43 results on '"Karttunen V"'
Search Results
2. Meta-analysis of data from human ex vivo placental perfusion studies on genotoxic and immunotoxic agents within the integrated European project NewGeneris
- Author
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Mose, T., Mathiesen, L., Karttunen, V., Nielsen, J.K.S., Sieppi, E., Kummu, M., Mørck, T.A., Myöhänen, K., Partanen, H., Vähäkangas, K., Knudsen, L.E., and Myllynen, P.
- Published
- 2012
- Full Text
- View/download PDF
3. Oppilaan sosioemotionaaliset taidot:tukikeinot koulussa ja tukemisen laaja-alaiset vaikutukset
- Author
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Isotalo, I. (Iida) and Karttunen, V. (Veera)
- Abstract
Tiivistelmä. Sosioemotionaaliset taidot ovat merkittävässä roolissa yksilön kokonaisvaltaisen kehityksen kannalta. Sosioemotionaalisten taitojen on havaittu olevan yhteydessä muun muassa yksilön ajattelukykyyn sekä kykyyn säädellä omia tunteita ja käyttäytymistä, jotka puolestaan auttavat selviytymään elämän haastavista tilanteista. Sosioemotionaalisilla taidoilla on yhteyttä myös yksilön koulumenestykseen sekä sosiaalisten suhteiden solmimiseen ja ylläpitoon. Yksilön sosioemotionaalisilla taidoilla on merkittäviä vaikutuksia myös luokka- ja kouluyhteisölle sekä laajemmin yhteiskunnalle. Tutkimustulokset osoittavat oppilaiden sosioemotionaalisen kyvykkyyden vähentävän aggressiivista käyttäytymistä luokassa sekä lisäävän positiivista luokkailmapiiriä. Yhteiskunnan tasolta tarkasteltuna sosioemotionaaliset taidot ovat merkittäviä monesta eri syystä: hyvät sosioemotionaaliset taidot edistävät yksilön mielenterveyttä ja näin vähentävät muun muassa syrjäytymisriskiä ja työttömyyttä. Sosioemotionaalisesti kyvykkäät yksilöt voidaankin nähdä toimivan aktiivisina yhteiskunnan jäseninä. Tämän vuoksi näiden taitojen harjoitteluun tulisi panostaa jo varhaisina kouluvuosina. Vaikka sosioemotionaalisten taitojen opettaminen kuuluu osaksi opetussuunnitelmaa, ei opettajilla ole yleisesti ottaen tarvittavia työkaluja näiden taitojen opettamiseksi. Tutkielman aineistosta kävi ilmi, että sosioemotionaalisia taitoja voidaan tukea monin keinoin kuten interventioilla, vuorovaikutusta tukemalla sekä oppilaita osallistavalla opetuksella. On myös huomattava, että opettajan olemuksella, opettaja-oppilassuhteella sekä koulun toimintaperiaatteilla on suuri merkitys oppilaiden sosioemotionaalisiin taitoihin. Keskeistä oppilaiden sosioemotionaalisten taitojen tukemisessa on kuitenkin varata riittävästi aikaa näiden taitojen harjoittelemiselle, sillä taitojen omaksuminen ei tapahdu hetkessä. Sosioemotionaalisia taitoja tukevat harjoitteet tulisikin integroida opetuksen jatkuviin käytänteisiin, jotta kestäviä tuloksia voidaan saavuttaa. Tämän kandidaatintutkielman tavoitteena on tuoda näkyväksi keinoja, joilla oppilaiden sosioemotionaalisia taitoja voidaan tukea alakoulussa sekä selvittää, mitä käytetyissä harjoitteissa tulee ottaa huomioon. Tavoitteenamme on myös kuvata sosioemotionaalisten taitojen merkitystä niin yksilön, luokkayhteisön kuin yhteiskunnankin tasoilla.Pupil’s socio-emotional skills : school support and the broad effects of support. Abstract. Socio-emotional skills play a significant role in the individuals’ overall development. Socio-emotional skills have been found to be associated with an individual’s ability to think and ability to regulate their own feelings and behaviors, which in turn help them to cope with challenging situations one may face. Socio-emotional skills are also linked to an individual’s school success and the establishment and maintenance of social relationships. An individual’s socio-emotional skills also have a significant impact on the class, school community and the whole society. The research results show that students’ socio-emotional ability reduces aggressive behavior in the classroom and increases the positive classroom atmosphere. At the societal level, socio-emotional skills are important for several reasons: good socio-emotional skills promote an individual’s mental health and thus reduce the risk of exclusion and unemployment. Thus, socio-emotionally capable individuals can be seen as active members of society and therefore the training of these skills should be invested in the early school years. Although teaching socio-emotional skills is a part of the schools’ curriculum, teachers generally do not have the necessary tools to teach these skills. The data of the research showed that socio-emotional skills can be supported in many ways, such as interventions, supporting interaction and participatory teaching. It should also be noted that the teacher’s characteristics, the teacher-student relationship, and the school’s principles play a major role in students’ socio-emotional skills. However, the key to supporting students’ socio-emotional skills is to set aside enough time to practice these skills, as the acquisition of skills does not happen in an instant. Exercises that support socio-emotional skills should therefore be integrated into ongoing teaching practices to achieve lasting results. The aim of this bachelor’s thesis is to highlight the ways in which students’ socio-emotional skills can be supported in primary school and to find out what should be considered in the exercises used. Our aim is also to describe the importance of socio-emotional skills at the level of the individual, the class community and society.
