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  • Jansson, Kim (Helsingin yliopisto, 2007)
    Anterior cruciate ligament (ACL) tear is a common sports injury of the knee. Arthroscopic reconstruction using autogenous graft material is widely used for patients with ACL instability. The grafts most commonly used are the patellar and the hamstring tendons, by various fixation techniques. Although clinical evaluation and conventional radiography are routinely used in follow-up after ACL surgery, magnetic resonance imaging (MRI) plays an important role in the diagnosis of complications after ACL surgery. The aim of this thesis was to study the clinical outcome of patellar and hamstring tendon ACL reconstruction techniques. In addition, the postoperative appearance of the ACL graft was evaluated using several MRI sequences. Of the 175 patients who underwent an arthroscopically assisted ACL reconstruction, 99 patients were randomized into patellar tendon (n=51) or hamstring tendon (n=48) groups. In addition, 62 patients with hamstring graft ACL reconstruction were randomized into either cross-pin (n=31) or interference screw (n=31) fixation groups. Follow-up evaluation determined knee laxity, isokinetic muscle performance and several knee scores. Lateral and anteroposterior view radiographs were obtained. Several MRI sequences were obtained with a 1.5-T imager. The appearance and enhancement pattern of the graft and periligamentous tissue, and the location of bone tunnels were evaluated. After MRI, arthroscopy was performed on 14 symptomatic knees. The results revealed no significant differences in the 2-year outcome between the groups. In the hamstring tendon group, the average femoral and tibial bone tunnel diameter increased during 2 years follow-up by 33% and 23%, respectively. In the asymptomatic knees, the graft showed homogeneous and low signal intensity with periligamentous streaks of intermediate signal intensity on T2-weighted MR images. In the symptomatic knees, arthroscopy revealed 12 abnormal grafts and two meniscal tears, each with an intact graft. Among 3 lax grafts visible on arthroscopy, MRI showed an intact graft and improper bone tunnel placement. For diagnosing graft failure, all MRI findings combined gave a specificity of 90% and a sensitivity of 81%. In conclusion, all techniques appeared to improve patients' performance, and were therefore considered as good choices for ACL reconstruction. In follow-up, MRI permits direct evaluation of the ACL graft, the bone tunnels, and additional disorders of the knee. Bone tunnel enlargement and periligamentous tissue showing contrast enhancement were non-specific MRI findings that did not signify ACL deficiency. With an intact graft and optimal femoral bone tunnel placement, graft deficiency is unlikely, and the MRI examination should be carefully scrutinized for possible other causes for the patients symptoms.
  • Sjöberg, Sami (2012)
    The thesis essays examine the avant-garde movement known as lettrism, and the influence of medieval Jewish mysticism and messianism on its art. Most research in this area has focused on the history of lettrism but has disregarded the possibility of a Jewish influence. This volume offers the first detailed examination of the aesthetic, philosophical and practical implications and manifestations of religious mysticism, the Kabbalah, and messianism in lettrist poetics. Lettrist poetry consists of glossographic writing with imaginary signs, which amalgamates pictorial and linguistic (literary) expression and makes a categorical distinction between these media impossible. By virtue of such a melange, the conventions involved in the mediation of meaning are undermined, and lettrist poetry appears nonsensical. Lettrist poetics applies themes such as ineffability, obscurity and nothingness, which derive from the Kabbalah. The use of these themes establishes an anti-rational theory of language, which regards the lacunae of meaning recurring in lettrist poems as essential poetic elements with respect to meaning. Furthermore, the lacunae evoke a potentiality of meaning. Such potential meaning differs radically from conventional conceptions of textual meaning through its temporal suspension. This suggests that lettrism adapts the futureorientedness of messianism on a linguistic level. Potentiality evokes literary structures that circumvent dualisms based on any straightforward presence or absence of meaning. In the essays comprising this thesis, such structures are illustrated by the notions of nothing (rien), 'void' (blanc) and the 'secret'. Methodologically, the thesis introduces a theoretical device suitable for an examination of the aforementioned structures. The hermeneutics of the included middle extends the scope of hermeneutical inquiry to the potentiality of meaning. In addition to dialectical antinomic terms, the hermeneutics of the included middle acknowledges the middle both as a lack and as potentiality. In other words, any present lack of meaning is regarded as potential meaning and thus the poems themselves cannot be deemed meaningless. The study therefore argues that lettrism adapts the structures of religious messianism and incorporates a religious component into the glossography and lacunae of poetry. The quasi-language of lettrist poetry becomes both the means by which the religious inclination is manifested and its mainstay.
