Argyrophil cell density in the oxyntic mucosa is higher in female than in male morbidly obese patients

Obesity is a multifactorial disorder often associated with many important diseases such as diabetes, hypertension and other metabolic syndrome conditions. Argyrophil cells represent almost the total population of endocrine cells of the human gastric mucosa and some reports have described changes of specific types of these cells in patients with obesity and metabolic syndrome. The present study was designed to evaluate the global population of argyrophil cells of the gastric mucosa of morbidly obese and dyspeptic non-obese patients. Gastric biopsies of antropyloric and oxyntic mucosa were obtained from 50 morbidly obese patients (BMI >40) and 50 non-obese patients (17 dyspeptic overweight and 33 lean individuals) and processed for histology and Grimelius staining for argyrophil cell demonstration. Argyrophil cell density in the oxyntic mucosa of morbidly obese patients was higher in female (238.68 ± 83.71 cells/mm2) than in male patients (179.31 ± 85.96 cells/mm2) and also higher in female (214.20 ± 50.38 cells/mm2) than in male (141.90 ± 61.22 cells/mm2) morbidly obese patients with metabolic syndrome (P = 0.01 and P = 0.02, respectively). In antropyloric mucosa, the main difference in argyrophil cell density was observed between female morbidly obese patients with (167.00 ± 69.30 cells/mm2) and without (234.00 ± 69.54 cells/mm2) metabolic syndrome (P = 0.001). In conclusion, the present results show that the number of gastric argyrophil cells could be under gender influence in patients with morbid obesity. In addition, gastric argyrophil cells seem to behave differently among female morbidly obese patients with and without metabolic syndrome.

Virtaustehokkuuden parantaminen tuotannossa visuaalisen ohjauksen avulla

Yrityksen kilpailukyvyn turvaaminen muuttuvassa toimintaympäristössä on välttämätöntä. Lean-ajattelun avulla tuotantoyritysten on mahdollista toimia tehokkaammin parantamalla virtausta. Tämän työn tarkoituksena on parantaa kotimaisen elintarviketeollisuusyrityksen tuotannon sisäisten materiaalivirtojen tehokkuutta. Tavoitteena tutkimuksella on löytää nykyisistä materiaalivirroista kehittämiskohteita sekä rakentaa niihin ratkaisuja. Tätä kautta kohdeyritystä autetaan saavuttamaan tehokkaampi ja turvallisempi työympäristö. Tutkimuksessa käytettiin kvalitatiivista tutkimusmenetelmää. Teoriaosiossa tehtiin kirjallisuuskatsaus lean-ajatteluun sekä visuaaliseen ohjaukseen. Teoriasta saatiin menetelmät materiaalivirtojen analysointiin sekä toiminnan kehittämiseen. Empiirisessä osiossa tietoa kerättiin tuotannon henkilöstön haastatteluilla sekä havainnoimalla työntekoa tuotannossa materiaalivirtojen kuvaamiseksi. Kuvausten perusteella paikallistettiin materiaalivirroista hukkia, joiden vähentämiseksi luotiin virtaustehokkuutta parantavia kehitysehdotuksia. Virtaustehokkuuden parantamisessa käytettiin hyödyksi materiaalitarpeesta ilmoittavaa andon-järjestelmää, joka kuuluu visuaalisen ohjauksen menetelmiin. Tämän lisäksi käytettiin kohdeyrityksellä jo käytössä olevaa 5S-menetelmää. Näiden menetelmien tehokas hyödyntäminen edellyttää kuitenkin lean-ajattelun periaatteiden mukaisia muutoksia työskentelytapoihin, materiaalien varastopaikkoihin sekä tuotannossa toimiviin osastoihin.

