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Sourander A, Ishikawa S, Ståhlberg T, Kishida K, Mori Y, Matsubara K, Zhang X, Hida N, Korpilahti-Leino T, Ristkari T, Torii S, Gilbert S, Hinkka-Yli-Salomäki S, Savolainen H, Närhi V. Cultural adaptation, content, and protocol of a feasibility study of school-based "Let's learn about emotions" intervention for Finnish primary school children. Front Psychiatry 2024; 14:1334282. [PMID: 38274431 PMCID: PMC10810134 DOI: 10.3389/fpsyt.2023.1334282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Emotional awareness and emotion regulation are crucial for cognitive and socio-emotional development in children. School-based interventions on socio-emotional skills have the potential to prevent these problems and promote well-being of children. The Japanese school-based program, Universal Unified Prevention Program for Diverse Disorders (Up2-D2), has shown preventive effects on mental health of children in Japan. The aims of this protocol paper are to describe the unique process of adapting the Up2-D2 from Eastern to Western context, and to present a feasibility study of the intervention, conducted in Finland. Methods The cultural adaptation process started with the linguistic translation of materials, followed by the modification of language to fit the Finnish context. While the Japanese ideology was saved, some content was adapted to fit Finnish school children. Further modifications were made based on feedback from pupils and teachers. The Finnish version of the program was named "Let's learn about emotions" and consisted of 12 sessions and targeted 8- to 12-year-old pupils. A teacher education plan was established to assist Finnish teachers with the intervention, including a workshop, teachers' manual, brief introductory videos, and online support sessions. A feasibility study involving 512 4th graders in the City of Hyvinkää, South of Finland, was conducted. It assessed emotional and behavioral problems, classroom climate, bullying, loneliness, perception of school environment, knowledge of emotional awareness, and program acceptability. Discussion The originality of this study underlies in the East-West adaptation of a cognitive behavioral therapy-based program. If promising feasibility findings are replicated in Finland, it could pave the way for further research on implementing such programs in diverse contexts and cultures, promoting coping skills, awareness, social skills and early prevention of child mental health problems. Ethics The ethical board of the University of Turku gave ethics approval for this research. The educational board of the City of Hyvinkää accepted this study.
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Affiliation(s)
- A. Sourander
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
- Department for Child Psychiatry, Turku University Hospital, Turku, Finland
| | - S. Ishikawa
- Faculty of Psychology, Doshisha University, Kyoto, Japan
| | - T. Ståhlberg
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
- Department for Adolescent Psychiatry, Turku University Hospital, Turku, Finland
| | - K. Kishida
- School of Humanities, Kwansei Gakuin University, Nishinomiya, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Y. Mori
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - K. Matsubara
- Organization for Research Initiatives and Development, Doshisha University, Kyoto, Japan
| | - X. Zhang
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - N. Hida
- Center for Wing of Empirically Supported Treatments, Doshisha University, Kyoto, Japan
| | - T. Korpilahti-Leino
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - T. Ristkari
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - S. Torii
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - S. Gilbert
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - S. Hinkka-Yli-Salomäki
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - H. Savolainen
- School of Educational Sciences and Psychology, University of Eastern Finland, Kuopio, Finland
| | - V. Närhi
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
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Savolainen H, Volpe A, Phinikaridou A, Douek M, Fruhwirth G, de Rosales RTM. 68Ga-Sienna+ for PET-MRI Guided Sentinel Lymph Node Biopsy: Synthesis and Preclinical Evaluation in a Metastatic Breast Cancer Model. Nanotheranostics 2019; 3:255-265. [PMID: 31263657 PMCID: PMC6584137 DOI: 10.7150/ntno.34727] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/31/2019] [Indexed: 12/17/2022] Open
Abstract
Sentinel lymph node biopsy (SLNB) is commonly performed in cancers that metastasise via the lymphatic system. It involves excision and histology of sentinel lymph nodes (SLNs) and presents two main challenges: (i) sensitive whole-body localisation of SLNs, and (ii) lack of pre-operative knowledge of their metastatic status, resulting in a high number (>70%) of healthy SLN excisions. To improve SLNB, whole-body imaging could improve detection and potentially prevent unnecessary surgery by identifying healthy and metastatic SLNs. In this context, radiolabelled SPIOs and PET-MRI could find applications to locate SLNs with high sensitivity at the whole-body level (using PET) and guide high-resolution MRI to evaluate their metastatic status. Here we evaluate this approach by synthesising a GMP-compatible 68Ga-SPIO (68Ga-Sienna+) followed by PET-MR imaging and histology studies in a metastatic breast cancer mouse model. Methods. A clinically approved SPIO for SLN localisation (Sienna+) was radiolabelled with 68Ga without a chelator. Radiochemical stability was tested in human serum. In vitro cell uptake was compared between 3E.Δ.NT breast cancer cells, expressing the hNIS reporter gene, and macrophage cell lines (J774A.1; RAW264.7.GFP). NSG-mice were inoculated with 3E.Δ.NT cells. Left axillary SLN metastasis was monitored by hNIS/SPECT-CT and compared to the healthy right axillary SLN. 68Ga-Sienna+ was injected into front paws and followed by PET-MRI. Imaging results were confirmed by histology. Results.68Ga-Sienna+ was produced in high radiochemical purity (>93%) without the need for purification and was stable in vitro. In vitro uptake of 68Ga-Sienna+ in macrophage cells (J774A.1) was significantly higher (12 ± 1%) than in cancer cells (2.0 ± 0.1%; P < 0.001). SPECT-CT confirmed metastasis in the left axillary SLNs of tumour mice. In PET, significantly higher 68Ga-Sienna+ uptake was measured in healthy axillary SLNs (2.2 ± 0.9 %ID/mL), than in metastatic SLNs (1.1 ± 0.2 %ID/mL; P = 0.006). In MRI, 68Ga-Sienna+ uptake in healthy SLNs was observed by decreased MR signal in T2/T2*-weighted sequences, whereas fully metastatic SLNs appeared unchanged. Conclusion.68Ga-Sienna+ in combination with PET-MRI can locate and distinguish healthy from metastatic SLNs and could be a useful preoperative imaging tool to guide SLN biopsy and prevent unnecessary excisions.
