Modern surgical treatment of otosclerosis

The modern unilateral surgical treatment of otosclerosis started in 1956. Simultaneous bilateral surgery has not been reported in stapes surgery and in case of bilateral otosclerosis ears are operated in two different sessions. Simultaneous surgery would give the patient the opportunity to gain advantages of bilateral hearing within one session, with less time spent in hospital and on sick leave. The mechanism for vestibular symptoms and the exact end organ affected after surgery is still unveiled. This thesis presents the results of experimental simultaneous bilateral stapes surgery, and vestibular symptoms and findings before and after unilateral stapes surgery. In addition, we explore reasons for outpatient failures in otosclerosis surgery. -- Study I examines the outcome of simultaneous bilateral surgery. Hearing was evaluated with standard pure tone and speech audiograms and vestibular apparatus with visual feedback posturography (VFP) during the one-year follow-up. Subjective symptoms and quality of life were assessed with questionnaires. In study II, reasons for outpatient failures in stapes surgery were explored. Forty-seven consecutive stapedotomies and stapedectomies performed by the same surgeon were included, and the effect of failures on hearing results were analysed. Vestibular symptoms and the end organ(s) affected after stapes surgery were investigated in studies III and IV. With video-oculography (VOG), nystagmus was measured preoperatively, and at one week, one month and 3 months postoperatively in the first phase (III). In the second phase (IV), recordings were obtained some hours postoperatively. The hearing results of the simultaneous bilateral surgery were comparable with unilateral surgeries reported. Recovery from the surgery was fast. Significant improvement in performance and quality of life was noted already month after operation in subjective evaluations. Based on these results, simultaneous bilateral surgery is a suitable approach in bilateral otosclerosis Significantly more outpatient failures occurred for medical reasons in the stapedectomy group (13%) than in the stapedotomy group (2%). Stapedotomy should be favoured if outpatient surgery is planned. However, unplanned admission did not worsen the prognosis. VOG measurements in study III did not show any specific type of nystagmus in patients having vestibular symptoms postoperatively. However, VOG measurements immediately after surgery (IV) revealed nystagmus consistent with a minor disturbance of the semicircular canals in 33% of the patients. Subjectively, half of the patients reported vestibular symptoms that were probably of diverse origin, and could have originated from both otolith and semicircular canal parts of the vestibular organ. Since vestibular symptoms and signs are mild, patients may be safely discharged some hours after stapes surgery.

Modern computed tomography techniques in stroke management

Technological development of fast multi-sectional, helical computed tomography (CT) scanners has allowed computed tomography perfusion (CTp) and angiography (CTA) in evaluating acute ischemic stroke. This study focuses on new multidetector computed tomography techniques, namely whole-brain and first-pass CT perfusion plus CTA of carotid arteries. Whole-brain CTp data is acquired during slow infusion of contrast material to achieve constant contrast concentration in the cerebral vasculature. From these data quantitative maps are constructed of perfused cerebral blood volume (pCBV). The probability curve of cerebral infarction as a function of normalized pCBV was determined in patients with acute ischemic stroke. Normalized pCBV, expressed as a percentage of contralateral normal brain pCBV, was determined in the infarction core and in regions just inside and outside the boundary between infarcted and noninfarcted brain. Corresponding probabilities of infarction were 0.99, 0.96, and 0.11, R² was 0.73, and differences in perfusion between core and inner and outer bands were highly significant. Thus a probability of infarction curve can help predict the likelihood of infarction as a function of percentage normalized pCBV. First-pass CT perfusion is based on continuous cine imaging over a selected brain area during a bolus injection of contrast. During its first passage, contrast material compartmentalizes in the intravascular space, resulting in transient tissue enhancement. Functional maps such as cerebral blood flow (CBF), and volume (CBV), and mean transit time (MTT) are then constructed. We compared the effects of three different iodine concentrations (300, 350, or 400 mg/mL) on peak enhancement of normal brain tissue and artery and vein, stratified by region-of-interest (ROI) location, in 102 patients within 3 hours of stroke onset. A monotonic increasing peak opacification was evident at all ROI locations, suggesting that CTp evaluation of patients with acute stroke is best performed with the highest available concentration of contrast agent. In another study we investigated whether lesion volumes on CBV, CBF, and MTT maps within 3 hours of stroke onset predict final infarct volume, and whether all these parameters are needed for triage to intravenous recombinant tissue plasminogen activator (IV-rtPA). The effect of IV-rtPA on the affected brain by measuring salvaged tissue volume in patients receiving IV-rtPA and in controls was investigated also. CBV lesion volume did not necessarily represent dead tissue. MTT lesion volume alone can serve to identify the upper size limit of the abnormally perfused brain, and those with IV-rtPA salvaged more brain than did controls. Carotid CTA was compared with carotid DSA in grading of stenosis in patients with stroke symptoms. In CTA, the grade of stenosis was determined by means of axial source and maximum intensity projection (MIP) images as well as a semiautomatic vessel analysis. CTA provides an adequate, less invasive alternative to conventional DSA, although tending to underestimate clinically relevant grades of stenosis.

