FDG-PET Imaging in Cardiac Sarcoidosis : Importance of the pathological findings in the right ventricle

Sarkoidoosi on tulehdussairaus joka voi esiintyä missä elimessä tahansa. Yleisimmin se ilmenee keuhkoissa ja välikarsinan imusolmukkeissa. Sarkoidoosi on usein oireeton sattumalöydös ja sen ennuste on suotuisa. Sarkoidoosi voi kuitenkin esiintyä sydänlihaksessa jopa neljänneksessä tapauksista. Sydämessä esiintyvään tautimuotoon liittyy merkittävää sairastavuutta ja kuolleisuutta. FDG-PET on isotooppitutkimus, jolla voidaan kuvata elimistön metabolista aktiivisuutta ja osoittaa muun muassa tulehdusprosessiin liittyvää korostunutta sokeriaineenvaihduntaa. Tätä väitöskirjatutkimusta varten uudelleenanalysoitiin 137 tehtyä FDG-PET tutkimusta, jotka oli tehty elokuun Tampereen yliopistosairaalassa elokuun 2012 ja syyskuun 2015 välillä sydänsarkoidoosiepäilyn vuoksi. Halusimme tutkia PET- kuvauksen merkitystä potilailla, joilla epäiltiin sydämen sarkoidoosia. Vertasimme PET-löydöksiä potilaiden perustietoihin, sairaushistoriaan ja EKG-löydöksiin. Lisäksi tutkimme sydämen ja sydämen ulkopuolisten poikkeavien aineenvaihduntafokusten suhdetta ja selvitimme PET-löydösten kykyä ennustaa sydäntapahtumia. Havaitsimme, että poikkeavia sydänlöydöksiä oli enemmän naisilla ja niillä joilla oli sairaushistoriassa merkintä eteis-kammiokatkoksesta. Oikean kammion poikkeavia muutoksia oli useammin potilailla, joilla oli ollut kammioperäisiä rytmihäiriöitä. Poikkeavat sydänlöydökset olivat yleisempiä potilailla, joiden EKG:ssa oli nähtävissä QRS-kompleksin fragmentaatiota useissa kytkennöissä, oikean etuhaarakkeen katkos. Poikkeavat sydämen PET-löydökset liittyivät myös väliseinän uudelleenmuovautumiseksi ja alaseinän uudelleenmuovautumiseksi nimettyihin, hiljattain määriteltyihin EKG-muuttujiin. Sarkoidoosiin sopiva kudosnäyte saatiin useammin potilailta, joilla nähtiin aineenvaihduntafokuksia sydämen ulkopuolella. Sydämen ulkopuolisilla ja oikean kammion poikkeavilla PET-löydöksillä havaittiin olevan yhteys. Oikean kammion poikkeavat löydökset ja korkea sydämen kokonaisaineenvaihdunta-aktiivisuus ennustivat sydäntapahtumia. Tulosten perusteella FDG-PET on käyttökelpoinen tutkimus sydänsarkoidoosiepäilyssä. Tunnistimme potilasryhmiä, joilla poikkeavan PET- löydöksen todennäköisyys on korkea. Havaitsimme, että PET-tutkimus voi osoittaa kohteita kudosnäytteen ottoon ja auttaa siten diagnoosiin pääsyssä. Lisäksi havaitsimme tiettyjen PET-löydösten liittyvän suureen sydäntapahtumien riskiin, mikä tulee ottaa huomioon potilaan hoidossa.Sarcoidosis is a granulomatous inflammatory disease that can affect any organ system. It most often manifests in lungs and hilar lymph nodes. It is often asymptomatic and has a benign prognosis. With a quarter of the patients, sarcoid inflammation affects the heart and this cardiac involvement accounts for the majority of sarcoidosis-related morbidity and mortality. FDG-PET is a nuclear medicine imaging study with an ability to visualize inflammatory foci. Lately, it has gained importance in the workup of cardiac sarcoidosis. One hundred thirty-seven PET studies performed in Tampere University Hospital between August 2012 and September 2015 for patients suspected with cardiac sarcoidosis were retrospectively analysed. With an aim to study the role of FDG- PET in the workup of cardiac sarcoidosis, we examined the associations of PET- findings and patient characteristics, PET-findings and ECG-parameters and the association of PET-findings in the heart and metabolically active foci elsewhere in the body. In addition, we assessed the prognostic role of PET. Pathological cardiac PET-findings were found to be more frequent in female patients and with those with a history of atrioventricular block. Right ventricular uptake was also associated with a history of ventricular tachycardia. Pathological cardiac PET findings also correlated to novel ECG parameters septal remodelling and inferolateral remodelling in addition to widespread QRS fragmentation and left anterior hemiblock. A biopsy sample indicating sarcoidosis was obtained more frequently from patients with metabolically active foci outside of the heart. Additionally, an association between right ventricular uptake and uptake in mediastinal and hilar lymph nodes was observed. In our population, right ventricular uptake and high total cardiac metabolic activity predicted adverse cardiac events during follow-up. Our study identified a group of patients, defined according to sex, medical history and certain ECG parameters, who have a higher frequency of positive cardiac findings in FDG-PET. The imaging study can be a useful tool in the workup of cardiac sarcoidosis as it can aid in the diagnosis by pointing targets for tissue biopsy. Furthermore, certain findings could be considered as indicators for high risk of cardiac events