  • Levas, Naemi (1913)
  • Halme, Heikki ((191)
  • Virtaranta, Pertti (1943)
  • Parkatti, Jarre Johan (2007)
    Frågan om hur relationen mellan aktörers handling och den sociala strukturen skall förstås är ett centralt samhällsvetenskapligt problem. Metodologiska avgöranden om hur förhållandet undersöks i historiskt, geografiskt och socialt avgränsade situationer är beroende av hur det uppfattas ontologiskt. Samhällsvetenskapen har präglats av en tudelning i approacher som utgår från fritt handlande subjekt respektive social determination. Filosofiskt har klyftan mellan forskningsansatserna bl.a. tagit sig uttryck i kontroversen mellan metodologiska individualister och holister. Struktureringsteorin utgör ett försök att lösa problemet genom att omformulera centrala samhällsvetenskapliga begrepp som aktör, handling och struktur. Dessa sammanknyts i teorin av strukturens dualitet, som gör strukturen beroende av aktörernas handling och vice versa. Giddens betraktar aktören som sofistikerad, framför allt på en praktiskt medveten nivå, på vilken denna utan explicit reflektion förmår kreativt tillämpa regler för handlandet med hjälp av materiella och immateriella resurser. Reglerna och resurserna bygger upp strukturen, som uppfattas som ”virtuell” och därmed beroende av aktörernas föreställningar. Giddens kritiserar voluntaristisk samhällsteori och anglosaxisk handlingsfilosofi för att betrakta avsikter och handling som helt genomskinliga för aktören och handlingsflödet som oproblematiskt uppdelat i ”enskilda” handlingar samt för att bortse från frågor om makt och institutionell förändring. Omvänt kritiserar han funktionalism och strukturalism för att inte kunna redogöra för aktörernas roll som upprätthållare av de sociala mönster som beskrivs. Jag försöker avfärda kritik som går ut på att Giddens teoribyggnad är eklektisk, att hans regelbegrepp är för vagt och att strukturen måste sätta strikta gränser för handlingen, men finner vissa problem beträffande materiella resursers virtuella status samt särskiljandet av regler och immateriella resurser. Trots dessa begreppsliga oklarheter finner jag den struktureringsteoretiska lösningen på förhållandet mellan aktör och struktur överlägsen dem som förekommit i diskussionen mellan metodologiska individualister och holister, där varken aktörens eller den sociala ”helhetens” ontologiska status normalt analyserats kritiskt och som dessutom ofta utgått från oproblematiserade empiristiska antaganden. Giddens ”räddar” egenskaper hos aktören som är viktiga för individualister utan att ge avkall på strukturens betydelse. Vissa synpunkter som presenterats i kontroversen kunde dock berika struktureringsteorin, bl.a. tanken om i någon mening emergenta sociala egenskaper – förutsatt att man inte förbiser den grundläggande struktureringsprocess som konstituerar den sociala verkligheten.
  • Räisänen, Riikka (Helsingin yliopisto, 2009)
    This study is based on the multidiciplinary approach of using natural colorants as textile dyes. The author was interested in both the historical and traditional aspects of natural dyeing as well as the modern industrial applications of the pure natural compounds. In the study, the anthraquinone compounds were isolated as aglycones from the ectomycorrhizal fungus Dermocybe sanguinea. The endogenous beta-glucosidase of the fungus was used to catalyse the hydrolysis of the O-glycosyl linkage in emodin- and dermocybin-1-beta-D-glucopyranosides. The method, in which 10.45 kg of fresh fungi was starting material, yielded two fractions: 56.0 g of Fraction 1 (94% of the total amount of pigment,) consisting almost exclusively of the main pigments emodin and dermocybin, and 3.3 g of Fraction 2 (6%) consisting mainly of the anthraquinone carboxylic acids. The anthraquinone compounds in Fractions 1 and 2 were separated by one- and two-dimensional thin-layer-chromatography (TLC) using silica plates. 1D TLC showed that neither an acidic nor a basic solvent system alone separated completely all the anthraquinones isolated from D. sanguinea, in spite of the variation of the rations of the solvent components in the systems. Thus, a new 2D TLC technique was developed, applying n-pentanol-pyridine-methanol (6:4:3, v/v/v) and toluene-ethyl acetate-ethanol-formic acid (10:8:1:2, v/v/v/v) as eluents. Fifteen different anthraquinone derivatives were completely separated from one another. Emodin, physcion, endocrocin, dermolutein, dermorubin, 5-chlorodermorubin, emodin-1-beta-D-glucopyranoside, dermocybin-1-beta-D-glucopyranoside and dermocybin, and five new compounds, not earlier identified in D. sanguinea, 7-chloroemodin, 5,7-dichloroemodin, 5,7-dichloroendocrocin, 4-hydroxyaustrocorticone and austrocorticone, were separated and identified on the basis of their Rf-values, UV/Vis spectra and mass spectra. One substance remained unidentified, because of its very low concentration. The anthraquinones in Fractions 1 and 2 were preparatively separeted by liquid-liquid partition, with isopropylmethyl ketone and aqueous phosphate buffer as the solvent system. Advantage was taken of the principle of stepwise pH-gradient elution. The multiple liquid-liquid partition (MLLP) offered an excellent method for the preparative separation of compounds, which contain acidic groups such as the phenolic OH and COOH groups. Due to their strong aggregation properties, these compounds are, without derivatization, very difficult to separate on a preparative scale by chromatographic methods. By the MLLP method remarkable separations were achieved for the components in each mixture. Emodin and dermocybin were both obtained from Fraction 1 in a purity of at least 99%. Pure emodin and dermocybin were applied as mordant dyes to wool and polyamide and as disperse dyes to polyester and polyamide, using the high temperature (HT) technique. A mixture of dermorubin and 5-chlorodermorubin was applied as an acid dye to wool. In these experiments, synthetic dyes were used as references. Experiments were also performed using water extract of the air-dried fungi as dye liquor for wool and silk. The main colouring compounds in the crude water extract were emodin and dermocybin, which indicated that the O-glycosyl linkages in emodin- and dermocybin-1-beta-D-glucopyranosides were broken by the beta-glucosidase enzyme. Apparently, the hydrolysis occurred during the drying of the fungi and during the soaking of the dried fruit