12 resultados para 1995_03292156 TM-56 4502002

em Helda - Digital Repository of University of Helsinki


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Tutkielman tavoitteena on tuottaa neulakinnasrekonstruktio Euran Luistarin kalmiston haudan 56 neulakinnasfragmenttien pohjalta. Hauta on tutkittu vuonna 1969, jolloin kalmistoalueen arkeologiset kaivaukset aloitettiin. Haudan löytöjen perusteella on aikaisemmin tehty kokonainen pukurekonstruktio, Euran muinaispuku. Luistarin hauta 56 on ruumishauta ja se on tehty naisvainajalle rautakaudella, 1000-luvun alkupuolella jKr. Neulakinnastekniikalla on valmistettu neuloksia jo tuhansia vuosia. Eri neulakinnastekniikoita on yritetty kuvata useilla teorioilla, joista paras lienee Egon H. Hansenin merkintätapa. Suomalaisen kansanperinteen mukaan maassamme on tehty neuleita kolmella erilaisella neulakinnastekniikalla: suomeksi , venäjäksi ja pyöräyttäen . Luistarin haudan 56 neulakinnastekniikalla valmistetut tekstiilifragmentit löytyivät vainajan vatsalta suuren puukontupen päältä sekä kämmenluiden ja sormusten yhteydestä. Fragmentteja saatiin kaivauksissa talteen yhteensä kuusi, joista suurin on kooltaan 6x9 cm. Fragmentit on sijaintinsa perusteella tulkittu kintaiden jäänteiksi. Hautaustilanteessa kintaat ovat ilmeisesti sijainneet vainajan vatsalla, eivätkä käsiin puettuina, sillä fragmentteja ei löytynyt kaikkien sormusten yhteydestä. Myös eräistä muista rautakautisista ruumishaudoista on löydetty neulakintaiden jäänteitä. Luistarin haudan 56 neulakinnasfragmenteista on tutkittu valmistustekniikka, lankojen paksuudet ja kierteisyydet. Selkeänä erottuvat kolme väriä on tulkittu mikroskooppitarkastelussa siniseksi, punaiseksi ja keltaiseksi. Pieni punaisen kerroksen pätkä aivan suurimman fragmentin reunassa on tulkittu peukalon tyveksi. Muita Suomesta löytyneitä rautakautisia neulakinnasfragmentteja ja niistä saatuja tietoja on käytetty vertailuaineistona. Kinnasrekonstruktioon käytetyt langat on värjätty luonnonväreillä. Värjäyksessä on käytetty osittain nykypäivän keinoja, mutta niin, että lopputulos poikkeaisi mahdollisimman vähän muinaistekniikoilla tehdystä. Punainen lanka on värjätty värimataralla eli krapilla, keltainen kanervalla ja sininen luonnonindigolla. Kintaiden muotoilu perustuu suomalaiseen neulakinnastraditioon ja lähialueiltamme löytyneisiin keskiaikaisiin neulakintaisiin.

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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.

