M Kormano

Turku University Hospital, Turku, Province of Western Finland, Finland

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Publications (119)301.14 Total impact

  • M. Maass, M. Kosonen, M. Kormano
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    ABSTRACT: Purpose: To identify costs deriving from data migration of obsolete digital archives by measuring the workload, and to analyse migration-associated problems.Material and Methods: Two digital archives were used (DTL and MOD) and the capacity of these archives could no longer support the needs of the Medical Imaging Centre. The entire content of the DLT archive and selected data from the MOD archive were transferred to the current higher capacity (17 TB) tape archive. The running time of work processes was measured by self-reporting, and the cost of work was calculated.Results: The transfer of 43,096 studies required 314 working hours over the course of 15 months in total. The work was partly manual, partly automatic. The percentage of non-retrievable MOD images was 35. Less than 0.2% of the DLT image transfers failed due to incorrect patient or image data. The MOD – DLT transfer cost was six times higher per study than the DLT – DLT transmission cost.Conclusion: At present, data migration may be inevitable as the amount of data increases and technology advances. The data transfer proved to be labour intensive, with high fault sensitivity regarding the MOD archive. The cost of work of data migration was 0.4% of estimated digital archiving total yearly cost. Automated data migration is preferable.
    Acta Radiologica 12/2001; 42(4):426 - 429. · 1.33 Impact Factor
  • M Maass, M Kosonen, M Kormano
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    ABSTRACT: Introduction of a picture archiving and communication system (PACS) into an old hospital poses several problems since the system cannot be implemented instantaneously. We analysed the costs of a halfway implemented PACS in Turku University Central Hospital (TUCH) during 1998. Manual and digital archiving in 1998 continued parallel so that only 10% reduction of film usage was achieved. A 21% increase in image manipulation and storage expenses occurred. A calculation based on potential 90% reduction of film usage and changes in the amount of personnel suggest some direct savings. Also, indirect savings due to more efficient patient treatment and the reduction of time spent in the hospital, and overhead costs of information handling are expected to lead to savings. However, these savings were not included in our calculations. When full-scale PACS is installed, equipment investments, network and digital ware maintenance costs will drop from 121 to 116% compared with traditional film archiving activity costs.
    Computer Methods and Programs in Biomedicine 08/2001; 66(1):41-5. · 1.56 Impact Factor
  • M Maass, M Kosonen, M Kormano
    [show abstract] [hide abstract]
    ABSTRACT: To identify costs deriving from data migration of obsolete digital archives by measuring the workload, and to analyse migration-associated problems. Two digital archives were used (DTL and MOD) and the capacity of these archives could no longer support the needs of the Medical Imaging Centre. The entire content of the DLT archive and selected data from the MOD archive were transferred to the current higher capacity (17 TB) tape archive. The running time of work processes was measured by self-reporting, and the cost of work was calculated. The transfer of 43,096 studies required 314 working hours over the course of 15 months in total. The work was partly manual, partly automatic. The percentage of non-retrievable MOD images was 35. Less than 0.2% of the DLT image transfers failed due to incorrect patient or image data. The MOD - DLT transfer cost was six times higher per study than the DLT - DLT transmission cost. At present, data migration may be inevitable as the amount of data increases and technology advances. The data transfer proved to be labour intensive, with high fault sensitivity regarding the MOD archive. The cost of work of data migration was 0.4% of estimated digital archiving total yearly cost. Automated data migration is preferable.
