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Tiivistelmä. Tässä sanastontutkimusta, sanasemantiikkaa ja deskriptiiviverbien tutkimusta edustavassa pro gradu -tutkielmassa tutkin ”Pienen Kainuun murteen verbisanaston” liikeverbien semantiikkaa ja deskriptiivisyyttä. Minna ja Maiju Seppäsen vuodesta 2002 lähtien internetiin kokoamaan sanastoon kuuluu kokonaisuudessaan 132 murreverbiä merkityksineen ja esimerkkivirkkeineen, mutta varsinainen aineistoni koostuu 40 liikeverbistä. Olen selvittänyt, kuinka hyvin kunkin aineistossa esitetyn verbin tarkoite vastaa sanakirjoissa olevia samojen sanojen merkityksiä. Päätavoitteenani on ollut selvittää kyseisten verbien deskriptiivisyyttä aineistoni perusteella sekä tehdä näkyväksi se, mikä tekee juuri kyseisistä verbeistä deskriptiivisiä. Tämän olen toteuttanut siten, että olen muodostanut Jarvan (2003) ja Jääskeläisen (2013) väitöskirjojen pohjalta seitsemän deskriptiivisille verbeille ominaista piirrettä. Näistä piirteistä muodostetut luokat ovat monimerkityksisyys, merkityksen tilannesidonnaisuus, silmiinpistävyys ja affektiivisuus, äänteellinen variaatio, äänteiden distribuutio, suosikkijohtimet ja morfologiset kaavat sekä esiintyminen koloratiivikonstruktiossa. Olen analysoinut, missä aineiston lekseemeissä kukin piirre esiintyy ja miten se näkyy kyseisten verbien rakenteessa. Piirteiden esiintymismäärän perusteella olen tutkinut, mitkä sanat ovat erityisen deskriptiivissävyisiä ja missä verbeissä piirteitä esiintyy vähemmän. Aineiston kaikissa 40 sanassa on äänteiden distribuutiota. Suosikkijohtimia ja affektiivisuutta esiintyy kumpaakin 35 sanassa. Monimerkityksisyyttä on 32 lekseemissä. Äänteellistä variaatiota on 11 verbissä, neljä lekseemeistä esiintyy koloratiivikonstruktiossa, eikä tilannesidonnaisuutta ole yhdessäkään aineiston sanoista. Kokonaisuudessaan deskriptiivisiä piirteitä esiintyy aineistossa huomattavan paljon, sillä jokaisessa verbissä toteutuu 2–5 piirrettä. Piirteiden yleisyys aineistossa osoittaa osaltaan todeksi väittämän, jonka mukaan Kainuun murteissa, kuten muissakin savolaismurteissa, on erityisen paljon deskriptiivistä sanastoa. Valtaosalle aineiston verbeistä, jopa 29 lekseemille 40:stä, löytyy ainakin läheinen merkitys lähteiden kanssa. Näistä 17 verbin merkitykset ovat täsmäävät sekä aineistossa että käyttämissäni sanakirjalähteissä. 12 verbin kohdalla merkitykset ovat läheiset, mutta eivät aivan vastaavat. Viiden lekseemin merkitykset eroavat toisistaan aineistossa ja lähteissä, eikä kuudesta verbistä ole riittävästi tietoja, jotta semanttinen analyysi olisi mahdollista tehdä. Koska jokaisessa aineiston verbissä toteutuu vähintään kaksi deskriptiivistä piirrettä ja yleensä paljon useampi piirre ja kielitajunikin mukaan sanat ovat deskriptiivisiä, olen voinut melko yksiselitteisesti todeta kaikki aineiston sanat deskriptiivisiksi tai ainakin deskriptiivissävyisiksi. Valtaosalle aineiston verbeistä löytyy lähteistä ainakin läheinen merkitys, joten tarkoitteet ovat semanttisesti melko samankaltaisia.

