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Biomedical subjects

J Meriläinen

Publications and source records attributed to J Meriläinen.

16 recordsLinked to original sources
PubMed2003

Register based monitoring shows decreasing socioeconomic differences in Finnish perinatal health.

STUDY OBJECTIVE: Several studies on differences in infant outcome by socioeconomic position have been done, but these have usually been based on ad hoc data linkages. The aim of this paper was to investigate whether socioeconomic differences in perinatal health in Finland could be regularly monitored using routinely collected data from one single register. DESIGN AND SETTING: Since October 1990, the Finnish Medical Birth Register (MBR) has included data on maternal occupation. A special computer program that converted the occupation name into an occupational code and into a socioeconomic position was prepared. Perinatal health was measured with five different indicators. The Finnish MBR data for years 1991 to 1999 (n=565 863 newborns) were used in the study. The study period was divided into three, three year periods to study time trends. RESULTS: An occupational code was derived for 95% of women, but it was not possible to define a socioeconomic position for 22% of women, including, for example, students and housewives (the group "Others"). For the rest, the data showed socioeconomic differences in all perinatal health indicators. Maternal smoking explained up to half of the excess risk for adverse perinatal outcome in the lowest socioeconomic group. The socioeconomic differences narrowed during the 1990s: infant outcome improved in the lowest socioeconomic group, but remained at the same level or even deteriorated in other groups. When comparing the lowest group with the highest group, the odds ratios (OR) adjusted for maternal background characteristics at least halved for prematurity (from 1.32 (95% confidence intervals 1.24 to 1.43) in 1991-1993 to 1.16 (1.08 to 1.25) in 1997-1999), for low birth weight (from 1.49 (1.36 to 1.63) to 1.25 (1.17 to 1.40)), and for perinatal mortality (from 1.79 (1.44 to 2.21) to 1.33 (1.07 to 1.66)). CONCLUSIONS: Social inequality in perinatal health outcomes exists in Finland, but seems to have diminished in the 1990s. These data showed that routinely collected birth register data provide a good source for studies on socioeconomic health differences in the perinatal period, but that uncertainty, mainly attributable to the large group of women with difficult to classify socioeconomic status, remains.

Birth Certificates↗
PubMed1999

Reproductive effects of in utero exposure to estrogen and progestin drugs.

OBJECTIVE: To determine whether in utero exposure to estrogens and progestins other than diethylstilbestrol reduces fertility in offspring. DESIGN: Retrospective cohort study. SETTING: Helsinki, Finland. PATIENT(S): One thousand eight hundred eighty-eight women and men exposed to female hormone drugs in utero from 1954-1963 and 2,044 age-matched controls. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The numbers and timing of live births and marriages for men and women and of unsuccessful pregnancies for women. RESULT(S): There were no differences between the exposed and control men in most outcome indicators. However, fewer exposed men than control men had their first liveborn child within a short time after getting married, and the mean time from the first to the second live birth was shorter. The former also was found for the women. The overall cumulative proportions of liveborn children and pregnancies were similar in the exposed and control groups, but younger exposed men and women had liveborn children and pregnancies somewhat later. CONCLUSION(S): Estrogen- and progestin-containing drugs as used in the study population did not have much impact on the fertility of offspring.

Abortion, Spontaneous↗
PubMed1998

EAST, an epidermal growth factor receptor- and Eps15-associated protein with Src homology 3 and tyrosine-based activation motif domains.

We describe the cloning and characterization of a new cytoplasmic protein designated epidermal growth factor receptor-associated protein with SH3- and TAM domains (EAST). It contains an Src homology 3 domain in its midregion and a tyrosine-based activation motif in its COOH terminus. Antibodies to EAST recognize a 68-kDa protein that is present in most chicken tissues. An epidermal growth factor (EGF)-dependent association between the EGF receptor (EGFR) and EAST was shown by reciprocal immunoprecipitation/immunoblotting studies with specific antibodies. Activated EGFR catalyzed the tyrosine phosphorylation of EAST, as judged by an in vitro kinase assay with both immunoprecipitated and purified EGFR. Immunoprecipitation/immunoblotting experiments also demonstrated an association between EAST and eps15, an EGFR substrate associated with clathrin-coated pits and vesicles, which is essential in the endocytotic pathway. The association between EAST and eps15 was not affected by EGF treatment. In immunofluorescence microscopy, EAST was shown to partially colocalize with clathrin. The sequence of the NH2-terminal portion of EAST shows a high degree of similarity with a group of proteins involved in endocytosis or vesicle trafficking. Thus, EAST is a novel signal transduction component probably involved in EGF signaling and in the endocytotic machinery.

