Surgical treatment of hamstring injuries and disorders – the clinical spectrum from chronic tendinopathy to complete rupture

Hamstring muscle injuries and tendon disorders are common, especially in sports. They can be severe and difficult to treat, often resulting in impaired athletic performance and long rehabilitation times. Previous studies considering treatment of these problems are scarce. The current study was designed to investigate the effect of surgery on different types of hamstring muscle injuries and on proximal hamstring tendinopathy. In addition, we wanted to study the typical histopathological findings relating to proximal hamstring tendinopathy. In the study of complete (all three muscles torn) proximal hamstring avulsions (41 patients), our results showed that early operative treatment gives significantly better results than late surgery, and is therefore recommended. Despite this, considerable improvement of symptoms could also be achieved in chronic cases. In the study of partial (one or two muscles torn) proximal hamstring tears (47 patients), we observed that these injuries can cause significant functional deficit and impaired performance in athletes. The main finding was that after surgical repair most of the patients were able to return to their pre-injury level of sports. In the study of distal hamstring tears (18 patients), the results showed that surgical treatment had a good effect in the majority of these cases. In proximal hamstring tendinopathy, the main problem is pain which limits sports. In this study (90 patients), we found that after unsuccessful conservative treatment, surgery was a good treatment option resulting in full return to sports in most cases. In tendinopathic hamstring tendons, the morphological changes of tendinosis were largely identical to those previously described in other common (e.g. Achilles and patellar) tendinopathies. In chronic proximal hamstring avulsions, and also in reoperations, a large defect between distally retracted tendons and the ischial tuberosity may occasionally prevent anatomic reinsertion. We have described a reconstruction method using fascia lata autograft augmentation to be used in these most challenging repairs. This technique was utilized in the treatment of five patients, with encouraging results.

Fourier self-deconvolution in coherent anti-Stokes Raman scattering spectrum analysis

Coherent anti-Stokes Raman scattering (CARS) microscopy is rapidly developing into a unique microscopic tool in biophysics, biology and the material sciences. The nonlinear nature of CARS spectroscopy complicates the analysis of the received spectra. There were developed mathematical methods for signal processing and for calculations spectra. Fourier self-deconvolution is a special high pass FFT filter which synthetically narrows the effective trace bandwidth features. As Fourier self-deconvolution can effectively reduce the noise, which may be at a higher spatial frequency than the peaks, without losing peak resolution. The idea of the work is to experiment the possibility of using wavelet decomposition in spectroscopic for background and noise removal, and Fourier transformation for linenarrowing.

Hybrid LC Filter for Power Electronic Drives: Theory and Implementation

Power electronic converter drives use, for the sake of high efficiency, pulse-width modulation that results in sequences of high-voltage high-frequency steep-edged pulses. Such a signal contains a set of high harmonics not required for control purposes. Harmonics cause reflections in the cable between the motor and the inverter leading to faster winding insulation ageing. Bearing failures and problems with electromagnetic compatibility may also result. Electrical du/dt filters provide an effective solution to problems caused by pulse-width modulation, thereby increasing the performance and service life of the electrical machines. It is shown that RLC filters effectively decrease the reflection phenomena in the cable. Improved (simple, but effective) solutions are found for both differential- and common-mode signals; these solutions use a galvanic connection between the RLC filter star point and the converter DC link. Foil chokes and film capacitors are among the most widely used components in high-power applications. In actual applications they can be placed in different parts of the cabinet. This fact complicates the arrangement of the cabinet and decreases the reliability of the system. In addition, the inductances of connection wires may prevent filtration at high frequencies. This thesis introduces a new hybrid LC filter that uses a natural capacitance between the turns of the foil choke based on integration of an auxiliary layer into it. The main idea of the hybrid LC filter results from the fact that both the foil choke and the film capacitors have the same roll structure. Moreover, the capacitance between the turns (“intra capacitance”) of the foil inductors is the reason for the deterioration of their properties at high frequencies. It is shown that the proposed filter has a natural cancellation of the intra capacitance. A hybrid LC filter may contain two or more foil layers isolated from each other and coiled on a core. The core material can be iron or even air as in the filter considered in this work. One of the foils, called the main foil, can be placed between the inverter and the motor cable. Other ones, called auxiliary foils, may be connected in star to create differential-mode noise paths, and then coupled to the DC link midpoint to guarantee a traveling path, especially for the common-mode currents. This way, there is a remarkable capacitance between the main foil and the auxiliary foil. Investigations showed that such a system can be described by a simple equivalent LC filter in a wide range of frequencies. Because of its simple hybrid construction, the proposed LC filter can be a cost-effective and competitive solution for modern power drives. In the thesis, the application field of the proposed filter is considered and determined. The basics of hybrid LC filter design are developed further. High-frequency behaviour of the proposed filter is analysed by simulations. Finally, the thesis presents experimental data proving that the hybrid LC filter can be used for du/dt of PWM pulses and reduction of common-mode currents.

