82 resultados para cardiac troponin I
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Tutkimuksen tarkoituksena oli selvittää helsinkiläisten perusopetuksen yläluokkien kielikylpy-oppilaiden ja heidän vanhempiensa käsityksiä ruotsinkielisestä kielikylvystä. Tarkoituksena oli tutkia syitä kielikylpymenetelmän tai vastaavasti perinteisen opetuksen valitsemiseksi sekä oppilaiden ja heidän vanhempiensa käsityksiä kielikylpyoppilaiden koulumenetyksestä ja kielitaidosta. Tarkoituksena oli myös selvittää, mikä asema kielikylvyllä on oppilaiden elämässä koulukontekstin ulkopuolella sekä miten oppilaat ja heidän vanhempansa suhtautuvat kielikylpyyn kokonaisuutena. Tutkimuksen perusjoukkoon kuuluivat kaikki lukuvuonna 2002−2003 Helsingin perusopetuksen yläluokkien ruotsinkielisessä kielikylvyssä olevat oppilaat sekä heidän vanhempansa. Otokseen saatiin 128 oppilasta ja 94 vanhempaa. Näiden lisäksi tutkimukseen osallistui 40 vanhempaa, joiden lapset osallistuivat yksikieliseen suomenkieliseen perusopetukseen. Tutkimusjoukon oppilaista osa on ollut alaluokilla varhaisessa täydellisessä kielikylvyssä ja osa varhaisessa osittaisessa kielikylvyssä. Tutkimus edustaa survey-tutkimusta, jossa aineistonhankintamenetelmänä on käytetty sekä lomakekyselyä että haastattelua. Teemahaastatteluun valittiin 10 oppilasta tutkimuksen perusjoukosta. Tutkimusaineisto kerättiin kevään 2003 aikana. Aineistosta laskettiin frekvenssejä, keskilukuja ja korrelaatioita sekä käytettiin ristiintaulukointeja. Keskiarvojen merkitsevyystestaukset suoritettiin yksisuuntaisilla varianssianalyyseillä F- ja t-testein. Tutkimuksen teoriaosuudessa käsitellään kielitaidon ja kaksikielisyyden käsitteitä sekä esitellään erilaisia pedagogisia menetelmiä, joilla pyritään kehittämään kielitaitoa. Teoriaosuudessa pohditaan myös asenteiden ja motivaation merkitystä kielen omaksumisessa. Tutkimustulokset osoittavat, että perusopetuksen yläluokkien kielikylpyoppilailla ja heidän vanhemmillaan on varsin yhdensuuntaisia käsityksiä kielikylvystä. Kielikylpyyn ollaan varsin tyytyväisiä kokonaisuutena, mutta kehitettävää ja parannettavaa on. Opiskelu kielikylpyluokalla miellettiin positiivisena, mutta ruotsinkielisen opetuksen määrään toivottiin muutosta. Vanhemmat arvostivat kielikylpyä erityisesti siinä käytettävien opetusmenetelmien ja saavutettavien tulosten perusteella. Sekä vanhemmat että oppilaat kokevat ruotsin kielen oppimisen erittäin tarpeelliseksi ja hyödylliseksi peilaten vastauksissaan tulevaisuuden opiskelu- ja työelämän tarpeita. Oppilaiden ruotsin kielen taidot arvioitiin erittäin korkeiksi. Kielikylpykielen asema oppilaiden elämässä koulun ulkopuolella oli erittäin vähäinen. Ruotsin kielen käyttötilanteet rajoittuivat matkoihin ja erilaisiin opastustilanteisiin. Omaehtoista kielen käyttöä ei juuri ilmennyt hyvästä kielitaidosta huolimatta. Oppilaiden käsityksissä ei ollut havaittavissa eroja eri sukupuolten välillä. Joissain tapauksissa luokka-asteella, mutta erityisesti oppilaan koululla ja kielikylpymuodolla oli vaikutusta tutkittuihin käsityksiin.