bodies overnight when preparing the dyebath. The colour of each dyed material was investigated in terms of the CIELAB L*, a* and b* values, and the colour fastness to light, washing and rubbing was tested according to the ISO standards. In the mordant dyeing experiments, emodin dyed wool and polyamide yellow and red, depending on the pH of the dyebath. Dermocybin gave purple and violet colours. The colour fastness of the mordant-dyed fabrics varied from good to moderate. The fastness properties of the natural anthraquinone carboxylic acids on wool were good, indicating the strength of the ionic bonds between the COO- groups of the dyes and the NH3+ groups of the fibres. In the disperse dyeing experiments, emodin dyed polyester bright yellow and dermocybin bright reddish-orange, and the fabrics showed excellent colour fastness. In contrast, emodin and dermocybin successfully dyed polyamide brownish-orange and wine-red, respectively, but with only moderate fastness. In industrial dyeing processes, natural anthraquinone aglycone mixtures dyed wool and silk well even at low concentrations of mordants, i.e. with 10% of the weight of the fibre (owf) of KAl(SO4)2 and 1 or 0.5% owf of other mordants. This study showed that purified natural anthraquinone compounds can produce bright hues with good colour-fastness properties in different textile materials. Natural anthraquinones have a significant potential for new dyeing techniques and will provide useful alternatives to synthetic dyes.
  • Song, Xin (Helsingin yliopisto, 2015)
    Background and aims: Obesity has become the sixth most important risk factor contributing to the overall burden of a variety of diseases worldwide. The association of anthropometric measures of obesity with mortality from various causes and incidence of cancers of various sites has been investigated, but it remains controversial. The aims of this study were to: 1) evaluate the epidemiological nature of the association of anthropometric measures of obesity with mortality from various causes, and to detect a potential threshold in this association; 2) study the epidemiological nature of the association between body mass index and incidence of cancer of different sites, and to detect a potential threshold in the association; 3) compare the strengths of different anthropometric measures of obesity in relation to cardiovascular disease (CVD) mortality; 4) assess the risk of CVD mortality in relation to obesity and sex in the general population, and also separately for those with or without diabetes at baseline. Study population and Methods: This study was based on data subsets of the Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe (DECODE) study and the National FINRISK study, including 72 947 European men and 62 798 women (I), 26 636 Finnish men and 28 089 women (II), 24 686 European men and 21 965 women (III/IV), and 23 629 European men and 21 965 women (V) aged 24 years or above at baseline. Hazard ratios (HRs) corresponding to categorical or continuous body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) or waist-to-stature ratio (WSR), a body shape index (ABSI) and waist-to-hip-to-height ratio (WHHR) were estimated by the Cox proportional hazards model adjusting for several potential confounding factors measured at baseline. The non-parametric smooth functions of several anthropometric measures of obesity were fitted to health outcomes in order to explore the potential curvilinear relationship using the spline regression model, with a threshold detected by a piecewise regression model (II/III). HR per standard deviation increment of each anthropometric measure of obesity in relation to CVD mortality was compared using the paired homogeneity test (IV). Results: BMI, WC and WHtR had a U- or J-shaped relationship with all-cause mortality (I/III), whereas WHR, ABSI and WHHR had a linear positive relationship with all-cause mortality (III). BMI had a J-shaped relationship with CVD mortality (I/III), whereas anthropometric measures of abdominal obesity (WC, WHR, WHtR and ABSI) had a linear positive relationship with CVD mortality (III). BMI had a U-shaped relationship with cancer mortality in both men and women but disappeared among non-smokers, which showed no association (I). BMI had a linear positive association with incidence of cancers of the colon, liver, kidney, bladder and all sites combined in men, and of cancers of the stomach, colon, gallbladder and ovary in women, an inverse association with incidence of cancers of the lung in men and the lung and breast in women, and a J-shaped association with incidence of all cancers combined in women (II). A one-standard-deviation increase in all obesity indicators were significantly associated with a more than 19% increase of CVD mortality risk in both men and women, and the prediction for CVD mortality was stronger with anthropometric measures of abdominal obesity than that with BMI and ABSI, and most strongly with the WHtR/WSR (IV). Men had higher CVD mortality rates and higher HRs across BMI categories, and categories of abdominal obesity than women (V). The sex difference in CVD mortality was slightly smaller in obese than in non-obese individuals; the negative interactions were statistically significant between sex and WC (p =0.02), and sex and WHtR (p =0.01). None of the interaction terms was significant when the analyses were carried out among non-diabetic or diabetic individuals separately (V). Conclusions: This study confirmed the deleterious effect of obesity on mortality from various causes and incidence of cancers of certain sites. The prediction for CVD mortality with anthropometric measures of abdominal obesity was stronger than that with BMI, which may imply a more important role of fat distribution than fat accumulation and suggest that an effective obesity prevention strategy should emphasize the importance of abdominal obesity. Men had higher CVD mortality than women across all categories of anthropometric measures of obesity, which further supports the view of higher intra-abdominal fat accumulation in men than in women, even in non-obese individuals. Obesity seems slightly to diminish the female advantage in CVD mortality, irrespective of diabetes status. This may indicate that women may gradually lose their cardiovascular advantage when they are obese, probably due to a more pronounced clustering of CVD risk factors among obese women.
