Complications of surgical treatment of cervical carcinoma

A total of 302 patients with stage Ib and IIa cervical carcinoma were submitted to radical hysterectomy and lymphadenectomy during the period from 1980 to 1994. The morbidity rate was 37.5% and the mortality rate 0.6%. The most common intraoperative complications were injuries to the great pelvic vessels and the most frequent postoperative complications involved the urinary tract. The leading causes of morbidity were urinary infection (20.8%), bladder dysfunction (9.2%) and ureteral fistulas (2.9%). Although the rate of complications was high, morbidity has been decreasing over the last five years. Thus, radical hysterectomy continues to be one of the methods for the treatment of early cervical carcinoma that presents an acceptable 5-year survival rate.

Finlandiae pars

Julkaisussa: Den groten dobbelden nieuwen Spiegel der Zeevaert van de navigatie der westersche Zee. - Vol. II: Teerste deel van de pars prima Speculum nauticum ... per Lucam Joannis Aurigarium

Nordic alcohol policy in Europe: the adaptation of Finland’s, Sweden’s and Norway’s alcohol policies to a new policy framework, 1994-2013

The purpose of this thesis is to study how and to which extent Finland, Sweden and Norway have adapted their alcohol policies to the framework imposed to them by the EU and the European Economic Area (EEA) since the mid-1990s. This is done by studying the underlying mechanisms that have influenced the formation of alcohol policy in the Nordic countries in that period. As a part of this analysis main differences in alcohol policies and alcohol consumption between the three countries are assessed and the phenomenon of cross-border trade with alcohol is discussed. The study examines also the development of Finnish, Norwegian and Swedish alcohol policies between 1994 and 2012 and compares the Nordic alcohol policies with other alcohol policies in Europe as the situation was in 2012. The time frame of the study spans from the mid-1990s to the end of 2013 and is divided into three phases. Studying the role of the Europeanisation process on the formation of alcohol policies has a key role in the analysis. Besides alcohol policies, the analyses comprise the development of alcohol consumption and cross-border trade with alcohol. In addition, a quantitative scale constructed to measure the strictness of alcohol policies is utilised in the analyses. The results from the scale are used to substantiate the qualitative analysis and to test whether the stereotypical view of a strict Nordic alcohol policy is still true. The results from the study clearly corroborate earlier findings on the significance of Europeanisation and the Single Market for the development of alcohol policies in the Nordic countries. Free movement of goods and unhindered competition have challenged the principle of disinterest and enabled private profit seeking in alcohol trade. The Single Market has also contributed to the increase in availability of alcohol and made it more difficult for the Nordic EU member states to maintain restrictive alcohol policies. All in all, alcohol policies in the Nordic countries are more liberal in 2013 than they were in 1994. Norway, being outside the EU has, however, managed to maintain a stricter alcohol policy than Finland and Sweden. Norway has also been spared from several EU directives that have affected Finland and Sweden, the most remarkable being the abolishment of the travellers’ import quotas for alcohol within the EU. Due to its position as a non-EU country Norway has been able to maintain high alcohol taxes without being subjected to a ”race to the bottom” regarding alcohol taxes the same way as Finland and Sweden. Finland distinguishes as the country that has liberalised its alcohol policy most during the study period. The changes in alcohol policies were not only induced by Europeanisation and the Single Market, but also by autonomous decision-making and political processes in the individual countries. Furthermore, the study shows that alcohol policy measures are implemented more widely in Europe than before and that there is a slow process of convergence going on regarding alcohol policy in Europe. Despite this, alcohol policies in the Nordic countries are still by far the strictest in all of Europe. From a Europeanisation perspective, the Nordic countries were clearly on the receiving end during the first two study phases (1994–2007), having more to adjust to rules from the EU and the Single Market than having success in uploading and shaping alcohol policy on the European and international field. During the third and final study phase (2008–2013), however, the Nordic countries have increasingly succeeded in contributing to shape the alcohol policy arena in the EU and also more widely through the WHOs global alcohol strategy. The restrictive Nordic policy tradition on which the current alcohol policies in Finland, Sweden and Norway were built on has still quite a solid evidence base. Although the basis of the restrictive alcohol policy has crumbled somewhat during the past twenty years and the policies have become less effective, nothing prevents it from being the base for alcohol policy in the Nordic countries even in the long term. In the future, all that is needed for an effective and successful alcohol policy is a solid evidence base, enough political will and support from the general public.

