Euran Vaaniin pohjavesialueen rajojen tarkistus ja alueen maaperän vedenjohtavuus

Tämän Pro Gradu –tutkielman tarkoituksena oli selvittää Euran Vaaniin pohjavesialueen rajojen muutostarve. Tutkimus oli osana laajempaa ympäristöministeriön ja maa –ja metsätalousministeriön hanketta, jonka tarkoituksena on luoda yhtenäinen ja selkeä ohjeistus hienoainespeitteisten akviferien pohjavesialueiden rajaamiselle. Kenttätyöt tehtiin kesällä 2011. Tutkimusmenetelminä olivat raekokoanalyysi kuiva- ja märkäseulonnalla ja hiukkasmittarilla, ionikromatografia, massaspektrometria, veden stabiilien isotooppien määritys ja rakennetulkinta. Tutkimusten perusteella Vaaniin pohjavesialueen nykyiset rajat eivät ole toimivia pohjaveden suojelun kannalta. Nykyisen pohjavesialueen ulkopuolisilta alueilta, joiden vedenjohtavuusarvot mahdollistavat pohjaveden muodostumisen, on hydraulinen yhteys harjuun. Vedenjohtavuusarvojen perusteella tutkimusalue voidaan jakaa kolmeen eri luokkaan, jotka ovat muodostumisalue (K > 10-6 ms-1), vettä osittain läpäisevä alue (10-7 < K < 10-6 ms-1) ja vettä läpäisemätön alue (K < 10-7 ms-1). Rakennetulkinnan perusteella hyvin vettä johtavat kerrokset ovat jatkuvia Vaaniin ja Euran keskustan välisellä osuudella. Harjun morfologia on vaihtelevaa eivätkä muutokset näy maanpinnalla aluilla, joilla harju on hienoainessedimenttien peittämä. Pohjaveden päävirtaussuunnat Kauttualta kohti Vaaniita ja jokilaakson reunoilta harjuun. Pohjaveden redox-oloissa tapahtuu muutos Mölsin alueen hapettavista oloista pelkistäviksi kohti Vaaniin vedenottamoa ja samanaikaisesti kemiallinen koostumus muuttuu jonkin verran. Veden stabiilien isotooppien perusteella pohjaveden osuus jokivedestä on noin 5 – 8 %. Vaaniin pohjavesialueen rajoja on tutkimusten perusteella syytä muuttaa. Ehdotetaan kahta muutosvaihtoehtoa. Ensimmäisessä pohjavesialueen rajoja siirretään itään ja länteen siten, että muodostumisalueeksi lukeutuvat moreenikumpareet ovat pohjavesialueella. Toisessa vaihtoehdossa pohjavesi- ja muodostumisalueiksi rajataan alueet, joiden vedenjohtavuusarvot mahdollistavat pohjaveden muodostumisen. Peitteisten akviferien pohjavesialueiden rajauksissa tulisi tutkimusten perusteella ottaa huomioon myös harjualueen ulkopuoliset alueet, joilta voi olla hydraulinen yhteys harjuun. Muodostumisalueen rajauksissa käytetään perusteena, että muodostumisalueeksi rajaan alue, jonka vedenjohtavuusarvo vastaa hienon hiekan vedenjohtavuutta tai on sitä suurempi. Tutkimusten perusteella määritelmää suositellaan muutettavaksi siten, että rajaksi otetaan vedenjohtavuusarvo 10-6 ms-1, koska se ei ota kantaa sedimentin laatuun

Multi-core platforms for audio and multimedia coding algorithms in telecommunications

Tietoliikenteessä käytettävät multimedian koodausalgoritmit eli koodekit kehittyvät jatkuvasti. USAC ja Opus ovat uusia, sekä puheelle että musiikille soveltuvia audiokoodekkeja. Molemmat ovat sijoittuneet korkealle koodekkien äänenlaatua vertailevissa tutkimuksissa. Näiden keskeisiä ominaisuuksia käsitellään kirjallisuuskatsaukseen perustuen. Varsinkin HD-tasoisen videon käsittelyssä käytettävät koodekit vaativat suurta laskentatehoa. Tilera TILEPro64 -moniydinsuorittimen ja sille optimoitujen multimediakoodekkien suorituskykyä testattiin tarkoitukseen suunnitelluilla tietokoneohjelmilla. Tulokset osoittivat, että suoritinytimiä lisättäessä videon koodausalgoritmien suoritusnopeus kasvaa tiettyyn rajaan asti. Testatuilla äänen koodausalgoritmeillä ytimien lisääminen ei parantanut suoritusnopeutta. Tileran moniydinratkaisuja verrattiin lopuksi Freescalen ja Texas Instrumentsin moniydinratkaisuihin. Huolimatta eroista laitteistoarkkitehtuureissa, kyseisten toimittajien kehitystyökaluissa todettiin olevan paljon samoja piirteitä.Multimedia coding algorithms used in telecommunications evolve constantly. Benefits and properties of two new hybrid audio codecs (USAC, Opus) were reviewed on a high level as a literature study. It was found that both have succeeded well in subjective sound quality measurements. Tilera TILEPro64-multicore platform and a related software library was evaluated in terms of performance in multimedia coding. The performance in video coding was found to increase with the number of processing cores up to a certain point. With the tested audio codecs, increasing the number of cores did not increase coding performance. Additionally, multicore products of Tilera, Texas Instruments and Freescale were compared. Development tools of all three vendors were found to have similar features, despite the differences in hardware architectures

