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Frontiers of Medicine 2023年第1期17卷 75-84页

作者： Sanna Uskela Antti Eranti Jussi MKärkkäinen Tuomas TRissanen North Karelia Central hospital-Heart Center Tikkamaentie 16 Joensuu 80210Finland kuopio university hospital puijonlaaksontie 2 KuopioPohjois-Savo 70210Finland

This retrospective single-center registry study included all consecutive patients who underwent percutaneous coronary intervention (PCI) for a de novo left main coronary artery lesion using drug coated-balloon (DCB)-only strategy between August 2011 and December 2018. To best of our knowledge, no previous studies of DCB-only strategy of treating de novo left main coronary artery disease, exist. The primary endpoint was major adverse cardiovascular events (MACEs) including cardiac death, non-fatal myocardial infarction, and target lesion revascularization (TLR). The cohort was divided into two groups depending on weather the lesion preparation was done according to the international consensus group guidelines. Sixty-six patients (mean age 75±8.6, 72% male), 52% of whom had acute coronary syndrome, underwent left main PCI with the DCB-only strategy. No procedural mortality and no acute closures of the treated left main occurred. At 12 months, MACE and TLR occurred in 24% and 6% of the whole cohort, respectively. If the lesion preparation was done according to the guidelines, the MACE and TLR rates were 21.2% and 1.9%. Left main PCI with the DCB only-strategy is safe leading to acceptable MACE and low TLR rates at one year, if the lesion preparation is done according to the guidelines.

关键词： drug-coated balloon left main high bleeding risk predilatation calcifield lesion percutaneous coronary intervention

Spatial analysis of the osteoarthritis microenvironment: techniques, insights, and applications

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Bone Research 2024年第1期12卷 1-19页

作者： Xiwei Fan Antonia Rujia Sun Reuben S.E.Young Isaac O.Afara Brett R.Hamilton Louis Jun Ye Ong Ross Crawford Indira Prasadam Centre for Biomedical Technologies Queensland University of TechnologyBrisbaneQLDAustralia School of Mechanical Medical&Process EngineeringQueensland University of TechnologyBrisbaneQLDAustralia Central Analytical Research Facility Queensland University of TechnologyBrisbaneQLDAustralia Molecular Horizons University of WollongongWollongongNSWAustralia Department of Technical Physics University of Eastern FinlandKuopioFinland School of Electrical Engineering and Computer Science Faculty of EngineeringArchitecture and Information TechnologyUniversity of QueenslandBrisbaneQLDAustralia Centre for Microscopy and Microanalysis University of QueenslandBrisbaneQLDAustralia The Prince Charles hospital BrisbaneQLDAustralia

Osteoarthritis(OA)is a debilitating degenerative disease affecting multiple joint tissues,including cartilage,bone,synovium,and adipose *** presents diverse clinical phenotypes and distinct molecular endotypes,including inflammatory,metabolic,mechanical,genetic,and synovial ***,innovative technologies are needed to support the development of effective diagnostic and precision therapeutic *** analysis of bulk OA tissue extracts has limitations due to technical constraints,causing challenges in the differentiation between various physiological and pathological phenotypes in joint *** issue has led to standardization difficulties and hindered the success of clinical *** insights into the spatial variations of the cellular and molecular structures in OA tissues,encompassing DNA,RNA,metabolites,and proteins,as well as their chemical properties,elemental composition,and mechanical attributes,can contribute to a more comprehensive understanding of the disease *** resolved biology enables biologists to investigate cells within the context of their tissue microenvironment,providing a more holistic view of cellular *** advances in innovative spatial biology techniques now allow intact tissue sections to be examined using various-omics lenses,such as genomics,transcriptomics,proteomics,and metabolomics,with spatial *** fusion of approaches provides researchers with critical insights into the molecular composition and functions of the cells and tissues at precise spatial ***,advanced imaging techniques,including high-resolution microscopy,hyperspectral imaging,and mass spectrometry imaging,enable the visualization and analysis of the spatial distribution of biomolecules,cells,and *** these molecular imaging outputs to conventional tissue histology can facilitate a more comprehensive characterization of disease *** review summarizes the rec

关键词： insight Spatial enable

Ursodeoxycholic acid as adjuvant treatment to phototherapy for neonatal hyperbilirubinemia:a systematic review and meta‑analysis

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World Journal of Pediatrics 2022年第9期18卷 589-597页