Estradiol decreases iodide uptake by rat thyroid follicular FRTL-5 cells

Estradiol has well-known indirect effects on the thyroid. A direct effect of estradiol on thyroid follicular cells, increasing cell growth and reducing the expression of the sodium-iodide symporter gene, has been recently reported. The aim of the present investigation was to study the effect of estradiol on iodide uptake by thyroid follicular cells, using FRTL-5 cells as a model. Estradiol decreased basal iodide uptake by FRTL-5 cells from control levels of 2.490 ± 0.370 to 2.085 ± 0.364 pmol I-/µg DNA at 1 ng/ml (P<0.02), to 1.970 ± 0.302 pmol I-/µg DNA at 10 ng/ml (P<0.003), and to 2.038 ± 0.389 pmol I-/µg DNA at 100 ng/ml (P<0.02). In addition, 4 ng/ml estradiol decreased iodide uptake induced by 0.02 mIU/ml thyrotropin from 8.678 ± 0.408 to 7.312 ± 0.506 pmol I-/µg DNA (P<0.02). A decrease in iodide uptake by thyroid cells caused by estradiol has not been described previously and may have a role in goiter pathogenesis.

Can organic and transgenic soy be used as a substitute for animal protein by rats?

We evaluated the protein quality of organic and transgenic soy fed to rats throughout life. Thirty female Wistar rats were divided into three groups (N = 10): organic soy group (OSG) receiving organic soy-based diet, genetically modified soy group (GMSG) receiving transgenic soy-based diet, and a control group (CG) receiving casein-based diet. All animals received water and isocaloric diet (10% protein), ad libitum for 291 days. After this, the weight of GMSG animals (290.9 ± 9.1 g) was significantly lower (P <= 0.04) than CG (323.2 ± 7.9 g). The weight of OSG (302.2 ± 8.7 g) was between that of the GMSG and the CG. Protein intake was similar for OSG (308.4 ± 6.8 g) and GMSG (301.5 ± 2.5 g), and significantly lower (P <= 0.0005) than the CG (358.4 ± 8.1 g). Growth rate was similar for all groups: OSG (0.80 ± 0.02 g), GMSG (0.81 ± 0.03 g) and CG (0.75 ± 0.02 g). In addition to providing a good protein intake and inducing less weight gain, both types of soy were utilized in a manner similar to that of casein, suggesting that the protein quality of soy is similar to that of the standard protein casein. The groups fed soy-based diet gained less weight, which may be considered to be beneficial for health. We conclude that organic and transgenic soy can be fed throughout life to rats in place of animal protein, because contain high quality protein and do not cause a marked increase in body weight.

Remote sensing for three-dimensional modelling of hydromorphology

Successful management of rivers requires an understanding of the fluvial processes that govern them. This, in turn cannot be achieved without a means of quantifying their geomorphology and hydrology and the spatio-temporal interactions between them, that is, their hydromorphology. For a long time, it has been laborious and time-consuming to measure river topography, especially in the submerged part of the channel. The measurement of the flow field has been challenging as well, and hence, such measurements have long been sparse in natural environments. Technological advancements in the field of remote sensing in the recent years have opened up new possibilities for capturing synoptic information on river environments. This thesis presents new developments in fluvial remote sensing of both topography and water flow. A set of close-range remote sensing methods is employed to eventually construct a high-resolution unified empirical hydromorphological model, that is, river channel and floodplain topography and three-dimensional areal flow field. Empirical as well as hydraulic theory-based optical remote sensing methods are tested and evaluated using normal colour aerial photographs and sonar calibration and reference measurements on a rocky-bed sub-Arctic river. The empirical optical bathymetry model is developed further by the introduction of a deep-water radiance parameter estimation algorithm that extends the field of application of the model to shallow streams. The effect of this parameter on the model is also assessed in a study of a sandy-bed sub-Arctic river using close-range high-resolution aerial photography, presenting one of the first examples of fluvial bathymetry modelling from unmanned aerial vehicles (UAV). Further close-range remote sensing methods are added to complete the topography integrating the river bed with the floodplain to create a seamless high-resolution topography. Boat- cart- and backpack-based mobile laser scanning (MLS) are used to measure the topography of the dry part of the channel at a high resolution and accuracy. Multitemporal MLS is evaluated along with UAV-based photogrammetry against terrestrial laser scanning reference data and merged with UAV-based bathymetry to create a two-year series of seamless digital terrain models. These allow the evaluation of the methodology for conducting high-resolution change analysis of the entire channel. The remote sensing based model of hydromorphology is completed by a new methodology for mapping the flow field in 3D. An acoustic Doppler current profiler (ADCP) is deployed on a remote-controlled boat with a survey-grade global navigation satellite system (GNSS) receiver, allowing the positioning of the areally sampled 3D flow vectors in 3D space as a point cloud and its interpolation into a 3D matrix allows a quantitative volumetric flow analysis. Multitemporal areal 3D flow field data show the evolution of the flow field during a snow-melt flood event. The combination of the underwater and dry topography with the flow field yields a compete model of river hydromorphology at the reach scale.

