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Biomedical subjects

A Rissanen

Publications and source records attributed to A Rissanen.

At least 19 recordsLinked to original sources
PubMed1995

Effect of intensive training on the isokinetic strength and structure of lumbar muscles in patients with chronic low back pain.

STUDY DESIGN: This study investigated the effects of the intensive physical rehabilitation program on the trunk and knee extensor muscles in patients with chronic low back pain. At baseline and after 3 months, strength was measured and muscle biopsies were taken. OBJECTIVES: To evaluate the effects of strength exercises on the structure of back muscles. SUMMARY OF BACKGROUND DATA: Rehabilitation designed for chronic low back pain patients improves trunk muscle strength, mobility of the spine, and the patients' functional capacity. The effects of such programs on the structure of back muscles have not been reported previously. METHODS: Thirty patients with chronic low back pain volunteered to participate in the study. Biopsies were taken from the multifidus and vastus lateralis muscles. The sizes of Types 1 and 2 muscle fibers were measured. The peak-torques of isokinetic trunk and knee extension were determined at two different angular velocities. RESULTS: Strength increased by 19-22% (P < 0.05) in trunk extension and by 7-11% (P < 0.05) in knee extension. Type 1 fibers maintained their pre-exercise size. The size of Type 2 muscle fibers in men increased by 11% (P < 0.05) in the multifidus and by 8% (P < 0.05) in the vastus lateralis. In women, the corresponding increases were 11% (P = 0.16) and 11% (P < 0.05). The correlation between the size of Type 2 muscle fibers in the multifidus and the strength of trunk extension improved, especially in men at follow-up. CONCLUSIONS: The results of the present study suggest that training with maximal or submaximal effort may reverse the selective atrophy of Type 2 fibers in the multifidus muscles in men. Intensive training also can significantly increase the trunk extension strength in women, but women may need a longer training period than men to achieve significant structural changes in their back muscles.

Adult↗
PubMed1995

Consistency and change of body mass index and weight. A study on 5967 adult Finnish twin pairs.

OBJECTIVE: To study twin resemblance for weight change (delta wt) and to assess the consistency of body mass index (BMI) over 6 years. DESIGN: 6 year follow-up based on identical mailed questionnaires in 1975 (baseline) and in 1981 (follow-up). SUBJECTS: 5967 same-sexed non-pregnant Finnish twin pairs aged 18-54 in 1975 (1106 male and 862 female monozygotic (MZ) and 2430 male and 1569 female dizygotic (DZ) pairs). MAIN OUTCOME MEASURES: Intra-pair correlations of delta wt and BMI, estimates of genetic and environmental components of variance of delta wt and BMI. RESULTS: Unadjusted mean delta wt was +2.0 (s.d. = 4.6) kg among MZ and 2.1 (4.9) kg among DZ male individuals. Corresponding values among MZ and DZ female individuals were +1.5 (4.4) kg and +1.7 (4.4) kg, respectively. Age and initial BMI together explained 8.0% of the male and 2.3% of the female phenotypic variance of delta wt. The intraclass correlations for delta wt (adjusted for age and initial BMI) for all pairs were 0.29 and 0.07 for MZ and DZ men and 0.25 and 0.05 for MZ and DZ women, respectively. The BMI of the twins increased slightly during the follow-up compared to the baseline values (23.9 (2.7) for MZ and 24.1 for DZ men and 23.0 (3.3) for MZ and 23.2 (3.42) for DZ women). The intra-class correlations for BMI at baseline (0.69 for MZ and 0.34 for DZ men and 0.67 for MZ and 0.29 for DZ women) were almost identical with the correlations at follow-up (0.67 for MZ and 0.32 for DZ men and 0.69 for MZ and 0.29 for DZ women). The intra-class correlations for both BMI and delta wt were consistently higher among pairs living together than among pairs living apart at baseline and at follow-up in both zygosity groups (MZ and DZ). Among pairs living apart at baseline, the longitudinal model for BMI showed that the correlation between genetic effects at baseline and at follow-up was very high (> 0.9 in all age groups among both genders). The correlations for environmental effects ranged from 0.50 to 0.67 during the follow-up period. CONCLUSION: Weight changes in adults over a 6-year period appear to be determined by environmental effects rather than genetic factors. However, the genetic component in BMI is considerable and stable over time. Shared environment is likely to contribute to the resemblance of both delta wt and BMI among adult twin pairs, especially among MZ pairs.