    Acta Radiologica 08/2001; 42(4):426-9. · 1.33 Impact Factor
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    ABSTRACT: A total of 39 patients who had undergone microdiscectomy or percutaneous nucleotomy for lumbar disc herniation were examined after a follow-up of 5 years. The overall outcome was satisfactory in 80% of the patients treated, and only 1 (3%) patient had been reoperated during the follow-up. Clinical signs and symptoms of lumbar instability were detected in 10 (26%) patients. All these 39 patients had been examined with lumbar magnetic resonance imaging (MRI) on the day preceding the operation; the presence of disc degeneration was graded as severe, mild or non-existent depending on the visual brightness of the discs on T2-weighted images, as compared to the signal intensity of the lumbar vertebrae. None of the 12 patients with no preoperative disc degeneration in MRI suffered from postoperative clinical signs and symptoms of instability as compared to 10 (37%) of the 27 patients with mild or severe disc degeneration suffering from instability (p = 0.04). Thus, the results of the present study imply that the grade of the disc degeneration in preoperative T2-weighted MR images significantly predicted the occurrence of postoperative clinical instability.
    min - Minimally Invasive Neurosurgery 04/2001; 44(1):31-6. · 0.62 Impact Factor
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    ABSTRACT: Coronary flow reserve (CFR) measurements have been widely used in assessing the functional significance of coronary artery stenosis because they are more sensitive in predicting major cardiac events than angiographically detected reductions of coronary arteries. Myocardial blood flow can be determined by measuring coronary sinus (CS) flow with velocity-encoded cine magnetic resonance imaging (VEC-MRI). The purpose of this study was to compare global myocardial blood flow (MBF) and CFR measured using VEC-MRI with MBF and CFR measured using positron emission tomography (PET). We measured MBF at baseline and after dipyridamole-induced hyperemia in 12 male volunteers with VEC-MRI and PET. With VEC-MRI, MBF was 0.64 +/- 0.09 (ml/min/g) at baseline and 1.59 +/- 0.79 (ml/min/g) at hyperemia, which yielded an average CFR of 2.51 +/- 1.29. With PET, MBF was 0.65 +/- 0.20 (ml/min/g) at baseline and 1.78 +/- 0.72 (ml/min/g) at hyperemia, which yielded an average CFR of 2.79 +/- 0.97. The correlation of MBFs between these two methods was good (r = 0.82, P < 0.001). The CFRs measured by MRI correlated well with those measured using PET (r = 0.76, P < 0.004). These results suggest that MRI is a useful and accurate method to measure global MBF and CFR. Therefore, it would be suitable for studying risk factor modifications of vascular function at an early stage in healthy volunteers.
    Journal of Magnetic Resonance Imaging 04/2001; 13(3):361-6. · 2.57 Impact Factor
  • M Maass, A Kiuru, M Kormano
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    ABSTRACT: This study was designed to evaluate effectiveness of radiological image data compression in terms of image quality and archiving material costs using DLT tapes, and to assess the relationship between loss of quality and cost savings. Six radiologists used Subjective Fidelity Criteria (SFC) in random fashion to evaluate the quality of 105 digitally acquired radiological images. In addition, 5 radiologists and 2 nonradiologists evaluated at random three phantom images exposed in conditions mimicking chest, bone, and colon examinations, displayed in five modes (a total of 15 images). Both patient images and phantom images were submitted to 3:1 (Ziv-Lempel method) and 10:1 compression (wavelet-based compression method). Cost information on material cost savings and the effect of compression on tape space requirements were compared. The results indicate that image quality was not degraded using either of the compression ratios. The interobserver proportion of agreement exceeded overwhelmingly the limit of a good proportion of agreement regarding each compression ratio and each image type. The divergence in the rest of the assessments was not consistent. The adoption of 10:1 compression would not bring a substantial decrease of archiving costs as compared to the total yearly operating costs, and especially as considering the consequences of possible image quality deterioration.