Alppihiihdon alkutaival : Pujottelu- ja tunturihiihto Suomessa 1920-luvulta 1960-luvulle

The object of study in this thesis is Finnish skiing culture and Alpine skiing in particular from the point of view of ethnology. The objective is to clarify how, when, why and by what routes Alpine skiing found its way to Finland. What other phenomena did it bring forth? The objective is essentially linked to the diffusion of modern sports culture to Finland. The introduction of Alpine skiing to Finland took place at a time when skiing culture was changing: flat terrain skiing was abandoned in favour of cross-country skiing in the early decades of the 20th century, and new techniques and equipment made skiing a much more versatile sport. The time span of the study starts from the late 19th century and ends in the mid-20th century. The spatial focus is in Finland. People and communities formed through their actions are core elements in the study of sports and physical activity. Organizations tend to raise themselves into influential actors in the field of physical culture even if active individuals work in their background. Original archive documents and publications of sports organizations are central source material for this thesis, complemented by newspapers and sports magazines as well as photographs and films on early Alpine skiing in Finland. Ever since their beginning in the late 19th century skiing races in Finland had mostly taken place on flat terrain or sea ice. Skiing in broken cross-country terrain made its breakthrough in the 1920 s, at a time when modern skiing techniques were introduced in instruction manuals. In the late 1920 s the Finnish Women s Physical Education Association (SNLL) developed unconventional forms of pedagogical skiing instruction. They abandoned traditional Finnish flat terrain skiing and boldly looked for influences abroad, which caused friction between the leaders of the women s sports movement and the (male) leaders of the central skiing organization. SNLL was instrumental in launching winter tourism in Finnish Lapland in 1933. The Finnish Tourism Society, the State Railways and sports organizations worked in close co-operation to instigate a boom in tourism, which culminated in the inauguration of a tourist hotel at Pallastunturi hill in the winter of 1938. Following a Swedish model, fell-skiing was developed as a domestic counterpart to Alpine skiing as practiced in Central Europe. The first Finnish skiing resorts were built at sites of major cross-country skiing races. Inspired by the slope at Bad Grankulla health spa, the first slalom skiing races and fell-skiing, slalom enthusiasts began to look for purpose-built sites to practice turn technique. At first they would train in natural slopes but in the late 1930 s new slopes were cleared for slalom races and recreational skiing. The building of slopes and ski lifts and the emergence of organized slalom racing competitions gradually separated Alpine skiing from the old fell-skiing. After the Second World War fell-skiing was transformed into ski trekking on marked courses. At the same time Alpine skiing also parted ways with cross-country skiing to become a sport of its own. In the 1940 s and 1950 s Finnish Alpine skiing was almost exclusively a competitive sport. The specificity of Alpine skiing was enhanced by rapid development of equipment: the new skis, bindings and shoes could only be used going downhill.

