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Biomedical subjects

S Suominen

Publications and source records attributed to S Suominen.

At least 19 recordsLinked to original sources
PubMed2005

Comparison of phenotypic and genotypic detection of penicillin G resistance of Staphylococcus aureus isolated from bovine intramammary infection.

Resistance of Staphylococcus aureus to penicillin G is common among isolates from bovine mastitis. We determined phenotypic resistance to penicillin G for 151 S. aureus isolates derived from dairy cows with intramammary infection by two methods. The methods were determination of minimum inhibitory concentration (MIC) by a standard agar dilution technique and direct testing of beta-lactamase production using a chromogenic cephalosporin, nitrocefin. The results from these tests were compared with the presence of the beta-lactamase (blaZ) gene in the isolates, which was detected by polymerase chain reaction (PCR). Testing beta-lactamase production with nitrocefin was more predictive for the presence of the blaZ gene than the agar dilution method and the results of the former agreed highly with the presence of the blaZ gene in the isolates. In contrast, the resistance breakpoint generally used in the agar dilution method may be too high for prediction of penicillin resistance in S. aureus isolates with borderline MICs. Using this method, 40% of the isolates possessing the blaZ gene were classified as susceptible; however, majority of these isolates produced beta-lactamase when tested with nitrocefin.

Animals↗
PubMed2005

The MDM2 promoter polymorphism SNP309T-->G and the risk of uterine leiomyosarcoma, colorectal cancer, and squamous cell carcinoma of the head and neck.

BACKGROUND: MDM2 acts as a principal regulator of the tumour suppressor p53 by targeting its destruction through the ubiquitin pathway. A polymorphism in the MDM2 promoter (SNP309) was recently identified. SNP309 was shown to result, via Sp1, in higher levels of MDM2 RNA and protein, and subsequent attenuation of the p53 pathway. Furthermore, SNP309 was proposed to be associated with accelerated soft tissue sarcoma formation in both hereditary (Li-Fraumeni) and sporadic cases in humans. METHODS: We evaluated the possible contribution of SNP309 to three tumour types known to be linked with the MDM2/p53 pathway, using genomic sequencing or restriction fragment length polymorphism as screening methods. Three separate Finnish tumour materials (population based sets of 68 patients with early onset uterine leiomyosarcomas and 1042 patients with colorectal cancer, and a series of 162 patients with squamous cell carcinoma of the head and neck) and a set of 185 healthy Finnish controls were analysed for SNP309. RESULTS: Frequencies of SNP309 were similar in all four cohorts. In the colorectal cancer series, SNP309 was somewhat more frequent in women and in patients with microsatellite stable tumours. Female SNP309 carriers were diagnosed with colorectal cancer approximately 2.7 years earlier than those carrying the wild type gene. However, no statistically significant association of SNP309 with patients' age at disease onset or to any other clinicopathological parameter was found in these three tumour materials. CONCLUSION: SNP309 had no significant contribution to tumour formation in our materials. Possible associations of SNP309 with microsatellite stable colorectal cancer and with earlier disease onset in female carriers need to be examined in subsequent studies.

Adult↗
PubMed2003

A new index to measure the accuracy of refractive operations.

PURPOSE: To create a new index to help evaluate the accuracy of the outcome of refractive surgery. METHODS: By combining information given by the cross-cylinder form of surgically induced refractive change (SIRC) and basic methods of vector analysis, we constructed a new index which serves as a tool to evaluate postoperatively the changes achieved by refractive surgery. This new index gives easily understandable numerical values and takes into account changes in both spherical refraction and astigmatism. We demonstrated the use of this index in two study populations consisting of 20 consecutive eyes operated on using two different lasers, Meditec MEL60 and MEL70, respectively. RESULTS: Although postoperative uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were better in the MEL70 group, the difference of photoefractive keratectomy (PRK) for combined astigmatism and myopia was not statistically significant. Comparison of the changes in refraction achieved by the two lasers indicated that the MEL60 was more accurate; this was also seen when comparing the total index of error between the two groups. CONCLUSIONS: We suggest the use of this total index of error (TIE) in clinical praxis because it provides an easy and accurate method of evaluating the accuracy of refractive operations. These inaccuracies might otherwise go unnoticed if the basic values only (e.g. UCVA, BCVA and haze) were used in postoperative evaluation.

