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S Savolainen

Publications and source records attributed to S Savolainen.

At least 19 recordsLinked to original sources
PubMed2006

Long-lasting Campylobacter jejuni contamination of milk associated with gastrointestinal illness in a farming family.

This report describes an outbreak of gastroenteritis of 5 months' duration in a farming family, associated with the consumption of unpasteurized cows' milk, where Campylobacter jejuni was implicated. A total of six individuals in the family acquired the illness, and two had several episodes of diarrhoea within the 5-month period. Identical PFGE genotypes of C. jejuni were isolated from human and bovine faeces, and bulk tank milk samples. Incompletely sealed rubber liners fitted to a milking machine shortly before the outbreak started was the probable reason, allowing faecal material to contaminate the milk over the period concerned.

Adolescent↗
PubMed2005

1H MRS studies in the Finnish boron neutron capture therapy project: detection of 10B-carrier, L-p-boronophenylalanine-fructose.

This article summarizes the current status of 1H MRS in detecting and quantifying a boron neutron capture therapy (BNCT) boron carrier, L-p-boronophenylalanine-fructose (BPA-F) in vivo in the Finnish BNCT project. The applicability of 1H MRS to detect BPA-F is evaluated and discussed in a typical situation with a blood containing resection cavity within the gross tumour volume (GTV). 1H MRS is not an ideal method to study BPA concentration in GTV with blood in recent resection cavity. For an optimal identification of BPA signals in the in vivo 1H MR spectrum, both pre- and post-infusion 1H MRS should be performed. The post-infusion spectroscopy studies should be scheduled either prior to or, less optimally, immediately after the BNCT. The pre-BNCT MRS is necessary in order to utilise the MRS results in the actual dose planning.

Adult↗
PubMed2004

MRI quality control: six imagers studied using eleven unified image quality parameters.

Quality control of the magnetic resonance imagers of different vendors in the clinical environment is non-harmonised, and comparing the performance is difficult. The purpose of this study was to develop and apply a harmonised long-term quality control protocol for the six imagers in our organisation in order to assure that they fulfil the same basic image quality requirements. The same Eurospin phantom set and identical imaging parameters were used with each imager. Values of 11 comparable parameters describing the image quality were measured. Automatic image analysis software was developed to objectively analyse the images. The results proved that the imagers were operating at a performance level adequate for clinical imaging. Some deficiencies were detected in image uniformity and geometry. The automated analysis of the Eurospin phantom images was successful. The measurements were successfully repeated after 2 weeks on one imager and after half a year on all imagers. As an objective way of examining the image quality, this kind of comparable and objective quality control of different imagers is considered as an essential step towards harmonisation of the clinical MRI studies through a large hospital organisation.

Algorithms↗
PubMed2004

The TL analysis methods used to determine absorbed gamma doses in vivo for the BNCT patients treated at FiR 1.

The gamma dose determination using thermoluminescent (TL) dosimeters in mixed neutron-gamma fields, such as in boron neutron capture therapy (BNCT), is difficult due to the thermal neutron sensitivity of the detectors; especially when equipment capable of glow curve analysis is not available. The two TL analysis methods used previously in Finnish BNCT to correct the measured TL signal to obtain absorbed gamma dose in vivo were studied and compared, and an enhanced method was introduced. The three TL methods were found surprisingly consistent despite, e.g. the rough estimate made in the first method.

Boron Neutron Capture Therapy↗
PubMed2004

Design and construction of shoulder recesses into the beam aperture shields for improved patient positioning at the FiR 1 BNCT facility.

Improvements have been made at the FiR 1 BNCT facility to ease the positioning of the patient with a tumor in the head and neck region into a lateral neutron beam. Shoulder recesses were constructed horizontally on both sides of the beam aperture. When shoulder recesses are not needed, they are filled with neutron attenuating filling blocks. MCNP simulations using an anthropomorphic human model BOMAB phantom showed that the main contribution to the increase in the effective dose to the patient's body due to the shoulder recesses was from the neutron dose of the arm. In a position when one arm is inside the shoulder recess, the maximal effective dose of the patient was estimated to be 0.7Sv/h. Dose measurements using the twin ionization chamber technique showed that the neutron dose increased on the sides as predicted by the MCNP model but there was no noticeable change in the gamma doses. When making the recesses into the lithium containing neutron shield material tritium contamination was confined using an underpressurized glove box and machine tools with local exhaust. The shoulder recesses give space for more flexible patient positioning and can be considered as a significant improvement of the Finnish BNCT facility.

Boron Neutron Capture Therapy↗
PubMed2004

Enhanced blood boron concentration estimation for BPA-F mediated BNCT.