    Telemedicine and e-Health 02/2001; 7(3):267-71. · 1.40 Impact Factor
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    ABSTRACT: Dynamic Chest Image Analysis aims to develop model-based computer analysis and visualization methods for showing focal and general abnormalities of lung ventilation and perfusion based on a sequence of digital chest fluoroscopy frames collected with the Dynamic Pulmonary Imaging technique. We have proposed and evaluated a multiresolutional method with an explicit ventilation model based on pyramid images for ventilation analysis. We have further extended the method for ventilation analysis to pulmonary perfusion. This paper focuses on the clinical evaluation of our method for perfusion analysis. Three clinical cases are included to illustrate the effects of contrast media in perfusion analysis and a dozen clinical cases without using contrast media are used for evaluation. Our clinical evaluation shows that our method is effective for pulmonary embolism, demonstrating consistent correlations with computed tomography (CT) and nuclear medicine (NM) studies. This performance is the consequence of the idea that the cardiac information recorded in the perfusion image sequence may be utilized to accelerate pulmonary perfusion analysis and improve its sensitivity in detecting pulmonary embolism
    Engineering in Medicine and Biology Society, 2001. Proceedings of the 23rd Annual International Conference of the IEEE; 02/2001
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    ABSTRACT: Previous studies using intravascular Doppler sonography and positron emission tomography (PET) have shown that the hemodynamic significance of coronary artery stenosis can be evaluated by measuring coronary flow reserve. The purpose of this study was to assess whether MR imaging measurements of coronary flow reserve in the left anterior descending artery are comparable with those obtained with PET in the corresponding territory. MR imaging and PET flow measurements were obtained in 10 healthy volunteers. Blood flow velocity in the left anterior descending artery was measured with breath-hold velocity-encoded cine MR imaging before and after IV administration of dipyridamole. The coronary flow velocity reserve measured by MR imaging was compared with the myocardial perfusion reserve in the anterior myocardium quantified on using PET and (15)O-labeled water. The average flow velocity reserve in the left anterior descending artery measured on MR imaging was 2.44+/-1.14 in healthy volunteers, which was comparable with the myocardial perfusion reserve measured by PET (2.52+/-0.84). MR imaging and PET measurements of the coronary flow reserve showed a significant correlation (r = 0.79, p<0.01). MR imaging measurement of the flow velocity reserve in the proximal left anterior descending artery correlates well with the myocardial perfusion reserve obtained with PET and (15)O-labeled water.
    American Journal of Roentgenology 10/2000; 175(4):1029-33. · 2.90 Impact Factor
  • M Maass, M Kosonen, M Kormano
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    ABSTRACT: Since 1996, Turku University Central Hospital has offered teleradiology consultations regarding computerized tomography examinations of the brain to three regional hospitals in Finland, in which neurosurgical or neuroradiological specialist services are not available, in order to avoid unnecessary patient transportation. We performed a retrospective survey of the teleconsultations performed in 1998. Medical records and the relevant radiology images were obtained. During the study period, teleconsultations were carried out for a total of 83 patients, of whom 16 were transported to the university hospital (i.e. 81% of these patients had avoided unnecessary transportation). The total savings amounted to 42,100 ECU. Of the 16 transported patients, 12 were immediately operated on in the university hospital. It was judged that, because of the consultation service, the patients undergoing an operation had benefited from a more rapid and a more complete recovery. In 1998 the teleradiology consultation service was established as part of the routine work of the Medical Imaging Centre and a fee for its services was adopted.
    Journal of Telemedicine and Telecare 02/2000; 6(3):142-6. · 1.47 Impact Factor
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    ABSTRACT: To test a new software tool developed for analysis of radiology reports and to compare CT reports from four different teaching hospitals. Four hundred CT reports were randomly collected from four Finnish university hospitals. A Windows 3.1-based software tool was developed to make a comparative analysis of the information content of CT reports. The structure of the reports was partly analyzed manually. The new software tool greatly facilitated semiquantitative analysis of the information content of residents' and radiologists' reports. There were some local differences in the length and structure of the reports, the choice of vocabulary and the number of differential diagnoses given, and large differences in the use of an "impression" section. Thorough description of focal lesions was included in less than 50% of the reports from each of the four institutions. The variation in well-structured CT reports indicates considerable geographic differences in radiology reporting, which may reflect the long-term influences of a few teachers. Rational application of the communication standards should improve the quality of written radiology reports. Such standards should be emphasized, particularly in teaching hospitals.
