Management accounting change. Case: Finlayson Pop Up -shops

This case study aims to describe the management accounting change taking place at a Finnish home textile company Finlayson Oy. The focus of the study is on the development and adoption of a new business model for Pop Up -Shops business area as part of renewing the retail strategy and analyzing how the changes in management accounting systems linked to the new business model took place. Furthermore, the nature of the management accounting change as a phenomenon at the case company is discussed. In the literature review the following areas are covered: retail as business; management accounting practices such as management accounting systems, performance measurement and management accounting tools; and management accounting change. The management accounting change is analyzed in accord to the management accounting change models provided by Innes & Mitchell (1990), Cobb et al (1995) and Kasurinen (2002). Furthermore, scholars such as Burns & Vaivio (2001) provide further framework by which management accounting change as a phenomenon can be perceived and analyzed. This research was conducted as a longitudinal single case study. The study took place from June 2014 to February 2016. During this time new strategy was introduced at Finlayson including also a new strategy for Retail business division where the developments of the Pop Up -Shops business area took place. During the study period the company developed reporting and introduced new type of ad hoc analysis that supported the development and evaluation of the new Pop Up -Shops business model. Different data sources including documentation, archival records, 13 interviews, direct observations and participant-observation were used. In the findings such changes in the management accounting systems took place as a change in the role of a management accountant; new organizational and accounting structures; new style of reporting; and an introduction of internal benchmarking practice that was new to the company. The factors advancing the change included competition in the markets, organizational structure, culture of "measurement", availability of resources, a leader for the changes and recent experience of organizational changes endorsing momentum of change in the process of management accounting change. Barriers of change included the uncertain role of the new Pop Up -Shops business model, increased certainty about the future in the business operations, lack of resources in the accounting staff and inadequate IT systems. Overall, the management accounting change at Finlayson could be perceived as a centrally driven effort with some informal elements. The developments in the management accounting systems raised also questions about the role of non-financial measurement at Finlayson and whether the management systems were focused in the right areas in the company

