714 results on '"Räsänen J"'
Search Results
2. ASO Visual Abstract: Major Intraoperative Complications During Minimally Invasive Esophagectomy
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Söderström, H., Moons, J., Nafteux, P., Uzun, E., Grimminger, P., Luyer, M. D. P., Nieuwenhuijzen, G. A. P., Nilsson, M., Hayami, M., Degisors, S., Piessen, G., Vanommeslaeghe, H., Van Daele, E., Cheong, E., Gutschow, Ch. A., Vetter, D., Schuring, N., Gisbertz, S. S., and Räsänen, J.
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- 2023
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3. Electron acceleration and radio emission following the early interaction of two coronal mass ejections
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Morosan, D. E., Palmerio, E., Räsänen, J. E., Kilpua, E. K. J., Magdalenić, J., Lynch, B. J., Kumari, A., Pomoell, J., and Palmroth, M.
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Astrophysics - Solar and Stellar Astrophysics ,Physics - Space Physics - Abstract
Context. Coronal mass ejections (CMEs) are large eruptions of magnetised plasma from the Sun that are often accompanied by solar radio bursts produced by accelerated electrons. Aims. A powerful source for accelerating electron beams are CME-driven shocks, however, there are other mechanisms capable of accelerating electrons during a CME eruption. So far, studies have relied on the traditional classification of solar radio bursts into five groups (Type I-V) based mainly on their shapes and characteristics in dynamic spectra. Here, we aim to determine the origin of moving radio bursts associated with a CME that do not fit into the present classification of the solar radio emission. Methods. By using radio imaging from the Nan\c{c}ay Radioheliograph, combined with observations from the Solar Dynamics Observatory, Solar and Heliospheric Observatory, and Solar Terrestrial Relations Observatory spacecraft, we investigate the moving radio bursts accompanying two subsequent CMEs on 22 May 2013. We use three-dimensional reconstructions of the two associated CME eruptions to show the possible origin of the observed radio emission. Results. We identified three moving radio bursts at unusually high altitudes in the corona that are located at the northern CME flank and move outwards synchronously with the CME. The radio bursts correspond to fine-structured emission in dynamic spectra with durations of ~1 s, and they may show forward or reverse frequency drifts. Since the CME expands closely following an earlier CME, a low coronal CME-CME interaction is likely responsible for the observed radio emission., Comment: 14 pages, 13 figures
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- 2020
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4. Time trends in mortality of oesophageal cancer in Finland over 30 years
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Sirviö, V. E. (Ville E. J.), Räsänen, J. V. (Jari V.), Kauppila, J. H. (Joonas H.), Sirviö, V. E. (Ville E. J.), Räsänen, J. V. (Jari V.), and Kauppila, J. H. (Joonas H.)
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Introduction: Oesophageal cancer survival is reported by epidemiological studies, but knowledge on survival trends regarding different histologies and operative treatment status is lacking. Materials and methods: Data from all patients diagnosed with oesophageal cancer in Finland in 1987–2016 was collected from national registries. 1-, 3- and 5-year survival rates were examined stratified by histology (adenocarcinoma (OAC) and squamous cell carcinoma (OSCC)) and treatment strategy (surgery, no surgery). Hazard ratios (HR) with 95% confidence intervals (CI) for death were provided by multivariable Cox regression, adjusted for confounders. Results: Of the 9102 patients, 3140 had OAC (1074 [34%] oesophagectomies), and 3778 had OSCC (870 [23%] oesophagectomies). Men were overrepresented in both OAC (77%) and OSCC (55%). The proportion of oesophagectomies decreased in both histologies. From 1987 to 1991 to 2012–2016, 5-year survival increased from 11% to 22% in OAC and from 7% to 13% in OSCC. For patients undergoing oesophagectomy, the corresponding increases were from 20% to 49% in OAC and from 11% to 54% in OSCC, and non-operated patients from 5% to 8% and from 5% to 7%, respectively. Earlier calendar period, older age and comorbidity were associated with mortality in both histologies. Female sex was a protective factor for patients operated for OSCC (HR 1.56 (95% CI 1.33–1.83), men versus women). Conclusions: The prognosis of oesophageal cancer has improved in Finland over the last 30 years in both main histological types. The survival of patients undergoing oesophagectomy has drastically improved, while the prognosis of patients not undergoing surgery is slowly improving but remains poor.
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- 2023
5. Preoperative esophageal stenting and 5-year survival in patients undergoing esophagectomy for esophageal cancer:a population-based nationwide study from Finland
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Helminen, O. (Olli), Sihvo, E. (Eero), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Valtola, A. (Antti), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Sihvo, E. (Eero), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Valtola, A. (Antti), and Kauppila, J. H. (Joonas H.)
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Background: Preoperative esophageal stenting is proposed to have a negative effect on outcomes. The aim was to compare a 5-year survival in patients undergoing esophagectomy for esophageal cancer with and without preoperative esophageal stent in a population-based nationwide cohort from Finland. The secondary outcome was 90-day mortality. Methods: This study included curatively intended esophagectomies for esophageal cancer in Finland between 1999 and 2016, with follow-up until December 31, 2019. Cox proportional hazards models provided hazard ratios (HRs) with 95% confidence intervals (CIs) of overall 5-year and 90-day mortality. Model 1 was adjusted for age, sex, year of the surgery, comorbidities, histology, pathological stage, and neoadjuvant therapy. Model 2 included also albumin level and BMI. Result: Of 1064 patients, a total of 134 patients underwent preoperative stenting and 930 did not. In both adjusted models 1 and 2, higher 5-year mortality was seen in patients with preoperative stent with HRs of 1.29 (95% CI 1.00–1.65) and 1.25 (95% CI 0.97–1.62), respectively, compared to no stenting. The adjusted HR of 90-day mortality was 2.49 (95% CI 1.27–4.87) in model 1 and 2.49 (95% CI 1.25–4.99) in model 2. When including only neoadjuvant-treated patients, those with preoperative stent had a 5-year survival of 39.2% compared to 46.4% without stent (adjusted HR 1.34, 95% CI 1.00–1.80), and a 90-day mortality rate of 8.5% and 2.5% (adjusted HR 3.99, 95% CI 1.51–10.50). Discussion: This nationwide study reports worse 5-year and 90-day outcomes in patients with preoperative esophageal stent. Since residual confounding remains possible, observed difference could be only an association rather than the cause.
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- 2023
6. Disintegrin and metalloproteinases (ADAMs) expression in gastroesophageal reflux disease and in esophageal adenocarcinoma
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Kauttu, T., Mustonen, H., Vainionpää, S., Krogerus, L., Ilonen, I., Räsänen, J., Salo, J., and Puolakkainen, P.