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Affiliation(s)
- Heli Savolainen
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Alessia Volpe
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Alkystis Phinikaridou
- Department of Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Michael Douek
- Department of Research Oncology, School of Cancer & Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Gilbert Fruhwirth
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Rafael T. M. de Rosales
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
- London Centre for Nanotechnology, King's College London, Strand Campus, London, WC2R 2LS, United Kingdom (UK)
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Colabufo NA, Contino M, Cantore M, Berardi F, Perrone R, Tonazzi A, Console L, Panaro MA, Savolainen H, Luurtsema G. An innovative small molecule for promoting neuroreparative strategies. RSC Adv 2018; 8:5451-5458. [PMID: 35542423 PMCID: PMC9078125 DOI: 10.1039/c7ra11812k] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/22/2018] [Indexed: 11/21/2022] Open
Abstract
In this study, a new regenerative strategy to treat several neurodegenerative diseases is suggested by the use of a multitarget approach induced by our small molecule, MC111. Considering the importance of P-gp and BCRP expression on stem cell differentiation and the involvement of TLR4 on neurodegeneration processes, we investigated the effect of MC111, belonging to our library of P-gp active compounds on: (i) TLR4 signaling; (ii) P-gp and BCRP activity and expression; (iii) neurite sprouting. The observed findings exerted by MC111, open a new scenario for a multitarget and regenerative approach in neurodegenerative diseases encouraging the in vivo evaluation of MC111 as new tool in neuroreparative medicine. In this study, a new regenerative strategy to treat several neurodegenerative diseases is suggested by the use of a multitarget approach induced by our small molecule, MC111.![]()
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Affiliation(s)
- Nicola Antonio Colabufo
- Dipartimento di Farmacia-Scienze del Farmaco
- University of Bari “Aldo Moro”
- Bari
- Italy
- Biofordrug srl
| | | | - Mariangela Cantore
- Biofordrug srl
- Dipartimento di Farmacia-Scienze del Farmaco
- University of Bari “Aldo Moro”
- Bari
- Italy
| | - Francesco Berardi
- Dipartimento di Farmacia-Scienze del Farmaco
- University of Bari “Aldo Moro”
- Bari
- Italy
| | - Roberto Perrone
- Dipartimento di Farmacia-Scienze del Farmaco
- University of Bari “Aldo Moro”
- Bari
- Italy
| | - Annamaria Tonazzi
- CNR-IBIOM (Institute of Biomembrane, Bioenergetics and Molecular Biotechnologies)
- 70126 Bari
- Italy
- Dipartimento di Bioscienze
- Biotecnologie e Biofarmaceutica
| | - Lara Console
- Department BEST (Biologia, Ecologia, Scienze della Terra)
- Unit of Biochemistry and Molecular Biotechnology
- University of Calabria
- Italy
| | - Maria Antonietta Panaro
- Dipartimento di Bioscienze
- Biotecnologie e Biofarmaceutica
- University of Bari “Aldo Moro”
- Bari
- Italy
| | - Heli Savolainen
- University of Groningen
- University Medical Center Groningen
- Department of Nuclear Medicine and Molecular Imaging
- Groningen
- Netherlands
| | - Gert Luurtsema
- University of Groningen
- University Medical Center Groningen
- Department of Nuclear Medicine and Molecular Imaging
- Groningen
- Netherlands
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Raaphorst RM, Savolainen H, Cantore M, van de Steeg E, van Waarde A, Colabufo NA, Elsinga PH, Lammertsma AA, Windhorst AD, Luurtsema G. Comparison of In Vitro Assays in Selecting Radiotracers for In Vivo P-Glycoprotein PET Imaging. Pharmaceuticals (Basel) 2017; 10:ph10030076. [PMID: 29036881 PMCID: PMC5620620 DOI: 10.3390/ph10030076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 09/13/2017] [Accepted: 09/15/2017] [Indexed: 12/24/2022] Open
Abstract
Positron emission tomography (PET) imaging of P-glycoprotein (P-gp) in the blood-brain barrier can be important in neurological diseases where P-gp is affected, such as Alzheimer´s disease. Radiotracers used in the imaging studies are present at very small, nanomolar, concentration, whereas in vitro assays where these tracers are characterized, are usually performed at micromolar concentration, causing often discrepant in vivo and in vitro data. We had in vivo rodent PET data of [11C]verapamil, (R)-N-[18F]fluoroethylverapamil, (R)-O-[18F]fluoroethyl-norverapamil, [18F]MC225 and [18F]MC224 and we included also two new molecules [18F]MC198 and [18F]KE64 in this study. To improve the predictive value of in vitro assays, we labeled all the tracers with tritium and performed bidirectional substrate transport assay in MDCKII-MDR1 cells at three different concentrations (0.01, 1 and 50 µM) and also inhibition assay with P-gp inhibitors. As a comparison, we used non-radioactive molecules in transport assay in Caco-2 cells at a concentration of 10 µM and in calcein-AM inhibition assay in MDCKII-MDR1 cells. All the P-gp substrates were transported dose-dependently. At the highest concentration (50 µM), P-gp was saturated in a similar way as after treatment with P-gp inhibitors. Best in vivo correlation was obtained with the bidirectional transport assay at a concentration of 0.01 µM. One micromolar concentration in a transport assay or calcein-AM assay alone is not sufficient for correct in vivo prediction of substrate P-gp PET ligands.
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Affiliation(s)
- Renske M Raaphorst
- Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1085C, 1081 HV Amsterdam, The Netherlands.
| | - Heli Savolainen
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - Mariangela Cantore
- Dipartimento di Farmacia-Scienze del Farmaco, Università Degli Studi di Bari, via Orabona 4, 70125 Bari, Italy.
- Biofordrug slr, via Orabona 4, 70125 Bari, Italy.
| | - Evita van de Steeg
- Microbiology Systems and Biology Group, Netherlands Organisation for Applied Scientific Research (TNO), Utrechtseweg 48, 3704 HE Zeist, The Netherlands.
| | - Aren van Waarde
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - Nicola A Colabufo
- Dipartimento di Farmacia-Scienze del Farmaco, Università Degli Studi di Bari, via Orabona 4, 70125 Bari, Italy.
- Biofordrug slr, via Orabona 4, 70125 Bari, Italy.
| | - Philip H Elsinga
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - Adriaan A Lammertsma
- Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1085C, 1081 HV Amsterdam, The Netherlands.
| | - Albert D Windhorst
- Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1085C, 1081 HV Amsterdam, The Netherlands.
| | - Gert Luurtsema
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
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Savolainen H, Windhorst AD, Elsinga PH, Cantore M, Colabufo NA, Willemsen AT, Luurtsema G. Evaluation of [ 18F]MC225 as a PET radiotracer for measuring P-glycoprotein function at the blood-brain barrier in rats: Kinetics, metabolism, and selectivity. J Cereb Blood Flow Metab 2017; 37:1286-1298. [PMID: 27354093 PMCID: PMC5453451 DOI: 10.1177/0271678x16654493] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
P-glycoprotein is a protective efflux transporter at the blood-brain barrier showing altered function in many neurological disorders. The purpose of this study was to validate [18F]MC225 as a radiotracer for measuring P-glycoprotein function with positron emission tomography. Three groups of Sprague-Dawley rats were used to assess tracer uptake at baseline (group 1), after inhibition of P-glycoprotein (group 2), and after inhibition of both P-glycoprotein and breast cancer resistance protein (Bcrp, group 3). A two-tissue compartment model with a metabolite-corrected plasma input function provided the best fit to the positron emission tomography data, but parameter estimates were more reliable in a one-tissue compartment model, which was selected as the preferred model. Regional distribution volumes ( VT) in the control group ranged from 6 to 11, which is higher than for other radiotracers. [18F]MC225 showed transporter selectivity, since inhibition of P-glycoprotein caused a two to fourfold increase in the cerebral VT values, but additional inhibition of Bcrp did not cause any further increase. Metabolic stability of [18F]MC225 was moderate (at 1 h post-injection 15% of plasma radioactivity and 76% of brain radioactivity represented intact parent). Thus, [18F]MC225 may be a useful radiotracer to measure especially increases of P-glycoprotein function at the blood-brain barrier.
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Affiliation(s)
- Heli Savolainen
- 1 Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Albert D Windhorst
- 2 Department of Radiology and Nuclear Medicine, VU University Medical Center Amsterdam, Amsterdam, Netherlands
| | - Philip H Elsinga
- 1 Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Mariangela Cantore
- 3 Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari, Bari, Italy.,4 Biofordrug slr, Bari, Italy
| | - Nicola A Colabufo
- 3 Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari, Bari, Italy.,4 Biofordrug slr, Bari, Italy
| | - Antoon Tm Willemsen
- 1 Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Gert Luurtsema
- 1 Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Abstract
BACKGROUND AND AIMS Implementation of a clinical risk score into diagnostics of acute appendicitis may provide accurate diagnosis with selective use of imaging studies. The aim of this study was to prospectively validate recently described diagnostic scoring system, Adult Appendicitis Score, and evaluate its effects on negative appendectomy rate. MATERIAL AND METHODS Adult Appendicitis Score stratifies patients into three groups: high, intermediate, and low risk of appendicitis. The score was implemented in diagnostics of adult patients suspected of acute appendicitis in two university hospitals. We analyzed the effects of Adult Appendicitis Score on diagnostic accuracy, imaging studies, and treatment. The study population was compared with a reference population of 829 patients suspected of acute appendicitis originally enrolled for the study of construction of the Adult Appendicitis Score. RESULTS This study enrolled 908 patients of whom 432 (48%) had appendicitis. The score stratified 49% of all appendicitis patients into high-risk group with specificity of 93.3%. In the low-risk group, prevalence of appendicitis was 7%. The histologically confirmed negative appendectomy rate decreased from 18.2% to 8.7%, p<0.001, compared to the original dataset. CONCLUSION Adult Appendicitis Score is a reliable tool for stratification of patients into selective imaging, which results in low negative appendectomy rate.
