Matti Korppi

University of Eastern Finland, Kuopio, Eastern Finland Province, Finland

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Publications (332)842.15 Total impact

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    ABSTRACT: Hyperimmunoglobulinemia D syndrome (HIDS) is an autoinflammatory disorder that is caused by mevalonate kinase deficiency (MKD). Recent advances in the pathogenesis of MKD, including the proposed mechanisms of inflammasome activation, provide the basis for the development of new treatment modalities. So far, feedback on the treatment of HIDS with biological medicines has come from case reports with limited numbers of patients. In this review, we summarize the data that is currently available on the treatment of HIDS in children, with the emphasis on new therapies, and present three Finnish pediatric cases treated with anakinra. Case reports have been published on 33 pediatric HIDS patients who have been treated with biological medicines, and in some cases, they were treated with more than one drug. Of these patients, 21 were treated with anakinra and 16 with etanercept, resulting in complete or partial responses in 90 and 50 % of cases, respectively. A further five patients were treated with canakinumab, with complete or partial responses. Conclusion: The accumulating evidence on the efficacy and safety of biological drugs in pediatric HIDS suggests that the anti-interleukin-1 agent anakinra is the drug of choice for HIDS in children. What is Known: • Various biologic drugs have been tried for the treatment of HIDS. What is New: • Based on the 90 % response rate, anakinra seems to be the drug of choice for HIDS in children.
    European Journal of Pediatrics 02/2015; DOI:10.1007/s00431-015-2505-9 · 1.98 Impact Factor
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    ABSTRACT: Excess moisture and visible mold are associated with increased risk of asthma. Only a few studies have performed detailed home visits to characterize the extent and location of moisture damage and mold growth. Structured home inspections were performed in a birth cohort study when the children were 5 months old (on average). Children (N = 398) were followed up to the age of 6 years. Specific immunoglobulin E concentrations were determined at 6 years. Moisture damage and mold at an early age in the child's main living areas (but not in bathrooms or other interior spaces) were associated with the risk of developing physician-diagnosed asthma ever, persistent asthma, and respiratory symptoms during the first 6 years. Associations with asthma ever were strongest for moisture damage with visible mold in the child's bedroom (adjusted odds ratio: 4.82 [95% confidence interval: 1.29-18.02]) and in the living room (adjusted odds ratio: 7.51 [95% confidence interval: 1.49-37.83]). Associations with asthma ever were stronger in the earlier part of the follow-up and among atopic children. No consistent associations were found between moisture damage with or without visible mold and atopic sensitization. Moisture damage and mold in early infancy in the child's main living areas were associated with asthma development. Atopic children may be more susceptible to the effects of moisture damage and mold. Copyright © 2015 by the American Academy of Pediatrics.
    Pediatrics 02/2015; 135(3). DOI:10.1542/peds.2014-1239 · 5.30 Impact Factor
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    ABSTRACT: AimToll-like receptors (TLR) 1, 2, 6 and 10, the TLR2 subfamily, are known to be associated with immunity against tuberculosis. We evaluated whether polymorphisms in genes encoding TLR1, TLR2 and TLR6 were associated with osteitis in infants who received the Bacillus Calmette-Guérin (BCG) vaccination soon after birth.Methods Blood samples from 132 adults aged 21-49 who had BCG osteitis in early childhood, were analysed in a controlled study for TLR1 T1805G (rs5743618), TLR2 G2258A (rs5743708) and TLR6 C745T (rs5743810) gene single nucleotide polymorphisms.ResultsThe frequencies of the variant genotypes differed between the cases and controls: 11.4% versus 5.7% for TLR2 G2258A (p=0.033) and 77.3% versus 61.6% for TLR6 C745T (p=0.001). The TLR2 and TLR6 variant genotypes were associated with a higher risk of BCG osteitis, with adjusted odds ratios (aOR) of 2.154 (95%CI 1.026-4.521) and 1.907 (95%CI 1.183-3.075), respectively. The frequency of the TLR1 T1805G variant genotype was 19.7% in the cases and 33.6% in the controls (p=0.003). The TLR1 variant genotype was associated with a lower risk of BCG osteitis (aOR 0.554, 95%CI 0.336-0.911).Conclusion Gene polymorphisms that regulate the function of the TLR2 subfamily play a role in the development of BCG osteitis in vaccinated infants.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 01/2015; DOI:10.1111/apa.12927 · 1.84 Impact Factor