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- 2017
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7. Risk of Second Primary Cancer Among Patients with Cardio-Esophageal Cancer in Finland: A Nationwide Population-Based Study
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Nikkilä R, Hirvonen E, Pitkäniemi J, Räsänen JV, Malila NK, and Mäkitie A
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esophageal squamous cell carcinoma ,adenocarcinoma ,gastric cardia carcinoma ,tumor ,second primary cancer ,Infectious and parasitic diseases ,RC109-216 - Abstract
Rayan Nikkilä,1– 4 Elli Hirvonen,1 Janne Pitkäniemi,1,5,6 Jari V Räsänen,7 Nea K Malila,1 Antti Mäkitie2,3,8 1Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland; 2Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 3Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; 4Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, Lahti, 15850, Finland; 5Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland; 6Department of Public Health, University of Helsinki, Helsinki, Finland; 7Department of General Thoracic and Oesophageal Surgery, Heart and Lung Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 8Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, SwedenCorrespondence: Antti Mäkitie, Helsinki University Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, P.O.Box 263, FI-00029 HUS, Helsinki, Finland, Tel +358-50-428 6847, Email antti.makitie@helsinki.fiPurpose: The occurrence of a second primary cancer (SPC) after primary esophageal carcinoma (EC) or gastric cardia carcinoma(GCC) is well acknowledged. However, previous research on the risk of SPC among these patients has been predominantly conducted in Asian countries. Yet, notable population-dependent variation in histological types and risk profiles exists. This register-based study assesses the histology-specific risk of SPC among individuals initially diagnosed with a first primary EC or GCC.Patients and Methods: We obtained data on 7197 patients diagnosed with EC/GCC in Finland between 1980 and 2022 from the Finnish Cancer Registry. Standardized incidence ratios (SIR) of SPC were subsequently calculated relatively to the cancer risk of the general population.Results: The average and median follow-up times were 2.8 years and 10.5 months. Adenocarcinomas and squamous cell carcinomas comprised 57.8% (n = 4165) and 36.6% (n = 2631) of all cases, respectively. An increased SIR was noted among EC/GCC patients after 15– 20 years of follow-up (SIR 1.49, 95% CI: 1.01– 2.11). Among adenocarcinoma patients, an increased SIR for SPCs of the digestive organs was seen in the 40– 54-year-old group (SIR 9.86, 95% CI: 3.62– 21.45). Squamous cell carcinoma patients displayed increased SIRs for cancer of the mouth/pharynx (SIR 3.20, 95% CI: 1.17– 6.95) and respiratory organs (1.77, 1.07– 2.76).Conclusion: Healthcare professionals should be aware of the increased risk of SPCs occurring in the mouth/pharynx, respiratory and digestive organs in survivors of EC/GCC. Patients should be advised about this risk and remain alert for symptoms, even beyond the standard 5-year follow-up period.Keywords: esophageal squamous cell carcinoma, adenocarcinoma, gastric cardia carcinoma, tumor, second primary cancer
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- 2024
8. Central nervous system distribution of buprenorphine in pregnant sheep, fetuses and newborn lambs after continuous transdermal and single subcutaneous extended-release dosing
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Hakomäki, H. (Henriikka), Eskola, S. (Sophia), Kokki, H. (Hannu), Lehtonen, M. (Marko), Räsänen, J. (Juha), Laaksonen, S. (Sakari), Voipio, H.-M. (Hanna-Marja), Ranta, V.-P. (Veli-Pekka), Kokki, M. (Merja), Hakomäki, H. (Henriikka), Eskola, S. (Sophia), Kokki, H. (Hannu), Lehtonen, M. (Marko), Räsänen, J. (Juha), Laaksonen, S. (Sakari), Voipio, H.-M. (Hanna-Marja), Ranta, V.-P. (Veli-Pekka), and Kokki, M. (Merja)
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Buprenorphine is used during pregnancy for the treatment of opioid use disorder. Limited data exist on the central nervous system (CNS) permeation and distribution, and on the fetal exposure to buprenorphine. The aim of our study was to determine the extent of buprenorphine distribution to CNS in the pregnant sheep, and their fetus at steady-state, and their newborn lambs postdelivery, using three different dosing regimens. Twenty-eight pregnant ewes in late gestation received buprenorphine via 7-day transdermal patch releasing buprenorphine 20 µg/h (n=9) or 40 µg/h (n=11), or an extended-release 8 mg/week subcutaneous injection (n=8). Plasma, cerebrospinal fluid, and CNS tissue samples were collected at steady-state from ewes and fetuses, and from lambs 0.33–45 hours after delivery. High accumulation of buprenorphine was observed in all CNS tissues. The median CNS/plasma concentration -ratios of buprenorphine in different CNS areas ranged between 13 and 50 in the ewes, and between 26 and 198 in the fetuses. In the ewes the CNS/plasma -ratios were similar after the three dosing regimens, but higher in the fetuses in the 40 µg/h dosing group, medians 65–122, than in the 20 µg/h group, medians 26–54. The subcutaneous injection (theoretical release rate 47.6 µg/h) produced higher concentrations than observed after 40 µg/h transdermal patch dosing. The median fetal/maternal concentration -ratios in different dosing groups ranged between 0.21 and 0.54 in plasma, and between 0.38 and 1.3 in CNS tissues, respectively, with the highest ratios observed in the spinal cord. Buprenorphine concentrations in the cerebrospinal fluid were 8–13 % of the concurrent plasma concentration in the ewes and 28 % in the fetuses. Buprenorphine was quantifiable in the newborn lambs’ plasma and CNS tissues two days postdelivery. Norbuprenorphine was analyzed from all plasma, cerebrospinal fluid, and CNS tissue samples but was nondetectable or below the LLOQ in most. The current study
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- 2022
9. Preoperative hemoglobin count and prognosis of esophageal cancer, a population-based nationwide study in Finland
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Jokela, E. M. (Ella M.K.), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Ohtonen, P. (Pasi), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Sihvo, E. (Eero), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Valtola, A. (Antti), Jokela, E. M. (Ella M.K.), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Ohtonen, P. (Pasi), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Sihvo, E. (Eero), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), and Valtola, A. (Antti)
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Background: The prognostic value of preoperative hemoglobin in patients undergoing esophagectomy is unknown. The aim of this study was to examine whether preoperative hemoglobin is associated with prognosis in patients undergoing esophagectomy for cancer. Materials and methods: This was a population-based nationwide retrospective cohort study in Finland, using Finnish National Esophago-Gastric Cancer Cohort (FINEGO). Esophagectomy patients with available preoperative hemoglobin measurement were included. Multivariable cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period of surgery, age at surgery, sex, comorbidity (Charlson Comorbidity Index), tumor histology, tumor stage, neoadjuvant therapy, type of surgery (minimally invasive or open) and annual hospital volume. Results: Of the 1313 patients, 932 (71.0%) were men and 799 (60.9%) had esophageal adenocarcinoma. Overall all-cause mortality was significantly higher in the lowest hemoglobin count tertile (HR 1.26 (1.07–1.47)) compared to the highest tertile, but this association was attenuated after adjustment for confounding. No differences were found between the preoperative hemoglobin groups in the adjusted analyses of 90-day all-cause, 5-year all-cause, and 5-year cancer-specific mortality. Conclusions: In this population-based nationwide study, preoperative hemoglobin count had no independent prognostic significance in esophageal cancer.
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- 2022
10. Research letter: Oncological treatment reported by the Finnish Cancer Registry compared to given neoadjuvant treatment in patients undergoing esophagectomy for cancer:a nationwide study
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Sirviö, V. E. (Ville E. J.), Räsänen, J. V. (Jari V.), Kauppila, J. H. (Joonas H.), Sirviö, V. E. (Ville E. J.), Räsänen, J. V. (Jari V.), and Kauppila, J. H. (Joonas H.)
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- 2022
11. Alcohol-induced premature permeability in mouse placenta-yolk sac barriers in vivo
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Haghighi Poodeh, S., Salonurmi, T., Nagy, I., Koivunen, P., Vuoristo, J., Räsänen, J., Sormunen, R., Vainio, S., and Savolainen, M.J.
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- 2012
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12. Peripheral chemoreflex activation and cardiac function during hypoxemia in near term fetal sheep without placental compromise
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Lantto, J, Erkinaro, T, Haapsamo, M, Huhta, H, Alanne, L, Kokki, M, Ohtonen, P, Bhide, A, Acharya, G, and Räsänen, J
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A drop in arterial oxygen content activates fetal chemoreflex including an increase in sympathetic activity leading to peripheral vasoconstriction and redistribution of blood flow to protect the brain, myocardium, and adrenal glands. By using a chronically instrumented fetal sheep model with intact placental circulation at near-term gestation, we investigated the relationship between peripheral chemoreflex activation induced by hypoxemia and central hemodynamics. 17 Åland landrace sheep fetuses at 115-128/145 gestational days were instrumented. Carotid artery was catheterised in 10 fetuses and descending aorta in 7 fetuses. After a 4-day recovery, baseline measurements of fetal arterial blood pressures, blood gas values, and fetal cardiovascular hemodynamics by pulsed Doppler ultrasonography were obtained under isoflurane-anesthesia. Comparable data to baseline was collected 10 (acute hypoxemia) and 60 minutes (prolonged hypoxemia) after maternal hypo-oxygenation to saturation level of 70-80% was achieved. During prolonged hypoxemia, pH and base excess (BE) were lower, and lactate levels higher in the descending aorta than in the carotid artery. During hypoxemia mean arterial blood pressure (MAP) in the descending aorta increased, while in the carotid artery MAP decreased. In addition, right pulmonary artery pulsatility index values increased, and the diastolic component in the aortic isthmus blood flow velocity waveform became more retrograde. Both fetal ventricular cardiac outputs were maintained even during prolonged hypoxemia when significant fetal metabolic acidemia developed. Fetal chemoreflex activation induced by hypoxemia decreased the perfusion pressure in the cerebral circulation. Fetal weight-indexed LVCO or AoI Net Flow-ratio did not correlate with a drop in carotid artery blood pressure.
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- 2021
13. Airway Pressure Release Ventilation
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Räsänen, J. and Gullo, Antonino, editor
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- 1996
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14. Neural Networks in Critical Care
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Räsänen, J., Léon, M. A., and Vincent, Jean-Louis, editor
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- 1995
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15. Airway Pressure Release Ventilation
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Räsänen, J. and Rügheimer, Erich, editor
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- 1995
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16. Airway Pressure Release Ventilation
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Räsänen, J. and Lemaire, François, editor
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- 1991
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17. Long-term indwelling pleural catheter (PleurX) for malignant pleural effusion unsuitable for talc pleurodesis
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Sioris, T., Sihvo, E., Salo, J., Räsänen, J., and Knuuttila, A.
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- 2009
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18. A novel peptide (Thx) homing to non-small cell lung cancer identified by ex vivo phage display
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Koivistoinen, A., Ilonen, I. I. K., Punakivi, K., Räsänen, J. V., Helin, H., Sihvo, E. I., Bergman, M., and Salo, J. A.