Genetic Basis and Diagnostics of Extended-Spectrum Beta-Lactamases among Enterobacteriaceae in Finland

Since the introduction of antibiotic agents, the amount and prevalence of Beta-lactam resistant enterobacteria has become an increasing problem. Many enterobacteria are opportunistic pathogens that easily acquire resistance mechanisms and genes, which make the situation menacing. These bacteria have acquired resistance and can hydrolyse extended spectrum cephalosporins and penicillins by producing enzymes called extended-spectrum Beta-lactamases (ESBLs). ESBL-producing bacteria are most commonly found in the gastro-intestinal tract of colonised patients. These resistant strains can be found in both health-care associated and community-acquired isolates. The detection and treatment of infections caused by bacteria producing ESBLs are problematic. This study investigated the genetic basis of extended-spectrum Beta-lactamases in Enterobacteriaceae, especially in Escherichia coli and Klebsiella pneumoniae isolates. A total of 994 Finnish Enterobacteriaceae strains, collected at 26 hospital laboratories, during 2000 and 2007 were analysed. For the genetic basis studies, PCR, sequencing and pyrosequencing methods were optimised. In addition, international standard methods, the agar dilution and disk diffusion methods were performed for the resistance studies, and the susceptibility of these strains was tested for antimicrobial agents that are used for treating patients. The genetic analysis showed that bla_CTX-M was the most prevalent gene among the E. coli isolates, while blaS_HV-12 was the most common Beta-lactamase gene in K. pneumoniae. The susceptibility testing results showed that about 60% of the strains were multidrug resistant. The prevalence of ESBL-producing isolates in Finland has been increasing since 2000. However, the situation in Finland is still much better than in many other European countries.

Software Licensing: Implementing Electronic Licensing in Medical Technology Company

The purpose of this thesis is to examine software licensing, how a software developer can benefit from it and to define specifications for licensing system of software based medical technology product. The thesis has been divided into theoretical and empirical parts. In the theoretical part the concept of software licensing and different aspects that are connected to it are examined with a help of research material. On the ground of this research, in the empirical part, a licensing system for a medical software product called iCentral is designed. The empirical part is based on interviews, questionnaire and on authors own experience gained while working for the case-company.The thesis has great practical importance for the case-company by proposing both an ideal, and more importantly, practical implementation for a licensing system of a product. Thesis shows that electronic licensing is a viable option to sell medical technology products without a need to revise existing procedures or the enterprise resource system in the case company.

Licensing of eResources - views from Denmark's Electronic Research Library (DEFF)

Bo Öhrströmin esitys Kirjastoverkkopäivillä 27.10.2011 Helsingissä.

Usable Privacy Preservation in Mobile Electronic Personality

Personalised ubiquitous services have rapidly proliferated due technological advancements in sensing, ubiquitous and mobile computing. Evolving societal trends, business and the economic potential of Personal Information (PI) have overlapped the service niches. At the same time, the societal thirst for more personalised services has increased and are met by soliciting deeper and more privacy invasive PI from customers. Consequentially, reinforcing traditional privacy challenges and unearthed new risks that render classical safeguards ine ective. The absence of solutions to criticise personalised ubiquitous services from privacy perspectives, aggravates the situation. This thesis presents a solution permitting users' PI, stored in their mobile terminals to be disclosed to services in privacy preserving manner for personalisation needs. The approach termed, Mobile Electronic Personality Version 2 (ME2.0), is compared to alternative mechanisms. Within ME2.0, PI handling vulnerabilities of ubiquitous services are identi ed and sensitised on their practices and privacy implications. Vulnerability where PI may leak through covert solicits, excessive acquisitions and legitimate data re-purposing to erode users privacy are also considered. In this thesis, the design, components, internal structures, architectures, scenarios and evaluations of ME2.0 are detailed. The design addresses implications and challenges leveraged by mobile terminals. ME2.0 components and internal structures discusses the functions related to how PI pieces are stored and handled by terminals and services. The architecture focusses on di erent components and their exchanges with services. Scenarios where ME2.0 is used are presented from di erent environment views, before evaluating for performance, privacy and usability.