Adult↗
PubMed2003

Effect of intramammary Escherichia coli endotoxin in early- vs. late-lactating dairy cows.

We investigated the differences in the effect of intramammarily infused endotoxin for cows in early (EL) and late (LL) lactation. In this crossover study, nine cows were challenged twice with 100 microg of intramammarily infused Escherichia coli 0111:B4 LPS, each cow serving its own control. Systemic and local signs were recorded throughout the experiment to assess the severity of each cow's response. Daily milk yield and indicators of inflammation in blood and milk were also recorded. The response was significantly more severe in the EL period. Before the challenge, milk yield and serum free fatty acid concentration were higher and serum urea concentration lower in EL compared with LL cows. No significant differences were present in other parameters. After the challenge, milk SCC and leukocyte function, measured as chemiluminescence, increased, more markedly in EL. Blood neutrophil content varied from neutropenia to neutrophilia. Simultaneously with neutropenia, the function of neutrophils increased in LL but decreased in EL. Serum cortisol peaked 4 h after challenge in both groups. In conclusion, endotoxin challenge resulted in more severe response in EL. During that time cows also had impaired neutrophil function postchallenge.

Animals↗
PubMed2001

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults.

UNLABELLED: A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.

Adolescent↗
PubMed2001

Non-response and related factors in a nation-wide health survey.

OBJECTIVE: To analyse selective factors associated with an unexpectedly low response rate. SUBJECTS AND METHODS: The baseline questionnaire survey of a large prospective follow-up study on the psychosocial health of the Finnish working-aged randomly chosen population resulted in 21,101 responses (40.0%) in 1998. The non-respondent analysis used demographic and health-related population characteristics from the official statistics and behavioural, physical and mental health-related outcome differences between early and late respondents to predict possible non-response bias. Reasons for non-response, indicated by missing responses of late respondents, and factors affecting the giving of consent were also analysed. RESULTS: The probability of not responding was greater for men, older age groups, those with less education, divorced and widowed respondents, and respondents on disability pension. The physical health-related differences between the respondents and the general population were small and could be explained by differences in definitions. The late respondents smoked and used more psychopharmaceutical drugs than the early ones, suggesting similar features in non-respondents. The sensitive issues had a small effect on the response rate. The consent to use a medical register-based follow-up was obtained from 94.5% of the early and 90.9% of the late respondents (odds ratio: 1.70; 95% confidence interval: 1.49-1.93). Consent was more likely among respondents reporting current smoking, heavy alcohol use, panic disorder or use of tranquillisers. CONCLUSIONS: The main reasons for non-response may be the predisposing sociodemographic and behavioural factors, the length and sensitive nature of the questionnaire to some extent, and a suspicion of written consent and a connection being made between the individual and the registers mentioned on the consent form.

Adult↗
PubMed2001

Evaluation of blood flow in free microvascular flaps.

Free flap surgery is routine today, yet little is known of its pathophysiology. In this study, the authors evaluated the hemodynamics in different types of free microvascular flaps, by measuring intraoperative transit-time flow. Eighty-six free transplants--21 free TRAM flaps for breast reconstruction, 18 radial forearm flaps for head and neck reconstructions, and 47 muscle flaps for head and neck, trunk and lower extremity reconstructions--were studied. Donor artery flow was highest in the radial artery (mean: 57.5 +/- 50 (SD) ml/min) but dropped (p < 0.001) to one tenth (6.1 +/- 2 ml/min) after anastomosis. The flow was lowest (4.9 +/- 3 ml/min) in the recipient artery of the TRAM flap but, after anastomosis, increased significantly (13.7 +/- 5 ml/min) to the level of the flow in the donor artery. The donor-artery flow in muscle flaps had a mean of 15.9 +/- 11 ml/min, and it significantly increased after anastomosing (23.9 +/- 12 ml/min). Weight-related intake of blood was highest in the radial forearm flap (18.5 +/- 6 ml/ min/100g) and lowest in the TRAM flap (2.5 +/- 1 ml/min/100g). The study showed that blood flow through a free microvascular flap does not depend on recipient artery flow. Even low-flow arteries can be used as recipients, because the flow increases according to free-flap requirements. The blood flow through a free microvascular flap depends on the specific tissue components of the flap.