Amino Acid Sequence↗
PubMed1998

IA-2 antibodies--a sensitive marker of IDDM with clinical onset in childhood and adolescence. Childhood Diabetes in Finland Study Group.

To study the relationship of IA-2 antibodies (IA-2A) to other autoantibodies and genetic risk markers in insulin-dependent diabetes mellitus (IDDM), 758 children and adolescents younger than 15 years of age (mean age 8.4 years) with newly diagnosed diabetes were analysed for IA-2A, GAD antibodies (GADA) and insulin autoantibodies (IAA) with radiobinding assays, for islet cell antibodies (ICA) with immunofluorescence and for HLA DR alleles by serology. IA-2A were detected in 85.9% of cases with no association with gender or age. An overwhelming majority of the patients (71.3%) tested positive for three or more antibodies, and 90.7% for at least two. Fifty-four subjects (7.1%) had one antibody detectable, whereas only 2.1% of the patients tested negative for all four. A higher proportion of patients was positive for IA-2A and/or GADA than for ICA alone (95.5 vs 84.2%, p < 0.001). The prevalence and level of IA-2A were increased in cases carrying HLA DR4/non-DR3 compared with other DR combinations. The results indicate that almost all patients with newly diagnosed childhood IDDM can be identified by screening with these four autoantibodies. The combination of IA-2A and/or GADA had a higher sensitivity for IDDM than ICA alone. The close association between IA-2A and HLA DR4, the strongest single allele predisposing to IDDM, suggests that IA-2A may be a more specific marker of beta-cell destruction than GADA, which have been shown to associate with the DR3 allele and thyroid autoimmunity.

Adolescent↗
PubMed1997

FAP52, a novel, SH3 domain-containing focal adhesion protein.

Src-homology 3 (SH3) domain is a 60-70-amino acid motif present in a large variety of signal transduction and cytoskeletal proteins. We used reverse transcriptase-polymerase chain reaction with degenerate and specific primers and chicken brain mRNA to clone a cDNA that codes for a novel SH3 domain-containing protein. The sequence predicts a 448-amino acid polypeptide with a molecular mass of 51, 971 daltons. In the amino terminus, it shows a very high propensity for alpha-helicity, suggesting coiled-coil and possibly a higher order oligomeric arrangement. In the carboxyl terminus, there is a unique SH3 sequence. In Northern blotting, a major 3.7-kilobase and a minor 7.2-kilobase transcript was detected in most chicken tissues. In immunofluorescence microscopy and immunoelectron microscopy on cultured chicken fibroblasts, the protein was localized to focal adhesions in which it showed a distinct codistribution with the focal adhesion proteins vinculin, talin, and paxillin. Phosphoamino acid analysis showed that in cultured chicken heart fibroblasts, the protein contains phosphoserine, but no phosphothreonine or phosphotyrosine, and that the phosphorylation is not dependent on fibronectin. We propose this protein the name FAP52, for Focal Adhesion Protein of 52 kDa, and suggest that it forms part of the multimolecular complex constituting focal adhesion sites.

Amino Acid Sequence↗
PubMed1997

Experience of Finnish women with Norplant insertions and removals.

OBJECTIVE: Norplant and Norplant-2 have been available for use by Finnish women since 1984 and 1986, respectively. The objective of this study was to explore Norplant users' experiences of insertions, removals and medical treatments. DESIGN: A questionnaire was sent to women who had received Norplant or Norplant-2 implants one to two years earlier (n = 262) in normal clinical settings; the response rate was 79%. RESULTS: At insertion, problems were experienced by 9% and at least some pain by 23% of women. During the first year 20% of all users (14% of Norplant and 33% of Norplant-2 users) had their implants removed. Problems were experienced at removal by 33% of women and pain was experienced by 40%; nevertheless most users were satisfied with the device. Findings were similar for the two types of Norplant. Forty-two percent of the women had received minipills containing levonorgestrel before Norplant insertions in an attempt to assess Norplant's suitability, and 8% had received drugs for adverse effects caused by Norplant. CONCLUSIONS: Studies including perspectives of Norplant users and the whole lifespan of Norplant (including removal) should be conducted in all clinical settings where Norplant is provided.

