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Children’s language skills can be evaluated by formal testing, parent report or assessing spontaneous speech in recorded language samples. This study focused on measures of lexical diversity determined from children’s spontaneous speech. These measures are one way to assess children’s lexical skills. However, there is only little research on the relation between the most recent lexical diversity measures and validated measures of lexical skills. The first aim of this study was to find out if there is a relation between the lexical diversity assessed from spontaneous speech of preschool children and lexical skills assessed by validated methods. The second aim was to examine if the measures of lexical diversity predict the lexical skills of a child assessed by validated measures and if so, which of the measures is the best predictor of a child’s lexical skills. The data of the study was collected in LEINIKKI research project. The participants (N = 68) were 2;6–4;0-year-old, healthy, Finnish-speaking children. The spontaneous speech of the participants was recorded in free play settings, the speech of the children was transcribed and token, type, type-token ratio (TTR) and moving-average type-token ratio (MATTR) values were determined from the first ten minutes of each language sample. These values were used as measures of the children’s lexical diversity. The following validated methods were used to assess the children’s lexical skills: the lexical skills assessing part of the parent report method LEINIKKI and Wechsler Preschool and Primary Scale of Intelligence 3rd edition subtests Picture Naming and Receptive Vocabulary. The relation between the lexical diversity measures and the validated measures of lexical skills was examined by Spearman’s correlation. It was also researched if the measures of lexical diversity had the ability to differentiate the children who scored the least in the validated lexical measures. Linear regression models were used in examining whether the measures of lexical diversity predicted the lexical skills assessed by validated methods when the age of the children was considered as a background variable. The token values neither correlated with the children’s lexical skills nor differentiated the least scoring quarter in the validated lexical measures. The type and TTR values correlated significantly (p < 0,05) with two out of three validated measures of lexical skills but were not statistically significant predictors of the children’s lexical skills. The type value did not differentiate the least scoring quarter in the validated lexical measures whereas the TTR value did in two out of three validated lexical measures. The relation of the MATTR value to a child’s lexical skills was the most significant: the MATTR value correlated highly significantly (p < 0,001) with all validated measures of lexical skills, differentiated the least scoring quarter in all three validated lexical measures and was a highly significant (p < 0,001) predictor of lexical skills in all regression models. This study supports the use of the MATTR value instead of the more traditional measures of lexical diversity when assessing the lexical diversity of preschool children. The MATTR value can be used especially in supplementing the view of a child’s lexical skills acquired by other measures. However, more research on the topic is needed.

Objectives The study aimed to determine the costs of short-term (1 to 14 days) sickness absence of the employees to the employer and the impact of employees' physical activity on the costs. Methods The Helsinki Health Study follow-up survey made in 2007, including 3935 employees, was used in the analysis. Physical activity was based on the questionnaire data and classified into inactive, moderately active and vigorously active. Sickness absence and salary data were derived from the employer's registers. The follow-up for sickness absence was three years. The effect of physical activity on the cost of absence was analyzed with a two-part model. Results On average, an employee was absent six days a year due to short-term sickness absence, with a production loss of 2350 EUR in / during the three years. The vigorously active were less likely to have sickness absences and their absence spells were shorter than those in the less active groups. The production loss of a vigorously active employee was 404 EUR less than of an inactive employee. The average annual salary varied according to employees' physical activity, with higher physical activity associated to higher salary. Conclusions Production loss is associated with physical activity. Increasing employees' physical activity would decrease production loss. Studies on the cost of sickness absence should be based on individual level salary data as using an industry or occupational average proxy measure does not account for salary differences among different level of physical activity.