Adolescent↗
PubMed1994

Isokinetic and non-dynamometric tests in low back pain patients related to pain and disability index.

STUDY DESIGN: This study compared isokinetic and non-dynamometric tests for their correlation with subjective low back pain symptoms. METHODS: A total of 185 patients with chronic low back pain were examined. RESULTS: The repetitive arch-up and sit-up tests correlated significantly with pain and disability (Million index) both in men and women (r ranged from -0.39 to -0.46; P < 0.001). In women, the isokinetic trunk flexion and extension tests and the non-dynamometric tests correlated equally well with the Million index. In men, the isokinetic flexion and extension tests had weaker correlations. Overall, the isokinetic lifting tests showed lower correlations than did the isokinetic trunk extension tests. In the isokinetic flexion and extension tests, fast testing speeds (120 degrees/sec and 150 degrees/sec) correlated somewhat better with the subjective symptoms than did the lowest speed (30 degrees/sec). CONCLUSIONS: The non-dynamometric tests are still useful in clinical practice in spite of the development of more accurate muscle strength evaluation methods.

Adult↗
PubMed1994

Intensive physical and psychosocial training program for patients with chronic low back pain. A controlled clinical trial.

STUDY DESIGN: The authors conducted a controlled clinical trial with 1-year follow-up to define the effectiveness of an intensive physical and psychosocial training program on patients with low back pain. SUMMARY OF BACKGROUND DATA: The intervention group included 152 patients (mean age 40.5 yr, Million index 45.1/100), and the reference group included 141 patients (mean age 40.4 yr, Million-index 44.5/100). METHODS: The progressive intervention program consisted of intensive physical training and psychosocial activation. The outcomes were physical and psychosocial measures, the pain and disability index (Million), sick leaves, and occupational handicap. RESULTS: The intervention was more efficient with respect to physical measures and pain and disability index. There were only mild or no differences in changes between the study groups in psychologic variables, sick leaves, or retirement. CONCLUSIONS: The intervention program could improve physical disability, but to improve occupational handicap, activities of the whole society (social legislation, labor market policy) are needed.

Absenteeism↗
PubMed1994

Lumbar muscle fiber size and type distribution in normal subjects.

The macroanatomy of the clinically important lumbar muscles has recently been investigated in detail, whereas the information about their microscopic structure in healthy persons is still scanty. In this study we have analysed lumbar multifidus and erector spinae muscles from 21 previously healthy persons who died suddenly and were of working age (range 23-65 years, mean 44.7 years). The microscopic structure of myofibers within the lumbar muscles was found to be regionally uniform, which renders in vivo biopsies representative of the whole muscle bulk. Somewhat surprisingly, age did not significantly influence fiber type composition, fiber size, or proportion of nonmuscular tissue. There was a slight predominance of type 1 fibers. The size of type 1 fibers (mean lesser diameter 54.0 microns) corresponded to that in other skeletal muscles, with no significant sex difference (55.1/51.6 microns male/female). Selective type 2 fiber atrophy was a common finding in both sexes, but significantly less so in men (mean diameter 38.8/28.4 microns male/female). We suggest that the values of fiber type proportions and fiber size in the deep multifidus presented in this study can be used as reference values for healthy adults in the present society with limited physical activity.

Adult↗
PubMed1994

A randomized, double-blind, placebo-controlled trial of nimodipine in acute ischemic hemispheric stroke.

