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[{"key": "dc.contributor.advisor", "value": "Sipil\u00e4, Sarianna", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "M\u00e4\u00e4tt\u00e4, Mira", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2023-06-14T07:18:02Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2023-06-14T07:18:02Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2023", "language": "", "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/87742", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Mahasy\u00f6v\u00e4t ovat maailmanlaajuisesti viidenneksi yleisin sy\u00f6p\u00e4ryhm\u00e4. Mahasy\u00f6p\u00e4\u00e4n liittyy tyypillisesti potilaiden kehonkoostumuksessa tapahtuvat m\u00e4\u00e4r\u00e4lliset ja laadulliset heikkenemismuutokset. Muutosten taustalla vaikuttavat prim\u00e4\u00e4risairauden lis\u00e4ksi muun muassa sy\u00f6v\u00e4nhoitomenetelmien haittavaikutukset, muut pitk\u00e4aikaissairaudet ja ik\u00e4\u00e4ntymismuutokset. \n\nT\u00e4ss\u00e4 tutkielmassa tarkastellaan leikattujen mahasy\u00f6p\u00e4potilaiden (n=150) luurankolihas- ja rasvamassassa tapahtuvia m\u00e4\u00e4r\u00e4llisi\u00e4 ja laadullisia muutoksia. Tutkimusaineisto ker\u00e4ttiin Keski-Suomen sairaanhoitopiirin kirurgisessa yksik\u00f6ss\u00e4 ja se koostuu tutkittavien potilastietoj\u00e4rjestelm\u00e4st\u00e4 ker\u00e4tyist\u00e4 taustatiedoista sek\u00e4 heid\u00e4n hoitoprosessinsa aikana otetuista vartalon tietokonetomografiakuvista (CT). Tutkielmassa analysoidaan potilaiden CT-kuvista vartalon alueen luurankolihasten poikkipinta-alassa ja tiheydess\u00e4 sek\u00e4 kokonaisrasvan, ihonalaisen- ja sis\u00e4elinrasvan poikkipinta-alassa tapahtuvia muutoksia l\u00e4ht\u00f6tilanteen ja kuuden sek\u00e4 12 kuukauden kontrollikuvauksen v\u00e4lill\u00e4. Lis\u00e4ksi alaryhm\u00e4analyysiss\u00e4 verrataan leikkaukseen valmistelevia neoadjuvanttihoitoja saaneiden (n=7) potilaiden luurankolihas- ja rasvamassan muutoksia muihin tutkittaviin. Tilastomenetelmin\u00e4 k\u00e4ytet\u00e4\u00e4n toistettujen mittausten varianssianalyysi\u00e4 (ANOVA) ja yleisiin estimaatteihin perustuvaa arviota (GEE-malli).\n\nTutkielman tulokset osoittivat, ett\u00e4 l\u00e4ht\u00f6tilanteen ja seurantapisteiden v\u00e4lill\u00e4 luurankolihasten poikkipinta-alassa, lihasten tiheydess\u00e4 sek\u00e4 kaikissa rasvamuuttujissa tapahtui tilastollisesti eritt\u00e4in merkitsev\u00e4 muutos (p<0.001). Taustamuuttujilla vakioinnin j\u00e4lkeen muutos s\u00e4ilyi tilastollisesti eritt\u00e4in merkitsev\u00e4n\u00e4 kokonaisrasvan ja ihonalaisen rasvan poikkipinta-aloissa ja muissa p\u00e4\u00e4muuttujissa tulokset muuttuivat tilastollisesti merkitseviksi (p<0.01). Neoadjunvanttiryhm\u00e4\u00e4n kuuluvien tutkittavien lihas- ja rasvamassan muutokset eiv\u00e4t eronneet muista tutkittavista ensimm\u00e4isen kuuden kuukauden seurannassa. T\u00e4m\u00e4n j\u00e4lkeen molempien ryhmien kehityskulussa tapahtui toipumiseen viittaava k\u00e4\u00e4nne: neoadjuvanttiryhm\u00e4n lihasmassan poikkipinta-ala kasvoi 0,5 % ja vertailuryhm\u00e4ll\u00e4 1 %. Samalla neoadjuvanttihoitoja saaneilla kokonais- ja sis\u00e4elinrasvan m\u00e4\u00e4r\u00e4t kasvoivat vertailuryhm\u00e4\u00e4n n\u00e4hden ja heid\u00e4n lihastiheytens\u00e4 aleni. Vertailuryhm\u00e4ll\u00e4 rasvamuuttujat heikkeniv\u00e4t j\u00e4lkimm\u00e4isell\u00e4 seurantajaksolla maltillisesti. \n\nTutkielman tulokset havainnollistavat mahasy\u00f6p\u00e4potilaiden vartalon alueen lihaksistossa ja rasvakudoksessa tapahtuvia muutoksia, jotka tulisi hoitotulosten optimoinnin vuoksi pyrki\u00e4 tulevaisuudessa tunnistamaan mahdollisimman varhaisessa vaiheessa. Jatkotutkimuksissa olisi t\u00e4rke\u00e4\u00e4 selvitt\u00e4\u00e4 prospektiivisella tutkimusasetelmalla, millainen vaikutus lihaskadon varhaisella tunnistamisella sek\u00e4 laadukkailla moni-interventioilla on kehonkoostumuksen muutoksiin.