Large granular lymphocytic (LGL) leukemia is a rare form of chronic lymphocytic leukemia, that is characterized by clonal expansion of mature cytotoxic T- or natural killer (NK)- cells. As the white cell count in patients is predominantly not distinguishably altered, it often goes underdiagnosed or is diagnosed accidentally. T lymphocytic LGL leukemia (T-LGLL), that makes up 85% of all LGL leukemia (LGLL) cases is characterized by a prolonged expansion of peripheral blood T-lymphocytes, mostly CD8+ lymphocytes. 40 % of T-LGLL patients harbor mutations in the Signal Transducer and Activator of Transcription 3 (STAT3) gene. Y640F mutation of STAT3 (STAT3 Y640F) is the most commonly occurring alteration, present in approximately 17% of all T-LGLL patients, and 42% of patients that bear a mutation in STAT3. Furthermore, a higher prevalence of rheumatoid arthritis (RA) can be observed in patients with mutated STAT3 (26% vs 6%, p=0.02). As T-LGLL patients with the Y640F mutation have a higher incidence of co-occurring RA, we aimed to understand the possible role CD8+ T-cell clones carrying somatic mutation of STAT3 may play in the autoimmune process. We applied lentiviral vectors to express STAT3 wild type (wt) and STAT3 Y640F in murine and human CD8+ T cells. We were able to show their successful integration into the host genome using droplet digital PCR (ddPCR). ddPCR showed high selectivity in its ability to differentiate between the hosts’ gDNA and virally inserted cDNA. The custom-designed probes showed high specificity for either STAT3 wt or STAT3 Y640F, proving the functionality of the assay. Sensitivity studies provided us with accurate quantification even with the presence of STAT3 wt or STAT3 Y640F cDNA under 1%, displaying successful detection of rare variants in low concentration samples. In our expression studies, using Flow cytometry and Western Blotting (WB), we detected a modest rise in STAT3 expression in the virally transduced CD8+ cells. We hypothesized that the CD8+ cells were successfully transduced, but unable to accommodate sufficient STAT3 expression.To determine the role of Y640F mutation in the migration of CD8+ lymphocytes in different tissues in vivo, we injected lentivirally transduced cells, mixed in a 1:1 ratio (wt:mut), into the mice. Unfortunately, our ddPCR method was not sensitive enough to reliably quantitate the transduced cells in the diverse tissue samples. Consequently, we decided that any further mouse experiments cannot be justified. In conclusion, we present successful integration of lentivirally expressed wt and mutant STAT3 in both human and mouse primary CD8+ T lymphocytes and human peripheral blood mononuclear cells. The successfully constructed and optimized ddPCR assay was not, however sensitive enough for in vivo quantification of the transduced cells. As the lentivirally mediated expression of STAT3 variants was low, new approaches and tools are needed to study the role of STAT3 mutated T cells in the pathogenesis of RA.