- Published
- 2022
4. Activities of metabolizing enzymes in human placenta
- Author
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Mohammed, A. M. (Ali Mustafa), Huuskonen, P. (Pasi), Juvonen, R. (Risto), Sahlman, H. (Heidi), Repo, J. (Jenni), Myöhänen, K. (Kirsi), Myllynen, P. (Päivi), Jackson Woo, C.-S. (Chit-Shing), Karttunen, V. (Vesa), Vähäkangas, K. (Kirsi), Mohammed, A. M. (Ali Mustafa), Huuskonen, P. (Pasi), Juvonen, R. (Risto), Sahlman, H. (Heidi), Repo, J. (Jenni), Myöhänen, K. (Kirsi), Myllynen, P. (Päivi), Jackson Woo, C.-S. (Chit-Shing), Karttunen, V. (Vesa), and Vähäkangas, K. (Kirsi)
- Abstract
In addition to the transfer across the placenta, placenta displays hormonal and xenobiotic metabolism, as well as enzymatic defense against oxidative stress. We analyzed aromatase (CYP19A1), uridine 5’-diphospho-glucuronyltransferase (UGT), glutathione-S-transferase (GST) and catalase (CAT) activities in over 70 placentas from nonsmokers stored at -80 °C from former perfusion studies. A wide interindividual variation in all activities was found. Longterm storage at -80 °C did not affect the activities. Ethoxyresorufin-O-deethylase (EROD, CYP1A1) was not detected in any of the studied placentas perfused with chemicals. Several compounds in placental perfusion changed statistically significantly the enzyme activities in placental tissue. Melamine and nicotine increased CYP19A1, melamine increased UGT and GST, PhIP with ethanol decreased CYP19A1 and increased GST, and PhIP with buprenorphine decreased CAT. Antipyrine in 100 μg/ml also changed the studied enzyme activities, but not statistically significantly. Because antipyrine is a reference compound in placental perfusions, its potential effects must be taken into account in human placental perfusion. Enzyme activities deserve further studies as biomarkers of placental toxicity. Finally, enzyme activities deserve further studies as biomarkers of placental toxicity.
- Published
- 2020
5. Risk factors for cryptogenic ischaemic stroke
- Author
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Karttunen, V., Alfthan, G., Hiltunen, L., Rasi, V., Kervinen, K., Kesäniemi, Y. A., and Hillbom, M.
- Published
- 2002
6. Dye dilution and oximetry for detection of patent foramen ovale
- Author
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Karttunen, V., Ventilä, M., Hillbom, M., Salonen, O., Haapaniemi, H., and Kaste, M.
- Published
- 1998
7. Psychiatric diagnoses of children affected by their parents’ traumatic brain injury:the 1987 Finnish Birth Cohort study
- Author
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Kinnunen, L. (Lotta), Niemelä, M. (Mika), Hakko, H. (Helinä), Miettunen, J. (Jouko), Merikukka, M. (Marko), Karttunen, V. (Vesa), Ristikari, T. (Tiina), Gissler, M. (Mika), and Räsänen, S. (Sami)
- Subjects
offspring ,traumatic brain injury ,psychiatric diagnoses ,parental TBI ,Children ,mental health - Abstract
Objective: To investigate whether parental TBI increases the overall risk for psychiatric disorders and the risk for specific psychiatric diagnoses in the children affected by parental TBI. Methods: The 1987 Finnish Birth Cohort (n = 59 476) were followed up through national registers from birth to the end of 2008. The diagnoses of cohort members and their parents were obtained from the Care Register of Health Care, provided by the National Institute of Health and Welfare. Results: During the 21-year follow-up, the likelihood for psychiatric diagnoses being assessed in psychiatric care was significantly increased in males with any mental disorder (odds ratio (OR) = 1.43), substance-use-related disorders (OR = 1.71) and behavioural and emotional disorders (OR = 1.75), and in females with disorders of psychological development (OR = 1.85). Conclusions: Children affected by parental TBI are at increased risk for psychiatric disorders: males for externalizing disorders and females for developmental disorders. Observed gender interactions in the association between parental TBI and the psychiatric disorders of children warrant further study.
- Published
- 2018
8. Influence of pH on the accumulation of cadmium and lead in earthworms (Aporrectodea caliginosa) under controlled conditions
- Author
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Perämäki, P., Itämies, J., Karttunen, V., Lajunen, L. H. J., and Pulliainen, E.
- Published
- 1992
9. Potential Toxicity of Silver Nanoparticles (AgNP) to Human Placenta
- Author
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Yan Adrian, S.C., primary, Repo, J., additional, Huovinen, M., additional, Karttunen, V., additional, Ma Stephanie, W.-Y., additional, Greiner, R., additional, Vähäkangas, K., additional, and El-Nezami, H., additional
- Published
- 2016
- Full Text
- View/download PDF
10. H-Implantation-Induced Damage in Si
- Author
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Keinonen, J., primary, Hautala, M., additional, Rauhala, E., additional, Karttunen, V., additional, Kuronen, A., additional, Räisänen, J., additional, Lahtinen, J., additional, Vehanen, A., additional, Punkka, E., additional, and Hautojärvi, P., additional
- Published
- 1988
- Full Text
- View/download PDF
11. Redistribution of implanted H in annealings of n-type GaAs.
- Author
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Räisänen, J., Keinonen, J., Karttunen, V., and Koponen, I.
- Subjects
HYDROGEN ,ION implantation ,GALLIUM arsenide ,SOLUBILITY - Abstract
Presents a study which determined the effect of the hydrogen (H) implantation-induced defects on the H migration in n-type gallium arsenide. Determination of the depth scale; Effects of the deposited energy on the H migration; Indication of the dependence of the H solubilities on the annealing temperature.
- Published
- 1988
12. Patent foramen ovale and cryptogenic brain infarction
- Author
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Karttunen, V. (Vesa)
- Subjects
dye dilution technique ,patent foramen ovale ,oximetry ,risk factors ,cardiovascular diseases ,cerebral infarction ,thrombophilia - Abstract
Patent foramen ovale (PFO) is a common finding in the general population and is present in approximately one quarter of adults. The potential role of PFO in the pathogenesis of ischaemic brain infarction of unknown aetiology in young adults has been investigated during the past 15 years, and associations with other diseases have been proposed. The most plausible mechanism of stroke associated with PFO is paradoxical embolism, but there is uncertainty about this because a venous source of emboli is seldom identified. If the theory of venous emboli is relevant, prothrombotic states should be associated with PFO and ischaemic stroke. Relatively little is known about the risk factors of cryptogenic brain infarction, although this subgroup of stroke is relatively common. As the present diagnostic methods for detecting PFO have certain limitations, new non-invasive, simple and reliable methods would be useful. Two new methods examined here, the dye dilution method and ear oximetry, were both found to be feasible and to be highly specific and sensitive in relation to the present gold standard, contrast transoesophageal echocardiography. A case-control study among adult patients with PFO and cryptogenic brain infarction showed the presence of a prothrombotic state, particularly factor V Leiden and prothrombin G2021OA gene mutation, to be associated with an increased risk of stroke, and migraine was also identified as a risk factor. Associations with the classical risk factors for venous thrombosis and Valsalva manoeuvre-like activities at the onset of stroke were also observed. The results lend support to the theory that paradoxical embolism is one of the pathogenic mechanisms behind cryptogenic brain infarction with associated PFO. In another case-control study among adult patients with cryptogenic brain infarction but without associated PFO, prothrombotic states were not identified as risk factors, except that an association was found between elevated factor VIII activity and stroke. The major independent risk factors for such cryptogenic strokes were current cigarette smoking, hypertension and a low level of high density lipoprotein cholesterol.
