The association between chronic inflammation and the metabolic syndrome and their impact on development of cardiovascular disease in type 1 diabetes

Personer med typ 1-diabetes har ökad risk för att insjukna i kardiovaskulära sjukdomar. Målsättningen med studien är att undersöka sambandet mellan kronisk inflammation, metabolt syndrom och kardiovaskulär risk vid typ 1-diabetes. I den här uppföljningsstudien, som är en del av FinnDiane-studien, ingår 2665 personer med typ 1-diabetes utan diabetisk njursjukdom. Klinisk information om deltagarna samlades in under ett basalbesök. Kronisk inflammation undersöktes med hjälp av inflammationsmarkören C-reaktivt protein (hsCRP). Vi observerade ett samband mellan kronisk inflammation och metabolt syndom vid typ 1-diabetes. Alla komponenter av det metabola syndromet, förutom blodtryckskomponenten, hade ett samband med kronisk inflammation. Under en uppföljningstid på ca 17 år insjuknade 7 % av personerna i kardiovaskulär sjukdom. Trots att koncentrationen av hsCRP och prevalensen av metabolt syndrom var högre hos de som insjuknade i kardiovaskulär sjukdom under uppföljningstiden, kunde vi inte påvisa en additiv effekt av kronisk inflammation och metabolt syndrom för kardiovaskulär risk efter beaktande av övriga riskfaktorer. Sammanfattningsvis kan vi konstatera att vid typ 1-diabetes tillägger inte mätning av hsCRP-koncentration hos personer med metabolt syndrom signifikant information om personens risk för att insjukna i kardiovaskulär sjukdom. Studien utesluter dock inte att det kunde löna sig att mäta någon annan inflammationsmarkör för att utvärdera kardiovaskulär risk vid typ 1-diabetes

Från nyheter till söndagsläsning. Reportagestilens utveckling i tre dagstidningar under åren 1972-2002

Only abstract. Paper copies of master’s theses are listed in the Helka database (http://www.helsinki.fi/helka). Electronic copies of master’s theses are either available as open access or only on thesis terminals in the Helsinki University Library.Vain tiivistelmä. Sidottujen gradujen saatavuuden voit tarkistaa Helka-tietokannasta (http://www.helsinki.fi/helka). Digitaaliset gradut voivat olla luettavissa avoimesti verkossa tai rajoitetusti kirjaston opinnäytekioskeilla.Endast sammandrag. Inbundna avhandlingar kan sökas i Helka-databasen (http://www.helsinki.fi/helka). Elektroniska kopior av avhandlingar finns antingen öppet på nätet eller endast tillgängliga i bibliotekets avhandlingsterminaler.I uppsatsen undersöker jag med både kvantitativa och kvalitativa metoder hur användningen av berättartekniker i tre dagstidningars reportagetexter har förändrats under de tre senaste decennierna. Syftet var att ta reda på om det stämmer att reportagen har blivit 'tråkigare' och mindre personliga, vilket tycks vara en allmän uppfattning. De undersökta tidningarna är Dagens Nyheter, Hufvudstadsbladet och Västra Nyland, och som material använder jag texter från år 2002, 1987 och 1972. De fyra berättarteknikerna jag undersöker är förekomsten av berättelsestruktur, reporterns egen röst i texten samt miljö- och personbeskrivningar. Min kvantitativa mätning visar att det inte finns någon gemensam trend som gäller alla tidningarna. I DN syns en negativ trend mellan 1972 och 1987, med färre berättelser och mindre personliga texter, men den har svängt i och med de nya specialbilagorna som ofta satsar stort på reportage. Både Hbl och VN har genomgått en positiv förändring under den första 15-årsperioden, då texterna har blivit klart mer varierade och mindre stela. Indelningen i reportage och nyheter är dock klarare i DN än i Hbl och VN, vilket har lett till att reportagen i Hbl och VN under den andra 15-årsperioden också har påverkats mer av nyhetsformatet. Den andra delen av min undersökning är en textanalys av 17 utvalda reportagetexter, där jag mera på djupet diskuterar texternas egenskaper. Resultaten stöder de jag fick i den kvantitativa undersökningen: Referat och framför allt citat utgör den största delen av texten, medan reporterns egen röst hörs mera sällan. Reporterns röst har dessutom ändrat karaktär - han nöjer sig numera med att beskriva, i stället för att tycka och tolka som förr. Min slutsats är att tidningarnas specialbilagor har varit ett lyckat koncept då det gällt att stärka reportagets ställning. Detta syns speciellt i DN men också i Hbl. Därmed ser också dagstidningsreportagets framtid trots allt ganska ljus ut idag

