I-Fn had weaker affinity towards the Mr 140,000 polypeptide. Instead, proteolytic Fn-fragments, lacking the cell binding site, did not bind to any proteins in the assay. Radioactive cell-surface labelling showed differences in the corresponding surface polypeptide profiles of normal and malignant cells. The results suggest that the failure of pericellular matrix deposition in malignant cells could be due to either defective surface exposition or defective binding property of the Fn-receptor-like polypeptides.     

Results of reoperations for coronary artery disease

Seventy-one patients undergoing reoperation for coronary artery disease were examined on average 2.5 years postoperatively. Operative mortality was 9.9% and late mortality 6.3%. 88% of the patients improved subjectively, and although only 7.8% were angina-free, 79.9% were in NYHA Class I or II. All patients who had been working before reoperation returned to work, and either patients who were on sick-leave before resumed their activities. A follow-up examination was performed in 21 patients with a follow-up time of more than three years. The mean peak work capacity did not change after reoperation and also the ST changes during the bicycle ergometer exercise test were the same after reoperation. The mean ejection fraction diminished from 54 +/- 15.5% to 44.7 +/- 15.2%. In thallium perfusion studies areas of hypoperfusion were observed in 14 cases (67%). Coronary angiograms showed 3.0 +/- 1.0 patent anastomoses at the follow-up examination; 76% of the anastomoses performed in the reoperations were patent. It can be concluded that although the objective results of repeat myocardial revascularisation in this material are not optimal, the subjective improvement of the patients was satisfactory, and in the majority of cases reoperation ensures an acceptable quality of life for years.     

Feeding habits as determinants of early childhood caries in a population where prolonged breastfeeding is the norm

Abstract – Objectives: To investigate the impact of feeding habits and daytime sugar intake on the prevalence of early childhood caries in a population where prolonged breastfeeding is a norm. Methods: A cross‐sectional study was carried out at 18 of 102 public health centers in Tehran. During a 4‐day period at each center, between 20 and 35 children aged 1–3 years were enrolled, resulting in a sample of 504 children. In structured interviews, mothers were asked to give information about their child’s feeding habits, daytime sugar intake, and their family’s background. Sugar intake during the night was operationalized as separately calculated burdens of nighttime breastfeeding and bottle‐feeding. Clinical dental examinations followed the World Health Organization criteria. Data analysis included chi‐square test, t‐test, anova , and logistic regression modeling. Results: Of the children, 56% were solely breastfed (mean duration 16.6 months; 95% CI 16.0–17.2), 42% were both breastfed and bottle‐fed, and 2% were solely bottle‐fed. Mean duration of breastfeeding for the solely breastfed 24‐ to 36‐month olds was 22.8 months (95% CI 21.8–23.9). At bedtime, 69% were breastfed, 11% bottle‐fed, and 20% were not fed at all. With respect to feeding during the night, 72% of children were breastfed, 12% were bottle‐fed with milk, 1% received a bottle with water, while 15% were not fed. Early childhood caries (ECC) occurred in 3–26% of the children, depending on age group (P < 0.001). The burden of milk‐bottle feeding at night was a clear determinant for ECC (OR = 5.5) whereas breastfeeding per se, its duration, the burden of breastfeeding at night, and daytime sugar intake were not. Conclusion: On account of its association with ECC, milk‐bottle feeding at night should be limited, whereas prolonged breastfeeding appears to have no such negative dental consequences.     

Obesity, increased linear growth, and risk of type 1 diabetes in children

OBJECTIVE: The purpose of the present study was to evaluate the effect of obesity and linear growth on the risk of developing type 1 diabetes in children. RESEARCH DESIGN AND METHODS: The study population consists of all diabetic children <15 years of age diagnosed from September 1986 to April 1989 in Finland and their birth date- and sex-matched population-based control subjects. Growth data were obtained from well-baby clinics and school health care units for 586 diabetic and 571 control subjects, resulting in a total of 18,823 paired weight-height observations. RESULTS: Both boys and girls who developed type 1 diabetes were heavier and taller throughout childhood than control children. A 10% unit increment in relative weight was associated with a 50-60% increase in the risk of type 1 diabetes before 3 years of age and a 20-40% increase from 3 to 10 years of age. The increase in risk of type 1 diabetes for 1 SD score increment in relative height was 20-30%. Obesity (relative weight > 120%) after 3 years of age was associated with a more than twofold risk of developing type 1 diabetes. CONCLUSIONS: The present observation that obesity and rapid linear growth are risk factors for type 1 diabetes in children indicates that the increase in the prevalence of obesity and secular growth that has occurred in most industrialized countries over the last decades may be involved in the increase in type 1 diabetes incidence simultaneously observed in many countries.     

