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The present report describes exposure to respirable silica and dust in the construction industry, as well as means to manage them. The average exposure in studied work tasks ( n = 148) amounted to 64% of the Finnish OEL value of 0.05 mg/m 3 . While 10% of exposure estimates exceeded the OEL, the 60% percentile was well below 10% of the OEL, as was the median exposure. In other words, exposure was low in more than half of the tasks. Work tasks where exposure was low included construction cleaning, work management, installation of concrete elements, rebar laying, driving work machines equipped with cabin air intake filtration, and landscaping, in addition to some road construction tasks. Excessive exposure (>OEL) was related to not using respiratory protection at all or not using it for long enough after the dusty activity ceased. Excessive exposures were found in sandblasting, dismantling facade elements, diamond drilling, drilling hollow-core slabs, drilling with a drilling rig, priming of explosives, tiling, use of cabinless earthmoving machines, and jackhammering, regardless of whether the hammering took place in an underpressurized compartment or not. Even in these tasks, it was possible to perform the work safely, following good dust prevention measures and, when necessary, using respiratory protection suitable for the job. Furthermore, in all tasks with generally low exposure, one could be significantly exposed through the general air or by making poor choices in terms of dust control.

Objectives: To assess work-related exposure to tobacco smoke in Finnish restaurants, a series of nationwide questionnaire surveys were conducted among restaurant workers and the levels of indoor air nicotine concentrations were measured in restaurants. The survey aimed to evaluate the impact of the smoke-free legislation in general and in particular after the total smoking ban launched in 2007., Materials and Methods: In 2003-2010, four national questionnaire surveys were conducted among restaurant workers and the concentration of nicotine in indoor air was measured in different types of restaurants, bars and nightclubs., Results: Between 2003 and 2010, the proportion of restaurant workers reporting occupational exposure to tobacco smoke dropped from 59% to 11%. Among pub workers, the decrease was from 97% to 18% and in workers of dining restaurants from 49% to 10%, respectively. The median concentration of nicotine in indoor air of all restaurants decreased from 11.7 μg/m(3) to 0.1 μg/m(3). The most significant decrease was detected in pubs where the decrease was from 16.1 μg/m(3) to 0.1 μg/m(3). Among all restaurant workers, in 2003-2010 the prevalence of daily smokers was reduced from 39% to 31% in men and from 35% to 25% in women., Conclusion: Total prohibition of smoking but not partial restriction in restaurants was effective in reducing work-related exposure to tobacco smoke. Strict tobacco legislation may partly be associated with the significant decrease of daily smoking prevalence among restaurant workers.

During early adulthood, a phase in which the central nervous system displays considerable plasticity and in which important cognitive traits are shaped, the effects of exercise on cognition remain poorly understood. We performed a cohort study of all Swedish men born in 1950 through 1976 who were enlisted for military service at age 18 (N = 1,221,727). Of these, 268,496 were full-sibling pairs, 3,147 twin pairs, and 1,432 monozygotic twin pairs. Physical fitness and intelligence performance data were collected during conscription examinations and linked with other national databases for information on school achievement, socioeconomic status, and sibship. Relationships between cardiovascular fitness and intelligence at age 18 were evaluated by linear models in the total cohort and in subgroups of full-sibling pairs and twin pairs. Cardiovascular fitness, as measured by ergometer cycling, positively associated with intelligence after adjusting for relevant confounders (regression coefficient b = 0.172; 95% CI, 0.168-0.176). Similar results were obtained within monozygotic twin pairs. In contrast, muscle strength was not associated with cognitive performance. Cross-twin cross-trait analyses showed that the associations were primarily explained by individual specific, non-shared environmental influences (> or = 80%), whereas heritability explained < 15% of covariation. Cardiovascular fitness changes between age 15 and 18 y predicted cognitive performance at 18 y. Cox proportional-hazards models showed that cardiovascular fitness at age 18 y predicted educational achievements later in life. These data substantiate that physical exercise could be an important instrument for public health initiatives to optimize educational achievements, cognitive performance, as well as disease prevention at the society level.