Human papillomavirus infection and its association with cervical dysplasia in Ecuadorian women attending a private cancer screening clinic

Women living in Latin American countries bear a disproportionate burden of cervical cancer, a condition caused by infection with the human papillomavirus (HPV). We performed a study in Santa Elena, Guayas (currently Santa Elena Province), Ecuador, to determine how often HPV could be detected in women attending a private cancer screening clinic. Participants underwent a Pap test, and vaginal and cervical swabs were performed for HPV testing by the polymerase chain reaction (PCR). Each participant completed a verbally administered survey. The mean age of 302 participants was 37.7 years (range 18 to 78 years). The majority of cervical and vaginal specimens contained sufficient DNA to perform PCR. Overall, 24.2% of the participants had either a cervical or vaginal swab that tested positive for HPV. In general, there was a good correlation between the HPV types detected in the cervical and vaginal swabs from the participants, but vaginal swabs were more likely to contain HPV DNA than were cervical swabs. The high-risk HPV types 16, 52, 58, and 59 and the low-risk HPV types 62, 71, 72, and 83 were the most frequently detected HPV types. The number of lifetime sexual partners was positively associated with detection of any HPV type, detection of oncogenic HPV, and abnormal Pap smears. Further studies are needed to determine if these results are representative of all Ecuadorian women and to determine if cervical cancers in Ecuadorian women are caused by the same HPV types found in the swab specimens obtained in this study.

Purificação da enzima polifenoloxidase (PFO) de polpa de pinha (Annona squamosa L.) madura

A PFO (EC 1.10.3.2) extraída de polpa de pinha madura (Annona squamosa L.), foi parcialmente purificada por fracionamento em sulfato de amônio a 80% e purificada 411 (Fração I) e 118 (Fração II) vezes após cromatografia em coluna de troca iônica em DEAE-Toyopearl 650M, e 566 vezes em coluna de Toyopearl HW55F. A enzima da fração mais ativa foi caracterizada bioquimicamente. Quanto aos parâmetros cinéticos, a enzima apresentou valores de Km e Vmax de 7,14mM e 302,0 unidades/min/ml para catecol e 25,0mM e 180,2 unidades/min/ml para L-dopa respectivamente, substratos que demonstraram maior especificidade. O peso molecular foi estimado em 90.700 daltons através de filtração em gel Sephadex G-200. O teor de cobre da enzima purificada encontrado foi de 11ppm/peso da amostra liofilizada. Quanto à composição de aminoácidos, a PFO apresentou maiores teores de ácido aspártico, ácido glutâmico e lisina e menores teores de metionina, arginina e tirosina, com ausência de cisteína.

Função renal e disfunção cognitiva: estudo transversal de utentes inscritos na unidade de saúde familiar-ponte

