KHO 2006:37 : metsälain 10 §:n erityisen tärkeää elinympäristöä koskevan ennakkotiedon oikeusvaikutukset

Käsittelee Korkeimman hallinto-oikeuden ratkaisua KHO:2006:37

Carcinoembryonic antigen expression, antibody localisation and immunophotodetection of human colon cancer liver metastases in nude mice: a model for radioimmunotherapy.

Colorectal cancer frequently disseminates through the portal vein into the liver. In this study, outbred Swiss nude mice were adapted to facilitate the induction of liver metastases by a pre-grafting treatment with 6 Gy total body irradiation and i.v. injection of anti-asialo GM1 antibody. One day later, cultured LS 174T human colon cancer cells were injected into the surgically exposed spleen, which was resected 3 min later. In 48 of 65 mice, a few to several hundred liver metastases were macroscopically observed at dissection 3 to 4 weeks after transplantation. Ten of 10 mice, followed-up for survival, died with multiple large confluent liver metastases. By reducing the radiation dose to 4 or 0 Gy, or omitting the anti-asialo GM1 antibody injection, only 60%, 37% or 50% of mice, respectively, had visible metastases 3 weeks after transplantation. Carcinoembryonic antigen (CEA) measured in tumour extracts was in the mean 25.6 micrograms/g in liver metastases compared with 9.2 micrograms/g in s.c. tumours. Uptake of radiolabelled anti-CEA monoclonal antibody (MAb) in the metastases 12, 24 and 48 hr after injection gave a mean value of 39% of the injected dose per gram of tissue (ID/g). In comparison, MAb uptake in s.c. and intrasplenic tumours or lung metastases gave a mean percentage ID/g of 20, 18 and 15, respectively. Laser-induced fluorescence after injection of indocyanin-MAb conjugate allowed direct visual detection of small liver metastases, including some that were not visible under normal light. Preliminary results showed that mice, pre-treated with 4 Gy irradiation and the anti-asialo GM1 injection, were tolerant to radioimmunotherapy with a total dose of 500 muCi 131I labeled anti-CEA intact MAbs given in 3 injections.

Bone mineral density (BMD), micro-architecture estimation (TBS) and vertebral fracture assessment (VFA) extracted from a single DXA device in combination with clinical risk factors improve significantly the identification of women at high risk of fracture.

Osteoporosis (OP) is a systemic skeletal disease characterized by a low bone mineral density (BMD) and a micro-architectural (MA) deterioration. Clinical risk factors (CRF) are often used as a MA approximation. MA is yet evaluable in daily practice by the trabecular bone score (TBS) measure. TBS is very simple to obtain, by reanalyzing a lumbar DXA-scan. TBS has proven to have diagnosis and prognosis values, partially independent of CRF and BMD. The aim of the OsteoLaus cohort is to combine in daily practice the CRF and the information given by DXA (BMD, TBS and vertebral fracture assessment (VFA)) to better identify women at high fracture risk. The OsteoLaus cohort (1400 women 50 to 80 years living in Lausanne, Switzerland) started in 2010. This study is derived from the cohort COLAUS who started in Lausanne in 2003. The main goal of COLAUS is to obtain information on the epidemiology and genetic determinants of cardiovascular risk in 6700 men and women. CRF for OP, bone ultrasound of the heel, lumbar spine and hip BMD, VFA by DXA and MA evaluation by TBS are recorded in OsteoLaus. Preliminary results are reported. We included 631 women: mean age 67.4 ± 6.7 years, BMI 26.1 ± 4.6, mean lumbar spine BMD 0.943 ± 0.168 (T-score − 1.4 SD), and TBS 1.271 ± 0.103. As expected, correlation between BMD and site matched TBS is low (r2 = 0.16). Prevalence of VFx grade 2/3, major OP Fx and all OP Fx is 8.4%, 17.0% and 26.0% respectively. Age- and BMI-adjusted ORs (per SD decrease) are 1.8 (1.2-2.5), 1.6 (1.2-2.1), and 1.3 (1.1-1.6) for BMD for the different categories of fractures and 2.0 (1.4-3.0), 1.9 (1.4-2.5), and 1.4 (1.1-1.7) for TBS respectively. Only 32 to 37% of women with OP Fx have a BMD < − 2.5 SD or a TBS < 1.200. If we combine a BMD < − 2.5 SD or a TBS < 1.200, 54 to 60% of women with an osteoporotic Fx are identified. As in the already published studies, these preliminary results confirm the partial independence between BMD and TBS. More importantly, a combination of TBS subsequent to BMD increases significantly the identification of women with prevalent OP Fx which would have been misclassified by BMD alone. For the first time we are able to have complementary information about fracture (VFA), density (BMD), micro- and macro architecture (TBS and HAS) from a simple, low ionizing radiation and cheap device: DXA. Such complementary information is very useful for the patient in the daily practice and moreover will likely have an impact on cost effectiveness analysis.

