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Diverticular disease of the large intestine in Northern Norway.

In 280 unselected necropsies on patients over 20 years of age in Northern Norway, diverticular disease was present in 25% of the males and 43% of the females. The frequency of diverticular disease increased in both sexes by age. Both the frequency of diverticular disease and the average number of diverticula per case with diverticular disease were higher in females than in males in all age groups. The sigmoid was the most frequent site of diverticula in both sexes and for all ages, and the average number of diverticula per diverticulum-bearing segment was also highest in the sigmoid for all ages and in both sexes. The average number of diverticula in the sigmoid of affected individuals increased with age and with the number of segments involved. Diverticular disease was not associated with adenomas of the large intestine or with malignant or benign neoplasms elsewhere in the body or with any of the common diseases thought to be related to a Western type of diet, except with cerebrovascular disease.

Adult

The psychiatrist's role at a local hospital in the northern part of Norway and his cooperation with the primary health service in the area.

This paper describes a practical working situation for a psychiatrist situated in the northern part of Norway. The psychiatrist is attached to the local hospital on a part time basis and takes care of the psychiatric cases in the medical ward together with somatic cases. In addition, he works in a polyclinical setting in town, in close contact with several health and social services, and tries to be close to where the problems originate. The psychiatrist deals mainly with crisis interventions and has a social psychiatric approach.

Arctic Regions

Seasonal patterns of sleep stages and secretion of cortisol and growth hormone during 24 hour periods in northern Norway.

A group of 7 healthy male subjects was studied in regard to sleep stages and 24 h plasma cortisol and growth hormone patterns during the 4 seasons of the year in an Arctic environment (Tromsø, Norway). No difference in total sleep or sleep stage per cents was found for any of the yearly seasons. A small but statistical significant increase in mean plasma cortisol concentration and amount secreted for 24 h was found for the autumn-winter seasons, as compared with the spring and summer. However, no difference in the circadian curve of cortisol hormonal pattern was found. All subjects secreted growth hormone shortly after sleep onset at night and no difference was found as a function of season of the year.

Adult

Obstetric service and perinatal mortality in Norway.

Information on personnel, equipment and care facilities at all maternity institutions has been related to the perinatal mortality among all single births in Norway, 1967--1973. There was a total of 454,358 single births during this seven year period which comprised the study data set. An obstetric score based on personnel and equipment as defined in a previous study has been used to divide the country into three groups of counties, with low, medium and high obstetric scores. Perinatal, fetal and early neonatal (less than seven days) mortality rates specific to birth weight categories in 500 gram intervals have been compared between the county groups. Significant differences were found in the mortality rates between the group of counties with low obstetric score and the two other groups. There is both a relative and absolute increased difference in mortality for births weighing 3000 grams or more compared to births less than 3000 grams. The major component in the perinatal mortality difference is due to a difference between the low and higher obstetric score county groups in the early neonatal mortality rates. Time trends indicate that the relative differences in perinatal mortality are not decreasing over the seven year period, but rather, have increased slightly. Potential differences in the populations at risk in the three county groups are discusses. An adjustment was made to eliminate the effects of some potential confounding variables, namely high parity and maternal age and illegitimacy, without basically changing the results.

Adult

Oral hygiene, periodontal health and need for periodontal treatment among institutionalized mentally subnormal persons in Norway.

Oral hygiene, periodontal health and periodontal treatment needs were studied in the dentulous patients (n = 328) of a sample selected to be representative of all institutionalized mentally subnormal persons in Norway aged 5--45. The average oral hygiene and periodontal health was poor except for patients in a few institutions where the nurses were trained to clean teeth regularly. Increased age, epilepsy, Down's syndrome and a high degree of mental deficiency were all elements that apparently contributed to impairment of periodontal health and to increased treatment requirements. The preventive programs used in some institutions seemed to be effective. Still better results, however, could probably be obtained by the use of dental hygienists.

Adolescent

The use of dental services in a population in Northern Norway.