Objectives: The Finnish Tobacco Act was amended on 1 March 2000 to include restrictions on smoking in restaurants and bars. To evaluate the effectiveness of the restrictions, environmental tobacco smoke (ETS) concentrations in restaurants and bars were measured prior and after the amended Act entered into force. The Act was enforced in stages so that all stages were effective on 1 July 2003. According to the Act, smoking is prohibited in all Finnish restaurants and bars with certain exceptions. Smoking may be allowed in establishments where the service area is not larger than 50 m(2) if the exposure of employees working there to ETS can be prevented. On premises with larger service area, smoking may be allowed on 50% of the service area, provided tobacco smoke does not spread into the area where smoking is prohibited. At bar counters or gambling tables smoking is not allowed, if the spreading of tobacco smoke cannot be restricted to the employee side of the counter. Therefore, according to the Act all areas where smoking is prohibited are to be smoke-free., Methods: Establishments with a serving area larger than 100 m(2) were selected for the present study. The evaluation both before and after the enforcement of the Act included the following: The ventilation rate was first measured in each establishment. Then 3-5 area samplers, depending on the layout, were placed in locations that best described the establishment and the working areas of the personnel. The measurements were performed twice at each establishment, during peak hours. The sample collection time was 4 h during which the guests and the cigarettes smoked were counted. The air samples were analysed for nicotine, 3-ethenylpyridine (3-EP) and total volatile organic compounds (TVOC) by thermodesorption-gas chromatography-mass spectrometry., Results: Altogether 20 restaurants and bars situated in three Finnish cities participated in the study out of which 16 participated during all four measurement periods. None of the establishments had introduced a total ban on smoking and they all had reserved only the smallest area allowed by the Finnish Tobacco Act as the smoke-free area. The measured geometric mean (GM) nicotine concentration in all participating establishments was 7.1 microg m(-3) before the amended act was in force and 7.3 microg m(-3) after all stages of the Act had been enforced. The GM concentration of nicotine in food and dining restaurants was 0.7 microg m(-3) before and 0.6 microg m(-3) after the enforcement of the Act, in bars and taverns the concentrations were 10.6 and 12.7 microg m(-3), and in discos and night-clubs 15.2 and 8.1 microg m(-3), respectively. The GM nicotine concentrations measured in the smoke-free sections varied between 2.9 and 3 microg m(-3). 3-EP concentrations measured correlated well with the nicotine concentrations and were approximately one-fifth of the nicotine concentrations. The measurements showed higher TVOC values in the smoking sections than in the smoke-free sections, but because there are many other sources of TVOC compounds in restaurants and bars TVOC cannot be regarded as a marker for ETS., Conclusions: The overall air nicotine concentration decreased in 10 out of the 18 establishments that participated in the study both before and after all stages of the amended Act had been in force. Structural changes or changes to the ventilation systems had been carried out in nine of these establishments, i.e. the smoke-free sections were actually non-smoking and were mainly separated from other sections by signs and very little was done to keep the smoke from spreading into the smoke-free sections. In four establishments, the highest air nicotine concentration was measured in the smoke-free section. In 10 establishments, the air nicotine concentration at bar counters had dropped after the Act. Exposure of the workers and the public to ETS was, therefore, not reduced as intended by the Finnish legislature. Thus, it seems obvious from the present study that improving ventilation will not be a solution to restricting tobacco smoke from reaching smoke-free areas and physical barriers separating smoking from smoke-free areas are required.

The objectives of this study were to identify and describe the demographics and social conditions as well as characteristics of the places of death in a randomly selected sample that died in a county in Sweden during 2001. The present study reports part of the findings from a larger study undertaken during 2003 using a survey design of retrospective reviews of death certificates, medical records, and nursing records. Among several noteworthy findings are: first, an examination of these individuals' living arrangements reveal not only a large and vulnerable group that lives alone at the end-of-life but also a group living separated from their partners near end-of-life; second, individuals differ with respect to residence prior to death, that is private homes versus residential care facilities, imparting highly different contexts of care at the end-of-life; and third, a high prevalence of institutionalized deaths demonstrates that places of death other than hospitals and residential care facilities are uncommon, if not rare. It is concluded that increased attention to the social circumstances of the time period surrounding individuals' at the end-of-life is essential. There is need to develop more integrated models of care for dying people. Contemporary services available are not designed to meet a wide range of peoples' needs at the end-of-life. Home-based care, residential care and hospital care must be adapted to the changing patterns of dying. The services available should be organized to the benefit of the users rather than around the providers. This is the first study of its kind of a Swedish sample and while the data are limited to one county in Sweden its findings may contribute to a deeper understanding of demographic and social patterns at the end-of-life in general.