- Published
- 2002
13. Meta-analysis of data from human ex vivo placental perfusion studies on genotoxic and immunotoxic agents within the integrated European project NewGeneris
- Author
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Mose, T, Mathiesen, L, Karttunen, V, Nielsen, J K S, Sieppi, E, Kummu, M, Mørck, T A, Myöhänen, K, Partanen, H, Vähäkangas, K, Knudsen, L E, Myllynen, P, Mose, T, Mathiesen, L, Karttunen, V, Nielsen, J K S, Sieppi, E, Kummu, M, Mørck, T A, Myöhänen, K, Partanen, H, Vähäkangas, K, Knudsen, L E, and Myllynen, P
- Abstract
In the EU integrated project NewGeneris, we studied placental transport of thirteen immunotoxic and genotoxic agents in three ex vivo placental perfusion laboratories. In the present publication, all placental perfusion data have been re-analyzed and normalized to make them directly comparable and rankable. Antipyrine transfer data differed significantly between the studies and aboratories, and therefore normalization of data was necessary. An antipyrine normalization factor was introduced making the variance significantly smaller within and between the studies using the same compound but performed in different laboratories. Non-normalized (regular) and normalized data showed a good correlation. The compounds were ranked according to their transplacental transfer rate using either antipyrine normalized AUC120 or transfer index (TI120(%)). Normalization generated a division of compounds in slow, medium and high transfer rate groups. The transfer rate differed slightly depending on the parameter used. However, compounds with passage similar to antipyrine which goes through the placenta by passive diffusion, and good recovery in media (no accumulation in the tissue or adherence to equipment) were highly ranked no matter which parameter was used. Antipyrine normalization resulted in the following ranking order of compounds according to AUC120NORM values: NDMA = EtOH = BPA = IQ =AA = GA = PCB180 = PhIP = AFB1 > DON = BP = PCB52 = TCDD. As the variance in all parameters within a study decreased after antipyrine normalization, we conclude that this normalization approach at least partially corrects the bias caused by the small methodological differences between studies. 2012 Elsevier Ltd. All rights reserved., In the EU integrated project NewGeneris, we studied placental transport of thirteen immunotoxic and genotoxic agents in three ex vivo placental perfusion laboratories. In the present publication, all placental perfusion data have been re-analyzed and normalized to make them directly comparable and rankable. Antipyrine transfer data differed significantly between the studies and laboratories, and therefore normalization of data was necessary. An antipyrine normalization factor was introduced making the variance significantly smaller within and between the studies using the same compound but performed in different laboratories. Non-normalized (regular) and normalized data showed a good correlation. The compounds were ranked according to their transplacental transfer rate using either antipyrine normalized AUC(120) or transfer index (TI(120)(%)). Normalization generated a division of compounds in slow, medium and high transfer rate groups. The transfer rate differed slightly depending on the parameter used. However, compounds with passage similar to antipyrine which goes through the placenta by passive diffusion, and good recovery in media (no accumulation in the tissue or adherence to equipment) were highly ranked no matter which parameter was used. Antipyrine normalization resulted in the following ranking order of compounds according to AUC(120NORM) values: NDMA = EtOH = BPA = IQ =AA = GA = PCB180 = PhIP = AFB1 > DON = BP = PCB52 = TCDD. As the variance in all parameters within a study decreased after antipyrine normalization, we conclude that this normalization approach at least partially corrects the bias caused by the small methodological differences between studies.
- Published
- 2012
14. Dye dilution and oximetry for detection of patent foramen ovale
- Author
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Karttunen, V., primary, Ventilä, M., additional, Hillbom, M., additional, Salonen, O., additional, Haapaniemi, H., additional, and Kaste, M., additional
- Published
- 2009
- Full Text
- View/download PDF
15. Transplacental transfer of acrylamide and glycidamide are comparable to that of antipyrine in perfused human placenta
- Author
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ANNOLA, K, primary, KARTTUNEN, V, additional, KESKIRAHKONEN, P, additional, MYLLYNEN, P, additional, SEGERBACK, D, additional, HEINONEN, S, additional, and VAHAKANGAS, K, additional
- Published
- 2008
- Full Text
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16. A CPU-friendly approach to on-demand positioning with a software GNSS receiver.
- Author
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Jokitalo, T., Kaisti, K., Karttunen, V., Salo, V.-P., and So?derholm, S.
- Published
- 2010
- Full Text
- View/download PDF
17. Ear oximetry: a noninvasive method for detection of patent foramen ovale: a study comparing dye dilution method and oximetry with contrast transesophageal echocardiography.
- Author
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Karttunen, V, Ventilä, M, Ikäheimo, M, Niemelä, M, and Hillbom, M
- Published
- 2001
- Full Text
- View/download PDF
18. Defects on Ne-bubble surfaces in Mo
- Author
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Keinonen, J., primary and Karttunen, V., additional
- Published
- 1988
- Full Text
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19. Constant-pressure molecular dynamics simulations of room-temperature pressure-volume isotherms of Ne and Ar at high densities
- Author
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Karttunen, V, primary, Ignatius, J, additional, Keinonen, J, additional, and Nieminen, R M, additional
- Published
- 1989
- Full Text
- View/download PDF
20. Annealing behavior of hydrogen traps in Ne-implanted Ta
- Author
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Keinonen, J., primary, Karttunen, V., additional, Räisänen, J., additional, Bergmeister, F. -J., additional, Luukkainen, A., additional, and Tikkanen, P., additional
- Published
- 1986
- Full Text
- View/download PDF
21. Damage production in hydrogen-implanted silicon
- Author
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Lahtinen, J., primary, Vehanen, A., additional, Punkka, E., additional, Hautojärvi, P., additional, Keinonen, J., additional, Hautala, M., additional, Rauhala, E., additional, Karttunen, V., additional, Kuronen, A., additional, and Räisänen, J., additional
- Published
- 1988
- Full Text
- View/download PDF
22. Defect formation in H implantation of crystalline Si
- Author
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Keinonen, J., primary, Hautala, M., additional, Rauhala, E., additional, Karttunen, V., additional, Kuronen, A., additional, Räisänen, J., additional, Lahtinen, J., additional, Vehanen, A., additional, Punkka, E., additional, and Hautojärvi, P., additional
- Published
- 1988
- Full Text
- View/download PDF
23. Velocity dependence in low-velocity electronic stopping power of heavy ions
- Author
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Keinonen, J., primary, Kuronen, A., additional, Hautala, M., additional, Karttunen, V., additional, Lappalainen, R., additional, and Uhrmacher, M., additional