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- 2013
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19. Maternal and fetal buprenorphine pharmacokinetics in pregnant sheep during transdermal patch dosing:buprenorphine pharmacokinetics in pregnant sheep
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Hakomäki, H. (Henriikka), Kokki, H. (Hannu), Lehtonen, M. (Marko), Räsänen, J. (Juha), Voipio, H.-M. (Hanna-Marja), Ranta, V.-P. (Veli-Pekka), and Kokki, M. (Merja)
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Sheep ,Pregnancy ,Transdermal ,Buprenorphine - Abstract
Background: Buprenorphine is used in the opioid maintenance treatment for opioid dependent patients, including pregnant women. Despite the wide use, limited data exists on buprenorphine pharmacokinetics and fetal exposure during pregnancy. The aim of our study was to determine the buprenorphine pharmacokinetics during transdermal patch dosing to pregnant sheep and, to determine the extent of transplacental transfer of buprenorphine to the fetus. Methods: Pregnant sheep in late gestation (n=50) received 20, 25 or 40 µg/h of buprenorphine as a 7-day extended-release transdermal patch. Plasma samples were collected from the ewe and the fetus on days 1–6, and buprenorphine and norbuprenorphine concentrations were determined. During the exposure period the sheep had a surgical procedure on the second day, a recovery phase, and an experimental procedure on the sixth day. In the experiment, hypoxia was induced under anesthesia for 18 sheep to investigate if decreased fetal pH would cause ion-trapping of buprenorphine in the fetus. The fetal/maternal plasma concentration ratio was determined on the second and on the sixth exposure day at baseline and during hypoxia. Maternal pharmacokinetics were modelled with a population pharmacokinetic method using the data from this study and our previous intravenous administration study. Results: The transdermal patch provided an extended release of buprenorphine throughout the exposure period, but the release rate declined approximately 20 h after patch placement. The median fetal/maternal plasma concentration ratio was 13–27 % throughout the exposure period at baseline. A ratio over 100 % was observed for four sheep on the sixth exposure day (102–269 %). A minor increase was seen in the median fetal/maternal-ratios during maternal hypoxia. Norbuprenorphine was undetected in all plasma samples. Conclusions: The low transplacental passage of less than one fourth of the ewe’s exposure supports buprenorphine as an alternative to methadone in opioid maintenance therapy during pregnancy.
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- 2021
20. Functional diagnostics using fresh uncultured lung tumor cells to guide personalized treatments
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Talwelkar,S., Mäyränpää, M., Søraas, L., Potdar, S., Bao, J, Hemmes,A., Linnavirta, N., Lømo, J, Räsänen,J, Knuuttila, A, Wennerberg,K. Verschuren, EW
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- 2021
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21. Fetal cardiovascular hemodynamics in type 1 diabetic pregnancies at near‐term gestation
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Lehtoranta, L. (Lara), Haapsamo, M. (Mervi), Vuolteenaho, O. (Olli), Palo, P. (Pertti), Ekholm, E. (Eeva), and Räsänen, J. (Juha)
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aortic isthmus ,cardiac dysfunction ,natriuretic peptide ,placenta ,type 1 diabetes ,Doppler ultrasound ,branch pulmonary artery - Abstract
Introduction: Poor glycemic control in maternal type 1 diabetes mellitus during pregnancy can affect fetal cardiac and placental function. However, studies concerning fetal central hemodynamics have revealed conflicting results. We hypothesized that in pregnancies complicated by maternal type 1 diabetes, fetal cardiovascular and placental hemodynamics are comparable to the control fetuses at near‐term gestation. In addition, we investigated the relation between newborn serum biomarkers of cardiac function and fetal cardiovascular and placental hemodynamics. Furthermore, we studied whether maternal diabetes is associated with placental inflammation. Material and methods: In this prospective case‐control study, fetal central and peripheral hemodynamics were assessed by ultrasonography in 33 women with type 1 diabetes and in 67 controls with singleton pregnancies between 34+2 and 40+2 gestational weeks. Newborn umbilical cord serum was collected to analyze cardiac natriuretic peptides (atrial and B‐type natriuretic peptides) and troponin T concentrations. Placental tissue samples were obtained for cytokine analyses. Results: Fetal ventricular wall thicknesses were greater and weight‐adjusted stroke volumes and cardiac outputs were lower in the type 1 diabetes group than in the control group. Pulsatility in the aortic isthmus and inferior vena cava blood flow velocity waveforms was greater in the type 1 diabetes group fetuses than in the controls. A positive correlation was found between branch pulmonary artery and aortic isthmus pulsatility index values. Umbilical artery pulsatility indices were comparable between the groups. Umbilical cord serum natriuretic peptide and troponin T concentrations were elevated in the type 1 diabetes fetuses. These cardiac biomarkers correlated significantly with cardiovascular hemodynamics. Placental cytokine levels were not different between the groups. Conclusions: In maternal type 1 diabetes pregnancies, fetal cardiovascular hemodynamics is impaired. Maternal type 1 diabetes does not seem to alter placental vascular impedance or induce placental inflammation.
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- 2021
22. Centralized repeated resectability assessment of patients with colorectal liver metastases during first-line treatment:prospective study
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Isoniemi, H. (H.), Uutela, A. (A.), Nordin, A. (A.), Lantto, E. (E.), Kellokumpu, I. (I.), Ovissi, A. (A.), Kosunen, J. (J.), Kallio, R. (R.), Soveri, L. M. (L. M.), Salminen, T. (T.), Ålgars, A. (A.), Lamminmäki, A. (A.), Halonen, P. (P.), Ristamäki, R. (R.), Räsänen, J. (J.), Karjula, H. (H.), Vaalavuo, Y. (Y.), Lavonius, M. (M.), and Osterlund, P. (P.)
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Background: Metastasectomy is probably underused in metastatic colorectal cancer. The aim of this study was to investigate the effect of centralized repeated assessment on resectability rate of liver metastases. Methods: The prospective RAXO study was a nationwide study in Finland. Patients with treatable metastatic colorectal cancer at any site were eligible. This planned substudy included patients with baseline liver metastases between 2012 and 2018. Resectability was reassessed by the multidisciplinary team at Helsinki tertiary referral centre upfront and twice during first-line systemic therapy. Outcomes were resectability rates, management changes, and survival. Results: Of 812 patients included, 301 (37.1 per cent) had liver-only metastases. Of these, tumours were categorized as upfront resectable in 161 (53.5 per cent), and became amenable to surgery during systemic treatment in 63 (20.9 per cent). Some 207 patients (68.7 per cent) eventually underwent liver resection or ablation. At baseline, a discrepancy in resectability between central and local judgement was noted for 102 patients (33.9 per cent). Median disease-free survival (DFS) after first resection was 20 months and overall survival (OS) 79 months. Median OS after diagnosis of metastatic colorectal cancer was 80, 32, and 21 months in R0–1 resection, R2/ablation, and non-resected groups, and 5-year OS rates were 68, 37, and 9 per cent, respectively. Liver and extrahepatic metastases were present in 511 patients. Of these, tumours in 72 patients (14.1 per cent) were categorized as upfront resectable, and 53 patients (10.4 per cent) became eligible for surgery. Eventually 110 patients (21.5 per cent) underwent liver resection or ablation. At baseline, a discrepancy between local and central resectability was noted for 116 patients (22.7 per cent). Median DFS from first resection was 7 months and median OS 55 months. Median OS after diagnosis of metastatic colorectal cancer was 79, 42, and 17 months in R0–1 resection, R2/ablation, and non-resected groups, with 5-year OS rates of 65, 39, and 2 per cent, respectively. Conclusion: Repeated centralized resectability assessment in patients with colorectal liver metastases improved resection and survival rates.
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- 2021
23. Design and development of poly-L/D-lactide copolymer and barium titanate nanoparticle 3D composite scaffolds using breath figure method for tissue engineering applications
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Kemppi, H. (H.), Finnilä, M. A. (M. A.), Lorite, G. S. (G. S.), Nelo, M. (M.), Juuti, J. (J.), Kokki, M. (M.), Kokki, H. (H.), Räsänen, J. (J.), Mobasheri, A. (A.), Saarakkala, S. (S.), Kemppi, H. (H.), Finnilä, M. A. (M. A.), Lorite, G. S. (G. S.), Nelo, M. (M.), Juuti, J. (J.), Kokki, M. (M.), Kokki, H. (H.), Räsänen, J. (J.), Mobasheri, A. (A.), and Saarakkala, S. (S.)
- Abstract
In tissue engineering, the scaffold topography influences the adhesion, proliferation, and function of cells. Specifically, the interconnected porosity is crucial for cell migration and nutrient delivery in 3D scaffolds. The objective of this study was to develop a 3D porous composite scaffold for musculoskeletal tissue engineering applications by incorporating barium titanate nanoparticles (BTNPs) into a poly-L/D-lactide copolymer (PLDLA) scaffold using the breath figure method. The porous scaffold fabrication utilised 96/04 PLDLA, dioleoyl phosphatidylethanolamine (DOPE), and different types of BTNPs, including uncoated BTNPs, Al2O3-coated BTNPs, and SiO2-coated BTNPs. The BTNPs were incorporated into the polymer scaffold, which was subsequently analysed using field emission scanning electron microscopy (FE-SEM). The biocompatibility of each scaffold was tested using ovine bone marrow stromal stem cells. The cell morphology, viability, and proliferation were evaluated using FE-SEM, LIVE/DEAD staining, and Prestoblue assay. Porous 3D composite scaffolds were successfully produced, and it was observed that the incorporation of uncoated BTNPs increased the average pore size from 1.6 μm (PLDLA) to 16.2 μm (PLDLA/BTNP). The increased pore size in the PLDLA/BTNP scaffolds provided a suitable porosity for the cells to migrate inside the scaffold, while in the pure PLDLA scaffolds with their much smaller pore size, cells elongated on the surface. To conclude, the breath figure method was successfully used to develop a PLDLA/BTNP scaffold. The use of uncoated BTNPs resulted in a composite scaffold with an optimal pore size while maintaining the honeycomb-like structure. The composite scaffolds were biocompatible and yielded promising structures for future tissue engineering applications.