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Ehkäisypainotteisuus karieksen hoidossa: iranilaishammaslääkärien hoitovalinnat Karies aiheuttaa hampaiden kovan pinnan ja hammasluun syöpymistä, joka lopulta näkyy ”reikänä”. Iästä riippumatta kariesvaara vaanii kaikkia hampaiden omistajia, vauvasta vaariin, ja lähes kaikilla aikuisilla on suussaan merkkejä karieksesta. Karies etenee yleensä hitaasti ja antaa siten aikaa ehkäisevälle hoidolle. Tämä etsikkoaika jää usein käyttämättä, ja karieksen hoito painottuu reikien paikkaamiseen. Karies voitaisiin pitää kurissa sen ehkäisyyn kehitetyillä monipuolisilla keinoilla. Hammaslääkärit ovat avainasemassa, sillä he tekevät kauaskantoisia valintoja — hoidetaanko kariesta paikkaamalla vai valitaanko ehkäisevä hoito? Valintojen taustalla ovat hammaslääkärin tietotaso, asenteet ja omat terveystavat sekä potilaiden ja vastaanoton aiheuttamiksi koetut esteet. Tämä kyselytutkimus selvitti karieksen hoitovalintoja ja niiden taustoja Iranissa. Kysymyslomakkeet jaettiin kahdessa hammaslääkärien kongressissa Teheranissa (2004─2005) ja palautettiin nimettöminä. Kysely kartoitti hammaslääkärien tietoja karieksen ehkäisykeinoista ja asenteita ehkäisyä kohtaan sekä koettuja esteitä sen toteuttamisessa. Hoitovalintoja selvitettiin tarkasti kuvattujen esimerkkipotilaiden avulla. Kysely kartoitti myös hammaslääkärien omat terveystavat: suun omahoidon, tupakoinnin ja hammaslääkärissä käynnin. Aineisto käsitti 980 iältään keskimäärin 37-vuotiasta hammaslääkäriä, joista 64 % oli miehiä. Iranilaishammaslääkärien tiedot karieksen ehkäisystä olivat fluorihammastahnan merkitystä lukuun ottamatta hyvät ja heidän asenteensa ehkäisyä kohtaan valtaosin myönteiset. Tästä huolimatta 77 % heistä olisi valinnut suuren kariesvaaran potilaalle hammaskiilteessä olevan reiän hoidoksi paikkauksen. Ehkäisyhoidoksi tarjotuista 8:sta keinosta lähes kaikki hammaslääkärit valitsivat suuren kariesvaaran potilaalle hoidoksi harjausopetuksen ja säännölliset hammastarkastukset, noin 80 % valitsi hampaiden puhdistamisen vastaanotolla ja ravintoneuvonnan, 70 % ohjeet fluorihuuhteluista kotona ja 53 % vastaanotolla tehtävän fluorikäsittelyn. Potilaiden vastustavat mielipiteet arvioitiin suurimmaksi esteeksi ehkäisevän hoidon toteuttamiselle. Hammaslääkäreistä 59 % ilmoitti harjaavansa hampaansa kahdesti päivässä; 76 % ei tupakoinut ja 56 % kertoi aina ehdottavansa tupakoivalle potilaalle tupakoinnin lopettamista. Hammaslääkärien ehkäisypainotteisuus karieshoidossa oli naisilla vahvempi kuin miehillä. Tulosten perusteella voi päätellä, että Iranissa tulisi nykyistä selvemmin suosia ehkäisevää linjaa karieksen hoitovalintoja tehtäessä ja hammaslääkäreitä koulutettaessa. Potilastyössä koettujen ehkäisyhoidon esteiden syvällisempi ymmärtäminen edesauttaisi niiden poistamisessa.

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Theory of developmental origins of adult health and disease proposes that experiences during critical periods of early development may have consequences on health throughout a lifespan. Thesis studies aimed to characterize associations between early growth and some components of the metabolic syndrome cluster. Participants belong to two epidemiological cohorts with data on birth measurements and, for the younger cohort, on serial recordings of weight and height during childhood. They were born as singletons between 1924-33 and 1934-44 in the Helsinki University Central Hospital, and 500 and 2003 of them, respectively, attended clinical studies at the age of 65-75 and 56-70 years, respectively. In the 65-75 year old men and women, the well-known inverse relationship between birth weight and systolic blood pressure (SBP) was confined to people who had established hypertension. Among them a 1-kg increase in birth weight was associated with a 6.4-mmHg (95% CI: 1.0 to 11.9) decrease in SBP. This relationship was further confined to people with the prevailing Pro12Pro polymorphism of the peroxisome proliferator-activated receptor-γ2 (PPARγ2) gene. People with low birth weight were more likely to receive angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (ACEI/ARB, p=0.03), and, again, this relationship was confined to the carriers of the Pro12Pro (p=0.01 for interaction). These results suggest that the inverse association between birth weight and systolic BP becomes focused in hypertensive people because pathological features of BP regulation, associated with slow fetal growth, become self-perpetuating in adult life. Insulin resistance of the Pro12Pro carriers with low birth weight may interact with the renin-angiotensin system leading to raised BP levels. Habitual physical activity protected men and women who were small at birth, and thus at increased risk for the development of type 2 diabetes, against glucose intolerance more strongly. Among subjects with birth weight ≤3000 g, the odds ratio (OR) for glucose intolerance was 5.2 (95% CI: 2.1 to 13) in those who exercised less than 3 times per week compared to regular exercisers; in those who scored their exercise light compared with moderate exercisers (defined as comparable to brisk walking) the OR was 3.5 (1.5 to 8.2). In the 56-70 year old men a 1 kg increase in birth weight corresponded to a 4.1 kg (95% CI: 3.1 to 5.1) and in women to a 2.9 kg (2.1 to 3.6) increase in adult lean mass. Rapid gain in body mass index (BMI), i.e. crossing from an original BMI percentile to a higher one, before the age of 2 years increased adult lean mass index (LMI, lean mass/height squared) without excess fat accumulation whereas rapid gain in BMI during later childhood, despite the concurrent rise in LMI, resulted in a relatively higher increase in adult body fat mass. These findings illustrate how genes, the environment and their interactions, early growth patterns, and adult lifestyle modify adult health risks which originate from early life.