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Gastric cancers are the fifth most common group of cancers worldwide. Gastric cancer is typically associated with quantitative and qualitative deterioration changes in patients\u00b4 body composition. These changes are influenced not only by the primary disease but also by the side effects of cancer treatments, other chronic diseases, and aging processes. \n\nThis study examines the quantitative and qualitative changes in skeletal muscle and adipose tissue of cancer patients who underwent curative gastrectomy (n = 150). The research data was collected at the surgical unit of the Central Finland Health Care District and consists of patient\u2019s background information from medical record system, as well as midsection computed tomography (CT) images taken at the time of gastric cancer diagnose and follow up pictures at six month and 12 months after the gastrectomy. The sub-group analysis compares the changes in skeletal muscle and adipose tissue variables of patients who received neoadjuvant treatment (n=7) before surgery to the other study subjects. The statistical methods are repeated measures ANOVA from the exact values and estimation based on general estimating equations (GEE model) of the whole data. \n\nThe results of the study showed that there was a statistically significant change (p<0.001) in the cross-sectional area of the skeletal muscles, skeletal muscle density and in all fat variables during the follow-up. After adjusting for background variables, the change remained statistically significant in total adipose tissue and subcutaneous adipose tissue cross-sectional areas. In other main variables, the results became statistically significant (p<0.01). The neoadjuvant group showed changes in muscle and adipose tissue during the first six months which was similar to the other participants, without significant differences. Afterwards, both groups showed a turning point in the developmental trend that indicated recovery: the neoadjuvant group's cross-sectional muscle mass increased by 0.5% and the control group\u00b4s by 1%. In neoadjuvant group, the amounts of total fat mass and visceral fat mass increased more strongly compared to the control group, which led to a decrease in muscle density in the group. In the control group, fat variables moderately worsened in the latter follow-up period. \n\nThe results of the study illustrate the changes that occur in the muscle and adipose tissues of the abdominal region in patients with gastric cancer. These changes should be identified as early as possible for the optimization of treatment outcomes. In further research, it would be important to investigate prospectively the impact of early detection of skeletal muscle loss and offer multi-intervention treatment on changes in body composition.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Paivi Vuorio (paelvuor@jyu.fi) on 2023-06-14T07:18:02Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2023-06-14T07:18:02Z (GMT). No. of bitstreams: 0\n Previous issue date: 2023", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.format.extent", "value": "69", "language": "", "element": "format", "qualifier": "extent", "schema": "dc"}, {"key": "dc.language.iso", "value": "fin", "language": null, "element": "language", "qualifier": "iso", "schema": "dc"}, {"key": "dc.rights", "value": "In