BACKGROUND AND PURPOSE: A randomized, double-blind, placebo-controlled multicenter trial was conducted to test the hypothesis that nimodipine would improve the functional outcome in acute ischemic hemispheric stroke. METHODS: A total of 350 patients were randomized to nimodipine 120 mg/d PO or matching placebo for 21 days. Randomization was stratified by onset of therapy, age, and stroke severity. Treatment was begun within 48 hours of onset. The patients had neurological evaluation on admission, on days 1, 7, and 21, and at 3 and 12 months. The primary end points were Rankin grade, neurological score, and mobility at 12 months. RESULTS: We did not find any differences in the functional outcome between the treatment groups or between the stratified subgroups. We were also unable in post hoc analyses to find any groups of patients who benefited from nimodipine. During the first month and at 3 months the case-fatality rate was higher in the nimodipine-treated patients than in those on placebo (P = .004 and P = .030, respectively), but at the 1-year follow-up this difference had lost statistical significance. During the first week nimodipine had a statistically significant lowering effect on both systolic (P = .005) and diastolic (P = .013) blood pressure. CONCLUSIONS: Nimodipine did not improve the functional outcome of acute ischemic hemispheric stroke. The early case-fatality rate was higher in the nimodipine group, possibly due to the blood pressure-lowering effect of nimodipine.

Aged↗
PubMed1992

Serum antioxidant vitamins and risk of cataract.

OBJECTIVE: To investigate serum concentrations of alpha tocopherol, beta carotene, retinol, and selenium for their prediction of end stage cataract. DESIGN: A case-control study, nested within a cohort study, based on the linkage of records of subjects aged 40-83 from a health survey with those from the national Finnish hospital discharge register. SUBJECTS: 47 patients admitted to ophthalmological wards for senile cataract over 15 years and two controls per patient individually matched for sex, age, and municipality. MAIN OUTCOME MEASURE: Concentration of serum micronutrients, development of cataract according to whether operation was performed. RESULTS: Low serum concentrations of antioxidant vitamins predicted the development of senile cataract, the odds ratio between the lowest third and the two higher thirds of the distribution of serum concentrations of alpha tocopherol and beta carotene being 1.9 (95% confidence interval 0.9 to 4.1) and 1.7 (0.8 to 3.8), respectively. Patients with both alpha tocopherol and beta carotene concentrations in the lowest third had an odds ratio of 2.6 (1.0 to 6.8) of cataract compared with subjects in the top two thirds. The associations were strengthened by adjustment for potential confounding factors such as occupation, smoking, blood pressure, serum cholesterol concentration, body mass index, and diabetes. No association was found between the serum concentrations of selenium, retinol, and retinol binding protein and the risk of cataract. CONCLUSIONS: Low serum concentrations of the antioxidant vitamins alpha tocopherol and beta carotene are risk factors for end stage senile cataract. Controlled trials of the role of antioxidant vitamins in cataract prevention are therefore warranted.

Adult↗
PubMed1992

Serum ceruloplasmin and the risk of cancer in Finland.

The relationship between serum ceruloplasmin level and cancer incidence was investigated in a case-control study nested within a longitudinal study of 39,268 Finns participating in the Social Insurance Institution's Mobile Clinic Health Examination Survey carried out in 1968-1972. During a median follow-up of 8 years, 766 cancer cases were identified. Ceruloplasmin levels were determined from stored serum samples collected at the baseline from these cancer cases and from two matched controls per case. The overall incidence of cancer was positively associated with serum ceruloplasmin level. The association was strongest for lung cancer and other cancers related to smoking and, consequently, in males. The smoking-adjusted relative risk of lung cancer among men was 4.3 (95% confidence interval (CI) = 1.8-10.6) in the highest quintile of serum ceruloplasmin as compared with that in the lowest quintile. The corresponding relative risks for cancers related to smoking combined, and for cancers not related to smoking were 3.9 (CI = 1.9-8.4) and 0.9 (CI = 0.6-1.5), respectively. The elevated risk of lung cancer at high concentrations of serum ceruloplasmin persisted after further adjustment for several potential confounding factors such as serum levels of vitamins A and E and selenium. The risk was stronger during the first 6 years of follow-up than later, and strongest during the first 2 years. The most likely explanation of the present results thus is that high serum ceruloplasmin levels in lung cancer are mainly due to occult cancer.

Adolescent↗
PubMed1992

Effects of weight loss on substrate oxidation, energy expenditure, and insulin sensitivity in obese individuals.