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Affiliation(s)
- H E Sammalkorpi
- 1 Department of Gastrointestinal Surgery, Helsinki University Central Hospital, Helsinki, Finland.,2 Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - P Mentula
- 1 Department of Gastrointestinal Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - H Savolainen
- 3 Department of Surgery, Kuopio University Hospital, Kuopio, Finland
| | - A Leppäniemi
- 1 Department of Gastrointestinal Surgery, Helsinki University Central Hospital, Helsinki, Finland
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Abstract
Background and Aims: Femoral artery aneurysms are rare. Their natural history, tendency to embolize or rupture are not well known. Material and Methods: Data of all patients seen 1996–2002 with femoral artery aneurysms at the Swiss Cardiovascular Center were analysed. Nine patients with 13 aneurysms of the common femoral artery (CFA) were identified. Only true aneurysms with a diameter of at least 2.5 cm were included. All patients were male, mean age 70 years (range: 57–85 years). Four patients had bilateral femoral aneurysms. Risk factors included hypertension (9/9), smoking (7/9). One of the aneurysms was palpable in 5/9. Four patients were asymptomatic, 5 had Fontaine class II claudication. Five patients also had an aortic aneurysm (AAA), one a thoracic aneurysm; and 6/9 popliteal aneurysms. In all patients, diagnosis was confirmed with duplex scan. Angiography was performed preoperatively. Results: The aneurysms were operated on electively using aneurysm secclusion and interposition grafting. There were no significant perioperative complications. Median hospital stay was 8 days. Conclusion: CFA aneurysms are rare. They are palpable in nearly half of the cases. They rarely cause thrombotic or embolic complications, but are almost always connected to other aneurysms. Patients with CFA aneurysms should be screened with duplex scan. Operative therapy is straightforward, few complications can be expected. Postoperative follow-up with annual duplex scans is suggested.
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Affiliation(s)
- H Savolainen
- Swiss Cardiovascular Center, University Hospital, Berne, Switzerland.
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Savolainen H, Meerlo P, Elsinga PH, Windhorst AD, Dierckx RA, Colabufo NA, van Waarde A, Luurtsema G. P-glycoprotein Function in the Rodent Brain Displays a Daily Rhythm, a Quantitative In Vivo PET Study. AAPS J 2016; 18:1524-1531. [DOI: 10.1208/s12248-016-9973-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 08/08/2016] [Indexed: 12/21/2022]
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Abstract
Spontaneous dissection of the iliac artery is very rare but known as a complication of highenergy traumatic injuries and has been reported in connection with pregnancy, collagen diseases, and alpha-1-antitrypsin deficiency. The authors report a 42-year-old man with an acute dissection of the common iliac artery during exercise. Groin pain and claudication were the early symptoms. Computerized angiotomography was diagnostic. Operative iliac artery reconstruction was performed. A prerelease control computed tomography examination showed a dissection of the distal aorta and left iliac artery. To their knowledge, the combination of the 2 dissections has not been previously published.
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Affiliation(s)
- H Savolainen
- Swiss Cardiovascular Center, University Hospital, Bern, Switzerland.
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Savolainen H, Cantore M, Colabufo NA, Elsinga PH, Windhorst AD, Luurtsema G. Synthesis and Preclinical Evaluation of Three Novel Fluorine-18 Labeled Radiopharmaceuticals for P-Glycoprotein PET Imaging at the Blood-Brain Barrier. Mol Pharm 2015; 12:2265-75. [PMID: 26043236 DOI: 10.1021/mp5008103] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
P-Glycoprotein (P-gp), along with other transporter proteins at the blood-brain barrier (BBB), limits the entry of many pharmaceuticals into the brain. Altered P-gp function has been found in several neurological diseases. To study the P-gp function, many positron emission tomography (PET) radiopharmaceuticals have been developed. Most P-gp radiopharmaceuticals are labeled with carbon-11, while labeling with fluorine-18 would increase their applicability due to longer half-life. Here we present the synthesis and in vivo evaluation of three novel fluorine-18 labeled radiopharmaceuticals: 4-((6,7-dimethoxy-3,4-dihydroisoquinolin-2(1H)-yl)methyl)-2-(4-fluorophenyl)oxazole (1a), 2-biphenyl-4-yl-2-fluoroethoxy-6,7-dimethoxy-1,2,3,4-tetrahydro-isoquinoline (2), and 5-(1-(2-fluoroethoxy))-[3-(6,7-dimethoxy-3,4-dihydro-1H-isoquinolin-2-yl)-propyl]-5,6,7,8-tetrahydronaphthalen (3). Compounds were characterized as P-gp substrates in vitro, and Mdr1a/b((-/-))Bcrp1((-/-)) and wild-type mice were used to assess the substrate potential in vivo. Comparison was made to (R)-[(11)C]verapamil, which is currently the most frequently used P-gp substrate. Compound [(18)F]3 was performing the best out of the new radiopharmaceuticals; it had 2-fold higher brain uptake in the Mdr1a/b((-/-))Bcrp1((-/-)) mice compared to wild-type and was metabolically quite stable. In the plasma, 69% of the parent compound was intact after 45 min and 96% in the brain. Selectivity of [(18)F]3 to P-gp was tested by comparing the uptake in Mdr1a/b((-/-)) mice to uptake in Mdr1a/b((-/-))Bcrp1((-/-)) mice, which was statistically not significantly different. Hence, [(18)F]3 was found to be selective for P-gp and is a promising new radiopharmaceutical for P-gp PET imaging at the BBB.
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Affiliation(s)
- Heli Savolainen
- †Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, Netherlands
| | - Mariangela Cantore
- ‡Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari, via Orabona 4, 70125 Bari, Italy.,§Biofordrug slr, via Orabona 4, 70125 Bari, Italy
| | - Nicola A Colabufo
- ‡Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari, via Orabona 4, 70125 Bari, Italy.,§Biofordrug slr, via Orabona 4, 70125 Bari, Italy
| | - Philip H Elsinga
- †Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, Netherlands
| | - Albert D Windhorst
- ∥Department of Radiology and Nuclear Medicine, VU University Medical Center Amsterdam, De Boelelaan 1085 C, 1081 HV Amsterdam, Netherlands
| | - Gert Luurtsema
- †Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, Netherlands
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Savolainen H. Adverse drug reactions. CMAJ 2011; 183:1173, 1175. [DOI: 10.1503/cmaj.111-2055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Abstract
Background and Aims: Two thirds of patients with an abdominal aortic aneurysm (AAA) have relevant coronary artery disease (CAD). AAAs are prevalent in up to 16% of smokers with CAD. General screening of AAA is controversial. Aim was to assess the potential of finding AAA prior to rupture among patients with known CAD. Main endpoint was whether AAA could have been found during follow-up by sonography or at other time of cardiovascular evaluation. Material and Methods: Retrospective study. 213 consecutive, formerly unknown emergently operated AAAs, treated emergently for symptoms (n = 91) or rupture (n = 122) (rAAA) between January 1998 and June 2005. Patient charts were analysed and primary care physicians contacted. Results: At presentation, mean age was 71 (+/–9) years, twenty (9%) were female. AAA had a mean diameter of 7.6 cm. Two thirds (143) were clinically obese (BMI 27 +/–5). 137 (64%) were active smokers, 32 (15%) had diabetes, 151 (71%) were hypertensive, and 80 (38%) received statin treatment. CAD had been diagnosed in 95 (45%) 9 years earlier and followed up. Thirty-five (16%) had had myocardial infarction. Echocardiography had been performed in 52 (24%). Thirty day mortality after open surgery was 25 (21%). Conclusion: All patients with rAAA had been seen by a GP or cardiologist within a year prior to presentation. The cost effectiveness of selective AAA screening should be evaluated in a larger study.