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Tämä pro gradu -tutkielma on tehty osana Svenska i toppen -projektia, joka alkoi syksyllä 2008 Pohjoismaisten kielten ja pohjoismaisen kirjallisuuden laitoksella. Tutkimuksen tavoitteena on selvittää, mitkä tekijät vaikuttavat lukiolaisten näkökulmasta hyvien tulosten saavuttamiseen ruotsin ylioppilaskirjoituksissa kolmessa suomenkielisessä lukiossa, jotka sijaitsevat Turun, Tampereen ja Joensuun seuduilla. Lisäksi tavoitteena on selvittää, miten maantieteelliset tekijät vaikuttavat opiskelijoiden ruotsin kielen osaamiseen sekä mitä eroja on keskipitkän ja pitkän ruotsin oppimäärän opiskelijoiden asenteissa kieltä kohtaan. Tutkielman aineistona on kolme ryhmähaastattelua, joihin on osallistunut 14 lukiolaista, 11 tyttöä ja 3 poikaa. Haastattelut on tehty joulukuussa 2008 sekä tammi- ja maaliskuussa 2009. Haastatteluissa on käytetty strukturoitua kyselylomaketta, jossa kysytään opiskelijoiden näkemyksiä ruotsin opiskelusta. Tutkimusmenetelmänä on kvalitatiivinen tutkimusote, jossa on piirteitä kolmesta eri menetelmästä: tapaustutkimuksesta, etnografisesta tutkimuksesta sekä temaattisesta analyysistä. Tärkeimpänä teoriataustana on ruotsi toisena kielenä -tutkimus, oppiminen sosiokonstruktivistisena ilmiönä sekä motivaatiotutkimus. Tarkastelen kielenoppijaa luokkahuoneessa sosiaalisena osallistujana omassa oppimisprosessissaan. Oppiminen nähdään kokonaisuutena, johon kuuluu eri osa-alueita, esimerkiksi koulujen käytännöt, yhteisön vaikutus oppimiseen sekä opiskelijan identiteetin muokkautuminen kouluyhteisössä. Motivaatiota tarkastelen kielenoppimisen näkökulmasta, ja se koostuu erilaisista dynaamisista vaiheista, esimerkiksi tavoitteiden asettamisesta oppimisprosessin alussa, valintojen tekemisestä sekä motivaation ylläpitämisestä oppimisprosessin kuluessa. Tutkimuksen tulokset osoittavat, että suurin yksittäinen syy menestykseen opiskelijoiden näkökulmasta on opettaja, joka omalla toiminnallaan voi merkittävästi parantaa opiskelijoiden oppimisedellytyksiä. Työhön panostaminen, opiskelijoiden yksilöllinen kohtaaminen myös luokkahuoneen ulkopuolella ja esimerkiksi omien oppimateriaalien valmistaminen ovat opettajaan liittyviä tekijöitä, jotka voivat nostaa opiskelijoiden motivaatiota huomattavasti. Myös lukion maantieteellisellä sijainnilla on vaikutusta. Paikkakunnilla, joilla ruotsin kieltä käytetään vähän, korostuu opettajan rooli kielellisen oppimisympäristön luomisessa. Keskipitkän ja pitkän ruotsin opiskelijoiden välillä ei tutkimuksessa ilmene eroja asenteissa kieltä kohtaan.