The utilization of dental services was studied by means of records from dentist's files, a method which permits gathering of detailed information with high reliability and validity. 53% of the adult population of 358 persons living in a coastal community in Northern Norway had visited a dentist during a period of two years. In the group of 13% who were considered to be regular treatment attenders, number of teeth, sex and socio-economical status were the most influential predictors of utilization. Among the 182 persons with 10 or more remaining teeth, 59% had made preventive and restorative dental visits, and in this group there was a dominating proportion of women, young people and people with high income and/or social class. In contrast, only six persons out of 61 with one to nine remaining teeth had made such visits. People in social class 3 were overrepresented among the 26% of the population who visited a dentist because of extractions or complete denture services. The treatment profile according to age showed that younger people used most of their treatment time on consultations, preventive measures and conservative treatments, while fixed and removable prosthetics constituted a major part of the treatment time among elderly people.

Adult

Oral health status in a population in Northern Norway.

Information concerning oral health status was obtained through a clinical and radiographic examination of 297 persons aged 20--69 years out of a population of 358 persons living in a coastal community in Northern Norway. The oral health was generally poor. 71% had one or more remaining teeth and the dentulous persons had a mean number of 18 remaining teeth. The mean number of DMF teeth was 27,3 while the mean number of decayed teeth was 4,9 and filled teeth 12,0 giving a percent of decayed and filled teeth of 27 and 65 respectively. Only every fourth dentulous person had one or more crowns and/or bridge units and 4% of all teeth had been treated endodontically. 41% of the teeth had visible plaque and 56% of the teeth had one or more gingival margins bleeding after gentle probing. One fourth of all teeth had gingival pockets exceeding 3 mm and 17% of all teeth showed a bone loss of 20% or more. The number of remaining teeth decreased with increasing age and decreasing income and/or social class. In general, women, young people and people with a high socioeconomic status had less caries, better oral hygiene and periodontal condition and had received more restorative dental care than the remaining part of the population.

Adult

Frequency of hepatitis in dental health personnel in Norway.

Hepatitis B infection is considered a risk to dentists and their ancillary staff. To evaluate the magnitude of the risk for personnel in dental practice in Norway a questionnaire survey and a serologic investigation was performed, both disclosing frequencies of hepatitis B insignificantly higher than those in the general Norwegian population. The occurrence of anti-HBs in the general population, represented by 800 sera, appeared to be lower than the corresponding values found in Sweden and Denmark.

Adult

The prevalence of toxoplasma antibodies among 11,736 pregnant women in Norway.

A serologic screening for toxoplasma antibodies by dye test (DT) and IgG indirect fluorescent antibody test (IgG-IFAT) has been carried out among 10729 pregnant women in the Oslo area and 1 007 pregnant women from the county of Møre and Romsdal situated on the west coast of Norway. The frequency of toxoplasma antibodies was found to be higher in women living in rural areas and a higher prevalence was observed among women living in the western districts of Oslo than among women from the eastern districts of the city. The mean frequency of DT antibodies was found to be 12.5% in the Oslo area and 13.3% in Møre and Romsdal, whereas the yearly incidence of acquired infections in the two areas was found to be 5 and 2.3%, respectively. The predicted incidence of congenital toxoplasmosis in the Oslo area, and presumably also in the whole country, would represent 2% of all pregnancies. No serologic differences were found when women with prior histories of either sporadic or habitual abortions were compared to a total group of multigravidae among the Oslo women.

Antibodies

The prophylactic use of vitamin D3 in parturient paresis in the cow in a practice district in eastern Norway. A retrospective investigation.

