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Your search keyword '"Laukkarinen, J. (Johanna)"' showing total 8 results
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8 results on '"Laukkarinen, J. (Johanna)"'

1. Pancreatic secretory trypsin inhibitor (SPINK1) gene mutation in patients with acute alcohol pancreatitis (AAP) compared to healthy controls and heavy alcohol users without pancreatitis

Author

Nikkola, A. (Anssi), Mäkelä, K. A. (Kari Antero), Herzig, K.-H. (Karl-Heinz), Mutt, S. J. (Shivaprakash Jagalur), Prasannan, A. (Aishwarya), Seppänen, H. (Hanna), Lehtimäki, T. (Terho), Kähönen, M. (Mika), Raitakari, O. (Olli), Seppälä, I. (Ilkka), Pakkanen, P. (Pihla), Nordback, I. (Isto), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Nikkola, A. (Anssi), Mäkelä, K. A. (Kari Antero), Herzig, K.-H. (Karl-Heinz), Mutt, S. J. (Shivaprakash Jagalur), Prasannan, A. (Aishwarya), Seppänen, H. (Hanna), Lehtimäki, T. (Terho), Kähönen, M. (Mika), Raitakari, O. (Olli), Seppälä, I. (Ilkka), Pakkanen, P. (Pihla), Nordback, I. (Isto), Sand, J. (Juhani), and Laukkarinen, J. (Johanna)

Abstract

Only 3–5% of heavy alcohol users develop acute alcohol pancreatitis (AAP). This suggests that additional triggers are required to initiate the inflammatory process. Genetic susceptibility contributes to the development of AAP, and SPINK1 mutation is a documented risk factor. We investigated the prevalence of the SPINK1(N34S) mutation in patients with AAP compared to heavy alcohol users who had never suffered an episode of pancreatitis. Blood samples for the mutational analysis from patients with first episode (n = 60) and recurrent AAP (n = 43) and from heavy alcohol users without a history of AAP (n = 98) as well as from a control population (n = 1914) were obtained. SPINK1 mutation was found in 8.7% of the patients with AAP. The prevalence was significantly lower in healthy controls (3.4%, OR 2.72; 1.32–5.64) and very low in alcoholics without pancreatitis (1.0%, OR 9.29; 1.15–74.74). In a comparison adjusted for potential cofounders between AAP patients and alcoholics, SPINK1 was found to be an independent marker for AAP. The prevalence of the SPINK1 mutation is overrepresented in AAP patients and very low in alcoholics without pancreatitis. This finding may play a role in understanding the variable susceptibility to AAP found in heavy alcohol users.

Published
2022

2. Long-term morbidity and mortality in patients diagnosed with an insulinoma

Author

Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Metso, S. (Saara), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Sirén, J. (Jukka), Soinio, M. (Minna), Nuutila, P. (Pirjo), Moilanen, L. (Leena), Laaksonen, D. E. (David E), Ebeling, T. (Tapani), Arola, J. (Johanna), Schalin-Jäntti, C. (Camilla), Jaatinen, P. (Pia), Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Metso, S. (Saara), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Sirén, J. (Jukka), Soinio, M. (Minna), Nuutila, P. (Pirjo), Moilanen, L. (Leena), Laaksonen, D. E. (David E), Ebeling, T. (Tapani), Arola, J. (Johanna), Schalin-Jäntti, C. (Camilla), and Jaatinen, P. (Pia)

Abstract

Objective: Insulinomas are rare functional pancreatic neuroendocrine tumours. As previous data on the long-term prognosis of insulinoma patients are scarce, we studied the morbidity and mortality in the Finnish insulinoma cohort. Design: Retrospective cohort study. Methods: Incidence of endocrine, cardiovascular, gastrointestinal and psychiatric disorders, and cancers was compared in all the patients diagnosed with an insulinoma in Finland during 1980–2010 (n = 79, including two patients with multiple endocrine neoplasia type 1 syndrome), vs 316 matched controls, using the Mantel–Haenszel method. Overall survival was analysed with Kaplan–Meier and Cox regression analyses Results: The median length of follow-up was 10.7 years for the patients and 12.2 years for the controls. The long-term incidence of atrial fibrillation (rate ratio (RR): 2.07 (95% CI: 1.02–4.22)), intestinal obstruction (18.65 (2.09–166.86)), and possibly breast (4.46 (1.29–15.39) and kidney cancers (RR not applicable) was increased among insulinoma patients vs controls, P < 0.05 for all comparisons. Endocrine disorders and pancreatic diseases were more frequent in the patients during the first year after insulinoma diagnosis, but not later on. The survival of patients with a non-metastatic insulinoma (n = 70) was similar to that of controls, but for patients with distant metastases (n = 9), the survival was significantly impaired (median 3.4 years). Conclusions: The long-term prognosis of patients with a non-metastatic insulinoma is similar to the general population, except for an increased incidence of atrial fibrillation, intestinal obstruction, and possibly breast and kidney cancers. These results need to be confirmed in future studies. Metastatic insulinomas entail a markedly decreased survival.

