Pancreatic Resection for Carcinoma of the Pancreas and the Periampullary Region. A Twenty-Year Experience

410 patients were treated for pancreatic and periampullary carcinoma in 1968–1987 of whom 89 (21.5%) underwent resection. Hospital mortality decreased from 33% in 1968–1972 to 0% in 1983–1987, but the morbidity rate remained unchanged. The trends were similar in patients ≥ 70 and < 70 years of age. The pylorus-saving technique did not increase mortality, morbidity, operative blood loss or the incidence of delayed gastric emptying, but it did reduce the operative time by one hour (p< 0.01). The real 5 year survival for periampullary cancer was 52%, but none of the patients with pancreatic carcinoma survived for 5 years

Infektiotautien etiologia akuutisti sairailla lapsilla

Tiivistelmä. Tutkimus käsittelee infektiotautien etiologiaa ja taudinaiheuttajia lasten päivystykseen tulleilla lapsilla yhden vuoden ajanjaksolla Oulun yliopistollisessa sairaalassa. Kohorttitutkimukseen kuului 4647 lasta, joista 2559 (55%) todettiin kliinisesti infektio. Infektiopotilaista 1582 (62%) saatiin tarkka taudinaiheuttaja selville. Näiden joukosta rinovirus nousi yleisimmäksi etiologiseksi tekijäksi sekä lasten päivystyksessä että lasten teho-osastolla. Väestökohtainen ilmaantuvuus rinovirukseen liittyvillä päivystyskäynneillä alle 5-vuotiailla lapsilla oli 1796/100000/vuosi. Yleisin bakteeritaudinaiheuttaja oli Escherichia coli