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Affiliation(s)
- H. Savolainen
- University of the West Indies, Queen Elizabeth Hospital, Bridgetown, Barbados
| | - J. Novak
- Swiss Cardiovascular Centre, University Hospital, Berne, Switzerland
| | - F. Dick
- Swiss Cardiovascular Centre, University Hospital, Berne, Switzerland
| | - M.K. Widmer
- Swiss Cardiovascular Centre, University Hospital, Berne, Switzerland
| | - T. Carrel
- Swiss Cardiovascular Centre, University Hospital, Berne, Switzerland
| | - J. Schmidli
- Swiss Cardiovascular Centre, University Hospital, Berne, Switzerland
| | - B. Meier
- Swiss Cardiovascular Centre, University Hospital, Berne, Switzerland
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Savolainen H. Lack of physician scientists. CMAJ 2010; 182:63. [DOI: 10.1503/cmaj.110-2005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Palo J, Riekkinen P, Rinne UK, Irjala J, Puro K, Savolainen H. Protein and ganglioside composition of human central nervous system myelin. Acta Neurol Scand 2009; 46:240. [PMID: 5457836 DOI: 10.1111/j.1600-0404.1970.tb02208.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Warncke C, Alberio L, Savolainen H, von Allmen R, Baumgartner I, Husmann M. "HIT on Trousseau" double trouble: acquired coagulopathy with femoral artery thrombosis. VASA 2008; 37:281-4. [PMID: 18690597 DOI: 10.1024/0301-1526.37.3.281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Trousseau Syndrome is a paraneoplastic procoagulant phenomenon. Heparin-induced thrombocytopenia (HIT) is a rare complication of anticoagulation with heparin. To our knowledge, the coincidence of the two has not been reported so far. We report a case of an acute thrombosis of the left femoral artery and distal leg arteries in a patient with an otherwise normal cardiovascular status. Endovascular revascularization attempts using mechanical rotational thrombectomy catheter, aspiration and local thrombolysis were unsuccessful. Progressive coagulation along the intra-arterial catheter was seen. Surgical thrombectomy of the femoral-pedal axis was successful, but the patient developed an immune-mediated HIT postoperatively. An adenocarcinoma of the colon was the likely cause for the initial arterial thrombosis, and probably adversely affected endovascular revascularization attempts. Subsequent HIT with microvascular thrombosis worsened ischemic damage leading to a below knee-amputation, despite patent large vessels. Compared to venous thrombosis, arterial thrombosis is a rare manifestation of Trousseau syndrome. The coincidence of it with HIT is even rarer. There may be a causal relationship between the two.
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Affiliation(s)
- C Warncke
- Division of Angiology and Vascular Surgery, Cardiovascular Department, Inselspital Bern, University Hospital and University of Bern, Switzerland.
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Lutz HJ, Michael R, Gahl B, Savolainen H. Local versus General Anaesthesia for Carotid Endarterectomy – Improving the Gold Standard ? Eur J Vasc Endovasc Surg 2008; 36:145-149. [DOI: 10.1016/j.ejvs.2008.03.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Accepted: 03/15/2008] [Indexed: 10/22/2022]
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Savolainen H, Hansen A, Diehm N. Small is beautiful: Why profundaplasty should not be forgotten. J Vasc Surg 2008. [DOI: 10.1016/j.jvs.2008.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Savolainen H, Hansen A, Diehm N, Baumgartner I, Dick F, Heller G, Gahl B, Schmidli J. Small Is Beautiful: Why Profundaplasty Should Not Be Forgotten. World J Surg 2007; 31:2058-61. [PMID: 17661187 DOI: 10.1007/s00268-007-9188-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Surgical profundaplasty (SP)is used mainly as an adjunct to endovascular management of peripheral vascular disease (PAD) today. Results from earlier series of profundaplasty alone have been controversial, especially regarding its hemodynamic effect. The question is: Can profundaplasty alone still be useful? Our aim was to evaluate its role in the modern management of vascular patients. METHODS This was a retrospective outcome study. A consecutive series of 97 patients (106 legs) from January 2000 through December 2003 were included. In 55 (52%) legs, the superficial femoral artery was occluded. These patients were included in the current analysis. Of these patients 14 (25%) were female. Mean age was 71 ((11) years. Nineteen (35%) were diabetic. The indication for operation was claudication in 29 (53%), critical leg ischemia (CLI) in 26 (47%), either with rest pain in 17 (31%), or ulcer/gangrene in 9 (16%). Endarterectomy with patch angioplasty with bovine pericardium was performed in all cases. Mean follow-up was 33 ( 14 months. Mean preoperative ankle brachial index (ABI) was 0.6. Sustained clinical efficacy was defined as upward shift of 1 or greater on the Rutherford scale without repeat target limb revascularization (TLR) or amputation. Mortality, morbidity, need for TLR, or amputation were separate endpoints. RESULTS Postoperatively, ABI was significantly improved (mean = 0.7), in 24 (44%) by more than 0.15. At three years, cumulative clinical success rate was 80%. Overall, patients with claudication had a better outcome than those with CLI (p = 0.04). Two (4%) major amputations and 2 (4%) minor ones were performed, all in patients with CLI. None of the 9 (16%) ulcers healed. CONCLUSION Profundaplasty is still a valuable option for patients with femoral PAD and claudication without tissue loss. It is a straightforward procedure that combines good efficacy with low complication rates. Further endovascular treatment may be facilitated. It is not useful for patients with the combination of critical ischemia and tissue loss.
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Affiliation(s)
- H Savolainen
- Swiss Cardiovascular Center, University Hospital, 3010, Berne, Switzerland.
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Husmann MJ, Heller G, Kalka C, Savolainen H, Do DD, Schmidli J, Baumgartner I. Stenting of Common Iliac Vein Obstructions Combined with Regional Thrombolysis and Thrombectomy in Acute Deep Vein Thrombosis. Eur J Vasc Endovasc Surg 2007; 34:87-91. [PMID: 17324594 DOI: 10.1016/j.ejvs.2007.01.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2006] [Accepted: 01/05/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate the efficacy of stent placement after infrainguinal loco-regional thrombolysis and iliac thrombectomy (surgical TT) of acute deep vein thrombosis (DVT) in patients with May-Thurner-Syndrome. MATERIAL AND METHODS We retrospectively analysed a group of 11 patients (9 women) (mean age 34 years, range 16-64 years) with surgical TT and additional intra-operative stenting due to compression of the common iliac vein. Patients underwent venography to demonstrate outflow patency after surgical TT, and to identify any obstruction at the level of the left-sided common iliac vein ("Beckenvenen-Sporn"). Obstruction at the level of arterial crossing was treated using Wallstents placed via an introducer sheath from the inguinal access site. Stents were fully deployed using balloons adjusted to the size of vein. Patients were treated with oral anticoagulants for 6 months, and followed using duplex ultrasonography. RESULTS Technical success defined as complete vein patency and normal valve function was documented in all 11 patients. One patient needed early stent extension due to residual stenosis. At 6 months follow-up one patient (9%) had an asymptomatic occlusion of the stented common iliac vein. In all 11/11 (100%) patients the femoral segment was found to be patent, and in 1/11 (9%) there was mild reflux with few clinical symptoms of post-thrombotic syndrome. The calculated cumulative primary patency rate for venous iliac stents was 82%, and assisted patency rate was 91%, which remained unchanged over a mean follow-up of 22 months. CONCLUSION Combining surgical TT and stenting of common iliac vein obstructions in DVT is safe, effective, and results in a acceptable venous patency.
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Affiliation(s)
- M J Husmann
- Swiss Cardiovascular Center, University Hospital Bern, Switzerland.