Business models for Finnish biobanks

This study concentrates on developing a suitable business model for Finnish biobanks, with particular emphasis on value creation to stakeholders. The sub-objective of this thesis are to map the commercial possibilities of biobanks and potential barriers for business development. The study approaches the subject from the biobanks’ as well as the stakeholders’ point of view, integrating their hopes and needs considering current and future co-operation into the findings. In 2013 the Biobank Act came into effect, after which six biobanks have been established and several other pending biobank projects are in process. There is relatively little research in regard to the commercial opportunities of this newcomer of the biomedical industry, and particularly in the Finnish markets. Therefore, the aim of this study is to partially fill the research gap of the commercial potential of biobanks and particularly outline the problematic elements in developing business. The theoretical framework consists of a few select theories, which depict business modeling and value creation of organizations. The theories are combined to form a synthesis, which best adapts to biobanks, and acts as a backbone for interviews. The empirical part of the study was conducted mainly by seven face-to-face interviews, and complemented by two phone interviews and an e-mail questionnaire with four responses. The findings consist mainly of the participants’ reflections on the potential products and services enabled by consumer genomics, as well as perceptions on different obstacles for biobanks’ business development. The nature of the study is tentative, as biobanks are relatively new organizations in Finland, and their operation models and activities are still molding. The aim is to bring to surface the hopes and concerns of biobanks’ representatives, as well as the representatives of stakeholders, in order to transparently discuss the current situation and suggestions for further development. The study concludes that in principle, the interviewees’ agree on the need for development in order not to waste the potential of biobanks; regardless, the participants emphasize different aspects and subsequently lean on differing methods.

Os limites da participação dos trabalhadores nos ganhos das empresas

This article argues that workers’ share in profits are actually a share in extra surplus value obtained by means of more intensified labor. Cost reductions obtained by means of more intensified lean production methods cause wages to represent a smaller fraction of the product of a working day when measured at market value. The increased market rate of surplus value is the basis for workers’ shares in profits. However, as competition continuously levels out such advantages, the share in profits becomes dependent on a continuous strive to reducing costs and intensifying labor.

Tuotannon- ja materiaalinsuunnittelu ja sen ennustaminen Metsä Wood:n Suolahden koivuvaneritehtaalla

Tässä diplomityössä tutkitaan Metsä Woodin Suolahden koivuvaneritehtaan toimitustarkkuuteen negatiivisesti vaikuttavia tekijöitä. Tarkoituksena on löytää ne ongelmakohdat, mitkä heijastuvat toimitusten myöhästymisenä sekä muutostekijät, mitkä vaikuttavat toimitusviikon myöntämiseen. Lisäksi työssä kartoitetaan kuinka hyvin tietoa ja informaatiota on tarjolla sitä tarvitseville henkilöstötahoille. Teoriaosuudessa tarkastellaan tuotannonsuunnitteluun liittyviä teorioita sekä tiedon liikkumista organisaation sisällä. Työssä kuvataan Suolahden koivuvaneritehtaan nykyinen vanerin valmistusprosessi ja tuotannonsuunnittelu. Varsinainen tutkimustyö suoritetaan laadullisia tutkimusmenetelmiä hyväksikäyttäen. Tulosten tarkastelussa käsitellään työn aikana tapahtuneita muutoksia ja ongelmakohtia sekä analysoidaan kyselytutkimuksen tuloksia ja tulosten luotettavuutta. Yhteenvedossa esitetään pääongelmakohdat ja niiden ratkaisut ja esitetään uusia mielenkiintoisia jatkotutkimusaiheita.

Gut Microbiota and Metabolic Disorders

Obesity and its co-morbidities, such as metabolic syndrome (MetS), non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes, have increased over the last few decades like an epidemic. So far the mechanisms of many metabolic diseases are not known in detail and currently there are not enough effective means to prevent and treat them. Several recent studies have shown that the unbalanced gut microbiota composition (GMC) and activity have an influence on the fat accumulation in the body. Further, it seems that the GMC of obese individuals differs from the lean. The aim of this study was to investigate whether there are differences between the GMC of metabolically impaired overweight/obese (MetS group), metabolically healthy overweight/obese and normal-weight individuals. In addition, the mechanisms by which the gut bacteria as well as their specific structures, such as flagellin (FLG) that stimulates the Toll-like receptor 5 (TLR5) affect metabolism, were investigated both in vivo and in vitro in human adipocytes and hepatocytes. The results of this study show that the abundance of certain gram-positive bacteria belonging to the Clostridial cluster XIV was higher in the MetS group subjects compared to their metabolically healthy overweight/obese and lean counterparts. Metabolically impaired subjects tended to also have a greater abundance of potentionally inflammatory Enterobacteria in their gut and thus seemed to have aberrant GMC. In addition, it was found that subjects with a high hepatic fat content (HHFC group) had less Faecalibacterium prausnitzii in their gut than individuals with low hepatic fat content. Further gene expression analysis revealed that the HHFC group also had increased inflammation cascades in their adipose tissue. Additionally, metabolically impaired individuals displayed an increased expression of FLG-recognizing TLR5 in adipose tissue, and the TLR5 expression levels associated positively both with liver fat content and insulin resistance in humans. These changes in the adipose tissue may further contribute to the impaired metabolism observed, such as insulin resistance and dyslipidemia. In vitro -studies showed that the FLG-induced TLR5 activation in adipocytes enhanced the hepatic fat accumulation by decreasing insulin signaling and mitochondrial functions and increasing triglyceride synthesis due to increased glycerol secretion from adipocytes. In conclusion, the findings of this study suggest that it may be possible that the novel prevention and personalized treatment strategies based on GM modulation will succesfully be developed for obesity and metabolic disorders in the future.