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Tarkastelen pro gradu -tutkielmassani opettajan direktiivejä eli ohjailevia lausumia peruskoulun ruotsinopetuksessa. Aineistoni koostuu kuudennella ja kahdeksannella luokalla nauhoitetuista ruotsintunneista, ja sitä on yhteensä 3 tuntia 15 minuuttia. Analysoin sitä, miten opettaja muotoilee direktiivinsä, annetaanko direktiivit suomeksi vai ruotsiksi ja miten opettajan ohjaileva puhe vaikuttaa oppilaiden käytökseen. Direktiivien tehtävänä on saada oppilaat toimimaan opettajan toivomalla tavalla. Direktiivit ovat yleensä vierusparin etujäseniä, jolloin oppilaiden kielellinen tai ei-kielellinen reaktio muodostaa jälkijäsenen. Opettajan direktiivi voi olla myös jälkijäsen, jolloin se on reaktio siihen, mitä oppilaat ovat tehneet. On preferoitua, että oppilaat noudattavat opettajan ohjeita. Opettaja voi käyttää direktiivinä imperatiivia, kysymys- ja väitelausetta sekä nominaalilauseketta. Imperatiivi on tunnusmerkitön tapa ilmaista ohjailua, ja opettaja käyttää sitä rutiininomaisissa kehotuksissa. Kysymyslauseen muotoisia direktiivejä opettaja käyttää varmistaakseen, että opetus voi jatkua, ja säilyttääkseen työrauhan. Väitelauseilla opettaja puolestaan antaa erilaisia ohjeita ja säätelee työrauhaa. Nominaalilauseketta opettaja voi käyttää direktiivinä antaessaan oppilaalle vastausvuoron tai kieltäessään oppilasta häiritsemästä työrauhaa. Suomea käytetään direktiiveissä, jotka liittyvät kieliopin opettamiseen, kun taas ruotsiksi ilmaistaan usein toistuvat direktiivit. Usein opettaja käyttää ensin ruotsia ja toistaa sitten direktiivin suomeksi. Opettajan institutionaaliseen rooliin kuuluu se, että hänellä on auktoriteetti luokkahuoneessa. Siksi oppilaiden on noudatettava opettajan ohjeita, ja tavallisesti he tekevätkin niin, mutta siihen kuluu joskus paljon aikaa.
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TRANSFORMATIONS OF NATURE Science, Knowledge and Freedom in the Early Thinking of Rudolf Steiner. Perspectives on Waldorf Education in the light of the History of Ideas Waldorf Education is based on the worldview that Rudolf Steiner (1861-1925) developed to a wide-ranging anthroposophical movement in the first decades of the 20th century. This thesis takes as its departure the early thinking of Rudolf Steiner that precedes anthroposophy, and its main purpose is to uncover the tradition of ideas represented in Steiner´s early life and which, in different ways, have emerged in the practice of Waldorf Education. Through systematic analysis I attempt to bring to light different aspects of Steiner’s early thinking: his concept of science, his epistemological startingpoints and his philosophy of freedom. By departing from J. W. Goethe’s qualitative concept of science, Steiner strove in his early works to formulate a monistic worldview which appears to be closely related to the Romantic Movement and its philosophy of nature. Characteristic traits of his thinking are, on the one hand, a critique of a one-sided enlightenment and, on the other hand, an aspiration to see the world as a living organic unity. Human beings can, by developing our intuitive faculties, get a deeper understanding of the indissoluble relationship between man and nature. Against this background Steiner´s early thinking can be read as a special kind of romantic development narrative. Steiner’s early thinking also opens the way for romantic perspectives on Waldorf Education. It appears that many central aims and conceptions in Waldorf Education can be illuminated by the epistemological perspective upon which Steiner elaborated early in his life. An organic curriculum, phenomenological didactics and high ideal of freedom can be considered seen as educational applications of conceptions that played an important role in Goethe and his age. Thus, Waldorf Education provides in our contemporary society an exceptional set of educational values: a holistic education with romantic undertones.