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Husmann M, Heller G, Kalka C, Savolainen H, Do D, Schmidli J, Baumgartner I. Stenting of Common Iliac Vein Obstructions Combined with Regional Thrombolysis and Thrombectomy in Acute Deep Vein Thrombosis. J Vasc Surg 2007. [DOI: 10.1016/j.jvs.2007.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tordoir JHM, Scheffers I, Schmidli J, Savolainen H, Liebeskind U, Hansky B, Herold U, Irwin E, Kroon AA, de Leeuw P, Peters TK, Kieval R, Cody R. An Implantable Carotid Sinus Baroreflex Activating System: Surgical Technique and Short-Term Outcome from a Multi-Center Feasibility Trial for the Treatment of Resistant Hypertension. Eur J Vasc Endovasc Surg 2007; 33:414-21. [PMID: 17227715 DOI: 10.1016/j.ejvs.2006.11.025] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2006] [Accepted: 11/17/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess perioperative outcomes and blood pressure (BP) responses to an implantable carotid sinus baroreflex activating system being investigated for the treatment of resistant hypertension. METHODS We report on the first seventeen patients enrolled in a multicenter study. Bilateral perivascular carotid sinus electrodes (CSL) and a pulse generator (IPG) are permanently implanted. Optimal placement of the CSL is determined by intraoperative BP responses to test activations. Acute BP responses were tested postoperatively and during the first four months of follow-up. RESULTS Prior to implant, BP was 189.6+/-27.5/110.7+/-15.3 mmHg despite stable therapy (5.2+/-1.8 antihypertensive drugs). The mean procedure time was 202+/-43 minutes. No perioperative strokes or deaths occurred. System tests performed 1 or up to 3 days postoperatively resulted in significant (all p < or = 0.0001) mean maximum reduction, with standard deviations and 95% confidence limits for systolic BP, diastolic BP and heart rate of 28+/-22 (17, 39) mmHg, 16+/-11 (10, 22) mmHg and 8+/-4 (6, 11) BPM, respectively. Repeated testing during 3 months of therapeutic electrical activation demonstrated a durable response. CONCLUSIONS These preliminary data suggest an acceptable safety of the procedure with a low rate of adverse events and support further clinical development of baroreflex activation as a new concept to treat resistant hypertension.
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Affiliation(s)
- J H M Tordoir
- Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
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Tordoir J, Scheffers I, Schmidli J, Savolainen H, Liebeskind U, Hansky B, Herold U, Irwin E, Kroon A, de Leeuw P, Peters T, Kieval R, Cody R. An Implantable Carotid Sinus Baroreflex Activating System: Surgical Technique and Short-Term Outcome from a Multi-Center Feasibility Trial for the Treatment of Resistant Hypertension. J Vasc Surg 2007. [DOI: 10.1016/j.jvs.2007.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liesivuori J, Pennanen S, Stedt H, Manáková S, Heiskanen K, Laitinen J, Savolainen H. Apoptotic mechanisms of ethylene glycol ether end metabolites. Toxicol Lett 2006. [DOI: 10.1016/j.toxlet.2006.07.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Draeger A, Monastyrskaya K, Mohaupt M, Hoppeler H, Savolainen H, Allemann C, Babiychuk EB. Statin therapy induces ultrastructural damage in skeletal muscle in patients without myalgia. J Pathol 2006; 210:94-102. [PMID: 16799920 DOI: 10.1002/path.2018] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Muscle pain and weakness are frequent complaints in patients receiving 3-hydroxymethylglutaryl coenzymeA (HMG CoA) reductase inhibitors (statins). Many patients with myalgia have creatine kinase levels that are either normal or only marginally elevated, and no obvious structural defects have been reported in patients with myalgia only. To investigate further the mechanism that mediates statin-induced skeletal muscle damage, skeletal muscle biopsies from statin-treated and non-statin-treated patients were examined using both electron microscopy and biochemical approaches. The present paper reports clear evidence of skeletal muscle damage in statin-treated patients, despite their being asymptomatic. Though the degree of overall damage is slight, it has a characteristic pattern that includes breakdown of the T-tubular system and subsarcolemmal rupture. These characteristic structural abnormalities observed in the statin-treated patients were reproduced by extraction of cholesterol from skeletal muscle fibres in vitro. These findings support the hypothesis that statin-induced cholesterol lowering per se contributes to myocyte damage and suggest further that it is the specific lipid/protein organization of the skeletal muscle cell itself that renders it particularly vulnerable.
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Affiliation(s)
- A Draeger
- Institute of Anatomy, Department of Cell Biology, University of Bern, Baltzerstrasse 2, 3012 Bern, Switzerland.
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Berode M, Jost M, Ruegger M, Savolainen H. Host factors in occupational diisocyanate asthma: a Swiss longitudinal study. Int Arch Occup Environ Health 2005; 78:158-63. [PMID: 15714334 DOI: 10.1007/s00420-004-0568-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2004] [Accepted: 08/16/2004] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the usefulness of surrogates for individual susceptibility to organic diisocyanates in occupational asthma. SUBJECTS All new cases declared to the Swiss National Accident Insurance Company (SUVA) for establishment of a case for compensable occupational disease during 1993. Sixty-nine persons, of whom three were women, were suspected of having occupational asthma due to isocyanates. Of these, 47 subjects fulfilled the criteria to be accepted as an occupational disease case. METHODS All subjects were studied clinically and gave a blood sample for the phenotyping of their alpha-antitrypsin status and for immunological studies. The subjects were also given a peroral dose of caffeine for the determination of their N-acetylation capacity. Finally, those with an occupational disease were subjected to the methacholine provocation test. RESULTS Forty-four persons with occupational disease, out of 47, were heterozygous antitrypsin carriers and/or slow acetylators of primary amines. In the bronchial provocation with methacholine, 12 of these subjects had an unaltered response and seven had a mild reaction, 13 a moderate one and 15 a severe reaction. INTERPRETATION The study confirms the finding that slow N-acetylators are susceptible to asthma from exposure to common diisocyanate monomers at work. The same applies to heterozygous antitrypsin-phenotype carriers. Thus, the use of these markers may reinforce the diagnostic procedure, but they cannot completely replace the immunological tests.
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Affiliation(s)
- M Berode
- Institute of Occupational Health Sciences, Bugnon 19, 1005 Lausanne, Switzerland.
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Sollfrank M, Savolainen H, Vock P. [Aortocaval fistula in an abdominal aortic aneurysm]. ROFO-FORTSCHR RONTG 2004; 176:1050-2. [PMID: 15237352 DOI: 10.1055/s-2004-812997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- M Sollfrank
- Inselspital in Bern, Departement Radiologie, Neurochirurgie und Nuklearmedizin.
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Widmer MK, Aregger F, Stauffer E, Savolainen H, Heller G, Hakki H, Carrel T, Schmidli J, Mohaupt MG. Intermediate Outcome and Risk Factor Assessment of Bovine Vascular Heterografts used as AV-Fistulas for Hemodialysis Access. Eur J Vasc Endovasc Surg 2004; 27:660-5. [PMID: 15121120 DOI: 10.1016/j.ejvs.2004.01.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2004] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This observational study was set up to prospectively follow all bovine heterograft (ProCol) fistulas implanted for hemodialysis access between 1998 and 2002. METHODS ProCol was implanted if autogenous vein was not available or if patients presented with a history of failed, infected or otherwise complicated ePTFE grafts and/or on immunosuppressive therapy. Fistula patency was the primary outcome; secondary outcomes were clinical events and the rate of access revisions. RESULTS Sixty-two ProCol grafts were implanted in 56 patients. The mean primary (PP) and secondary patency (SP) was 334 (SEM 57) and 528 (SEM 59) days, respectively. Coronary heart disease was associated with a significantly better SP (OR 0.2, 95% CI 0.1-0.9) whilst diabetes mellitus was associated with a significantly worse SP (OR 0.2, 95% CI 0.1-0.9). Reinterventions were performed at a mean rate of 1.23 (SEM 0.17) per fistula. The relative risk of access revision was significantly higher in patients with diabetes mellitus (OR 9.2, 95% CI 2.3-37.2). CONCLUSIONS ProCol grafts, used for AV-fistulas, demonstrate acceptable patency rates in high-risk haemodialysis patients. Diabetes mellitus jeopardizes the patency of these fistulas and is associated with a high revision rate.
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Affiliation(s)
- M K Widmer
- Division of Cardiovascular Surgery, University of Berne, Berne, Switzerland
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Abstract
Since the first use of vacuum-assisted therapy (V.A.C.) in wound care, the indications of this therapy have rapidly expanded. Vascular surgery presents many types of problematic wounds. In the current cost conscious atmosphere, there is a great demand for simple and effective therapies. The V.A.C. system has a lot of potential in the management of vascular wounds. In this article we present indications for vacuum-assisted therapy in vascular surgery: chronic leg ulcers, mesh skin graft, wound care after fasciotomy for compartment syndrome, problematic inguinal wound, false aneurysms, diabetic foot gangrene and amputations with marginal circulations.