Progression of diffuse gliomas : from the first diagnosis to recurrence

Gliomas are the most frequent primary brain tumours. The cardinal features of gliomas are infiltrative growth pattern and progression from low-grade tumours to a more malignant phenotype. These features of gliomas generally prevent their complete surgical excision and cause their inherent tendency to recur after initial treatment and lead to poor long-term prognosis. Increasing knowledge about the molecular biology of gliomas has produced new markers that supplement histopathological diagnostics. Molecular markers are also used to evaluate the prognosis and predict therapeutic response. The purpose of this thesis is to study molecular events involved in the malignant progression of gliomas. Gliomas are highly vascularised tumours. Contrast enhancement in magnetic resonance imaging (MRI) reflects a disrupted blood-brain barrier and is often seen in malignant gliomas. In this thesis, 62 astrocytomas, oligodendrogliomas and oligoastrocytomas were studied by MRI and immunohistochemistry. Contrast enhancement in preoperative MRI was associated with angiogenesis, tumour cell proliferation and histological grade of gliomas. Activation of oncogenes by gene amplification is a common genetic aberration in gliomas. EGFR amplification on chromosome 7p12 occurs in 30-40% of glioblastomas. PDGFRA, KIT and VEGFR2 are receptor tyrosine kinase genes located on chromosome 4q12. Amplification of these genes was studied using in situ hybridisation in the primary and recurrent astrocytomas, oligodendrogliomas and oligoastrocytomas of 87 patients. PDGFRA, KIT or VEGFR2 amplification was found in 22% of primary tumours and 36% of recurrent tumours including low-grade and malignant gliomas. The most frequent aberration was KIT amplification, which occurred in 10% of primary tumours and in 27% of recurrent tumours. The expression of ezrin, cyclooxygenase 2 (COX-2) and HuR was studied immunohistochemically in a series of primary and recurrent gliomas of 113 patients. Ezrin is a cell membrane-cytoskeleton linking-protein involved in the migration of glioma cells. The COX-2 enzyme is implicated in the carcinogenesis of epithelial neoplasms and is overexpressed in gliomas. HuR is an RNA-stabilising protein, which regulates the expression of several proteins including COX-2. Ezrin, COX-2 and HuR were associated with histological grade and the overall survival of glioma patients. However, in multivariate analysis they were not independent prognostic factors. In conclusion, these results suggest that contrast enhancement in MRI can be used as a surrogate marker for the proliferative and angiogenic potential of gliomas. Aberrations of PDGFRA, KIT and VEGFR2 genes, as well as the dysregulated expression of ezrin, COX-2 and HuR proteins, are linked to the progression of gliomas.Glioomien uusiutuminen ja pahanlaatuisuuden eteneminen Aivojen tukisoluista lähtöisin olevat kasvaimet, glioomat, ovat yleisin primaaristen aivokasvainten ryhmä. Glioomien kasvutapa on epätarkkarajainen ja aivokudokseen tunkeutuva, minkä vuoksi niiden täydellinen kirurginen poisto on yleensä mahdotonta. Glioomilla on taipumus uusiutua hoidon jälkeen ja edetä pahanlaatuisemmiksi. Kudosnäytteestä määritettävä glioomien pahanlaatuisuusaste on tärkeä ennusteellinen ja potilaiden hoitoa ohjaava tekijä. Glioomien molekyylipatologisen tutkimuksen perusteella on löydetty uusia geenimuutoksia, joita voidaan tutkia kudosnäytteistä ja käyttää apuna kasvainten diagnostiikassa sekä ennusteen ja hoitovasteen arvioinnissa. Väitöskirjassa tutkittiin geenimuutoksia ja proteiineja, jotka liittyvät glioomien pahanlaatuisuuden etenemiseen. Glioomat ovat tiheästi verisuonittuneita kasvaimia. Magneettikuvauksessa glioomien varjoainetehostuminen viittaa veri-aivoesteen vaurioon ja pahanlaatuiseen kasvaimeen. Väitöskirjassa verrattiin glioomien varjoainetehosteisen magneettikuvauksen tuloksia potilailta leikattujen kasvainten mikroskooppisiin ja immunohistokemiallisiin löydöksiin. Tutkimuksessa havaittiin, että glioomien tehostuminen varjoaineella korreloi kudosleikkeistä todettavan kasvainten pahanlaatuisuusasteen, verisuonten uudismuodostuksen ja solunjakautumisen määrän kanssa. Syöpägeenien aktivoituminen geenimonistuman tai -mutaation seurauksena on syöpäkasvaimille tyypillinen muutos, jota esiintyy myös glioomissa. Väitöskirjassa tutkittiin kromosomissa 7 sijaitsevien PDGFRA, KIT ja VEGFR2 -geenien monistumien esiintyvyyttä glioomissa. Tutkimuksessa havaittiin em. geenien monistumia sekä matalan että korkean pahanlaatuisuusasteen glioomissa ja niiden uusiutumissa. KIT-geenin monistuman esiintyvyys glioomissa oli taudin toteamishetkellä 10% ja uusiutuneissa kasvaimissa 27%. Lisäksi tutkittiin esriini-, syklo-oksigenaasi 2- (COX-2) ja HuR-proteiinien ilmentymistä immunohistokemiallisin menetelmin glioomissa ja niiden uusiutumissa. Esriini on solun tukirankaan ja liikkuvuuteen liittyvä proteiini. COX-2- ja HuR-proteiinien ilmentyminen on aiemmin havaittu kohonneeksi epiteelistä lähtöisin olevissa syövissä. Tutkimuksessa osoitettiin, että esriinin, COX-2- ja HuR-proteiinien ilmentyminen lisääntyi glioomissa pahanlaatuisuusasteen noustessa, mutta ne eivät ole käyttökelpoisia itsenäisinä glioomien ennustetekijöinä

Medulloblastoma, macrocephaly, and a pathogenic germline PTEN variant : Cause or coincidence?

Background Medulloblastomas (MBs) are a heterogeneous group of childhood brain tumors with four consensus subgroups, namely MBSHH, MBWNT, MBGroup 3, and MBGroup 4, representing the second most common type of pediatric brain cancer after high-grade gliomas. They suffer from a high prevalence of genetic predisposition with up to 20% of MBSHH caused by germline mutations in only six genes. However, the spectrum of germline mutations in MBSHH remains incomplete. Methods Comprehensive Next-Generation Sequencing panels of both tumor and patient blood samples were performed as molecular genetic characterization. The panels cover genes that are known to predispose to cancer. Results Here, we report on a patient with a pathogenic germline PTEN variant resulting in an early stop codon p.(Glu7Argfs*4) (ClinVar ID: 480383). The patient developed macrocephaly and MBSHH, but reached remission with current treatment protocols. Conclusions We propose that pathogenic PTEN variants may predispose to medulloblastoma, and show that remission was reached with current treatment protocols. The PTEN gene should be included in the genetic testing provided to patients who develop medulloblastoma at an early age. We recommend brain magnetic resonance imaging upon an unexpected acceleration of growth of head circumference for pediatric patients harboring pathogenic germline PTEN variants.Peer reviewe