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We described the patterns and extent of microsatellite DNA variation in historical and present-day Atlantic salmon (Salmo salar L.) stocks in the Baltic Sea and neighbouring areas, and in European whitefish (Coregonus lavaretus) ecotypes, populations and run-timing types in Finland. Moreover, the amount and pattern of genetic diversity in historical salmon populations before human impact were described, and the proportion of diversity maintained in the present hatchery stocks evaluated. Salmon populations in the Baltic Sea were, on average, significantly less variable than eastern Atlantic populations, and the diversity of landlocked populations (Lakes Vänern, Saimaa, Onega and Ladoga) was in turn significantly lower than that of anadromous salmon populations in the Baltic Sea populations. Within the Baltic Sea, the anadromous populations of Atlantic salmon formed three clear groups, corresponding to the northern (Gulf of Bothnia), eastern (Gulf of Finland and eastern Baltic Main Basin) and southern (western Baltic Main Basin) regions. Based on microsatellite data, three salmon population groups in the Baltic Sea were considered potentially different colonization lineages. In short- and long-term breeding programmes of Atlantic salmon, the average observed rate of loss of alleles was 4.9% and 2.0% per generation and the average rate of loss of heterozygosity was 1.4% and 1% per generation, respectively. When comparing the genetic parameters of stocks before and after hatchery breeding of several successive generations (Rivers Iijoki and Oulujoki), statistically significant changes in allele frequencies were common, while large wild stock in the Teno River has remained temporally very stable over 56 years. Despite the observed losses of genetic diversity in broodstock breeding, a large proportion of the genetic resources of the extirpated stocks are still conserved in the broodstocks. Genetic differentiation among European whitefish ecotypes was generally low, thus giving support to the hypothesis of one native European whitefish species in Fennoscandia. Among the ecotypes, the northern, large sparsely rakered, bottom-dwelling whitefish was the most unique. The known genetic differences in quantitative traits have thus either developed independently of potential phylogenetic lineages, or the lineages have mixed and the quantitative traits of the ecotypes, like gill-raker number, have later changed according to environment and selection pressures. Overall, genetic distances between the anadromous whitefish populations along the Finnish coast, especially in the Bothnian Bay area, were small. Wild whitefish populations studied had slightly higher allelic diversity than hatchery-reared populations in corresponding rivers.

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Ruptured abdominal aortic aneurysm (RAAA) is a life-threatening event, and without operative treatment the patient will die. The overall mortality can be as high as 80-90%; thus repair of RAAA should be attempted whenever feasible. The quality of life (QoL) has become an increasingly important outcome measure in vascular surgery. Aim of the study was to evaluate outcomes of RAAA and to find out predictors of mortality. In Helsinki and Uusimaa district 626 patients were identified to have RAAA in 1996-2004. Altogether 352 of them were admitted to Helsinki University Central Hospital (HUCH). Based on Finnvasc Registry, 836 RAAA patients underwent repair of RAAA in 1991-1999. The 30-day operative mortality, hospital and population-based mortality were assessed, and the effect of regional centralisation and improving in-hospital quality on the outcome of RAAA. QoL was evaluated by a RAND-36 questionnaire of survivors of RAAA. Quality-adjusted life years (QALYs), which measure length and QoL, were calculated using the EQ-5D index and estimation of life expectancy. The predictors of outcome after RAAA were assessed at admission and 48 hours after repair of RAAA. The 30-day operative mortality rate was 38% in HUCH and 44% nationwide, whereas the hospital mortality was 45% in HUCH. Population-based mortality was 69% in 1996-2004 and 56% in 2003-2004. After organisational changes were undertaken, the mortality decreased significantly at all levels. Among the survivors, the QoL was almost equal when compared with norms of age- and sex-matched controls; only physical functioning was slightly impaired. Successful repair of RAAA gave a mean of 4.1 (0-30.9) QALYs for all RAAA patients, although non-survivors were included. The preoperative Glasgow Aneurysm Score was an independent predictor of 30-day operative mortality after RAAA, and it also predicted the outcome at 48- hours for initial survivors of repair of RAAA. A high Glasgow Aneurysm Score and high age were associated with low numbers of QALYs to be achieved. Organ dysfunction measured by the Sequential Organ Failure Assessment (SOFA) score at 48 hours after repair of RAAA was the strongest predictor of death. In conclusion surgery of RAAA is a life-saving and cost-effective procedure. The centralisation of vascular emergencies improved the outcome of RAAA patients. The survivors had a good QoL after RAAA. Predictive models can be used on individual level only to provide supplementary information for clinical decision-making due to their moderate discriminatory value. These results support an active operation policy, as there is no reliable measure to predict the outcome after RAAA.