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    ABSTRACT: The aim of the study was to evaluate the association between previous use of ICS and bone mineral density (BMD) at school age in a cohort followed after early childhood wheezing. As part of a prospective follow-up study after hospitalization for wheezing at <24 months of age, BMD was measured in 89 children at 12.3 (median) years of age. Data on ICS use were collected by interviewing the parents, and this was supplemented with data from patient records. Cumulative doses and the duration of ICS use were calculated. Areal BMD (BMDareal , g/cm(2) ) was measured by dual energy X-ray absorptiometry (DXA), and apparent volumetric BMD (aBMDvol , g/cm(3) ) was calculated, for the lumbar spine and femoral neck. Weight, height and pubertal stage were recorded. Age, sex, and pubertal stage were significantly associated with BMDareal and aBMDvol of the lumbar spine and BMDareal of the femoral neck. The regular use of ICS for >6 months at age <6 years was associated with a lower BMD of the lumbar spine. A lower BMDareal and aBMDvol of the femoral neck were associated with higher cumulative doses of ICS at age 0-12.3 (median) years. The results were robust to adjustment for age, sex, pubertal stage, height, weight, and use of systemic steroids. ICS use during childhood may be related to a decrease in BMD at late school age. It is important to use the lowest possible ICS dose that maintains adequate asthma control. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.
    Pediatric Pulmonology 01/2015; 50(1). DOI:10.1002/ppul.22968 · 2.30 Impact Factor
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    ABSTRACT: BACKGROUND: Elevated serum Mead acid as a proportion of total fatty acids is an indirect marker of a deficiency of essential fatty acids (EFA). The aim of the study was to evaluate the symptoms and nutrition of food-allergic children with elevated or normal serum Mead acid. METHODS: Serum fatty acid compositions from 400 children were studied by clinical indications, mostly by suspicion of deficiency of EFA due to inadequate nutrition. A Mead acid level exceeding 0.21% (percentage of total fatty acids) was considered to be a specific sign of an insufficient EFA supply. From a total of 31 children with elevated Mead acid (MEADplus group), 23 (74%) had food allergy. The symptoms and dietary restrictions of this MEADplus group of food allergic children were compared to 54 age-and sex-matched controls with food allergy but normal Mead acid proportions (MEADminus group) before and 6 months after the serum fatty acid determination. RESULTS: At the beginning of the 6-month follow-up, 44% of the food allergic children in both MEADplus and MEADminus groups were on an elimination diet. These diets did not differ between the two groups and we were not able to document an association between the severity of elimination diet and elevated Mead acid proportion. However, the MEADplus children were on average more symptomatic than MEADminus children. In the MEADplus group, food allergy presented with skin symptoms in 100% (vs. 70% in the MEADminus group, p < 0.001) and with vomiting or diarrhea in 70% (vs. 44% in the MEADminus group, p < 0.05). Clinical suspicion of malnutrition resulted in increase in the use of vegetable oil and milk-free margarine in both groups from <50% to 65-74% during the follow-up. After 6 months, 64% of the MEADplus children with food allergy had been sent to a control serum fatty acid analysis. Of these children, Mead acid had declined to normal level in 69%, and remained elevated in 31%. CONCLUSIONS: Severe symptoms of food allergy combined with elimination diets in children may lead to insufficient nutrition presenting with elevated serum Mead acid. Adding of supplementary polyunsaturated fat to the diet should be considered in these children.