Introdução: Estudos recentes demonstram o aumento da prevalência de Disfunção Cognitiva em pacientes com Doença Renal Crônica. Objetivo: Avaliar a referida associação nos utentes inscritos na Unidade de Saúde Familiar-Ponte. Métodos: Estudamos uma amostra constituída por 246 idosos. Avaliamos a função cognitiva por meio do Mini Mental State Examination e a Taxa de Filtração Glomerular com recurso à equação Modification of Diet in Renal Disease. Os valores da Taxa de Filtração Glomerular obtidos (ml/min/1,73 m2) foram distribuídos por três categorias: < 60,00, 60-89,99 e ≥ 90. Recolhemos variáveis adicionais do Serviço de Apoio ao Médico e estudamos os dados recorrendo a análises bivariadas e a modelos de regressão logística. Resultados: Os grupos com Taxa de Filtração Glomerular < 60 e ≥ 90 apresentaram maior prevalência de Disfunção Cognitiva, independentemente de outros fatores. Os odds-ratio foram, respectivamente, de 4,534 (IC95%: 1,257-16,356) e 3,302 (IC95%: 1,434-7,607). Discussão: Conforme a literatura, verificamos maior prevalência de Disfunção Cognitiva no grupo com Taxa de Filtração Glomerular < 60. A elevada prevalência de Disfunção Cognitiva nos utentes com Taxa de Filtração Glomerular ≥ 90 está descrita em alguns estudos e poderá dever-se a situações que induzam a sobrestimação da mesma taxa, como nos estados de caquexia, ou a situações de hiperfiltração glomerular. Conclusão: Constatamos que a relação entre a função renal e a prevalência de Disfunção Cognitiva não foi linear, mas sim parabólica. Novos estudos são necessários para se explicar o porquê deste achado e para se averiguar a necessidade de vigilância da Disfunção Cognitiva em pacientes com alterações da função renal.

Älykkään vaihtuvan ohjausjärjestelmän pilotointi, esiselvitys : Valtatie 4 Koskela, Helsinki - Järvenpää

Valtatie 4 Helsingin Koskelan ja Järvenpään eritasoliittymien välillä on erittäin vilkkaasti liikennöity väylä, joka ruuhkautuu sekä aamun että iltapäivän ruuhkatunteina ja jonka turvallisuustilanne on heikko. Ongelmien ratkaisemiseksi on aiemmissa suunnitteluvaiheissa esitetty nykyaikaisen vaihtuvan ohjausjärjestelmän toteuttamista valtatielle 4 Järvenpäähän saakka sekä valtatielle 7 välille vt 4–Kehä III. Tämän esiselvityksen tavoitteena oli laatia alustava suunnitelma laadukkaan ja monipuolisen liikennetieto-ohjauksen mahdollistavasta ohjausjärjestelmästä, jossa on huomioitu uusien seurantateknologioiden luomat mahdollisuudet. Laadittu suunnitelma sisältää tavanomaisiin liikenteen vaihtuviin ohjausjärjestelmiin nähden uusina elementteinä aiempaa monipuolisemman ja tarkemman liikenteen seurantajärjestelmän sekä aiempaa proaktiivisemman ja hienojakoisemman liikenteen ohjausjärjestelmän ja –politiikan. Lisäksi järjestelmän operointi tieliikennekeskuksessa poikkeaa totutusta, koska ohjauksen automaatiotaso on korkeampi. Uutta on myös järjestelmän integraatio tieliikenteen ohjauksen integroidun käyttöliittymän ympäristöön (TLOIK) sekä muista piloteista, kuten kooperatiivisista järjestelmistä, saatavat herätteet. Suunnitellun vaihtuvan ohjausjärjestelmän voidaan kansainvälisten kokemusten valossa arvioida ehkäisevän henkilövahinkoihin johtavia onnettomuuksia Suomen olosuhteissa noin 10 % ja pienentävän ruuhka-aikojen viivytyksiä vähintään 20 %. Pääkaupunkiseudun säteittäisväylien vaihtuvan ohjauksen hyöty-kustannussuhteeksi on aiemmin laskettu 3,3–6,3, eli investointi on erittäin kannattava. Hanke kannattaa toteuttaa kaksivaiheisena pilottina, jonka tavoitteena on selvittää toimivimmat teknologiat ja ohjauspolitiikat laajempaa hyödyntämistä varten. Valtakunnallisesta ulottuvuudesta johtuen hanketta kannattaa viedä eteenpäin Liikenneviraston ja Uudenmaan ELY-keskuksen yhteishankkeena. Järjestelmästä saatavia kokemuksia voidaan hyödyntää sekä muiden pääkaupunkiseudun pääväylien liikenteen hallintajärjestelmien uusimisen/toteutuksen yhteydessä että muiden kaupunkiseutujen vastaavien järjestelmien toteutuksessa. Pilottihankkeen ensimmäisen osan, seurantapilotin alustava kustannusarvio on 320 000 euroa ja toisen, varsinaisen ohjauspilotin kustannusarvio 6,0 miljoonaa euroa sisältäen koko ohjausjärjestelmän toteutuksen.