Incidence and outcome of progressive multifocal leukoencephalopathy over 20 years of the Swiss HIV Cohort Study.

BACKGROUND: We investigated the incidence and outcome of progressive multifocal leukoencephalopathy (PML) in human immunodeficiency virus (HIV)-infected individuals before and after the introduction of combination antiretroviral therapy (cART) in 1996. METHODS: From 1988 through 2007, 226 cases of PML were reported to the Swiss HIV Cohort Study. By chart review, we confirmed 186 cases and recorded all-cause and PML-attributable mortality. For the survival analysis, 25 patients with postmortem diagnosis and 2 without CD4+ T cell counts were excluded, leaving a total of 159 patients (89 before 1996 and 70 during 1996-2007). RESULTS: The incidence rate of PML decreased from 0.24 cases per 100 patient-years (PY; 95% confidence interval [CI], 0.20-0.29 cases per 100 PY) before 1996 to 0.06 cases per 100 PY (95% CI, 0.04-0.10 cases per 100 PY) from 1996 onward. Patients who received a diagnosis before 1996 had a higher frequency of prior acquired immunodeficiency syndrome-defining conditions (P = .007) but similar CD4+ T cell counts (60 vs. 71 cells/microL; P = .25), compared with patients who received a diagnosis during 1996 or thereafter. The median time to PML-attributable death was 71 days (interquartile range, 44-140 days), compared with 90 days (interquartile range, 54-313 days) for all-cause mortality. The PML-attributable 1-year mortality rate decreased from 82.3 cases per 100 PY (95% CI, 58.8-115.1 cases per 100 PY) during the pre-cART era to 37.6 cases per 100 PY (95% CI, 23.4.-60.5 cases per 100 PY) during the cART era. In multivariate models, cART was the only factor associated with lower PML-attributable mortality (hazard ratio, 0.18; 95% CI, 0.07-0.50; P < .001), whereas all-cause mortality was associated with baseline CD4+ T cell count (hazard ratio per increase of 100 cells/microL, 0.52; 95% CI, 0.32-0.85; P = .010) and cART use (hazard ratio, 0.37; 95% CI, 0.19-0.75; P = .006). CONCLUSIONS: cART reduced the incidence and PML-attributable 1-year mortality, regardless of baseline CD4+ T cell count, whereas overall mortality was dependent on cART use and baseline CD4+ T cell count.

[Loi n° 49-1097 du 2 août 1949. Décrets n° 50783 du 24 juin 1950, du Ministre des Finances et des affaires économiques.]

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Efeito anestésico do eugenol em juvenis de pacamã

O objetivo deste trabalho foi avaliar o efeito do eugenol como anestésico para juvenis de pacamã (Lophiosilurus alexandri). Os animais foram divididos em dois grupos, denominados juvenil I (0,72 g) e juvenil II (7,44 g), e submetidos a seis tratamentos de eugenol (20, 40, 60, 80, 100 e 120 mg L-1), em dez repetições. Durante o experimento, foram realizadas biometrias e cronometragens dos tempos de indução e recuperação. Com o aumento das doses, o tempo de anestesia foi reduzido de 69 para 27 s, em juvenis I, e de 93,8 para 37,3 s em juvenis II. A sobrevivência foi de 100%.

