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Biomedical subjects

M Turunen

Publications and source records attributed to M Turunen.

At least 37 records · Page 2Linked to original sources
PubMed1997

Limited usefulness of traction-compression films in the radiographic diagnosis of lumbar spinal instability. Comparison with flexion-extension films.

STUDY DESIGN: A prospective, within-patient comparison of two methods for functional radiography of lumbar spine with consecutive patients. OBJECTIVE: To evaluate the usefulness of traction-compression radiography compared with conventional flexion-extension radiography in diagnosis of lumbar spinal instability. SUMMARY OF BACKGROUND DATA: Flexion-extension radiography generally is used and widely recognized as an effective method for diagnosis of segmental lumbar spinal instability, but the usefulness and findings of traction-compression films are less well known. METHODS: Flexion-extension and traction-compression radiography were performed on 306 consecutive patients (mean age, 43 years; range, 14-68 years) with clinically suspected lumbar spinal instability. Radiography was performed of each patient in an upright position. Axial traction was accomplished by letting the patient hang by his or her hands from a horizontal bar. Compression views were taken when the patient had sandbags of approximately 30% of the his or her weight on the shoulders. Main interest was translational forward and backward displacement of one vertebra on another. RESULTS: Signs of translational instability were present on the functional radiographs of 27% (84 of 306) of the patients. In diagnosis of instability, the overall agreement of flexion-extension and traction-compression films was only 0.786, and also statistic Kappa remained poor (0.05). Flexion-extension films more frequently revealed signs of instability than traction-compression films: 81 versus seven patients. CONCLUSIONS: Traction-compression films seem to be of questionable value in diagnosis of lumbar spinal instability.

Adolescent↗
PubMed1997

Quantitative determination of glutamate turnover by 1H-observed, 13C-edited nuclear magnetic resonance spectroscopy in the cerebral cortex ex vivo: interrelationships with oxygen consumption.

The kinetics of glutamate 13C-4 label appearance from D-[1-13C]-glucose and 13C-4 label disappearance from steady state following D-12C-glucose incubation were quantified with 1H-observed, 13C-edited nuclear magnetic resonance (NMR) spectroscopy in the superfused brain slices under largely varying oxygen consumption. Label incorporation to and from glutamate C-4 were fitted into mono- or bicompartmental models in order to determine the respective rate constants and to assess the presence of plausible multiple pools. At a steady-state oxygen consumption of approximately 4 mumol/min/g dry weight, glutamate labelling could be fitted into a biexponential equation, suggesting that there were two compartments with a large difference in their rates (respective rate constants of 0.022 and 0.149) and pool sizes (relative contributions of 91.2 and 8.8%, respectively). Stimulation of oxygen consumption in the brain slice preparations with either 40 mM KCl by 59.5 +/- 10.3% or 5 microM carbonyl cyanide m-fluorophenyl hydrazone by 61.4 +/- 8.4% increased glutamate C-4 labelling rate constants to 0.058 +/- 0.009 and 0.054 +/- 0.006, respectively. In the stimulated slice preparation, glutamate labelling could only be fitted into a monoexponential equation. 13C-4 label disappearance, independent of oxygen uptake, could also only be fitted into a monoexponential equation. There was a close match between the rate constants of label disappearance and appearance in non-stimulated and carbonyl cyanide m-fluorophenyl hydrazone-stimulated slices. In the presence of 40 mM KCl label disappearance did not, however, increase. These data show that glutamate C-4 turnover from exogenous D-[1-13C]-glucose can be used as an index of oxidative metabolism in situ under steady-state conditions as well as when oxygen metabolism is strongly stimulated. The results are discussed with respect to the use of NMR spectroscopy as a means of mapping brain oxidative metabolism.

Animals↗
PubMed1996

Scots pine needle surfaces on radial transects across the north boreal area of Finnish Lapland and the Kola Peninsula of Russia.