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- 2021
24. Peripheral chemoreflex activation and cardiac function during hypoxemia in near-term fetal sheep without placental compromise
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Lantto, J. (Juulia), Erkinaro, T. (Tiina), Haapsamo, M. (Mervi), Huhta, H. (Heikki), Alanne, L. (Leena), Kokki, M. (Merja), Ohtonen, P. (Pasi), Bhide, A. (Amarnath), Acharya, G. (Ganesh), Räsänen, J. (Juha), Lantto, J. (Juulia), Erkinaro, T. (Tiina), Haapsamo, M. (Mervi), Huhta, H. (Heikki), Alanne, L. (Leena), Kokki, M. (Merja), Ohtonen, P. (Pasi), Bhide, A. (Amarnath), Acharya, G. (Ganesh), and Räsänen, J. (Juha)
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A drop in arterial oxygen content activates fetal chemoreflex including an increase in sympathetic activity leading to peripheralvasoconstriction and redistribution of bloodflow to protect the brain, myocardium, and adrenal glands. By using a chronicallyinstrumented fetal sheep model with intact placental circulation at near-term gestation, we investigated the relationship betweenperipheral chemoreflex activation induced by hypoxemia and central hemodynamics. A total of 17 Åland landrace sheep fetusesat 115–128/145 gestational days were instrumented. Carotid artery was catheterized in 10 fetuses and descending aorta in 7fetuses. After a 4-day recovery, baseline measurements of fetal arterial blood pressures, blood gas values, and fetal cardiovascu-lar hemodynamics by pulsed Doppler ultrasonography were obtained under isoflurane anesthesia. Comparable data to baselinewere collected 10 min (acute hypoxemia) and 60 min (prolonged hypoxemia) after maternal hypo-oxygenation to saturation levelof 70%–80% was achieved. During prolonged hypoxemia, pH and base excess (BE) were lower and lactate levels were higher inthe descending aorta than in the carotid artery. During hypoxemia mean arterial blood pressure (MAP) in the descending aortaincreased, whereas in the carotid artery, MAP decreased. In addition, right pulmonary artery pulsatility index values increased,and the diastolic component in the aortic isthmus bloodflow velocity waveform became more retrograde, thus decreasing theaortic isthmus antegrade/retrograde bloodflow (AoI Net Flow) ratio. Both fetal ventricular cardiac outputs were maintained evenduring prolonged hypoxemia when significant fetal metabolic acidemia developed. Fetal chemoreflex activation induced by hy-poxemia decreased the perfusion pressure in the cerebral circulation. Fetal weight-indexed left ventricular cardiac output (LVCO)or AoI Net Flow ratio did not correlate with a drop in carotid artery blood pressure.
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- 2021
25. Nifedipine disturbs fetal cardiac function during hypoxemia in a chronic sheep model at near term gestation
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Alanne, L. (Leena), Bhide, A. (Amarnath), Lantto, J. (Juulia), Huhta, H. (Heikki), Kokki, M. (Merja), Haapsamo, M. (Mervi), Acharya, G. (Ganesh), Räsänen, J. (Juha), Alanne, L. (Leena), Bhide, A. (Amarnath), Lantto, J. (Juulia), Huhta, H. (Heikki), Kokki, M. (Merja), Haapsamo, M. (Mervi), Acharya, G. (Ganesh), and Räsänen, J. (Juha)
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Background: Nifedipine is a widely used drug in pregnancies complicated by maternal hypertensive disorders that can be associated with placental insufficiency and fetal hypoxemia. The evidence regarding fetal myocardial responses to nifedipine in hypoxemia is limited. Objective: We hypothesized that nifedipine would not impair fetal sheep cardiac function under hypoxemic environment. In particular, we investigated the effects of nifedipine on fetal ventricular functional parameters and cardiac output. Study design: A total of 21 chronically instrumented fetal sheep at 122 to 134 gestational days (term, 145 days) were included in this study. Fetal cardiac function was evaluated by measuring global longitudinal strain, indices describing ventricular systolic and diastolic function, and cardiac outputs using two-dimensional speckle tracking and tissue and spectral pulsed-wave Doppler echocardiography. Fetal carotid artery blood pressure and blood gas values were invasively monitored. After baseline data collection, fetal hypoxemia was induced by maternal hyperoxygenation. After hypoxemia phase data collection, 9 fetuses received nifedipine infusion, and 12 fetuses received saline infusion. Data were collected 30 and 120 minutes after the infusion was started. After 120 minutes of data collection, maternal and fetal oxygenation were normalized, and normoxemia phase data were collected, while infusion was continued. Results: Hypoxemia decreased fetal carotid artery mean arterial pressure from 40 (8) mm Hg to 35 (8) mm Hg (P<.007), and left ventricular global longitudinal strain showed less deformation than at baseline(P=0.001). Under hypoxemia, nifedipine caused a reduction in right ventricular global longitudinal strain (P<0.05), a decrease in right ventricular isovolumic relaxation velocity and its deceleration (P<0.01) indicating diastolic dysfunction, and a drop in right ventricular cardiac output (P<0.05). Nifedipine did not alter fetal left ven
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- 2021
26. Repeated centralized multidisciplinary team assessment of resectability, clinical behavior, and outcomes in 1086 Finnish metastatic colorectal cancer patients (RAXO):a nationwide prospective intervention study
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Österlund, P. (Pia), Salminen, T. (Tapio), Soveri, L.-M. (Leena-Maija), Kallio, R. (Raija), Kellokumpu, I. (Ilmo), Lamminmäki, A. (Annamarja), Halonen, P. (Paivi), Ristamäki, R. (Raija), Lantto, E. (Eila), Uutela, A. (Aki), Österlund, E. (Emerik), Ovissi, A. (Ali), Nordin, A. (Arno), Heerva, E. (Eetu), Lehtomäki, K. (Kaisa), Räsänen, J. (Jari), Murashev, M. (Maija), Aroviita, L. (Laura), Jekunen, A. (Antti), Lindvall-Andersson, R. (Renee), Nyandoto, P. (Paul), Kononen, J. (Juha), Lepistö, A. (Anna), Poussa, T. (Tuija), Muhonen, T. (Timo), Algars, A. (Annika), Isoniemi, H. (Helena), Österlund, P. (Pia), Salminen, T. (Tapio), Soveri, L.-M. (Leena-Maija), Kallio, R. (Raija), Kellokumpu, I. (Ilmo), Lamminmäki, A. (Annamarja), Halonen, P. (Paivi), Ristamäki, R. (Raija), Lantto, E. (Eila), Uutela, A. (Aki), Österlund, E. (Emerik), Ovissi, A. (Ali), Nordin, A. (Arno), Heerva, E. (Eetu), Lehtomäki, K. (Kaisa), Räsänen, J. (Jari), Murashev, M. (Maija), Aroviita, L. (Laura), Jekunen, A. (Antti), Lindvall-Andersson, R. (Renee), Nyandoto, P. (Paul), Kononen, J. (Juha), Lepistö, A. (Anna), Poussa, T. (Tuija), Muhonen, T. (Timo), Algars, A. (Annika), and Isoniemi, H. (Helena)
- Abstract
Background: Resection of colorectal cancer (CRC) metastases provides good survival but is probably underused in real-world practice. Methods: A prospective Finnish nationwide study enrolled treatable metastatic CRC patients. The intervention was the assessment of resectability upfront and twice during first-line therapy by the multidisciplinary team (MDT) at Helsinki tertiary referral centre. The primary outcome was resection rates and survival. Findings: In 2012–2018, 1086 patients were included. Median follow-up was 58 months. Multiple metastatic sites were present in 500 (46%) patients at baseline and in 820 (76%) during disease trajectory. In MDT assessments, 447 (41%) were classified as resectable, 310 (29%) upfront and 137 (18%) after conversion therapy. Six-hundred and ninety curative intent resections or local ablative therapies (LAT) were performed in 399 patients (89% of 447 resectable). Multiple metastasectomies for multisite or later developing metastases were performed in 148 (37%) patients. Overall, 414 liver, 112 lung, 57 peritoneal, and 107 other metastasectomies were performed. Median OS was 80·4 months in R0/1-resected (HR 0·15; CI95% 0·12–0·19), 39·1 months in R2-resected/LAT (0·39; 0·29–0·53) patients, and 20·8 months in patients treated with “systemic therapy alone” (reference), with 5-year OS rates of 66%, 40%, and 6%, respectively. Interpretation: Repeated centralized MDT assessment in real-world metastatic CRC patients generates high resectability (41%) and resection rates (37%) with impressive survival, even when multisite metastases are present or develop later.