- Published
- 1987
- Full Text
- View/download PDF
24. Novel inhibitors of bromodomain and extra-terminal domain trigger cell death in breast cancer cell lines.
- Author
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Rahnasto-Rilla M, Puumalainen T, Karttunen V, Adla SK, and Lahtela-Kakkonen M
- Subjects
- Female, Humans, Bromodomain Containing Proteins, Cell Cycle Proteins antagonists & inhibitors, Cell Cycle Proteins metabolism, Cell Death drug effects, Cell Line, Tumor, Cell Proliferation drug effects, Dose-Response Relationship, Drug, Drug Screening Assays, Antitumor, Molecular Structure, Protein Domains drug effects, Structure-Activity Relationship, Flavonoids chemistry, Flavonoids pharmacology, Antineoplastic Agents pharmacology, Antineoplastic Agents chemistry, Antineoplastic Agents chemical synthesis, Breast Neoplasms drug therapy, Breast Neoplasms pathology, Breast Neoplasms metabolism, Transcription Factors antagonists & inhibitors, Transcription Factors metabolism
- Abstract
Small molecule inhibitors targeting the bromodomain and extra-terminal domain (BET) family proteins have emerged as a promising class of anti-cancer drugs. Nevertheless, the clinical advancement of these agents has been significantly hampered by challenges related to their potency, oral bioavailability, or toxicity. In this study, virtual screening approaches were employed to discover novel inhibitors of the bromodomain-containing protein 4 (BRD4) by analyzing their comparable chemical structural features to established BRD4 inhibitors. Several of these compounds exhibited inhibitory effects on BRD4 activity ranging from 60 % to 70 % at 100 µM concentrations, while one compound also exhibited an 84 % inhibition of Sirtuin 2 (SIRT2) activity. Furthermore, a subset of structurally diverse compounds from the BRD4 inhibitors was selected to investigate their anti-cancer properties in both 2D and 3D cell cultures. These compounds exhibited varying effects on cell numbers depending on the specific cell line, and some of them induced cell cycle arrest in the G0/G1 phase in breast cancer (MDA-MB-231) cells. Moreover, all the compounds studied reduced the sizes of spheroids, and the most potent compound exhibited a 90 % decrease in growth at a concentration of 10 µM in T47D cells. These compounds hold potential as epigenetic regulators for future studies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
25. Activities of metabolizing enzymes in human placenta.
- Author
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Mohammed AM, Huuskonen P, Juvonen R, Sahlman H, Repo J, Myöhänen K, Myllynen P, Woo CJ, Karttunen V, and Vähäkangas K
- Subjects
- Adult, Female, Humans, Pregnancy, Antipyrine metabolism, Aromatase metabolism, Catalase metabolism, Cytochrome P-450 CYP1A1 metabolism, Glucuronosyltransferase metabolism, Glutathione Transferase metabolism, Placenta metabolism
- Abstract
In addition to the transfer across the placenta, placenta displays hormonal and xenobiotic metabolism, as well as enzymatic defense against oxidative stress. We analyzed aromatase (CYP19A1), uridine 5'-diphospho-glucuronyltransferase (UGT), glutathione-S-transferase (GST) and catalase (CAT) activities in over 70 placentas from nonsmokers stored at -80 °C from former perfusion studies. A wide interindividual variation in all activities was found. Longterm storage at -80 °C did not affect the activities. Ethoxyresorufin-O-deethylase (EROD, CYP1A1) was not detected in any of the studied placentas perfused with chemicals. Several compounds in placental perfusion changed statistically significantly the enzyme activities in placental tissue. Melamine and nicotine increased CYP19A1, melamine increased UGT and GST, PhIP with ethanol decreased CYP19A1 and increased GST, and PhIP with buprenorphine decreased CAT. Antipyrine in 100 μg/ml also changed the studied enzyme activities, but not statistically significantly. Because antipyrine is a reference compound in placental perfusions, its potential effects must be taken into account in human placental perfusion. Enzyme activities deserve further studies as biomarkers of placental toxicity. Finally, enzyme activities deserve further studies as biomarkers of placental toxicity., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020. Published by Elsevier B.V.)
- Published
- 2020
- Full Text
- View/download PDF
26. Transplacental transfer and metabolism of diuron in human placenta.
- Author
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Mohammed AM, Karttunen V, Huuskonen P, Huovinen M, Auriola S, and Vähäkangas K
- Subjects
- Activation, Metabolic, Cell Line, Tumor, Diuron adverse effects, Female, Herbicides adverse effects, Humans, Kinetics, Microsomes enzymology, Pregnancy, Risk Assessment, Smoking adverse effects, Smoking blood, Toxicokinetics, Cytochrome P-450 CYP1A1 metabolism, Diuron blood, Herbicides blood, Maternal-Fetal Exchange, Placenta blood supply, Placenta enzymology, Placental Circulation
- Abstract
Diuron is a broad-spectrum phenylurea derived herbicide which is commonly used across the globe. Diuron is toxic to the reproductive system of animals and carcinogenic to rat urothelium, and recently found to be genotoxic in human cells. In in vivo, it is metabolized predominately into 3-(3,4-dichlorophenyl)-1-methyl urea (DCPMU) in humans and 3-(3, 4-dichlorophenyl)urea (DCPU) in animals. Information on diuron toxicokinetics and related toxicity in human placenta is absent. We have investigated the toxicokinetics of diuron in ex vivo human placental perfusion and in in vitro human placental microsomes and human trophoblastic cancer cells (BeWo). Diuron crossed human placenta readily in placental perfusion. Furthermore, diuron was metabolized into DCPMU in perfused placenta and in in vitro incubations using microsomes from placentas of smokers. In incubations with placental microsomes from non-smokers, and in BeWo cells, metabolism to DCPMU was detected but only with the highest used diuron concentration (100 μM). Diuron metabolism was inhibited upon addition of α-naphthoflavone, a CYP1A1 inhibitor, underscoring the role of CYP1A1 in the metabolism. In conclusion, it is evident that diuron crosses human placenta and diuron can be metabolized in the placenta to a toxic metabolite via CYP1A1. This implicates in vivo fetal exposure to diuron if pregnant women are exposed to diuron, which may result in fetotoxicity., (Copyright © 2018. Published by Elsevier B.V.)