Background . Increased pulmonary vascular resistance (PVR) and decreased arterial oxygenation frequently complicate lung transplantation. Inhaled nitric oxide (NO) and aerosolized prostacyclin (PGI 2 ) both dilate the pulmonary vasculature and improve oxygenation in adult respiratory distress syndrome. We investigated whether similar effects would occur during early reperfusion of a lung graft. Methods . Eighteen pigs underwent left lung transplantation. We measured blood flow distribution, mean pulmonary artery pressure, PVR, and gas exchange in each lung separately. Animals were randomized into three groups to receive NO (10 ppm/30 minutes, 40 ppm/30 minutes), nebulized PGI 2 (25 μg/mL/30 minutes, 50 μg/mL/30 minutes), or no drugs (control). Results . In the transplanted lung, PVR was significantly higher than in the native lung. Pulmonary vascular resistance of the transplanted lung was lower in the NO and PGI 2 groups in comparison with the control group. During the first hour of inhalation, NO decreased PVR more than PGI 2 . Neither drug improved oxygenation in the graft. Conclusions . Nitric oxide and PGI 2 decreased PVR of the transplanted lung slightly, but the effect did not produce a normal pressure in pulmonary vasculature.

The presence of Epstein-Barr virus (EBV), human papilloma virus (HPV), and cytomegalovirus (CMV) was studied in 20 patients who developed malignancies after heart transplantation in the Helsinki University Central Hospital. The tumors were analyzed for the presence of HPV by polymerase chain reaction and for EBV by in situ hybridization. Clinical CMV infection was verified by immunochemical quantitation of CMV antigen in peripheral blood cells. HPV was detected in one of the eight epithelial malignant tumors studied. Three of the six lymphomas were positive for EBV. Two (67%) of 3 patients with EBV-positive lymphomas and one (33%) of the other three lymphomas but only 2 (14%) of 14 patients who developed other malignancies had a history of a manifest post-transplantation CMV infection prior to the development of malignancy. These results confirm the presence of EBV in lymphomas of heart transplant recipients and suggest that CMV might have a contributory role in the development of EBV-associated lymphomas.

Inhaled nitric oxide has been shown to ameliorate early lung graft dysfunction. It improves oxygenation by inducing pulmonary vasodilatation in well-ventilated lung areas, and it also modulates leukocyte-endothelium interactions. We used a porcine, single lung transplantation model to evaluate whether the benefits of exogenously administered gas could be achieved easier by adding L-arginine, the substrate of endogenous nitric oxide synthesis, as an additive to the flush solution and intravenously during reperfusion.Six pig lungs were flushed with modified Euro-Collins solutions containing L-arginine (2 g/liter). After cold (4 degrees C) storage, the left lung was transplanted. Ischemic time was 260 minutes. The recipients received intravenous boluses of L-arginine (30 mg/kg), followed by infusion (20 mg/kg/min) during the first 30 minutes of reperfusion. Six control animals received saline as placebo. We measured the blood flow and pulmonary vascular resistance (PVR) in the transplanted and in the native lung using a right heart bypass model. We measured blood gases, leukocyte counts, plasma free-radical trapping capacity, and diene conjugates in pulmonary venous blood and myeloperoxidase activity of the lung tissue.Pulmonary vascular resistance was 4 to 5-fold higher in the transplanted lung than in the native lung, which received 80% of the total blood flow. L-arginine reduced PVR by 30% in the native lung (p0.001), but not in the transplanted lung. L-arginine had no effect on oxygenation or carbon dioxide exchange of the transplanted lung. Nor did L-arginine treatment have any effect on leukocyte sequestration or myeloperoxidase activity in the transplanted lung. The plasma antioxidant capacity in venous blood of the transplanted lung almost doubled shortly during early reperfusion without influence of L-arginine.L-arginine reduced PVR in the native lung but did not improve pulmonary hemodynamics, gas exchange, or reduce leukocyte sequestration of the transplanted lung.