作者： Ilari Kuitunen Panu Kiviranta Ulla Sankilampi Marjo Renko Institute of Clinical Medicine Department of PediatricsUniversity of Eastern FinlandKuopioFinland Department of Pediatrics Mikkeli Central HospitalPorrassalmenkatu 35-3750100 MikkeliFinland Department of Pediatrics Kuopio University HospitalKuopioFinland

Background Neonatal hyperbilirubinemia is observed in most newborns,and 5–15%of neonates require *** is efective but often prolongs hospitalization and has both short-term and potential long-term *** aim of this systematic review and meta-analysis was to evaluate the role of ursodeoxycholic acid(UDCA)combined with phototherapy in neonatal *** A literature search was conducted on September 1,2021;590 studies were screened,and 17 full texts were assessed by two *** included randomized controlled trials with or without placebo *** outcomes were changes in total bilirubin levels at 24 hours and phototherapy *** calculated mean diferences with 95%confdence intervals(CI).Results Six studies with 880 neonates were *** these studies,only two used a placebo-controlled double-blinded *** overall risk of bias was high in one and moderate in four of the included *** mean decrease in the total bilirubin level during the frst 24 hours was 2.06 mg/dL(95%CI 0.82–3.30;six studies)greater in the UDCA treatment *** phototherapy duration was 19.7 hours(95%CI 10.4–29.1;fve studies)shorter in the UDCA treatment *** We found low-quality evidence that UDCA as an adjuvant to phototherapy seems to decrease total bilirubin faster and shorten phototherapy duration compared to standard *** studies are needed to confrm the efcacy,acute and long-term outcomes,and safety before implementing UDCA as an adjuvant to phototherapy in neonatal hyperbilirubinemia.

关键词： Jaundice Phototherapy Unconjugated hyperbilirubinemia Ursodeoxycholic acid

Neural and Müller glial adaptation of the retina to photoreceptor degeneration

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Neural Regeneration Research 2023年第4期18卷 701-707页

作者： Henri O.Leinonen Edward Bull Zhongjie Fu Faculty of Health Sciences School of PharmacyUniversity of Eastern FinlandKuopioFinland Department of Ophthalmology Boston Children’s HospitalHarvard Medical SchoolBostonMAUSA

The majority of inherited retinal degenerative diseases and dry age-related macular degeneration are characterized by decay of the outer retina and photoreceptors,which leads to progressive loss of *** inner retina,including second-and third-order retinal neurons,also shows aberrant structural changes at all stages of degeneration.Müller glia,the major glial cells maintain retinal homeostasis,activating and rearranging immediately in response to photoreceptor *** phenomena are collectively known as retinal remodeling and are anatomically well described,but their impact on visual function is less well *** remodeling has traditionally been considered a detrimental chain of events that decreases visual ***,emerging evidence from functional assays suggests that remodeling could also be a part of a survival mechanism wherein the inner retina responds plastically to outer retinal *** visual system’s first synapses between the photoreceptors and bipolar cells undergo rewiring and functionally compensate to maintain normal signal output to the *** classes of retinal ganglion cells remain even after the massive loss of photoreceptors.Müller glia possess the regenerative potential for retinal recovery and possibly exert adaptive transcriptional changes in response to neuronal *** types of homeostatic changes could potentially explain the well-maintained visual function observed in patients with inherited retinal degenerative diseases who display prominent anatomic retinal *** review will focus on our current understanding of retinal neuronal and Müller glial adaptation for the potential preservation of retinal activity during photoreceptor *** retinal self-compensatory responses could help generate universal strategies to delay sensory disease progression.

关键词： bipolar cells electroretinography Müller glia photoreceptors plasticity retinal degeneration retinal neuron retinal remodeling retinal ganglion cells

Acute and Persistent Post-Craniotomy Pain: A Prospective 6-Month Follow-Up Questionnaire Study

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Open Journal of Anesthesiology 2023年第6期13卷 119-133页

作者： Pasi Lahtinen Ville Koskela Pawel Florkiewicz Juha E. Jääskeläinen Timo Koponen Jari Halonen Tadeusz Musialowicz Department of Anesthesia and Intensive Care Medicine Kuopio University Hospital Kuopio Finland Department of Neurosurgery of Neuro Centre Unit Kuopio University Hospital Kuopio Finland Department of Anesthesia and Intensive Care Medicine North Karelia Central Hospital Joensuu Finland Heart Center Department Kuopio University Hospital Kuopio Finland