Published
2021

3. Stromal hyaluronan accumulation is associated with low immune response and poor prognosis in pancreatic cancer

Author

Tahkola, K. (Kyösti), Ahtiainen, M. (Maarit), Mecklin, J.-P. (Jukka-Pekka), Kellokumpu, I. (Ilmo), Laukkarinen, J. (Johanna), Tammi, M. (Markku), Tammi, R. (Raija), Väyrynen, J. P. (Juha P.), Böhm, J. (Jan), Tahkola, K. (Kyösti), Ahtiainen, M. (Maarit), Mecklin, J.-P. (Jukka-Pekka), Kellokumpu, I. (Ilmo), Laukkarinen, J. (Johanna), Tammi, M. (Markku), Tammi, R. (Raija), Väyrynen, J. P. (Juha P.), and Böhm, J. (Jan)

Abstract

Hyaluronan (HA) accumulation has been associated with poor survival in various cancers, but the mechanisms for this phenomenon are still unclear. The aim of this study was to investigate the prognostic significance of stromal HA accumulation and its association with host immune response in pancreatic ductal adenocarcinoma (PDAC). The study material consisted of 101 radically treated patients for PDAC from a single geographical area. HA staining was evaluated using a HA-specific probe, and the patterns of CD3, CD8, CD73 and PD-L1 expression were evaluated using immunohistochemistry. HA staining intensity of tumour stromal areas was assessed digitally using QuPath. CD3- and CD8-based immune cell score (ICS) was determined. High-level stromal HA expression was significantly associated with poor disease-specific survival (p = 0.037) and overall survival (p = 0.013) In multivariate analysis, high-level stromal HA expression was an independent negative prognostic factor together with histopathological grade, TNM stage, CD73 positivity in tumour cells and low ICS. Moreover, high-level stromal HA expression was associated with low ICS (p = 0.017). In conclusion, stromal HA accumulation is associated with poor survival and low immune response in PDAC.

Published
2021

4. Long‐term health‐related quality of life in persons diagnosed with an insulinoma in Finland 1980‐2010

Author

Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Sintonen, H. (Harri), Metso, S. (Saara), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Schalin‐Jäntti, C. (Camilla), Sirén, J. (Jukka), Soinio, M. (Minna), Nuutila, P. (Pirjo), Moilanen, L. (Leena), Ebeling, T. (Tapani), and Jaatinen, P. (Pia)

Subjects
endocrine system, insulin, quality of life, hyperinsulinism, pancreas, insulinoma, neuroendocrine tumors, hypoglycaemia
Abstract

Objective: Insulinomas are rare pancreatic neoplasms, which can usually be cured by surgery. As the diagnostic delay is often long and the prolonged hyperinsulinemia may have long‐term effects on health and the quality of life, we studied the long‐term health‐related quality of life (HRQoL) in insulinoma patients. Design, patients and measurements: The HRQoL of adults diagnosed with an insulinoma in Finland in 1980‐2010 was studied with the 15D instrument, and the results were compared to those of an age‐ and gender‐matched sample of the general population. The minimum clinically important difference in the total 15D score has been defined as ±0.015. The clinical characteristics, details of insulinoma diagnosis and treatment, and the current health status of the subjects were examined to specify the possible determinants of long‐term HRQoL. Results: Thirty‐eight insulinoma patients participated in the HRQoL survey (response rate 75%). All had undergone surgery with a curative aim, a median of 13 (min 7, max 34) years before the survey. The insulinoma patients had a clinically importantly and statistically significantly better mean 15D score compared with the controls (0.930 ± 0.072 vs 0.903 ± 0.039, P = .046) and were significantly better off regarding mobility, usual activities and eating. Among the insulinoma patients, younger age at the time of survey, higher level of education and smaller number of chronic diseases were associated with better overall HRQoL. Conclusions: In the long term, the overall HRQoL of insulinoma patients is slightly better than that of the general population.