    Lipids in Health and Disease 12/2014; 13:180. DOI:10.1186/1476-511X-13-180 · 2.31 Impact Factor
  • Paula Heikkilä, Leena Forma, Matti Korppi
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    ABSTRACT: Up to 3% of infants with bronchiolitis under 12-months-of-age are hospitalised and up to 9% require intensive care. We evaluated the costs of bronchiolitis hospitalisation, with a special focus on whether infants needed intensive care. Baseline and cost data were retrospectively collected, using electronic hospital files, for 80 infants under 12-months-old who were treated in the paediatric intensive care unit (PICU) for bronchiolitis during a 13-year period. We calculated the daily costs for patients admitted to the PICU and compared them with 104 admitted to inpatient wards and 56 outpatients treated in the emergency department. The mean hospitalisation cost for PICU patients was €8,061 (95%CI 6,193-9,929), compared to €1,834 (1,649-2,020) for other inpatients and €359 (331-387) for the outpatients. The hospitalisation cost per patient was associated with length of hospital stay, but not gender, age on admission or gestational age. There was no constant increase or decrease in hospitalisation costs during the study period. The hospitalisation costs of infants treated in the PICU for bronchiolitis at less than 12-months-of-age were approximately four times more than for other inpatients and over 20 times more than for outpatients. Strategies are needed to reduce the need for intensive care This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Acta paediatrica (Oslo, Norway: 1992). Supplement 11/2014; 104(3). DOI:10.1111/apa.12881
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    ABSTRACT: AimThe role of inflammation in the bronchopulmonary dysplasia (BPD) survivors is indistinct. We evaluated lung function in relation to inflammatory markers in plasma, exhaled breath condensate and exhaled air in school-aged very low birth weight (VLBW) survivors with and without radiographic BPD.Methods Pre- and post-bronchodilator impulse oscillometry were performed by 21 six to 14-years-old VLBW children with radiographic BPD, 19 VLBW children without radiographic BPD and 19 age-matched non-asthmatic term controls. Eosinophilic cationic protein, interleukins 6 and 8, adiponectin, adipsin, leptin and resistin in plasma, leukotriene B4 and 8-isoprostane in exhaled breath condensate, andbronchial andalveolar nitric oxideoutput were measured.ResultsAbnormal lung function was found in 12.5% of the former VLBW children. Airway resistance at 5Hzwashighest in the radiographicBPD, but bronchodilator responses were most prominent in the nonBPD group.Plasma adiponectinhad a modest positive correlation with obstructionand with bronchodilatorresponses, and alveolar nitric oxideand plasma interleukin 6 withbronchodilator responses.ConclusionVLBW children with radiographic BPD had poorestlung function. The most pronounced bronchodilator responses were found in VLBW children without radiographic BPD. Current detected inflammatorymarkers had only a minor association with lung function in school-aged BPD survivorsThis article is protected by copyright. All rights reserved.
    Acta Paediatrica 10/2014; 104(3). DOI:10.1111/apa.12837 · 1.84 Impact Factor
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    ABSTRACT: AimThe Finnish national allergy programme was introduced in 2008 to decrease the burden of allergy in the population. This study, carried out in 2013, evaluated the prevalence of parent-reported food allergies, treated with an avoidance diet until early school age, and discussed the rates in relation to those found in an identical study in 2009.Methods School health nurses used a structured questionnaire to interview the parents of 1,653 children aged of six or seven in the first year of elementary school. The criterion for a parent-reported food allergy was that the parents considered it necessary for their child to follow an avoidance diet at school.ResultsIn 2013, 6.1% of the children were allergic to at least one food and 2.5% of the children were allergic to basic foods, such as cows’ milk, eggs and wheat, compared to 2.7% in 2009. A significant decrease was seen in allergies to nuts, fruits and vegetables.Conclusion Parent-reported allergies to basic foods, such as cow's milk, eggs and wheat, remained rather stable in first-graders of elementary schools during the first five years of the Finnish national allergy programme, but allergies to nuts, fruits and vegetables decreased.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 09/2014; DOI:10.1111/apa.12809 · 1.84 Impact Factor