Nitecapone is an antioxidant molecule which has been shown to protect the heart against ischemia-reperfusion injury. We investigated whether a similar effect could be detected on lung graft preservation in a porcine model of single lung transplantation. Donors received either nitecapone or placebo in a modified Euro-Collins pulmonary flush solution. After cold storage for 19 h the left lung was transplanted. Patients in the nitecapone group received a nitecapone infusion during the graft reperfusion. A right-side heart bypass was used to measure flow distribution and pulmonary vascular resistance (PVR) in the recipient's transplanted and native lungs, respectively. Pulmonary vein blood samples were analyzed for blood gases, free radical trapping capacity and diene conjugates. PVR was high in the transplanted lung, which received only 20% of the blood flow. Oxygen tension in the transplanted lung was low (2.3-26.7 kPa). Nitecapone treatment increased the plasma free radical trapping capacity threefold. In spite of this increase in antioxidative capacity nitecapone could not protect the lung against ischemia-reperfusion injury when pulmonary hemodynamics, gas exchange or plasma diene conjugates were used as measures of lung graft function.

In this report we present our experience of non-invasive magnetic resonance imaging (MR) angiography and selective catheter angiography in assessing the patency of bronchial artery revascularization grafts after an en bloc double-lung and heart-lung transplantation. We studied 8 patients who had undergone pulmonary transplantation with direct bronchial artery revascularization. Catheter angiography was performed 10 days to 63 months postoperatively. MR angiography was performed within 24 h of the catheter procedure and the results were compared with the findings from catheter angiography. Catheter angiography showed the bronchial revascularization graft to be patent in 6 patients and occluded in 2. At MR angiography, the patency of bronchial artery revascularization grafts was reliably identified in 7 of the 8 patients. One patient had inadequate image quality because of void artefacts caused by haemostatic clips. It is concluded that MR angiography is a reliable method for assessing the patency of bronchial artery revascularization grafts.

Background . Nitecapone has been shown to have a protective effect against ischemia-reperfusion injury in experimental heart transplantation and in Langendorff preparations. This prospective, randomized study assessed the effects of nitecapone in patients who had coronary artery bypass grafting. Methods . Thirty patients with normal myocardial function were randomly divided into control patients (n = 15), who received crystalloid (Plegisol) cardioplegia, and nitecapone patients, who received nitecapone in a 50 μM solution (n = 15) in Plegisol. Cardioplegia was administered as an initial dose of 15 mL/kg of body mass after cross-clamping and 2 mL/kg every 15 minutes. Simultaneous coronary sinus and aortic blood samples, and myocardial biopsies were taken at 1, 5, and 10 minutes after unclamping. Hemodynamics were measured invasively for 24 hours and with transesophageal echocardiography for 3 hours after cardiopulmonary bypass. Results . There were no adverse effects. The incidence of ventricular arrhythmias was significantly lower in the treatment group during the recovery period ( p = 0.02). Cardiac output and stroke volume did not differ significantly between the groups. The conjugated dienes gradient between the aorta and the coronary sinus increased significantly during the first minute of reperfusion in the control group ( p = 0.02) compared with the nitecapone group. Myeloperoxidase activity in myocardial biopsies was higher in the control group (2.3 times higher at 5 minutes and 3.2 times higher at 10 minutes) than in the nitecapone group ( p = 0.13). Conclusions . Nitecapone did not exert any significant hemodynamic effects in patients with normal ejection fraction.

Prostaglandin E1 (PGE1) is widely used to improve early graft function after lung transplantation, but some studies have questioned its benefits. Therefore we evaluated the effect of donor pretreatment with PGE1 in our porcine model of single lung transplantation. Donors received PGE1 or placebo intravenously before flushing the pulmonary artery with modified Euro-Collins solution. After cold storage, the excised left lung was transplanted. Ischemic time was 4 h. We used our right side heart bypass model to measure standardized pulmonary vascular resistance and to study blood flow distribution between recipient’s native and transplanted lung. Systemic and pulmonary hemodynamics and gas exchange were also measured. After transplantation, pulmonary vascular resistance was significantly higher in the transplanted lung, which received only one fourth of the total pulmonary blood flow. PGE1 pretreatment did not improve pulmonary hemodynamic parameters, or gas exchange.

A 32-year-old man received a left-sided thoracic stab wound, which was primarily treated with percutaneous tube thoracostomy. Ipsilateral empyema appeared 8 weeks later and subsequent investigations revealed herniation of the stomach through the diaphragm. The diaphragmatic rupture and a perforation in the gastric wall were repaired at thoracotomy. The literature on such wounds is reviewed.