Contraceptive Agents, Female↗
PubMed1997

Pregnancy-associated deaths in Finland 1987-1994--definition problems and benefits of record linkage.

BACKGROUND: Our aim was to study the impact of record linkage and different classification principles on maternal mortality rate. METHODS: The death certificates of all fertile-aged women who died in 1987-94 in Finland (n = 9,192) were linked to the Birth, Abortion, and Hospital Discharge Registers (n = 513,472 births, 93,807 induced abortions, and 71,701 other ended pregnancies) to identify the women who had been pregnant during their last year of life. All deaths that occurred up to 1 year after the end of pregnancy were classified according to their connection to pregnancy. RESULTS: In total, 281 qualifying deaths were found. Only in 22% of the death certificates was the pregnancy or its end mentioned. The mortality rate was 41 per 100,000 registered ended pregnancies (27 for births, 48 for miscarriages or ectopic pregnancies, and 101 for abortions). The maternal mortality rate depended greatly on which of these 281 cases were defined as maternal deaths. The early maternal mortality rate varied between 5.6 and 6.8 per 100,000 live births, and the late maternal mortality rate between 0.6 and 2.5 depending on the definition used. The classification of other than direct maternal deaths was ambiguous, especially in case of late cancers, cardio- and cerebrovascular diseases, and early suicides. The official Finnish figure for early maternal mortality (6.0/100,000 live births) seems to be a good estimate, although only 65% of individual deaths were unambiguously classified. CONCLUSIONS: Register linkage is necessary to identify late maternal deaths and pregnancy-associated deaths. The current official classification of maternal deaths as indirect, direct and fortuitous is arbitrary and allows much variation in defining a maternal death.

Adult↗
PubMed1996

Long-term effects of cesarean sections: ectopic pregnancies and placental problems.

OBJECTIVE: Few studies on the long-term effects of cesarean sections exist. The purpose of this study was to investigate the occurrence of three long-term effects, ectopic pregnancy, placenta previa, and abruptio placentae, in the subsequent pregnancy. STUDY DESIGN: This retrospective cohort study was based on two nationwide registers in Finland: the birth register and the hospital inpatient register. Women (n = 16,938) having had a cesarean section (exposed women) and a matched control group were identified from the birth register. The occurrence and outcome of the first subsequent pregnancy was determined from the 1987 to 1993 hospital inpatient register and the first subsequent birth from the 1987 to 1993 birth register. RESULTS: During the follow-up time in the hospital inpatient register, fewer exposed women had a completed pregnancy. Ectopic pregnancy was more common among the exposed women than among the controls (risk ratio 1.28). In the first subsequent birth abruptio placentae was more common among primiparous (at index the birth, risk ratios of 3.22 in hospital inpatient register and 2.41 in birth register) and multiparous women (4.52 in hospital inpatient register and 3.89 in birth register). Placenta previa was more common among primiparous exposed women than among control women (risk ratio 5.34 in hospital inpatient register and 3.78 in birth register). CONCLUSIONS: Cesarean section is a modest risk factor for ectopic pregnancy and an important risk factor for placental problems.

Abruptio Placentae↗
PubMed1995

Long-term follow-up of mothers and their infants in a randomized trial on iron prophylaxis during pregnancy.

OBJECTIVE: A randomized trial comparing women who were given iron only if needed and those given iron prophylactically showed that routine prophylaxis is not crucial for mothers' or infants' health up to postpartum examination. This study investigated these infants' and mothers' subsequent health, as available in routine registers in a 7-year follow-up. STUDY DESIGN: Original data (N = 2693) were linked to the national population, birth, and hospital inpatient registers. RESULTS: The outcomes in the two groups were very similar: there were no statistically significant differences in deaths after birth, number or timing of infants' or mothers' hospitalizations, reasons for mothers' first hospitalization, number or timing of subsequent miscarriages or births, or problems or outcomes in the next birth. However, infants of the prophylactically supplemented group were more frequently hospitalized because of convulsions. CONCLUSION: This study does not support routine iron prophylaxis for well-nourished pregnant women.

Abortion, Spontaneous↗
PubMed1995

Data quality after restructuring a national medical registry.