KUMPPANUUDEN HAASTEITA PK-YRITYKSEN KANSAINVÄLISTYVÄSSÄ LIIKETOIMINNASSA: Tapaustutkimus kahdesta metallialan yrityksestä

Pk-yritysten kansainvälistymisen rajoituksena usein pidetään resurssien ja osaamisen puutteita. Yritykset voivat tehdä yhteistyötä voimavaroja yhdistelemällä, jotta ne pääsisivät parempiin tuloksiin kuin yksin toimimalla. Voidaan olettaa, että yhteistyön avulla pk-yrityksellä on mahdollisuus päästä kansainvälistymään helpommin. Tämän tutkimuksen tavoitteena oli ymmärtää millaisia haasteita pk-yritys kohtaa tämänlaisessa toiminnassa. Kumppanuudella tarkoitetaan tässä yhteydessä kahden yrityksen välistä yhteistyösuhdetta, joka perustuu keskinäiseen luottamukseen sekä resurssien ja osaamisten yhdistämiseen niin, että molemmat hyötyvät. Tutkimuksen kohteina oli kaksi metallialan pk-yritystä, jotka ovat kansainvälistyneet kumppaneiden avulla. Teoriatausta koostuu kansainvälistymiseen ja yritysten väliseen yhteistyöhön liittyvästä kirjallisuudesta, joita on lähestytty pk-yrityksen näkökulmasta. Tutkimuksen on luonteeltaan kvalitatiivinen ja sen empiirinen osa toteutettiin teemahaastatteluin. Aineistoa analysoitiin vertailemalla yrityksiä keskenään erojen ja yhtäläisyyksien löytämiseksi. Lisäksi tuloksia peilattiin teoriaan. Tutkimuksen tuloksissa haasteet kohdistuivat kumppanin valintaan, itse yhteistyösuhteeseen sekä kumppanuuden kehitykseen.fi=Opinnäytetyö kokotekstinä PDF-muodossa.|en=Thesis fulltext in PDF format.|sv=Lärdomsprov tillgängligt som fulltext i PDF-format

Long-term Outcomes and Health Perceptions in Pediatric-onset Portal Hypertension Complicated by Varices

Objectives: Outcomes of pediatric-onset portal hypertension are poorly defined. We aimed to assess population-based long-term outcomes of pediatric-onset portal hypertension complicated by varices. Methods: All children with esophageal varices (n = 126) were identified from 14,144 single nationwide referral center endoscopy reports during 1987 to 2013, and followed up through national health care and death registers. A questionnaire was sent to survivors (n = 94) of whom 65 (69%) responded. Results: Nineteen underlying disorders included biliary atresia (35%), extrahepatic portal vein obstruction (35%), autosomal recessive polycystic kidney disease (7%), and other disorders (23%). During median follow-up of 15.2 (range 0.5-43.1) years patients underwent median 9 (1-74) upper gastrointestinal endoscopies. Esophageal varices were first observed at a median age of 4.0 (0.3-18.2) years, 112 (89%) patients underwent median 6 (1-56) sclerotherapy/banding sessions, and 61 (48%) experienced median 2 (range 1-20) variceal bleeding episodes. Forty-eight surgical shunt procedures were performed to 41 (36%) patients and 38% underwent liver transplantation. Portal hypertensive biliopathy was diagnosed in 4 patients. Hepatopulmonary syndrome necessitated liver transplantation in 2 patients, hepatic encephalopathy in 2, and hepatorenal syndrome in 1. No patient died of variceal bleeding. Patient-reported perception of health on a scale of 1 to 10 was 9 (range 4-10), and 86% reported no current symptoms attributable to esophageal varices. Conclusions: Pediatric-onset portal hypertension is a heterogeneous disease with significant long-term morbidity, requiring multimodal approach with considerable resources and continuation of follow-up in adulthood. Although mortality to variceal bleeding was avoided, bleeding episodes recurred also in adulthood, while patient-reported health of long-term survivors was encouraging.Peer reviewe