Background. In search of the ideal composition of the flush solution for pulmonary preservation, we studied the effects of prostaglandin E 1 (PGE 1 ) and prostacyclin as an additive to Euro-Collins solution (ECS) on pulmonary hemodynamics and gas exchange in a porcine single lung transplantation model using extracorporeal circulation and right heart bypass. Methods. Twenty-two pigs served as donors. The animals were randomized to receive either modified ECS alone (control group, n=8), ECS with 100 μg/L of PGE 1 (PGE 1 group, n=6), or ECS with 200 μg/L of prostacyclin (prostacyclin group, n=8). Left lung transplantation was performed in 22 recipients after approximately 4 hours of cold ischemia. Results. Carbon dioxide elimination was significantly depressed in the two prostaglandin groups, and the use of PGE 1 was associated with a significant decrease in arterial oxygen tension compared with the control group. Both drugs were inefficient in alleviating the increase in pulmonary vascular resistance after transplantation. Conclusion. The use of prostaglandins as constituents of the flush solution was not followed by any improvement of early graft function after cold ischemia.

Ninety patients with esophageal perforations were operated on at our institutions between 1970 and 1992. Thirty-four of them were seen after delayed diagnosis (> 24 hours) with mediastinal sepsis caused by perforation of the thoracic esophagus. There were 18 patients with spontaneous ruptures, 11 with instrumental perforations (including one caused during laparotomy), and 3 perforations caused by foreign bodies. One patient had perforation of an esophageal ulcer into the pericardium and another had perforation of an esophageal diverticulum into the mediastinum. Nineteen patients underwent primary repair of the perforation with cleansing and drainage of the mediastinum and the pleural cavity. The remaining 15 had primary extirpation of the thoracic esophagus, irrigation of the mediastinum with antibiotics, cervical esophagostomy, gastrostomy, and drainage of the mediastinum and pleural cavity. Nineteen of the 34 patients survived (hospital mortality 44%). Of patients with primary repair, only six survived (in-hospital mortality 68%), whereas only two patients treated with esophagectomy died (in-hospital mortality 13%). The difference was highly significant (p = 0.001). The most common cause of death was multiorgan failure resulting from sepsis. Postoperative complications developed in four patients treated with primary repair (two sepsis, one empyema, and one anuria) and in seven patients treated with esophagectomy (two empyema, two sepsis, one pneumonia, one mediastinal abscess, and one brain abscess). After healing of the mediastinitis, the esophagogastric continuity was reconstructed with colon in 11 patients and stomach in two patients. In the management of delayed esophageal perforation with mediastinal sepsis, esophagectomy is superior to primary repair alone, which often leads to mediastinal leakage, continued sepsis, and death.

The aim of this doctoral thesis is to study culture bound translation phenomena in translations from Finland-Swedish to German. The data consists of Tove Jansson’s Sommarboken and Bildhuggarens Dotter and Kjell Westö’s collection of short stories Lugna Favoriter and the German translations of these books. The general aim of the analysis is to identify the strategies used by the translators to translate different cultural phenomena. Moreover, the consequences of the strategies are dealt with on a pragmatic level. In addition, the aim is to study whether it is easier to translate a Finland-Swedish book into Finnish than into German from the cultural point of view. Semiotics, the science of signs, relations and meanings of signs is an important tool in this doctoral thesis. Translation can be understood not only as a translation of a written text A into a written text B but also in a wider meaning. In addition, the cover of a book and different cultural phenomena can be translated. This point of view is visible, for example, in the semiotic analysis of four bookcovers. The analysis shows that the translators use nine different adaptation strategies. There are also six types of non-adaptation. The adaptations used by the translator, the context and the semiotic space of the reader of the target culture are the factors which have an influence on the level of understanding the target text. It also becomes evident that the more different the target culture is from the source culture, the harder it is to translate from the cultural point of view. Abstrakt Föreliggande avhandling har som syfte att undersöka kulturellt bundna översättningsfenomen vid översättning av skönlitteratur från finlandssvenska till tyska. Materialet jag valt är Tove Janssons Sommarboken och Kjell Westös novellsamling Lugna Favoriter och verkens översättningar till tyska. Det övergripande målet i analysen är att kasta ljus över de strategier som översättarna använder vid översättningen av olika kulturella fenomen. Dessutom behandlas konsekvenserna av dessa strategier på pragmatisk nivå. Det gäller också att studera om ett finlandssvenskt verk ur kulturell synvinkel är lättare att översätta till finska eller till tyska. Semiotiken som är vetenskapen om tecken, teckenrelationer och teckens betydelser är då ett viktigt arbetsredskap. Översättning anses i föreliggande avhandling inte bara vara översättning av skriven text A till skriven text B, utan översättning har här en bredare betydelse. En pärm eller ett kulturellt fenomen kan också överföras. Denna uppfattning kommer till synes t.ex. i den bildsemiotiska analysen av fyra bokpärmar. Av analysen framgår att översättarna använder nio olika adaptationsmetoder. Det finns sex olika typer av icke-adaptationer. Kontext, översättarens adaptationer och den målkulturella läsarens semiotiska rum är de faktorer som påverkar läsarens förståelsenivå av måltexten. Det visar sig också att ju längre borta målkulturen är från källkulturen, desto svårare blir en översättning ur kulturell synvinkel.