Adolescent↗
PubMed1997

Magnetic resonance imaging of the TRAM flap donor site.

High-field magnetic resonance imaging (Magnetom 42 SP, 1.0 Tesla) was performed a mean of 22 months (range, 8-42 months) postoperatively on 29 women who had undergone unilateral breast reconstruction with a transverse rectus abdominis musculocutaneous (TRAM) flap (19 free and 10 pedicled TRAM flaps). Fifteen T1-weighed, cross-sectional spin-echo images of the abdominal wall were obtained using a surface coil. The free TRAM flap was elevated sparing the lateral third of the rectus muscle. In the pedicled TRAM flap the whole rectus muscle was used. The patient groups were demographically similar, with no statistical differences in age or body mass index. In the free TRAM group the mean (+/-standard deviation) area of the rectus muscle in the upper third of the muscle (first five slices) was smaller on the operated side (376 +/- 135 mm2) than on the contralateral side (462 +/- 78 mm2), p = 0.02. The mean signal intensity (reflecting intramuscular fat content) of the upper third of the muscle was significantly higher on the operated side than on the nonoperated side, p = 0.04. Intramuscular fat content was also estimated and graded using an arbitrary scale from 1 to 4. The fat content of the upper third of the muscle was graded higher on the donor side (median, 3) than on the contralateral side (median, 2), p < 0.01. In pedicled TRAM flap patients, the remaining rectus was responsible for a mean of 47 +/- 5% of the distance between the lateral muscles, leaving a mean of 63 +/- 10 mm of the abdominal wall covered by fascia only. No hernias were detected in either group. This study shows that harvesting of a free TRAM flap seems to affect the quality of the donor rectus muscle over its whole length.

Case-Control Studies↗
PubMed1997

Abdominal wall competence after free transverse rectus abdominis musculocutaneous flap harvest: a prospective study.

A prospective study was designed to evaluate the possible changes in abdominal wall strength following free transverse rectus abdominis musculocutaneous (TRAM) flap surgery for breast reconstruction. Twenty-two patients were examined 1 day before surgery, and at 3, 6, and 12 months postoperatively. Trunk muscle strength was measured by the same physiotherapist using an isokinetic dynamometer (Lido Multi Joint II, Loredan Biomedical Inc., Davies, CA). The peak torque and average torque for both flexion and extension at 60 degrees per second angular velocity were recorded from the curves obtained. There was a significant reduction in trunk flexion strength at 3 months postoperatively (peak torque mean, 92% of the preoperative value; p = 0.04), but this was corrected by 6 months (mean, 96%), and improved to 98% by 12 months. The patient's ability to do curled trunk sit-ups was evaluated by the same physiotherapist and graded on a scale from 1 to 6. In 9 of 19 patients the operation had no effect on sit-up performance during follow-up. In 10 of 19 patients there was a reduction of one or two grades at 3 months that did not improve by 12 months. Magnetic resonance imaging of the abdominal wall was performed on 9 patients. The mean area of the upper third of both rectus muscles was measured on the axial images. At 3 months postoperatively the mean area of the upper third of the donor muscle was significantly larger than the contralateral (p = 0.03). There was no difference in size at 6 months, and by 12 months the donor side was smaller. This prospective study shows that harvesting of a free TRAM flap can cause a subclinical reduction in abdominal strength, although this was not noticed by the patients themselves.

Abdominal Muscles↗
PubMed1996

Femoral component fixation with and without intramedullary plug. A 6-year follow-up.