Resistance responses blocking systemic movement of Potato virus A in potato

Peruna kestää A-virusta estämällä sen leviämistä Peruna on maissin ohella maailman kolmanneksi tärkein ravintokasvi vehnän ja riisin jälkeen. Perunaa lisätään kasvullisesti mukuloita istuttamalla, jolloin virukset siirtyvät sairaiden siemenmukuloiden välityksellä kasvukaudesta toiseen. Virustauteja voi torjua ainoastaan terveen siemenperunan ja kestävien lajikkeiden avulla. Kestävyys perustuu usein siihen, että kasvi estää viruksen leviämisen tartuntakohdasta välttyäkseen virustaudilta. Tässä työssä tutkittiin kolmea perunan A-viruksen (PVA) liikkumista estävää kestävyysmekanismia perunassa. Lisäksi työn kokeelliseen osaan oleellisesti kuuluvaa virustartutusta varten kehitettiin uusi paranneltu versio geenipyssystä. Tämä itse rakennettu laite optimoitiin PVA:n tartuttamiseen mahdollisimman helposti ja pienin käyttökustannuksin. Tutkimuksen kohteena olleessa perunan risteytysjälkeläistössä oli PVA:ta kestäviä kasveja (ryhmä nnr), jotka estivät viruksen liikkumisen aiheuttamatta oireita tartutuskohdassa, sekä kasveja, joissa PVA aiheutti kuolioläikkinä näkyvän yliherkkyysvasteen (ryhmä HR). Molemmissa kestävyystyypeissä virus pystyi monistumaan ja leviämään solusta soluun paikallisesti, mutta liikkuminen muihin kasvinosiin nilan kautta estyi. Ryhmän nnr kasveissa PVA-tartunta ei aiheuttanut tilastollisesti merkitsevää muutosta useimpien geenien ilmenemiseen tartuntakohdassa. Ainoastaan geeniperhe, joka ilmentää tiettyä proteinaasi-inhibiittoria (PI), reagoi PVA:han 24 tuntia tartutuksesta. Kun tämän PVA:han reagoivan geeniperheen jäsenet hiljennettiin nnr- perunalinjoissa, ne muuttuivat alttiiksi PVA:lle ja virus levisi tartuntakohdasta muihin kasvinosiin. Tulos osoittaa, että PI on viruskestävyystekijä. Lisäksi muut tutkimuksessa saadut tulokset tukevat mahdollisuutta, että PI estää PVA:n P1-proteinaasin toimintaa. HR-linjoissa todettiin erilaisiin puolustusvasteisiin liittyvien PR-geenien aktivoitumista PVA-tartunnan seurauksena, mutta myös ilman sitä kasvien kasvettua mullassa noin neljä viikkoa. Sen sijaan solukkoviljelyssä tai vasta kaksi viikkoa mullassa kasvaneissa kasveissa vastaavaa ei vielä todettu. Tulos viittaa siihen, että HR-perunat reagoivat herkemmin ympäristöön ja/tai kasvin kehitysasteeseen laukaisten puolustusvasteita, jotka saattavat parantaa kestävyyttä taudinaiheuttajia vastaan. Kolmas tutkittu kestävyystyyppi havaittiin Pito-perunalajikkeessa. Se muistutti nnr-kestävyyttä siten, että myös siinä viruksen liikkuminen nilassa muihin kasvinosiin estyi. PVA:n todettiin pysähtyvän vasta lehtiruodin tyvelle muodostuvaan irtoamisvyöhykkeeseen, mitä havainnollistettiin käyttämällä muunnettua PVA-rotua, joka tuotti UV-valossa fluoresoivaa vihreää valoa. Tulos viittaa siihen, että virus ei pääse kulkemaan vyöhykkeeseen kuuluvan suojaavan kerroksen läpi, jollei sillä ole pääsyä nilaan. Tällainen kestävyys on tarpeen, jotta virus ei voi korvata nilakuljetusta solusta soluun leviämisellä. Tulokset tuovat uusia näkökulmia kasvien viruskestävyyteen ja auttavat selittämään viruksen nilakuljetuksen estymistä sekä solusta soluun leviämisen pysähtymistä kestävissä kasveissa.

Modern Societal Impulses and their Nordic Manifestations : On Emancipation and Constraint in Societal Development