  • Nyamdorj, Regzedmaa (Helsingin yliopisto, 2010)
    Clinical trials have shown that weight reduction with lifestyles can delay or prevent diabetes and reduce blood pressure. An appropriate definition of obesity using anthropometric measures is useful in predicting diabetes and hypertension at the population level. However, there is debate on which of the measures of obesity is best or most strongly associated with diabetes and hypertension and on what are the optimal cut-off values for body mass index (BMI) and waist circumference (WC) in this regard. The aims of the study were 1) to compare the strength of the association for undiagnosed or newly diagnosed diabetes (or hypertension) with anthropometric measures of obesity in people of Asian origin, 2) to detect ethnic differences in the association of undiagnosed diabetes with obesity, 3) to identify ethnic- and sex-specific change point values of BMI and WC for changes in the prevalence of diabetes and 4) to evaluate the ethnic-specific WC cutoff values proposed by the International Diabetes Federation (IDF) in 2005 for central obesity. The study population comprised 28 435 men and 35 198 women, ≥ 25 years of age, from 39 cohorts participating in the DECODA and DECODE studies, including 5 Asian Indian (n = 13 537), 3 Mauritian Indian (n = 4505) and Mauritian Creole (n = 1075), 8 Chinese (n =10 801), 1 Filipino (n = 3841), 7 Japanese (n = 7934), 1 Mongolian (n = 1991), and 14 European (n = 20 979) studies. The prevalence of diabetes, hypertension and central obesity was estimated, using descriptive statistics, and the differences were determined with the χ2 test. The odds ratios (ORs) or  coefficients (from the logistic model) and hazard ratios (HRs, from the Cox model to interval censored data) for BMI, WC, waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) were estimated for diabetes and hypertension. The differences between BMI and WC, WHR or WSR were compared, applying paired homogeneity tests (Wald statistics with 1 df). Hierarchical three-level Bayesian change point analysis, adjusting for age, was applied to identify the most likely cut-off/change point values for BMI and WC in association with previously undiagnosed diabetes. The ORs for diabetes in men (women) with BMI, WC, WHR and WSR were 1.52 (1.59), 1.54 (1.70), 1.53 (1.50) and 1.62 (1.70), respectively and the corresponding ORs for hypertension were 1.68 (1.55), 1.66 (1.51), 1.45 (1.28) and 1.63 (1.50). For diabetes the OR for BMI did not differ from that for WC or WHR, but was lower than that for WSR (p = 0.001) in men while in women the ORs were higher for WC and WSR than for BMI (both p < 0.05). Hypertension was more strongly associated with BMI than with WHR in men (p < 0.001) and most strongly with BMI than with WHR (p < 0.001), WSR (p < 0.01) and WC (p < 0.05) in women. The HRs for incidence of diabetes and hypertension did not differ between BMI and the other three central obesity measures in Mauritian Indians and Mauritian Creoles during follow-ups of 5, 6 and 11 years. The prevalence of diabetes was highest in Asian Indians, lowest in Europeans and intermediate in others, given the same BMI or WC category. The  coefficients for diabetes in BMI (kg/m2) were (men/women): 0.34/0.28, 0.41/0.43, 0.42/0.61, 0.36/0.59 and 0.33/0.49 for Asian Indian, Chinese, Japanese, Mauritian Indian and European (overall homogeneity test: p > 0.05 in men and p < 0.001 in women). Similar results were obtained in WC (cm). Asian Indian women had lower  coefficients than women of other ethnicities. The change points for BMI were 29.5, 25.6, 24.0, 24.0 and 21.5 in men and 29.4, 25.2, 24.9, 25.3 and 22.5 (kg/m2) in women of European, Chinese, Mauritian Indian, Japanese, and Asian Indian descent. The change points for WC were 100, 85, 79 and 82 cm in men and 91, 82, 82 and 76 cm in women of European, Chinese, Mauritian Indian, and Asian Indian. The prevalence of central obesity using the 2005 IDF definition was higher in Japanese men but lower in Japanese women than in their Asian counterparts. The prevalence of central obesity was 52 times higher in Japanese men but 0.8 times lower in Japanese women compared to the National Cholesterol Education Programme definition. The findings suggest that both BMI and WC predicted diabetes and hypertension equally well in all ethnic groups. At the same BMI or WC level, the prevalence of diabetes was highest in Asian Indians, lowest in Europeans and intermediate in others. Ethnic- and sex-specific change points of BMI and WC should be considered in setting diagnostic criteria for obesity to detect undiagnosed or newly diagnosed diabetes.