The prophylactic effect in parturient paresis of an intramuscular injection of 10 million i.u. vitamin D3 one week prior to the expected calving date, was investigated in 84 cows which had previously suffered from parturient paresis. Clinical observations in connection with the development of parturient paresis after injection of vitamin D3 were compared with corresponding observations made on cows within the same population at the previous calving when no vitamin D3 was administered. The incidence of clinical parturient paresis in cows given vitamin D3 was 44.3 per cent. There were no significant differences in the incidence of parturient paresis in cows injected with vitamin D3 during the periods less than 2, 2--4, 5--8 and greater than 8 days before parturition. Average plasma calcium levels (mg/100 ml) before first calcium treatment, results of treatment, and the incidence of retained placenta in vitamin D3 injected cows did not differ significantly from corresponding data for cows with clinical parturient paresis which had not been given vitamin D3 before calving. It is concluded that vitamin D3 does not have any prophylactic effect in parturient paresis in cows in Eastern Norway.

Animals

Predominance of extreme geographical proximity of the spouses of heirs to independent farms in a mountain valley in Norway between 1600 and 1850.

The marriages contracted between 1600 and 1850 in the parishes Vang and Slidre in the mountain valley of Valdres in Norway were investigated, using the information in the genealogical and local history of the parishes and in various public archives. The parishes functioned as a marriage isolate, in spite of regular communication with neighbouring districts. Only 54 of 4334 marriages were with residents outside the parishes, and marriages with a non-farming class (clergy) were as rare (47); 1130 marriages were probably between offspring of crofters and independent farmers. The further analysis concerns 3103 marriages contracted by the eldest sons and other heirs to 463 of the 493 farms, with members of the farming class within the parishes. Because of the linear settlement with clusters of same-named farms along both sides of the river, marital distance was measured by counting the number of farm-clusters (neighbourhood steps) between places of birth. In comparison with expectation when the marriage partner is chosen at random, marriages within the cluster occurred 13 times more frequently than expected, with an adjoining cluster 8 times more frequently and with a neighbour 1-2 clusters away 6 times as frequently as expected. One-third of the 3103 marriages were contracted within a distance of two clusters or less, and 60% eight clusters or less apart. A marital distance of 15 clusters (= 7 km) included 74% of the marriages. The predominance of a marriage pattern based on such geographical proximity must necessarily imply similarity in genetic structure of the descendants. Close consanguineous mating was apparently consciously avoided. This extreme geographical proximity of the spouses of heirs to the independent farms is probably explained by the function of a marriage as a contract to benefit the farm: promoting good neighbourliness and preventing quarrels and lawsuits related to the already very complicated ownership of cultivated land.

Female

Primary care in Norway.

The organization of primary care in Norway is described and the shortage of general practitioners, particularly in remote areas, discussed. Improvement in working conditions is one approach to solving this problem. However, enhanced status for the general practitioner, achieved by improvements in his vocational training, is acknowledged as an important prerequisite for better recruitment to general practice.

Family Practice

Sensitivity patterns of bacteria and antibiotic usage at the National Hospital of Norway in 1976 and 1978.

During the first three months of 1976 and 1978 the sensitivity patterns of bacteria and the antibiotic usage at the National Hospital of Norway was recorded. The computerized results showed that bacteria isolated at the department of pediatrics was more resistant to penicillins. Isolates from two other departments did not differ very much in their sensitivity patterns. Comparing the sensitivity patterns, a tendency of increased sensitivity to antibiotics from 1976 to 1978 was seen. Exception was the increasing resistance to gentamicin. Furthermore, tobramycin was found less effective than gentamicin on our isolates. The antibiotics most widely used at the hospital are the penicillins which account for more than 50 per cent of the usage. From 1976 to 1978 the usage of antibiotics increased about 30 per cent. A more extensive use of penicillin V and G, and sulfamethoxazole/trimethoprim was responsible for most of the increase. No clear cut relationship between the antibiotic usage and the changes in sensitivity patterns of the bacteria from 1976 to 1978 was seen. Our work confirms, the usefulness of using "daily defined doses", as recommended by WHO, for estimating the antibiotic usage in a hospital.

Anti-Bacterial Agents

Organochlorines in fish and crabs from the Kristiansand fjord in Norway.