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Affiliation(s)
- G Heller
- Klinik für Herz- und Gefässchirurgie Bern.
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Schmidli J, Savolainen H, Heller G, Widmer MK, Then-Schlagau U, Baumgartner I, Carrel TP. Bovine mesenteric vein graft (ProCol) in critical limb ischaemia with tissue loss and infection. Eur J Vasc Endovasc Surg 2004; 27:251-3. [PMID: 14760592 DOI: 10.1016/j.ejvs.2003.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Poor results have been reported following infrainguinal reconstructions using heterogenous grafts. The objective of this study was to assess the use of bovine mesenteric vein (ProCol) graft in patients with critical limb ischaemia (CLI), tissue loss/infection and no autologous vein available for reconstruction. METHODS Prospective analysis of 32 patients with CLI and tissue loss/infection, in whom reconstruction with ProCol was undertaken between October 1999 and May 2002. RESULTS The primary patency rate was 16% at 1 month. After thrombectomy, the secondary patency rate was 50% at 1 month and 26% at 14 months. No graft infections were seen. Aneurysmal dilatation of the graft occurred in 2 (6%). Limb salvage at 14 months was 47%. CONCLUSION In patients with critical limb ischaemia, tissue loss/infection and no available vein, the ProCol graft may be an alternative. However, primary patency is a problem. In situations without tissue loss/infection, where the risk of graft infection is less, prosthetic material may be a better alternative.
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Affiliation(s)
- J Schmidli
- Swiss Cardiovascular Center, University Hospital, 3010 Berne, Switzerland
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Keskinen P, Korhonen S, Kupila A, Veijola R, Erkkilä S, Savolainen H, Arvilommi P, Simell T, Ilonen J, Knip M, Simell O. First-phase insulin response in young healthy children at genetic and immunological risk for Type I diabetes. Diabetologia 2002; 45:1639-48. [PMID: 12488953 DOI: 10.1007/s00125-002-0981-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2002] [Revised: 07/30/2002] [Indexed: 10/27/2022]
Abstract
AIMS/HYPOTHESIS A reduced first-phase insulin response to intravenous glucose is perceived as a sign of far-advanced deterioration of beta-cell function during the development of Type I (insulin-dependent) diabetes mellitus, but data on insulin responses at the onset of diabetes-related autoimmunity are lacking. We studied the first-phase insulin responses of small children soon after observed seroconversion to autoantibody positivity. METHODS In the Type I Diabetes Prediction and Prevention Study newborn infants are screened for HLA-DQB1-associated genetic risk for Type I diabetes and those with increased risk are followed-up for the emergence of islet-cell antibodies. If antibodies are detected, autoantibodies to three other antigens (insulin, GAD65 and IA-2) are also measured. To measure first-phase insulin responses, intravenous glucose tolerance tests were carried out in 52 (1 to 5-year-old) children who had recently seroconverted to islet-cell antibody positivity. RESULTS The first-phase insulin response was subnormal (<38 mU/l, the 5(th) percentile of insulin responses of 20 islet-cell antibody negative healthy children at this age) in 22 of the 52 children (42%). Stepwise multiregression analysis showed that islet-cell antibody greater than 20 JDFU (p=0.0005), insulin autoantibodies (p=0.0009) and an increasing number of positive autoantibodies (p=0.0011) were independent predictors of low first-phase insulin response. CONCLUSION/INTERPRETATION A decreased first-phase insulin response could be an early phenomenon in the course of prediabetes in young children, implying a rapid autoimmune destruction or loss of function of beta cells as well as possible metabolic compensation mechanisms, since 11 out of the 22 high risk children remain nondiabetic for a considerable period of time despite low insulin responses.
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Affiliation(s)
- P Keskinen
- The JDRF Center for Prevention of Type I Diabetes in Finland.
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Lutz HJ, Do DD, Schroth G, Mahler F, Savolainen H, Carrel T, Schmidli J. Hybrid therapy of symptomatic stenosis of the innominate artery. Eur J Vasc Endovasc Surg 2002; 24:184-5. [PMID: 12389244 DOI: 10.1053/ejvs.2002.1686] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- H J Lutz
- Clinic for Cardiovascular Surgery, University Hospital, Berne, Switzerland
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Schmidli J, Do DD, Triller J, Widmer MK, Savolainen H, Carrel T. Iliac graft access to facilitate endovascular repair of a ruptured thoracic aortic aneurysm -- a case report. Vasc Endovascular Surg 2002; 36:237-9. [PMID: 12075391 DOI: 10.1177/153857440203600313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Arterial access for endovascular aortic aneurysm repair is usually gained through a common femoral artery approach. In small femoral arteries this can be difficult or even impossible owing to the large size of the introduction sheath of the delivery system. In such cases the iliac arteries or the abdominal aorta can be used for vascular access, although, in heavily calcified arteries,even this can be hazardous. The authors report an 81-year-old woman with a contained rupture of the thoracic aorta in whom a polyester graft was used to facilitate vascular access to the common iliac artery for a safe two-stage endovascular repair of the aneurysm.
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Affiliation(s)
- Jurg Schmidli
- Clinic for Cardiovascular Surgery, University Hospital Bern, Switzerland.
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Savolainen H, Frösen J, Petrov L, Aavik E, Häyry P. Expression of estrogen receptor sub-types alpha and beta in acute and chronic cardiac allograft vasculopathy. J Heart Lung Transplant 2001; 20:1252-64. [PMID: 11744408 DOI: 10.1016/s1053-2498(01)00363-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The vasculoprotective effects of estrogen are well-established not only in women with age-related atherosclerosis, but also after experimental vascular injury and in chronic allograft vasculopathy. Evidence exists that the newly discovered estrogen receptor (ER) beta, rather than the classical ERalpha is related to the vasculoprotective effect. Here we investigate whether and to what extent the two ERs are expressed in cardiac allografts in the rat and human in native state and during acute and chronic rejection. METHODS Rat cardiac allografts were performed from male DA (AG-B4, RT1(a)) to male WF (AG-B2, RT1(v)) strain and syngeneic transplants from DA to DA strain; human male-to-male heart allograft endomyocardial biopsies came from our biopsy files. RESULTS Under in situ hybridization, ERbeta mRNA was prominently expressed in rat vessels and stroma, whereas ERalpha mRNA was present in low levels only. In immunohistochemistry, 2 ERbeta-specific antibodies stained rat and human vessels and stroma, whereas only a weak or no signal was obtained with 2 ERalpha-specific antibodies. Interestingly, the mRNA and protein expression levels in the rat carried only a weak correlation with the intensity of acute rejection, i.e., was not related to the intensity of inflammation. CONCLUSIONS Our results demonstrate that ERbeta is the predominant ER in rat and human cardiac allografts, and suggest that, unless additional ERs are identified, the vasculoprotective effects of estrogen derivatives in cardiac allograft vasculopathy are mediated by ERbeta rather than by the classical ERalpha.
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Affiliation(s)
- H Savolainen
- Transplantation Laboratory, and the Rational Drug Design Programme, Biomedicum, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
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Mämmelä P, Tuomainen A, Savolainen H, Kangas J, Vartiainen T, Lindroos L. Determination of gallic acid in wood dust as an indicator of oak content. J Environ Monitor 2001; 3:509-11. [PMID: 11695120 DOI: 10.1039/b105998j] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A high-performance liquid chromatography (HPLC) method was developed for the detection of extracted gallic acid in wood dust. Gallic acid is a polyphenol present in carcinogenic oak wood dust, but not in beech, ash, pine or spruce dusts, as confirmed by HPLC analyses. The method involved the extraction of gallic acid from the oak dust, followed by liquid chromatographic analysis. The correlation coefficient for the share of oak dust vs. the gallic acid concentration of wood dust was 0.995. The method was tested with oak wood dust samples collected on polycarbonate membrane filters during an 8 h workshift in a floor board factory, where the dust content of the air samples was determined gravimetrically. The oak dust and the gallic acid concentrations varied from 0.2 to 13.8 mg m-3 and from 0.03 to 3.8 micrograms m-3, respectively. These parameters were linearly correlated with a correlation coefficient of 0.95. The airborne gallic acid determination is a useful technique to confirm occupational exposure to oak wood dust, a recognized human carcinogen.