Introduction: The incidence of acute pain after craniotomy differs remarkably in previous studies, and the prevalence of persistent pain is not precisely known. We conducted 6-month follow-up surveys on the incidence and intensity of acute and persistent pain after elective craniotomy. Methods: We carried out a prospective cohort study via a series of structured questionnaires to record acute pain intensity preoperatively and postoperatively, and the incidence of persistent pain 3 and 6 months after a craniotomy in a tertiary care center. Patients scheduled for elective craniotomy were interviewed the day before surgery, postoperatively before discharge from the hospital, and 3 and 6 months after surgery. Pain was assessed on a numeric rating scale (0 - 10) at rest and movement, as well as expectations of pain before surgery, efficacy of pain therapy, and satisfaction with pain treatment. The incidence of adverse events, sleep time and interruptions caused by pain, different pain types, and drugs used for pain treatment were also recorded. Results: A total of 152 patients were enrolled in the study and completed the preoperative questionnaire;123 (81%) completed postoperative questionnaire and 108 (72%) completed the 3- and 6-month follow-ups. The average pain score at the time of the postoperative questionnaire was moderate, 4 at rest and 5 upon movement. The percentage of patients experiencing mild pain at rest and upon movement was 52% and 49%, and moderate pain was 15% and 16%, respectively. Severe postoperative pain was detected in 5% and 8% of patients at rest and upon movement, respectively. Three months after surgery, 6% of patients reported mild pain at rest, 3% moderate pain at rest, and 1% severe pain at rest. Persistent mild and moderate pain at rest after 6 months was reported by 3% and 1% of patients, respectively. The most common adverse events were postoperative nausea and vomiting (11%) and abdominal discomfort (8%). During postoperative pain treatm

关键词： Craniotomy Acute Pain Persistent Pain Pain Treatment Adverse Events Neurosurgery

Association of symptoms with gastrointestinal microbiota in irritable bowel syndrome

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World Journal of Gastroenterology 2010年第36期16卷 4532-4540页

作者： Erja Malinen Lotta Krogius-Kurikka Janne Nikkil Airi Palva Anna Lyra Anne Jskelinen Teemu Rinttil Terttu Vilpponen-Salmela Atte Johannes von Wright Department of Veterinary Biosciences Faculty of Veterinary MedicineUniversity of Helsinki00014 HelsinkiFinland Danisco Sweeteners Health and Nutrition02460 KantvikFinland Department of Clinical Nutrition Institute of Public Health and Clinical NutritionFaculty of Health SciencesUniversity of Eastern Finland70211 KuopioFinland Alimetrics Ltd. Koskelontie 19 B02920 EspooFinland kuopio Harjula hospital 70101 KuopioFinland Department of Biosciences University of Eastern Finland70211 KuopioFinland

AIM:To investigate the correlations between selfreported symptoms of irritable bowel syndrome(IBS) and the gastrointestinal(GI) microbiota ***:Fecal samples were collected from a total of 44 subjects diagnosed with *** symptoms were monitored with a validated inflammatory bowel disease questionnaire adjusted for IBS *** quantitative real-time polymerase chain reaction assays were applied to evaluate the GI microbiota *** and GI bacterial genera(Bifidobacterium,Lactobacillus and Veillonella),groups(Clostridium coccoides/Eubacterium rectale,Desulfovibrio desulfuricans) and distinct bacterial phylotypes [closest 16S rDNA sequence resemblance to species Bifidobacterium catenulatum,Clostridium cocleatum,Collinsella aerofaciens(***),Coprococcus eutactus(***),Ruminococcus torques and Streptococcus bovis ] with a suspected association with IBS were *** between quantities or presence/absence data of selected bacterial groups or phylotypes and various IBSrelated symptoms were ***:Associations were observed between subjects' self-reported symptoms and the presence or quantities of certain GI bacteria.A Ruminococcus torques(***)-like(94% similarity in 16S rRNA gene sequence) phylotype was associated with severity of bowel ***,among IBS subjects with *** 94% detected,the amounts of *** 88%,***-like and *** 97% phylotypes were significantly *** observations were also made concerning the effect of a subject's weight on GI microbiota with regard to *** like phylotype,Bifidobacterium *** Lactobacillus ***:Bacteria seemingly affecting the symptom scores are unlikely to be the underlying cause or cure of IBS,but they may serve as biomarkers of the condition.