Business models for Finnish biobanks

This study concentrates on developing a suitable business model for Finnish biobanks, with particular emphasis on value creation to stakeholders. The sub-objective of this thesis are to map the commercial possibilities of biobanks and potential barriers for business development. The study approaches the subject from the biobanks’ as well as the stakeholders’ point of view, integrating their hopes and needs considering current and future co-operation into the findings. In 2013 the Biobank Act came into effect, after which six biobanks have been established and several other pending biobank projects are in process. There is relatively little research in regard to the commercial opportunities of this newcomer of the biomedical industry, and particularly in the Finnish markets. Therefore, the aim of this study is to partially fill the research gap of the commercial potential of biobanks and particularly outline the problematic elements in developing business. The theoretical framework consists of a few select theories, which depict business modeling and value creation of organizations. The theories are combined to form a synthesis, which best adapts to biobanks, and acts as a backbone for interviews. The empirical part of the study was conducted mainly by seven face-to-face interviews, and complemented by two phone interviews and an e-mail questionnaire with four responses. The findings consist mainly of the participants’ reflections on the potential products and services enabled by consumer genomics, as well as perceptions on different obstacles for biobanks’ business development. The nature of the study is tentative, as biobanks are relatively new organizations in Finland, and their operation models and activities are still molding. The aim is to bring to surface the hopes and concerns of biobanks’ representatives, as well as the representatives of stakeholders, in order to transparently discuss the current situation and suggestions for further development. The study concludes that in principle, the interviewees’ agree on the need for development in order not to waste the potential of biobanks; regardless, the participants emphasize different aspects and subsequently lean on differing methods.

Production Quality Analysis of Special Elevator Cars Based on Six Sigma Approach

Project scope is to utilize Six Sigma DMAIC approach and lean principles to improve production quality of the case company. Six Sigma tools and techniques are explored through a literature review and later used in the quality control phase. The focus is set on the Pareto analysis to demonstrate the most evident development areas in the production. Materials that are not delivered to the customer or materials that damaged during transportation comprise the biggest share of all feedbacks. The goal is set to reduce these feedbacks by 50 %. Production observation pointed out that not only material shortages but also over-production is a daily situation. As a result, an initial picking list where the purchased and own production components can be seen, is created, reduction of over- and underproduction and material marking improvement are seen the most competitive options so that the goal can be reached. The picking list development should still continue to make sure that the list can be used not only in the case study but also in the industrial scale. The reduction of material missing category can be evaluated reliably not sooner than in few years because it takes time to gather the needed statistical information.

Increased profitability and efficiency by improving the Meetings & Events Category S2P-process – Case Company

The purpose of this research was to examine the most optimal way to arrange meetings and events management and source to pay –process in a global company. The research is a qualitative multi-method case study and is a commission from a global company. The theoretical framework of this research structures around two approaches. First approach focus on a purchasing strategy and management that shows the current role of procure-ment and introduce different ways to organize purchasing functions. Second approach focus on purchasing process management and improvement methods. Annual spend analyze, external and internal interviews and internal survey were done to gain compre-hensive knowledge about the current state of operations and possible solutions. Gathered data were then combined to theoretical framework in order to create optimal solution for the case company. Based on the research a source to pay –process and global policy for meeting and event category was created. The solution includes all relevant matters that are needed in order to secure efficient and profitable operations. The results show that optimal way to arrange meetings and events structures around standardized source to pay –processes, central-ized procurement, preferred supplier and clearly defined roles and responsibilities be-tween different stakeholders.