During aortic cross-clamping, the myocardium suffers from global ischemia, which is followed by reperfusion after declamping. The generation of free oxygen radicals increases during reperfusion, resulting in arrhythmias and impaired cardiac function. This study was conducted to evaluate the effect of a novel antioxidant nitecapone (NC) on cardiac reperfusion injury in vivo. Twelve pigs were anesthetized and after sternotomy the aorta and the right atrium were cannulated for cardiopulmonary bypass. The heart was arrested with either +4 degreesC crystalloid cardioplegia alone in the control group (n = 6) or cardioplegia with NC (50 µM) added in the NC group (n = 6). Cardioplegia was added every 20 minutes. After 1 hour of aortic cross-clamping, blood samples for oxidative stress analysis were taken, and hemodynamic profile surveillance continued for 90 minutes. Heart rate (p = 0.04) and left ventricular end diastolic pressure (LVEDP) (p = 0.04) were significantly lower in the NC group than in the C group after aortic declamping. Cardiac output and myocardial contractility (dP/dtmax) were also enhanced in the group receiving NC, but the difference was not statistically significant. At 30 minutes after reperfusion, the coronary production (coronary sinus-aorta) of thiobarbituric acid reactive substances correlated inversely with cardiac output (r = -0.90, p = 0.001) and stroke volume (r = -0.82, p = 0.007). The effect of NC on lipid peroxidation seems to be modest and therefore the target of NC is unclear. NC would appear, however, to be a beneficial additive in the crystalloid cardioplegia in terms of functional recovery.

Aims The aim of the study was to evaluate the effects on systemic and coronary haemodynamics and myocar-dial substrate utilization of a new calcium sensitizer, levosimendan, after coronary artery bypass grafting. Methods and Results Twenty-three low-risk patients were included in this randomized and double-blind study. They received placebo (n=8), 8 (n=8) or 24 (n=7) μg.kg−1of levosimendan after coronary artery bypass operation. Systemic and coronary sinus haemodynamics with thermodilution and myocardial substrate utilization were measured. The heart rate increased 11 beats.min−1after the higher dose (P

To investigate difficulties in diagnosing pulmonary rejection and to create a new model to observe long-term histological consequences, 21 piglets were subjected to left single lung transplantation. Five of these transplants served as targets for unmodified rejection in piglets without immunosuppression (Group I), 13 recipients were treated with cyclosporin A, azathioprine and methylprednisolone (Group II), and in 3 cases reimplantation of an autograft was performed (Group III). In the course of postoperative graft monitoring, transthoracic/bronchial biopsies were obtained on days 3, 5, 7, 10, 14, and 20, and thereafter less frequently up to 134 days. In the unmodified rejection group, grafts consolidated in one week and histologically presented perivascular mononuclear cell infiltrates, except for one case which showed vasculitis. Lymphocytic bronchiolitis and or peribronchiolar infiltrate was present in three of the four autopsied grafts. In Group II acute rejection was detected six times in three piglets, and all except one of these specimens had a peribronchiolar component. Although no incontestable bronchiolitis obliterans developed, mild to moderate chronic obliterative vascular lesions were detected in all immunosuppressed piglets (n = 3) surviving more than 80 days. Contralateral lungs and Group III autografts showed mild changes related to the operation itself and interstitial swine endemic pneumonia (SEP). Chronic changes related to rejection were limited to the vascular wall. The mainly inflammatory bronchiolar changes are thought to present an incipient phase leading to obliterative lesions.