To gain an understanding of the characteristics of the needle surfaces of naturally regenerated Scots pine (Pinus sylvestris L.) and their geographical distribution, eight physicochemical variables were investigated within the north boreal forest area. The visibly undamaged needles were collected in autumn 1990 from 114 plots (3-5 pines per plot) along radial transects from the Monchegorsk and Nikel smelters, emitting SO2 and heavy metals, on the Kola Peninsula, Russia, to Finnish Lapland. The needles were examined by scanning electron microscopy (SEM) and measured for surface wettability using the droplet contact angle (DCA) method. Significant geographical south-north and west-east patterns could be observed in needle surface characteristics, correlating with emissions from the smelters and to climate. Despite the slightly higher initial DCAs (61.4-87.6 degrees) towards the north, the pine needle surfaces of the northernmost transects exhibited higher annual needle wettability change (ANWC) and wax erosion rate (AWER), expressed as the reduction in DCAs and epistomatal wax tube distribution (WTD) during one year, respectively, but a lower occurrence of particles and fungal hyphae than those of more southern transects. The higher ANWC was related to higher atmospheric SO2 concentration, and to the lower long-term temperature sum, but not clearly to annual precipitation. In the Monchegorsk smelter area, the current needles exhibited, on average, a 15% higher WTD and seven degree larger DCA, resulting in more hydrophobic needle surfaces than in Finnish Lapland, but during their first year, both the AWER and ANWC, were greatly increased. In Finnish Lapland, 30%, of all the epistomatal wax tubes disappeared from the needle surface during the first year, the value being 70% for the pines located 8 km from the smelter. The mineral composition of the particles deposited on the needle surfaces mirrored that of the minerals being produced by the smelters (e.g. FexSx, CuFeS2, NixSx, FexOx). Stomatal densities were in the range of 71.1-141.7 stomata mm(-2). The lower densities of stomata on needles close to the smelters correlated with reduced number of needle age classes of the pines, higher dry weights, higher pollutant accumulation and lower Mn and Zn concentrations in the needles. The AWER and ANWC were able to indicate the most seriously deteriorated needle surfaces on a regional scale, e.g. including the surroundings of both smelters, although the plot-specific relationships between 'needle surface variables' and 'pollution variables' were generally weak. The present study showed that the exposure of pine needles to the combined effects of ambient pollutants and harsh climate led to a deterioration in the physicochemical characteristics of the epicuticular wax, which may have serious ecophysiological consequences in the long term.

Journal Article↗
PubMed1996

Restricted uptake of dietary coenzyme Q is in contrast to the unrestricted uptake of alpha-tocopherol into rat organs and cells.

The dietary uptake of alpha-tocopherol and coenzyme Q was investigated in rats. Rats were fed diets supplemented with alpha-tocopherol or coenzyme Q10 (1 g/kg diet) or an unsupplemented control diet. In control rat tissues, the content of coenzyme Q was 4-11 times higher than that of alpha-tocopherol, but in plasma, the ratio was reversed. Among the subcellular fractions of rat liver homogenate, Golgi vesicles and lysosomes had the highest alpha-tocopherol concentration, and high concentrations of coenzyme Q were observed in the outer and inner mitochondrial membranes as well as in lysosomes, Golgi vesicles and plasma membranes. The uptake of alpha-tocopherol into the liver and plasma reached a maximal level after only 2 d of supplementation, whereas in the kidney, heart, muscle and brain, the levels continued to increase throughout the 6-wk treatment period. In contrast, dietary coenzyme Q was taken up into the liver and plasma only, and not into the other organs. This lipid appeared mainly in the Golgi system, whereas alpha-tocopherol exhibited a more general cellular distribution. The decay of the supplied alpha-tocopherol was slow in the various organs, but the disappearance of coenzyme Q was rapid from both liver and plasma. Pretreatment of rats with alpha-tocopherol increased the levels of both endogenous and exogenous coenzyme Q in the liver and plasma. These results demonstrate that the uptake of alpha-tocopherol from the diet is an extensive and general phenomenon at both the tissue and cellular levels, in contrast to the selective and restricted uptake of coenzyme Q.

Animals↗
PubMed1996

Introducing epidural fentanyl for on-ward pain relief after major surgery.

BACKGROUND: Epidural opioids have been recommended for analgesia after major surgery. In this report we describe how we introduced a low-cost, on-ward, nurse-based acute pain service using epidural fentanyl after major surgery in the University Hospitals of Oulu and Kuopio. METHODS: In order to evaluate the feasibility of epidural fentanyl infusion administered by ward nurses, we prospectively assessed pain and side effects during fentanyl infusion (median duration 41 h) after major surgery in 305 consecutive patients in Kuopio. RESULTS: 92% of the patients on the ward who had received epidural fentanyl infusion at 31-54 micrograms h-1 reported at most three episodes of severe pain (/Numerical Rating Scale > 3/ 10) during the initial postoperative days, but there were some patients (8%) who reported several episodes (> 3) of more severe pain (Numerical Rating Scale > 3). Three patients (0.9%) showed a diminished respiratory rate (< 10/min), but only one of them (0.3%) was somnolent. One other patient (0.3%) was not arousable until the cessation of infusion. Nausea and pruritus were minor problems in our patients, but a majority needed a urinary catheter. CONCLUSION: With well-trained nurses, careful monitoring and appropriate protocols, epidural fentanyl infusion proved to be a feasible method for pain relief after major surgery on a surgical ward.