Fetal alcohol spectrum disorders in Finnish children and adolescents : diagnosis, cognition, behavior, adaptation and brain metabolic alterations

Alcohol consumption during pregnancy can potentially affect the developing fetus in devastating ways, leading to a range of physical, neurological, and behavioral alterations most accurately termed Fetal Alcohol Spectrum Disorders (FASD). Despite the fact that it is a preventable disorder, prenatal alcohol exposure today constitutes a leading cause of intellectual disability in the Western world. In Western countries where prevalence studies have been performed the rates of FASD exceed, for example, autism spectrum disorders, Down’s syndrome and cerebral palsy. In addition to the direct effects of alcohol, children and adolescents with FASD are often exposed to a double burden in life, as their neurological sequelae are accompanied by adverse living surroundings exposing them to further environmental risk. However, children with FASD today remain remarkably underdiagnosed by the health care system. This thesis forms part of a larger multinational research project, The Collaborative Initiative on Fetal Alcohol Spectrum Disorders (the CIFASD), initiated by the National Institute of Alcohol Abuse and Alcoholism (NIAAA) in the U.S.A. The general aim of the present thesis was to examine a cohort of children and adolescents growing up with fetal alcohol-related damage in Finland. The thesis consists of five studies with a broad focus on diagnosis, cognition, behavior, adaptation and brain metabolic alterations in children and adolescents with FASD. The participants consisted of four different groups: one group with histories of prenatal exposure to alcohol, the FASD group; one IQ matched contrast group mostly consisting of children with specific learning disorder (SLD); and two typically-developing control groups (CON1 and CON2). Participants were identified through medical records, random sampling from the Finnish national population registry and email alerts to students. Importantly, the participants in the present studies comprise a group of very carefully clinically characterized children with FASD as the studies were performed in close collaboration with leading experts in the field (Prof. Edward Riley and Prof. Sarah Mattson, Center for Behavioral Teratology, San Diego State University, U.S.A; Prof. Eugene Hoyme, Sanford School of Medicine, University of South Dakota, U.S.A.). In the present thesis, the revised Institute of Medicine diagnostic criteria for FASD were tested on a Finnish population and found to be a reliable tool for differentiating among the subgroups of FASD. A weighted dysmorphology scoring system proved to be a valuable additional adjunct in quantification of growth deficits and dysmorphic features in children with FASD (Study 1). The purpose of Study 2 was to clarify the relationship between alcohol-related dysmorphic features and general cognitive capacity. Results showed a significant correlation between dysmorphic features and cognitive capacity, suggesting that children with more severe growth deficiency and dysmorphic features have more cognitive limitations. This association was, however, only moderate, indicating that physical markers and cognitive capacity not always go hand in hand in individuals with FASD. Behavioral problems in the FASD group proved substantial compared to the typically developing control group. In Study 3 risk and protective factors associated with behavioral problems in the FASD group were explored further focusing on diagnostic and environmental factors. Two groups with elevated risks for behavioral problems emerged: length of time spent in residential care and a low dysmorphology score proved to be the most pervasive risk factor for behavioral problems. The results underscore the clinical importance of appropriate services and care for less visibly alcohol affected children and highlight the need to attend to children with FASD being raised in institutions. With their background of early biological and psychological impairment compounded with less opportunity for a close and continuous caregiver relationship, such children seem to run an especially great risk of adverse life outcomes. Study 4 focused on adaptive abilities such as communication, daily living skills and social skills, in other words skills that are important for gradually enabling an independent life, maintain social relationships and allow the individual to become integrated into society. The results showed that adaptive abilities of children and adolescents growing up with FASD were significantly compromised compared to both typically-developing peers and IQ-matched children with SLD. Clearly different adaptive profiles were revealed where the FASD group performed worse than the SLD group, who in turn performed worse than the CON1 group. Importantly, the SLD group outperformed the FASD group on adaptive behavior in spite of comparable cognitive levels. This is the first study to compare adaptive abilities in a group of children and adolescents with FASD relative to both a contrast group of IQ-matched children with SLD and to a group of typically-developing peers. Finally, in Study 5, through magnetic resonance spectroscopic imaging (MRS) evidence of longstanding neurochemical alterations were observed in adolescents and young adults with FASD related to alcohol exposure in utero 14-20 years earlier. Neurochemical alterations were seen in several brain areas: in frontal and parietal cortices, corpus callosum, thalamus and frontal white matter areas as well as in the cerebellar dentate nucleus. The findings are compatible with neuropsychological findings in FASD. Glial cells seemed to be more affected than neurons. In conclusion, more societal efforts and resources should be focused on recognizing and diagnosing FASD, and supporting subgroups with elevated risk of poor outcome. Without adequate intervention children and adolescents with FASD run a great risk of marginalization and social maladjustment, costly not only to society but also to the lives of the many young people with FASD.