Background: Environmental tobacco smoke (ETS) exposure levels in different restaurant types in Finland were assessed before the National Tobacco Act restricting smoking in restaurants was activated., Methods: Exposure to ETS was determined by measuring nicotine in the breathing zone of non-smoking restaurant workers and by quantification of the nicotine metabolites cotinine and 3-hydroxycotinine in the urine of these workers during one whole work week. Altogether 23 workers from 15 restaurants were included in the study., Results: The geometric mean (GM) breathing-zone nicotine level was 3.9 microg/m(3) (3.7 microg/m(3) in pubs, 1.4 microg/m(3) in dining restaurants, and 10.2 microg/m(3) in nightclubs). The GM cotinine and trans-3'-hydroxycotinine level in urine were 3.3 ng/mg((creatinine)) and 15.3 ng/mg((creatinine)), respectively. The exposure to ETS of restaurant workers in dining restaurants was clearly lower than that of workers in pubs and nightclubs as indicated by all ETS-markers used in the present study. During the work week, the cotinine and 3'-hydroxycotinine levels in urine of the study subjects increased. The correlation between breathing zone nicotine and urine cotinine and hydroxycotinine was 0.66 for both compounds. Post-shift cotinine and hydroxycotinine levels were not significantly higher than the pre-shift levels., Conclusions: If 9 ng cotinine/mg((creatinine)) is considered as the level above which heavy exposure has occurred, then this level was exceeded by 14 (approximately 60%) subjects at least once during the work week. Nicotine metabolite concentrations in the urine increased during the work week in 80% of the subjects, and the increase was especially noticeable for subjects working in both pubs and nightclubs. The study indicates that measures to restrict ETS exposure in restaurants are needed., (Copyright 2003 Wiley-Liss, Inc.)

A method is described for the simultaneous determination of common aflatoxins (G1, G2, B1, B2) and their precursor sterigmatocystin, and also citrinine and ochratoxin A. The method was applied to a building material matrix artificially contaminated with mycotoxin-producing fungi. The method includes extraction, sample pre-treatment and reversed-phase HPLC separation with tandem mass spectrometric identification and quantification using electrospray ionisation on a quadrupole ion trap mass analyser (ESI-MS-MS). Aqueous methanol was used in the initial extraction and solvent partitioning and solid phase extraction in the purification of samples. The HPLC separation was run on-line with the ESI-MS-MS detection. The limit of quantification of the procedure was 200 ng for all compounds. Recoveries of the sample pre-treatment varied from 28 to 99%. The average compound- and concentration-dependent accuracy and precision (RSD) were 21 and 113%, respectively. The method includes small sample volumes (approximately 1 g in 20 ml) and few, non-labour intensive, sample treatment steps. It should allow for a high throughput of samples with good prospects of automation.

Insufficient efficacy and/or specificity of antisense oligonucleotides limit their in vivo usefulness. We demonstrate here that a high-affinity DNA analog, locked nucleic acid (LNA), confers several desired properties to antisense agents. Unlike DNA, LNA/DNA copolymers were not degraded readily in blood serum and cell extracts. However, like DNA, the LNA/DNA copolymers were capable of activating RNase H, an important antisense mechanism of action. In contrast to phosphorothioate-containing oligonucleotides, isosequential LNA analogs did not cause detectable toxic reactions in rat brain. LNA/DNA copolymers exhibited potent antisense activity on assay systems as disparate as a G-protein-coupled receptor in living rat brain and an Escherichia coli reporter gene. LNA-containing oligonucleotides will likely be useful for many antisense applications.

We analyzed 79 bulk samples of moldy interior finishes from Finnish buildings with moisture problems for 17 mycotoxins, as well as for fungi that could be isolated using one medium and one set of growth conditions. We found the aflatoxin precursor, sterigmatocystin, in 24% of the samples and trichothecenes in 19% of the samples. Trichothecenes found included satratoxin G or H in five samples; diacetoxyscirpenol in five samples; and 3-acetyl-deoxynivalenol, deoxynivalenol, verrucarol, or T-2-tetraol in an additional five samples. Citrinine was found in three samples. Aspergillus versicolor was present in most sterigmatocystin-containing samples, and Stachybotrys spp. were present in the samples where satratoxins were found. In many cases, however, the presence of fungi thought to produce the mycotoxins was not correlated with the presence of the expected compounds. However, when mycotoxins were found, some toxigenic fungi usually were present, even if the species originally responsible for producing the mycotoxin was not isolated. We conclude that the identification and enumeration of fungal species present in bulk materials are important to verify the severity of mold damage but that chemical analyses are necessary if the goal is to establish the presence of mycotoxins in moldy materials.

