Bacterial infection in under school age children with expiratory difficulty

Serological evidence of bacterial infection was prospectively studied in less than 6 years old patients during 188 acute episodes of expiratory difficulty requiring hospital treatment. Such evidence indicated by antibody or antigen assays was found in 40 patients (21%). Streptococcus pneumoniae was identified in 25 cases; antigenemia was found in 10, antigenuria in 2 and seroconversion in 14 cases. Seroconversion to nontypable Haemophilus influenzae was found in 9 and to Branhamella catarrhalis in 2 cases. Seroconversion to Chlamydia spp. was demonstrated in 8 patients, but specific tests for C. trachomatis were negative. C-reactive protein was over 40 mg/L in 35 patients (19%); serological evidence of bacterial infection was present in 14 and absent in 21 of them. Thus, either serological evidence of bacterial infection or an elevated C-reactive protein was found in 61 of the 188 cases (32%). We conclude that bacterial infection is commonly associated with acute wheezing in children under school age. We suggest that bacterial, as well as viral, infections may trigger an acute obstructive attack in children with reactive airways.     

Changes in the oral health of adolescents treated by the Finnish public dental services between the ages of 13 and 15 years

Oral cavity health was monitored in 2422 young people aged 13–15 years attending four health centres in Finland between 1992 and 1995. Assessments were made in terms of DMF, D and CPITN indices at clinical examinations. Of those who had no carious teeth at the initial examination, 60% did not develop cavities during the whole period, whereas half of those who had at least two carious teeth at the initial examination developed at least three new carious teeth The treatment time needed by the latter accounted for half of the total time expended by the researchers until the end of the period. Costs can be saved or new patients brought into the dental care system by reorganizing the treatment of the patients who suffer from abundant caries and by reducing the resources devoted to the treatment of healthy patients.     

Titanium implants and lateral forces. An experimental study with sheep.

The purpose of this study was to investigate the resistance of titanium implants to horizontal forces in a sheep model. Twenty implants were inserted into the foreheads of 5 sheep, 4 implants on each animal. After a healing period of 3 months, abutments were mounted on the implants. After a further healing period of 3 weeks, the implants were loaded with a horizontal pull of orthodontic elastics. The force varied between 250 and 350 grams. The duration of loading was 3 months. After the loading period the animals were sacrificed and the forehead bones with implants were fixed in formalin and evaluated histologically. In the histological specimens no signs of infection or bone loss were found around the implants. The results of the present study encourage the use of titanium implants also in cases where constant lateral forces are present.     

Five-year prognosis for dysthymic disorder in old age

The 5-year prognosis for 199 elderly patients (60 yr+) suffering from dysthymic disorder is described. Twenty-nine per cent of the men and 39% of the women recovered, 26% of both were suffering from depression after 5 years, 9% of both had a possible dementia, 32% of the men and 22% of the women had died and 3% of the men and 5% of the women could not be contacted. The outcome did not differ between the sexes or age groups. A poor prognosis among men was related to a low educational level, a non-independent previous occupation, the occurrence of depression previously, a high number of hobbies and the following depressive symptoms: initial and delayed insomnia, retardation and psychomotor agitation. A poor prognosis was also found for those whose functional capacities, hobbies or emotional relations with their wives had declined or who had experienced a pulmonary disease or few or no social growth events during the follow-up. A poor prognosis among women was related to low self-perceived health, high sum score of the Hamilton Rating Scale for Depression, thyroid disorder and the following depressive symptoms: loss of libido and diurnal variation of symptoms. A poor prognosis was also found for those whose physical health, functional capacities, social participation rate or hobbies had declined or who had experienced a serious disease during the follow-up. A favourable prognosis was found for women who moved to live alone or became more active in taking physical exercise.     

Arthrography, clinical examination, and stress radiograph in the diagnosis of acute injury to the lateral ligaments of the ankle.

We examined 188 consecutive patients, each of whom had an acute ankle sprain, using clinical stability assessment, stress radiographs, and arthrography to compare the reliability of these methods used in diagnosing lateral ligament ruptures of the ankle. Sixty-six of the ankles were treated operatively. Arthrography accurately detected ligament damage in all of the patients with this injury and revealed the extent of the injury in about 85%, whereas clinical examination and stress radiographs detected only about half of the injuries. The injuries and the results of these two methods were often controversial, as our study will show.     