Leukaluun osteomyeliitti on harvinainen sairaus, jolla katsotaan olevan kaksi pääasiallista etiologialtaan toisistaan eroavaa muotoa: leukaluun bakterielli osteomyeliitti ja leukaluun autoinflammatorinen osteomyeliitti. Ensimmäisen aiheuttaa bakteerin invaasio luuhun, esimerkiksi hammasperäisen infektion seurauksena. Jälkimmäisessä on kyse steriilistä luupesäkkeestä ja autoinflammatorisesta reaktiosta, jonka käynnistymisen syy on toistaiseksi tuntematon. Leukaluun kroonisen bakteriellin osteomyeliitin ja leukaluun kroonisen autoinflammatorisen osteomyeliitin kliiniset oireet sekä luutulehduspesäkkeen radiologinen näkymä muistuttavat toisiaan. Tämä tekee diagnostiikasta haastavaa ja siksi tällä hetkellä krooninen, ei bakteeriperäinen osteomyeliitti tunnistetaan huonosti. Potilaalle oikean diagnoosin ja hoidon saaminen voi kestää vuosia. Tutkimuksen tavoitteena oli helpottaa ja nopeuttaa leukaluun autoinflammatorisen osteomyeliitin diagnostiikkaa. Tutkimus toteutettiin analysoimalla potilasaineisto, johon sisältyi HUS Pää- ja kaulakeskuksen suu- ja leukasairauksien linjassa diagnosoidut leukaluun osteomyeliittipotilaat vuosina 2008-2018. Tutkimuskriteerit täytti 77 potilasta. Tutkimuksen ulkopuolelle jätettiin osteoradionekroosia sekä bisfosfonaattien aiheuttamaa osteomyeliittiä sairastavat potilaat. Tutkimuksen tulosten perusteella voidaan päätellä, että potilaan iän, oireiden, löydösten ja mahdollisten osteomyeliitille altistavien tekijöiden tunnistamisen perusteella voidaan arvioida melko luotettavasti, onko potilaan osteomyeliitti bakterielli vai autoinflammatorinen. Bakteeriviljely luunäytteistä tulee tehdä mahdollisimman aseptisella tekniikalla, jotta mahdollinen sylki- tai ihokontaminaatio voidaan välttää. Myös mikrobilöydösten oikea tulkinta ja erityisesti näytekontaminaation mahdollisuuden huomioon ottaminen on tärkeää. Erityisesti epäily autoinflammatorisesta osteomyeliitista tulisi herätä, jos osteomyeliitti ei ole märkivä, sen taustalla ei ole hammasperäistä infektiota tai hampaan poistoa, oirejaksot ovat toistuvia, potilas on alle 20-vuotias tai potilas ei ole saanut mikrobilääkehoidolle vastetta, vaan oireet palaavat aina uudestaan mikrobilääkityksestä huolimatta.

Alveoliluun tiheys ja muoto ovat riippuvaisia siihen kohdistuvasta toiminnallisesta ärsykkeestä, joka välittyy leukaluuhun hampaiden purentavoimien kautta. Hampaiden menetys johtaa siten ennen pitkää alveoliluun atrofioitumiseen eli leveyden ja korkeuden menetykseen. Hammaspuutosten korvaamisessa voidaan käyttää hammasimplantteja, jotka ovat estetiikaltaan ja toiminnaltaan lähes oman hampaan veroisia. Hammasimplanttihoidon onnistumisen perustana on pidetty muun muassa riittävää kova- ja pehmytkudostukea, jotta implantin asettelu voidaan toteuttaa asianmukaisesti. Mikäli tämä ei toteudu, voidaan luutukea lisätä kirurgisin keinoin. Tämä syventävä tutkielma on kirjallisuuskatsaus, jonka tarkoituksena on käsitellä hampaan poiston vaikutuksia ympäröiviin kudoksiin, sekä ennen implantointia tai sen yhteydessä toteutettavia leukaluun augmentaatiotoimenpiteitä ja niissä käytettäviä leukaluusiirremateriaaleja. Tavoitteena on alan oppikirjallisuuteen ja tutkimusartikkeleihin perehtymällä tutkia ja vertailla eri augmentaatiotekniikoita ja materiaaleja, sekä selvittää millaisissa kliinisissä tilanteissa ja olosuhteissa niitä käytetään. Leukaluusiirremateriaalit jaotellaan omaluusiirteisiin, sekä niiden korvikkeisiin, jotka voivat olla ihmis- tai eläinperäistä materiaalia, tai kokonaan synteettisesti valmistettuja. Yleisesti omaluusiirteitä on pidetty ominaisuuksiltaan ihanteellisena luusiirremateriaalina leukaluun augmentaatioissa, mutta luumäärän rajallisuuden ja siirteen keräysalueella ilmenevien haittojen vuoksi on kehitetty erilaisia korvaavia materiaaleja vähentämään omaluusiirteiden tarvetta. Materiaalivalinnassa on otettava huomioon materiaalien ominaisuudet suhteutettuna käyttötarkoitukseen ja valittuun toimenpiteeseen.