Analgesia, Epidural↗
PubMed1996

Treatment results of nasopharyngeal cancer--a nationwide survey from Finland.

The nationwide experience of treating nasopharyngeal cancer in Finland during the period 1980-1989 was reviewed. Of the 107 patients included in the present analysis, 13 were treated palliatively only, and three had metastatic disease at their first clinical presentation, whereas the rest (n = 91) were treated with radical radiotherapy, of whom, 8 patients received adjuvant chemotherapy after radiotherapy. The 5-year actuarial survival rates of these 91 patients was 52%, and by the UICC stage they were classified as follows: stage I 75% (n = 12), stage II 60% (n = 5), stage III 59% (n = 34), and stage IV 38% (n = 40). According to the Cox's stepwise proportional hazard model the most important factors influencing favourable survival were the total dose of radiotherapy expressed in terms of Biologically Effective Dose (BED) with a time factor, a small size of the primary tumour and a high performance status according to the WHO scale, whereas the most important factors influencing the local control analysis were the total dose of radiotherapy (expressed in BED) and the cervical lymph node status.

Adolescent↗
PubMed1995

Intermittent interferon and polychemotherapy in metastatic melanoma.

This study was conducted to evaluate the efficacy and the tolerability of a four-drug chemotherapy regimen combined with interferon alpha (IFN) in metastatic melanoma. Between March 1991 and August 1993, 55 patients with advanced melanoma were enrolled for the present multicentre phase II study. Forty-nine patients were eligible and evaluable for toxicity; 48 patients were evaluable for response. The treatment schedule consisted of a 5-day regimen of dacarbazine, vincristine, bleomycin and lomustine, plus 6 x 10(6) IU IFN alpha three times weekly subcutaneously for 2 weeks starting on day 8. The cycle was repeated on day 29. Among the 48 assessable patients, 16 objective responses were seen, yielding a response rate of 33% (95% confidence interval 20%-46%). Seven patients achieved a complete response (CR) of a median of 6+ months (range 1+ to 21+ months) and 9 patients achieved a partial response (PR) of a median of 9 months (range 4-13 months). The median overall survival was 12+ months (range 6+ to 23+ months) for the patients with CR and 15+ months (range 8-20 months) for the patients with PR. Even the survival of the 7 patients with stable disease was fairly long (median 12, range 7-17 months), appearing to be significantly longer than the survival of the 25 patients with progressive disease (median 5, range 1-24+ months). The treatment was moderately well tolerated, although all patients experienced some mild form of toxicity, mostly gastrointestinal symptoms, neurotoxicity and haematotoxicity. Grade 3-4 adverse effects were noted in 39% of the patients. No toxic deaths occurred. It can be concluded that the present regimen produces meaningful responses for patients with metastatic melanoma. A randomised study is needed to determine the effect on survival.

Adult↗
PubMed1995

Effects of acid rain on growth and nutrient concentrations in Scots pine and Norway spruce seedlings grown in a nutrient-rich soil.

The effects of artificially applied acid precipitation on growth and nutrient concentrations of Scots pine (Pinus sylvestris L.) and Norway spruce (Picea abies [L.] Karst.) seedlings were investigated in a long-term acid irrigation experiment in field conditions. Seedlings of northern and southern origin were planted in boxes containing peat and composted soil rich in nutrients, and sprinkler irrigated with water acidified with nitric and sulphuric acids to pH 3 or pH 4 for periods varying from two to three and a half growing seasons during 1986-1989. Water irrigated (pH 5.4-7.6) and non-irrigated groups of seedlings were also included in the experiment. At the end of the experiment needles, main and lateral shoots and roots were collected from the seedlings for the determination of height growth and biomass partitioning, and for the analysis of S, N, Mg, P, K, Ca, Mn and Fe concentrations. The treatment effects compared to the irrigated control were studied using multivariate analyses of variance and covariance. In the pine seedlings the total dry matter production increased by 25-70% compared with the irrigated controls when the total wet deposition to the seedlings exceeded 67 kg S ha(-1) and 36 kg N ha(-1) (e.g. after two growing seasons' exposure of the pH 3 treatment). The increase was mainly due to an increase in needle dry weight (54-72% greater at pH 3) and root weight (20-65% greater at pH 3), whereas the height growth or shoot weight growth were less affected. The northern provenance pine seedlings responded more clearly to the pH 3 irrigation than the southern ones. The treatments had no consistent effects on any of the growth variables studied in the spruce seedlings, however. The pines had higher root and foliage Ca concentrations as a result of the acid irrigation, whereas in spruce, acid rain decreased the Ca concentration in needles and shoots. Root Mn and Fe concentrations were higher in both species as a result of the pH 3 treatment. A higher soil conductivity and Ca concentration resulted from the prolonged pH 3 treatment. The results strongly support the hypothesis that the long-term growth and nutrient allocation response of conifers to acid precipitation is dependent both on the tree species and on the nutritional status of the soil.