Interferon-gamma protects human endothelial cells from lymphokine-activated killer cell-mediated lysis

In adoptive immunotherapy the lymphokine-activated killer (LAK) cells, known to be cytotoxic to many tumor cell lines, are injected i.v. into tumor-bearing animals or cancer patients. However, in addition to a significant reduction in tumor masses, complications occur in many cases, most severe of which are the vascular leak syndrome and hypotension. In this report we show that LAK cells are also cytotoxic to normal vascular endothelial cells, which may partly contribute to these complications. Incubation of the endothelial cells with interferon-gamma (IFN-gamma), but not with interleukin 1 (IL 1) or tumor necrosis factor, protects the endothelial cells from LAK-mediated lysis in a dose- and time-dependent manner. The protective effect is abolished by monoclonal antibody against IFN-gamma. However, the IFN-gamma treatment does not protect LAK-sensitive tumor cell lines from LAK-mediated lysis. Concomitantly IFN-gamma also induces both class I and class II antigens on endothelial cells. The induction of these major histocompatibility complex (MHC) antigens does not explain the protective effect: timewise, the protection is complete already within 24 h after addition of IFN-gamma to endothelial cell culture, whereas the induction of MHC antigens peaks at 72 h, and antibodies against these antigens are not able to abolish the protective effect.     

Microvascular flaps from the lateral arm and radial forearm for the repair of defects of the Achilles tendon region. Case report

Two patients presented with loss of skin in the Achilles tendon region, which is difficult to repair satisfactorily. They were both treated with microvascular flaps, one of which was taken from the lateral arm, and the other from the radial forearm. Both methods gave good functional results.     

Angiotensin-converting enzyme genotypes in the high- and low-risk area for coronary heart disease in Finland

The deletion/deletion genotype of the insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) gene has been suggested to be a risk factor for myocardial infarction (MI). The objective of this study was to evaluate whether genotypic distributions of the I/D polymorphism of the ACE gene are different between individuals from high-risk and low-risk areas for coronary heart disease in the genetically isolated population of Finland and to assess the impact of this genetic risk factor by comparing individuals with different parental histories of MI. Representative population-based samples of middle-aged men (n = 363) and women (n = 358) from two areas of Finland were used. The area had a borderline significant effect on the prevalence of the genotype DD (β = 0.35, SE = 0.16, χ² = 4.70, df = 1, P = 0.03), the DD genotype being more prevalent in eastern Finland (the high-risk area). The II genotype was more prevalent in women with parental history of MI, so we could not replicate the previous findings of the risk-increasing effect of DD genotype in this sample. Although the observed difference in the ACE DD genotype between the high-risk and low-risk areas for coronary heart disease might represent one of the genetic factors contributing to the difference in risk of coronary heart disease between eastern and southwestern Finland, the data emphasize the fact that also other risk factors, including other genes, contribute to this difference and the high incidence of MI in Finland. ©1995 Wiley-Liss, Inc.     

Bayesian oligogenic analysis of quantitative and qualitative traits in general pedigrees

A Bayesian method for multipoint oligogenic analysis of quantitative and qualitative traits is presented. This method can be applied to general pedigrees, which do not necessarily have to be “peelable” and can have large numbers of markers. The number of quantitative/qualitative trait loci (QTL), their map positions in the genome, and phenotypic effects (mode of inheritances) are all estimated simultaneously within the same framework. The summaries of the estimated parameters are based on the marginal posterior distributions that are obtained through Markov chain Monte Carlo (MCMC) methods. The method uses founder alleles together with segregation indicators in order to determine the genotypes of the trait loci of all individuals in the pedigree. To improve mixing properties of the sampler, we propose (1) joint sampling of map position and segregation indicators, (2) omitting data augmentation for untyped or uninformative markers (homozygous parent), and (3) updating several markers jointly within a single block. The performance of the method was tested with two replicate GAW10 data sets (considering two levels of available marker information). The results were concordant and similar to those presented earlier with other methods. These analyses clearly illustrate the utility and wide applicability of the method. Genet. Epidemiol. 21:224–242, 2001. © 2001 Wiley‐Liss, Inc.     

Examination of the sprained ankle: anterior drawer test or arthrography?

The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis.