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Biomedical subjects

M Kauppi

Publications and source records attributed to M Kauppi.

At least 55 records · Page 3Linked to original sources
PubMed1998

Active conservative treatment of atlantoaxial subluxation in rheumatoid arthritis.

Twenty patients with rheumatoid atlantoaxial subluxation (AAS) underwent an active conservative treatment programme, aiming at relieving the symptoms and influencing the natural course of AAS. The treatment consisted of intensive multiprofessional intervention in the hospital for a fortnight, and control and motivational visits 6 and 12 months later. The patients self-evaluated the symptoms several times, and the cervical spine radiographs were taken at the first and last visit. Seventeen of the 20 patients adopted the instructions well and undertook the exercise programme at least weekly, even after a 12 month follow-up. Cervical pain was significantly reduced (P < 0.001) during the first intervention, and the favourable effect continued at least 12 months. Promising changes were also seen in some cervical radiographs. It is possible to educate and motivate AAS patients to take active care of their neck, and to relieve their chronic neck pain significantly. Atlantoaxial instability may also be reduced during active conservative treatment.

Adult↗
PubMed1997

The Influence of Air Pollution on the Concentration of Airborne Elementsand on the Production of Stress-Ethylene in the Lichen Usnea hirta(L.) Weber em. Mot. Transplanted in Urban Sites in Oulu, N. Finland

The purpose of the present study was to examine theresponse, as indicated by the production of stress-ethylene, of the lichenUsnea hirta, to a buffered acidic solution and to a solutioncontaining bisulfite ion, both at pH 4.0. In addition, the study investigatedthe accumulation capacity of U. hirta transplanted either to thevicinity of two streets with slow traffic, or to the vicinity of a highway inthe city of Oulu, N. Finland for a short period (45 d), and to analyze thecomparative production of stress-ethylene and the amounts of airborneelements accumulated in the thallus. Thalli of U. hirta manifested ahigh accumulation capacity for K, Ca, Na, Mg, Fe, Zn, and Mn in samplesexposed in one of the two streets with slow traffic in Oulu, in comparisonwith thalli left at the control site in the forest outside of the city. Twoof the observed elements, Pb and Ca, exhibited a positive correlation withthe concentration of ethylene detected consecutive to the treatment of lichenthalli with H2O (pH 6.8). The concentrations of stress-ethylene inlichen thalli retrieved from the streets with slow traffic and less cars(14,000 per day), soaked in solutions of NaHSO3 (pH 4.0), werehigher than those produced by thalli retrieved from a site near the highway(with 25,000 cars per day) and by thalli left in the forest. It is suggestedthat the streets with slow traffic and less cars are more polluted than thehighway as a result of bad ventilation conditions and a slow rate ofdispersion of airborne pollutants.

Journal Article↗
PubMed1997

Elevated incidence of hematologic malignancies in patients with Sjögren's syndrome compared with patients with rheumatoid arthritis (Finland).

The risk of hematologic malignancies was studied in Finnish patients with rheumatoid arthritis or Sjögren's syndrome, and the difference in the risk between those diseases was evaluated. The study cohorts comprised 676 patients with primary Sjögren's syndrome, 709 with secondary Sjögren's syndrome, and 9,469 with rheumatoid arthritis identified from the Finnish hospitals' national discharge register. The follow-up times were 5,336, 4,254 and 65,391 person-years, respectively. Data on the incidence of malignancies were collected from the files of the Finnish Cancer Registry. The incidence of hematologic malignancies was elevated in the study cohorts. The standardized incidence ratio (SIR) of non-Hodgkin's lymphoma was: 2.2 (95 percent confidence interval [CI] 1.5-3.1) for rheumatoid arthritis; 4.5 (CI = 1.5-11) for secondary Sjögren's syndrome; and 8.7 (CI = 4.3-16) for primary Sjögren's syndrome. The ratio of the SIR of primary Sjögren's syndrome cf rheumatoid arthritis alone was 3.9 (CI = 1.8-8.0) in non-Hodgkin's lymphoma, and 3.4 (CI = 1.2-8.1) in other hematologic cancers. The incidence of hematologic malignancies, especially that of non-Hodgkin's lymphoma, is elevated in patients with rheumatoid arthritis. It is higher in patients with secondary Sjögren's syndrome and highest in patients with primary Sjögren's syndrome. Differences in the immunologic aberration influence oncogenesis.