Published
2020

5. A randomised placebo-controlled double-blind multicentre trial comparing antibiotic therapy with placebo in the treatment of uncomplicated acute appendicitis:APPAC III trial study protocol

Author

Sippola, S. (Suvi), Grönroos, J. (Juha), Sallinen, V. (Ville), Rautio, T. (Tero), Nordström, P. (Pia), Rantanen, T. (Tuomo), Hurme, S. (Saija), Leppäniemi, A. (Ari), Meriläinen, S. (Sanna), Laukkarinen, J. (Johanna), Savolainen, H. (Heini), Virtanen, J. (Johanna), and Salminen, P. (Paulina)

Subjects
appendicitis, uncomplicated acute appendicitis, randomized controlled trial, antibiotic therapy, placebo, double-blind
Abstract

Introduction: Recent studies show that antibiotic therapy is safe and feasible for CT-confirmed uncomplicated acute appendicitis. Spontaneous resolution of acute appendicitis has already been observed over a hundred years ago. In CT-confirmed uncomplicated acute diverticulitis (left-sided appendicitis), studies have shown no benefit from antibiotics compared with symptomatic treatment, but this shift from antibiotics to symptomatic treatment has not yet been widely implemented in clinical practice. Recently, symptomatic treatment of uncomplicated acute appendicitis has been demonstrated in a Korean open-label study. However, a double-blinded placebo-controlled study to illustrate the role of antibiotics and spontaneous resolution of uncomplicated acute appendicitis is still lacking. Methods and analysis: The APPAC III (APPendicitis ACuta III) trial is a multicentre, double-blind, placebo-controlled, superiority randomised study comparing antibiotic therapy with placebo in the treatment CT scan-confirmed uncomplicated acute appendicitis aiming to evaluate the role of antibiotics in the resolution of uncomplicated acute appendicitis. Adult patients (18–60 years) with CT scan-confirmed uncomplicated acute appendicitis (the absence of appendicolith, abscess, perforation and tumour) will be enrolled in five Finnish university hospitals. Primary endpoint is success of the randomised treatment, defined as resolution of acute appendicitis resulting in discharge from the hospital without surgical intervention within 10 days after initiating randomised treatment (treatment efficacy). Secondary endpoints include postintervention complications, recurrent symptoms after treatment up to 1 year, late recurrence of acute appendicitis after 1 year, duration of hospital stay, sick leave, treatment costs and quality of life. A decrease of 15 percentage points in success rate is considered clinically important difference. The superiority of antibiotic treatment compared with placebo will be analysed using Fisher’s one-sided test and CI will be calculated for proportion difference. Ethics and dissemination: This protocol has been approved by the Ethics Committee of Turku University Hospital and the Finnish Medicines Agency (FIMEA). The findings will be disseminated in peer-reviewed academic journals. Trial registration number: NCT03234296; Pre-results