A total of 113 patients underwent a cemented total hip replacement (THR) operation involving femoral component fixation either without the use of a distal intramedullary plug (n = 57, group 1) or with the plug (n = 56, group 2). We studied the femoral component fixation radiographically at on average 6 years after THR. The cement coating was assessed as technically good in 86% and 95% of groups 1 and 2, respectively. There was radiographically diagnosable loosening of the femoral component at the follow-up in 25 cases in which stems were inserted without the intramedullary plug, and in 6 cases in those with the plug (P < 0.0008), and the mean subsidence of the femoral component was 5 mm in group 1 and 1.5 mm (P < 0.0003) in group 2, respectively. Osteolytic changes around the femoral component were noticed in both groups in equal numbers and with no statistical difference. The use of a distal intramedullary plug in the cementation of the femoral stem results in a better cement coating, reduces femoral component subsidence and ameliorates the loosening rates.

Aged↗
PubMed1996

Sequelae in the abdominal wall after pedicled or free TRAM flap surgery.

Twenty-seven free transverse rectus abdominis musculocutaneous (TRAM) and 16 pedicled TRAM flap breast reconstruction patients were studied for 7 to 41 months (mean, 23 months) postoperatively to compare abdominal sequelae after these two operations. The patient groups were demographically similar; mean age was 47 years in both groups. Subjective grading of the results was similar in both groups. The incidence of minor lower abdominal bulges was higher (44%, 7/16) in the pedicled group than in the free TRAM flap group (4%, 1/27). No hernias were found. Delayed healing of the abdominal scar occurred in 3 free TRAM flap and 1 pedicled TRAM flap patients. Two free TRAM flap (8%) and 7 pedicled TRAM (44%) flap patients had minor edge necrosis of the breast. Trunk strength was tested using an isokinetic device (Lido Multi Joint II), and peak torque for flexion (mean, 111 Nm +/- 25 Nm in the free TRAM flap group and 123 Nm +/- 28 Nm in the pedicled TRAM flap group) and extension (mean, 144 Nm +/- 38 Nm and 167 Nm +/- 45 Nm) were measured. No statistical differences occurred between these groups. Sit-up performance was tested and graded from 1 to 6. Both groups performed equally (4.8 and 4.8) and within normal values for this age group. Ultrasonography of the rectus muscles revealed that in the free TRAM flap group, the rectus muscle of the operated side was significantly thinner (cranial segment 6.8 mm vs. 7.8 mm, p < 0.05), thus the harvesting of a segment of muscle below the umbilicus seems to disturb the quality of the entire muscle. The mean size of the muscular defect in the free TRAM flap group was 4.3 x 6.1 cm. In this study no differences in patient satisfaction or trunk strength could be found between free and pedicled TRAM flap patients.

Abdominal Muscles↗
PubMed1996

Thermography of hands after a radial forearm flap has been raised.

To evaluate possible circulatory changes in the donor hand 18 patients underwent cold stress testing and thermography of both hands a mean of 13 months after a radial forearm flap had been harvested. Temperatures were measured with a computed Inframetrics 600L infrared thermocamera, and the images were videotaped at room temperature and after a cold challenge (immersion in a water bath at 15 degrees C for five minutes). Temperatures were measured on the volar aspect of each fingertip, and rewarming curves were plotted for both hands. The patients could be divided into three groups according to the rewarming pattern: mean temperature of the donor hand was more than 0.5 degree C warmer than that of the other hand (n = 7), rewarming was similar in both hands (n = 6), and the mean temperature of the donor hand was less than 0.5 degree C colder than that of the other hand (n = 5). Patients with a colder donor hand had significantly wider (Pearson's r = 0.62, p = 0.005) and longer (r = 0.71, p = 0.001) defects. The rewarming pattern did not correlate with subjective cold intolerance, but the temperature of the donor hand was a mean of 0.5 degree C less than that of the other hand in room temperature in subjects who experienced cold intolerance (p = 0.019). We conclude that the raising of a radial forearm flap, particularly a large one, affects the thermoregulatory system of the donor hand, results in abnormal rewarming, and can cause subjective cold intolerance.