Arthritis, Rheumatoid↗
PubMed1997

Thrombolysis for acute ischemic stroke in the primary antiphospholipid syndrome.

Successful intravenous thrombolytic treatment for acute major ischemic stroke was given to a 24-year-old woman with primary antiphospholipid syndrome. Our patient was a smoker and used oral contraceptives containing estrogen at the time of the stroke. We discuss risk factors for stroke and the treatment of arterial thrombosis in patients with antiphospholipid antibodies.

Adult↗
PubMed1996

Ultrasonography is a nonspecific method in the evaluation of joints.

Two cases of unilateral abnormal ultrasonographic findings in the hip joints are introduced. The correct diagnoses were detected by radiography after the failure of intra-articular glucocorticoid injections given as first aid. Ultrasonography (US) has poor specificity, since all phenomena causing effusion into the joint cavity may be detected as abnormal by US, and may include stress fractures and malignant myeloma, as we show here. In the case of an abnormal ultrasonographic finding in a joint, the recent radiological status should also be considered.

Adult↗
PubMed1996

A stiff collar for the treatment of rheumatoid atlantoaxial subluxation.

Conservative treatment of atlantoaxial subluxation (AAS) has tended to be rather passive, since there has been a lack of effective tools. The stabilizing effect of a stiff collar in the treatment of AAS was evaluated. Fifty successive rheumatoid patients with unstable AAS were interviewed and examined clinically. Lateral view radiographs of the cervical spine were taken in neutral position, during flexion and extension without a collar, and during flexion with a stiff collar. Seventeen patients did not have cervical symptoms. A stiff collar was able to significantly stabilize AAS in more than half of the cases, the effect being predictable from neutral-position radiographs. The improvement in bearing enhanced the effect of the collar. The means and strategy of conservative treatment of AAS are discussed.

Adult↗
PubMed1996

Pathogenetic mechanism and prevalence of the stable atlantoaxial subluxation in rheumatoid arthritis.

OBJECTIVE: To study the pathogenetic mechanisms responsible for and prevalence of stable atlantoaxial subluxation (AAS). METHODS: Lateral view cervical spine radiographs during flexion and extension were studied in 262 patients with rheumatoid arthritis (RA). RESULTS: AAS was found in 130 patients, 42 (32%) of whom had a stable deformity; in a population based subseries, stable AAS was seen in 16% of the patients with ASS. Atlantoaxial impaction (AAI) was diagnosed in 98 cases and in 37 (88%) of the 42 patients with stable AAS. CONCLUSION: The main cause of the spontaneous stabilization and occasional ankylosis of the atlantoaxial area is the development of erosions and collapse in the lateral facet joints leading to AAI.

Arthritis, Rheumatoid↗
PubMed1995

Differential responses of certain lichen species to sulfur-containing solutions under acidic conditions as expressed by the production of stress-ethylene.