  • Mattsson, Johanna (Helsingin yliopisto, 2014)
    Prostate-specific antigen (PSA) is a very useful biomarker for prostate cancer. The PSA concentration in circulation increases due to leakage of PSA from cancerous tissue. Normally PSA, a serine protease with chymotrypsin-like enzymatic activity, is secreted into seminal fluid by the epithelial cells of the prostate. The major physiological function of PSA in seminal fluid is to digest semenogelins, which leads to liquefaction of the seminal clot. Several other functions have also been suggested for PSA, some of which are associated with cancer. PSA exerts antiangiogenic activity, but PSA may also promote tumor growth and metastatic dissemination. The aim of the research presented in this thesis was to characterize the antiangiogenic and proteolytic activities of PSA. One of the main goals was to elucidate whether the enzymatic activity of PSA is a requirement for its antiangiogenic activity. The antiangiogenic activity of PSA was studied using an in vitro angiogenesis model based on tube formation of human umbilical vein endothelial cells (HUVEC). In this model only enzymatically active PSA was able to inhibit angiogenesis. Peptides that stimulate the proteolytic activity of PSA enhanced the antiangiogenic activity, while small molecule compounds that inhibit PSA abolished this activity. DNA microarray study showed that PSA-induced changes in the gene expression of HUVECs were small during tube formation, and it was not clear whether these changes were primary or secondary to the antiangiogenic activity of PSA. The results of this thesis suggest that the antiangiogenic activity of PSA is mediated by a proteolytic product generated by PSA. The proteolytic activity of PSA was studied using several peptide and protein substrates. Semenogelins are the major physiological substrates of PSA and they were shown to be degraded much more rapidly than any other protein substrate studied. Nidogen-1, a component of the basement membrane, was identified as a novel substrate for PSA by mass spectrometry. However, the cleavage of nidogen-1 did not explain the antiangiogenic activity of PSA, since either its fragments or full-length form did not affect HUVEC tube formation. Contrary to a previous report, we showed that the antiangiogenic activity of PSA was not mediated by angiostatin-like fragments generated by the cleavage of plasminogen. The results of this thesis established that the proteolytic activity is necessary for the antiangiogenic activity of PSA and that the antiangiogenic activity can be enhanced by PSA-stimulating peptides and abolished by PSA-inhibitors. The comparison of the efficiency of PSA to cleave different protein substrates and the identification of nidogen-1 as one of these substrates provided new information about the biological role of PSA. The typically slow growth of most prostate cancers may be caused by the antiangiogenic activity of PSA, as there are high concentrations of active PSA present in prostatic tissue. Therefore, peptides that stimulate the antiangiogenic activity of PSA and reduce tumor angiogenesis could be used to control prostate cancer growth.