    Acta Radiologica 02/2000; 41(1):102-5. · 1.33 Impact Factor
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    ABSTRACT: The development of a novel positioning device for magnetic resonance imaging of the upper cervical spine and an evaluation of motion patterns of the craniovertebral junction in asymptomatic volunteers as a part of the whole cervical spine motion. To design and construct a positioning device that enables magnetic resonance imaging of the cervical spine in rotation, lateral bending, flexion, and extension in a horizontally open magnetic resonance scanner, and to define reference values for movements of the occiput (C0), the atlas (C1), and the axis (C2) in asymptomatic volunteers. In previously used devices, the direction of motion is limited usually to flexion-extension, or the position of the head and neck are adjusted without a positioning device using semihard wedges or pillows. Magnetic resonance imaging of the upper cervical spine in 20 asymptomatic individuals (10 men and 10 women) was performed in a horizontally open 0.23-T magnetic resonance imager in progressive steps during rotation, lateral bending, and flexion-extension using axial, coronal, and sagittal imaging planes, respectively. The positions of C0, C1, and C2 were measured, and pattern of motions between segments analyzed. Lateral displacement of the atlas during lateral bending and cranial migration distance during flexion-extension were assessed. The nonferromagnetic positioning device was designed and constructed. The motion patterns of the craniovertebral junction during rotation did not differ between the men and women, but in lateral bending there was a small difference between genders at C1-C2. In men, the position of C1 during flexion-extension was consistently more extended in relation to C0 and C2 than in women. The new positioning device allows magnetic resonance imaging of the upper cervical spine during flexion, extension, rotation, and lateral bending. To assess the relationship between C0-C1 and C1-C2 in flexion and extension, separate reference values for men and women are recommended.
    Spine 11/1999; 24(19):2046-56. · 2.16 Impact Factor
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    ABSTRACT: A prospective 9-year follow-up study involving randomized matched subgroups of 15-year-old schoolchildren with or without low back pain at baseline. To evaluate the long-term persistence of initially reported recurrent low back pain, and to examine the significance of abnormalities found in magnetic resonance imaging of lumbar discs in individuals 15 and 18 years of age as possible contributors to persistently recurrent low back pain. In surveys among children and teenagers during the past few years, as many as half of all children in a community report a history of low back pain. The current results, in accordance with previous findings, indicate that there is a subgroup of adolescents with more chronic symptoms which, in the authors' opinion, deserves more attention. Disc disease accompanying low back pain is a key issue both in research and clinical practice. The significance of early degenerative findings in the lumbar discs is not known. In the survey of 14-year-olds (n = 1503), a subgroup (7.8%) with recurrent low back pain was found. A random sample of individuals with recurrent low back pain (n = 40) and an equal number of completely asymptomatic control subjects were selected for a comparative study. The selected groups were examined by magnetic resonance imaging at 15 and 18 years of age. The participation rate of youth at 14, 18, and 23 years of age for all three questionnaires was 82% (29 boys and 33 girls). Imaging data were interpreted by two blinded radiologists experienced in low-field-strength magnetic resonance imaging. In calculations of relative risks, the participants reporting recurrent low back pain in all phases of the study were compared with participants who had no persistently recurrent pain. Eleven participants (35%) in the original group with low back pain persistently reported recurrent pain. In 15-year-old participants with disc degeneration, the relative risk of reporting recurrent low back pain up to the age of 23 years was 16 (95% confidence interval 2.2-118) compared with those having no disc degeneration. In addition, disc protrusion and Scheuermann-type changes at 15 years contributed to the risk of persistently recurrent low back pain. The authors' earlier findings already favored the hypothesis of a causal relation between the early evolution of a degenerative process of lower lumbar discs and recurrent low back pain in the near future. The current results further strengthen this hypothesis, indicating that individuals with disc degeneration soon after the phase of rapid physical growth not only have an increased risk of recurrent low back pain at this age, but also a long-term risk of recurrent pain up to early adulthood.