- Published
- 2018
- Full Text
- View/download PDF
27. Psychiatric diagnoses of children affected by their parents' traumatic brain injury: the 1987 Finnish Birth Cohort study.
- Author
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Kinnunen L, Niemelä M, Hakko H, Miettunen J, Merikukka M, Karttunen V, Ristikari T, Gissler M, and Räsänen S
- Subjects
- Adult, Cohort Studies, Female, Finland epidemiology, Humans, Logistic Models, Male, Odds Ratio, Psychiatric Status Rating Scales, Sex Factors, Brain Injuries, Traumatic complications, Brain Injuries, Traumatic epidemiology, Child of Impaired Parents psychology, Mental Disorders diagnosis, Mental Disorders epidemiology, Mental Disorders etiology, Parents psychology
- Abstract
Objective: To investigate whether parental TBI increases the overall risk for psychiatric disorders and the risk for specific psychiatric diagnoses in the children affected by parental TBI., Methods: The 1987 Finnish Birth Cohort (n = 59 476) were followed up through national registers from birth to the end of 2008. The diagnoses of cohort members and their parents were obtained from the Care Register of Health Care, provided by the National Institute of Health and Welfare., Results: During the 21-year follow-up, the likelihood for psychiatric diagnoses being assessed in psychiatric care was significantly increased in males with any mental disorder (odds ratio (OR) = 1.43), substance-use-related disorders (OR = 1.71) and behavioural and emotional disorders (OR = 1.75), and in females with disorders of psychological development (OR = 1.85)., Conclusions: Children affected by parental TBI are at increased risk for psychiatric disorders: males for externalizing disorders and females for developmental disorders. Observed gender interactions in the association between parental TBI and the psychiatric disorders of children warrant further study.
- Published
- 2018
- Full Text
- View/download PDF
28. Human placental cell and tissue uptake of doxorubicin and its liposomal formulations.
- Author
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Soininen SK, Repo JK, Karttunen V, Auriola S, Vähäkangas KH, and Ruponen M
- Subjects
- Antibiotics, Antineoplastic administration & dosage, Cell Line, Tumor, Cell Survival, Doxorubicin administration & dosage, Doxorubicin analogs & derivatives, Doxorubicin chemistry, Female, Humans, Liposomes, Pregnancy, Antibiotics, Antineoplastic pharmacokinetics, Doxorubicin pharmacokinetics, Placenta cytology, Placenta metabolism
- Abstract
The anticancer drug doxorubicin and its liposomal formulations are in clinical use, doxorubicin also during pregnancy. However, little is known about how doxorubicin and its liposomal formulations are taken up by placental cells and whether they can cross human placenta. We therefore investigated quantitative cellular uptake and toxicity of doxorubicin and its two liposomal formulations, pH-sensitive liposomal doxorubicin (L-DOX) and commercially available pegylated liposomal doxorubicin (PL-DOX), in human placental choriocarcinoma (BeWo) cells. PL-DOX showed significantly lower cellular uptake and toxicity compared with doxorubicin and L-DOX. In preliminary studies with human placental perfusion, PL-DOX did not cross the placenta at all in 4h, whereas doxorubicin and L-DOX crossed the placenta at low levels (max 12% of the dose). Furthermore, PL-DOX did not accumulate in placental tissue while doxorubicin did (up to 70% of the dose). Surface pegylation probably explains the low placental cell and tissue uptake of PL-DOX. Formulation of doxorubicin thus seems to enable a decrease of fetal exposure., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
29. Improved survival of patients with warfarin-associated intracerebral haemorrhage: a retrospective longitudinal population-based study.
- Author
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Huhtakangas J, Tetri S, Juvela S, Saloheimo P, Bode MK, Karttunen V, Käräjämäki A, and Hillbom M
- Subjects
- Aged, Anticoagulants therapeutic use, Blood Coagulation Factors therapeutic use, Cerebral Hemorrhage drug therapy, Coagulants therapeutic use, Female, Finland epidemiology, Humans, Longitudinal Studies, Male, Retrospective Studies, Survival Analysis, Treatment Outcome, Warfarin therapeutic use, Anticoagulants adverse effects, Cerebral Hemorrhage chemically induced, Cerebral Hemorrhage epidemiology, Warfarin adverse effects
- Abstract
Background: Warfarin-associated intracerebral haemorrhage carries poor outcome due to rapid haemorrhage growth. Reversal of warfarin anticoagulation with prothrombin complex concentrate has been implemented as an acute treatment option for these subjects., Aim: We investigated whether survival of subjects with warfarin-associated intracerebral haemorrhage had improved after implementation of reversal of warfarin anticoagulation with prothrombin complex concentrate., Methods: We identified all subjects with warfarin-associated intracerebral haemorrhage during 1993-2008 among the population of Northern Ostrobothnia, Finland. From 2004 onwards, prothrombin complex concentrate was used in Oulu University Hospital, the only hospital treating intracerebral haemorrhage subjects in the region, to counteract the effect of warfarin in subjects with warfarin-associated intracerebral haemorrhage. We compared the outcomes of subjects admitted during 1993-2003 and 2004-2008 and those treated and not treated with prothrombin complex concentrate. We also explored the predictors for one-year survival of the warfarin-associated intracerebral haemorrhage subjects., Results: We identified altogether 181 subjects who had intracerebral haemorrhage while on warfarin. One-year survival was significantly (P = 0·031) higher for the 60 subjects admitted during 2004-2008 (43·3%) than for the 121 admitted before 2004 (30·6%). In multivariable analysis, prothrombin complex concentrate treatment reduced one-year case fatality (hazard ratio 0·52, 95% confidence interval 0·29-0·93). Thromboembolic complications did not occur more frequently among those treated with prothrombin complex concentrate., Conclusion: The survival of warfarin-associated intracerebral haemorrhage subjects among the population of Northern Ostrobothnia has improved likely because of introduction of prothrombin complex concentrate., (© 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.)
- Published
- 2015
- Full Text
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30. Parents' traumatic brain injury increases their children's risk for use of psychiatric care: the 1987 Finnish Birth Cohort study.