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Atherosclerosis is the main underlying pathology of coronary heart disease. Coronary heart disease is a serious health problem in Finland, and it is the leading cause of morbidity and mortality in industrialized countries. Psychological stress correlates with coronary heart disease events – myocardial infarction and sudden death, which are the most common clinical syndromes of atherosclerotic narrowing of arteries. The present series of studies examines the interaction between stress and endothelial function in relation to atherosclerosis. The study also aims to give new information on the mechanisms through which stress has its effect on atherosclerosis progression, focusing on possible relations between psychological stress and the functioning of the endothelium. Our project is based on data from one of the largest national epidemiological studies, the Cardiovascular Risk in Young Finns study, which has monitored the development of risk factors for coronary heart disease in 3596 young adults since 1980. The present study combines experimental stress research with epidemiology and uses an advanced method for examining atherosclerosis development in healthy subjects (intima-media thickness ultrasound measurement). The physiological parameters used were heart rate, respiratory sinus arrhythmia and pre-ejection period. Chronic stress was assessed by vital exhaustion. The ultrasound measurements that served as the indexes of preclinical atherosclerosis were carotid intima-media thickness, brachial flow-mediated dilatation and carotid artery compliance. The effects of cardiovascular risk factors found to be important were taken into account: serum cholesterols level, triglyceride level, serum insulin level and systolic and diastolic blood pressure. There were 69, 1596, 81 and 1721 participants in studies I-IV, respectively. The results showed that both chronic and acute stress may exert an effect on atherosclerosis in subjects with impaired endothelial responses. The findings are consistent with the idea that risk factors are more harmful if the endothelium is not working properly. Chronic stress was found to be a risk if it has resulted in ineffective cardiac stress reactivity or delayed recovery. Men were shown to be at increased risk for atherosclerotic progression in early life, which suggests men’s decreased stress coping ability in relation to stressful psychosocial coronary risk factors. Autonomic imbalance may be the common mechanism of the stress influence on atherosclerosis development. The results of the present study contain background information for the identification the first stages of atherosclerosis, and they may be useful for preventive medicine programs for young adults and could help to improve cardiovascular health in Finland as well as in other countries.
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The aim of the present study was to advance the methodology and use of time series analysis to quantify dynamic structures in psychophysiological processes and thereby to produce information on spontaneously coupled physiological responses and their behavioral and experiential correlates. Series of analyses using both simulated and empirical cardiac (IBI), electrodermal (EDA), and facial electromyographic (EMG) data indicated that, despite potential autocorrelated structures, smoothing increased the reliability of detecting response coupling from an interindividual distribution of intraindividual measures and that especially the measures of covariance produced accurate information on the extent of coupled responses. This methodology was applied to analyze spontaneously coupled IBI, EDA, and facial EMG responses and vagal activity in their relation to emotional experience and personality characteristics in a group of middle-aged men (n = 37) during the administration of the Rorschach testing protocol. The results revealed new characteristics in the relationship between phasic end-organ synchronization and vagal activity, on the one hand, and individual differences in emotional adjustment to novel situations on the other. Specifically, it appeared that the vagal system is intimately related to emotional and social responsivity. It was also found that the lack of spontaneously synchronized responses is related to decreased energetic arousal (e.g., depression, mood). These findings indicate that the present process analysis approach has many advantages for use in both experimental and applied research, and that it is a useful new paradigm in psychophysiological research. Keywords: Autonomic Nervous System; Emotion; Facial Electromyography; Individual Differences; Spontaneous Responses; Time Series Analysis; Vagal System