Ruokatorviatresia - hoito, komplikaatiot ja pitkäaikaisongelmat

English summaryPeer reviewe

Combined management of perianal rhabdomyosarcoma with chemotherapy, radical surgery, and irradiation : A series of three consecutive children

Background and aim: We describe a series of three successive patients with perianal rhabdomyosarcoma (PRMS) from 2014 to 2017 managed with combined chemotherapy, radical surgery, and radiotherapy. Methods: Ethical consent was obtained. Data including tumor presentation, treatment, and survival was collected from hospital reports. Results: Two girls aged 15 and 16 years (patient #1 and #2) and one boy aged five years (patient #3) were referred because of a suspected perianal abscess. MRI showed large perianal tumors from 7 to 12 cm in diameter that surrounded or infiltrated the anal sphincters and were inconsistent with abscess. Tumor biopsies showed RMS of alveolar (#1 and #2) and embryonal (#3) types. Patient #1 had lymph node and bone metastases, patient #2 lymph node metastases, and patient # 3 no metastases. Pretreatment staging, IRS Clinical Group, and Risk Groups were: Stage 4, II, high; Stage 3, GII, intermediate; and Stage 3, I, low, respectively. All underwent colostomy before neoadjuvant chemotherapy (CWS-RMS 2009 program). Neoadjuvant chemotherapy failed to clear the tumors from anal sphincters preventing anus-saving surgery, and all patients underwent abdominoperineal excision. All removed specimens had freemargins with negative lymph nodes. After adjuvant chemotherapy and local radiation, the patients were tumor free after 48, 13, and 18 months. Conclusion: In PRMS local surgical control required abdominoperineal excision. Confusion between PRMS and abscess may cause unnecessary delay in management. (C) 2018 Elsevier Inc. All rights reserved.Peer reviewe

Risk factors and outcomes of tapering surgery for small intestinal dilatation in pediatric short bowel syndrome

Background: In remains unclear why in some short bowel syndrome (SBS) patients, the remaining small bowel (SB) dilates excessively leading to requirement of tapering surgery. Methods: Among SBS children, we retrospectively analyzed risk factors for tapering surgery with logistic regression and compared the outcome of operated patients (n = 16) to those managed conservatively (n = 44) with Cox proportional hazards regression. Results: SBS was caused by necrotizing enterocolitis (NEC) (n = 31), SB atresia (SBA) (n = 13), midgut volvulus (n = 12), or gastroschisis (n = 4). Patients with spontaneous symptomatic SB dilatation unable to wean parenteral nutrition (PN) underwent tapering surgery at median age of 1.04 (interquartile range 0.70-3.27) years. Missing ICV was related to an 8-fold (p = 0.003) increased risk while SBA diagnosis was related to a 13-fold risk of tapering surgery (p <0.001). Increasing SB length and NEC diagnosis were protective of tapering (p = 0.027-0.004). Of operated patients, 75% reached enteral autonomy during follow-up and their postoperative adjusted PN weaning rate was similar to nonoperated children (p = 0.842). Conclusion: SBS children with short remaining SB, missing ICV, and SBA etiology are more likely while NEC patients are less likely than others to necessitate tapering surgery. Postoperative PN weaning rates were comparable to patients who initially had more favorable intestinal anatomy and adapted without surgery. (C) 2017 Elsevier Inc. All rights reserved.Peer reviewe

Outcomes of fundoplication in oesophageal atresia associated gastrooesophageal reflux disease