Heart rate variability derived from exercise ECG in the detection of coronary artery disease

The diagnostic performance of heart rate variability (HRV) analysis from exercise ECG in the detection of coronary artery disease (CAD) is unknown. Bicycle exercise ECG recordings from The Finnish Cardiovascular Study (FINCAVAS) of angiography-proofed CAD patients (n = 112) and a patient group with a low likelihood of CAD (n = 114) were analyzed. HRV parameters (SDNN, RMSSD, Poincaré SD1 and SD2) were calculated from 1 min segments before exercise, during exercise and after exercise. All the parameters were in addition calculated from heart rate (HR)-corrected RR-interval segments. The ST-segment depressions in each stage were also determined. The diagnostic performance of the parameters was evaluated with the area under the receiver operating characteristic (ROC) curve method. The uncorrected HRV parameters showed the best diagnostic performance in the recovery segments but the correlation with HR was also high (SDNN: 0.758/-0.64, RMSSD: 0.747/-0.60; area under the ROC/correlation coefficient). The HR correction decreased the correlation and the diagnostic performance in recovery segments (SDNN: 0.515/-0.12, RMSSD: 0.609/0.20). The diagnostic performance of ST-level at its best was higher than any of HRV parameters (ST-level: 0.795/0.36). According to the results, the HR correction decreased the diagnostic performance of the recovery phase. The HRV parameters calculated from 1 min segments of exercise test ECG were not as capable as traditional ST-segment analysis. In conclusion, the HRV analysis from exercise or recovery phase seems to be inadequate in the detection of CAD.     

Mass screenings for cervical cancer in Finland 1963-71. Organization, extent, and epidemiological implications.

In Finland, up to 100,000 smears are taken annually from Finnish women, who number more than 2 millions, in conjunction with the mass screening programme organized by the Cancer Society of Finland. About 400,000 smears were taken during the period 1963-71; the detection rates per 10(5) were found to be 69 for invasive cancer, 6 for microinvasive carcinoma, 168 for carcinoma in situ, 127 for dysplasia of high degree. Those previously married, and those experiencing bleeding on sexual intercourse, formed high risk groups (relative risk 2 and 6) whereas those previously electro-coagulated had a relative risk of 0.13 only. Probably no changes will occur in the time trends of mortality rates as a result of the screening. The incidence of invasive carcinomas was found to be decreasing by time, although the increase in carconoma in situ cases exceeded this decline.     

Trimethoprim resistance of Escherichia coli in outpatients in Finland after ten years' use of plain trimethoprim

Development of trimethoprim resistance among Escherichia coli collected from urine samples in three areas in Finland was studied in 1978-1984. Three different trends of development of resistance were found: in the Turku area resistance has increased evenly during 1978-1982 from 5.4% to 10.1%, but thereafter a plateau seems to have been reached; in the Helsinki area resistance increased rapidly from 2.9% in 1980 to 11.1% in 1984, possibly due to the spread of a trimethoprim resistance transposon Tn7, which occurred significantly more often among E. coli strains in this area than in the Turku area; in the Rovaniemi area resistance has been at a plateau level, between 3.1 and 5.7%, during the whole study. No clear correlation between the consumption of trimethoprim and the level of resistance was found. The frequency of trimethoprim resistance in E. coli isolated from patients less than 65 years was 5.2% and in those isolated from patients greater than or equal to 65 years 14.7%.     

What degree of work overload is likely to cause increased sickness absenteeism among nurses? Evidence from the RAFAELA patient classification system

AIM: This paper reports a study examining whether nurses' work overload is associated with increased sick leave and quantifying the loss of working days from work overload. BACKGROUND: The RAFAELA patient classification system indicates nursing care intensity in relation to an optimum and is one of the few validated monitoring instruments of patient-associated workload among nurses. However, it is not clear whether work overload is a risk factor for increased sickness absenteeism, an important occupational problem in health care. METHOD: An observational cohort study was carried out with 877 nurses, 31 wards and five Finnish hospitals. Patient-associated workload scores from the RAFAELA system were based on a 6-month monitoring period in 2004. Records of 12-month self certified (1-3 days) and medically certified (>3 days) periods of sick leave in the same year were obtained from employers' registers. FINDINGS: The mean workload was 9% (sd = 8%) above the optimum. There was a linear trend between increasing workload and increasing sick leave (P < or = 0.006). Among nurses with workload > or =30% above the optimum the rate of self certified periods of sick leave was 1.44 (95% CI 1.13-1.83) times higher than among those with an optimum workload. The corresponding rate ratio for medically certified sick leave was 1.49 (1.10-2.03). These excess rates of sickness absence resulted in 12 extra sick leave days per person-year. CONCLUSION: Measuring nurses' workload may be an important part of strategic human resource management of nurses to reduce sick leave among nurses.