Tämän tutkielman tarkoituksena on kartoittaa leukanivelartroosin eli leukanivelrikon diagnostiikkaa erilaisilla kuvantamisen modaliteeteilla, ja koostaa aiheesta kirjallisuuskatsaus. Tämän kirjallisuuskatsauksen painopiste on erityisesti leikekuvantamisessa, kartiokeilatietokonetomografiassa (KKTT) sekä magneettikuvauksessa. Pyrimme selvittämään, minkälaisia tekijöitä on artroosin taustalla, ja kuinka artroottinen leukanivel kuvautuu eri kuvantamismodaliteeteilla. Aineistona tutkimusta varten hyödynnettiin anatomian oppikirjojen lisäksi lääketieteellisiä ja hammaslääketieteellisiä tietokantoja, kuten Pudmedia sekä aihetta käsitteleviä tieteellisiä artikkeleita. Pubmedissa aineisto rajattiin vuoden 2010 jälkeen julkaistuihin artikkeleihin, tapausraportteihin sekä kuviin. Leukanivelartroosi on yksi purentaelimistön toimintahäiriöistä (TMD) ja yleisin leukanivelsairaus. Sen taustalla on jokin häiriötekijä, kuten palautumaton diskusdislokaatio, leukanivelen yliliikkuvuus tai poikkeava kuormitus. Artroosissa esiintyy leukanivelen nivelpinnoilla patologisia muutoksia, kuten litistymistä ja osteofyyttejä eli niin sanottuja luupiikkejä. Sairaus on luonteeltaan etenevä. PTG on yleisin kuvantamismodaliteetti, mutta tarvittaessa voidaan tapauskohtaisesti tutkimusta täydentää tarkentavilla KKTT- tai magneettikuvantamisilla. Ne ovat täten jatkotutkimuksia, eivätkä rutiininomainen osa hammaslääkärin tutkimuksia. KKTT:ssa lukuisista kaksiulotteisista röntgenkuvista muodostetaan kolmiulotteista kuvaa. Menetelmä soveltuu leukanivelen luisten komponenttien kuvantamiseen. Myös magneettikuvauksella saadaan kolmiulotteista kuvaa ja silläkin saadaan kohtuullinen kuva kovakudoksista, mutta sen erityinen etu verrattuna KKTT:aan on sen kyky kuvantaa pehmytkudoksia. Näin ollen magneettikuvaus sopii esimerkiksi leukanivelen rustoisen välilevyn (diskus) kuvantamiseen, mihin KKTT:n erotuskyky ei riitä.

Levottomien jalkojen oireyhtymä (RLS) on merkittävästi potilaiden elämänlaatuun vaikuttava neurologinen sairaus, jonka esiintyvyys länsimaissa on 4-29 %. Oireyhtymä on vahvasti periytyvä. Tutkielman tarkoituksena oli kartoittaa laajaa suomalaista sukua, jossa oireyhtymä on yleinen, sekä tarkastella suomalaisten RLS-potilaiden ominaisuuksia yleisesti. Lisäksi tutkielma toimii kirjallisuuskatsauksena levottomien jalkojen oireisiin diagnostiikkaan ja hoitoon. Yhteensä 29:ltä suomalaisen suvun jäseneltä kerättiin kyselylomakkein tietoa levottomien jalkojen oireista, muista uneen vaikuttavista tekijöistä ja elintavoista. Lisäksi analyyseihin sisällytettiin 140 muuta RLS-potilasta, joilta kerättiin vastaavat tiedot. Tutkimuksessa kartoitetussa suvussa merkittäviä levottomien jalkojen oireita oli 17 henkilöllä (59%), mikä sopii sairauden perinnölliseen luonteeseen. Vaikeusaste vaihteli kuitenkin huomattavasti. Toistimme myös aiempien tutkimusten havainnon, että unettomuus, nukahtamisvaikeudet, yöllinen heräily ja päiväväsymys ovat levottomista jaloista kärsivillä yleisiä.