关键词： Irritable bowel syndrome Self-reported symptoms Gastrointestinal microbiota Quantitative realtime polymerase chain reaction

Exercise cardiac power and the risk of heart failure in men:A population-based follow-up study

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Journal of Sport and Health Science 2022年第2期11卷 266-271页

作者： Sudhir Kurl Sae Young Jae Timo H.Makikallio Ari Voutilainen Magnus J.Hagnas Jussi Kauhanen Jari A.Laukkanen Institute of Public Health and Clinical Nutrition Department of MedicineUniversity of Eastern FinlandKuopio 70210Finland Department of Sports Informatics College of Arts and Physical EducationUniversity of SeoulSeoul 130-743Republic of Korea Division of Cardiology Department of Internal MedicineUniversity Hospital of OuluOulu 90220Finland Department of Internal Medicine Lapland Central HospitalRovaniemi 96400Finland Faculty of Sport and Health Sciences University of JyvaskylaJyvaskyla 40620Finland Central Finland Health Care District Jyvaskyla 40620Finland

Background:Little is known about exercise cardiac power(ECP),defined as the ratio of directly measured maximal oxygen uptake with peak systolic blood pressure during exercise,on heart failure(HF)*** examined the association of ECP and the risk of ***:This was a population-based cohort study of 2351 men from eastern *** average time to follow-up was 25 *** participated at baseline in an exercise stress test.A total of 313 cases of HF ***:Men with low ECP(2.37-fold(95%confidence interval(95%CI):1.68-3.35,p13.92 mL/mmHg,the highest quartile),after adjusting for *** ECP was associated with a 1.96-fold risk(95%CI:1.38-2.78,p2.66,p28%(95%CI:17%-37%).Conclusion:ECP provides a noninvasive and easily available measure from cardiopulmonary exercise tests in predicting ***,ECP did not provide additional value over maximal oxygen uptake.

关键词： Exercise cardiac power Heart failure Men

Mixed Venous Oxygen Saturation during the Transcatheter Aortic Valve Replacement—A Prospective Cohort Study

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Open Journal of Anesthesiology 2019年第7期9卷 140-153页

作者： Tadeusz Musialowicz Sten Ellam Antti Valtola Jari Halonen Pasi Lahtinen Department of Anesthesiology and Intensive Care Medicine Kuopio University Hospital Kuopio Finland Heart Centre Department Kuopio University Hospital Kuopio Finland

Purpose: Patients scheduled to undergo the transcatheter aortic valve replacement (TAVR) are usually octogenarians with severe co-morbidities and an increased risk of surgery-associated complications. The aim of this study was to determine the incidence of insufficient oxygen delivery as measured by mixed venous oxygen saturation (SvO2) via invasive continuous cardiopulmonary monitoring and the low cardiac output syndrome (LCOS) in patients undergoing the TAVR procedure. The second objective was to examine how these hemodynamic measurements would change during critical events, such as rapid ventricular pacing (RVP) during this procedure. Methods: This prospective, observational study, examined twenty patients undergoing TAVR under general anesthesia. Hemodynamic variables, SvO2 and the continuous cardiac output (CO) were assessed using pulmonary artery catheter (PAC) and a Vigilance? monitor. Insufficient oxygen delivery was defined as a SvO2 value under 58% and LCOS as a cardiac index (CI) under 2 L/min/m2. Total intravenous anesthesia and hemodynamic management protocol were standardized. RVP was induced twice during the procedure at a frequency of 180 - 200/min. Predefined clinical endpoints were assessed during the procedure and hemodynamic values were analyzed before and after twelve critical events. Results: The data of twenty patients with a mean age of 80 ± 4 years and EuroSCORE 18 ± 10 were analyzed. Fourteen (70%) of the TAVR procedures were performed transapically, the other six (30%) transfemorally. The SvO2 value under 58% (mean 54 ± 6) and the CI under 2 L/min/m2 (mean 1.6 ± 0.2) were detected in 60% of patients (n = 12) before the use of RVP. All of these patients received perioperative inotropic medication and required norepinephrine infusion for maintenance of adequate blood pressure. The SvO2, CO and CI were significantly decreased after the use of RVP (P 2 reverted rapidly to the same level as before the application of RVP (1 min), CO, and CI 10 m

关键词： Transcatheter Aortic Valve Replacement Mixed Venous Oxygen Saturation Low Cardiac Output Syndrome Aortic Valve Stenosis Rapid Ventricular Pacing