Published
2018

6. European evidence-based guidelines on pancreatic cystic neoplasms

Author

Del Chiaro, M. (Marco), Besselink, M.G. (Marc), Scholten, L. (Lianne), Bruno, M.J. (Marco), Cahen, D.L. (Djuna), Gress, T. (Thomas), Hooft, J.E. (Jeanin) van, Lerch, M. (M.), Mayerle, J. (Julia), Hackert, T. (Thilo), Satoi, S. (Sohei), Zerbi, A. (Alessandro), Cunningham, D. (David), Angelis, C. (Claudio) de, Giovannini, M. (Marc), de-Madaria, E. (Enrique), Hegyi, P. (Peter), Rosendahl, J. (Jonas), Friess, H., Manfredi, R. (Riccardo), Lévy, P. (Philippe), Real, F.X. (Francisco), Sauvanet, A., Abu Hilal, M., Marchegiani, G. (Giovanni), Esposito, I. (I.), Ghaneh, P. (P.), Engelbrecht, M.R.W. (Marc R.W.), Fockens, P. (Paul), van Huijgevoort, N.C.M. (Nadine C.M.), Wolfgang, C.L. (Christopher L.), Bassi, C. (Claudio), Gubergrits, N.B. (Natalya B.), Verbeke, C. (Caroline), Kloppel, G. (Günter), Scarpa, A. (Aldo), Zamboni, W.C., Lennon, A.M. (Anne Marie), Sund, R. (Reijo), Kartalis, N. (Nikolaos), Grenacher, L. (Lars), Falconi, M. (Massimo), Arnelo, U. (U.), Kopchak, K.V. (Kostantin V.), Oppong, K. (K.), McKay, C. (Colin), Hauge, A.W. (Anne Werner), Conlon, K. (Kevin), Adham, I.M., Ceyhan, G.O. (Güralp O.), Salvia, R. (Roberto), Dervenis, C. (Christos), Allen, P.J. (Peter), Paye, F. (François), Bartsch, D.K. (Detlef), Löhr, M. (M.), Mutignani, M. (Massimiliano), Laukkarinen, J. (Johanna), Schulick, R. (Richard), Valente, R. (Roberto), Seufferlein, T. (Thomas), Capurso, G. (Gabriele), Siriwardena, A. (Ajith), Neoptolemos, J.P. (John), Pukitis, A.P. (A.), Segersvärd, R. (Ralf), Aghdassi, A. (A.), Andrianello, S. (S.), Bossuyt, P.M.M. (Patrick), Bülow, R. (R.), Cárdenas-Jaén, K. (K.), Cortegoso, P. (P.), Fontana, M. (M.), Haeberle, L. (L.), Heckler, M. (M.), Litvin, A. (Andrey), Mann, K. (K.), Michalski, C. (C.), Michl, P. (P.), Nappo, G. (G.), Perri, G. (G.), Persson, S. (S.), Scheufele, F. (F.), Sclafani, F. (F.), Schmidt, M. (M.), Venezia, L. (L.), Volker, F. (F.), Vullierm, M.-P. (M. P.), Wüsten, L. (L.), Del Chiaro, M. (Marco), Besselink, M.G. (Marc), Scholten, L. (Lianne), Bruno, M.J. (Marco), Cahen, D.L. (Djuna), Gress, T. (Thomas), Hooft, J.E. (Jeanin) van, Lerch, M. (M.), Mayerle, J. (Julia), Hackert, T. (Thilo), Satoi, S. (Sohei), Zerbi, A. (Alessandro), Cunningham, D. (David), Angelis, C. (Claudio) de, Giovannini, M. (Marc), de-Madaria, E. (Enrique), Hegyi, P. (Peter), Rosendahl, J. (Jonas), Friess, H., Manfredi, R. (Riccardo), Lévy, P. (Philippe), Real, F.X. (Francisco), Sauvanet, A., Abu Hilal, M., Marchegiani, G. (Giovanni), Esposito, I. (I.), Ghaneh, P. (P.), Engelbrecht, M.R.W. (Marc R.W.), Fockens, P. (Paul), van Huijgevoort, N.C.M. (Nadine C.M.), Wolfgang, C.L. (Christopher L.), Bassi, C. (Claudio), Gubergrits, N.B. (Natalya B.), Verbeke, C. (Caroline), Kloppel, G. (Günter), Scarpa, A. (Aldo), Zamboni, W.C., Lennon, A.M. (Anne Marie), Sund, R. (Reijo), Kartalis, N. (Nikolaos), Grenacher, L. (Lars), Falconi, M. (Massimo), Arnelo, U. (U.), Kopchak, K.V. (Kostantin V.), Oppong, K. (K.), McKay, C. (Colin), Hauge, A.W. (Anne Werner), Conlon, K. (Kevin), Adham, I.M., Ceyhan, G.O. (Güralp O.), Salvia, R. (Roberto), Dervenis, C. (Christos), Allen, P.J. (Peter), Paye, F. (François), Bartsch, D.K. (Detlef), Löhr, M. (M.), Mutignani, M. (Massimiliano), Laukkarinen, J. (Johanna), Schulick, R. (Richard), Valente, R. (Roberto), Seufferlein, T. (Thomas), Capurso, G. (Gabriele), Siriwardena, A. (Ajith), Neoptolemos, J.P. (John), Pukitis, A.P. (A.), Segersvärd, R. (Ralf), Aghdassi, A. (A.), Andrianello, S. (S.), Bossuyt, P.M.M. (Patrick), Bülow, R. (R.), Cárdenas-Jaén, K. (K.), Cortegoso, P. (P.), Fontana, M. (M.), Haeberle, L. (L.), Heckler, M. (M.), Litvin, A. (Andrey), Mann, K. (K.), Michalski, C. (C.), Michl, P. (P.), Nappo, G. (G.), Perri, G. (G.), Persson, S. (S.), Scheufele, F. (F.), Sclafani, F. (F.), Schmidt, M. (M.), Venezia, L. (L.), Volker, F. (F.), Vullierm, M.-P. (M. P.), and Wüsten, L. (L.)