Katsaus säätösähköteknologioihin

Tiivistelmä. Tulevaisuus asettaa monia haasteita sähköjärjestelmän toiminnalle niin Suomessa kuin muuallakin maailmassa. Yhteiskunnan kasvava sähkönkulutus lisää kuormitusta sähköntuotannolle, ja uusia tuotantolaitoksia tarvitaan koko ajan lisää. Tuotettavan sähkön tulisi kuitenkin olla mahdollisimman ympäristöystävällistä ja puhdasta, mikä lisää sähköjärjestelmän haasteita entisestään, sillä uusiutuvien energianlähteiden avulla tuotettava sähkö on altis säätilan muutoksille. Näin ollen sähkön tuotanto ei ole tasaista, ja tuotettavan sähkön määrää on vaikeampaa arvioida perinteisiin sähkön tuotantomuotoihin verrattuna. Sähköjärjestelmän toiminnan kannalta on kuitenkin hyvin tärkeää, että sähkön kysyntä ja tarjonta vastaisivat toisiaan mahdollisimman tarkasti. Ideaalitilanteessa sähköä tuotetaan täsmälleen saman verran kuin sitä kulutetaan, mutta todellisuudessa tällainen tilanne ei toteudu. Säätösähkön avulla pyritään reagoimaan sähkön tuotannon ja kulutuksen vaihteluihin ja ylläpitämään näiden välistä tasapainoa. Suomen sähköjärjestelmä käyttää erilaisia säätösähköteknologioita, joita käytetään sen mukaan, kuinka suuri tarve säädölle on. Työssä tarkastellaan Suomessa käytössä olevia säätösähköteknologioita. Suomen sähköverkko toimii osana yhteispohjoismaista synkronijärjestelmää, joka puolestaan liittyy muihin Euroopan alueella toimiviin vastaaviin järjestelmiin. Työssä tarkastellaan myös pohjoismaiden sähköntuotantoa ja tilannetta Euroopassa suurempana kokonaisuutena. Älykkäät energiajärjestelmät tulevat olemaan yhä suuremmassa roolissa yhteiskunnan eri teknisisissä infrastruktuureissa, joten työssä pohditaan myös tulevaisuuden älykkäiden sähkö- ja energiajärjestelmien vaikutusta säätösähköä silmällä pitäen. Sähköntuotannossa Suomessa ollaan menossa kohti puhtaampaa ja päästöttömämpää tulevaisuutta. Esimerkiksi tuulivoimaan tullaan investoimaan paljon, ja ydinvoimankin kapasiteetti kasvaa lähitulevaisuudessa. Ympäristön kannalta tämä on erinomainen asia, mutta varsinkin tuulivoiman lisääminen kasvattaa säätösähkön tarvetta. Vesivoima tulee olemaan jatkossakin käytetyin kotimainen säätösähköteknologia sen nopean säätökyvyn ansiosta. Suomessa on kuitenkin käytetty jo suurin osa vesivoimapotentiaalista, ja uusia, varsinkaan suuria voimalaitoksia tuskin tullaan rakentamaan, sillä vesivoimalaitoksen ympäristövaikutukset ovat mittavat. Niinpä vesivoiman lisäämiseksi olemassa olevia voimalaitoksia täytyy päivittää uudenpien ja tehokkaampien teknologioiden pariin. Myös pumppuvoimalaitokset voivat tulevaisuudessa tarjota ympäristöystävällistä ja puhdasta energiaa sähköjärjestelmän säätötarpeisiin. Vesivoiman lisäksi tarvitaan myös muita toimia, jotta sähköjärjestelmän säätökyky säilyy riittävänä. Älykkäät sähkö-ja energiajärjestelmät yhdessä kysyntäjouston kanssa tulevat mahdollistamaan sähköjärjestelmän tehokkaamman ja joustavamman käytön. Kun sähköjärjestelmän kysyntäpiikkejä voidaan siirtää tai pienentää, vähenee säätösähkön tarve. Myös pohjoismaiden välisten sähköyhteyksien merkitys korostuu, sillä Suomen lisäksi muita pohjoismaita ja Eurooppaa ajaa samat ilmastotavoitteet. Pohjoismaissa sähköntuotannon rakenne on maiden välillä hyvinkin erilainen, joten on tärkeää, että tarpeen vaatiessa säätömahdollisuuksia on saatavilla kotimaisten ratkaisujen lisäksi.Overview of balancing energy technologies. Abstract. The future poses many challenges to the operation of the power system in Finland, world-wide. Society’s growing power demand increases pressure on electricity production, and new production facilities are needed. However, the electricity produced should be as environmentally friendly and clean as possible, which increases the challenges of the power system even more, because the electricity produced with the aid of renewable energy sources is weather dependent. Consequently, electricity production is not uniform, and it is more difficult to estimate the amount of electricity produced compared to traditional forms of electricity production. In terms of the operation of the power system, it is very important that the demand and supply of electricity is matched as closely as possible. In an ideal situation, exactly the same amount of electricity should be produced, as it is consumed. In reality, such situation rarely happens due to the fluctuating nature of both consumption and variable energy generation. With the help of balancing power, the aim is to react to these fluctuations in electricity production and consumption and to maintain the balance between them. The Finnish power system uses different balancing power technologies, which are used depending on how great the need for control is and how short the reaction time must be. The thesis examines the balancing power technologies used in Finland. Finland’s electricity network operates as part of the Nordic synchronous system, which in turn is connected to other similar systems operating in Europe. The work also examines electricity production in the Nordic countries and the situation in Europe as a larger entity. Smart energy systems will play an increasingly important role in society’s various technical infrastructures, therefore the work also considers the impact of smart energy technologies of the future with regard to balancing power. Electricity production in Finland is heading towards a cleaner and emission-free future. For example, there will be a lot of investment in wind power, and the capacity of nuclear power will also increase in the near future. From an environmental point of view, this is excellent, however, especially higher share of wind power increases the need for balancing power. Hydropower will continue to be the most used domestic balancing power technology thanks to its fast control capability. However, most of the hydropower potential has already been used in Finland, and new, especially large, power plants will hardly be built, because the environmental impacts of a hydropower plant are considerable. Therefore, in order to increase hydropower, existing power plants must be updated with newer and more efficient technologies. In the future, pumped-storage-hydro-power plants can also offer environmentally friendly and clean energy for balancing the power system. In addition to hydropower, other measures are also needed to maintain sufficient controllability of the power system. Smart energy systems together with demand response will enable more efficient and flexible power use. During peak power, electricity consumption can be shifted or reduced, which will reduce the need for balancing power. The importance of electricity connections between the Nordic countries is also emphasized, because other Europeancountries are also driven by the same climate goals. In the Nordic countries, the composition of electricity production is varies between countries, so it is important that cross-border balancing possibilities are available in addition to domestic solutions

Effects of cognac on coronary flow reserve and plasma antioxidant status in healthy young men