The need for long-term surveillance of recovery of psychiatric patients with somatic complaints

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Open Journal of Psychiatry 2012年第2期2卷 157-163页

作者： Marja Kokkonen Kari Salke Tarja Saharinen Kaisa Haatainen Heli Koivumaa-Honkanen Department of Psychiatry Kuopio University Hospital Kuopio Finland

Objective: Treatment of psychiatric patients with psychosomatic or somatic symptoms needs special attention. Methods: We examined correlates, change and recovery from depression among psychiatric patients (n = 150) during the assessment of their work ability. Patients were referred to an open psychiatric ward during 8/2004-9/2005. Psychiatric diseases were diagnosed with the ICD-10 by the psychiatrist, but also the Structured Clinical Interview for DSM-IV (SCID I and II) was conducted. The patients replied to questionnaires after admission and before discharge including questions on life changes, somatic health, psychosocial and health-related factors as well as psychometric scales for depression (BDI), life satisfaction (LS) and general psychopathology (SCL). RESULTS. At baseline, 75% of the patients reported clinically significant depression (BDI > 15) and a quarter of them experienced their depression as severe (BDI ≥ 30). Whereas, according to ICD-10 guidelines, 91% of the patients suffered from depressive disorder and 66% of them from major depression. The average duration of inpatient evaluation was 24 (SD 9, 4) days. Baseline poor general health, life dissatisfaction, psychosomatic symptoms, bodily pains as well as poor financial situation and adverse life events predicted prevailing depression at discharge. Clinical symptoms improved significantly, especially among younger patients, recovery could not be reached by the time of discharge. Conclusions: Psychiatric patients with somatic complaints tended to under-rate their depression. To enhance their recovery, long-term and individually planned out-patient treatment and surveillance are needed.

关键词： Depression BDI Somatic Symptoms Life Satisfaction Life Events

Development of otology specific outcome measure:Ear Outcome Survey-16 (EOS-16)

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Journal of Otology 2021年第3期16卷 150-157页

作者： Juha T.Laakso Juha Silvola Timo Hirvonen Samuli Suutarla Ilkka Kivekas Riitta Saarinen Lotta Haavisto Jaakko Laitakari Antti A.Aarnisalo Aarno Dietz Jussi Jero Maija Hytonen Saku T.Sink Department of Otorhinolaryngology-Head and Neck Surgery Head and Neck CenterHelsinki University Hospital and University of HelsinkiHelsinkiFinland Department of Ear Noseand Throat-Division of SurgeryAkershus University HospitalLørenskogNorway Department of Otorhinolaryngology Kymenlaakso Central HospitalKotkaFinland Department of Otorhinolaryngology-Head and Neck Surgery Tampere University Hospital and Tampere UniversityTampereFinland Department of Otorhinolaryngology-Head and Neck Surgery Turku University Hospital and University of TurkuTurkuFinland Department of Otorhinolaryngology-Head and Neck Surgery Oulu University Hospital and PEDEGO Research UnitUniversity of Oulu and Medical Research Center OuluFinland Department of Otorhinolaryngology-Head and Neck Surgery Kuopio University Hospital and University of KuopioKuopioFinland

Purpose An important outcome measure of patient care is the impact on the patient’s health-related quality of life(HRQoL).Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different subdivisions such as symptoms,hearing problems,psychosocial impact,and the need for *** optimal length of the recall period has not been *** these reasons,a new survey is needed that would cover most chronic ear *** A preliminary 24-item survey(EOS-24)was *** adult patients(included n=186)with one of seven different chronic otologic conditions from all university hospitals in Finland were recruited to respond to EOS-24 and the 15D general HRQoL *** recruiting otologists evaluated the severity of the disease and the disability caused by it.A control group was *** on the patients’responses in different diagnosis groups,the items were reduced according to pre-defined *** resulting survey was validated using a thorough statistical *** The relevance and necessity of the original 24 items were thoroughly investigated,leading to the exclusion of 8 items and the modification of *** remaining 16 items were well-balanced between subdivisions and were useful in all seven diagnosis groups,thus constituting the final instrument,*** most suitable recall period was three *** EOS-16 has been created according to the HRQoL survey guidelines with a versatile nationwide patient *** survey has been validated and can be used for a wide range of chronic ear diseases as a HRQoL instrument.

关键词： Otology Chronic ear diseases HRQoL Health-related quality of life PROM