Modularity in Health and Social Services: Perspectives on Organization and Management

Organizations that provide health and social services operate in a complex and constantly changing environment. Changes occur, for example, in ageing, technology and biotechnology, and customers’ expectations, as well as the global economic situation. Organizations typically aim to adapt the changes by introducing new organizational structures and managerial practices, such as process and lean management. Only recently has there been an interest in evaluating whether organizations providing health and social services could apply modularity in order to respond to some of the changes. The concept of modularity originates from manufacturing, but is applied in many other disciplines, such as information technology and logistics. However, thus far, the literature concerning modularity in health and social services is scarce. Therefore the purpose of this thesis is to increase understanding concerning modularity and the possibilities to apply modularity in the health and social services context. In addition, the purpose is to shed light on the viewpoints that are worth taking into account when considering the application of modularity in the health and social services context. The aim of the thesis is to analyze the way in which the modular structures are applied in the health and social services context and to analyze what advantages and possible barriers, as well as managerial concerns, might occur if modularity is applied in the health and social services context. The thesis is conducted by using multiple methods in order to provide a broad aspect to the topic. A systematic literature review provided solid ground for pre-understanding the topic and supported the formulation of the research questions. Theoretical reasoning provided a general overview of the special characteristics of the health and social services context and their effect on application of modularity. Empirical studies concentrated on managerial concerns of modularity particularly from the perspective of health and social services for the elderly. Results of the thesis reveal that structures in products, services, processes, and organizations are rather modular in health and social services. They can be decomposed in small independent units, while the challenges seem to occur especially in the compatibility of the services. It seems that health and social services managers have recognized this problem and they are increasingly paying attention to this challenge in order to enhance the flexible compatibility of services. Advantages and possible barriers of modularity are explored in this thesis, and from the theoretical perspective it could be argued that modularity seems to be beneficial in the context of health and social services. In fact, it has the potential to alleviate several of the challenges that the health and social services context is confronting. For example, modular structures could support organizations in their challenging task to respond to customers’ increasing demand for heterogeneous services. However, special characteristics of the health and social services context create barriers and provide significant challenges in application of modularity. For example, asymmetry of information, negative externalities, uncertainty of demand, and rigid regulation prevent managers from extensively drawing benefits from modularity. Results also reveal that modularity has managerial implications in health and social service. Modularity has the potential to promote and support new service development and outsourcing. Results also provide insights into network management and increases managerial understanding of different network management strategies. Standardization in health and social services is extensive due to legislation and recommendations. Modularity provides alternative paths to take an advantage of standardization while still ensuring the quality of the services. Based on this thesis, it can be concluded, both from a theoretical perspective and from empirical results concerning modularity in health and social services, that modularity might fit well and be beneficial. However, the special characteristics of the health and social services context prevent some of the benefits of modularity and complicate its application. This thesis contributes to the academic literature on the organization and management of health and social services by describing modularity as an alternative way for organizing and managing health and social services. In addition, it contributes to the literature of modularity by exploring the applicability of modularity in the context of health and social services. It also provides practical contribution to health and social services managers by evaluating the pros and cons of modularity when applied to health and social services.

Kahden lämmitysjärjestelmiä valmistavan tuotantoyksikön toimintojen yhdistäminen kustannustehokkuuden lisäämiseksi

Tämä työ käsittelee Oilon Oy:n tehtaan layout -suunnittelua, kun yhdistetään kaksi eri kiinteistössä toimivaa tuotantoyksikköä saman katon alle. Yksiköt ovat Hollolassa toimiva Oilon Home Oy ja Lahden pääkonttorissa toimiva Oilon Industry Oy. Yhdistämisellä haetaan säästöjä tuotantoyksiköiden välisistä logistiikkakuluista sekä kiinteistön vuokra- ja ylläpitokuluista ja samalla tehostetaan tehtaan sisäistä materiaalinkäsittelyä. Oilon Oy on toiminut Lahden pääkonttorissa jo yli 50 vuoden ajan ja sen tuotanto on kokenut historiansa aikana useita pienempiä muutoksia, jotka ovat jättäneet nykyiseen layoutiin paljon toivomisenvaraa. Jotta molemmat tuotantoyksiköt saadaan mahtumaan Lahden yksikköön, on sinne saatava luotua tarvittavat tilat siellä olemassa oleville toiminnoille ja Hollolan yksiköstä saapuville tuotantolinjoille. Työn alussa perehdytään kirjallisuuden avulla siihen kuinka tuotanto on kehittynyt maailmalla lähihistorian aikana, jotta voidaan paremmin ymmärtää Oilon Oy:n nykytilanteeseen johtaneita syitä. Koska Hollolasta saapuville tuotantolinjoille ei ole tarkoitus rakentaa uutta tuotantotilaa, pyritään tilaa vapauttamaan Lahden tehtaalta varastointia tehostamalla ja sen logistiikkaa helpottamalla. Tämän vuoksi vertaillaan yleisimpiä tavaroiden varastointi ratkaisuita sekä tutkitaan kuinka materiaalin käsittelyä voitaisiin tehostaa varastossa ja tuotantosuluissa. Varastoinnin tehostaminen ei kuitenkaan yksin riitä vapauttamaan tarvittavia tiloja, joten layout-muutoksen aikana rakennetaan myös kaksi uuttaa varastohallia. Uudessa layout-suunnitelmassa huomioidaan kunkin solun nykyiset ja tulevat tilantarpeet, sekä rakennetaan ne niin, että työvoimaa voidaan käyttää niissä joustavasti eri tuotteiden valmistamiseen. Tutkimusmetodeina käytetään teemahaastatteluita, joilla selvitetään työntekijöiden tarpeet sekä kirjallisuuden avulla perehdytään Lean-tuotantoon, kanban:iin, 5S:ään ja arvovirta-analyysiin. Näitä soveltamalla saadaan luotua tehokkaasti toimiva kokonaisuus, jolla tavoitellut säästöt saadaan toteutumaan.