Adult↗
PubMed1996

Donor site morbidity of radial forearm flaps. A clinical and ultrasonographic evaluation.

Harvesting of a forearm flap based on the radial artery has been thought to cause functional or circulatory problems in the donor hand. Eighteen patients were examined three to 24 months after a radial forearm flap had been raised. The function of both hands was studied for grip strength, mobility of the wrist and elbow joints, and sensitivity of the area served by the superficial radial nerve. The patients were interviewed and the cosmetic result was evaluated. Duplex ultrasonography and colour Doppler ultrasonography of both ulnar arteries were done, and the brachial arteries were measured as controls. Angle-corrected peak flow velocity (cm/s) in the ulnar artery of the donor forearm was significantly increased at the level of the wrist compared with the control forearm (100.9 compared with 73.1 cm/s, p = 0.017), as was the ulnar: brachial peak flow velocity ratio (1.18 compared with 0.76, p = 0.001). The grip strength of the donor hand was weaker by 11.9% (86.5 compared with 72.2 Kp), 10 (56%) had areas of sensory loss over the radial nerve distribution, and seven of the 18 patients complained of cold intolerance. Four patients considered the donor site result so bad that they would not have chosen the operation had they known what the result would look like. The radial forearm flap donor site is not without problems, and the patients must be carefully selected and properly informed preoperatively.

Adult↗
PubMed1996

Revision total hip arthroplasty in deficient proximal femur using a distal load-bearing prosthesis.

Eleven revision total hip replacements (THR) were performed with the use of transfemoral distally fixing stems. Nine Wagner and two Link cementless stems were used. The mean age of the patients was 62 years (range 44-78) and in mean they had undergone 2.4 previous hip operations. The mean follow-up was 43 months in nine patients and two patients had a new revision during the follow-up. The reasons for these revisions were loosening of stems in association with proximal lysis and periprosthetic fracture in eight cases, proximal femoral resection after infection in one case, loosening and deficient proximal bone in one case and proximal intraoperative fracture in a dysplastic hip after previous intertrochanteric osteotomy in one patient. The subsidence of the stem varied from 0 to 40 mm and two stems were revised during the first year because stability was lost due to subsidence. In those nine cases who were not revised the mean Harris hip score was 74 points. The final results were excellent in two, good in three, fair in two and poor in four cases. Our results suggest that revision total hip arthroplasty in cases where the proximal femur is deficient after lysis, old infection or fracture, using a distal load bearing stem gives satisfactory results in more than half of cases.

Adult↗
PubMed1996

Revision total hip replacement using the bias proximal porous-coated femoral component.

Revision total hip replacement (THR) to replace the loose femoral component using BIAS proximally porous-coated femoral revision stem was followed up in 39 patients for five years. In six cases a new revision of the stem was carried out for symptomatic stem loosening and five more were definitely loose and in 15 cases radiographs revealed clear radiolucent periprosthetic zones evidencing fibrous integration. The survival of the BIAS revision stem was 83% after five years. The mean Harris hip score (HHS) was 75 points and the final result was excellent in six, good in eight, fair in four and poor in 16 cases. The outcome was unacceptably poor and the use of this stem should be abandoned in THR revisions.

Adult↗
PubMed1995

Free flap failures.

A retrospective analysis of 75 consecutive free flap patients, operated on during 1989-1990, was performed to find out more about factors associated with free flap failure or immediate vascular complications. The overall failure rate was 9.3% (7/75) and the immediate vascular complication rate 22.7% (17/75). Sixteen patients required explorative surgery during the first postoperative day. The results were statistically analysed to find factors promoting either failure or vascular complications. Pre-operative infection of the recipient site or prolonged operation time correlated with flap failure. The use of a vein graft or long per-operative ischaemia correlated with immediate vascular complications. It is interesting that many factors often blamed for failure (age, body mass, history of cardiovascular disease, smoking, or previous irradiation of the recipient site) were not significant in this study.

Adolescent↗