Pahanlaatuisuusaste ei yksin riitä - molekyylitutkimukset tarkentavat glioomien diagnostiikkaa

Vertaisarvioitu. Teema : aivokasvaimet. English summary.Glioomat ovat primaareista aivokasvaimista yleisimpiä. Glioomien diagnostiikka perustuu kasvainten histologisiin piirteisiin ja molekulaarisiin muutoksiin. Vuonna 2016 päivitetty WHO:n aivokasvainluokitus tuo geneettiset muutokset osaksi kasvainten diagnoosia. Integroitu diagnoosi sisältää kasvaimen histologisen tyypin, pahanlaatuisuusasteen ja molekulaariset muutokset. Glioomien tärkeimmät molekyylimuutokset ovat IDH (isositraattidehydrogenaasi) -geenin mutaatio ja 1p/19q-kodeleetio. Astrosytoomissa IDH-mutaatio erottaa suotuisan ennusteen kasvaimet omaksi ryhmäkseen. IDH-mutatoitumaton glioblastooma on glioomista tavallisin ja pahanlaatuisin. Paremman ennusteen oligodendroglioomassa on samanaikaisesti IDH-mutaatio ja 1p/19q-kodeleetio. H3 K27M -mutatoitunut keskiviivan gliooma on uusi aggressiivinen glioomatyyppi. Molekyylimuutoksiin perustuva luokittelu parantaa glioomien diagnostiikan tarkkuutta ja luo pohjan niiden tulokselliselle hoidolle.Peer reviewe

IDH1 Expression via the R132H Mutation-Specific Antibody in Adrenocortical Neoplasias-Prognostic Impact in Carcinomas

Context: Mutations to isocitrate dehydrogenase (IDH) appear to play a prognostic or predictive role in several neoplasias. Immunohistochemical staining designed to detect a specific R132H mutation to IDH1 showed expression in the normal adrenal cortex, raising interest to study the potential role of IDH1 in the pathogenesis of adrenocortical tumors. Objective: The objective of this work is to study the role of IDH1 and its mutations in adrenocortical tumors. Design and patients: IDH1 R132H immunohistological staining was performed on a cohort of 197 adrenocortical tumors. The exon of the IDH1 gene was sequenced in 16 tumors. Results: Positive IDH1 R132H immunohistochemical staining correlated with a better prognosis among patients with a malignant adrenocortical tumor. However, IDH1 R132H immunohistochemistry did not distinguish between local and metastasized tumors. We were unable to identify IDH1 mutations among our adrenocortical tumors using a targeted next-generation sequencing panel or via exon sequencing. Conclusions: Among adrenocortical carcinomas, IDH1 R132H immunopositivity correlated with a better prognosis. Thus, IDH1 R132H immunohistochemical staining could serve as a prognostic or as a potential predictive marker in adrenocortical carcinomas. Further research is needed to identify the possible alterations in IDH1 that could explain our findings, because we identified no known mutations to the IDH1 gene. (C) Endocrine Society 2020.Peer reviewe

Clinical relevance of integrin alpha 4 in gastrointestinal stromal tumours

The molecular mechanisms for the dissemination and metastasis of gastrointestinal stromal tumours (GIST) are incompletely understood. The purpose of the study was to investigate the clinical relevance of integrin alpha 4 (ITGA4) expression in GIST. GIST transcriptomes were first compared with transcriptomes of other types of cancer and histologically normal gastrointestinal tract tissue in the MediSapiens in silico database. ITGA4 was identified as an unusually highly expressed gene in GIST. Therefore, the effects of ITGA4 knock-down and selective integrin alpha 4 beta 1 (VLA-4) inhibitors on tumour cell proliferation and invasion were investigated in three GIST cell lines. In addition, the prognostic role of ITGA4 expression in cancer cells was investigated in a series of 147 GIST patients with immunohistochemistry. Inhibition of ITGA4-related signalling decreased GIST cell invasion in all investigated GIST cell lines. ITGA4 protein was expressed in 62 (42.2%) of the 147 GISTs examined, and expression was significantly associated with distant metastases during the course of the disease and several adverse prognostic features. Patients whose GIST expressed strongly ITGA4 had unfavourable GIST-specific survival and overall survival compared to patients with low or no ITGA4 expression. Taken together, ITGA4 is an important integrin in the molecular pathogenesis of GIST and may influence their clinical behaviour.Peer reviewe