Materiaalin virtauksen parantaminen metalliteollisuudessa tuotannon- ja varastonohjausta tehostamalla

Työssä on tavoitteena kehittää kohdeyrityksen tuotannon- ja varastonohjausta sekä lisätä prosessin virtausta. Työ toteutettiin analysoimalla yrityksen toiminnanohjausjärjestelmästä kerättyä dataa sekä keskustelemalla henkilöstön kanssa. Yrityksessä koettiin tarvetta saada tuotanto virtaamaan paremmin ja pienentää samalla varaston arvoa. Tuotanto koettiin tehottomaksi ja varaston arvo liian suureksi. Työssä selvisi, että yrityksellä olisi mahdollisuus pudottaa varaston arvo puoleen säilyttäen silti nykyisen palvelutason. Tuotannon virtausta saadaan lisättyä käyttämällä kanban-ohjausta volyyminimikkeillä ja luomalla toimivat pelisäännöt muiden nimikkeiden ohjaukselle.

Lääketehtaan valmistusosaston toimitusketjun arvovirtamallintaminen

Tässä diplomityössä laadittiin prosessikuvaus lääketehtaan valmistusosaston toimitusketjusta. Työn tavoitteena oli kuvata toimitusketjun eri prosessit nykytilassaan ja luoda samalla työkalu arvovirtakarttojen luomiseen lean-tuotantomallin mukaisesti. Prosessikaaviot toteutettiin soveltaen IDEF0-prosessienmallinnusmenetelmää. Kaavioissa kuvattiin järjestelmällisesti eri organisaatioiden prosessit sekä niihin liittyvät informaatio- ja materiaalivirrat. Esimerkki arvovirran tunnistamisesta ja arvovirtakarttojen luomisesta tehtiin yhdestä prosessivaiheesta, pakkausprosessista, josta myös määritettiin lean-tuotantomallin mukaisesti sen arvoa tuottavat, arvoa tuottamattomat, mutta välttämättömät ja arvoa tuottamattomat työvaiheet eli hukka. Arvovirran tunnistus suoritettiin työntutkimuksen avulla. Pakkausprosessin arvovirran määrittämisessä havaittiin, että tuotevaihdon aikana työntekijöiden käyttämästä työajasta arvoa tuottavia työvaiheita oli 3 %, arvoa lisäämättömiä työvaiheita, mutta välttämättömiä oli 53 % ja arvoa lisäämätöntä eli hukkaa oli 44,0 %. Pakkaustyön aikana työntekijöiden työajasta arvoa lisääviksi työvaiheiksi saatiin 4 %. Arvoa lisäämättömiä työvaiheita, mutta välttämättömiä oli 38 % ja arvoa lisäämätöntä eli hukkaa oli 58 %. Koneajasta tuotteen arvoa lisäävää oli koneesta riippuen 50–76 % ja arvoa lisäämätöntä 24–50 %. Työn lopuksi esitettiin jatkotoimenpiteitä hukan eliminoimiseksi.