Background: A method is described for the simultaneous analysis of nicotine and two of its major metabolites, cotinine and 3-hydroxycotinine, as well as for caffeine from urine samples. The method was developed to assess exposure of restaurant and hotel workers to environmental tobacco smoke., Methods: The method includes sample pretreatment and reversed-phase HPLC separation with tandem mass spectrometric identification and quantification using electrospray ionization on a quadrupole ion trap mass analyzer. Sample pretreatment followed standard protocols, including addition of base before liquid-liquid partitioning against dichloromethane on a solid matrix, evaporation of the organic solvent using gaseous nitrogen, and transferring to HPLC vials using HPLC buffer. HPLC separation was run on-line with the electrospray ionization-tandem mass spectrometric detection., Results: The detection limits of the procedure were in the 1 microg/L range, except for nicotine (10 microg/L of urine). Still lower detection limits can be achieved with larger sample volumes. Recoveries of the sample treatment varied from 99% (cotinine) to 78% (3-hydroxycotinine)., Conclusions: The method described is straightforward and not labor-intensive and, therefore, permits a high throughput of samples with excellent prospects for automation. The applicability of the method was demonstrated in a small-scale study on restaurant employees.

5-Lipoxygenase (EC 1.13.11.34) is the key enzyme in the regulation of leukotriene synthesis. Here, the effects of various substituted nitrobenzene compounds on 5-lipoxygenase activity and the formation of leukotriene B4 (LTB4) were studied in polymorphonuclear leukocytes (PMNL), B lymphocytes, and human whole blood. 1-Chloro-2,4,6-trinitrobenzene (TNCB) was found to inhibit calcium ionophore A23187-induced leukotriene synthesis in PMNL in a biphasic manner. Thus, 1.0 microM TNCB caused 50% inhibition of LTB4 formation, but only 16% inhibition was found at 10 times higher concentration. In contrast, this higher concentration of TNCB activated the synthesis of LTB4 when PMNL were stimulated with arachidonic acid alone, demonstrating that TNCB can exert both stimulatory and inhibitory effects on leukotriene synthesis depending on the experimental conditions. The inhibitory effect of 1.0 microM TNCB on ionophore A23187-induced leukotriene synthesis could be circumvented by addition of exogenous arachidonic acid. At high concentrations of TNCB (25-100 microM), the drug blocked ionophore A23187-induced leukotriene synthesis. TNCB also inhibited LTB4 formation in B lymphocytes, as well as in human whole blood. The activity of recombinant 5-lipoxygenase was inhibited by TNCB, and reduced glutathione or beta-mercaptoethanol counteracted this inhibition. This suggests that TNCB might inhibit 5-lipoxygenase by alkylating thiol groups. TNCB possessed a high specificity for 5-lipoxygenase with only modest inhibitory effects on 12-lipoxygenase (EC 1.13.11.31), 15-lipoxygenase (EC 1.13.11.12), and phospholipase A2 (EC 3.1.1.4) activities. Taken together, these results show that TNCB can both specifically inhibit and stimulate leukotriene formation and might be useful in further studies on the regulation of 5-lipoxygenase.

The purpose of this investigation was to examine the effect of the surface macrostructure of a dimpled commercially pure titanium (cp Ti) implant on bone ingrowth in vivo by means of histological examination and a push-out test. Cylindrical implants were inserted in one femur of each experimental rabbit and the animals were killed at 1.5, 3 and 13 months after implantation. The femur with the implant of each animal was then examined in a push-out test. The fracture surfaces of the bone-implant interface after the push-out test were examined under light and electron microscopy. It seems that the dimpled cp Ti surface results in the increased retention of the cp Ti implant in bone due to interlocking between vital bone and the dimples.