    Spine 08/1999; 24(13):1316-21. · 2.16 Impact Factor
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    ABSTRACT: The aim of this study was to investigate sequential neuroradiologic changes in the brains of infants after transient neonatal hypoglycemia. We used magnetic resonance imaging (MRI) and ultrasonography (US) head scans. Eighteen symptomatic full-term infants whose serum glucose concentrations were </=45 mg/dL (2.5 mmol/L) without any other diseases were included in the hypoglycemic group. MRI and US head scans were performed at full-term age and at the age of 2 months. The imaging results were compared with the findings of MRI and US scans in 19 healthy normoglycemic term newborn infants at the respective ages. The neurologic outcome was followed in the both groups. MRI or US showed evidence of abnormality in 39% the hypoglycemic infants. MRI detected more abnormalities in the brains than US. Four infants showed patchy hyperintensity lesions either in the occipital periventicular white matter or the thalamus on T1-weighted images. These lesions had a good tendency to recover and only 1 of these infants appeared to be neurologically affected. Of the 19 controls, 10% (2 of 19) had caudothalamic cysts, which were detected both with MRI and US. The relative risk of the hypoglycemic child compared with nonhypoglycemic child, to have any abnormality detected in the brain, was 3.7, with a 90% confidence interval from 1.11 to 12.28. Postnatal full-term MRI and US scans showed abnormalities four times more often after transient neonatal hypoglycemia than in the healthy control group. However, most often lesions were absent 2 months later. The clinical relevance of these abnormal findings remains to be clarified with detailed neurologic examinations and follow-up.
    Pediatrics 05/1999; 103(4 Pt 1):724-9. · 5.12 Impact Factor
  • K Heikkinen, M Kormano
    Duodecim; lääketieteellinen aikakauskirja 02/1999; 115(22):2465-70.
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    ABSTRACT: The purpose of this study was to evaluate 1/T1rho in relation to 1/T1 and 1/T2 in characterizing normal and diseased muscle. We measured the muscle relaxation rates 1/T1 and 1/T2 at 0.1 T and 1/T1rho at on-resonance locking fields B1 between 10 and 160 microT in myositis patients and normal volunteers. 1/T2 and 1/T1rho of muscle were lower in the patients than in the volunteers, whereas there was no difference in the 1/T1 values. The lower relaxation rates 1/T2 and 1/T1rho in the diseased muscle may be due to fat and connective tissue infiltrations and edema. 1/T1rho contrast between muscle and subcutaneous fat was higher than 1/T2 and 1/T1 contrast. This may be explained by the different B1 dispersion behavior of these two tissue types. 1/T1rho of fat is B1 field independent, whereas 1/T1rho of muscle decreases clearly with increasing B1 field. In conclusion, 1/T1rho provides a useful tool in manipulating contrast in magnetic resonance imaging of diseased muscle.
    Magnetic Resonance Imaging 06/1998; 16(4):385-91. · 2.06 Impact Factor
  • A Virta, M Komu, N Lundbom, M Kormano
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    ABSTRACT: The authors evaluated the value of T1 rho in relation to T1 and T2 in the characterization of human muscles. The authors studied the effect of muscle type (anterior tibial [AT] and gastrocnemius [GC]), sex, and age on 1/T1 and 1/T2 at 0.1 T and on 1/ T1 rho at locking-field B1s (spin-locking radio-frequency magnetic induction field) of 10-160 microT in 38 healthy volunteers. The contrast-to-noise ratio (CNR) between muscle and fat was evaluated with different T1-, T2-, and T1 rho-weighted magnetic resonance (MR) sequences. The 1/T1, 1/T2, and 1/T1 rho were slightly higher in AT than in GC muscles. The 1/T2 and 1/T1 rho of AT muscles showed a sex dependence, whereas no correlation with age was found. The CNR of the T1 rho-weighted images did not markedly differ from that of the T1- and T2-weighted images. T1 rho is as sensitive as T2 to the composition of muscle, whereas T1 is less sensitive. In MR imaging of normal muscle, T1 rho and T2 provide a relatively similar tissue contrast.
    Academic Radiology 03/1998; 5(2):104-10. · 1.91 Impact Factor
  • K Heikkinen, M Kormano
    Duodecim; lääketieteellinen aikakauskirja 02/1998; 114(20):2053-8.