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- 2021
27. Pharmacokinetics of buprenorphine in pregnant sheep after intravenous injection
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Hakomäki, H. (Henriikka), Kokki, H. (Hannu), Lehtonen, M. (Marko), Ranta, V.-P. (Veli-Pekka), Räsänen, J. (Juha), Voipio, H.-M. (Hanna-Marja), Kokki, M. (Merja), Hakomäki, H. (Henriikka), Kokki, H. (Hannu), Lehtonen, M. (Marko), Ranta, V.-P. (Veli-Pekka), Räsänen, J. (Juha), Voipio, H.-M. (Hanna-Marja), and Kokki, M. (Merja)
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Buprenorphine is a semi‐synthetic opioid, widely used in the maintenance treatment for opioid‐dependent pregnant women. Limited data exist on the pharmacokinetics of buprenorphine in pregnancy. We conducted a pharmacokinetic study to determine the pharmacokinetics of intravenous buprenorphine in pregnant sheep. Fourteen pregnant sheep in late gestation received 10 µg/kg of buprenorphine as an intravenous bolus injection. Plasma samples were collected up to 48 h after administration. Buprenorphine and its metabolite, norbuprenorphine, were quantified from plasma using a LC/MS/MS method, with lower limits of quantification of 0.01 µg/L and 0.04 µg/L for buprenorphine and norbuprenorphine, respectively. The pharmacokinetic parameters were calculated using noncompartmental analysis. The pharmacokinetic parameters, median (minimum−maximum), were Cmax 4.31 µg/L (1.93–15.5), AUCinf 2.89 h*µg/L (1.72–40.2), CL 3.39 L/h/kg (0.25–6.02), terminal t½ 1.75 h (1.07–31.0), Vss 8.04 L/kg (1.05–49.3). Norbuprenorphine was undetected in all plasma samples. The median clearance in pregnant sheep was higher than previously reported for nonpregnant sheep and human (male) subjects. Our sensitive analytical method was able to detect long terminal half‐lives for six subjects, and a wide between‐subject variability in the study population. Significance statement: Buprenorphine is widely used for the treatment of opioid use disorder in pregnancy. However, limited data exist on the pharmacokinetics of buprenorphine during pregnancy. As this type of study cannot be done in humans due to ethical reasons, we conducted a study in pregnant sheep. This study provides pharmacokinetic data on buprenorphine in pregnant sheep and helps us to understand the pharmacokinetics of the drug in humans.
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- 2021
28. Fit-for-Discharge Criteria after Esophagectomy: An International Expert Delphi Consensus
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MS CGO, Cancer, Müller, P. C., Kapp, J. R., Vetter, D., Bonavina, L., Brown, W., Castro, S., Cheong, E., Darling, G. E., Egberts, J., Ferri, L., Gisbertz, S. S., Gockel, I., Grimminger, P. P., Hofstetter, W. L., Hölscher, A. H., Low, D. E., Luyer, M., Markar, S. R., Mönig, S. P., Moorthy, K., Morse, C. R., Müller-Stich, B. P., Nafteux, P., Nieponice, A., Nieuwenhuijzen, G. A.P., Nilsson, M., Palanivelu, C., Pattyn, P., Pera, M., Räsänen, J., Ribeiro, U., Rosman, C., Schröder, W., Sgromo, B., Van Berge Henegouwen, M. I., Van Hillegersberg, R., Van Veer, H., Van Workum, F., Watson, D. I., Wijnhoven, B. P.L., Gutschow, C. A., MS CGO, Cancer, Müller, P. C., Kapp, J. R., Vetter, D., Bonavina, L., Brown, W., Castro, S., Cheong, E., Darling, G. E., Egberts, J., Ferri, L., Gisbertz, S. S., Gockel, I., Grimminger, P. P., Hofstetter, W. L., Hölscher, A. H., Low, D. E., Luyer, M., Markar, S. R., Mönig, S. P., Moorthy, K., Morse, C. R., Müller-Stich, B. P., Nafteux, P., Nieponice, A., Nieuwenhuijzen, G. A.P., Nilsson, M., Palanivelu, C., Pattyn, P., Pera, M., Räsänen, J., Ribeiro, U., Rosman, C., Schröder, W., Sgromo, B., Van Berge Henegouwen, M. I., Van Hillegersberg, R., Van Veer, H., Van Workum, F., Watson, D. I., Wijnhoven, B. P.L., and Gutschow, C. A.
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- 2021
29. Regulation, regulative legitimacy and legitimation of ride-sourcing platforms in Finland
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Räsänen, J. (Juuso)
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Since their inception ride-sourcing companies have disrupted the traditional taxi markets with their digital platforms and match-making algorithms. However in the previous hundred years the incumbent taxi companies had become protected by national legislation which aimed to maintain public order and safety. Despite the well-developed regulation on taxi market the legislation has not been clear whether ride-sourcing is legal or not. This is what the new players such as Uber have been exploiting with their aggressive expansion strategies when trying to win the race on network effects. This thesis studies the regulative landscape of ride-sourcing phenomenon in Finland and the three law making processes in 2015–2020. It summarizes how the regulation changed from the ride-sourcing platform point of view and uncovers the legitimation strategies Uber used when establishing a subsidiary in Finland already before the first reform of the law on transportation in 2018. It matches the strategies to the ones previously identified in the literature and gives insight how disrupting technology company has tried to affect the law makers in order to create a legislation which would ultimately grant ride-sourcing regulative legitimacy. The results of the study tell the story of how the closed taxi market in Finland has opened up to welcome ride-sourcing platforms after a few missteps. Second it demonstrates how the IT legitimacy taxonomy by Kaganer et al. (2010) can be used to understand the legitimation strategies of a private organization during a law making process in the hopes of establishing regulative legitimacy in the future. Finally it reveals that while the regulation has changed to more favourable for ride-sourcing, the battle is far from over and new disputes are looming around the corner.
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- 2020
30. Centralized repeated resectability assessment of patients with colorectal liver metastases during first-line treatment: prospective study
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Isoniemi, H, primary, Uutela, A, additional, Nordin, A, additional, Lantto, E, additional, Kellokumpu, I, additional, Ovissi, A, additional, Kosunen, J, additional, Kallio, R, additional, Soveri, L M, additional, Salminen, T, additional, Ålgars, A, additional, Lamminmäki, A, additional, Halonen, P, additional, Ristamäki, R, additional, Räsänen, J, additional, Karjula, H, additional, Vaalavuo, Y, additional, Lavonius, M, additional, and Osterlund, P, additional
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- 2021
- Full Text
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31. Design and development of poly-L/D-lactide copolymer and barium titanate nanoparticle 3D composite scaffolds using breath figure method for tissue engineering applications
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Kemppi, H., primary, Finnilä, M.A., additional, Lorite, G.S., additional, Nelo, M., additional, Juuti, J., additional, Kokki, M., additional, Kokki, H., additional, Räsänen, J., additional, Mobasheri, A., additional, and Saarakkala, S., additional
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- 2021
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32. Ruokatorvisyövän hoito kehittyy
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Kauppila, J. H. (Joonas H.), Kallio, R. (Raija), and Räsänen, J. V. (Jari V.)
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Tiivistelmä Ruokatorvisyöpä on edelleen tappava tauti, ja vain joka kuudes potilas elää viiden vuoden kuluttua diagnoosin saamisesta. Taudin tyyppi ja levinneisyys selvitetään endoskopialla, biopsioilla ja kuvantamistutkimuksilla. Pinnallisen ruokatorvisyövän ensisijainen hoito on endoskooppinen limakalvoresektio tai endoskooppinen submukoosadissektio. Paikallinen, endoskooppiseen hoitoon soveltumaton syöpä leikataan. Suositeltava ruokatorvisyövän radikaalileikkaus on mini-invasiivinen esofagektomia. Paikallisesti edennyt syöpä hoidetaan yhdistämällä onkologinen ja leikkaushoito. Definitiivisellä kemosädehoidolla hoidetaan leikkaukseen soveltumattomat syövät. Leikatuista potilaista yli 40 % elää yli viisi vuotta. Jos tauti on levinnyt, elinajan odote on alle vuoden. Ravitsemuksesta huolehtiminen sekä kivun ja nielemisvaikeuksien hoito on keskeistä taudin kaikissa vaiheissa. Abstract Esophageal cancer continues to be a cancer of high mortality, the 5-year survival being 14 to 17%. The histological type and staging is based on endoscopy, biopsies and radiology. The first-line treatments of superficial cancers are endoscopic mucosal resection and endoscopic submucosal dissection. Local cancer that cannot be treated with endoscopy is treated operatively. Minimally invasive esophagectomy is the recommended type of radical surgery for esophageal cancer. Adjuvant therapy combined with esophagectomy is the mainstay of locally advanced cancer. Definitive chemoradiotherapy is mostly used in patients not suitable for surgery. The 5-year survival of operated esophageal cancer is over 40%. In advanced cancers, the prognosis is less than a year. Treating dysphagia, pain and nutrition is important in all stages of the disease.
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- 2020
33. Cohort profile:a nationwide population-based retrospective assessment of oesophageal cancer in the Finnish National Esophago-Gastric Cancer Cohort (FINEGO)
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Söderström, H. K. (Henna K.), Räsänen, J. (Jari), Saarnio, J. (Juha), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Rantanen, T. (Tuomo), Valtola, A. (Antti), Ohtonen, P. (Pasi), Pääaho, M. (Minna), Kokkola, A. (Arto), Kallio, R. (Raija), Karttunen, T. J. (Tuomo J.), Pohjanen, V.-M. (Vesa-Matti), Ristimäki, A. (Ari), Laine, S. (Simo), Sihvo, E. (Eero), and Kauppila, J. H. (Joonas H.)