Sosiaalinen tuki ja sen merkitys korkeakouluopinnoissa

Only abstract. Paper copies of master’s theses are listed in the Helka database (http://www.helsinki.fi/helka). Electronic copies of master’s theses are either available as open access or only on thesis terminals in the Helsinki University Library.Vain tiivistelmä. Sidottujen gradujen saatavuuden voit tarkistaa Helka-tietokannasta (http://www.helsinki.fi/helka). Digitaaliset gradut voivat olla luettavissa avoimesti verkossa tai rajoitetusti kirjaston opinnäytekioskeilla.Endast sammandrag. Inbundna avhandlingar kan sökas i Helka-databasen (http://www.helsinki.fi/helka). Elektroniska kopior av avhandlingar finns antingen öppet på nätet eller endast tillgängliga i bibliotekets avhandlingsterminaler.Tutkimuksen tarkoituksena on tutkia sosiaalista tukea korkeakouluopiskelijan voimavarana, ja sen merkitystä korkeakouluopinnoissa. Tutkielma tehdään osana valtakunnallista opiskelijoiden hyvinvointiprojektia, jonka tarkoituksena on korkeakouluopiskelijoiden hyvinvoinnin edistäminen. Tutkielmassa sosiaalista tukea tarkastellaan opiskelijoiden näkökulmasta. Tutkimusongelman muodostaa kysymys, miten korkeakouluopiskelijat määrittävät sosiaalista tukea, ja mikä merkitys sosiaalisella tuella koetaan olevan opiskelussa. Korkeakouluopiskelijoiden sosiaalista tukea on tutkittu aikaisemmin vähän, eikä aihetta ole lähestytty opiskelijoiden näkökulmasta. Tutkimuksen kohderyhmänä ovat pääkaupunkiseudun korkeakouluopiskelijat. Tutkimuksen lähestymistapa on laadullinen, ja aineistona on korkeakouluopiskelijoille järjestetyn kirjoituskilpailun antia sekä teemahaastatteluja. Kirjoituksia oli yhteensä yhdeksän kappaletta ja haastatteluja seitsemän. Haastattelut tehtiin yksilöhaastatteluina. Aineistoa analysoidaan teema-analyysimenetelmää käyttäen. Tutkimusongelmaan pyrittiin vastaamaan nostamalla aineistosta tutkimusongelmaa valaisevia teemoja. Opiskelijat määrittivät sosiaalista tukea emotionaaliseksi, tiedolliseksi ja aineelliseksi. Emotionaalinen tuki koostui puhumisesta, kannustamisesta, tunteesta hyväksymisestä omana itsenä ja luottamuksesta tuen saamiseen. Tiedollinen tuki muodostui toisilta opiskelijoilta saaduista neuvoista ja avusta opiskeluun liittyvissä ongelmissa. Aineelliseksi tueksi nähtiin perheenjäseniltä saatu tuki toimeentulossa, joka muodostui rahasta, ruoka-avusta ja hankinnoissa auttamisesta. Opiskelussa emotionaalisen tuen koettiin auttavan jaksamaan ja lisäävän uskoa omaan selviytymiseen opinnoissa. Emotionaalisella tuella näyttäisi myös olevan tärkeä merkitys opiskelijan itsetunnon ja elämänhallinnan tunteen vahvistajana, jotka ovat tärkeitä voimavaroja opiskelussa ja stressinhallinnassa. Tiedollinen ja aineellinen tuki nähtiin tärkeäksi opintojen etenemisessä. Toisilta opiskelijoilta saadun tiedollisen tuen koettiin auttavan opintojen järjestämiseen ja suunnitteluun liittyvissä kysymyksissä. Perheenjäsenten aineellisen tuen koettiin auttavan keskittymään opiskeluun sekä vähentävän työssäkäynnin tarvetta ja lisäävän opiskeluun käytettävää aikaa. Tärkeimpinä lähteinä olivat aikaisemmat opiskelijatutkimukset sekä sosiaaliseen tukeen liittyvä kirjallisuus