From electronic spare part catalog to eBusiness: Finding the best practices

Companies and organizations business activities rely on information. IT systems that manage master data must provide the highest level of service, world-class scalability and reliable information. This study discusses product information and how it can support the creation of a spare part catalog and the launching of eBusiness. The study consists of a theoretical and empirical part. The theoretical part contains a literature review and a framework for the analysis. For the empirical study two companies were selected and their information management processes were studied and analyzed based on the framework. The empirical results indicate that the challenges the companies face reflect the ones that can be found in the literature study. The results of the empirical study also show that the companies had recognized the issues which need to be developed and had recognized trends in eBusiness and product information management.

Tunable lumped-element bandpass filters for Cognitive Radio application

In this thesis the design of bandpass filters tunable at 400 MHz – 800 MHz was under research. Microwave filters are vital components which provide frequency selectivity in wide variety of electronic systems operating at high frequencies. Due to the occurrence of multi-frequency bands communication and diverse applications of wireless devices, requirement of tunable filters exists. The one of potential implementation of frequency-agile filters is frontends and spectrum sensors in Cognitive Radio (CR). The principle of CR is to detect and operate at a particular available spectrum without interfering with the primary user’s signals. This new method allows improving the efficiency of utilizing allocated spectrum such as TV band (400 MHz – 800 MHz). The focus of this work is development of sufficiently compact, low cost tunable filters with quite narrow bandwidth using currently available lumped-element components and PCB board technology. Filter design, different topologies and methods of tuning of bandpass filters are considered in this work. As a result, three types of topologies of bandpass filter were simulated and realised. They use digitally tunable capacitors (DTCs) for adjusting central frequency at TV "white space" spectrum. Measurements revealed that schematics presented in this work have proper output response and filters are successfully tuned by DTCs.

Integration of Electronic Commerce and Enterprise Systems

The necessity of EC (Electronic Commerce) and enterprise systems integration is perceived from the integrated nature of enterprise systems. The proven benefits of EC to provide competitive advantages to the organizations force enterprises to adopt and integrate EC with their enterprise systems. Integration is a complex task to facilitate seamless flow of information and data between different systems within and across enterprises. Different systems have different platforms, thus to integrate systems with different platforms and infrastructures, integration technologies, such as middleware, SOA (Service-Oriented Architecture), ESB (Enterprise Service Bus), JCA (J2EE Connector Architecture), and B2B (Business-to-Business) integration standards are required. Huge software vendors, such as Oracle, IBM, Microsoft, and SAP suggest various solutions to address EC and enterprise systems integration problems. There are limited numbers of literature about the integration of EC and enterprise systems in detail. Most of the studies in this area have focused on the factors which influence the adoption of EC by enterprise or other studies provide limited information about a specific platform or integration methodology in general. Therefore, this thesis is conducted to cover the technical details of EC and enterprise systems integration and covers both the adoption factors and integration solutions. In this study, many literature was reviewed and different solutions were investigated. Different enterprise integration approaches as well as most popular integration technologies were investigated. Moreover, various methodologies of integrating EC and enterprise systems were studied in detail and different solutions were examined. In this study, the influential factors to adopt EC in enterprises were studied based on previous literature and categorized to technical, social, managerial, financial, and human resource factors. Moreover, integration technologies were categorized based on three levels of integration, which are data, application, and process. In addition, different integration approaches were identified and categorized based on their communication and platform. Also, different EC integration solutions were investigated and categorized based on the identified integration approaches. By considering different aspects of integration, this study is a great asset to the architectures, developers, and system integrators in order to integrate and adopt EC with enterprise systems.