To evaluate the effect of weight loss on substrate oxidation, energy expenditure, and insulin sensitivity we studied 12 obese subjects (body mass index 33.4 +/- 1.1) before and after 6 wk of a very-low-calorie diet (VLCD) with euglycemic insulin clamp in combination with indirect calorimetry. Body weight decreased from 105.3 +/- 4.6 to 94.1 +/- 4.0 kg (P less than 0.001) and fat mass from 47.2 +/- 3.6 to 37.7 +/- 3.0 kg (P less than 0.001). Total glucose disposal during insulin clamp increased from 30.4 +/- 4.3 to 38.4 +/- 4.4 mumol.kg lean body mass (LBM)-1.min-1 (P less than 0.05), insulin-stimulated glucose oxidation from 14.3 +/- 4.6 to 19.1 +/- 1.4 mumol.kg LBM-1.min-1 (P less than 0.05), and non-oxidative glucose metabolism from 16.0 +/- 3.8 to 19.3 +/- 3.6 mumol.kg LBM-1.min-1 (NS). Lipid oxidation decreased in the basal state (P less than 0.05) and during the insulin clamp (P less than 0.01). The basal rate of energy expenditure decreased from 99.1 +/- 4.6 to 88.5 +/- 2.7 kJ.kg LBM-1.min-1 (P less than 0.05) after weight reduction. A reduction in fat mass achieved by VLCD is associated with reduced lipid oxidation and, because of substrate competition, enhanced glucose oxidation. The physiological consequence is improved insulin sensitivity.

Adult↗
PubMed1992

Weight loss by very-low-calorie diets: effects on substrate oxidation, energy expenditure, and insulin sensitivity in obese subjects.

Weight reduction improves glucose utilization, but it is not known whether this occurs primarily through the oxidative or nonoxidative pathways of glucose metabolism. We studied this question in 12 obese subjects [whose body mass index (BMI) was 33.4 +/- 1.1 kg/m2)] before and after 6 wk on a very-low-calorie diet of 1680 kJ/d with the euglycemic insulin clamp technique in combination with indirect calorimetry. The mean body weight decreased from 105.3 +/- 4.6 to 94.1 +/- 4.0 kg (P less than 0.001). This was mainly due to a reduction in fat mass from 47.2 +/- 3.6 to 37.7 +/- 3.0 kg (P less than 0.001), whereas lean body mass decreased only slightly (from 58.0 +/- 2.0 to 56.4 +/- 1.8 kg). The basal energy expenditure decreased with weight loss by 10.7%. This was associated with a reduced rate of lipid oxidation (P less than 0.05). Weight loss increased glucose utilization by 26%, primarily by enhancing insulin-stimulated glucose oxidation (P less than 0.05), whereas the effect on nonoxidative glucose metabolism was less pronounced (P greater than 0.05). Substantial weight loss increases glucose utilization by enhancing glucose oxidation.

Adult↗
PubMed1991

Leanness and lung-cancer risk.

Body mass index (weight/height2) was studied for its prediction of lung cancer in Finnish men examined by the Social Insurance Institution's Mobile Clinic and followed up by the Finnish Cancer Registry. Among 25,994 participants aged 20 to 75 years and free from cancer at the start of the study, 504 lung-cancer cases were diagnosed during a maximum follow-up of 19 years. There was a significant inverse gradient between body mass index and the incidence of lung cancer. This association was not due to confounding by age, smoking, social class, self-perceived general health, history of stress symptoms, chronic cough or chest X-ray findings, although these factors correlated with body mass index and were also significantly predictive of lung cancer. After adjustment for these factors, the relative risks of lung cancer were 1.0, 1.4, 1.5 and 1.8 (p for trend less than 0.001) from the highest to the lowest quartiles of body mass index. The association was noted among current smokers, but it was most obvious among men who had never smoked, the relative risk of lung cancer between the lowest and highest quartiles of body mass index being 7.6 (95% confidence interval = 2.0 to 29.4). The inverse gradient persisted throughout the entire follow-up period, and was most distinct after the first 10 years of follow-up, the relative risks for the quartiles of body mass index being 1.0, 1.9, 2.3 and 2.6 (p less than 0.001). The present study shows that the thinner the man, the more liable he is to develop lung cancer. Leanness or some factor or cluster of factors closely correlated to it, may play an aetiological role in lung cancer.

Adult↗
PubMed1991

Dietary antioxidants and the risk of lung cancer.