The 1980s and the early 1990s have proved to be an important turning point in the history of the Nordic welfare states. After this breaking point, the Nordic social order has been built upon a new foundation. This study shows that the new order is mainly built upon new hierarchies and control mechanisms that have been developed consistently through economic and labour market policy measures. During the post-war period Nordic welfare states to an increasing extent created equality of opportunity and scope for agency among people. Public social services were available for all and the tax-benefit system maintained a level income distribution. During this golden era of Nordic welfare state, the scope for agency was, however, limited by social structures. Public institutions and law tended to categorize people according to their life circumstances ascribing them a predefined role. In the 1980s and 1990s this collectivist social order began to mature and it became subject to political renegotiation. Signs of a new social order in the Nordic countries have included the liberation of the financial markets, the privatizing of public functions and redefining the role of the public sector. It is now possible to reassess the ideological foundations of this new order. As a contrast to widely used political rhetoric, the foundation of the new order has not been the ideas of individual freedom or choice. Instead, the most important aim appears to have been to control and direct people to act in accordance with the rules of the market. The various levels of government and the social security system have been redirected to serve this goal. Instead of being a mechanism for redistributing income, the Nordic social security system has been geared towards creating new hierarchies on the Nordic labour markets. During the past decades, conditions for receiving income support and unemployment benefit have been tightened in all Nordic countries. As a consequence, people have been forced to accept deteriorating terms and conditions on the labour market. Country-specific variations exist, however: in sum Sweden has been most conservative, Denmark most innovative and Finland most radical in reforming labour market policy. The new hierarchies on the labour market have co-incided with slow or non-existent growth of real wages and with a strong growth of the share of capital income. Slow growth of real wages has kept inflation low and thus secured the value of capital. Societal development has thus progressed from equality of opportunity during the age of the welfare states towards a hierarchical social order where the majority of people face increasing constraints and where a fortunate minority enjoys prosperity and security.

Globalization and the Political : in the Borderlands with the Zapatista Movement

This study explores the meaning, content and significance of the political as manifest in the Mexican Zapatista movement as historically and geopolitically situated struggle. The case study undertakes a critical analysis of the development, organization, practice and discourse of the movement by drawing on fieldwork experiences, interviews, discussions, documents, films and other material produced by the movement, and the critical engagement with the research of others, especially in Latin America and Mexico. The dissertation poses the need to reconsider what constitutes and what we understand by the political , related particularly to the challenges provided by the critical globalization literature, decolonization and the study of social movements. The analysis encompasses several inter-related levels: the theoretical knowledge regarding the conceptualization of the political; the methodological level, regarding how such research can and should be conducted and knowledge claims formulated given the inescapable context and effects of global power relations; and the substantive level of adding specific information and analytical insights to existing knowledge of the Zapatista movement. As a result of conceptualization of a range of practices and processes, distinct understandings of the political can be underlined. Firstly, the conception of the indigenous and the struggles as indigenous movements as specifically political, not just a cultural or ethnic identity or a static quality but rather, an active consciousness integrally linked both to a longer history of oppression and as political articulation in the concrete context and lived experience of contemporary struggle. Secondly, the practice of autonomy as central to an understanding of the political in the context of the Zapatista struggle as a practical response to the situation of oppression, counter-insurgency, siege and conflict in Chiapas, as well as a positively informed mode of political self-understanding, expression and practice in its own right. Thirdly, the notion of geopolitical positioning as important to understanding of the political that encompasses the historicity of specific context and the power relations which shape that context, developed in two different ways: in regard to the positioning of the researcher and knowledge production with and about the Zapatistas, and in regard to the practice and knowledge of the Zapatistas as a decolonizing force in their encounters, interaction and relations with others, especially the global civil society. Finally, the role of silence, absence, invisibility, revelation and hiding in political practice as a deliberate strategy in response to oppressive power. -

Pietismin kuva - ikkuna yksityiseen hengellisyyteen : Johann Arndtin opetukset pietistisen embleemin perustana