  • Lähteinen, Paula (2012)
    Vasikkaripuli on nautojen yleisin sairaus neonataalikaudella. Perinteisesti vasikkaripulia on hoidettu mm. nesteyttämällä vasikkaa joko suun kautta tai huonompikuntoista potilasta eläinlääkärin toimesta, ja varmuuden vuoksi eläinlääkäri on laittanut vasikan antibioottikuurille. Sen hyödystä ei kuitenkaan ole selkeää konsensusta, ja tämän työn tarkoituksena on kerätä yhteen tieto, joka maailmalla alle kolmen viikon ikäisten vasikoiden ripulin antibioottihoidosta on olemassa. Vasikkaripuli on vanha sairaus, jota koskeva perustutkimus on pääasiassa vuosikymmeniä vanhaa. Suomen erityinen tautitilanne, jossa esimerkiksi salmonella on erittäin harvinainen tuotantoeläimillä, vaikeuttaa kansainvälisen kirjallisuuden soveltamista suomalaiseen ympäristöön. Myös erilaiset perinteet antibioottien käytössä ja osin sen seurauksena muokkautuneet patogeenien antibioottiresistenssitilanteet hankaloittavat kirjallisuudessa mainittujen antibioottisuositusten käyttämistä sellaisenaan. Suomessa tavallisimmin vasikkaripulin hoitoon käytetty trimetopriimi-sulfonamidi mainitaan myös kansainvälisessä kirjallisuudessa ensisijaisten hoitojen joukossa. Meillä ei sen sijaan ole totuttu käyttämään amoksisilliinia tai amoksisilliini-klavulaanihappoa nautojen hoidossa lainkaan, mutta ne nousevat esiin hoitosuosituksissa. Erilaisten lääkityssäännösten vuoksi suomalaisissa ohjeissa toissijainen valinta, fluorokinolonit, on maailmalla se viimeinen vaihtoehto. Suomessa ei taas juurikaan käytetä kolmannen tai neljännen polven kefalosporiineja, jotka ovat toisissa maissa kovassa käytössä. Tässä työssä pyrittiin myös etsimään kirjallisuudesta tietoa pohjoismaisesta erikoisuudesta, dihydrostreptomysiinistä, mutta suun kautta annettuna siitä ei löytynyt yhtään tieteellistä artikkelia. Myöskään tämän vanhan lääkkeen käyttöönottotutkimuksia ei löytynyt. Vasikkaripuli ei vaadi läheskään aina antibioottihoitoa, vaan nesteterapia on ensimmäinen ja tärkein hoitomuoto olosuhdekorjauksen ohella. Antibiootteja käytetään vain huonokuntoisille potilaille, joilla on ripulin lisäksi yleisoireita, esimerkiksi alentunut imurefleksi, yli 6% dehydraatio, kuume, apaattisuus tai heikkous, tai sen ulosteissa on limaa. Huolehtimalla, että vasikka saa riittävästi vasta-aineita ternimaidosta, vältetään suuri osa ripuleista kokonaan. Antibioottien käyttö vasikkaripulin hoidossa on yleistä, mutta kasvava huoli lääkejäämistä lihassa ja antibioottiresistenssin kehittymisestä on ohjannut ajatuksia probioottien suuntaan. Niistä tehtyjä tutkimuksia ei eläinlääketieteellisestä kirjallisuudesta vielä juuri löydy, mutta ne ovat mielenkiintoinen lisätutkimuksen kohde tuleville vuosille.
  • Pekkarinen, Anni (2007)
    Antibiootit kuuluvat koirilla yleisimmin käytettyihin lääkeaineisiin Suomessa. Valitettavasti näillä tehokkailla lääkeaineilla on hyödyllisten vaikutustensa lisäksi myös haittoja. Pahimmillaan antibioottien aiheuttamat haittavaikutukset voivat johtaa potilaan kuolemaan. Haittavaikutukset voidaan kuitenkin usein ennakoida, ja niiden välttämiseksi eläinlääkäreiden tulisikin tuntea käyttämiensä lääkeaineiden farmakologiset ominaisuudet sekä potilaan sairauden aiheuttamat muutokset esimerkiksi lääkeaineen kinetiikassa.
  • Viita-aho, Teija (2008)
    Maa- ja metsätalousministeriö on asettanut suosituksensa mikrobilääkkeiden käytöstä eri sairaustiloissa. Suositusten noudattamista kissojen osalta ei ole kuitenkaan vielä selvitetty. Syventävät opintoni koostuvat sekä tutkimusosiosta että kirjallisuuskatsauksesta. Tutkimuksen tarkoituksena oli selvittää, mitä antibiootteja Suomessa työskentelevät eläinlääkärit käyttävät kissapotilaidensa hoitoon eri tulehdustiloissa. Kirjallisuuskatsauksessa perehdyin tutkimusten perusteella yleisimmiksi osoittautuneisiin sairaustiloihin, niissä tavattaviin patogeeneihin ja hoitosuosituksiin. Tutkimus 1 oli retrospektiivinen poikkileikkaustutkimus, jossa koottiin tiedot Yliopistollisessa eläinsairaalassa kissoille määrätyistä antibiooteista ajanjaksolta marraskuuhuhtikuu vuosina 2000-2001 (n = 419). Tutkimus 2 oli prospektiivinen poikkileikkaustutkimus, jossa kerättiin kyselylomaketta käyttäen tietoa eri