The relation between the intake of retinoids, carotenoids, vitamin E, vitamin C, and selenium and the subsequent risk of lung cancer was studied among 4,538 initially cancer-free Finnish men aged 20-69 years. During a follow-up of 20 years beginning in 1966-1972, 117 lung cancer cases were diagnosed. Inverse gradients were observed between the intake of carotenoids, vitamin E, and vitamin C and the incidence of lung cancer among nonsmokers, for whom the age-adjusted relative risks of lung cancer in the lowest tertile of intake compared with that in the highest tertile were 2.5 (p value for trend = 0.04), 3.1 (p = 0.12), and 3.1 (p less than 0.01) for the three intakes, respectively. Adjustment for various potential confounding factors did not materially alter the results, and the associations did not seem to be due to preclinical cancer. In the total cohort, there was an inverse association between intake of margarine and fruits and risk of lung cancer. The relative risk of lung cancer for the lowest compared with the highest tertile of margarine intake was 4.0 (p less than 0.001), and that for fruits was 1.8 (p = 0.01). These associations persisted after adjustment for the micronutrient intakes and were stronger among nonsmokers. The results suggest that carotenoids, vitamin E, and vitamin C may be protective against lung cancer among nonsmokers. Food sources rich in these micronutrients may also have other constituents with independent protective effects against lung cancer.

Adult↗
PubMed1991

Fuel metabolism in anorexia nervosa and simple obesity.

To examine insulin sensitivity and the relative contribution of different fuels to energy metabolism in anorexia nervosa and obesity, we measured oxidation (indirect calorimetry) of glucose, lipids, and proteins in the basal state and during an insulin clamp (+45 mU/m2.min) in 11 women with anorexia nervosa (age, 25 +/- 3 years; body mass index [BMI], 13.6 +/- 0.4 kg/m2; fat mass, 15.7% +/- 1.6%), eight obese women (age, 31 +/- 3; BMI 36.0 +/- 1.5; fat mass, 47.1% +/- 1.9%), and eight controls (age, 26 +/- 3; BMI, 21.8 +/- 0.9; fat mass, 25.7% +/- 3.6%). Expressed per lean body mass, (LBM), glucose disposal was equally reduced in anorectics (7.53 +/- 0.62 mg/kg LBM.min) and obese (6.80 +/- 1.07 mg/kg LBM.min) compared with controls (10.64 +/- 0.69 mg/kg LBM.min; P less than .01). The reduction in glucose disposal in anorectics was primarily due to a significant (P less than .01) reduction in glucose storage, while glucose oxidation was normal. In obese women, both storage and oxidation of glucose were reduced compared with controls (P less than .01). Basal energy expenditure was similar in anorectic, obese, and control subjects (20.6 +/- 1.00, 23.7 +/- 0.56, 23.2 +/- 1.36 cal/kg LBM.min, respectively). However, the contribution of glucose, lipids, and proteins to basal energy expenditure differed between anorectic (62%, 16%, 22%), obese (26%, 58%, 16%), and control (30%, 54%, 16%) subjects (P less than .05 v all). In conclusion, in anorexia nervosa, insulin stimulates glucose oxidation more than storage. In obesity, both components of insulin-stimulated glucose metabolism are impaired.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Risk factors for subarachnoid hemorrhage in a longitudinal population study.

The known risk factors of atherosclerotic diseases may be involved in the development of a subarachnoid hemorrhage. We studied the morbidity and mortality due to subarachnoid hemorrhage among 42,862 men and women aged 20-69 years who had participated in a large health survey in Finland. During a mean follow-up of 12 years, 102 non-fatal and 85 fatal cases of subarachnoid hemorrhage were observed. The total incidence was 37 per 100,000 person-years. Smoking and hypertension were positively associated and body mass index was inversely associated with the risk of subarachnoid hemorrhage. These associations were not confounded by age or each other. No statistically significant association with risk was detected for serum cholesterol level, hematocrit content, known heart disease, or diabetes. The risk was especially elevated among lean hypertensive subjects and lean smoking subjects. The age-adjusted relative risks of subarachnoid hemorrhage for lean, hypertensive smokers were 18.3 (95% confidence interval (CI), 7.8-42.7) among women and 6.7 (95% CI, 2.3-19.7) among men as compared to the risk among subjects without these risk factors. We conclude that modifiable risk factors are predictive of subarachnoid hemorrhage, for which reason subarachnoid hemorrhage may in part be preventable. Leanness combined with arterial hypertension and/or smoking, in particular, poses a substantially elevated risk.