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Pitfalls in the treatment of persons with dementia Persons with dementia require high-quality health care, rehabilitation and sufficient social services to support their autonomy and to postpone permanent institutionalization. This study sought to investigate possible pitfalls in the care of patients with dementia: hip fracture rehabilitation, use of inappropriate or antipsychotic medication, social and medicolegal services offered to dementia caregiving families. Three different Finnish samples were used from years 1999-2005, mean age 78 to 86 years. After hip fracture operation, the weight-bearing restriction especially in group of patients with dementia, was associated with a longer rehabilitation period (73.5 days vs. 45.5 days, p=0.03) and the inability to learn to walk after six weeks (p<0.001). Almost half (44%) of the pre-surgery home-dwellers with dementia in our sample required permanent hospitalization after hip fracture. Potentially inappropriate medication was used among 36.2% of nursing home and hospital patients. The most common PIDs in Finland were temazepam over 15 mg/day, oxybutynin, and dipyridamole. However, PID use failed to predict mortality or the use of health services. Nearly half (48.4%) of the nursing home and hospital patients with dementia used antipsychotic medication. The two-year mortality did not differ among the users of conventional or atypical antipsychotics or the non-users (45.3% vs.32.1% vs.49.6%, p=0.195). The mean number of hospital admissions was highest among non-users (p=0.029). A high number of medications (HR 1.12, p<0.001) and the use of physical restraints (HR 1.72, p=0.034) predicted higher mortality at two years, while the use of atypical antipsychotics (HR 0.49, p=0.047) showed a protective effect, if any. The services most often offered to caregiving families of persons with Alzheimer s disease (AD) included financial support from the community (36%), technical devices (33%), physiotherapy (32%), and respite care in nursing homes (31%). Those services most often needed included physiotherapy for the spouse with dementia (56%), financial support (50%), house cleaning (41%), and home respite (40%). Only a third of the caregivers were satisfied with these services, and 69% felt unable to influence the range of services offered. The use of legal guardians was quite rare (only 4.3%), while the use of financial powers of attorney was 37.8%. Almost half (47.9%) of the couples expressed an unmet need for discussion with their doctor about medico-legal issues, while only 9.9% stated that their doctor had informed them of such matters. Although we already have many practical methods to develop the medical and social care of persons with AD, these patients and their families require better planning and tailoring of such services. In this way, society could offer these elderly persons better quality of life while economizing on its financial resources. This study was supported by Social Insurance Institution of Finland and part of it made in cooperation with the The Central Union of the Welfare for the Aged, Finland.