The aim of the present study was to compare registered data of caries prevalence and incidence from cross-sectional studies of specified age groups with the corresponding caries data from cohorts of individuals receiving dental health service from the same dental clinic during the years studied. The study covered two 15-19-year groups, who had been offered complete dental care from three years of age in the City of Göteborg for the time periods 1986/7-1990/1. When compared, the longitudinal cohort attempts often gave statistically significant different values to those of the cross-sectional year classes, which should be considered when presenting caries index mean values in dental health reviews. It is not indifferent to choose between longitudinal cohort and cross-sectional year class attempts when searching for dental health treatment effects. Due to the advantages of using longitudinal cohort study methods, and with regard to the differences of the study design used, as pointed out in the study, the use of longitudinal cohort patient material, extracted from cross-sectional epidemiological data bases, could favour analysis of the effects of different preventive dental care programs.

Cellular fatty acids of 10 strains of lactic acid bacteria were analyzed. The purpose of this work was to find lactic acid bacteria with high lactobacillic acid contents. The bacteria studied were unable to synthesize oleic acid. Some strains did not synthesize lactobacillic acid, although all were able to form dihydrosterculic acid. Twenty-one to thirty-four percent of the fatty acid content of Lactobacillus fermentum and L. buchneri was lactobacillic acid, and these species were chosen for future studies of environmental factors affecting cyclopropane fatty acid synthesis.

The aim of this study was to investigate the accuracy of 17 forensic odontologists identifying individuals from two sets of radiographs, one regarded as ante- and the other as postmortem. Each case was observed twice and only one pair out of 31 did not match. The observers were asked to comment about each case, classifying it as easy, moderate or difficult. The results show that one observer was totally correct in the first analysis while four observers made no errors the second time. In the first evaluation 14 observers made between one and seven errors and two observers made 11 errors each. In the second evaluation 12 observers made between one and seven errors and one observer made 13 errors. At the first evaluation, the observers judged 18 of the cases as easy, eight as medium and five as difficult. At the second evaluation, the observers pronounced 13 of the cases as easy, 13 as medium and five as difficult. The corresponding values for the authors were 6, 12 and 13. Most of the mistakes were made on the cases with no restorations and the incorrect answers were found mostly among the difficult cases. In practical forensic work however additional dental chart information is usually available to the forensic odontologist.

The aim of the present study was (i) to identify the 10 approximal tooth sites that provide Extent and Severity estimates of clinical attachment loss which are maximally coherent to the full mouth scores, and (ii) to evaluate the applicability of such a partial recording system. Data from two subject samples, comprising 192 subjects aged 30-64 yr (sample A) and 175 subjects aged 35-80 yr (sample B), were involved in the development and the evaluation of the system, respectively. Approximal probing attachment loss (PAL) measurements were available from all subjects. A PAL value of > 1 mm was required for a tooth site in order to qualify for the Extent and Severity computations. A full mouth bivariate Extent and Severity Index (FESI) was firstly calculated for every subject in sample A. Multiple regression models applied on data derived from the same sample identified the 10 approximal tooth sites which provided the best correlation to the full-mouth scores (correlation coefficients between partial and full mouth scorings of Extent and Severity 0.85 and 0.88, respectively). All tooth types were found to be represented in this set of sites and the ratio of mesial/distal sites was 6/4. The applicability of a partial recording system (PESI) based on these sites was evaluated in sample B. Fully comparable estimates between PESI and FESI values were obtained, but the degree of correlation varied at different ages. Further adjustments by means of regression models failed to increase the validity and reliability of the PESI.(ABSTRACT TRUNCATED AT 250 WORDS)

By using a modified stepwise regression analysis technique, the structure of self-perceived handicap and tinnitus annoyance in 89 males with noise-induced hearing loss was described. Handicap was related to three clusters of variables, reflecting individual, environmental, and socioeconomic aspects, and 60% of the variance in self-perceived handicap was explained by the representatives of these clusters: i.e. 'acceptance of hearing problems', 'social support related to tinnitus' and 'years of education'. Tinnitus had no impact of its own on self-perceived handicap and only a modest portion (36%) of the variance in tinnitus annoyance was explained by 'sleep disturbance' and 'auditory perceptual difficulties'.