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surgery ,gastrointestinal tumours ,oesophageal disease ,epidemiology - Abstract
Purpose: The Finnish National Esophago-Gastric Cancer Cohort (FINEGO) was established to combine the available registry data with detailed patient information to form a comprehensive, retrospective, population-based research platform of surgically treated oesophageal and gastric cancer in Finland. This cohort profile describes the 2045 surgically treated patients with oesophageal cancer included in the FINEGO cohort. Participants: Registry data were collected from the National Cancer, Patient, Education and Death Registries from 1 January 1987 to 31 December 2016. All patients over 18 years of age, who had either curative surgery, palliative surgery or salvage surgery for primary cancer in the oesophagus are included in this study. Findings to date: 2045 patients had surgery for oesophageal cancer in the selected time period. 67.2% were man, and the majority had only minor comorbidities. The proportions of adenocarcinomas and squamous cell carcinomas were 43.1% and 44.4%, respectively, and 12.5% had other or missing histology. Only about 23% of patients received neoadjuvant therapy. Oesophagectomy was the treatment of choice and most patients were treated at low-volume centres, but median annual hospital volume increased over time. Median overall survival was 23 months, 5-year survival for all patients in the cohort was 32.9% and cancer-specific survival was 36.5%. Future plans: Even though Finland only has a population of 5.5 million, surgery for oesophageal carcinoma has not been centralised and therefore previously reported results have mostly been small, single-centre cohorts. Because of FINEGO, we now have a population-based, unselected cohort of surgically treated patients, enabling research on national trends over time regarding oesophageal cancer, including patient characteristics, tumour histology, stage and neoadjuvant treatment, surgical techniques, hospital volumes and patient mortality. Data collection is ongoing, and the cohort will be expanded to include more detailed data from patient records and national biobanks.
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- 2020
34. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process
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Konradsson, M., Berge Henegouwen, M.I. van, Bruns, C., Chaudry, M.A., Cheong, E., Cuesta, M.A., Darling, G.E., Gisbertz, S.S., Griffin, S.M., Gutschow, C.A., Hillegersberg, R. van, Hofstetter, W., Hölscher, A.H., Kitagawa, Y., Lanschot, J.Jan B. van, Lindblad, M., Ferri, L.E., Low, D.E., Luyer, M.D., Ndegwa, N., Mercer, S., Moorthy, K., Morse, C.R., Nafteux, P., Nieuwehuijzen, G.A.P., Pattyn, P., Rosman, C., Ruurda, J.P., Räsänen, J., Schneider, P.M., Schröder, W., Sgromo, B., Veer, H. van der, Wijnhoven, B.P., Nilsson, M., Konradsson, M., Berge Henegouwen, M.I. van, Bruns, C., Chaudry, M.A., Cheong, E., Cuesta, M.A., Darling, G.E., Gisbertz, S.S., Griffin, S.M., Gutschow, C.A., Hillegersberg, R. van, Hofstetter, W., Hölscher, A.H., Kitagawa, Y., Lanschot, J.Jan B. van, Lindblad, M., Ferri, L.E., Low, D.E., Luyer, M.D., Ndegwa, N., Mercer, S., Moorthy, K., Morse, C.R., Nafteux, P., Nieuwehuijzen, G.A.P., Pattyn, P., Rosman, C., Ruurda, J.P., Räsänen, J., Schneider, P.M., Schröder, W., Sgromo, B., Veer, H. van der, Wijnhoven, B.P., and Nilsson, M.
- Abstract
Contains fulltext : 225948.pdf (Publisher’s version ) (Open Access), Delayed gastric conduit emptying (DGCE) after esophagectomy for cancer is associated with adverse outcomes and troubling symptoms. Widely accepted diagnostic criteria and a symptom grading tool for DGCE are missing. This hampers the interpretation and comparison of studies. A modified Delphi process, using repeated web-based questionnaires, combined with live interim group discussions was conducted by 33 experts within the field, from Europe, North America, and Asia. DGCE was divided into early DGCE if present within 14 days of surgery and late if present later than 14 days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: >500 mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or >100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air-fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have 'quite a bit' or 'very much' of at least two of the following symptoms; early satiety/fullness, vomiting, nausea, regurgitation or inability to meet caloric need by oral intake and delayed contrast passage on upper gastrointestinal water-soluble contrast radiogram or on timed barium swallow. A symptom grading tool for late DGCE was constructed grading each symptom as: 'not at all', 'a little', 'quite a bit', or 'very much', generating 0, 1, 2, or 3 points, respectively. For the five symptoms retained in the diagnostic criteria for late DGCE, the minimum score would be 0, and the maximum score would be 15. The final symptom grading tool for late DGCE was accepted by 27 of 31 (87%) experts. For the first time, diagnostic criteria for early and late DGCE and a symptom grading tool for late DGCE are available, based on an international expert consensus process.
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- 2020
35. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer : international expert consensus based on a modified Delphi process
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Konradsson, M, van Berge Henegouwen, M I, Bruns, C, Chaudry, M A, Cheong, E, Cuesta, M A, Darling, G E, Gisbertz, S S, Griffin, S M, Gutschow, C A, van Hillegersberg, R, Hofstetter, W, Hölscher, A H, Kitagawa, Y, van Lanschot, J J B, Lindblad, M, Ferri, L E, Low, D E, Luyer, M D P, Ndegwa, N, Mercer, S, Moorthy, K, Morse, C R, Nafteux, P, Nieuwehuijzen, G A P, Pattyn, P, Rosman, C, Ruurda, J P, Räsänen, J, Schneider, P M, Schröder, W, Sgromo, B, Van Veer, H, Wijnhoven, B P L, Nilsson, M, Konradsson, M, van Berge Henegouwen, M I, Bruns, C, Chaudry, M A, Cheong, E, Cuesta, M A, Darling, G E, Gisbertz, S S, Griffin, S M, Gutschow, C A, van Hillegersberg, R, Hofstetter, W, Hölscher, A H, Kitagawa, Y, van Lanschot, J J B, Lindblad, M, Ferri, L E, Low, D E, Luyer, M D P, Ndegwa, N, Mercer, S, Moorthy, K, Morse, C R, Nafteux, P, Nieuwehuijzen, G A P, Pattyn, P, Rosman, C, Ruurda, J P, Räsänen, J, Schneider, P M, Schröder, W, Sgromo, B, Van Veer, H, Wijnhoven, B P L, and Nilsson, M
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- 2020
36. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process
- Author
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Konradsson, M. (M.), van Berge Henegouwen, M.I., Bruns, C. (C.), Chaudry, M.A. (M. A.), Cheong, E. (E.), Cuesta, M.A. (M. A.), Darling, G.E. (Gail E.), Gisbertz, S.S. (Suzanne S.), Griffin, S.M. (Michael), Gutschow, C.A. (C. A.), Hillegersberg, R. (Richard) van, Hofstetter, W.L. (Wayne), Hölscher, A. (Arnulf), Kitagawa, Y. (Y.), Lanschot, J.J.B. (Jan) van, Lindblad, M. (M.), Ferri, L.E. (L. E.), Low, D.E. (D. E.), Luyer, M. (Misha), Ndegwa, N. (N.), Mercer, S. (S.), Moorthy, K. (K.), Morse, C.R. (C. R.), Nafteux, P. (P.), Nieuwehuijzen, G.A.P. (G. A.P.), Pattyn, P. (Piet), Rosman, C. (Camiel), Ruurda, J.P. (Jelle), Räsänen, J. (J.), Schneider, P.M. (P. M.), Schröder, W. (W.), Sgromo, B. (B.), Van Veer, H. (H.), Wijnhoven, B.P.L. (Bas), Nilsson, M. (M.), Konradsson, M. (M.), van Berge Henegouwen, M.I., Bruns, C. (C.), Chaudry, M.A. (M. A.), Cheong, E. (E.), Cuesta, M.A. (M. A.), Darling, G.E. (Gail E.), Gisbertz, S.S. (Suzanne S.), Griffin, S.M. (Michael), Gutschow, C.A. (C. A.), Hillegersberg, R. (Richard) van, Hofstetter, W.L. (Wayne), Hölscher, A. (Arnulf), Kitagawa, Y. (Y.), Lanschot, J.J.B. (Jan) van, Lindblad, M. (M.), Ferri, L.E. (L. E.), Low, D.E. (D. E.), Luyer, M. (Misha), Ndegwa, N. (N.), Mercer, S. (S.), Moorthy, K. (K.), Morse, C.R. (C. R.), Nafteux, P. (P.), Nieuwehuijzen, G.A.P. (G. A.P.), Pattyn, P. (Piet), Rosman, C. (Camiel), Ruurda, J.P. (Jelle), Räsänen, J. (J.), Schneider, P.M. (P. M.), Schröder, W. (W.), Sgromo, B. (B.), Van Veer, H. (H.), Wijnhoven, B.P.L. (Bas), and Nilsson, M. (M.)