The levels of sum-DDT, PCBs, and HCB in fish liver and crab hepatopancreas from the Kristiansand fjord area in Norway have been determined (fig. 1). The respective mean levels (fat weight basis) in stationary fish species and crabs are given in table I. The levels of PCBs and sum-DDT were about the same, and the HCB level two to one hundred times higher than corresponding levels reported for codfish (liver) from several harbours along the Norwegian coasts (Brevik et al. in press). The levels calculated on a wet weight basis, found is stationary fish from the harbour of Kristiansand and Topdals-fjord were two to three times higher than those in crabs. Calculated on a fat weight basis, however, the levels in stationary fish and crabs were much more similar (table II). The harbour area was more contaminated with PCBs and HCB than the other sites examined. It seems impossible, however, on the basis of present data to further pinpoint sources of the relatively high degree of HCB contamination in the Kristiansand fjord area.

Animals

3H-deoxythymidine incorporation in graft-versus-host disease in the Norway rat. I. Liquid scintillation studies.

Graft-versus-host-disease was produced in newborn Brown Norway (BN) rats with an intravenous (iv) injection of adult allogeneic Lewis (L) lymph node cells (experimental) and the response was compared to littermates injected with adult syngeneic BN cells (control). By 4 days the reaction in the spleen of experimental animals was such that the spleen index was 1.70 and 2.58 on day 7, and continued to increase until death. A one hour iv pulse of tritiated deoxythymidine (3HdT) administered to experimental and control animals revealed a whole organ peak incorporation of 3HdT on day 6 in experimental spleens. A second larger peak occurred on day 10 in the experimental spleen as compared to a single peak at days 6 or 7, respectively, in the experimental mesenteric and combined superficial lymph nodes. However, analysis of the incorporation of 3HdT with respect to organ weight revealed a peak incorporation in animals receiving L cells on day 4--6 with a second smaller peak on day 10 in the experimental spleen and again a single peak on day 5 or 6 in the lymph nodes. Total 3HdT incorporation within both experimental lymph node compartments became less than controls by day 15 even though experimental nodes had a larger mass. 3HdT incorporation per milligram tissue weight decreased in all tissue compartments of experimental animals by day 13--14. The contribution of donor and host cell proliferation to the various peaks observed is discussed.

Animals

3H-deoxythymidine incorporation in graft-versus-host disease in the Norway rat. II. Autoradiographic studies.

A sequential analysis was made of various areas within the lymph nodes and spleen of newborn Brown Norway (BN) rats suffering from graft-versus-host disease (GVHD) subsequent to an allogeneic injection of adult Lewis (L) lymph node cells (experimental). One micron thick autoradiographs were compared between such experimental and control littermates having received the same number of syngeneic adult BN cells. Both experimental and control animals received tritiated deoxythymidine (3HdT) one hour before killing. The autoradiographs revealed a 2.25 and 2.50 times higher thymidine labeling index of lymphocytes in the deep cortex of mesenteric lymph nodes and white pulp of the spleen, respectively, for experimental animals. The experimental effect occurred within one day. The majority of the labeled cells in experimental animals were large lymphoblasts with prominent nucleoli. The labeling index within these areas remained significantly higher than control values until day 8 in the spleen and through day 14 within the lymph nodes. However, differences in labeled cells present in high powered microscopic fields reached a peak on day 3 within compartments in experimental animals but fell significantly below control values by day 9 owing to a pronounced disappearance of both small and large lymphocytes from these areas, and a decreased intensity of individual cell labeling as the reaction progressed. In contradistinction the concentration of labeled cells present in high powered microscopic fields of lymph nodes' medulla became 3.13 times controls by day 4. Most of these labeled cells contained a more basophilic cytoplasm than those found in the deep cortex and some were distinctly plasma cell precursors. In contrast to the deep cortex their concentration remained approximately three times control values until death. The data indicates that the major proliferative events within the spleen and lymph nodes in neonatal rat GVHD are initially restricted to donor cell localization areas of these tissue compartments. Subsequently the GVHD-related events may be attributed to other areas and possibly cell types. Thus any proliferation contributing to splenomegaly in the latter stages of GVHD appears to occur in the red pulp and that contributing to lymph node enlargement a medullary response.

Animals