In dentistry, there is a need for better understanding of the distribution of the time spent on different activities at dental clinics. In order to investigate these resource aspects, both for the total time and for various categories of personnel and/or patients in dental clinics at the Public Dental Service (PD), Göteborg, Sweden, a time study method was used. The present study reports on the development of the PD's time study method (TSM) and analyses its functionality. The TSM, based on formulated criteria, used a method for an observer-monitored counting of frequencies. Specially trained observers registered the sampled observations for each professional, using a separate code list for each personnel group to which the professional belonged. The observer registered the on-going activity, not the duration of the procedure. Each observer followed several persons working in separated areas of the dental clinic. In 1989, the TSM was tested with the purpose of obtaining mean time values for dental care activities in the PD clinics performing general dental care. This study comprised all personnel categories in the clinic teams. Clinics were randomly selected and stratified according to the amount of dentistry for children in relation to the total time for dental care, reported as the parameter "dentist hours". Eight out of a total of 36 clinics were randomized, two from each strata.(ABSTRACT TRUNCATED AT 250 WORDS)

The purpose of the present study was to develop a partial recording system based on the principles of the Extent and Severity Index, aiming at describing the degree of radiographic alveolar bone loss on a population level. The data analyzed were derived from a subject sample comprising 531 individuals aged 25-75 yr. In these subjects alveolar bone level (ABL) was radiographically assessed at all approximal tooth surfaces. An ABL value of greater than 2 mm was required for a tooth site to be included in the computation of a full mouth bivariate Extent and Severity Index (FESI). A partial recording index (PESI-2) based on 18 ad hoc selected tooth sites depicted in one periapical and one vertical bitewing radiograph was evaluated in comparison with the FESI as well as with partial recording indices based on the 9 and 18 tooth sites which displayed the highest correlation with full mouth scores (PESI-9 and PESI-18, respectively). It was shown that all three partial recording systems generated values reasonably close to the full-mouth scores. However, the fitness of all partial indices varied with age. The potential of the partial indices to predict full-mouth scores could be further enhanced via simple regression models. Such an evaluation should, ideally, be carried out in an independent subject sample.

The purpose of the present study was to evaluate the validity and reliability of a partial radiographic bivariate index system (PESI-2). The principles of the index were applied to data from a random sample of 192 industrial employees aged 30-65 yr. Estimates of Extent and Severity of radiographic bone loss provided by the PESI-2, as well as adjusted estimates by means of simple regression models, were compared to values obtained by a full mouth radiographic examination. It was shown that the values provided by the PESI-2 were of rather high validity and reliability. The use of the adjusting models resulted in increased validity of the severity estimates and enhanced reliability of both components of the bivariate. The results verified the applicability of the PESI-2 in epidemiologic research of destructive periodontal disease.

When implants are to be inserted in the mandible posterior to the mental foramen, tomography is required to determine the exact location of the mandibular canal and assess the dimensions of the body and alveolar process. Previous studies have shown discrepancies between the true distance between the alveolar crest and the upper border of the mandibular canal and that measured from computed tomograms. This study evaluates the reliability of such measurements made from hypocycloidal tomograms. Six examiners, three radiologists and three oral surgeons, independently measured the distance from the alveolar crest to the upper border of the mandibular canal in transverse hypocycloidal tomograms of the mandible. Analysis of variance showed an average standard deviation between observers of 1.33 mm. This variation, which is the total of inter- and intra-observer variation conditional upon patient and radiograph, was mainly due to the latter which amounted to a mean of 1.04 mm. Calculation of lower confidence limits showed that these could be decreased by the use of several observers. Various confidence levels, equal to the probabilities of obtaining lower confidence limits which are below the true values, can be used to choose acceptable levels of risk in overestimating the true distance.

The aim of the present study was to use a decision making model in order to assess the periodontal treatment needs of a random sample of employees in a large Swedish industrial corporation. The model used provided data on critical bone loss limits for different tooth types and ages, beyond which treatment must be initiated, in order to fulfill the goal of maintaining all teeth in a functional state throughout life. A sample comprising 192 subjects belonging to four age strata (31-35 yr, 41-45 yr, 51-55 yr, and 61-65 yr) was involved. From each subject, a full mouth series of intra-oral radiographs were available. The radiographic bone height was assessed at the mesial and distal aspect of all teeth by measuring the distance between the cementoenamel junction and the bone crest. The clinical examination included assessments of plaque, gingivitis, probing pocket depth, and probing attachment level. The results revealed that (i) only 3.1% of all approximal tooth sites exhibited radiographic bone loss exceeding the critical limit, (ii) all individuals and 70% of the approximal tooth sites were in need periodontal treatment when presence of gingival inflammation (bleeding on probing) was employed as the single criterion for therapeutic intervention, (iii) the proportion of individuals and tooth sites requiring treatment amounted to 98% and 27%. respectively, when a probing pocket depth of at least 4 mm was included as an additional criterion, and 54% and 4.1%, respectively, if a probing depth threshold of 6mm was used, while (iv) the use of bleeding on probing in combination with radiographic bone loss beyond the critical limits disclosed a need of treatment in 40% of the subjects and 2.5% of the approximal tooth sites.