puolilla Suomea työskenteleviltä eläinlääkäreiltä heidän kissapotilaillaan käyttämistään antibiooteista yhden viikon aikana vuonna 2002 (n = 311). Tutkimuksessa 1 yleisimmät suun kautta annettavien antibioottien käyttöindikaatiot olivat virtsatietulehdus (n = 102; 29 %), iho- ja korvatulehdus (n = 36; 10 %) sekä hengitystietulehdus (n = 35; 10 %). Virtsatietulehduksen hoidossa käytettiin yleisimmin amoksisilliinia (68 %) tai amoksisilliini-klavulaanihappoa (26 %), iho- ja korvatulehduksessa amoksisilliinia (44 %), kefalosporiineja (22 %) tai amoksisilliini-klavulaanihappoa (17 %) ja hengitystietulehduksessa amoksisilliinia (31 %), doksisykliiniä (26 %) tai amoksisilliini-klavulaanihappoa (20 %). Tutkimuksessa 2 yleisimmät antibioottien käyttöindikaatiot olivat kirurginen toimenpide (n = 78; 25 %), haava tai paise (n = 71; 23 %) ja virtsatietulehdus (n = 38; 12 %). Kirurgisen toimenpiteen yhteydessä käytettiin yleisimmin prokaiini- ja bentsyylipenisilliinin yhdistelmää (71 %) ja jatkohoidoksi määrättiin amoksisilliini-klavulaanihappoa (44 %) tai amoksisilliinia (33 %). Haavoissa ja paiseissa sekä virtsatietulehduksissa käytettiin yleisimmin amoksisilliinia (45 % ja 34 %) tai amoksisilliini-klavulaanihappoa (36 % ja 42 %). Tulosten perusteella eläinlääkärit noudattavat pääsääntöisesti hyvin mikrobilääketyöryhmän asettamia ja kirjallisuudessa esiintyviä hoitosuosituksia. Merkittävä havainto oli, että virtsatieoireisiin oli hyvin usein määrätty antibioottikuuri, vaikka kirjallisuuden mukaan todellinen virtsateiden bakteeritulehdus on kissalla harvinainen. Ihotulehduksiin määrätyt antibioottikuurit olivat suosituksista poiketen melko lyhyitä. Kissoilla iho-oireet tosin koostuvat hyvin usein erilaisista haavoista ja paiseista, ja niiden hoidossa suosituksia oli noudatettu hyvin. Suomessa bakteerien antibioottiresistenssi on vielä suhteellisen vähäistä. Jotta samanlainen tilanne voidaan säilyttää, on hyvin tärkeää, että eläinlääkärit noudattavat antibioottien käyttösuosituksia jatkossakin ja käyttävät antibiootteja harkiten.
  • Hakkarainen, Kristiina (1998)
    Työ oli kyselytutkimus, johon oli valittu EELA:n vuonna 1995 tekemän suuren utaretulehdustutkimuksen aineistosta 60 tilaa; näistä 25 tilalla ei oltu vuoden aikana käytetty lainkaan antibiootteja mastiitin hoitoon, kun taas 35 tilalla niitä oli käytetty poikkeuksellisen paljon, keskimäärin 0,93 hoitoa lehmää kohden. Näitä antibioottien käytön perusteella valittuja ryhmiä vertailtiin keskenään tilojen yleisten ominaisuuksien, kuten karjanhoitajan ja lehmien keski-iän, lehmien tuotosten, tilan lehmäluvun ja karjan tarkkailuun kuulumisen suhteen.Verrattiin myös lehmien utareterveyttä maidon solumäärien, sekä utareesta eristettyjen bakteerien että resistenttien bakteerien esiintymisen osalta. Tiloilta kyseltiin myös kuinka he olivat vuoden aikana hoitaneet utaretulehduksia ja vedinpolkemia, sekä millaisia ovat tilalla käytettävät toimenpiteet erilaisissa uteretulehdustilanteissa ja umpeenpanon yhteydessä, sekä käytännöt solu-, antibiootti- ja varoaikamaidon juottamisessa vasikoille. Lisäksi kysyttiin eläinlääkärin merkitystä hoitopäätöksiä tehtäessä ja puhelimitse määrättyjen lääkkeiden käyttöä. Kyselyyn vastasi 12 tilaa paljon antibiootteja käyttävien ryhmästä ja 15 tilaa vähän antibiootteja käyttävästä ryhmästä. Tilastollisesti merkitsevästi ryhmät erosivat toisistaan vain antibioottien käytön sekä lehmien keski-iän suhteen, joka oli paljon antibiootteja käyttäneiden ryhmässä alhaisempi. Kuitenkin oli havaittavissa selvä suuntaus, että ryhmässä, jossa käytettiin paljon antibiootteja, karjanhoitajien keski-ikä oli hieman alhaisempi, tilan lehmäluku suurempi, lehmät tuottivat hieman paremmin ja niiden maidon solu- ja bakteerimäärät olivat hieman alhaisemmat kuin vähän antibiootteja käyttävillä tiloilla keskimäärin. Vähän antibiootteja käyttävillä tiloilla oli vähemmän kliinisiä mastiitteja, kuin antibiootteja paljon käyttäneillä. EELA:N tekemän tutkimuksen tuloksiin verrattuna tilojen lehmäluvut olivat kasvaneet kummassakin ryhmässä, antibioottien käyttö oli hieman vähentynyt niitä paljon käyttäneiden ryhmässä ja hieman noussut niitä vähän käyttäneiden ryhmässä.