The validity of the 1991 Finnish Medical Birth Registry data was assessed, with special emphasis on the effects of changes made to the data collection form in 1990. Data abstracted from medical records for all births occurring in 49 hospitals during a five-day sample period (n = 865) were compared to the register information. Good or satisfactory validity was found for 32 of 33 variables, when minor error was tolerated in variables with continuous scales. For diagnoses and procedures, recorded in check-box format, satisfactory validity was found for 10 of 45 variables. Validity could not be assessed for 18 variables because of insufficient number of cases (13 items) or definition problems (5 items). When the results were compared to a 1987 data quality study, many of the variables that had been changed to the check-box format showed improvement in validity. In addition, in some cases a small change in question alternatives or instructions caused a noticeable change in validity.

Abstracting and Indexing↗
PubMed1993

Sequence of a chicken cDNA encoding a GRB2 protein.

The nucleotide (nt) sequence of a chicken cDNA encoding a protein homologous to the human GRB2 (growth factor receptor-binding protein) was determined. Remarkably high identities were found on the nt (88%) and deduced amino acid sequence (96%) levels.

Adaptor Proteins, Signal Transducing↗
PubMed1993

Reporting of malformations in routine health registers.

The utility of three national registers--the malformation, birth, and hospital in-patient discharge registers--in identification of malformations among 60,255 children born in 1987 in Finland was compared. Information in the malformation register is collected by specific reporting of physicians; information on the malformed children in the other two registers in 1987 through 1990 was routinely collected and identified by ICD 9-codes (740-759, 7886A). From October 1990 on, the ICD-9 codes were omitted from the birth register and malformation data were asked only in a yes-no question. In 1987, the malformation register included 1,032, the birth register 3,084 and the in-patient register 2,003 malformed infants identified up to the age of 1 year. There was underrepresentation of almost all malformation diagnoses in the malformation register. Individual linkage of the three registers showed that the malformation register revealed very few cases not recorded in the birth and the in-patient registers. With the adoption of the new recording method in the birth register beginning in October 1990, reports of malformation declined by 75%. Our analyses showed that data sources based on diagnoses collected routinely and not requiring an explicit decision on whether or not a problem is a malformation, can be more useful for routine surveillance of occurrence of malformations.

Congenital Abnormalities↗
PubMed1993

Binding of the alpha-fodrin SH3 domain to the leading lamellae of locomoting chicken fibroblasts.

Fodrin (nonerythroid spectrin) is a membrane skeletal protein that plays an important role in the establishment and maintenance of the cell shape and polarity. We have identified in alpha-fodrin an src homology 3 (SH3)-related region, a small domain that is present in a large number of proteins that are involved in signal transduction, cell polarization and membrane-cytoskeleton interactions. In this study we have explored the function of the alpha-fodrin SH3 by incubating fixed and permeabilized cultured chicken fibroblasts with the alpha-fodrin SH3 peptide, expressed in bacteria as a fusion protein with glutathione S-transferase. Immunofluorescence and immunoelectron microscopy showed that alpha-fodrin SH3 binds to the cytoplasmic face of the plasma membrane in the leading lamellae and the pseudopodial lobes of the spreading and locomoting cells. No, or only minimal, binding was seen in immotile cells, or in the stationary trailing ends of the locomoting cells. SH3 binding was also seen in cytochalasin-D-treated cells, suggesting that actin filaments are not responsible for the binding. These findings suggest that alpha-fodrin SH3 interacts with plasma membrane components that are present in the leading lamellae exclusively or are modulated in a manner specific to the leading lamellae.

Amino Acid Sequence↗
PubMed1992

Mother's education and perinatal problems in Finland.

This study using nationwide data expands a previous study from one area in Finland. The purpose was to study how perinatal problems (mortality, short gestation, low birthweight and low Apgar scores) vary by mother's social class, which is measured by level of education. Outcomes of all births in the 1987 Medical Birth Register were linked to the 1988 National Education Register with gives the estimated number of years of completed education. In unadjusted analyses, the lowest educational groups (less than 9 years) had the worst results for outcomes other than neonatal mortality. Results in the two highest educational groups (greater than or equal to 13 and 12 years of education) were similar and if anything, better in the second highest group. Excluding twins and adjusting for confounding variables (age, parity, county, urbanization of residence) by logistic regression analysis did not alter the results much. Adjustment for possible mechanisms correlated with social class (marital status, smoking, time of first antenatal visit) decreased the higher occurrence of low birthweight infants in the low educational groups. Reported previous miscarriages were more common in the higher educational groups. Based on the available background characteristics one would expect to have found the usual social gradient in perinatal problems to have persisted between the two highest educational groups. Further studies on factors causing the plateau in the gradient between these groups might be useful.

Abortion, Spontaneous↗