The blood boron concentration regulates directly the BNCT irradiation time in which the prescribed dose to the patient is delivered. Therefore a proper estimation of the blood boron concentration for the treatment field based on the measured blood samples before irradiation is required. The bi-exponential model fit using Levenberg-Marquardt method was implemented for this purpose to provide the blood boron concentration estimates directly to the treatment data flow during the BNCT procedure. The harmonic mean bi-exponential decay half-lives of the studied patient data (n=28) were 15+/-8 and 320+/-70 min for the faster and slower half-life. The model uncertainty (n=28) was reasonably low, 0.7+/-0.1 microg/g (about 5%). The implemented algorithm provides a robust method for temporal blood boron concentration estimation for BPA-F mediated BNCT. Utilization of the infusion data improves the reliability of the estimate. The overall data flow during the treatment fulfills the practical requirements concerning the BNCT procedure.

Algorithms↗
PubMed2004

Quality assurance procedures for the neutron beam monitors at the FiR 1 BNCT facility.

In order to assure the stability of the beam, the reliability of the beam monitoring system and the quality of the patient dose delivered, several procedures are followed at the FiR 1 epithermal beam in Finland. Routine procedures include in-phantom activation measurements before each patient treatment and a long-term follow-up of the results. The sensitivity of the beam monitors to external objects in the beam and to variations in the control rod positions in the reactor has been checked and found insignificant. The linearity of the beam monitor channels has been checked with activation measurements. It was found that due to saturation effects a correction of 11% has to be applied when extrapolating results from experiments at low power to full power using the reference monitor channel. The correction is even larger for other channels with higher count rates.

Boron Neutron Capture Therapy↗
PubMed2004

Measurement of free beam neutron spectra at eight BNCT facilities worldwide.

Eight epithermal neutron beams, constructed for clinical or preclinical studies of NCT, have been dosimetrically characterized by in-air measurements with a set of activation foils for the determination of the neutron energy spectra in free beam. Measurements have been made on the already closed epithermal BNCT facility at the BMRR of the Brookhaven National Laboratory, on the HFR at JRC in Petten, The Netherlands, on the epithermal mode beam at KURRI, Japan, on the fission converter beam at MIT, USA, on the epithermal beam of the RA-6 facility in Bariloche, Argentina, on the epithermal beam at WSU, USA, on the mixed mode beam at JRR-4 at JAERI, Japan, as well as on the epithermal beam at FiR 1 at VTT, Espoo, Finland.

Animals↗
PubMed2004

Dosimetric comparison at FiR 1 using microdosimetry, ionisation chambers and computer simulation.

Tissue equivalent proportional counter microdosimetry has been applied in the dosimetry of epithermal neutron beams as they can provide an independent and accurate method to determine gamma ray and neutron absorbed doses. Dosimetric comparison has been performed using a tissue equivalent proportional counter, dual ionisation chambers and DORT computer code at FiR 1 boron neutron capture therapy facility in Espoo, Finland. The three methods were applied to determine neutron and gamma ray absorbed doses at 25, 40, 60 and 120 mm depths along the beam centerline in a water-filled PMMA phantom. The determined absorbed doses were found to agree within the limits of the estimated uncertainties.

Boron Neutron Capture Therapy↗
PubMed2004

Propacetamol and diclofenac alone and in combination for analgesia after elective tonsillectomy.

BACKGROUND: Diclofenac and paracetamol have different mechanisms and sites of action. Therefore, we tested if their combination is more effective for analgesia after tonsillectomy than either drug alone with respect to rescue analgesic consumption and visual analog scale values. METHODS: The analgesic effects of intravenously administered propacetamol (injectable pro-drug of paracetamol) and diclofenac or a combination on postoperative pain were compared in 71 adult elective tonsillectomy patients in a randomized, double-blind study. After induction of anesthesia the patients received monotherapy with 2 g propacetamol (n = 25) or 75 mg diclofenac (n = 25), or a combined treatment with 2 g propacetamol and 75 mg diclofenac (n = 21) in physiologic saline as an infusion. Postoperatively the propacetamol dosage was repeated twice and diclofenac once on the ward. Oxycodone (0.03 mg kg(-1)) was used as a rescue analgesic by patient-controlled analgesia. RESULTS: On average the patients needed oxycodone 15.3, 13.2 and 10.6 times in the propacetamol, diclofenac and combination groups, respectively (NS). A verbal rating scale and a visual analog scale were employed for assessing post-tonsillectomy pain, nausea and patient satisfaction in all groups. No statistically significant differences were found between the groups. Twelve of the 25 (48%) patients having received propacetamol complained of pain at the cannulation site. CONCLUSION: Combined treatment with propacetamol and diclofenac with the dosages used provided clinically only a minor advantage over monotherapy with propacetamol or diclofenac with respect to postoperative analgesia or the incidence of side-effects in adult tonsillectomy patients.

Acetaminophen↗
PubMed2004

Estrogen receptor-beta is the predominant estrogen receptor subtype in human oral epithelium and salivary glands.