  • Manner, Leena (1993)
    Tämä syventävien opintojen tutkielma koostuu kirjallisuuskatsauksesta ja tutkimusosasta. Ärsyttävän lääkevalmisteen annostelu lihakseen on ongelmallista etiikan, farmakokinetiikan ja elintarvikehygienian kannalta. Kirjallisuuskatsauksessa käsitellään lääkeruiskeiden aiheuttaman kudosärsytyksen tutkimusmenetelmiä ja lääkkeiden ärsyttävyyteen vaikuttavia tekijöitä. Tutkimuksessa käytettiin 9 antibioottivalmistetta ja fysiologista suolaliuosta, joita annosteltiin naudoille ruiskeena lihakseen. Ruiskeiden aiheuttamaa kudosärsytystä seurattiin kliinisten oireiden ja seerumin kreatiinikinaasi (CK) aktiivisuuden muutosten perusteella. CK on lihasspesifinen entsyymi, joka vapautuu verenkiertoon lihassolujen vaurioituessa. Kutakin valmistetta injisoitiin 4:11e eläimelle ja CK-aktiivisuus määritettiin ennen injektiota sekä 2, 4, 8, 12, 24, 32 ja 48 h sen jälkeen. Prokaiinipenisilliini- ja NaCl-ruiskeiden jälkeen CK-arvot pysyivät normaalirajoissa. Enrofloksasiini-ruiskeen jälkeen CK-arvot kohosivat yli 15-kertaisiksi lähtöarvoihin verrattuna. Tylosiinidikloksasilliini-ja trimetopriimisulfadoksiini -valmisteet olivat myös voimakkaasti ärsyttäviä. Kliinisten oireiden perusteella ei voitu havaita selviä eroja eri valmisteiden ärsyttävyydessä.
  • Karkman, Antti (Helsingin yliopisto, 2015)
    Increasing microbial resistance against antibiotics is threatening their efficiency in the future and we might be heading back to pre-antibiotic era. Infectious diseases still treatable with antibiotics might soon become life threatening. There is a strong correlation between antibiotic use and antibiotic resistance occurrence. Hotspots for antibiotic resistance are mainly man made such as wastewater treatment plants, animal farms and aquaculture. Aquaculture is the fastest growing food industry in the world and uses antibiotics to treat and prevent fish diseases. The use of antibiotics is linked to increase in antibiotic resistance at the farms. At urban wastewater treatment plants microbes from various sources can mix and exchange genetic material. In addition wastewaters contain antibiotics that can further select for resistant microbes. In this work hundreds of antibiotic resistance genes were quantified with cutting-edge molecular methods. The global patterns of antibiotic resistance gene movement were determined using publicly available metagenomic data. In addition, the famous Baas-Becking hypothesis everything is everywhere, but the environment selects was tested on gene level. Aquaculture increases the amount of antibiotic resistance genes in the farms. The resistance genes persist in the aquaculture sites without a clear selection pressure, however the impact is only local. Urban wastewater treatment plants efficiently removed antibiotic resistance genes from wastewaters. The release of wastewater had only a limited impact on the sediment resistome near the release site. When looking at the metagenomic data, antibiotic resistance genes were found to have different dispersal pattern compared to other genes in the metagenomes. Antibiotic resistance genes can cross taxonomical and geographical barriers with ease, possibly explaining their wide dispersal in the environment and the clinic. These results show that antibiotic resistance is ubiquitous in the environment and the anthropogenic activities affect the incidence of antibiotic resistance.
  • Silvast, Antti (Helsingin yliopisto, 2013)
    During the past ten years, a number of social scientists have emphasized the importance of material infrastructures like electricity supply as a research topic for the social sciences. The developing of such new perspectives concerning infrastructures also includes uncertainties and risks. This research analyzes the management of uncertainties in the Finnish electricity infrastructure by posing the following research question: how are electricity interruptions, or blackouts, anticipated in Finland and how are these interruptions managed as risks? The main research methodology of the work is multi-sited field work. The empirical materials include interviews with experts and lay people (33 interviews); participant observation in two electricity control rooms; an electricity consumer survey (115 respondents); and also a number of infrastructure and security policy documents and observations from electricity security seminars. The materials were primarily gathered between 2004 and 2008. Social science research often links risks with major current social changes or socio-cultural risk perceptions. In recent international social science discussions, however, a new research topic has emerged those styles of reasoning and techniques of governance that are deployed to manage risk as a practical matter. My study explores these themes empirically by focusing on the specific habitual practices of risk management in the Finnish electricity infrastructure. The work develops various also semi-ethnographic inquiries into infrastructure risk techniques like monitor screening of real-time risks in electricity control rooms; the management of risks in a liberalized electricity market; the emergence of Finnish reasoning about blackouts from a specific historical background; and the ways in which electricity consumers respond to blackouts in their homes. In addition, the work reflects upon the position of a risk researcher in those situations when the research subjects do not define their management of uncertainties by the concept of risk. The work argues based on recent studies and its results that risk discourse in national and military planning offers a substantial resource to consider infrastructures and their contemporary issues. It also considers the idea, prominent in recent studies concerning insurance in particular, that risk management is a way of combining both public and market logics of provision. Drawing on semi-ethnographic data, the author also discusses the compression of timescales in liberalized infrastructure provision and elaborates the metaphor of screening to consider how market devices like computer monitors affect risk management in a large distributed energy market.