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Avhandlingen behandlar tidigt fullständigt svenskt språkbad i Esbo. Arbetet utreder vad tidigt fullständigt språkbad innebär samt vad språkbadsföräldrars och språkbadslärares åsikter om språkbadet i Esbo är. Undersökningen omfattar 60 familjer samt samtliga lärare (14 st) som arbetar med språkbad i Esbo. Undersökningen består av två enkäter; en till språkbadsföräldrar och en tillspråkbadslärare. Av de 60 enkäter som sändes ut till språkbadsföräldrarna besvarades 45, dvs. 75%. 12 lärare av 14, dvs. 86%, besvarade den andra enkäten. Det är viktigt att känna till centrala begrepp i anslutning till tvåspråkighet, då man talar om andraspråkstillägnandet i språkbad. I detta arbete presenteras en modell (Sahi, 1999) som åskådliggör centrala begrepp i anslutning till tvåspråkighet. Tidigtfullständigt språkbad är ett program som är planerat att omfatta hela grundskolan. Språkbad är ämnat för enspråkiga majoritetsbarn i ett tvåspråkigt land. Dessa barn tillägnar sig minoritetsspråket i skolan. Språkbadet är inte enbart ett program, utan även en metod. Skillnaden mellan språkbad och traditionell undervisning i språk är att man i språkbadet betonar kommunikation framom grammatik. Målet medspråkbadet är funktionell tvåspråkighet. Många faktorer inverkar på andraspråkstillägnandet i språkbadet. I detta arbete betonas attitydernas och motivationens betydelse. Språkbad kräver en medveten och aktiv insats av föräldrarna. Vidare betonar litteraturen som behandlar språkbad undervisningsmetodernas betydelse samt språkbadslärarens viktiga roll. Föräldrarna är nöjda med språkbadsprogrammet, eftersom det givit goda resultat och motsvarat förväntningarna. Enligt föräldrarna är språkbad ett mjukt, modernt och effektivt program. Föräldrarna anser att barnen lär sig badspråket på ett naturligt sätt och även får en öppnare inställning till språk och kulturer. Föräldrarna betonar lärarnas viktiga insatser samt kontinuitetens betydelse. Vidare tycker föräldrarna att språkbadet borde inledas i ett tidigare skede och att eleverna borde ha mera kontakt med badspråket utanför skolan. Målet med att barnen går i språkbad är, enligt föräldrarna, att barnen ska förstå och tala språket flytande samtkänna kulturen som hör ihop med språket. Både föräldrarna och lärarna tycker att språkbadsklasserna är för stora och att det är brist på material. Lärarna anser att man mer än tidigare borde informera allmänheten, beslutsfattare samt föräldrar om verksamheten. Därtill tycker lärarna att samarbetet mellan daghem och skola samt specialundervisningen borde utvecklas. Lärarna betonar att språkbad inte lämpar sig för alla barn. Lärarna anser sig främst behöva praktiska råd av andra som arbetar med språkbad samt teoretisk kunskap. Både föräldrarna och lärarna tycker att språkbadsverksamheten i Esbo borde koordineras och att språkbadselevernas prestationer noggrant borde följas upp. Nyckelord: Tvåspråkighet, Språkbad, Andraspråkstillägnande Keywords: Bilingualism, Immersion, Second Language Aquisition.
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Workplace bullying is a topic of current interest in Finland. Workplace bullying is found in all professions, including the artistic ones. This thesis aims to explore workplace bullying from the view of the Finland-Swedish actors as a phenomenon that within dramatic art is difficult to define due to the fact that the body and emotions of an actor constitute his or her working tools. The research aims to deepen the understanding of the actors’ working situation, and particularly of the difficulties and problems actors face when exercising their job. The research problems are: What forms of bullying are the actors exposed to? Who is bullying? How is the bullying received by the actors, and what are the possible consequences? The theoretical orientation of this thesis is based upon dialogical philosophy where phenomenology, hermeneutics and dialog meet in an orientation where the unseen is emphasized and made visible. Artistic leadership should be based upon a pedagogic understanding that by an open and equal dialog with the Other recognizes human diversity. The narrative research was undertaken by using an interview guide for the interviews with eleven actors, six women and five men with the voice of a sixth man represented by an article. The interviews, each on average 118 minutes, were recorded and transcribed. The method of discursive analysis was initiated by numerous reflective readings based on analytic induction. The inductive part of the analysis consisted of mapping out the individual experiences of bullying where after the process of finding connecting common features in the extensive material took place. The coded data was then deductively grouped together according to the research problems, and subgroups were formed for deeper description. The research findings show that workplace bullying is an everyday occurrence within the field of dramatic art. Actors are bullied by theatre managers and directors as well as by colleagues and other personnel. The main areas of bullying is depreciation of one’s professional skills, the existing jargon, sexual harassment, collective bullying and bullying because of personal qualities. A significant finding concerning this problem was the existing culture of silence. Even if actually seeing and hearing a colleague being bullied, few stood up to defend the person being bullied because of fear of retaliation. Even the person actually being the object for bullying found it difficult to take any actions.