Many studies have shown that the oral mucosa and salivary glands are sensitive to estrogen action. However, the expression of estrogen receptors (ERs) within these tissues is an area of controversy. ERs exist as two subtypes (ERalpha and ERbeta), and we hypothesized that the incongruity between ER expression and estrogen sensitivity may result from differential expression of ER subtypes in oral tissues. To test this hypothesis, we analyzed oral mucosal and salivary gland samples for ERalpha and ERbeta protein expression by immunohistochemistry from a cross-section of patients attending hospital for surgical problems of the head and neck. ERalpha was not detected in oral buccal and gingival epithelium or in salivary glands. In contrast, ERbeta was widely expressed at high levels in all oral tissues studied. Within these tissues, ERbeta was observed primarily in keratinocytes and salivary gland acinar and ductal cells. Our results demonstrating the expression of only the ERbeta subtype within oral tissues may explain the contradictory results from previous studies investigating ER expression in these tissues. Importantly, these results suggest that estrogens may act via ERbeta in oral tissues and explain the effect of hormonal changes on the oral mucosa as well as on saliva secretion and composition.

Adult↗
PubMed2003

Computational study of the required dimensions for standard sized phantoms in boron neutron capture therapy dosimetry.

The minimum size of a water phantom used for calibration of an epithermal neutron beam of the boron neutron capture therapy (BNCT) facility at the VTT FiR 1 research reactor is studied by Monte Carlo simulations. The criteria for the size of the phantom were established relative to the neutron and photon radiation fields present at the thermal neutron fluence maximum in the central beam axis (considered as the reference point). At the reference point, for the most commonly used beam aperture size at FiR 1 (14 cm diameter), less than 1% disturbance of the neutron and gamma radiation fields in a phantom were achieved with a minimum a 30 cm x 30 cm cross section of the phantom. For the largest 20 cm diameter beam aperture size, a minimum 40 cm x 40 cm cross-section of the phantom and depth of 20 cm was required to achieve undisturbed radiation field. This size can be considered as the minimum requirement for a reference phantom for dosimetry at FiR 1. The secondary objective was to determine the phantom dimensions for full characterization of the FiR 1 beam in a rectangular water phantom. In the water scanning phantom, isodoses down to the 5% level are measured for the verifications of the beam model in the dosimetric and treatment planning calculations. The dose distribution results without effects caused by the limited phantom size were achieved for the maximum aperture diameter (20 cm) with a 56 cm x 56 cm x 28 cm rectangular phantom. A similar approach to study the required minimum dimensions of the reference and water scanning phantoms can be used for epithermal neutron beams at the other BNCT facilities.

Boron Neutron Capture Therapy↗
PubMed2003

Study of the relative dose-response of BANG-3 polymer gel dosimeters in epithermal neutron irradiation.

Polymer gels have been reported as a new, potential tool for dosimetry in mixed neutron-gamma radiation fields. In this work, BANG-3 (MGS Research Inc.) gel vials from three production batches were irradiated with 6 MV photons of a Varian Clinac 2100 C linear accelerator and with the epithermal neutron beam of the Finnish boron neutron capture therapy (BNCT) facility at the FiR 1 nuclear reactor. The gel is tissue equivalent in main elemental composition and density and its T2 relaxation time is dependent on the absorbed dose. The T2 relaxation time map of the irradiated gel vials was measured with a 1.5 T magnetic resonance (MR) scanner using spin echo sequence. The absorbed doses of neutron irradiation were calculated using DORT computer code, and the accuracy of the calculational model was verified by measuring gamma ray dose rate with thermoluminescent dosimeters and 55Mn(n,gamma) activation reaction rate with activation detectors. The response of the BANG-3 gel dosimeter for total absorbed dose in the neutron irradiation was linear, and the magnitude of the response relative to the response in the photon irradiation was observed to vary between different gel batches. The results support the potential of polymer gels in BNCT dosimetry, especially for the verification of two- or three-dimensional dose distributions.

Boron Neutron Capture Therapy↗
PubMed2003

1H MRS of a boron neutron capture therapy 10B-carrier, L-p-boronophenylalanine-fructose complex, BPA-F: phantom studies at 1.5 and 3.0 T.

The quantification of a BNCT 10B-carrier, L-p-boronophenylalanine-fructose complex (BPA-F), was evaluated using 1H magnetic resonance spectroscopy (1H MRS) with phantoms at 1.5 and 3.0 T. For proper quantification, relaxation times T1 and T2 are needed. While T1 is relatively easy to determine, the determination of T2 of a coupled spin system of aromatic protons of BPA is not straightforward with standard MRS sequences. In addition, an uncoupled concentration reference for aromatic protons of BPA must be used with caution. In order to determine T2, the response of an aromatic proton spin system to the MRS sequence PRESS with various echo times was calculated and the product of the response curve with exponential decay was fitted to the measured intensities. Furthermore, the response curve can be used to correct the intensities, when an uncoupled resonance is used as a concentration reference. BPA was quantified using both phantom replacement and internal water referencing methods with accuracies of +/- 5% and +/- 15%. Our phantom results suggest that in vivo studies on BPA concentration determination will be feasible.