Biologia e tabela de vida de fertilidade da broca-do-morangueiro criada em dieta artificial

O objetivo deste trabalho foi determinar os parâmetros biológicos e a tabela de vida de fertilidade da broca-do-morangueiro (Lobiopa insularis) criada em dieta artificial à base de frutos de morangueiro, em condições de laboratório. A duração e a viabilidade média dos períodos embrionário, larval, pupal e ovo-adulto foram de: 4,1±1,5 dias e 80,6%; 22,2±5,0 dias e 60%; 10,8±2,3 dias e 90%; e 37,1±8,8 dias e 43,5%, respectivamente. Os períodos de pré-oviposição, oviposição e pós-oviposição foram de 96±18,9, 133±27,5 e 77±16,3 dias. A longevidade de machos (271±20,7 dias) foi menor do que a de fêmeas (318±14,9 dias). Há potencial de utilização de dieta artificial à base de morangos para a multiplicação da broca-do-morangueiro em laboratório.

Baerveldt implant in refractory glaucoma: long-term results and factors influencing outcome.

PURPOSE: To evaluate the clinical outcome of patients who received a Baerveldt implant for refractory glaucoma and to identify factors which may influence the outcome. METHODS: Retrospective study including 51 eyes of 51 patients with medically uncontrolled glaucoma who underwent Baerveldt implant surgery between June 1994 and December 1998. Criteria for success were intraocular pressure (IOP) < or = 21 mmHg and > 6 mmHg, necessity of further antiglaucoma medications, absence of additional glaucoma surgery and no loss of light perception. RESULTS: Over a mean follow-up of 37.6 (SD: +/-18.8) months, the mean intraocular pressure decreased from 34.8 (+/-12.5) mmHg to 14.0 (+/-4.3) mmHg at month 60. Qualified success rate, achieved when IOP was below 21 mmHg and higher than 6 mmHg with medications was 25/48 (52%), complete success rate (same IOP limits without medication) was 14/48 (29%). Seven eyes had major complications or lost light perception. Postoperative visual acuity improved or remained within one Snellen line of the preoperative visual acuity in 35 patients (73%). Factors associated with a better prognosis were a preoperative visual acuity better than 20/400 and etiology of glaucoma. CONCLUSION: The Baerveldt implant is effective in lowering intraocular pressure in most patients with refractory glaucoma. Long-term results are promising with satisfactory IOP control.

Jäähdytykseen ja täyssuolanpoistoon perustuva lauhteen puhdistus soodakattilalaitoksella