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The aim of the study was to explore why the MuPSiNet project - a computer and network supported learning environment for the field of health care and social work - did not develop as expected. To grasp the problem some hypotheses were formulated. The hypotheses regarded the teachers' skills in and attitudes towards computing and their attitudes towards constructivist study methods. An online survey containing 48 items was performed. The survey targeted all the teachers within the field of health care and social work in the country, and it produced 461 responses that were analysed against the hypotheses. The reliability of the variables was tested using the Cronbach alpha coefficient and t-tests. Poor basic computing skills among the teachers combined with a vulnerable technical solution, and inadequate project management combined with lack of administrative models for transforming economic resources into manpower were the factors that turned out to play a decisive role in the project. Other important findings were that the teachers had rather poor skills and knowledge in computing, computer safety and computer supported instruction, and that these skills were significantly poorer among female teachers who were in majority in the sample. The fraction of teachers who were familiar with software for electronic patient records (EPR) was low. The attitudes towards constructivist teaching methods were positive, and further education seemed to utterly increase the teachers' readiness to use alternative teaching methods. The most important conclusions were the following: In order to integrate EPR software as a natural tool in teaching planning and documenting health care, it is crucial that the teachers have sufficient basic skills in computing and that more teachers have personal experience of using EPR software. In order for computer supported teaching to become accepted it is necessary to arrange with extensive further education for the teachers presently working, and for that further education to succeed it should be backed up locally among other things by sufficient support in matters concerning computer supported teaching. The attitudes towards computing showed significant gender differences. Based on the findings it is suggested that basic skills in computing should also include an awareness of data safety in relation to work in different kinds of computer networks, and that projects of this kind should be built up around a proper project organisation with sufficient resources. Suggestions concerning curricular development and further education are also presented. Conclusions concerning the research method were that reminders have a better effect, and that respondents tend to answer open-ended questions more verbosely in electronically distributed online surveys compared to traditional surveys. A method of utilising randomized passwords to guarantee respondent anonymity while maintaining sample control is presented. Keywords: computer-assisted learning, computer-assisted instruction, health care, social work, vocational education, computerized patient record, online survey
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Hypertension, obesity, dyslipidemia and dysglycemia constitute metabolic syndrome, a major public health concern, which is associated with cardiovascular mortality. High dietary salt (NaCl) is the most important dietary risk factor for elevated blood pressure. The kidney has a major role in salt-sensitive hypertension and is vulnerable to harmful effects of increased blood pressure. Elevated serum urate is a common finding in these disorders. While dysregulation of urate excretion is associated with cardiovascular diseases, present studies aimed to clarify the role of xanthine oxidoreductase (XOR), i.e. xanthine dehydrogenase (XDH) and its post-translational isoform xanthine oxidase (XO), in cardiovascular diseases. XOR yields urate from hypoxanthine and xanthine. Low oxygen levels upregulate XOR in addition to other factors. In present studies higher renal XOR activity was found in hypertension-prone rats than in the controls. Furthermore, NaCl intake increased renal XOR dose-dependently. To clarify whether XOR has any causal role in hypertension, rats were kept on NaCl diets for different periods of time, with or without a XOR inhibitor, allopurinol. While allopurinol did not alleviate hypertension, it prevented left ventricular and renal hypertrophy. Nitric oxide synthases (NOS) produce nitric oxide (NO), which mediates vasodilatation. A paucity of NO, produced by NOS inhibition, aggravated hypertension and induced renal XOR, whereas NO generating drug, alleviated salt-induced hypertension without changes in renal XOR. Zucker fa/fa rat is an animal model of metabolic syndrome. These rats developed substantial obesity and modest hypertension and showed increased hepatic and renal XOR activities. XOR was modified by diet and antihypertensive treatment. Cyclosporine (CsA) is a fungal peptide and one of the first-line immunosuppressive drugs used in the management of organ transplantation. Nephrotoxicity ensue high doses resulting in hypertension and limit CsA use. CsA increased renal XO substantially in salt-sensitive rats on a high NaCl diet, indicating a possible role for this reactive oxygen species generating isoform in CsA nephrotoxicity. Renal hypoxia, common to these rodent models of hypertension and obesity, is one of the plausible XOR inducing factors. Although XOR inhibition did not prevent hypertension, present experimental data indicate that XOR plays a role in the pathology of salt-induced cardiac and renal hypertrophy.