Boron Compounds↗
PubMed2003

Brain biopsy prior to treatment of Alzheimer's disease.

A cortical biopsy was analyzed using immunohistochemical methodology in a total of 213 patients with suspected normal pressure hydrocephalus (NPH). Normal intracranial pressure (ICP) was registered in 121 (43 %) of patients with suspected NPH. The incidence of Alzheimer's disease (AD) related lesions was quite high, since 38 % of all subjects displayed beta-amyloid (betaA4) aggregates and in 8 % of subjects paired helical filament-tau (PHF-tau) pathology was noted. The AD associated pathologies were more common in subjects with normal than elevated ICP. Of the 121 subjects with NPH, 16 (13 %) had subclinical, histopathologically verified AD and a further 40 subjects (33 %) could be considered to be at high risk to develop AD. Pharmacological treatment trials of AD should be carried out on subjects with evident brain pathology (betaA4 aggregates or PHF-tau pathology) especially during the early stage of the disease, i.e., the subclinical stage. For this purpose a simple cortical biopsy with a low risk of complication would represent a diagnostic "method" of choice.

Aged↗
PubMed2003

Cerebral hemodynamics in a healthy population measured by dynamic susceptibility contrast MR imaging.

PURPOSE: To establish reference data and to study age-dependency for cerebral perfusion in various regions of the brain in a healthy population. MATERIAL AND METHODS: Eighty healthy subjects of both genders from 22 to 85 years of age were studied with spin echo echo-planar dynamic susceptibility contrast MR imaging (DSC MRI) at 1.5 T. Cerebral blood volume (CBV), cerebral blood flow (CBF), and contrast agent mean transit time (MTT) were calculated bilaterally for 20 distinct neuroanatomic structures. RESULTS: In gray matter, the following values were found (mean +/- SD): CBV (4.6 +/- 1.0 ml/100 g), CBF (94.2 +/- 23.0 ml/100 g/min), and MTT (3.0 +/- 0.6 s), and in white matter: CBV (1.3 +/- 0.4 ml/100 g), CBF (19.6 +/- 5.8 ml/100 g/min), and MTT (4.3 +/- 0.7 s). The perfusion parameters did not change with age, except for a tendency to an increase in gray matter MTT and CBV. Males exhibited higher MTT and CBV than females. No hemispheric difference was found in either gender. CONCLUSION: Cerebral hemodynamics can be assessed with DSC MRI. Age itself seems to have only a marginal effect on cerebral perfusion in healthy population.

Adult↗
PubMed2002

Five-year outcome of normal pressure hydrocephalus with or without a shunt: predictive value of the clinical signs, neuropsychological evaluation and infusion test.

BACKGROUND: Between 1993-1995, 51 patients under 75 years of age with clinical symptoms and CT-based diagnosis of normal pressure hydrocephalus were investigated prospectively in order to clarify the value of neuropsychological tests, clinical symptoms and signs and infusion test in the differential diagnosis and prediction of outcome in normal pressure hydrocephalus. METHODS: Patients had a thorough neurological examination, and neuropsychological evaluation. A 24-hour intraventricular ICP-measurement, infusion test, neurophysiological investigations and MRI study were performed, and a cortical biopsy was obtained. The ICP measurement defined the need for a shunt. All 51 patients were re-examined three and twelve months later. The final follow-up was accomplished five years postoperatively. FINDINGS: 25 of the patients needed a shunt operation. One year after a shunt placement 72% of these patients had a good recovery concerning activities of daily living, 58% benefited in their urinary incontinence and 57% walked better. During the 5 years of follow-up 8 patients with shunt and 9 without shunt had died. Positive effect of shunting remained. Only one neuropsychological test, recognition of words test, distinguishes the patients with the need for a shunt. Simple mini mental examination test was not different in those who improved. In the postoperative follow-up patients with shunt showed no change in neuropsychological tests even if they were subjectively better. The infusion test was of no value in diagnosing NPH. The 16 patients with Alzheimer's disease did worse after one year than those without pathological changes, but the mortality was not increased. INTERPRETATION: Specific neuropsychological tests are of little value in diagnosing NPH. Mini-Mental status examination was neither of value in diagnosing NPH nor in prediction of the outcome. In this study the infusion test did not improve diagnostic accuracy of NPH, but shunt placement relieves urinary incontinence and walking disability in patients with increased ICP. The patients with positive Alzheimer diagnosis on biopsy did not improve.

Aged↗