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    ABSTRACT: Viral bronchiolitis is a major cause of hospitalization in infancy, with increased asthma risk in later childhood. However, the principal mechanisms behind post-bronchiolitic asthma have remained unclear. Previously, different cytokine polymorphisms have been associated with asthma occurrence, but no previous follow-up study has investigated cytokine polymorphisms in relation to post-bronchiolitic asthma. We hypothesized that former bronchiolitis patients with cytokine gene variants associating with Th2 cell up-regulation are at asthma risk at preschool age. Our emphasis was in IL10 rs1800896, since IL-10 has an important role in immune tolerance, and lower production of IL-10 has been associated with Th2-type immunology, and accordingly, with increased asthma risk. IL10 rs1800896, IFNG rs2430561, and IL18 rs1872387 polymorphims and their associations with asthma and allergy were studied in 135 preschool-aged children hospitalized for bronchiolitis at age 0-6 months. Parents were interviewed to record asthma and allergy from infancy to present. At age 6.4 years (mean), asthma was present in 17(12.6%), atopic eczema in 47(34.8%) and allergic rhinitis in 36(26.7%) children. IL10 rs1800896 SNP associated significantly with asthma; only 1/32 (3.1%) of those with G/G genotype had asthma (P = 0.04). In logistic regression adjusted for gender, age and atopy, the carriage of allele A (rs1800896) was a significant risk factor for preschool asthma. IFNG rs2430561 or IL18 rs1872387 SNP's had no associations with asthma or allergy. In conclusion, IL10 rs1800896 SNP was significantly associated with preschool asthma after severe lower respiratory tract infection in early infancy. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.
    Pediatric Pulmonology 08/2014; 49(8). DOI:10.1002/ppul.22909 · 2.30 Impact Factor
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    ABSTRACT: Objective: To determine whether hospital length-of-stay (LOS) for bronchiolitis is influenced by the causative virus: respiratory syncytial virus (RSV) or rhinovirus. Methods: This prospective study was carried out in 3 university hospitals in Finland during 2 consecutive winter seasons. We enrolled consecutive children <2 years of age hospitalized with an attending physician's diagnosis of bronchiolitis. All enrolled children were included in the primary analysis. A parallel analysis was also conducted using a stricter definition for bronchiolitis (age <12 months and no history of wheeze). Polymerase chain reaction was used to test the nasopharyngeal aspirate samples for multiple respiratory pathogens. Results: The median age of the 408 children was 8 months, 73% had no history of wheeze and their median hospital LOS was 2 days. 144 (35%) children had RSV only and 92 (23%) children rhinovirus only infections. Children with rhinovirus only had shorter duration of prehospital symptoms, higher disease severity score at entry and more often a history of wheezing (all P <= 0.001). Controlling for 7 demographic and clinical characteristics, those with rhinovirus only had shorter hospital LOS when compared with children with RSV only (adjusted odds ratio: 0.45; 95% confidence interval: 0.22-0.92; P = 0.03). The rhinovirus only finding was similar in the subset of 206 children with stricter diagnosis (adjusted odds ratio: 0.30; 0.06-1.49; P = 0.14). Conclusions: Hospital LOS is associated with rhinovirus etiology of bronchiolitis. Our data call attention to the importance of both RSV and rhinovirus testing in clinical research.