- Abstract
Delayed gastric conduit emptying (DGCE) after esophagectomy for cancer is associated with adverse outcomes and troubling symptoms. Widely accepted diagnostic criteria and a symptom grading tool for DGCE are missing. This hampers the interpretation and comparison of studies. A modified Delphi process, using repeated web-based questionnaires, combined with live interim group discussions was conducted by 33 experts within the field, from Europe, North America, and Asia. DGCE was divided into early DGCE if present within 14 days of surgery and late if present later than 14 days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: >500 mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or >100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air-fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have 'quite a bit' or 'very much' of at least two of the following symptoms; early satiety/fullness, vomiting, nausea, regurgitation or inability to meet caloric need by oral intake and delayed contrast passage on upper gastrointestinal water-soluble contrast radiogram or on timed barium swallow. A symptom grading tool for late DGCE was constructed grading each symptom as: 'not at all', 'a little', 'quite a bit', or 'very much', generating 0, 1, 2, or 3 points, respectively. For the five symptoms retained in the diagnostic criteria for late DGCE, the minimum score would be 0, and the maximum score would be 15. The final symptom grading tool for late DGCE was accepted by 27 of 31 (87%) experts. For the first time, diagnostic criteria for early and late DGCE and a symptom grading tool for late DGCE are available, based on an international expert consensus process.
- Published
- 2020
- Full Text
- View/download PDF
37. Cohort profile: gastric cancer in the population-based, Finnish National Esophago-Gastric Cancer Cohort (FINEGO) Study
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Kauppila, J. H. (Joonas H.), Ohtonen, P. (Pasi), Rantanen, T. (Tuomo), Tyrväinen, T. (Tuula), Toikkanen, V. (Vesa), Pääaho, M. (Minna), Valtola, A. (Antti), Räsänen, J. (Jari), Kallio, R. (Raija), Sihvo, E. (Eero), Saarnio, J. (Juha), Karttunen, T. J. (Tuomo J.), Pohjanen, V.-M. (Vesa-Matti), Ristimäki, A. (Ari), Laine, S. (Simo), Kokkola, A. (Arto), Kauppila, J. H. (Joonas H.), Ohtonen, P. (Pasi), Rantanen, T. (Tuomo), Tyrväinen, T. (Tuula), Toikkanen, V. (Vesa), Pääaho, M. (Minna), Valtola, A. (Antti), Räsänen, J. (Jari), Kallio, R. (Raija), Sihvo, E. (Eero), Saarnio, J. (Juha), Karttunen, T. J. (Tuomo J.), Pohjanen, V.-M. (Vesa-Matti), Ristimäki, A. (Ari), Laine, S. (Simo), and Kokkola, A. (Arto)
- Abstract
Purpose: The Finnish National Esophago-Gastric Cancer Cohort (FINEGO) was established with the aim of identifying factors that could contribute to improved outcomes in oesophago-gastric cancer. The aim of this study is to describe the patients with gastric cancer included in FINEGO. Participants: A total of 10 457 patients with gastric cancer or tumour diagnosis in the Finnish Cancer Registry or the Finnish Patient Registry during 1987–2016 were included in the cohort, with follow-up from Causes of Death Registry until 31 December 2016. All of the participants were at least 18 years of age, and had undergone either resectional or endoscopic mucosal surgery with curative or palliative intent. Findings: to date Of the 10 457 patients, 90.1% were identified to have cancer in both cancer and patient registries. In all, the median age was 70 at the time of surgery, 54.5% of the patients were men and 64.4% had no comorbidities. Education data were available for 31.1% of the patients, of whom the majority had had <12 years of formal education. Of the 7798 with cancer staging data available, 41.1% had a local cancer. Adenocarcinoma was the most common (94.2%) histological type. Almost all patients underwent open gastrectomy and 214% in hospitals with annual volume of more than 30 gastrectomies per year. A total of 8561 deaths occurred during the study period, of which 6474 were due to oesophago-gastric cancers. The 5-year survival was 34.6% and 5-year cancer-specific survival was 39.7%. Future plans: The data in FINEGO can be currently used for registry-based research but is being expanded by data extraction from patient records and scanning of histological samples from the Finnish biobanks. Initially, we are planning on studies on the national trends in treatment and mortality, and studies on the demographic factors and their influence on survival.
- Published
- 2020
38. Effects of nifedipine and sildenafil on placental hemodynamics and gas exchange during fetal hypoxemia in a chronic sheep model
- Author
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Alanne, L. (Leena), Bhide, A. (Amarnath), Hoffren, J. (Jonna), Lantto, J. (Juulia), Huhta, H. (Heikki), Kokki, M. (Merja), Haapsamo, M. (Mervi), Acharya, G. (Ganesh), Räsänen, J. (Juha), Alanne, L. (Leena), Bhide, A. (Amarnath), Hoffren, J. (Jonna), Lantto, J. (Juulia), Huhta, H. (Heikki), Kokki, M. (Merja), Haapsamo, M. (Mervi), Acharya, G. (Ganesh), and Räsänen, J. (Juha)
- Abstract
Introduction: We hypothesized that nifedipine and sildenafil would have no detrimental effects on placental hemodynamics and gas exchange under fetal hypoxemia. Methods: In 33 chronically instrumented fetal sheep, placental volume blood flow (QPlac) and umbilical artery (UA) vascular impedance were measured by Doppler ultrasonography. Fetal carotid artery blood pressure and blood gas values were monitored. After baseline data collection, maternal and fetal hypoxemia were induced. Following hypoxemia phase data collection, 12 fetuses received sildenafil and 9 fetuses nifedipine infusion, and 12 fetuses served as controls receiving saline infusion. Data were collected 30 and 120 min after infusion was started. Then maternal oxygenation was normalized and normoxemia phase data were collected, while infusion was continued. Results: Hypoxemia significantly decreased fetal pO2 and blood pressure. In the sildenafil group at 30- and 120-min hypoxemia + infusion phases, fetal blood pressure and QPlac were significantly lower and pCO2 higher than at baseline without returning to baseline level at normoxemia + infusion phase. In hypoxemia, nifedipine did not affect fetal blood pressure or placental hemodynamics. Both in the sildenafil and nifedipine groups, fetal pO2 remained significantly lower at normoxemia + infusion phase than in the control group. Umbilical artery vascular impedance did not change during the experiment. Discussion: In fetal hypoxemia, sildenafil had detrimental effects on placental hemodynamics that disturbed placental gas exchange. Nifedipine did not alter placental hemodynamics in hypoxemia but disturbed placental gas exchange upon returning to normoxemia. Umbilical artery vascular impedance did not reflect alterations in placental hemodynamics.
- Published
- 2020
39. Diabetes is associated with familial idiopathic normal pressure hydrocephalus:a case–control comparison with family members
- Author
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Räsänen, J. (Joel), Huovinen, J. (Joel), Korhonen, V. E. (Ville E.), Junkkari, A. (Antti), Kastinen, S. (Sami), Komulainen, S. (Simo), Oinas, M. (Minna), Avellan, C. (Cecilia), Frantzen, J. (Janek), Rinne, J. (Jaakko), Ronkainen, A. (Antti), Kauppinen, M. (Mikko), Lönnrot, K. (Kimmo), Perola, M. (Markus), Koivisto, A. M. (Anne M.), Remes, A. M. (Anne M.), Soininen, H. (Hilkka), Hiltunen, M. (Mikko), Helisalmi, S. (Seppo), Kurki, M. I. (Mitja I.), Jääskeläinen, J. E. (Juha E.), Leinonen, V. (Ville), Räsänen, J. (Joel), Huovinen, J. (Joel), Korhonen, V. E. (Ville E.), Junkkari, A. (Antti), Kastinen, S. (Sami), Komulainen, S. (Simo), Oinas, M. (Minna), Avellan, C. (Cecilia), Frantzen, J. (Janek), Rinne, J. (Jaakko), Ronkainen, A. (Antti), Kauppinen, M. (Mikko), Lönnrot, K. (Kimmo), Perola, M. (Markus), Koivisto, A. M. (Anne M.), Remes, A. M. (Anne M.), Soininen, H. (Hilkka), Hiltunen, M. (Mikko), Helisalmi, S. (Seppo), Kurki, M. I. (Mitja I.), Jääskeläinen, J. E. (Juha E.), and Leinonen, V. (Ville)
- Abstract
Background: The pathophysiological basis of idiopathic normal pressure hydrocephalus (iNPH) is still unclear. Previous studies have shown a familial aggregation and a potential heritability when it comes to iNPH. Our aim was to conduct a novel case-controlled comparison between familial iNPH (fNPH) patients and their elderly relatives, involving multiple different families. Methods: Questionnaires and phone interviews were used for collecting the data and categorising the iNPH patients into the familial (fNPH) and the sporadic groups. Identical questionnaires were sent to the relatives of the potential fNPH patients. Venous blood samples were collected for genetic studies. The disease histories of the probable fNPH patients (n = 60) were compared with their ≥ 60-year-old relatives with no iNPH (n = 49). A modified Charlson Comorbidity Index (CCI) was used to measure the overall disease burden. Fisher’s exact test (two-tailed), the Mann–Whitney U test (two-tailed) and a multivariate binary logistic regression analysis were used to perform the statistical analyses. Results: Diabetes (32% vs. 14%, p = 0.043), arterial hypertension (65.0% vs. 43%, p = 0.033), cardiac insufficiency (16% vs. 2%, p = 0.020) and depressive symptoms (32% vs. 8%, p = 0.004) were overrepresented among the probable fNPH patients compared to their non-iNPH relatives. In the age-adjusted multivariate logistic regression analysis, diabetes remained independently associated with fNPH (OR = 3.8, 95% CI 1.1–12.9, p = 0.030). Conclusions: Diabetes is associated with fNPH and a possible risk factor for fNPH. Diabetes could contribute to the pathogenesis of iNPH/fNPH, which motivates to further prospective and gene-environmental studies to decipher the disease modelling of iNPH/fNPH.