Adult↗
PubMed1991

Weight and mortality in Finnish women.

Mortality in relation to body mass index (BMI) was studied in 17,159 healthy Finnish women aged 25-79 followed up for a median of 12 years. Mortality from all cases was related to BMI only in non-smokers aged 25-64, among whom the mortality pattern was "U"-shaped, with a minimum in the second quintile of BMI (the reference range), and about 1.5 times higher in quintiles I and V. Most of the excess risk of mortality among overweight women was due to cardiovascular diseases. During the first 7 years of follow-up, and high risk (relative risk (RR) = 1.7, 95% confidence interval (CI) = 1.0-2.9 for quintile V compared to quintile II) depended on the association of BMI with the initial blood pressure level, but in the later years, the relative risk of cardiovascular death, ranging from 1.6 (95% CI = 1.0-2.5) for women in quintile III up to 2.6 (95% Ci = 1.7-4.0) for those in quintile V, was largely independent of the baseline levels of the main biological risk factors. The excess mortality among thin women under the age of 65 was mainly due to non-cardiovascular diseases (RR = 1.7, 95% CI = 1.2-2.3 for quintile I compared to quintile II) and was not attributable to antecedent disease, smoking or the biological risk factors studied. Among women aged 65 and over, overall mortality varied little with BMI, but thinness seemed to predict deaths from cancers (RR = 1.6, 95% CI = 0.9-3.0).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Effects of gender and age on the heritability of body mass index.

We estimated genetic and environmental components of variance of body mass index (BMI) among 7245 same-sexed Finnish MZ and DZ twin pairs aged 18-54 years from the nationwide Finnish Twin Cohort. Age accounted for 20 per cent of variance among men and 26 per cent in women. The contributions of additive genetic effects, shared and non-shared environmental effects on BMI-variance were estimated by LISREL structural equation models. Genetic effects accounted for 72 per cent and 68 per cent of total variance in men and non-pregnant women respectively, while 28 per cent of variance among men and 32 per cent among women was due to non-shared environmental effects. This gender difference was statistically significant. Models including shared environmental effects did not improve model fits. The magnitude of the genetic component of BMI was also analysed separately for each 10-year age group. Models with age-specific parameters for genetic and environmental effects fitted significantly better than models with effects constrained to be equal over age. Our results indicate a substantial genetic component in BMI. However, the magnitude of additive genetic effects decreases with age in both genders.

Adult↗
PubMed1990

Risk of disability and mortality due to overweight in a Finnish population.

OBJECTIVE: To investigate the effect of overweight on premature mortality and work disability in young and middle aged Finns. DESIGN: Prospective cohort study based on data collected in the multiphasic health examinations by the Social Insurance Institution of Finland from 1966 to 1972 and follow up until 1982. SETTING: 34 Communities throughout Finland. SUBJECTS: 12,053 Women and 19,076 men who were employed and aged 25-64 at baseline. MAIN OUTCOME MEASURES: Mortality and work disability pensions from all and specified causes. RESULTS: Body mass index was a weak predictor of death but a strong predictor of early work disability, which increased linearly with body mass index. After adjustment for age, geographical region, occupation, and smoking the relative risks of work disability for women and men with a body mass index greater than or equal to 30 kg/m2 were, respectively, 2.0 (95% confidence interval 1.8 to 2.3) and 1.5 (1.3 to 1.7) when compared with those of subjects with body mass index less than 22.5 kg/m2. The increased risks were due to an excess of cardiovascular and musculoskeletal diseases but not of mental diseases. One fourth of all disability pensions from cardiovascular and musculoskeletal causes in women and half as many in men could be attributed to overweight (body mass index greater than 25 kg/m2) alone. CONCLUSIONS: Though modest overweight has little impact on mortality it predicts severe functional impairment. A considerable proportion of work disability pensions could probably be prevented by efficient weight control.

Adult↗