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    ABSTRACT: The aim of the study “dynamic chest image analysis” is to develop computer analysis and visualization methods for showing focal and general abnormalities of lung ventilation and perfusion based on a sequence of digital chest fluoroscopy frames collected at different phases of the respiratory/cardiac cycles in a short period of time. A multiresolutional method for ventilation study with an explicit ventilation model based on pyramid images is proposed. The model aims at extracting accurate, geographic ventilation parameters, and the pyramid helps in understanding ventilation at multiple resolutions and speeding up the convergence process in optimization. A research prototype has been produced in MATLAB. Both artificial signals and clinical cases are used for the evaluation. For artificial signals, the authors use the true parameters as reference for quantitative examination of the result accuracy. For clinical cases (including 53 patients), they visually divide the lung field into several regions (apex; upper, mid, lower fields; lateral; and base), classify the regional, functional abnormalities into five types (no ventilation, reduced ventilation, asynchronous ventilation, non-symmetrical ventilation and compensatory ventilation) and use high resolution computed tomography (HRCT) as reference to examine the correlation between structural abnormalities and functional abnormalities. They have found that asynchronous ventilation and non-symmetrical ventilation are the most frequent functional abnormalities
    Intelligent Processing Systems, 1997. ICIPS '97. 1997 IEEE International Conference on; 11/1997
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    ABSTRACT: The recently introduced horizontally open configuration imagers allow imaging of knee, hip or shoulder during whole range of motion, which is not possible in conventional MR imagers. Special joint motion devices can be used to provide accurate and reproducible studies. In cervical spine, functional MR imaging may be useful in evaluating alarligament stability in patients with late sequelae of a whiplash injury, and in patients with rheumatoid arthritis who are clinically suspected of having a cervical myelopathy or superior migration of the odontoid process. In shoulder, full range of motion abduction study may be helpful in assessing the supraspinatus tendon impingement. To evaluate patellofemoral malalignment, quadriceps loading is recommended since associated contracting muscles and related soft tissue structures can be evaluated. The position of the femoral head relative to the acetabulum during different positions can be assessed. Open-configuration scanners provide an access to patients during scanning procedure, and therefore permit interventional procedures to be monitored with MRI. Such interventions include aspiration cytology/biopsy and different drainage procedures.
    Der Radiologe 11/1997; 37(10):819-24. · 0.47 Impact Factor
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    ABSTRACT: To study the changes in pharyngeal behavior after laser uvulopalatopharyhgoplasty (LUPPP). The dynamic changes in the upper airway size were evaluated with digital fluoroscopy in 24 patients with obstructive sleep apnea (OSA) before and after LUPPP and in 16 normal controls, while they were awake and breathing normally. Cephalometric measurements were also made. The patients were classified into the categories of good and poor responders by means of a static-charge-sensitive bed. Following LUPPP, collapsibility at the velopharyngeal level was within the normal range m 15 of 17 good responders, but only in 2 of 7 poor responders (p = 0.0086). The minimum airway size at the same level showed a similar trend. In 3 of 7 poor responders the hyoid bone was positioned more caudally than in the good responders (p = 0.017). Digital fluoroscopy provides information on the change in upper airway behavior after LUPPP.
    Acta Radiologica 04/1997; 38(2):214-21. · 1.33 Impact Factor

Publication Stats

1k Citations
19 Downloads
301.14 Total Impact Points

Institutions

  • 1988–2001
    • Turku University Hospital
      • • Department of Radiology
      • • Department of Pediatrics
      Turku, Province of Western Finland, Finland
    • University of Turku
      • Department of Diagnostic Radiology
      Turku, Western Finland, Finland
  • 1997
    • Kuopio University Hospital
      • Department of Surgery
      Kuopio, Province of Eastern Finland, Finland
  • 1994
    • VTT Technical Research Centre of Finland
      Esbo, Southern Finland Province, Finland
  • 1989
    • Central Hospital Central Finland
      Jyväskylä, Province of Western Finland, Finland
  • 1987
    • Loyola University Medical Center
      Maywood, Illinois, United States