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Affiliation(s)
- P Mämmelä
- Lappeenranta Regional Institute of Occupational Health, Laserkatu 6, FIN-53850 Lappeenranta, Finland.
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Sarantila R, Reiman M, Kangas J, Husman K, Savolainen H. Exposure to endotoxins and microbes in the treatment of waste water and in the industrial debarking of wood. Bull Environ Contam Toxicol 2001; 67:171-178. [PMID: 11429673 DOI: 10.1007/s001280107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2000] [Accepted: 05/21/2001] [Indexed: 05/23/2023]
Affiliation(s)
- R Sarantila
- City of Kokkola, Post Office Box 43, FIN-67101 Kokkola, Finland
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Varis A, Puolakkainen P, Savolainen H, Kokkola A, Salo J, Nieminen O, Nordling S, Knuutila S. DNA copy number profiling in esophageal Barrett adenocarcinoma: comparison with gastric adenocarcinoma and esophageal squamous cell carcinoma. Cancer Genet Cytogenet 2001; 127:53-8. [PMID: 11408066 DOI: 10.1016/s0165-4608(00)00423-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We screened 18 specimens of Barrett adenocarcinoma for genetic alterations using comparative genomic hybridization (CGH) to analyze DNA copy number changes. The most common gains were at 20q (56%) and 17q (39%). High-level amplifications were observed in the same chromosomes. The most common losses were in chromosomes 4 (22%) and 5 (22%). Other recurrent changes were gains of chromosomes 8, 10q, and 13. We compared the copy number changes in Barrett adenocarcinoma and those previously reported in the intestinal type of stomach carcinoma. The similarities we found suggest a common molecular pathogenesis, whereas dissimilarities seen between Barrett adenocarcinoma and esophageal squamous cell carcinoma are in keeping with a well-known different etiology.
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Affiliation(s)
- A Varis
- Department of Medical Genetics, Haartman Institute and Central Hospital, University of Helsinki, Helsinki, Finland
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Kupila A, Muona P, Simell T, Arvilommi P, Savolainen H, Hämäläinen AM, Korhonen S, Kimpimäki T, Sjöroos M, Ilonen J, Knip M, Simell O. Feasibility of genetic and immunological prediction of type I diabetes in a population-based birth cohort. Diabetologia 2001; 44:290-7. [PMID: 11317658 DOI: 10.1007/s001250051616] [Citation(s) in RCA: 234] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIMS/HYPOTHESIS Population-wide genetic screening of susceptibility to multifactorial diseases will become relevant as knowledge of the pathogenesis of these diseases increases and preventive interventions are identified. METHODS Feasibility and acceptance of neonatal genetic screening for Type I (insulin-dependent) diabetes mellitus susceptibility and adherence of the at-risk children to frequent autoantibody follow-up were studied. Screening was offered to all families. The infants with HLA-DQB1 genotypes *02/*0302 and *0302/x (x not equal to *02, *0301, *0602) were invited to autoantibody follow-up. The children who developed signs of beta-cell autoimmunity were invited to a separate prevention trial. RESULTS The parents of 31,526 babies born between November 1994 and April 1999 (94.4% of those eligible) agreed to genetic screening. We found that 4651 infants (14.8%) had increased genetic risk (2.5 to 15 times that of the general population) for Type I (insulin-dependent) diabetes mellitus, and 80% of them joined the autoantibody surveillance. At the age of 1, 2, 3 and 4 years, 74, 69, 68 and 76% of the at-risk children, respectively, attended the follow-up. A total of 17 of the 22 children (77%) who were born during the study period and have developed diabetes carry the risk genotypes we currently use for screening. CONCLUSIONS/INTERPRETATION Population-based screening of genetic susceptibility for Type I diabetes, linked with a possibility to participate later in a prevention trial, is highly accepted in Finland and identifies about 75% of those developing diabetes at an early age. Families adhere well to the frequent measurement of signs of beta-cell autoimmunity in the children at-risk.
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Affiliation(s)
- A Kupila
- Dept. of Paediatrics, Univ. of Turku, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland
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Häyry P, Aavik E, Palgi M, Petrov L, Savolainen H, Luoto NM, Loubtchenkov M, Frösen J. Molecular biology of transplant arteriosclerosis and sites of therapeutic intervention. Transplant Proc 2001; 33:293-4. [PMID: 11266824 DOI: 10.1016/s0041-1345(00)02014-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P Häyry
- Transplantation Laboratory and The Rational Drug Design Programme of Biomedicum, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
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Savolainen H, Frösen J, Petrov L, Häyry P. Expression of the vasculoprotective estrogen receptor subtype beta in rat and human cardiac allograft vasculopathy. Transplant Proc 2001; 33:1605. [PMID: 11267437 DOI: 10.1016/s0041-1345(00)02610-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- H Savolainen
- Transplantation Laboratory, University of Helsinki, Helsinki, Finland.
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Mämmelä P, Savolainen H, Lindroos L, Kangas J, Vartiainen T. Analysis of oak tannins by liquid chromatography-electrospray ionisation mass spectrometry. J Chromatogr A 2000; 891:75-83. [PMID: 10999626 DOI: 10.1016/s0021-9673(00)00624-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Extractable tannins were analysed by liquid chromatography-electrospray ionisation mass spectrometry in two oak species, North American white oak (Quercus alba) and European red oak (Quercus robur). They mainly included various glucose gallic and ellagic acid esters. The structures were partially determined, and they included grandinin/roburin E, castalagin/vescalagin, gallic acid, valoneic acid bilactone, monogalloyl glucose, digalloyl glucose, trigalloyl glucose, ellagic acid rhamnose, quercitrin and ellagic acid.
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Affiliation(s)
- P Mämmelä
- Lappeenranta Regional Institute of Occupational Health, Finland
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Berode M, Sethre T, Läubli T, Savolainen H. Urinary methanol and formic acid as indicators of occupational exposure to methyl formate. Int Arch Occup Environ Health 2000; 73:410-4. [PMID: 11007345 DOI: 10.1007/s004200000160] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the validity of methanol (MeOH) and formic acid (FA) in urine as biological indicators of methyl formate (MF) exposure in experimental and field situations. METHODS The subjects were 28 foundrymen and two groups of volunteers (20 control and 20 exposed). Exposure assessment of the workers was performed by personal air and biological monitoring. Methyl formate vapour collected on charcoal tube was analysed by gas chromatography. The concentration of MF in the exposure chamber (volunteer-study) was monitored by two independent methods [flame ionisation detection (FID) and Fourier transformation infra-red detection (FTIR)]. Urinary metabolites (MeOH and FA) were analysed separately by headspace gas chromatography. RESULTS The volunteers exposed to 100 ppm MF vapour at rest for 8 h excreted 3.62 +/- 1.13 mg MeOH/l (mean +/- SD) at the end of the exposure. This was statistically different (P < 0.001) from pre-exposure MeOH excretion (2.15 +/- 0.80 mg/1), or from that of controls (1.69 +/- 0.48 mg/l). The urinary FA excretion was 32.2 +/- 11.3 mg/g creatinine after the exposure, which was statistically different (P < 0.001) from pre-exposure excretion (18.0 +/- 9.3 mg/g creatinine) or that of controls (13.8 +/- 7.9 mg/g creatinine). In foundrymen, the urinary FA excretion after the 8 h workshift exposure to a time weighted average (TWA) concentration of 2 to 156 ppm MF showed a dose-dependent increase best modelled by a polynomial function. The highest urinary FA concentration was 129 mg/g creatinine. The pre-shift urinary FA of the foundrymen (18.3 +/- 5.6 mg/g creatinine) did not differ from that of controls (13.8 +/- 7.9 mg/g creatinine). The urinary MeOH excretion of the foundrymen after the shift, varied from < 1 to 15.4 mg/l, while the correlation with the preceding MF exposure was poor. The foundrymen excreted more (P = 0.01) FA (2.12 +/- 3.56 mg/g creatinine) after the workshift than experimentally, once-exposed volunteers (0.32 +/- 0.11 mg/g creatinine) at a similar inhaled MF level of 1 ppm). CONCLUSIONS In spite of its high background level in non-exposed subjects, urinary FA seems to be a useful biomarker of methyl formate exposure. The question remains as to what is the reason for the differences in chronic and acute exposure respectively.