    The Pediatric Infectious Disease Journal 08/2014; 33(8):829-834. DOI:10.1097/INF.0000000000000313 · 3.14 Impact Factor
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    ABSTRACT: Background and AimsObesity has been linked with asthma symptoms, need for asthma treatment and reduced lung function but not with increased bronchial reactivity in children. The aim of this study was to evaluate the association between previous or current weight status and current lung function and bronchial reactivity to exercise at early school age.Methods Ninety-nine children hospitalized for bronchiolitis at the age of less than 6 months were studied with impulse oscillometry (IOS) at the mean age of 6.3 years. Data on birth weight and weight gain in infancy before hospitalization were collected during hospitalization. Current weight and height data were transformed into age- and sex-specific height-related body mass index z scores (zBMI) using the Finnish national population-based weight and height data as reference.ResultsSome significant though only low or modest correlations were found between current zBMI and baseline, post-exercise and post-bronchodilator IOS values in adjusted linear regression analysis. Seven obese children by zBMI had higher post-bronchodilator airway impedance (Zrs) and resistance (Rrs) at 5 Hz and lower post-bronchodilator frequency dependency of resistance (dRrs/df) than normal weight children. There were no significant differences in responses to exercise or to bronchodilators between currently obese or overweight children and normal weight children. Birth weight less than 3,000 g was associated with larger exercise-induced changes in Zrs and Rrs at 5 Hz, and in reactance (Xrs) at 5 Hz, than those with birth weight more than 3,000 g.Conclusions Preliminary evidence was found that obesity may be associated with airway obstruction, but not with bronchial hyper-reactivity. Pediatr Pulmonol. © 2014 Wiley Periodicals, Inc.
    Pediatric Pulmonology 07/2014; DOI:10.1002/ppul.23085 · 2.30 Impact Factor
  • Matti Korppi
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    ABSTRACT: Bronchiolitis is a viral lower respiratory tract infection characterised by inflammation and obstruction of the small airways. Respiratory syncytial virus (RSV) is the most common causative agent, followed by parainfluenza viruses, adenoviruses and the recently discovered metapneumovirus. Birth cohort studies have reported that the incidence of bronchiolitis is 18–32% during the first year of life, and 1–3% of infants need hospitalisation for bronchiolitis, with the majority being admitted before six-months-of-age (1).This article is protected by copyright. All rights reserved.
    Acta Paediatrica 07/2014; 103(10). DOI:10.1111/apa.12737 · 1.84 Impact Factor
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    ABSTRACT: All respiratory viruses are capable of causing lower respiratory tract infections. Active testing of influenza viruses during influenza epidemics is recommended. Antitussive medications are ineffective and should not be used. Croup presenting with inspiratory stridor is recommended to be treated with oral corticosteroids and inhaled racemic adrenalin. Corticosteroids and inhaled racemic adrenalin are ineffective for the treatment of bronchiolitis. Inhaled salbutamol administered by a spacer (with a mask) is recommended for wheezy bronchitis. Amoxicillin is recommended for treating pneumonia at home and intravenous penicillin in hospital (combined with macrolide if mycoplasma is suspected). Pertussis is treated with azithromycin or clarithromycin.
    Duodecim; lääketieteellinen aikakauskirja 06/2014; 130(15):1560-.
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    ABSTRACT: Early-life exposure to environmental microbial agents may be associated with the development of allergies. The aim of the study was to identify better ways to characterize microbial exposure as a predictor of respiratory symptoms and allergies.
    Allergy 06/2014; DOI:10.1111/all.12439 · 6.00 Impact Factor
  • Pediatrics 05/2014; 133(6). DOI:10.1542/peds.2014-0871 · 5.30 Impact Factor
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    Matti Korppi
    Acta Paediatrica 05/2014; DOI:10.1111/apa.12660 · 1.84 Impact Factor
  • Matti Korppi
    The Pediatric Infectious Disease Journal 05/2014; 33(5):546-7. DOI:10.1097/INF.0000000000000255 · 3.14 Impact Factor
  • Matti Korppi
    Pediatric Pulmonology 05/2014; 49(5). DOI:10.1002/ppul.22939 · 2.30 Impact Factor
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    ABSTRACT: Elevated white blood cells (WBC) in blood and C-reactive protein (CRP) in serum are often used as nonspecific markers for bacterial etiology of infection in children. The aim of the present study was to evaluate how rapid WBC and CRP testing influences the patient flow and costs in the pediatric emergency room (ER). The study was a retrospective chart review. In all, 166 children who were treated during three months in the ER of a children's hospital, and in whom rapid tests for WBC and CRP were done, were included. The association between rapid testing and the length of ER stay was evaluated, and the costs of rapid tests were compared with corresponding costs if done in hospital laboratory. The median ER stay lasted 147.5 min, if no other examinations than rapid CRP and WBC tests were taken and if no emergency treatments were given, compared with 201.5 min in those with other laboratory tests obtained or emergency treatments given (p<0.001). The respective figures were 142.5 and 179.5 min in those 96 children discharged home (p=0.003). The costs of rapid testing were only 41.5 % of the corresponding costs in laboratory. The simultaneous rapid testing of CRP and WBC in children with presumable infection decreased the costs and shortened the length of ER stay, if no other examinations or emergency treatment were needed. The costs of rapid testing were less than half of the corresponding costs in laboratory.