Papillary Tumor of the Pineal Region in Children : Presentation of a Case and Comprehensive Literature Review

BACKGROUND: Papillary tumor of the pineal region (PTPR) is a rare grade II-III pineal lesion with peculiar histological and immunohistochemical features. These tumors mostly occur in adults, only rarely in children, with 19 cases reported up to now. CASE DESCRIPTION: We present a 3-year-old boy who underwent reoperation for a recurrent PTPR (grade II). Gross total resection of the lesion through an occipital interhemispheric approach with the patient in a sitting position was followed by adjuvant radiotherapy and chemotherapy. Histological examination revealed tumor progression (grade III) and an MIB-1 proliferation index >25%. The patient continues to do well with no evidence of recurrence more than 3 years following surgery. A comprehensive literature review regarding the PTPR, including the current management in children, is reported. CONCLUSIONS: PTPRs are extremely rare in children, and immunohistochemistry is needed to differentiate them from other pineal tumors. These tumors show a high rate of recurrence, and a multidisciplinary management approach (microsurgical resection followed by radiotherapy and/or chemotherapy) can help achieve a favorable outcome.Peer reviewe

Tissue Restoration After Implantation of Polyglycolide, Polydioxanone, Polylevolactide, and Metallic Pins in Cortical Bone: An Experimental Study in Rabbits

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Extent of Resection and Long-Term Survival of Pineal Region Tumors in Helsinki Neurosurgery

BACKGROUND: Pineal region tumors represent challenging surgical lesions with wide ranges of survival reported in different surgical series. In this article, we emphasize the role of complete microsurgical resection (CMR) to obtain a favorable long-term outcome of pineal region tumors. METHODS: We report a retrospective study of pineal region tumors operated on in Helsinki Neurosurgery between 1997 and 2015. Information was obtained from the hospital records, and an evaluation of the Finnish population register was conducted in July 2018 to determine the current status of the patients. RESULTS: A total of 76 pineal region tumors were operated on. The survival was 62% at a mean follow-up of 125 +/- 105 months (range, 0-588 months), and the disease-related mortality was limited to 14 patients (18.4%). Up to July 2018, 29 patients had died. Two patients died 1 and 3 months after surgery of delayed thalamic infarctions, 12 patients of disease progression, and 15 had non-disease-related deaths. Only 1 patient was lost in the long-term follow-up. Ten of 14 disease-related deaths occurred during the first 5 years of follow-up: 5 diffuse gliomas, 3 germ cell tumors, 1 grade II-III pineal parenchymal tumor of intermediate differentiation, and 1 meningioma. CMR was linked to better tumor-free survival and long-term survival, with the exception of diffuse gliomas. CONCLUSIONS: CMR, in the setting of a multidisciplinary management of pineal region tumors, correlates with favorable survival and with minimal mortality. Surgically treated grade II-IV gliomas constitute a particular group with high mortality within the first 5 years independently of the microsurgical resection.Peer reviewe

The microsurgical management of benign pineal cysts: Helsinki experience in 60 cases

Background: Microsurgical resection represents a well-accepted management option for symptomatic benign pineal cysts. Symptoms such as a headache, hydrocephalus, and visual deficiency are typically associated with pineal cysts. However, more recent studies reported over the past years have characterized additional symptoms as a part of the clinical manifestation of this disease and represent additional indications for intervention. Methods: We present a retrospective review of patients with histologically confirmed benign pineal cysts that were operated on in our department between 1997 and 2015. A demographic analysis, evaluation of preoperative status, surgical treatment, as well as immediate and long-term clinical and radiological outcomes were conducted. Results: A total of 60 patients with benign pineal cysts underwent surgery between 1997 and 2015. Gross total resection was achieved in 58 cases. All patients except one improved in their clinical status or had made a full recovery at the time of the last follow-up. The key steps for surgical resection of pineal cysts are reported, based on an analysis of representative surgical videos. Conclusions: We describe in this paper one of the largest series of microsurgically treated pineal cysts. In our opinion, judicious microsurgery remains the most suitable technique to effectively deal with this disease.Peer reviewe