Development of a New Welding Product Quality Control and Management System Model for China

The Chinese welding industry is growing every year due to rapid development of the Chinese economy. Increasingly, companies around the world are looking to use Chinese enterprises as their cooperation partners. However, the Chinese welding industry also has its weaknesses, such as relatively low quality and weak management. A modern, advanced welding management system appropriate for local socio-economic conditions is required to enable Chinese enterprises to enhance further their business development. The thesis researches the design and implementation of a new welding quality management system for China. This new system is called ‗welding production quality control management model in China‘ (WQMC). Constructed on the basis of analysis of a survey and in-company interviews, the welding management system comprises the following different elements and perspectives: a ‗Localized congenital existing problem resolution strategies‘ (LCEPRS) database, a ‗human factor designed training system‘ (HFDT) training strategy, the theory of modular design, ISO 3834 requirements, total welding management (TWM), and lean manufacturing (LEAN) theory. The methods used in the research are literature review, questionnaires, interviews, and the author‘s model design experiences and observations, i.e. the approach is primarily qualitative and phenomenological. The thesis describes the design and implementation of a HFDT strategy in Chinese welding companies. Such training is an effective way to increase employees‘ awareness of quality and issues associated with quality assurance. The study identified widely existing problems in the Chinese welding industry and constructed a LCEPRS database that can be used in efforts to mitigate and avoid common problems. The work uses the theory of modular design, TWM and LEAN as tools for the implementation of the WQMC system.

Determinants of left ventricular mass as measured by Doppler echocardiography in pre-adolescents

This study examined factors contributing to the differences in left ventricular mass as measured by Doppler echocardiography in children. Fourteen boys (10.3 ± 0.3 years of age) and 1 1 girls (10.5 ± 0.4 years of age) participated in the study. Height and weight were measured, and relative body fat was determined from the measurement of skinfold thickness according to Slaughter et al. (1988). Lean Body Mass was then calculated by subtracting the fat mass from the total body mass. Sexual maturation was self-assessed using the stages of sexual maturation by Tanner (1962). Both pubic hair development and genital (penis or breast for boys and girls respectively) development were used to determine sexual maturation. Carotid Pulse pressure was assessed by applanation tomometry in the left carotid artery. Cardiac mass was measured by Doppler Echocardiography. Images of cardiac structures were taken using B-Mode and were then translated to M- Mode. The dimensions at the end diastole were obtained at the onset of the QRS complex of the electrocardiogram in a plane through a standard position. Measurements included: (a) the diameter of the left ventricle at the end diastole was measured from the septum edge to the endocardium mean border, (b) the posterior wall was measured as the distance from to anterior wall to the epicardium surface, and (c) the interventricular septum was quantified as the distance from the surface of the left ventricle border to the right ventricle septum surface. Systolic time measurements were taken at the peak of the T-wave of the electrocardiogram. Each measurement was taken three to five times before averaging. Average values were used to calculate cardiac mass using the following equation (Deveraux et al. 1986). Weekly physical activity metabolic equivalent was calculated using a standardize activity questionnaire (Godin and Shepard, 1985) and peakV02 was measured on a cycloergometer. There were no significant differences in cardiovascular mesurements between boys and girls. Left ventricular mass was correlated (p<0.05) with size, maturation, peakV02 and physical activity metabolic equivalent. In boys, lean body mass alone explained 36% of the variance in left ventricular mass while weight was the single strongest predictor of left ventricular mass (R =0.80) in girls. Lean body mass, genital developemnt and physical activity metabolic equivalent together explained 46% and 81% in boys and girls, respectively. However, the combination of lean body mass, genital development and peakV02 (ml kgLBM^ min"') explained up to 84% of the variance in left ventricular mass in girls, but added nothing in boys. It is concluded that left ventricular mass was not statistically different between pre-adolescent boys and girls suggesting that hormonal, and therefore, body size changes in adolescence have a main effect on cardiac development and its final outcome. Although body size parameters were the strongest correlates of left ventricular mass in this pre-adolescent group of children, to our knowledge, this is the first study to report that sexual maturation, as well as physical activity and fitness, are also strong associated with left ventricular mass in pre-adolescents, especially young females. Arterial variables, such as systolic blood pressure and carotid pulse pressure, are not strong determinants of left ventricular mass in this pre-adolescent group. In general, these data suggest that although there is no gender differences in the absolute values of left ventricular mass, as children grow, the factors that determine cardiac mass differ between the genders, even in the same pre-adolescent age.