To determine whether fluctuations in the concentration of ethylene produced by lichens exposed to sulfur-containing solutions at a low pH correlate with the tolerance/sensitivity of these lichens to air pollution, we measured the amount of ethylene produced by thalli soaked in H2SO4 and NaHSO3. The exposure of Hypogymnia physodes, Cladina stellaris, and Bryoria fuscescens to H2SO4 at a pH ranging between 4.0 and 2.0 did not produce changes in the concentration of ethylene in comparison with samples wetted with H2O at pH 6.8. The exposure of two pendulous lichens, Usnea hirta and Alectoria sarmentosa, to 1.0 and 5.0 mM H2SO4 at pH 2.7 and 2.0, respectively, stimulated only a slight increase of ethylene production, whereas another pendulous lichen, Bryoria fremontii, exposed to H2SO4 at pH 4.0-2.0 decreased its production of ethylene. The soaking of H. physodes, U. hirta, C. stellaris, and A. sarmentosa thalli in NaHSO3 at pH 4.0 gradually increased the production of ethylene. The exposure of B. fremontii and B. fuscescens to low NaHSO3 concentrations depressed the production of ethylene in these lichens. The indifference of H. physodes to H2SO4 under strong acidic conditions correlated with its resistance to SO2 in the air. In accordance with a model by D.M. Reid (In "Effects of Atmospheric Pollutants on Forests, Wetlands and Agricultural Ecosystems" (T.C. Hutchinson and K.M. Meema, Eds.), Vol G 16, pp. 241-245. NATO ASI Series, Springer-Verlag, Berlin and Heidelberg, 1987) referring to higher plants, it is suggested that sulfur-containing solutions under acidic conditions increase the solubility of particles containing heavy metals entrapped among the mycobiont hyphae in lichens. This may lead to an increase of the production of endogenous ethylene in lichens as they are exposed to sulfur-containing chemicals, to acidic rain, or to heavy metal-polluted air.

Acid Rain↗
PubMed1995

Anti-capsular polysaccharide antibody concentrations in saliva after immunization with Haemophilus influenzae type b conjugate vaccines.

IgG and IgA antibodies to Haemophilus influenzae type b (Hib) capsular polysaccharide (PS) were measured in saliva of 7- to 19-month-old children after vaccination with 2 or 3 doses of Hib conjugate vaccine. Both the concentration and the prevalence of these antibodies were higher after 3 than after 2 doses of vaccine. The presence and concentration of IgG Hib PS antibodies in saliva correlated with their concentration in serum. Fifty-four percent (20 of 37) of the children with serum IgG concentrations higher than 30 micrograms/ml had detectable salivary IgG, whereas the 21 children with a low serum IgG concentration (< 3 micrograms/ml) had no IgG in saliva. The IgA anti-Hib PS in saliva was mainly secretory and was found in saliva of 29% (19 of 65) of the children who had no detectable serum IgA anti-Hib PS. The results suggest that the IgG anti-Hib PS in saliva was derived from serum, whereas the IgA antibodies were locally produced. The Hib PS antibodies on mucosa are suggested to be responsible for the reduction of Hib carriage observed among children vaccinated with Haemophilus type b conjugates.

Age Factors↗
PubMed1995

Application of markers of collagen metabolism in serum and synovial fluid for assessment of disease process in patients with rheumatoid arthritis.

OBJECTIVE: To assess the potential of markers of collagen metabolism to reflect disease processes in rheumatoid arthritis (RA). METHODS: Serum (S) and synovial fluid (SF) from 59 patients with RA, and a knee joint effusion and serum from 90 control subjects were studied with radioimmunoassays for the aminoterminal propeptides of type I and type III procollagens (PINP and PIIINP, respectively). The breakdown of type I collagen was quantified with a radioimmunoassay for the cross linked carboxyterminal telopeptide of type I collagen (ICTP). RESULTS: About 50% of the patients had increased S-ICTP and S-PIIINP values, whereas S-PINP was increased in only 20% of the patients. The mean SF:S ratios of these markers varied between 4 (for ICTP) and 340 (for PIIINP), indicating that markers of collagen metabolism are formed locally and then released into the circulation. SF-PINP and SF-PIIINP correlated with each other (rs = 0.86, p < 0.001) and with SF-ICTP (rs = 0.69, p < 0.001, and rs = 0.65, p < 0.001, respectively). SF-ICTP was clearly related to radiographic findings in the corresponding knee joint, patients with gross bone deformation having the greatest SF-ICTP concentrations. S-ICTP and S-PIIINP also correlated with conventional markers of disease activity, such as C reactive protein and joint swelling score. CONCLUSION: Markers of collagen metabolism both in serum and synovial fluid can be measured to provide an assessment of disease process in patients with RA. ICTP and PIIINP are the most informative.