Metaplastic carcinoma of the breast : Prognosis and response to systemic treatment in metastatic disease

Background: Metaplastic breast carcinomas (MpBCs) are rare, aggressive breast cancers. Due to the scant literature of this disease most guidelines do not give recommendation for this entity. The aim of the study was to review the clinicopathologic features, treatment, and outcomes of the patients with MpBC treated at our institution. Material and methods: We searched databases for patients with histologically confirmed MpBC from 2002 to 2016. Results: A total of 78 patients with MpBC were included in the study. All histological material was reviewed by an experienced breast pathologist. Most tumors were grade 3 (83%) and triple negative (85%). Eighty-two percent were node negative. Sixty-four percent received adjuvant chemotherapy. The 5-year disease free survival was 63% and 5-year breast cancer specific overall survival was 61%. Tumor size and mixed metaplastic histology were associated with worse outcome in this patient group. One third of the patients (n = 28) had metastatic disease at initial presentation or developed metastases at follow-up. The lungs were the most common site of first distant recurrence. Half (n = 14) of these patients received palliative chemotherapy. Of those only 6% (n = 2) had partial response and 18% had stable disease as best response to treatment. The median overall survival time with metastatic disease was only 3.4 months. Conclusion: MpBC is an aggressive type of breast cancer with poor outcome despite low nodal involvement and aggressive local and systemic therapy. Tumor response to palliative systemic chemotherapy remains poor for MpBC patients.Peer reviewe

Expression of markers of stem cell characteristics, epithelial-mesenchymal transition, basal-like phenotype, proliferation, and androgen receptor in metaplastic breast cancer and their prognostic impact

Background Metaplastic breast cancer (MpBC) is a heterogeneous subtype of invasive mammary carcinoma associated with epithelial-mesenchymal transition (EMT) and cancer stem cell characteristics. Data regarding prognostic markers and potentially actionable targets for therapy are still limited. The present study aimed to characterize the immunohistochemical landscape of this rare malignancy and to identify potential prognostic factors and targets for therapy. Material and methods A total of 75 patients diagnosed with MpBC over a 15-year period were included in the study. We performed immunohistochemical analyses for Ki-67 (MIB-1), epidermal growth factor receptor (EGFR), cytokeratin 5/6, vimentin, CD44, and androgen receptor (AR) and correlated their expression with clinicopathologic features and clinical outcomes. The p-values for survival analyses were corrected for multiple testing (threshold 0.01). Results Most tumors expressed CK5/6 (73%), EGFR (59%), CD44 (81%), and vimentin (87%). Eighty-nine percent had a high Ki-67 index. Eighty-four percent were classified as basal-like (CK 5/6 or EGFR positive). AR was expressed in 21% of the tumors. The basal-like phenotype was significantly (p = 0.009) associated with inferior disease-free (DFS) and breast-cancer-specific overall survival (BCOS) with borderline significance (p = 0.01). In addition, a low Ki-67 index was associated with improved DFS (p = 0.033) and BCOS (p = 0.03). Conclusion Most MpBCs express basal markers (CK5/6, EGFR), epithelial-mesenchymal transition marker vimentin, and the stem cell marker CD44. Expression of basal-like markers was significantly related to inferior DFS. All the 11 patients with a lack of expression of basal markers survived without relapse.Peer reviewe

Oleaginous yeasts respond differently to carbon sources present in lignocellulose hydrolysate