- Author
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Niemelä M, Kinnunen L, Paananen R, Hakko H, Merikukka M, Karttunen V, Gissler M, and Räsänen S
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Cohort Studies, Female, Finland epidemiology, Humans, Infant, Infant, Newborn, Male, Mental Disorders therapy, Young Adult, Brain Injuries epidemiology, Child of Impaired Parents statistics & numerical data, Fathers statistics & numerical data, Mental Disorders epidemiology, Mental Health Services statistics & numerical data, Mothers statistics & numerical data, Registries statistics & numerical data
- Abstract
Objective: Traumatic brain injury (TBI) of a parent causes significant changes in their family life and parent-children relationships. However, the number of children affected by parental TBI and the long-term consequences for these children remain unknown. We estimated the prevalence of children affected by parental TBI and investigated whether these children had greater use of psychiatric services than their peers., Methods: This a retrospective population-based register study. All 60,069 children born in Finland in 1987 were followed up through national health and social registers from 1987 to 2008., Results: During the 21-year follow-up, 1532 (2.6%) children had a parent with TBI. Overall, 22.5% of those having a parent with TBI were treated in specialized psychiatric care. Use of psychiatric care was significantly increased among those cohort members with a parent with mild [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.37-2.38] or severe (OR 1.49, 95% CI 1.12-1.98) TBI compared to their peers., Conclusions: Parental TBI is associated with increased use of specialized psychiatric services by children. Adult health care services must have appropriate systems in place to address the psychosocial needs and support the welfare and development of children of patients with TBI., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
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31. Metal-free polymerization of phenylsilane: tris(pentafluorophenyl)borane-catalyzed synthesis of branched polysilanes at elevated temperatures.
- Author
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Feigl A, Chiorescu I, Deller K, Heidsieck SU, Buchner MR, Karttunen V, Bockholt A, Genest A, Rösch N, and Rieger B
- Abstract
The strong organoborane Lewis acid B(C6F5)3 catalyzes the polymerization of phenylsilane at elevated temperatures forming benzene and SiH4 as side-products. The resulting polymer is a branched polysilane with an irregular substitution pattern, as revealed by 2D NMR spectroscopy. Having explored the mechanism of this novel metal-free polymerization by computational chemistry methods at the DFT level, we have suggested that unusual cationic active species, namely monomer-stabilized silyl cations, propagate the polymerization. Hydride abstraction of SiH3 moiety by the catalyst in the initiation step was found to be kinetically preferred by around 9 kcal mol(-1) over activation by coordination of the monomer at the aromatic ring. The formation of linear Si-Si bonds during propagation was calculated to be less favorable than branching and ligand scrambling, which accounts for the branched and highly substituted form of the polymer that was obtained. This novel type of polymerization bears the potential for further optimization with respect to degree of polymerization and structure control for both primary as well as secondary silanes, which can be polymerized by sterically less hindered boranes., (Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)
- Published
- 2013
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32. Mild traumatic brain injury diagnosis frequently remains unrecorded in subjects with craniofacial fractures.
- Author
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Puljula J, Cygnel H, Mäkinen E, Tuomivaara V, Karttunen V, Karttunen A, and Hillbom M
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Alcohol Drinking adverse effects, Alcohol Drinking epidemiology, Brain Injuries epidemiology, Brain Injuries etiology, Child, Female, Finland epidemiology, Glasgow Coma Scale, Humans, Incidence, Logistic Models, Male, Mandibular Fractures complications, Mandibular Fractures epidemiology, Middle Aged, Orbital Fractures complications, Orbital Fractures epidemiology, Practice Guidelines as Topic, Predictive Value of Tests, Tomography, X-Ray Computed, Trauma Severity Indices, Young Adult, Brain Injuries diagnosis, Facial Bones injuries, Mandibular Fractures diagnosis, Orbital Fractures diagnosis
- Abstract
Background: Traumatic brain injuries (TBI) in subjects with craniofacial fractures are usually diagnosed by emergency room physicians. We investigated how often TBI remains unrecorded in these subjects, and whether diagnostic accuracy has improved after the implementation of new TBI guidelines., Methods: All subjects with craniofacial fractures admitted to Oulu University Hospital in 1999 and in 2007 were retrospectively identified. New guidelines for improving the diagnostic accuracy of TBI were implemented between 2000 and 2006. Clinical symptoms of TBI were gathered from notes on hospital charts and compared to the recorded diagnoses at discharge. Logistic regression was used to identify independent predictors for TBI to remain unrecorded., Results: Of 194 subjects with craniofacial fracture, 111(57%) had TBI, 40 in 1999 and 71 in 2007. Fifty-one TBIs (46%) remained unrecorded at discharge, 48 being mild and 3 moderate-to-severe. Subjects with unrecorded TBI were significantly less frequently referred to follow-up visits. Failures to record the TBI diagnosis were less frequent (29/71, 41%) in 2007 than in 1999 (22/40, 55%), but the difference was not statistically significant. The most significant independent predictor for this failure was the clinical specialty (other than neurology/neurosurgery) of the examining physician (p<0.001). The subject's alcohol intoxication did not hamper the diagnosis of TBI., Conclusions: TBIs remain frequently unrecorded in subjects with craniofacial fractures. Recording of mild TBI slightly but insignificantly improved after the implementation of new guidelines., (Copyright © 2012 Elsevier Ltd. All rights reserved.)
- Published
- 2012
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33. Fibrinolytic activity and platelet function in subjects with obstructive sleep apnoea and a patent foramen ovale: is there an option for prevention of ischaemic stroke?
- Author
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Reggiani M, Karttunen V, Wartiovaara-Kautto U, Riutta A, Uchiyama S, and Hillbom M
- Abstract
Obstructive sleep apnoea (OSA) carries an increased risk of ischaemic stroke, but the underlying mechanism is not clear. As right-to-left shunting can occur through a patent foramen ovale (PFO) during periods of apnoea, we investigated nocturnal changes in fibrinolytic activity and platelet function in subjects who had OSA with or without PFO and in controls. We determined plasminogen activator inhibitor 1 (PAI-1) activity and antigen and platelet activation parameters. The severity of OSA was verified by polygraphy and PFO was detected by ear oximetry. We found a higher PAI-1 activity and antigen and a lower ratio of 2,3-dinor-PGF(1α) to 2,3-dinor-TXB(2) in the subjects with OSA than in the controls. Linear regression analysis showed the apnoea-hypopnoea index (β-coefficient, 0.499; P = 0.032) and PFO (β-coefficient, 0.594; P = 0.015) to be associated independently with PAI-1 activity in the morning, while the increment in PAI-1:Ag from evening to morning was significantly associated with the presence of PFO (r(s) = 0.563, P = 0.002). Both OSA and PFO reduce fibrinolytic activity during nocturnal sleep. We hypothesize that subjects having both OSA and PFO may develop a more severe prothrombotic state during sleep than those having either OSA or PFO alone.