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Purpose: The aim of the present study was to develop and test new digital imaging equipment and methods for diagnosis and follow-up of ocular diseases. Methods: The whole material comprised 398 subjects (469 examined eyes), including 241 patients with melanocytic choroidal tumours, 56 patients with melanocytic iris tumours, 42 patients with diabetes, a 52-year old patient with chronic phase of VKH disease, a 30-year old patient with an old blunt eye injury, and 57 normal healthy subjects. Digital 50° (Topcon TRC 50 IA) and 45° (Canon CR6-45NM) fundus cameras, a new handheld digital colour videocamera for eye examinations (MediTell), a new subtraction method using the Topcon Image Net Program (Topcon corporation, Tokyo, Japan), a new method for digital IRT imaging of the iris we developed, and Zeiss photoslitlamp with a digital camera body were used for digital imaging. Results: Digital 50° red-free imaging had a sensitivity of 97.7% and two-field 45° and 50° colour imaging a sensitivity of 88.9-94%. The specificity of the digital 45°-50° imaging modalities was 98.9-100% versus the reference standard and ungradeable images that were 1.2-1.6%. By using the handheld digital colour video camera only, the optic disc and central fundus located inside 20° from the fovea could be recorded with a sensitivity of 6.9% for detection of at least mild NPDR when compared with the reference standard. Comparative use of digital colour, red-free, and red light imaging showed 85.7% sensitivity, 99% specificity, and 98.2 % exact agreement versus the reference standard in differentiation of small choroidal melanoma from pseudomelanoma. The new subtraction method showed growth in four of 94 melanocytic tumours (4.3%) during a mean ±SD follow-up of 23 ± 11 months. The new digital IRT imaging of the iris showed the sphincter muscle and radial contraction folds of Schwalbe in the pupillary zone and radial structural folds of Schwalbe and circular contraction furrows in the ciliary zone of the iris. The 52-year-old patient with a chronic phase of VKH disease showed extensive atrophy and occasional pigment clumps in the iris stroma, detachment of the ciliary body with severe ocular hypotony, and shallow retinal detachment of the posterior pole in both eyes. Infrared transillumination imaging and fluorescein angiographic findings of the iris showed that IR translucence (p=0.53), complete masking of fluorescence (p=0.69), presence of disorganized vessels (p=0.32), and fluorescein leakage (p=1.0) at the site of the lesion did not differentiate an iris nevus from a melanoma. Conclusions: Digital 50° red-free and two-field 50° or 45° colour imaging were suitable for DR screening, whereas the handheld digital video camera did not fulfill the needs of DR screening. Comparative use of digital colour, red-free and red light imaging was a suitable method in the differentiation of small choroidal melanoma from different pseudomelanomas. The subtraction method may reveal early growth of the melanocytic choroidal tumours. Digital IRT imaging may be used to study changes of the stroma and posterior surface of the iris in various diseases of the uvea. It contributed to the revealment of iris atrophy and serous detachment of the ciliary body with ocular hypotony together with the shallow retinal detachment of the posterior pole as new findings of the chronic phase of VKH disease. Infrared translucence and angiographic findings are useful in differential diagnosis of melanocytic iris tumours, but they cannot be used to determine if the lesion is benign or malignant.

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Children s participation has been a subject in the international research since past ten years. This research has explored participation from the standpoint of the UN s Convention of the Rights of the Child and focused mainly on schoolchildren or on the working youth s chances in developing countries to have impact on their own lives (eg. Sinclair, 2004 and Thomas, 2002). In Finland there has been less research about the children s rights while the main focus has been on the customers of the child welfare system. This study examines children s participation in Helsinki metropolitan area via the views and the practices of the personnel of early childhood education. The adopted viewpoint is Shier s level model of participation (2001), in which the children s participation process is building in phases, is observed via the everyday actions of the kindergarten personnel. Attention has been paid on the special characteristics of the Finnish early childhood education. This study was part of VKK-Metro s research project. The inquiry in May 2010 was directed to all working teams in the kindergartens of the Helsinki metropolitan area. Of these 56.59 % (1116 teams) answered. The quantitative data analyzed by principal component analysis gave four principal components, from which three were named after Shier s participation model. The fourth component included variables about rules and power. The level model of participation fit well to assess early childhood education in the Helsinki metropolitan area. The professionalism of the personnel became emphasized in the area of everyday interactions between the personnel and the children. Important aspects of the children s participation are to become heard, to get support in the play and in interaction and to be able to share both power and responsibility with personnel of the early childhood education.