Adult↗
PubMed1995

A stiff collar can restrict atlantoaxial instability in rheumatoid cervical spine in selected cases.

OBJECTIVE: To study the efficiency of a stiff collar in restricting the instability of anterior atlantoaxial subluxation (AAS). METHODS: Twenty two successive patients with an unstable AAS were studied. Lateral view radiographs were taken of the cervical spine in flexion, extension, and neutral positions without a collar, and in full flexion with a custom made stiff collar. RESULTS: The collar restricted more than 30% of the maximal instability of the AAS in 50% of the patients. These patients had significantly shorter atlantoaxial distance in the neutral position than those in whom the collar was not able to restrict the instability. CONCLUSION: A stiff collar can restrict the atlantoaxial instability in selected rheumatic patients with an unstable AAS. Lateral view radiographs of the cervical spine in a neutral position can be used to identify the patients whom the collar will benefit.

Adult↗
PubMed1994

A method for classification of the posterior atlanto-axial subluxation.

Atlanto-axial subluxation and dislocation in rheumatoid arthritis is a multidirectional abnormality. The most common subluxations take place anteriorly, vertically or laterally. Posterior atlanto-axial subluxations are rare. The distance between a line tangential to the anterior aspect of the axis (C2) and the most posterior aspect of the anterior arch of the atlas (C1) could be used to measure the displacement in posterior atlanto-axial subluxation. Routine measurement of this distance could give us a better idea of the frequency of this type of affection in rheumatoid arthritis of the cervical spine. Serial measurements might be used to estimate the progression of the disease.

Arthritis, Rheumatoid↗
PubMed1994

Prevalence of cervical spine subluxations and dislocations in a community-based rheumatoid arthritis population.

The prevalence of rheumatoid cervical spine subluxations was studied by plain radiography in a population of 13,000 adults with 98 out of 103 detected cases of rheumatoid arthritis. Anterior atlantoaxial subluxation (AAS) of 4 mm or more was found in 33% of the cases and vertical dislocation in 14% or 27% depending on the diagnostic method. Lateral, posterior and subaxial subluxations were found in 14%, 2% and 21% respectively. These figures agree with former findings in clinical populations. One patient had been operated on for subaxial subluxation. Anterior AAS of 9 mm or more was found in four cases, subaxial subluxation of more than 4 mm in one case and a combination of anterior AAS of 6-9 mm and vertical dislocation in six cases. If these limits are taken as indications for surgery, as recommended earlier, about 10% of the RA patients should be operated, an unrealistic figure. It is concluded that intolerable pain or cervical myelopathy, and not the plain radiological findings alone, are indications for surgery. Most cases are treated by conservative methods.

Aged↗
PubMed1993

Anti-capsular polysaccharide antibodies reduce nasopharyngeal colonization by Haemophilus influenzae type b in infant rats.

Haemophilus influenzae type b (Hib) conjugate vaccines reduced oropharyngeal carriage of Hib among children in Finland and the United States. To study the mechanisms of this reduction, a colonization model in infant rats with passively administered antibodies was developed. Of the pups, 94% were colonized 48 h and 64% 7 days after intranasal inoculation with approximately 2500 cfu of Hib. Intranasally administered anti-Hib antibodies, including human IgG and both serum and secretory IgA (sIgA) as well as murine monoclonal anti-Hib capsular polysaccharide (PS) of IgG1 isotype, given simultaneously with, before, or after bacteria, significantly reduced nasopharyngeal colonization by Hib. Hib colonization was also significantly reduced when the antibodies were given intraperitoneally, with a resultant anti-Hib PS serum concentration of > or = 7 micrograms/mL. Thus, anti-Hib PS antibodies, both sIgA and IgG, can function on the mucosal surface and prevent colonization.

Administration, Intranasal↗