Aim of the study: Conservative management of gastrooesophageal reflux (GORD) in oesophageal atresia (OA) is sometimes inefficient, and fundoplication is required. We assessed the outcomes of fundoplication among OA patients from 1980 to 2016. Methods: After ethical consent, hospital records of 290 patients, including 22 referred patients, were reviewed. Included were 262 patients with end-to-end repair. Excluded were patients who underwent oesophageal reconstruction (n = 23) or no repair (n = 5). Primary outcome measures included survival, retaining the native oesophagus, resolution of GGORD symptoms, failure of fundoplication, and long-term endoscopic results. Main results: Gross types of OA in 262 patients were A (n = 12), B (n = 2), C (n = 217), D (n = 10), E (n = 19), and F (n = 2). Eighty-six (33%) patients, type A (n = 12, 100%), B (n = 2, 100%), C (n = 69, 31%), D (n = 3, 30%), and F (n = 1, 50%), underwent fundoplication at the median age of 5.4 (IQR 3.1-16) months. Main indications included recalcitrant anastomotic stenosis (RAS) in 41 (48%), respiratory symptoms in 16 (19%), and acute life threatening events (ALTE) in 15 (17%) of patients. Associated tracheomalacia in 25 (29%) patients were treated with aortopexy. Median follow-up was 7.5 (IQR 1.8-15) years. RAS resolved in 30 (73%) patients, whereas 11 (27%) with unresolved RAS underwent oesophageal resection (n = 8) or replacement (n = 3). Six (7%) patients died of heart failure (n = 4), bolus impaction (n = 1), and ALTE (n = 1). Fundoplication failed in 27 (31%) patients, and 13 (15%) underwent redo fundoplication. Fundoplication failure was predicted by long-gap OA RR = 3.8 (95% CI = 1.1-13), P = 0.04. In total GORD associated symptoms persisted in 7 (8%) patients, including one with permanent feeding jejunostomy. Latest endoscopy showed moderate or severe oesophagitis in 7% of fundoplicated and in 3% nonfundoplicated patients and intestinal metaplasia in 3% and 1% (p = 0.20-0.29). Conclusion: Fundoplication provided a safe and relatively effective control of OA associated symptomatic GORD and oesophagitis. The failure rate of fundoplication was high in those with long-gap OA. Type of study: Treatment study. Level of evidence: IV (C) 2017 Elsevier Inc. All rights reserved.Peer reviewe

Altered Bile Transporter Expression and Cholesterol Metabolism in Children With Cholesterol and Pigment Gallstones

Objectives: We elucidated pathophysiology of pediatric gallstone disease by assessing liver expression of bile transporters in relation to bile acids and surrogates of cholesterol absorption and synthesis in serum and gallstones. Methods: RNA expression of canalicular bile transporters in liver biopsies from 32 pediatric gallstone patients and from 6 liver donors (controls) was measured by qRT-PCR (quantitative real-time reverse transcription polymerase chain reaction). Concentrations of cholesterol and precursors, plant sterols and bile acids in gallstones, and in serum of the patients and 82 healthy children were measured. Primary outcomes were the difference in RNA expressions and serum sterol profiles between patients and controls. Results: Cholesterol stones (CS; n = 15) contained cholesterol >42% and pigment stones (PS; n = 17)Peer reviewe

Intestinal failure associated cholestasis in surgical necrotizing enterocolitis and spontaneous intestinal perforation

Background: Surgery for necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) is often complicated by intestinal failure (IF) and intestinal failure associated cholestasis (IFAC). Objective: Assessment of incidence, predictors, and mortality associated with IFAC in surgically treated NEC and SIP. Methods: A retrospective observational study based on hospital records during 1986-2014 in the two largest Finnish neonatal intensive care units was performed. IFAC was defined as conjugated bilirubin >34 mu mo1/1 (2.0 mg/dl) for >= two postoperative weeks while receiving parenteral nutrition (PN). Results: In total 225 patients underwent surgery for NEC (n 142; 63%) or SIP (n = 83; 37%). Included were 57 survivors with >= two weeks PN. Sixty-five (42%) patients developed IFAC. Two-year survival with IFAC was 80% and without IFAC 89% (p = 0.13). Of the 65 patients with IFAC, all eight with unresolved IFAC died in comparison to six of 57 (11%) whose IFAC resolved (p <0.0001), while IFAC resolved in all survivors. Survival among patients with resolved IFAC was 89% and with unresolved IFAC (n = 8) 0%, (p <0.0001).IFAC lasted for median 83 (IQR 45-120) days and correlated with the duration of PN (R2 = 0.16, p = 0.03), delay of starting enteral feeds (R2 = 0.12, p = 0.05) and PN lipid emulsion (RR = 1.0 (95% CI = 1.0-1.1) (p = 0.02). In multivariate logistic regression analysis, IFAC development associated with septicemias and reoperations. Conclusions: 42% of pre matures who underwent surgery for NEC or SIP developed IFAC. Reoperations and septicemias increased the risk of IFAC. None of the patients with unresolved IFAC survived, but IFAC did not increase overall mortality. Type of study: Retrospective prognosis study. (C) 2018 Elsevier Inc. All rights reserved.Peer reviewe