The image of Pietism a window to personal spirituality. The teachings of Johann Arndt as the basis of Pietist emblems The Pietist effect on spiritual images has to be scrutinised as a continuum initiating from the teachings of Johann Arndt who created a protestant iconography that defended the status of pictures and images as the foundation of divine revelation. Pietist artworks reveal Arndtian part of secret, eternal world, and God. Even though modern scholars do not regarded him as a founding father of Pietism anymore, his works have been essential for the development of iconography, and the themes of the Pietist images are linked with his works. For Arndt, the starting point is in the affecting love for Christ who suffered for the humankind. The reading experience is personal and the words point directly at the reader and thus appear as evidence of the guilt of the reader as well as of the love of God. Arndt uses bounteous and descriptive language which has partially affected promoting and picturing of many themes. Like Arndt, Philipp Jakob Spener also emphasised the heart that believes. The Pietist movement was born to oppose detached faith and the lack of the Holy Ghost. Christians touched by the teachings of Arndt and Spener began to create images out of metaphors presented by Arndt. As those people were part of the intelligentsia, it was natural that the fashionable emblematics of the 17th century was moulded for the personal needs. For Arndt, the human heart is manifested as a symbol of soul, personal faith or unbelief as well as an allegory of the burning love for Jesus. Due to this fact, heart emblems were gradually widely used and linked with the love of Christ. In the Nordic countries, the introduction of emblems emanated from the gentry s connections to the Central Europe where emblems were exploited in order to decorate books, artefacts, interiors, and buildings as well as visual/literal trademarks of the intelligentsia. Emblematic paintings in the churches of the castles of Venngarn (1665) and Läckö (1668), owned by Magnus Gabriel De la Gardie, are one of the most central interior paintings preserved in the Nordic countries, and they emphasise personal righteous life. Nonetheless, it was the books by Arndt and the Poet s Society in Nurnberg that bound the Swedish gentry and the scholars of the Pietist movement together. The Finnish gentry had no castles or castle churches so they supported county churches, both in building and in maintenance. As the churches were not private, their iconography could not be private either. Instead, people used Pietist symbols such as Agnus Dei, Cor ardens, an open book, beams, king David, frankincense, wood themes and Virtues. In the Pietist images made for public spaces, the attention is focused on pedagogical, metaphorical, and meaningful presentation as well as concealed statements.

Paganism, Traditionalism, Nationalism : Narratives of Russian Rodnoverie

The topic of this dissertation is Rodnoverie, a religion that revives pre-Christian Slavic spirituality. Rodnoverie has been noted to be one of the fastest growing new religions in Russia and the aim of the study is to analyse why and how the movement has attained its popularity. First, the analysis asks how Rodnovers themselves explain the revival of ancient Paganism at this particular historical moment. Secondly, these interpretations are reflected in the framework of sociological discussions about contemporary religiosity. The analysis discusses how the Rodnoverie movement corresponds to some tendencies that are considered to characterise late modern religiosity. The primary material of the research is Rodnoverie texts: books, newspapers and electronic articles. The published literature is supplemented by fieldwork material which includes interviews with some Rodnoverie leaders and the author s participant observation of rituals and gatherings. Methodologically, the study draws on a sociological narrative approach that is focused on examining how individuals and groups use narratives to construct their identities and to challenge mainstream discussions and interpretations. The analysis discerns three narratives. The first one of these portrays Rodnoverie as a revival of the native Russian or Slavic religion. The narrative provides a new version of the old Slavophile idea, according to which imitation of the West has misguided Russia and, therefore, Russians should turn to their own tradition. In the second narrative, Rodnoverie is presented as a nature religion that features tolerance and pluralistic values. According to these perceptions, the emergence of Rodnoverie marks the dead-end of the earlier hegemonic universalistic world-views, the mono-ideologies . While the nationalist narrative focuses on Russia s national heritage, the third narrative interprets the tradition in more universal terms as an alternative to modern values and way of life. The main argument of this narrative is that contemporary people have become alienated from nature, their roots and their community. The themes that are discussed in the theoretical literature on late modern religiosity often configure in Rodnovers interpretations either directly or when looked at through an analytical framework. Of the various themes that are addressed in a sociological study of religion the ones that have most relevance for Rodnoverie are the discussions on individualisation, globalisation and secularisation. Rodnoverie reflects such tendencies as the subjectivisation of religion and the modern crisis of authority. The movement also both exemplifies and actively promotes religious pluralisation in Russia.

Tsoi Yuen Resistance and Post-80s Generation: A new wave of domestic social movement