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The aim of this work was to examine how breathing, swallowing and voicing are affected in different laryngeal disorders. For this purpose, we examined four different patient groups: patients who had undergone total laryngectomy, anterior cervical decompression (ACD), or injection laryngoplasty with autologous fascia (ILAF), and patients with dyspnea during exercise. We studied the problems and benefits related to the automatic speech valve used for the rehabilitation of speech in laryngectomized patients. The device was given to 14 total laryngectomized patients who used the traditional valve especially well. The usefulness of voice and intelligibility of speech were assessed by speech pathologists. The results demonstrated better performance with the traditional valve in both dimensions. Most of the patients considered the automatic valve a helpful additional device but because of heavier breathing and the greater work needed for speech production, it was not suitable as a sole device in speech rehabilitation. Dysphonia and dysphagia are known complications of ACD. These symptoms are caused due to the stretching of tissue needed during the surgery, but the extent and the recovery from them was not well known before our study. We studied two patient groups, an early group with 50 patients who were examined immediately before and after the surgery and a late group with 64 patients who were examined 3 9 months postoperatively. Altogether, 60% reported dysphonia and 69% dysphagia immediately after the operation. Even though dysphagia and dysphonia often appeared after surgery, permanent problems seldom occurred. Six (12 %) cases of transient and two (3 %) permanent vocal cord paresis were detected. In our third study, the long-term results of ILAF in 43 patients with unilateral vocal cord paralysis were examined. The mean follow-up was 5.8 years (range 3 10). Perceptual evaluation demonstrated improved results for voice quality, and videostroboscopy revealed complete or partial glottal closure in 83% of the patients. Fascia showed to be a stable injection material with good vocal results. In our final study we developed a new diagnostic method for exertional laryngeal dyspnea by combining a cardiovascular exercise test with simultaneous fiberoptic observation of the larynx. With this method, it is possible to visualize paradoxal closure of the vocal cords during inspiration, which is a diagnostic criterion for vocal cord dysfunction (VCD). We examined 30 patients referred to our hospital because of suspicion of exercise-induced vocal cord dysfunction (EIVCD). Twenty seven out of thirty patients were able to perform the test. Dyspnea was induced in 15 patients, and of them five had EIVCD and four high suspicion of EIVCD. With our test it is possible to set an accurate diagnosis for exertional laryngeal dyspnea. Moreover, the often seen unnecessary use of asthma drugs among these patients can be avoided.

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This study is divided into two parts: a methodological part and a part which focuses on the saving of households. In the 1950 s both the concepts as well as the household surveys themselves went through a rapid change. The development of national accounts was motivated by the Keynesian theory and the 1940 s and 1950 s were an important time for the development of the national accounts. Before this, saving was understood as cash money or money deposited in bank accounts but the changes in this era led to the establishment of the modern saving concept. Separate from the development of national accounts, household surveys were established. Household surveys have been conducted in Finland from the beginning of the 20th century. At that time surveys were conducted in order to observe the working class living standard and as a result, these were based on the tradition of welfare studies. Also a motivation for undertaking the studies was to estimate weights for the consumer price index. A final reason underpinning the government s interest in observing this data regarded whether there were any reasons for the working class to become radicalised and therefore adopt revolutionary ideas. As the need for the economic analysis increased and the data requirements underlying the political decision making process also expanded, the two traditions and thus, the two data sources started to integrate. In the 1950s the household surveys were compiled distinctly from the national accounts and they were virtually unaffected by economic theory. The 1966 survey was the first study that was clearly motivated by national accounts and saving analysis. This study also covered the whole population rather than it being limited to just part of it. It is essential to note that the integration of these two traditions is still continuing. This recently took a big step forward as the Stiglitz, Sen and Fitoussi Committee Report was introduced and thus, the criticism of the current measure of welfare was taken seriously. The Stiglitz report emphasises that the focus in the measurement of welfare should be on the households and the macro as well as micro perspective should be included in the analysis. In this study the national accounts are applied to the household survey data from the years 1950-51, 1955-56 and 1959-60. The first two studies cover the working population of towns and market towns and the last survey covers the population of rural areas. The analysis is performed at three levels: macro economic level, meso level, i.e. at the level of different types of households, and micro level, i.e. at the level of individual households. As a result it analyses how the different households saved and consumed and how that changed during the 1950 s.

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A method was developed for relative radiometric calibration of single multitemporal Landsat TM image, several multitemporal images covering each others, and several multitemporal images covering different geographic locations. The radiometricly calibrated difference images were used for detecting rapid changes on forest stands. The nonparametric Kernel method was applied for change detection. The accuracy of the change detection was estimated by inspecting the image analysis results in field. The change classification was applied for controlling the quality of the continuously updated forest stand information. The aim was to ensure that all the manmade changes and any forest damages were correctly updated including the attribute and stand delineation information. The image analysis results were compared with the registered treatments and the stand information base. The stands with discrepancies between these two information sources were recommended to be field inspected.