    Pediatrics International 04/2014; 56(5). DOI:10.1111/ped.12353 · 0.73 Impact Factor
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    ABSTRACT: Recent studies have revealed that adulthood asthma has its origin in early childhood. The aim of the present study was to evaluate the prevalence of asthma and respiratory health-related quality of life in adults 30 years after hospitalization for bronchiolitis or pneumonia in infancy. Patients who were hospitalized for bronchiolitis or pneumonia at age under 24 months in 1981-1982 have been followed in repeated visits. In 2010, 48 of the 83 former patients with bronchiolitis (57.8%), 22 of the 44 former patients with pneumonia (50.0%), and 138 matched controls participated in the clinical study at the age of 28-31 years. The participants completed a structured questionnaire on respiratory symptoms, the Saint George's Respiratory Questionnaire (SGRQ), and underwent 2-week peak expiratory flow (PEF) monitoring. Asthma was defined as doctor-diagnosed and self-reported asthma based on doctor-prescribed medication for asthma, the presence of asthma-presumptive symptoms, and the results of home PEF monitoring. Both doctor-diagnosed asthma (31.3% vs. 10.9% adjusted P = 0.002) and self-reported asthma (35.4% vs. 14.5% 0.003), as well as repeated on-demand use of bronchodilators (35.4% vs. 14.5% 0.002), and regular use of inhaled corticosteroids (20.8% vs. 8.7% 0.023) were more common in former bronchiolitis patients than in controls. Former bronchiolitis and pneumonia patients had higher total SGRQ scores than controls. The median scores were 5.4 (IQ25-75 0.0-14.7, P < 0.001) in bronchiolitis group, 4.9 (1.3-14.8, 0.012) in pneumonia group compared to controls 1.5 (0.0-6.0). Hospitalization for bronchiolitis in infancy is associated with an increased risk of asthma, and an increased use of asthma medication in adulthood at the age of 28-31 years. Impaired respiratory health-related quality of life in adulthood as measured by the SGRQ is present after bronchiolitis and pneumonia in infancy. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.
    Pediatric Pulmonology 04/2014; 49(4). DOI:10.1002/ppul.22842 · 2.30 Impact Factor

Publication Stats

6k Citations
842.15 Total Impact Points

Institutions

  • 2015
    • University of Eastern Finland
      • School of Medicine
      Kuopio, Eastern Finland Province, Finland
  • 2007–2015
    • University of Tampere
      • Paediatric Research Centre
      Tammerfors, Pirkanmaa, Finland
  • 2007–2014
    • Tampere University Hospital (TAUH)
      Tammerfors, Pirkanmaa, Finland
  • 2010
    • The Chinese University of Hong Kong
      • Department of Medicine and Therapeutics
      Hong Kong, Hong Kong
  • 1996–2010
    • University of Kuopio
      • Department of Paediatrics
      Kuopio, Northern Savo, Finland
  • 1988–2010
    • Kuopio University Hospital
      • Department of Paediatrics
      Kuopio, Northern Savo, Finland
  • 1986–2004
    • University of Turku
      • Department of Paediatrics
      Turku, Varsinais-Suomi, Finland
  • 1996–2003
    • National Public Health Institute
      Helsinki, Southern Finland Province, Finland
  • 2001
    • Pohjois-Karjalan Sairaanhoito
      Yoensu, Eastern Finland Province, Finland
  • 1989–1991
    • Helsinki University Central Hospital
      Helsinki, Uusimaa, Finland