Journal Article↗
PubMed1992

N-ras gene mutations in acute myeloid leukemia: accurate detection by solid-phase minisequencing.

Mutations in the N-ras gene are found in one-third of patients with acute myeloid leukemia. The N-ras mutations could serve as markers for residual cells, if a highly sensitive method for detecting the mutations was available. We applied a new method, solid-phase minisequencing, to analyze bone-marrow cells from 16 patients with acute myeloid leukemia for mutations in codon 12, 13 and 61 of the N-ras gene. In the solid-phase minisequencing technique the mutations are identified by a primer extension reaction, in which a single labelled nucleoside triphosphate is incorporated into an immobilized DNA fragment previously amplified by the polymerase chain reaction. We identified N-ras mutations in 5 of the patients (30%). In one patient, we observed 2 mutations that were shown to be located in different alleles. With the solid-phase minisequencing method, we were able to determine the proportion of mutated cells in the samples. We found that in 4 of the samples only a fraction (7-64%) of the blasts carried an N-ras mutation, and in one sample practically all blast cells were mutated. The method was highly sensitive, allowing us to identify N-ras mutations even when the sample consisted of 99.7% normal cells and only 0.3% mutated blasts.

Base Sequence↗
PubMed1992

Zuclopenthixol and haloperidol in patients with acute psychotic states. A double-blind, multi-centre study.

A double-blind, multi-centre study was carried out in 49 hospitalized patients with an acute psychosis or an exacerbation of a chronic psychosis to compare the wanted and unwanted effects of the neuroleptics, zuclopenthixol and haloperidol. Patients were allocated at random to receive treatment with one or other of the trial drugs for 8 weeks or until discharge. Five patients on zuclopenthixol and 6 on haloperidol were excluded from the efficacy analyses because they did not complete a minimum of 4-weeks' treatment. Dosage was chosen and adjusted to the individual patient's condition and response. The average daily doses in Week 4 were 33.5 mg and 10.3 mg, respectively. Clinical assessments, including CGI, BPRS and the UKU side-effect scale, were done at baseline, and after 1, 2, 4, 6 and 8 weeks of treatment or at discharge if the patient was discharged earlier than Week 8. Both treatments caused a significant reduction in scores with no between-group differences. More patients in the zuclopenthixol group were discharged early indicating slightly more rapid onset of action. Zuclopenthixol caused a significantly greater improvement in 'anxious-depression' factor score than haloperidol. The most frequent unwanted effects were extrapyramidal symptoms and there were no significant differences between the groups. The extrapyramidal symptoms tended to be transient in the zuclopenthixol group, but not in the haloperidol group. The study confirmed that both zuclopenthixol and haloperidol were effective drugs in the treatment of acute, psychotic patients. There was a trend towards a slightly more rapid onset of effect and a somewhat stronger anxiolytic-antidepressant effect by zuclopenthixol compared to haloperidol.

Adult↗
PubMed1992

Results of 500 general surgery patients operated on in the ambulatory surgery unit.

This study examined the outcome of 597 general surgery operations performed on 500 patients in the ambulatory surgery unit of the University Hospital of Kuopio between November 1989 and May 1990. Endoscopies were excluded from the study. Spinal (41.0%) and local infiltration (31.2%) were the most often used forms of anaesthesia. During anaesthesia 15.8% of patients required treatment for hypotension, and 13.6% for bradycardia. Of the 351 (70.2%) patients, who returned the one month follow-up questionnaire, 41 (11.7%) had visited a doctor postoperatively. The main reasons for this visit were pain in 41 (100%), minor bleeding in 24 (58.5%) and inflammation in 16 (39.0%) patients. No deaths or other major complications were observed. 92% of the patients were satisfied with the treatment and anaesthesia.

Adolescent↗
PubMed1991

Areliable sex determination assay for bovine preimplantation embryos using the polymerase chain reaction.