Background Microbial oils, generated from lignocellulosic material, have great potential as renewable and sustainable alternatives to fossil-based fuels and chemicals. By unravelling the diversity of lipid accumulation physiology in different oleaginous yeasts grown on the various carbon sources present in lignocellulose hydrolysate (LH), new targets for optimisation of lipid accumulation can be identified. Monitoring lipid formation over time is essential for understanding lipid accumulation physiology. This study investigated lipid accumulation in a variety of oleaginous ascomycetous and basidiomycetous strains grown in glucose and xylose and followed lipid formation kinetics of selected strains in wheat straw hydrolysate (WSH). Results Twenty-nine oleaginous yeast strains were tested for their ability to utilise glucose and xylose, the main sugars present in WSH. Evaluation of sugar consumption and lipid accumulation revealed marked differences in xylose utilisation capacity between the yeast strains, even between those belonging to the same species. Five different promising strains, belonging to the species Lipomyces starkeyi, Rhodotorula glutinis, Rhodotorula babjevae and Rhodotorula toruloides, were grown on undiluted wheat straw hydrolysate and lipid accumulation was followed over time, using Fourier transform-infrared (FTIR) spectroscopy. All five strains were able to grow on undiluted WSH and to accumulate lipids, but to different extents and with different productivities. R. babjevae DVBPG 8058 was the best-performing strain, accumulating 64.8% of cell dry weight (CDW) as lipids. It reached a culture density of 28 g/L CDW in batch cultivation, resulting in a lipid content of 18.1 g/L and yield of 0.24 g lipids per g carbon source. This strain formed lipids from the major carbon sources in hydrolysate, glucose, acetate and xylose. R. glutinis CBS 2367 also consumed these carbon sources, but when assimilating xylose it consumed intracellular lipids simultaneously. Rhodotorula strains contained a higher proportion of polyunsaturated fatty acids than the two tested Lipomyces starkeyi strains. Conclusions There is considerable metabolic diversity among oleaginous yeasts, even between closely related species and strains, especially when converting xylose to biomass and lipids. Monitoring the kinetics of lipid accumulation and identifying the molecular basis of this diversity are keys to selecting suitable strains for high lipid production from lignocellulose

Thoracolumbar vertebral fractures in Sweden: an analysis of 13,496 patients admitted to hospital

National Longitudinal data of thoracolumbar fracture incidence, trends or mortality rates are lacking. The correlation between admissions and operations of thoracolumbar vertebral fractures has not been investigated. The aim of our nationwide population-based epidemiological study was to analyse the incidence, admissions, operations, and case fatality rate among patients with thoracolumbar vertebral fractures admitted to hospital in Sweden. The Swedish Hospital Discharge Register (SHDR) and the Cause of Death Register (CDR) were linked to determine the incidence of surgical interventions, trends, characteristics of the patients, and case fatality rate for thoracolumbar vertebral fractures based on comprehensive national data. The annual incidence of thoracolumbar fractures was on average 30 per 100,000 inhabitants and did not change considerably during the study period. Among patients younger than 60 years of age the annual incidence was 13 per 100,000 and was twice as high in men compared to women. The proportion operated on was 15%. In the age-group 60 years and older the majority were women. In this group two percent were operated on. However, males were operated on twice as often as women. The 90-day case-fatality rate after surgery was 1.4%. This information may assist health care providers in health care planning. Moreover, these data can also be used for power calculations when planning future clinical studies

Screening of HELQ in breast and ovarian cancer families

Several high and moderate risk alleles have been identified for breast and ovarian cancer predisposition and most of them encode proteins that function in DNA repair. A prospective candidate for breast and ovarian cancer susceptibility is the HELQ helicase that has a role in the resolution of DNA interstrand cross-links. HELQ interacts with the RAD51 paralog complex BCDX2. Two components of the complex, RAD51C and RAD51D, increase the risk of ovarian cancer especially, and the other two, RAD51B and XRCC2 have been associated with breast cancer risk. To investigate the role of HELQ in cancer predisposition, we screened the gene for germline variation in 185 Finnish breast or ovarian cancer families and performed haplotype analyses for 1517 breast cancer cases, 308 ovarian cancer cases, and 1234 population controls using five common polymorphisms at the HELQ gene locus. No truncating mutations were identified among the families. One putatively pathogenic missense mutation c.1309A > G was identified but no additional carriers were observed in the subsequent genotyping of 332 familial breast or ovarian cancer patients. Furthermore, the haplotype distribution did not differ between breast or ovarian cancer cases and population controls. Our results indicate that HELQ is not a major breast and ovarian cancer susceptibility gene in the Finnish population. However, we cannot rule out rare risk-variants in the Finnish or other populations and larger datasets are needed to further assess the role of HELQ especially in ovarian cancer predisposition.Peer reviewe