Oral lichen planus and lichenoid lesions (OLP and OLL) are regarded as precursor lesions of oral squamous cell carcinoma (OSCC) with potential for malignant transformation. Our aim was to identify cancer-related etiological factors (such as alcohol consumption and smoking) and to pay special attention to previously identified OLP or OLL as precursor lesions in oral epidermoid cancer. We retrospectively reviewed all cases (total 323, comprising 164 females and 159 males) with OSCC treated at the Department of Oral and Maxillofacial Diseases and Surgery, Helsinki University Hospital during 2015. Confirmed by histopathological biopsy, 71 patients had OLP or OLL as precursor lesion. Patients with OLP or OLL were slightly older than those without them. OLP and OLL were more common in females than males. Cancer recurrences and TN class 1 tumors were more prevalent among patients with OLP and OLL as well. Interestingly, smoking and alcohol abuse were less frequent among OLL and OLP patients compared to other patients diagnosed by OSCC. Our findings confirm the importance of active follow-up of all patients with oral lichen planus (OLP) and oral lichenoid lesion (OLL) to detect the possible malignant transformation of these lesions.

Objectives. Autistic traits are normally distributed among general population and autism spectrum disorder can be thought to be in the other extreme end of the distribution. Preterm (<37 weeks) birth is a known risk factor for autism spectrum disorder and traits. Late preterm newborns (34+0 - 36+6) are the fastest growing subset of neonates worldwide. The majority of preterm births occur between these gestational weeks. Late preterm birth has been linked to autistic traits in toddlers but there is no current research on whether these traits persist into adulthood. This study examines whether late preterm birth is also associated with self-assessed autistic traits in adulthood. The study also examines whether the participant's birth weight relative to the length of gestation is a moderating factor for this association. Methods. The participants of this study are a part of the Arvo Ylppö Longitudinal Study follow-up cohort. The study sample comprised of 2193 infants whose gestational age was reliably specified and who filled in the Autism Spectrum Quotient (AQ) self report-questionaire. The final sample comprised of 684 participants of whom 90 were born late-preterm and 578 were born term. The effect of late-preterm birth to self-reported autistic traits was analyzed using linear regression models. Results and conclusions. Late preterm birth was not associated with increased risk of autistic traits in young adults. Neither was the relative birth weight a moderating factor for this association. More follow-up studies are needed to determine which are the specific factors contributing to autistic traits in specific age groups for different sub-categories of preterm birth. More information should be gathered about the potential confounding factors to determine which are the specific factors that may contribute to positive outcome.

Abstract Background: Pain is known to be socio-economically patterned and associated with disability. However, knowledge is scarce concerning life-course socio-economic circumstances and pain among young adults. Our aim was to examine the associations of childhood and current socio-economic circumstances with acute pain and chronic pain with low and high disability levels among young Finnish municipal employees. Methods: We analyzed questionnaire data retrieved from the Young Helsinki Health Study (n=4683) covering 18–39-year-old employees of the City of Helsinki, Finland. We included a comprehensive set of indicators of childhood and current socio-economic circumstances and examined their associations with acute pain and with chronic pain with low and high disability levels. The level of chronic pain–related disability was assessed by the Chronic Pain Grade Questionnaire. Multinomial logistic regression analyses were conducted with stepwise adjustments for socio-demographic, socio-economic and health-related covariates. Results: Childhood and current socio-economic disadvantage were associated with acute and chronic pain, particularly with chronic pain with high disability level. The strongest associations after adjustments for covariates remained between chronic pain with high disability level and low education level (OR 3.38, 95% CI 2.18–5.24), manual occupation (OR 3.75, 95% CI 1.92–7.34) and experiencing frequent economic difficulties (OR 3.07, 95% CI 2.00–4.70). Conclusions: Pain is highly prevalent already among young employees and there is a socio-economic gradient in both pain chronicity and chronic pain–related disability. Life-course socio-economic determinants of pain should be considered in pain-preventing strategies and in clinical practice.