- Published
- 2012
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34. Acute effects of ethanol on the transfer of nicotine and two dietary carcinogens in human placental perfusion.
- Author
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Veid J, Karttunen V, Myöhänen K, Myllynen P, Auriola S, Halonen T, and Vähäkangas K
- Subjects
- ATP Binding Cassette Transporter, Subfamily G, Member 2, ATP-Binding Cassette Transporters antagonists & inhibitors, ATP-Binding Cassette Transporters metabolism, Adenocarcinoma metabolism, Antipyrine chemistry, Biological Transport drug effects, Breast Neoplasms metabolism, Carbon Radioisotopes, Carcinogens chemistry, Cell Line, Tumor, Diffusion, Dimethylnitrosamine metabolism, Female, Food Contamination, Humans, Imidazoles metabolism, In Vitro Techniques, Indicators and Reagents chemistry, Kinetics, Neoplasm Proteins antagonists & inhibitors, Neoplasm Proteins metabolism, Nicotine chemistry, Perfusion, Placenta metabolism, Pregnancy, Carcinogens metabolism, Ethanol pharmacology, Nicotine metabolism, Placenta drug effects
- Abstract
Many mothers use, against instructions, alcohol during pregnancy. Simultaneously mothers are exposed to a wide range of other environmental chemicals. These chemicals may also harm the developing fetus, because almost all toxic compounds can go through human placenta. Toxicokinetic effects of ethanol on the transfer of other environmental compounds through human placenta have not been studied before. It is known that ethanol has lytic properties and increases the permeability and fluidity of cell membranes. We studied the effects of ethanol on the transfer of three different environmental toxins: nicotine, PhIP (2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine) and NDMA (N-nitrosodimethylamine) in placental perfusion. We tested in human breast cancer adenocarcinoma cell line MCF-7 whether ethanol affects ABCG2/BCRP, which is also the major transporter in human placenta. We found that the transfer of ethanol is comparable to that of antipyrine, which points to passive diffusion as the transfer mechanism. Unexpectedly, ethanol had no statistically significant effect on the transfer of the other studied compounds. Neither did ethanol inhibit the function of ABCG2/BCRP. These experiments represent only the effects of acute exposure to ethanol and chronic exposure remains to be studied., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2011
- Full Text
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35. Placental transfer and DNA binding of benzo(a)pyrene in human placental perfusion.
- Author
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Karttunen V, Myllynen P, Prochazka G, Pelkonen O, Segerbäck D, and Vähäkangas K
- Subjects
- Cell Line, Tumor, Choriocarcinoma metabolism, Cytochrome P-450 CYP1A1 metabolism, DNA Adducts, Dose-Response Relationship, Drug, Female, Humans, Perfusion, Placenta enzymology, Placenta physiology, Pregnancy, Time Factors, Benzo(a)pyrene chemistry, DNA chemistry, Maternal-Fetal Exchange physiology, Placenta drug effects
- Abstract
Benzo(a)pyrene (BP) is the best studied polycyclic aromatic hydrocarbon, classified as carcinogenic to humans. The carcinogenic metabolite, benzo(a)pyrene-7,8-dihydrodiol-9,10-epoxide (BPDE), binds covalently to DNA. The key enzyme in this metabolic reaction is CYP1A1, which has also been found in placenta and human trophoblastic cells. By using human placental perfusion we confirmed that BP added to the maternal circulation in concentrations of 0.1 and 1 microM reaches fetal compartment but somewhat slower than the freely diffusible reference substance antipyrine. A well-known P-glycoprotein (ABCB1/P-gp) antagonist verapamil did not affect the transfer more than it did in the case of antipyrine, indicating that ABCB1/P-gp does not have a role in BP transfer. In one of the two placentas perfused for 6 h with the higher concentration of BP (1 microM) BPDE specific DNA adducts were found in placental tissue after the perfusion, but not before. The ability of human trophoblastic cells to activate BP to BPDE-DNA adducts was confirmed in human trophoblastic BeWo cells. This study shows that maternal exposure to BP leads to the exposure of the fetus to BP and/or its metabolites and that placenta itself can activate BP to DNA adducts., (Copyright 2010 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2010
- Full Text
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36. Preliminary interlaboratory comparison of the ex vivo dual human placental perfusion system.
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Myllynen P, Mathiesen L, Weimer M, Annola K, Immonen E, Karttunen V, Kummu M, Mørck TJ, Nielsen JK, Knudsen LE, and Vähäkangas K
- Subjects
- Environmental Pollutants pharmacokinetics, Environmental Pollutants toxicity, Female, Humans, In Vitro Techniques, Pregnancy, Reproducibility of Results, Reproduction drug effects, Toxicity Tests methods, Toxicity Tests standards, Laboratories standards, Maternal-Fetal Exchange, Perfusion methods, Perfusion standards, Placenta metabolism, Placental Circulation
- Abstract
As a part of EU-project ReProTect, a comparison of the dual re-circulating human placental perfusion system was carried out, by two independent research groups. The detailed placental transfer data of model compounds [antipyrine, benzo(a)pyrene, PhIP (2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine) and IQ (2-amino-3-methylimidazo(4,5-f)quinoline] has been/will be published separately. For this project, a comparative re-analysis was done, by curve fitting the data and calculating two endpoints: AUC(120), defined as the area under the curve between time 0 and time 120 min and as t(0.5), defined as the time when the fetal to maternal concentration ratio is expected to be 0.5. The transport of the compounds from maternal to fetal circulation across the perfused placenta could be ranked in the order of antipyrine>IQ>PhIP in terms of both t(0.5) and AUC(120) by both partners. For benzo(a)pyrene the curve fitting failed. These prevalidation results give confidence for harmonization of the placental perfusion system to be used as one of the test methods in a panel for reproductive toxicology to model placental transfer in humans., (Copyright 2010 Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
37. [Microhemorrhages in the brain. A magnetic resonance imaging finding with emerging significance].
- Author
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Karttunen V and Bode MK
- Subjects
- Age Factors, Cerebrovascular Circulation, Chronic Disease, Humans, Prognosis, Risk Factors, Cerebral Hemorrhage diagnosis, Magnetic Resonance Imaging
- Abstract
Microhemorrhages in the brain refer to minor chronic hemorrhages that are revealed by specific magnetic imaging techniques. Whereas microhemorrhages in the brain are a common finding in patients with a disorder of the cerebral circulation, they are surprisingly often found also in elderly persons who are considered healthy. Microhemorrhages can be regarded as a biomarker of cerebral microangiopathy. They may also offer additional diagnostic information, provide clues for the prognosis of brain diseases, and influence clinical decisions. The patient's medical history, the location, number and distribution of imaging findings have a central role in the assessment of clinical significance.