Copyright", "language": null, "element": "rights", "qualifier": null, "schema": "dc"}, {"key": "dc.subject.other", "value": "luurankolihasmassa", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "lihaskato", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "neoadjuvanttihoito", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.title", "value": "Kehonkoostumuksen muutokset leikatuilla mahasy\u00f6p\u00e4potilailla", "language": "", "element": "title", "qualifier": null, "schema": "dc"}, {"key": "dc.type", "value": "master thesis", "language": null, "element": "type", "qualifier": null, "schema": "dc"}, {"key": "dc.identifier.urn", "value": "URN:NBN:fi:jyu-202306143810", "language": "", "element": "identifier", "qualifier": "urn", "schema": "dc"}, {"key": "dc.type.ontasot", "value": "Master\u2019s thesis", "language": "en", "element": "type", "qualifier": "ontasot", "schema": "dc"}, {"key": "dc.type.ontasot", "value": "Pro gradu -tutkielma", "language": "fi", "element": "type", "qualifier": "ontasot", "schema": "dc"}, {"key": "dc.contributor.faculty", "value": "Liikuntatieteellinen tiedekunta", "language": "fi", "element": "contributor", "qualifier": "faculty", "schema": "dc"}, {"key": "dc.contributor.faculty", "value": "Faculty of Sport and Health Sciences", "language": "en", "element": "contributor", "qualifier": "faculty", "schema": "dc"}, {"key": "dc.contributor.department", "value": "Liikunta- ja terveystieteet", "language": "fi", "element": "contributor", "qualifier": "department", "schema": "dc"}, {"key": "dc.contributor.department", "value": "Sport and Health Sciences", "language": "en", "element": "contributor", "qualifier": "department", "schema": "dc"}, {"key": "dc.contributor.organization", "value": "Jyv\u00e4skyl\u00e4n yliopisto", "language": "fi", "element": "contributor", "qualifier": "organization", "schema": "dc"}, {"key": "dc.contributor.organization", "value": "University of Jyv\u00e4skyl\u00e4", "language": "en", "element": "contributor", "qualifier": "organization", "schema": "dc"}, {"key": "dc.subject.discipline", "value": "Gerontologia ja kansanterveys", "language": "fi", "element": "subject", "qualifier": "discipline", "schema": "dc"}, {"key": "dc.subject.discipline", "value": "Gerontology and Public Health", "language": "en", "element": "subject", "qualifier": "discipline", "schema": "dc"}, {"key": "yvv.contractresearch.funding", "value": "0", "language": "", "element": "contractresearch", "qualifier": "funding", "schema": "yvv"}, {"key": "dc.type.coar", "value": "http://purl.org/coar/resource_type/c_bdcc", "language": null, "element": "type", "qualifier": "coar", "schema": "dc"}, {"key": "dc.rights.copyright", "value": "\u00a9 The Author(s)", "language": null, "element": "rights", "qualifier": "copyright", "schema": "dc"}, {"key": "dc.rights.accesslevel", "value": "openAccess", "language": null, "element": "rights", "qualifier": "accesslevel", "schema": "dc"}, {"key": "dc.type.publication", "value": "masterThesis", "language": null, "element": "type", "qualifier": "publication", "schema": "dc"}, {"key": "dc.subject.oppiainekoodi", "value": "50423", "language": "", "element": "subject", "qualifier": "oppiainekoodi", "schema": "dc"}, {"key": "dc.subject.yso", "value": "ik\u00e4\u00e4ntyminen", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "mahasy\u00f6p\u00e4", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "sarkopenia", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "liit\u00e4nn\u00e4ishoito", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "kehonkoostumus", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.rights.url", "value": "https://rightsstatements.org/page/InC/1.0/", "language": null, "element": "rights", "qualifier": "url", "schema": "dc"}]
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