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Affiliation(s)
- M Berode
- Institute of Occupational Health Sciences, Lausanne, Switzerland.
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Häyry P, Savolainen H, Luoto NM, Petrov L, Loubtchenkov M, Aavik E. Emerging therapeutic strategies for the prevention and treatment of chronic allograft rejection. Transplant Proc 2000; 32:519. [PMID: 10812093 DOI: 10.1016/s0041-1345(00)00870-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- P Häyry
- Transplantation Laboratory, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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Häyry P, Aavik E, Savolainen H. Mechanisms of chronic rejection. Transplant Proc 1999; 31:5S-8S. [PMID: 10576033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- P Häyry
- Transplantation Laboratory, University of Helsinki, Finland.
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Mäkelä S, Savolainen H, Aavik E, Myllärniemi M, Strauss L, Taskinen E, Gustafsson JA, Häyry P. Differentiation between vasculoprotective and uterotrophic effects of ligands with different binding affinities to estrogen receptors alpha and beta. Proc Natl Acad Sci U S A 1999; 96:7077-82. [PMID: 10359841 PMCID: PMC22061 DOI: 10.1073/pnas.96.12.7077] [Citation(s) in RCA: 184] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Estrogen-based drug therapy in cardiovascular diseases has been difficult because it has not been possible to separate the wanted vasculoprotective effect from the unwanted effects of the hormone to the reproductive system. Here, we demonstrate that, after endothelial denudation of rat carotid artery, the mRNA of the classical estrogen receptor (ERalpha) is constitutively expressed at a low level whereas the expression of the novel ERbeta mRNA increases >40-fold. Under in situ hybridization and immunohistochemistry, ERbeta mRNA and protein colocalize with the smooth muscle cells in the media and neointima. Treatment of ovariectomized female rats with the isoflavone phytoestrogen genistein, which shows 20-fold higher binding affinity to ERbeta than to ERalpha, or with 17beta-estradiol, which does not differentiate between the two receptors, provides similar dose-dependent vasculoprotective effect in rat carotid injury model. In addition in concentrations <10 microM, both ligands are equally inhibitory to the replication and migration of smooth muscle cells in vitro. However, only treatment with 17beta-estradiol, but not with genistein, is accompanied with a dose-dependent uterotrophic effect. The results suggest that preferential targeting to ERbeta will provide vasculoprotective estrogen analogs devoid of effects to the reproductive system.
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Affiliation(s)
- S Mäkelä
- University of Turku, Institute of Biomedicine and MediCity Research Laboratory, Kiinamyllynkatu 10, FIN-20520 Turku, Finland
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Abstract
Male Wistar rats were given ethanediol (9.4 g/l), 2-ethoxyethylacetate (5.4 g/l), 2-butoxyethylacetate (2.9 g/l) and 1,2-propanediol (40 g/l) respectively in their drinking water for 2 weeks. Urine was collected during the last 24 h of the exposure. There was a marked increase in the oxalic acid excretion by the rats given ethanediol while rats given the alkoxyacetates excreted large amounts of ethoxyacetic and butoxyacetic acid, respectively. While not increased compared with controls, the excretion of oxalic acid by the latter group of rats was correlated to the excretion of the respective alkoxyacetic acids. The ammonia and glycosaminoglycan excretion was also smaller than that of controls. The urinary activity of succinate dehydrogenase was decreased in rats given the alkoxyacetates but not in animals exposed to ethanediol or propanediol. The data show that oxalic acid is actually a minor metabolite of the alkoxyacetates while the biochemical effects in kidney are associated more with the alkoxyacetic acid load. Alkoxyacetic acids seem to be inhibitors of renal succinate dehydrogenase, which may account for the decreased ammonia and glycosaminoglycan excretion.
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Affiliation(s)
- J Liesivuori
- University of Kuopio, Department of Pharmacology and Toxicology, Finland.
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Savolainen H. New mechanistic model for organic diisocyanate-induced respiratory disease. Schweiz Med Wochenschr 1999; 129:465-7. [PMID: 10231900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The pathophysiological mechanisms of organic diisocyanate-induced respiratory disease remain largely unknown. Some 20% of patients have specific antibodies towards diisocyanate monomers whereas even in this circumstance their presence does not correlate very well with results in clinical provocation tests. The formation of diisocyanate haptens is the trigger for the immunological reactions. However, it is known that the reactions with protein and other macromolecules may be slow and hydrolysis of the isocyanate moities to corresponding amines as catalyzed by bicarbonate is more rapid. The liberated amines, or their intermediates, probably have an important role in the activation of tissue thromboplastin activator, loss of serum antitrypsin activity, and, finally, in neurogenic inflammation. Hypothetically, susceptible individuals probably include those which are slow acetylators of exogenous amines and carries of heterozygous antitrypsin phenotypes.
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Affiliation(s)
- H Savolainen
- Institute of Occupational Health Sciences, Lausanne
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Abstract
The aim of this study was to evaluate the reliability of distal pulse palpation. The dorsalis pedis and the tibialis posterior arteries of 25 patients with suspected lower limb arterial disease were independently palpated by three vascular surgeons and three medical students in the outpatient clinic and by two vascular nurses and one physician in the vascular laboratory. The palpation findings were compared to the ankle/brachial index (ABI). Palpable and unpalpable pulses were best separated with ABI 0.76 as the cutoff point. The degree of misdiagnosis was unacceptably high, with an underdiagnosis of more than 30%. The agreement was highest (kappa 0. 68, good) among the vascular laboratory personnel in the peaceful vascular laboratory and lowest (kappa 0.38, fair) among the vascular surgeons in the busy outpatient clinic. The poor agreement and the high proportion of misdiagnosis obtained in the outpatient clinic argue against the use of pulse palpation as a single diagnostic method. Palpable pulses with low ABIs clearly state the need for more objective measurements whenever ischemia is suspected. Yet, by carefully palpating both pedal arteries under good, nonhurried conditions the reproducibility and accuracy of pulse palpation can be tolerable.
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Affiliation(s)
- M Lundin
- Department of Surgery, Division of Vascular Surgery, Helsinki University Central Hospital, P.O. Box 262, 00029 HUCH, Helsinki, Finland
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Abstract
Proteoglycans contain a polypeptide core and an oligosaccharide chain composed of aminohexoses and uronic acid. The glycan chain is attached to the polypeptide in a bond to serine hydroxyl. The glycan chains may contain up to 200 disaccharide units and the proteoglycan molecular mass ranges from a few thousands to millions. Their physiological functions are related to barriers limiting diffusion across the membranes, articular lubrification, blood coagulation and cellular adhesion. The tissue proteoglycans can be extracted with 4 M guanidine hydrochloride and purified with chromatographic techniques. The soluble proteoglycans can be precipitated with cetylpyridinium chloride, purified by chromatography or by dialysis. All proteoglycan species are amenable to electrophoresis on polyacrylamide gels, and after blotting on polyvinylidene fluoride membranes, they can be stained for glycans. Proteoglycan analyses have shown their value in clinical mucopolysaccharidosis diagnostics, in occupational toxicology and in coagulation studies. Experimental applications include cell adhesion studies in tumor biology, regeneration in neurosciences or maturation of skin and kidneys.
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Affiliation(s)
- H Savolainen
- Institute of Occupational Health Sciences, Lausanne, Switzerland
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