We have developed a polymerase chain reaction (PCR)-based method for accurate sex determination of preimplantation bovine embryos. The method utilizes three different sets of primers in the PCR. The first pair of primers recognizes the bovine-specific satellite sequence that is amplified in both females and males. In addition, two pairs of primers recognize bovine Y chromosome-specific sequences that are amplified in males only. Duplicate embryo extracts were used in the PCR; the first sample was run in the presence of bovine-specific as well as one set of the Y chromosome-specific primers; the second sample was run in the presence of the other male-specific primers. The method has been specifically designed for screening bovine embryos. Based upon examining blood cell DNA from adult males and females, the assay is extremely accurate, as no single incorrect result has occurred yet. Missing samples were easily detected by the absence of the bovine-specific signal. The method has been used for the transfer of bovine embryos on which sex determinations have been performed.

Journal Article↗
PubMed1982

Head injuries and skull radiography: clinical factors predicting a fracture.

Five hundred and ninety-eight cases were studied where the patients had been subjected to skull radiography because of a head injury. Concussion had been established in 231 patients and a more severe brain injury in 8. Forty-nine patients (8.2 per cent) had skull fractures. The relative frequency of fractures was the highest among those aged between 40 and 59 years (16 per cent). From among 16 variables, either clinical or pertaining to the history, 4 had clearly sustained a fracture of the skull, the statistically significant features being amnesia, unconsciousness for over 30 minutes, a wound and subcutaneous haematoma in the scalp and a reduced level of consciousness. On the basis of these signs the patients could be divided into two groups which differed in the frequency of skull fractures by a factor of five. The skull fracture was not observed to have influenced the patient's care or recovery, particularly if the patient had a concurrent brain injury. Based on the results, the indications for skull radiography in patients with head injuries can be identified and this can reduce the need for X-ray examinations to one-half and still reveal 80 per cent of skull fractures.

Adolescent↗
PubMed1981

The effect of buprenorphine and oxycodone on the intracholedochal passage pressure.

The effect of i.v. buprenorphine (0.3 mg) and oxycodone (10mg) on intracholedochal passage pressure were studied in 20 patients who had undergone surgery of the common biliary tract, prior to the extraction of an indwelling T tube. Informed consent was obtained from all patients, each of who was given buprenorphine or oxycodone in random order. The intracholedochal passage pressure was measured from the T tube perfused with continuous saline infusion (55 ml/h). Both analgesics significantly (P less than 0.01) increased the intracholedochal passage pressure after 5 min, with an equal peak increase of about 1.5 kPa at about 7 min. The pressure decline was rapid and similar in both groups: 20 min after administration of the test drug only about 40% of the maximum elevation caused by either drug remained. Thereafter, a slower fall towards the baseline was recorded after both drugs during the remaining 45 min of the study period. The results indicate that buprenorphine can be used with the same indications and precautions as other narcotics for postoperative pain relief in patients who have undergone surgery of the biliary tract.

Adult↗
PubMed1979

Acromioclavicular complete dislocation. Analysis of the operative results in 48 patients.

Complete acromioclavicular separation in 48 patients was treated by operation, using Kirschner wire for fixation in 20 cases and the A--O cortical screw in 17. Late resection of the distal end of the clavicle was performed in 11 cases. Follow-up examination was performed on average two years after the operation. Attention was paid to subjective symptoms, the objective state, duration of incapacity, radiological evidence of dislocation without stress and under stress, osteoarthrosis and soft-tissue calcification. Pain, function and mobility were evaluated by a point system. In the groups primarily treated by surgery the result was at least good in 73%, fair in 16% and poor in 11%. Excellent results were noticed more often in patients under 30 years old than in those over 45 (p less than 0.01). Mobility of the shoulder joint was significantly more often normal when Kirschner wire was used for fixation than after screw fixation (p less than 0.05). Late resection gave at least a fair functional result.

Acromioclavicular Joint↗
PubMed1977

Comparison of nefopam and pethidine in postoperative pain.

A double-blind, between-patient, two-dose comparison was comparison was performed with pethidine and nefopam in 100 subjects, the majority of whom were recovering from upper abdominal surgery. Either 15 or 30 mg of nefopam or 50 or 100 mg of pethidine were given by i.m. injection in a random order. All assessments were made by the same observer on the first day after operation, at least 4 h after the previous analgesic injection. Nefopam 15 mg was equipotent with pethidine 50 mg, peak analgesia being achieved 1 h after the i.m. injection. Pethidine 100 mg provided significantly better pain relief than nefopam 30 mg, the latter being not more effective than nefopam 15 mg apart from the duration of analgesia which was longer. The incidence of nausea and vomiting was similar after both drugs. Sweating and tachycardia were observed more frequently after nefopam, whereas sedative side-effects were more common after pethidine.

Clinical Trials as Topic↗