- Published
- 2010
38. Alexander disease with occipital predominance and a novel c.799G>C mutation in the GFAP gene.
- Author
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Hinttala R, Karttunen V, Karttunen A, Herva R, Uusimaa J, and Remes AM
- Subjects
- Adult, Alexander Disease physiopathology, Amino Acid Substitution genetics, Astrocytes metabolism, Atrophy genetics, Atrophy pathology, Atrophy physiopathology, Autopsy, Brain metabolism, Brain pathology, Brain physiopathology, DNA Mutational Analysis, Disease Progression, Fatal Outcome, Genetic Markers genetics, Genetic Predisposition to Disease genetics, Genotype, Humans, Magnetic Resonance Imaging, Male, Muscular Atrophy genetics, Muscular Atrophy pathology, Muscular Atrophy physiopathology, Mutation genetics, Nerve Fibers, Myelinated metabolism, Occipital Lobe metabolism, Occipital Lobe physiopathology, Phenotype, Spinal Cord metabolism, Spinal Cord pathology, Spinal Cord physiopathology, Alexander Disease genetics, Alexander Disease pathology, Astrocytes pathology, Glial Fibrillary Acidic Protein genetics, Nerve Fibers, Myelinated pathology, Occipital Lobe pathology
- Published
- 2007
- Full Text
- View/download PDF
39. [Radiological findings of brain, connected to alcohol overuse].
- Author
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Bode MK, Karttunen A, Karttunen V, and Jartti P
- Subjects
- Female, Finland, Humans, Male, Pregnancy, Radiographic Image Enhancement, Sensitivity and Specificity, Alcohol-Induced Disorders, Nervous System diagnostic imaging, Brain diagnostic imaging, Fetal Alcohol Spectrum Disorders diagnostic imaging, Magnetic Resonance Imaging methods
- Published
- 2006
40. [Acute care of intracerebral hemorrhage is improving].
- Author
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Karttunen V, Hillbom M, and Kumpulainen T
- Subjects
- Anticoagulants therapeutic use, Combined Modality Therapy, Early Diagnosis, Female, Finland, Humans, Intracranial Hemorrhages diagnosis, Male, Prognosis, Risk Assessment, Severity of Illness Index, Survival Rate, Anticoagulants adverse effects, Emergency Medical Services methods, Intracranial Hemorrhages etiology, Intracranial Hemorrhages therapy
- Published
- 2005
41. [Severe consequences of drinking beer].
- Author
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Karttunen V and Hillbom M
- Subjects
- Alcoholism diagnosis, Blood Chemical Analysis, Critical Illness, Emergency Service, Hospital, Female, Finland, Follow-Up Studies, Humans, Magnetic Resonance Imaging methods, Middle Aged, Myelinolysis, Central Pontine diagnosis, Risk Assessment, Severity of Illness Index, Alcoholism complications, Beer poisoning, Myelinolysis, Central Pontine chemically induced
- Published
- 2005
42. Factor V Leiden and prothrombin gene mutation may predispose to paradoxical embolism in subjects with patent foramen ovale.
- Author
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Karttunen V, Hiltunen L, Rasi V, Vahtera E, and Hillbom M
- Subjects
- Adolescent, Adult, Case-Control Studies, Embolism, Paradoxical etiology, Female, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Migraine with Aura complications, Risk Factors, Stroke etiology, Stroke genetics, Thrombophilia complications, Embolism, Paradoxical genetics, Factor V genetics, Heart Septal Defects, Atrial complications, Mutation, Prothrombin genetics
- Abstract
The role of paradoxical embolism through patent foramen ovale as a mechanism of cryptogenic stroke is controversial. If a venous source of emboli is relevant, prothrombotic states should be associated with patent foramen ovale and cryptogenic stroke. We assessed the occurrence of several prothrombotic states (factor V Leiden, prothrombin G20210A, deficiencies in protein S, protein C and antithrombin, lupus anticoagulant, anticardiolipin antibodies, elevated factor VIII, resistance to activated protein C) and classical risk factors for venous thrombosis in 57 adult patients with cryptogenic stroke and patent foramen ovale and in 104 matched controls. Prothrombotic states [odds ratio (OR) 2.8; 95% confidence interval (CI), 1.2-6.5; P = 0.021], migraine with aura (OR 4.4; 95% CI 1.8-10.8; P = 0.001) and classical risk factors for venous thrombosis (OR 2.5; 95% CI 1.1-5.7; P = 0.037) were independent risk factors for cryptogenic stroke. In particular factor V Leiden or prothrombin G20210A associated with cryptogenic stroke (P = 0.022) whereas other coagulation abnormalities did not (P = 0.140). Among the patients with prothrombotic states, Valsalva manoeuvre was common at onset of stroke. Our results support the possibility of paradoxical embolism behind strokes in patients with patent foramen ovale.
- Published
- 2003
- Full Text
- View/download PDF
43. Mechanisms of alcohol-related strokes.
- Author
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Hillbom M, Juvela S, and Karttunen V
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Alcohol Drinking adverse effects, Cerebrovascular Disorders etiology, Cerebrovascular Disorders physiopathology
- Abstract
Epidemiological investigations have shown a linear positive correlation between the risk of haemorrhagic stroke and level of alcohol consumption. Ischaemic stroke shows a weaker relationship, which is J-shaped, suggesting that regular light-to-moderate alcohol consumption may carry a decreased risk. Case reports and case-control studies indicate that heavy recent drinking, but not heavy former drinking, increases the risk for both types of stroke. Larger amounts of alcohol are needed to trigger aneurysmal subarachnoid haemorrhage than spontaneous intracerebral haemorrhage. The increased risk caused by recent heavy drinking may be partly due to elevated systolic blood pressure, but alcohol may also provoke cerebral arterial vasospasm, as observed in animal experiments. Alcohol-induced fluctuation in haemostatic and fibrinolytic factors has not been proved to precipitate alcohol-related strokes, but may contribute to both an increase and a decrease of the risk. Subtypes of ischaemic stroke associate differently with alcohol consumption. A recent series of patients with ischaemic brain infarction showed that of the victims having a high and medium risk for cardiogenic embolism, 50% and 45% were intoxicated, respectively. This suggests that cardiogenic embolism is a significant mechanism leading to ischaemic stroke during heavy drinking of alcohol.
- Published
- 1998
- Full Text
- View/download PDF
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