Hong Kong was once a British colony and has been under the sovereignty of People’s Republic of China (PRC) since 1997. However, some of the unjust practices and colonial legacies are infiltrated into the development ideology as well as the social structures. The construction of intercity express railway project announced in 2008 causing the demolishment of Tsoi Yuen Tsuen, a “non-indigenous” agricultural village in Hong Kong, was one of the current examples. Tsoi Yuen village was established under the former colonial sovereignty sixty years ago. Approximately 450 populations were affected that they had to relocate their homeland involuntarily. However, these villagers were very attached to their homelands and were unwilling to move, and meanwhile they found that they were absent in the government’s consultation and decision-making process. Soon they began their resistance and demanded for “No Move! No Demolish!”. Their movement was strongly supported by a group of “Post-80s generation” and turned into the most important social movement of the city in recent years. In fact, demolition of Tsoi Yuen Village for city development is not an isolated case in the city. Meanwhile the situation is getting worse in Mainland China. I chose the case study of Tsoi Yuen Resistance from 2008 to 2011 for revelation of the complicated colonial history and postcolonial era of Hong Kong. I focused on discussing the Tsoi Yuen Resistance and the Post-80s movement, and how they have exposed the tension between top-down urban planning and development and public movements fighting for a more democratic process in choosing their way of living. Through the study of a village movement which as well as the rationale behind the Post-80s’ support, I hoped to illustrate how this movement has awaken a different sense of living for the new generations in the midst of the high-sounding urban development. It is an opportunity to examine Hong Kong’s colonial epoch in a different perspective: through studying the Tsoi Yuen Village, let them (subalterns) speak for themselves. Furthermore, the significance of this resistance, taking place eleven years after the handover to the PRC, is an important fact that I shall not miss in later discussion. Last but not least, during the resistance, advanced technology and social networks such as Facebook, Twitter, iPhone were used by Post 80s generation to spread the latest information in order to attract public’s concern and participation. Therefore, apart from studying Tsoi Yuen Resistance as a local social movement, I also regard it as a part of the global movement in perusing ecological lifestyle and civil society. How Post 80s’ generation manipulates the global idea in a local context will also be examined.

Texts "Con and Pro" : The Early Modern Medical Controversy over Tobacco

The habit of "drinking smoke" , meaning tobacco smoking, caused a true controversy in early modern England. The new substance was used both for its alleged therapeutic properties as well as its narcotic effects. The dispute over tobacco continues the line of written controversies which were an important means of communication in the sixteenth and seventeenth century Europe. The tobacco controversy is special among medical controversies because the recreational use of tobacco soon spread and outweighed its medicinal use, ultimately causing a social and cultural crisis in England. This study examines how language is used in polemic discourse and argumentation. The material consists of medical texts arguing for and against tobacco in early modern England. The texts were compiled into an electronic corpus of tobacco texts (1577 1670) representing different genres and styles of writing. With the help of the corpus, the tobacco controversy is described and analyzed in the context of early modern medicine. A variety of methods suitable for the study of conflict discourse were used to assess internal and external text variation. The linguistic features examined include personal pronouns, intertextuality, structural components, and statistically derived keywords. A common thread in the work is persuasive language use manifested, for example, in the form of emotive adjectives and the generic use of pronouns; the latter is especially pronounced in the dichotomy between us and them. Controversies have not been studied in this manner before but the methods applied have supplemented each other and proven their suitability in the study of conflictive discourse. These methods can also be applied to present-day materials.

Tracing water movement by means of Escherichia coli bacteriophages

Tiivistelmä: Escherichia coli bacteriofaagit merkkiaineena vesien kulkeutumistutkimuksissa

Publishing for the Masses : Early Modern English Witchcraft Pamphlets

This study is a pragmatic description of the evolution of the genre of English witchcraft pamphlets from the mid-sixteenth century to the end of the seventeenth century. Witchcraft pamphlets were produced for a new kind of readership semi-literate, uneducated masses and the central hypothesis of this study is that publishing for the masses entailed rethinking the ways of writing and printing texts. Analysis of the use of typographical variation and illustrations indicates how printers and publishers catered to the tastes and expectations of this new audience. Analysis of the language of witchcraft pamphlets shows how pamphlet writers took into account the new readership by transforming formal written source materials trial proceedings into more immediate ways of writing. The material for this study comes from the Corpus of Early Modern English Witchcraft Pamphlets, which has been compiled by the author. The multidisciplinary analysis incorporates both visual and linguistic aspects of the texts, with methodologies and theoretical insights adopted eclectically from historical pragmatics, genre studies, book history, corpus linguistics, systemic functional linguistics and cognitive psychology. The findings are anchored in the socio-historical context of early modern publishing, reading, literacy and witchcraft beliefs. The study shows not only how consideration of a new audience by both authors and printers influenced the development of a genre, but also the value of combining visual and linguistic features in pragmatic analyses of texts.