The risk of contracting cytomegalovirus (CMV) infection in nursing of infants and of congenital CMV infection in infants born to such nursing personnel were investigated. The investigation comprised 292 women working in paediatric clinics or day nurseries and a control group of 163 women who had no professional contact with infants. Among the women younger than 25, those who had tended infants for more than six months were significantly (p less than 0.001) more often seropositive for CMV than were those--mainly student nurses--with less than six months' infant nursing service, but ot more often than control women. At ages above 25 there was no demonstrable difference between the groups. In a separate study the occupation of 36 mothers of infants with congenital CMV infection was investigated. Compared to a control group no overrepresentation of nurses was found. All six congenitally infected infants born to nurses developed normally.

985 episodes of hepatitis representing 98% of all acute hepatitis episodes found in a Swedish city during a 10-year period were analyzed for anti-hepatitis A IgM antibodies and hepatitis B surface antigen. Hepatitis A was diagnosed in 311 episodes (32%), hepatitis B in 494 (50%), simultaneous acute hepatitis A and B in 12 (1.2%), and 168 episodes (17%) were classified as hepatitis non-A, non-B. The majority of the hepatitis A cases were drug addicts (58%), and all were concentrated in 3 outbreaks of 1-2 years duration. 16% of all hepatitis A cases were probably imported. Hepatitis B cases decreased significantly (p less than 0.001) between the first and second half of the study period. 47% were drug addicts. Hepatitis non-A, non-B was also dominated by drug addicts (61%). Approximately 20% of the cases in all 3 types of hepatitis had no identifiable source.

In a study of the prevalence of nine different micro-organisms in the female genital tract in a Swedish population, significantly higher isolation rates occurred among women attending a venereal disease clinic than among those attending a gynaecological health control department. The prevalence of Candida albicans, however, was similar in different groups, individual susceptibility being the most important factor. Chlamydia trachomatis, Trichomonas vaginalis, and Mycoplasma hominis occurred concomitantly with Neisseria gonorrhoeae, indicating a similar epidemiology for all these agents. Younger patients seemed to have an increased susceptibility to C. trachomatis whereas older patients had an increased susceptibility to T. vaginalis.

4 382 new mothers were examined retrospectively with the enzyme-linked immunosorbent assay (ELISA) for IgG activity to cytomegalovirus (CMV) during pregnancy. Some of them were also studied with the indirect immunofluorescence (IIF) test for CMV-IgM antibodies. All the infants had been studied for CMV excretion within the first week of life. Nineteen of them had been shown to be congenitally infected with CMV. 1 218 (28%) women lacked CMV-IgG activity at their first antenatal visit (usually in months III-IV). Fourteen of them seroconverted before parturition (primary infection). Thirteen of the seroconverters were shown to develop CMV-IgM activity. In 6 (43%) cases the primary infection was transmitted to the offspring. The remaining 13 congenitally infected infants were born to mothers with a positive IgM-test at their first antenatal control. Only one of these mothers had a clearly positive IgM-test. She was shown to lack CMV-antibodies before conception (primary infection during the first trimester). Preconceptional sera were obtained from further 4 of the 13 seropositive mothers of congenitally infected infants; all 4 had CMV antibodies before pregnancy (secondary infection during pregnancy). The combined studies of the mothers and infants revealed that 21-63% of the congenital infections could have been caused by secondary maternal infections. Prospectively performed, the study would only have disclosed one of the three fetal CMV infections that resulted in neurological sequelae.