- Published
- 2020
40. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer:International expert consensus based on a modified Delphi process
- Author
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Konradsson, M., Van Berge Henegouwen, M. I., Bruns, C., Chaudry, M. A., Cheong, E., Cuesta, M. A., Darling, G. E., Gisbertz, S. S., Griffin, S. M., Gutschow, C. A., Van Hillegersberg, R., Hofstetter, W., Hölscher, A. H., Kitagawa, Y., Van Lanschot, J. J.B., Lindblad, M., Ferri, L. E., Low, D. E., Luyer, M. D.P., Ndegwa, N., Mercer, S., Moorthy, K., Morse, C. R., Nafteux, P., Nieuwehuijzen, G. A.P., Pattyn, P., Rosman, C., Ruurda, J. P., Räsänen, J., Schneider, P. M., Schröder, W., Sgromo, B., Van Veer, H., Wijnhoven, B. P.L., Nilsson, M., Konradsson, M., Van Berge Henegouwen, M. I., Bruns, C., Chaudry, M. A., Cheong, E., Cuesta, M. A., Darling, G. E., Gisbertz, S. S., Griffin, S. M., Gutschow, C. A., Van Hillegersberg, R., Hofstetter, W., Hölscher, A. H., Kitagawa, Y., Van Lanschot, J. J.B., Lindblad, M., Ferri, L. E., Low, D. E., Luyer, M. D.P., Ndegwa, N., Mercer, S., Moorthy, K., Morse, C. R., Nafteux, P., Nieuwehuijzen, G. A.P., Pattyn, P., Rosman, C., Ruurda, J. P., Räsänen, J., Schneider, P. M., Schröder, W., Sgromo, B., Van Veer, H., Wijnhoven, B. P.L., and Nilsson, M.
- Abstract
Delayed gastric conduit emptying (DGCE) after esophagectomy for cancer is associated with adverse outcomes and troubling symptoms. Widely accepted diagnostic criteria and a symptom grading tool for DGCE are missing. This hampers the interpretation and comparison of studies. A modified Delphi process, using repeated webbased questionnaires, combined with live interim group discussions was conducted by 33 experts within the field, from Europe, North America, and Asia. DGCE was divided into early DGCE if present within 14 days of surgery and late if present later than 14 days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: >500 mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or >100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air-fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have 'quite a bit' or 'very much' of at least two of the following symptoms; early satiety/fullness, vomiting, nausea, regurgitation or inability to meet caloric need by oral intake and delayed contrast passage on upper gastrointestinal water-soluble contrast radiogram or on timed barium swallow. A symptom grading tool for late DGCE was constructed grading each symptom as: 'not at all', 'a little', 'quite a bit', or 'very much', generating 0, 1, 2, or 3 points, respectively. For the five symptoms retained in the diagnostic criteria for late DGCE, the minimum score would be 0, and the maximum score would be 15. The final symptom grading tool for late DGCE was accepted by 27 of 31 (87%) experts. For the first time, diagnostic criteria for early and late DGCE and a symptom grading tool for late DGCE are available, based on an international expert consensus process.
- Published
- 2020
41. Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process
- Author
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Cancer, MS CGO, Konradsson, M, van Berge Henegouwen, M I, Bruns, C, Chaudry, M A, Cheong, E, Cuesta, M A, Darling, G E, Gisbertz, S S, Griffin, S M, Gutschow, C A, van Hillegersberg, R, Hofstetter, W, Hölscher, A H, Kitagawa, Y, van Lanschot, J J B, Lindblad, M, Ferri, L E, Low, D E, Luyer, M D P, Ndegwa, N, Mercer, S, Moorthy, K, Morse, C R, Nafteux, P, Nieuwehuijzen, G A P, Pattyn, P, Rosman, C, Ruurda, J P, Räsänen, J, Schneider, P M, Schröder, W, Sgromo, B, Van Veer, H, Wijnhoven, B P L, Nilsson, M, Cancer, MS CGO, Konradsson, M, van Berge Henegouwen, M I, Bruns, C, Chaudry, M A, Cheong, E, Cuesta, M A, Darling, G E, Gisbertz, S S, Griffin, S M, Gutschow, C A, van Hillegersberg, R, Hofstetter, W, Hölscher, A H, Kitagawa, Y, van Lanschot, J J B, Lindblad, M, Ferri, L E, Low, D E, Luyer, M D P, Ndegwa, N, Mercer, S, Moorthy, K, Morse, C R, Nafteux, P, Nieuwehuijzen, G A P, Pattyn, P, Rosman, C, Ruurda, J P, Räsänen, J, Schneider, P M, Schröder, W, Sgromo, B, Van Veer, H, Wijnhoven, B P L, and Nilsson, M
- Published
- 2020
42. Hyperspectral Imaging Reveals Spectral Differences and Can Distinguish Malignant Melanoma from Pigmented Basal Cell Carcinomas: A Pilot Study
- Author
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Räsänen, J, primary, Salmivuori, M, additional, Pölönen, I, additional, Grönroos, M, additional, and Neittaanmäki, N, additional
- Published
- 2021
- Full Text
- View/download PDF
43. Petrogenesis of silicic magmatism related to the ∼ 2.44 Ga rifting of Archean crust in Koillismaa, eastern Finland
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Lauri, L.S., Rämö, O.T., Huhma, H., Mänttäri, I., and Räsänen, J.
- Published
- 2006
- Full Text
- View/download PDF
44. VP15.06: Peripheral chemoreflex and cardiac function during acute hypoxemia and metabolic acidosis without placental compromise in late‐term sheep fetuses
- Author
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Lantto, J., primary, Huhta, H., additional, Alanne, L., additional, Haapsamo, M., additional, Bhide, A., additional, Acharya, G., additional, and Räsänen, J., additional
- Published
- 2020
- Full Text
- View/download PDF
45. Electron acceleration and radio emission following the early interaction of two coronal mass ejections
- Author
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Morosan, D. E., primary, Palmerio, E., additional, Räsänen, J. E., additional, Kilpua, E. K. J., additional, Magdalenić, J., additional, Lynch, B. J., additional, Kumari, A., additional, Pomoell, J., additional, and Palmroth, M., additional
- Published
- 2020
- Full Text
- View/download PDF
46. Fit-for-Discharge Criteria after Esophagectomy: An International Expert Delphi Consensus
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Müller, P C, primary, Kapp, J R, additional, Vetter, D, additional, Bonavina, L, additional, Brown, W, additional, Castro, S, additional, Cheong, E, additional, Darling, G E, additional, Egberts, J, additional, Ferri, L, additional, Gisbertz, S S, additional, Gockel, I, additional, Grimminger, P P, additional, Hofstetter, W L, additional, Hölscher, A H, additional, Low, D E, additional, Luyer, M, additional, Markar, S R, additional, Mönig, S P, additional, Moorthy, K, additional, Morse, C R, additional, Müller-Stich, B P, additional, Nafteux, P, additional, Nieponice, A, additional, Nieuwenhuijzen, G A P, additional, Nilsson, M, additional, Palanivelu, C, additional, Pattyn, P, additional, Pera, M, additional, Räsänen, J, additional, Ribeiro, U, additional, Rosman, C, additional, Schröder, W, additional, Sgromo, B, additional, van Berge Henegouwen, M I, additional, van Hillegersberg, R, additional, van Veer, H, additional, van Workum, F, additional, Watson, D I, additional, Wijnhoven, B P L, additional, and Gutschow, C A, additional
- Published
- 2020
- Full Text
- View/download PDF
47. Hexyl aminolevulinate, 5‐aminolevulinic acid nanoemulsion and methyl aminolevulinate in photodynamic therapy of non‐aggressive basal cell carcinomas: A non‐sponsored, randomized, prospective and double‐blinded trial
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Salmivuori, M., primary, Grönroos, M., additional, Tani, T., additional, Pölönen, I., additional, Räsänen, J., additional, Annala, L., additional, Snellman, E., additional, and Neittaanmäki, N., additional
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- 2020
- Full Text
- View/download PDF
48. Low-dose aspirin reduces uteroplacental vascular impedance in early and mid gestation in IVF and ICSI patients: a randomized, placebo-controlled double-blind study
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Haapsamo, M., Martikainen, H., and Räsänen, J.
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- 2008
49. Significance of retrograde diastolic uterine artery blood flow during regional anesthesia in instrumented pregnant sheep
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KAVASMAA, T., MÄKIKALLIO, K., ERKINARO, T., ACHARYA, G., HAAPSAMO, M., ALAHUHTA, S., and RÄSÄNEN, J.
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- 2008
50. Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction
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Mäkikallio, K., Räsänen, J., Mäkikallio, T., Vuolteenaho, O., and Huhta, J. C.
- Published
- 2008
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