Prostaglandin E1 (PGE1 is a short-lived powerful vasodilator, which modifies platelet and neutrophil function and exerts a cytoprotective effect. In search of improved pulmonary preservation techniques PGE1 has been extensively studied as an adjunct to the crystalloid flush solutions or in donor pretreatment. Less attention has been paid to its possible usefulness when administered during the reperfusion period. Therefore, we evaluated the effects of PGE1-infusion on pulmonary hemodynamics and gas exchange during the first four hours of reperfusion of a pig left lung allotransplantation.

In two groups of patients, coronary artery bypass surgery for angina pectoris included internal mammary artery (IMA) sequential grafts (group I) or single grafts (group II). At postoperative angiography all grafts were patent. In addition, the patients received on average 1.8 vein grafts into other coronary arteries. The mean interval to postoperative follow-up was 9.5 years in group I and 9.7 years in group II. The preoperative incidence of acute myocardial infarction was 44% and 45% in groups I and II. Exercise thallium scan at follow-up showed IMA graft-related ischemia in 33% of the patients with sequential graft and in 64% of those with single graft (ns). Our results indicated that sequential IMA grafts functioned at least as well as single grafts and maintained adequate myocardial supply even 10 years postoperatively. Internal mammary arteries are superior graft material and can be recommended both as single and as sequential graft in coronary artery bypass surgery.

In the present study the functional and morphologic effects of two pulmoplegic solutions are evaluated. Single left-lung allotransplantation with ligation of the right pulmonary artery was performed in 15 piglets (13–20 kg). The lungs were preserved after donor prostaglandin E-l treatment with single pulmonary artery flush with either modified Euro-Collins solution (mECS) (9 pigs) or oxygenated fluorocarbon emulsion (FC-43) (6 pigs) and transplanted after 6-hr storage in cold Physiosol solution. Tidal volumes of 15 ml/kg ± fr (18) with 40% inspired oxygen were used for ventilation during reperfusion. Function of the transplanted lung was monitored for 4 hr postoperatively by determining pa CO2 and pa O2 levels from arterial samples and by noninvasive monitoring of end-tidal CO2 values and arterial oxygen saturations. Sequential morphologic changes in pulmonary artery flow surface and lung tissue were studied after 6-hr storage and 4-hr reperfusion, using light, scanning, and transmission electron microscopy (LM, SEM, TEM). There was no mortality. After transplantation the mECS group experienced significant hypoxia and hypercarbia and had low end-tidal CO2 values as signs of defective oxygenation and gas exchange, whereas the FC-43 group was normoxic and normoventilated without disturbed elimination of carbon dioxide. After storage and reperfusion, LM showed signs of increased vascular permeability and reperfusion damage—more evident in the mECS group compared with the FC-43 group—while the lymphoid cell population was more intensely activated in the latter group. Electron microscopy after storage showed good overall preservation of structures in both groups. After reperfusion preservation of pulmonary artery flow surface and lung tissue was estimated to be moderate in the mECS group, whereas it was good-to-moderate in the FC-43 group by SEM (NS). TEM of lung tissue, however, showed significantly better-preserved alveolar epithelial lining in the FC-43 group compared with the mECS group. In conclusion, oxygenated fluorocarbon (FC-43) pulmoplegia gave better functional and morphologic preservation of lung grafts compared with modified Euro-Collins solution.

Of 17 patients who underwent heart transplantation in 1985-1988, three were later operated for reasons unrelated to the transplant. Two of them had acute cholecystitis and one haemothorax, due to rupture of the internal mammary artery during endomyocardial biopsy. Cholecystectomy was performed in the first two cases and thoracotomy in the third, with uneventful recovery in all cases. Early diagnosis and adequate surgical treatment are necessary in these cases. Consideration of the immunosuppressive medication is important during and after operation.