<p>Abstract</p> <p>Background</p> <p>The cardioprotective effects of certain alcoholic beverages are partly related to their polyphenol content, which may improve the vasodilatory reactivity of arteries. Effect of cognac on coronary circulation, however, remains unknown. The purpose of this randomized controlled cross-over study was to determine whether moderate doses of cognac improve coronary reactivity as assessed with cold pressor testing (CPT) and coronary flow reserve (CFR) measument.</p> <p>Methods</p> <p>Study group consisted of 23 subjects. Coronary flow velocity and epicardial diameter was assessed using transthoracic echocardiography at rest, during CPT and adenosine infusion-derived CFR measurements before drinking, after a moderate (1.2 ± 0.1 dl) and an escalating high dose (total amount 2.4 ± 0.3 dl) of cognac. To explore the bioavailability of antioxidants, the antioxidant contents of cognac was measured and the absorption from the digestive tract was verified by plasma antioxidant capacity determination.</p> <p>Results</p> <p>Serum alcohol levels increased to 1.2 ± 0.2‰ and plasma antioxidant capacity from 301 ± 43.9 μmol/l to 320 ± 25.0 μmol/l by 7.6 ± 11.8%, (p = 0.01) after high doses of cognac. There was no significant change in flow velocity during CPT after cognac ingestion compared to control day. CFR was 4.4 ± 0.8, 4.1 ± 0.9 (p = NS), and 4.5 ± 1.2 (p = NS) before drinking and after moderate and high doses on cognac day, and 4.5 ± 1.4, and 4.0 ± 1.2 (p = NS) on control day.</p> <p>Conclusion</p> <p>Cognac increased plasma antioxidant capacity, but it had no effect on coronary circulation in healthy young men.</p> <p>Trial Registration</p> <p>NCT00330213</p

Adrenergic and myogenic regulation of viscoelasticity in the vascular bed of the human forearm

This study tested the hypothesis that the compliance (C) and viscoelasticity (K) of the forearm vascular bed are controlled by myogenic and/or α-adrenergic receptor (αAR) activation. Heart rate (HR) and waveforms of brachial artery blood pressure (Finometer) and forearm blood flow (Doppler ultrasound) were measured in baseline conditions and during infusion of noradrenaline (NA; αAR agonist), with and without phentolamine (αAR antagonist; n= 10; 6 men and 4 women). These baseline and αAR-agonist-based measures were repeated when the arm was positioned above or below the heart to modify the myogenic stimulus. A lumped Windkessel model was used to quantify the values of forearm C and K in each set of conditions. Baseline forearm C was inversely, and K directly, related to the myogenic load (P \u3c 0.001). Compared with saline infusion, C was increased, but K was unaffected, with phentolanine, but only in the \u27above\u27 position. Compliance was reduced (P \u3c 0.001) and K increased (P= 0.06) with NA infusion (main effects of NA) across arm positions; phentolamine minimized these NA-induced changes in C and K for both arm positions. Examination of conditions with and without NA infusion at similar forearm intravascular pressures indicated that the NA-induced changes in C and K were due largely to the concurrent changes in blood pressure. Therefore, within the range of arm positions used, it was concluded that vascular stiffness and vessel wall viscoelastic properties are acutely affected by myogenic stimuli. Additionally, forearm vascular compliance is sensitive to baseline levels of αAR activation when transmural pressure is low. © 2011 The Physiological Society

Self-Rated Mental Stress and Exercise Training Response in Healthy Subjects

Purpose: Individual responses to aerobic training vary from almost none to a 40% increase in aerobic fitness in healthy subjects. We hypothesized that the baseline self-rated mental stress may influence to the training response. Methods: The study population included 44 healthy sedentary subjects (22 women) and 14 controls. The laboratory controlled training period was 2 weeks, including five sessions a week at an intensity of 75% of the maximum heart rate for 40 min/session. Self-rated mental stress was assessed by inquiry prior to the training period from 1 (low psychological resources and a lot of stressors in my life) to 10 (high psychological resources and no stressors in my life), respectively. Results: Mean peak oxygen uptake (VO2peak) increased from 34 ± 7 to 37 ± 7 ml kg−1 min−1 in training group (p < 0.001) and did not change in control group (from 34 ± 7 to 34 ± 7 ml kg−1 min−1). Among the training group, the self-rated stress at the baseline condition correlated with the change in fitness after training intervention, e.g., with the change in maximal power (r = 0.45, p = 0.002, W/kg) and with the change in VO2peak (r = 0.32, p = 0.039, ml kg−1 min−1). The self-rated stress at the baseline correlated with the change in fitness in both female and male, e.g., r = 0.44, p = 0.039 and r = 0.43, p = 0.045 for ΔW/kg in female and male, respectively. Conclusion: As a novel finding the baseline self-rated mental stress is associated with the individual training response among healthy females and males after highly controlled aerobic training intervention. The changes in fitness were very low or absent in the subjects who experience their psychological resources low and a lot of stressors in their life at the beginning of aerobic training intervention