Tämän diplomityön oleellisempana tavoitteena oli tutkia ioninvaihtohartsien pitkäaikaista toiminnallista lämpötilakestävyyttä kirjallisuustutkimuksin ja kuormituskokein. Lisaksi työssä optimoitiin taloudellisesti ja teknisesti paras kytkentävaihtoehto soodakattilan lauhteenpuhdistuslaitokselle. Tässä diplomityössä selvitettiin myös soodakattilan ulospuhallusveden sisältämien veden jälkiannostelukemikaalien ja epäpuhtauksien vaikutusta ioninvaihtohartsien vanhenemiseen.; Ioninvaihtohartsien lämpötilakestävyyteen liittyvät koeajot suoritettiin Stora Enso Laminating Papers Oy Kotkan tehtaalla. Koeajoja varten oli erikseen suunniteltu koeajolaitteisto, jossa lauhdenäytettä puhdistettiin patruunasuotimella ja sekavaihtimella. Sekavaihtimessa käytettiin vahvoja anioni- ja kationihartseja. Koeajoja oli yhteensä neljäkappaletta ja niissä tutkittiin hartsien lämpötilakestävyyttä ja anionihartsin silikaatti-vuodon riippuvuutta lämpötilasta. Lämpötilakestävyyskoeajoissa käytetyt hartsit lähetettiin Rohm and Haasille analysoitavaksi. Lopulta koeajojen tuloksia verrattiin kirjallisuudessa esitettyihin aikaisempiin tutkimuksiin. Lauhteenpuhdistuslaitoksen kytkentävaihtoehtojen optimoinnissa käytettiin apuna Kotkan ja UPM-Kymmene Oyj Pietarsaaren tehtaiden kokemuksia. Kytkentävaihtoehtojen energiataseet laskettiin kuudelle eri laitokselle, joiden syöttöveden virtaukset olivat 37 -180 kg/s. Lisaksi selvitettiin kytkentävaihtoehtojen investointikustannukset ja kertakäyttöhartsien vuotuiset kustannukset laitokselle, jossa syöttöveden virtaus oli 67 kg/s. Ulospuhalluksen talteenottojärjestelmän energiataseet laskettiin kuudelle eri laitokselle, joiden syöttöveden virtaukset olivat 37 - 180 kg/s. Laskelmien lähtökohtana käytettiin kunkin soodakattilan ulospuhallusveden määriä, jotka selvitettiin tehdasvierailujen yhteydessä. Ulospuhallusveden epäpuhtauksien ja jälkiannostelukemikaalien pitoisuudet arvioitiin kattilaveden perusteella. Aikaisempien kokemusten perusteella arvioitiin, että ulospuhallusvesi johdettaisiin lisäveden valmistukseen ennen suolanpoistosarjoja. loninvaihtohartsien kuormituskokeiden ja kirjallisuustutkimusten perusteella oli selkeästi nähtävissä, että etenkin anionihartsin kapasiteetti heikkeni nopeasti lämpötilan ollessa yli 60 °C. Kationihartsin suolanpoistolle kriittinen lämpötilaraja on 100 °C.Lisäksi yli 60 °C:ssa anionihartsi ei pysty poistamaan silikaattia lauhteesta. Seuraavaksi on esitelty lauhteenpuhdistuslaitoksen optimikytkentävaihtoehdot sekä vanhoille että uusille laitoksille. Vanhalle laitokselle, jossa lauhteet on puhdistettu aikaisemmin mekaanisella suotimella ja lisäveden puhdistuksessa on käytetty sekavaihdinta, paras kytkentävaihto on erilliset sekavaihtimet lauhteelle ja lisävedelle. Uudelle ja vanhalle laitokselle, jossa lauhteet on puhdistettu aikaisemmin mekaanisella suotimella ja lisäveden puhdistuksessa ei ole käytetty sekavaihdinta, paras kytkentävaihto on yhteiset sekavaihtimet lauhteelle ja lisävedelle. Lauhteen puhdistuksessa käytetyt sekavaihtimen toimintalämpötila on 45 °C molemmissa kytkentävaihtoehdoissa. Kertakäyttöhartsien käyttö osoittautui suuressa mittakaavassa kannattamattomaksi. Tämä asia tarvinnee kuitenkin jatkotutkimuksia. Ulospuhallusveden talteenotolla saadaan energiasäästöä 6-53 k¤/a riippuenlaitoksesta. Etenkin soodakattilalaitoksissa, joissa soodakattila ja vedenkäsittelylaitos sijaitsevat lähellä toisiaan, kannattaa ulospuhallusvesi johtaa lisäveden valmistukseen. Jos edellä mainittujen laitosten etäisyydet kasvavat, saattavat ulospuhallusjärjestelmän investointi-kustannukset nousta kohtuuttoman suureksi. Tämä työ osoitti myös, että ulospuhallusveden epäpuhtauksilla ei ole merkittävää vaikutusta kemiallisesti puhdistetun veden laatuun ennen suolanpoistolaitosta ja ioninvaihtohartsien vanhenemiseen.