Annual variations in the microflora of some varieties of Finnish malting barley

Three major Finnish malting barley varieties were studied for annual variations in the incidence of seed-derived fungi, bacteria and actinomycetes. In 1990-1992, 114 characterized fungal, 59 uncharacterized bacterial and 12 uncharacterized actinomycetal isolates were extracted from samples of seed intended for use in malting. When the yield of the plant hormone, indole-3-acetic acid (lAA), from enriched microbial cultures was weighed against the microbial biomass and the endogenous lAA concentration of the barley harvests, it was concluded that potential exists for bacterial lAA production in biologically significant amounts, given some minor annual variations. As expected from the average rainfall and temperature during the growing season, microbial counts in all cultivars were highest in 1992. Most of the fungal species found were of saphrophytic character, and field fungi were dominant in the samples. On the whole, microbial counts and spectra in all samples confirmed that each harvest of all cultivars was of good vigour and well suited for malting purposes. Strains of plant pathogenic character included species of Septoria nodorum (Berk) Berk, Drechlera teres (Sacc) Subraim & Jain, D. sorokiniana (Sacc) Subram & Jain and D. graminea (Rab.) Shoem. A consistent difference was noted in the microbial infection severities of the cultivars

UASI Summer 2012 UAV flight campaign results for forest and agriculture applications

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Building a Linked Open Data Portal of War Victims in Finland 1914-1922

Peer reviewe

An Ontology of Finnish Historical Occupations

Peer reviewe

WarVictimSampo 1914–1922: A Semantic Portal and Linked Data Service for Digital Humanities Research on War History

This paper presents the semantic portal and Linked Open Data (LOD) service WarVictimSampo 1914–22 about the war victims, battles, and prisoner camps in the Finnish Civil and other wars. The system is based on a database of the National Archives of Finland and related data compiled during the project. The system contains detailed information about some 40 000 deaths extracted from several data sources, and data about prisoner camps and over 1000 battles of the Civil War. A key novelty of WarVictimSampo 1914–22 is the integration of ready-to-use Digital Humanities tooling with the data service, which allows, e.g., studying information about wider prosopographical groups in addition to individual victims. We demonstrate how the tools of the portal, as well as the underlying SPARQL endpoint, can be used to explore and analyze war history in flexible and visual ways. WarVictimSampo 1914–22 is a new member in the series of “Sampo” model based semantic portals. It was published in late 2019 and got 20 000 users in two weeks.Peer reviewe

Linked Data : A Paradigm Shift for Publishing and Using Biography Collections on the Semantic Web

Peer reviewe

Digital Humanities Solutions for Pan-European Numismatic and Archaeological Heritage Based on Linked Open Data

This paper discusses current challenges in archaeological cultural heritage data management and presents the interdisciplinary research project DigiNUMA. The project investigates solutions in data harmonisation and dissemination of pan-European cultural heritage through an interdisciplinary and cross-sectoral project in Digital Humanities, semantic computing, participatory heritage, museum collections management and archaeological/numismatic studies. Using Finnish and English numismatic data as a test case, DigiNUMA creates ontological infrastructure and a proof-of-concept data model for finely-grained Linked Open Data (LOD) harmonisation across national and international databases for cultural heritage data, and tests it through a broad suite of Digital Humanities analyses.Peer reviewe

Akatemiasampo-portaali ja -datapalvelu henkilöiden ja henkilöryhmien historialliseen tutkimukseen (AcademySampo Portal and Data Service for Biographical and Prosopographical Research)

Non peer reviewe

Free digital image analysis software helps to resolve equivocal scores in HER2 immunohistochemistry

Evaluation of human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) is subject to interobserver variation and lack of reproducibility. Digital image analysis (DIA) has been shown to improve the consistency and accuracy of the evaluation and its use is encouraged in current testing guidelines. We studied whether digital image analysis using a free software application (ImmunoMembrane) can assist in interpreting HER2 IHC in equivocal 2+ cases. We also compared digital photomicrographs with whole-slide images (WSI) as material for ImmunoMembrane DIA. We stained 750 surgical resection specimens of invasive breast cancers immunohistochemically for HER2 and analysed staining with ImmunoMembrane. The ImmunoMembrane DIA scores were compared with the originally responsible pathologists' visual scores, a researcher's visual scores and in situ hybridisation (ISH) results. The originally responsible pathologists reported 9.1 % positive 3+ IHC scores, for the researcher this was 8.4 % and for ImmunoMembrane 9.5 %. Equivocal 2+ scores were 34 % for the pathologists, 43.7 % for the researcher and 10.1 % for ImmunoMembrane. Negative 0/1+ scores were 57.6 % for the pathologists, 46.8 % for the researcher and 80.8 % for ImmunoMembrane. There were six false positive cases, which were classified as 3+ by ImmunoMembrane and negative by ISH. Six cases were false negative defined as 0/1+ by IHC and positive by ISH. ImmunoMembrane DIA using digital photomicrographs and WSI showed almost perfect agreement. In conclusion, digital image analysis by ImmunoMembrane can help to resolve a majority of equivocal 2+ cases in HER2 IHC, which reduces the need for ISH testing.Peer reviewe