A solid phase radio-immunoassay (SPRIA) was developed for the detection of anti-HBc IgM. The assay proved sensitive and easy to perform and rheumatoid factor did not affect the test results. Anti-HBc IgM titres were followed in consecutive samples from 15 patients after uncomplicated acute hepatitis B. In the acute phase anti-HBc IgM titres ranged from 10(-5) to 10(-7) (mean 10(-6.4)). One year after onset of disease ten of the 15 had titres below 10(-4) and between two and three years after onset most patients had titres 10(-3). Anti-HBc IgM titres were determined in six episodes of acute hepatitis B, all HBsAg negative but anti-HBc positive in the first samples obtained (within 8 days) and developing anti-HBs during convalescence. Acute phase anti-HBc IgM titres in these patients ranged between 10(-5.5) and 10(-7) (mean 10(-6.5)) and were thus identical with HBsAg positive cases. When acute phase sera from 168 episodes of acute hepatitis primarily classified as non-A, non-B, were tested for anti-HBc IgM titres above 10(-5), sera from 13 episodes were positive and in seven of these hepatitis B diagnosis could be confirmed by rising anti-HBs titres in convalescence. Sera from four of the 13 patients contained HBeAg, which was thus demonstrated in the absence of HBsAg. The results show that testing for anti-HBc IgM is important for a true non-A, non-B diagnosis.

The etiological role of Legionella pneumophila and other infectious agents in acute lower respiratory tract infections in 112 patients attending an infectious disease clinic was estimated by a serological study of paired sera and bacteriological culture of nasopharynx swabs and culture and immunoelectroosmophoresis of expectorates. Only 2 of the patients had a 4-fold rise in antibody titre to L. pneumophila, suggesting a similar incidence of legionnaires' disease as reported from USA.

The study included two clinical materials. First, the frequency of cytomegalovirus and its clinical significance were studied among 661 Swedish children under one year of age admitted to a paediatric hospital. Before the age of one week 4/326 (1%) children excreted virus. At one month the frequency had risen to 6/52 (12%) and after this age the frequency was constant around 20--25%. Sixty per cent of infants born to immigrants were infected after one month of age. One of the four congenitally infected children had symptoms at birth followed by neurological sequelae. The majority of the infections acquired at birth or in early infancy seemed to be subclinical and without sequelae. Second, a retrospective investigation of 18 695 children born during a six-year period was performed. Two cases of virologically confirmed congenital cytomegalic inclusion disease was found. Regarding seven microcephalic patients in the retrospective study congenital CMV-infection could be excluded in four cases. In the remaining three cases the data did not permit any conclusions regarding the etiology.

This study (March 1977-February 1978) was performed at the Ethio-Swedish Pediatric Clinic, Addis Ababa, to determine whether there were any seasonal fluctuations in the occurrence of diarrhoea associated with enterotoxigenic enterobacteria (ETEB), rotavirus and two parasites (Giardia lamblia and Entamoeba histolytica).A total of 1161 children (962 patients and 199 controls) were investigated. ETEB were isolated in 12.2% of the patients and 4.5% of the controls, rotavirus in 27.8% and 8%, and parasites in 6.8% and 1%, respectively. There is a statistically significant difference in the isolation rates between patients and controls (P<0.001 for rotavirus, P<0.01 for ETEB and parasites). Rotavirus was most prevalent in the 7-12 months age group and ETEB during the second year of life, while parasites showed a continuous increase with age.Two peaks in the occurrence of ETEB were found during the year, the first in August (32.6%), the second in January (19.2%). Two peaks for rotavirus though not as distinct as for ETEB, were seen in June (42.7%) and November (36.4%). The isolation rate of parasites showed no consistent pattern during the year.This study suggests a seasonal occurrence of ETEB and rotavirus but with no apparent correlation to climatological factors.

In the course of a six-month-study of acute gastroenteritis in children of ages up to six years, a reo-like virus was found in 54 per cent of the faecal specimens obtained at an early stage of the disease, using electron microscopy as screening test. By means of a concentrated complement fixation antigen, composed of a related calf diarrhoea virus cultivated in tissue culture, the rise in titre was found to be significant in 96 per cent of the patients whose faeces contained the reo-like virus. Antibodies were present in the remaining 4 per cent without rise in titre. In 10 per cent of the cases with gastroenteritis infection was caused by adenovirus or Salmonella. A probable aetiological agent was found in 71 per cent of the patients. It applies to 33 per cent of all cases caused by the reo-like virus that they were nosocomial infections.