Abstract

Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gas

Published
2018
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7. Characteristics and outcomes of 79 patients with an insulinoma:a nationwide retrospective study in Finland

Author

Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Metso, S. (Saara), Kiviniemi, U. (Ulla), Vornanen, M. (Martine), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Schalin-Jäntti, C. (Camilla), Arola, J. (Johanna), Sirén, J. (Jukka), Piiroinen, A. (Antti), Soinio, M. (Minna), Nuutila, P. (Pirjo), Söderström, M. (Mirva), Hämäläinen, H. (Hanna), Moilanen, L. (Leena), Laaksonen, D. (David), Pirinen, E. (Elina), Sundelin, F. (Fia), Ebeling, T. (Tapani), Salmela, P. (Pasi), Mäkinen, M. J. (Markus J.), Jaatinen, P. (Pia), Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Metso, S. (Saara), Kiviniemi, U. (Ulla), Vornanen, M. (Martine), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Schalin-Jäntti, C. (Camilla), Arola, J. (Johanna), Sirén, J. (Jukka), Piiroinen, A. (Antti), Soinio, M. (Minna), Nuutila, P. (Pirjo), Söderström, M. (Mirva), Hämäläinen, H. (Hanna), Moilanen, L. (Leena), Laaksonen, D. (David), Pirinen, E. (Elina), Sundelin, F. (Fia), Ebeling, T. (Tapani), Salmela, P. (Pasi), Mäkinen, M. J. (Markus J.), and Jaatinen, P. (Pia)

Abstract

Objective: Insulinomas are rare pancreatic tumours. Population-based data on their incidence, clinical picture, diagnosis, and treatment are almost nonexistent. The aim of this study was to clarify these aspects in a nationwide cohort of insulinoma patients diagnosed during three decades. Design and Methods: Retrospective analysis on all adult patients diagnosed with insulinoma in Finland during 1980–2010. Results: Retrospective analysis on all adult patients diagnosed with insulinoma in Finland during 1980–2010. Results. Seventy-nine patients were diagnosed with insulinoma over the research period. The median follow-up from diagnosis to last control visit was one (min 0, max 31) year. The incidence increased from 0.5/million/year in the 1980s to 0.9/million/year in the 2000s (p = 0 002). The median diagnostic delay was 13 months and did not change over the study period. The mean age at diagnosis was 52 (SD 16) years. The overall imaging sensitivity improved from 39% in the 1980s to 98% in the 2000s (p < 0 001). Seventy-one (90%) of the patients underwent surgery with a curative aim, two (3%) had palliative surgery, and 6 (8%) were inoperable. There were no significant differences in the types of surgical procedures between the 1980s, 1990s, and 2000s; tumour enucleations comprised 43% of the operations, distal pancreatic resections 45%, and pancreaticoduodenectomies 12%, over the whole study period. Of the patients who underwent surgery with a curative aim, 89% had a full recovery. Postoperative complications occurred in half of the patients, but postoperative mortality was rare.. Conclusions: The incidence of insulinomas has increased during the past three decades. Despite the improved diagnostic options, diagnostic delay has remained unchanged. To shorten the delay, clinicians should be informed and alert to consider the possibility of hypoglycemia and insulinoma, when symptomatic attacks are investigated in different sectors of the healthcare system.

Published
2018

8. Pancreatic cancer

Author

Funel, N. (Niccola), Del Chiaro, M. (Marco), Cahen, D.L. (Djuna), Laukkarinen, J. (Johanna), Funel, N. (Niccola), Del Chiaro, M. (Marco), Cahen, D.L. (Djuna), and Laukkarinen, J. (Johanna)

Published
2015
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