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End-stage renal disease is an increasingly common pathologic condition, with a current incidence of 87 per million inhabitants in Finland. It is the end point of various nephropathies, most common of which is the diabetic nephropathy. This thesis focuses on exploring the role of nephrin in the pathogenesis of diabetic nephropathy. Nephrin is a protein of the glomerular epithelial cell, or podocyte, and it appears to have a crucial function as a component of the filtration slit diaphragm in the kidney glomeruli. Mutations in the nephrin gene NPHS1 lead to massive proteinuria. Along with the originally described location in the podocyte, nephrin has now been found to be expressed in the brain, testis, placenta and pancreatic beta cells. In type 1 diabetes, the fundamental pathologic event is the autoimmune destruction of the beta cells. Autoantibodies against various beta cell antigens are generated during this process. Due to the location of nephrin in the beta cell, we hypothesized that patients with type 1 diabetes may present with nephrin autoantibodies. We also wanted to test whether such autoantibodies could be involved in the pathogenesis of diabetic nephropathy. The puromycin aminonucleoside nephrosis model in the rat, the streptozotocin model in the rat, and the non-obese diabetic mice were studied by immunochemical techniques, in situ -hybridization and the polymerase chain reaction -based methods to resolve the expression of nephrin mRNA and protein in experimental nephropathies. To test the effect of antiproteinuric therapies, streptozotocin-treated rats were also treated with aminoguanidine or perindopril. To detect nephrin antibodies we developed a radioimmunoprecipitation assay and analyzed follow-up material of 66 patients with type 1 diabetes. In the puromycin aminonucleoside nephrosis model, the nephrin expression level was uniformly decreased together with the appearance of proteinuria. In the streptozotocin-treated rats and in non-obese diabetic mice, the nephrin mRNA and protein expression levels were seen to increase in the early stages of nephropathy. However, as observed in the streptozotocin rats, in prolonged diabetic nephropathy the expression level decreased. We also found out that treatment with perindopril could not only prevent proteinuria but also a decrease in nephrin expression in streptozotocin-treated rats. Aminoguanidine did not have an effect on nephrin expression, although it could attenuate the proteinuria. Circulating antibodies to nephrin in patients with type 1 diabetes were found, although there was no correlation with the development of diabetic nephropathy. At diagnosis, 24% of the patients had these antibodies, while at 2, 5 and 10 years of disease duration the respective proportions were 23%, 14% and 18%. During the total follow-up of 16 to 19 years after diagnosis of diabetes, 14 patients had signs of nephropathy and 29% of them tested positive for nephrin autoantibodies in at least one sample. In conclusion, this thesis work could show changes of nephrin expression along with the development of proteinuria. The autoantibodies against nephrin are likely generated in the autoimmune process leading to type 1 diabetes. However, according to the present work it is unlikely that these autoantibodies are contributing significantly to the development of diabetic nephropathy.
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Nemaline myopathy (NM) is a rare muscle disorder characterised by muscle weakness and nemaline bodies in striated muscle tissue. Nemaline bodies are derived from sarcomeric Z discs and may be detected by light microscopy. The disease can be divided into six subclasses varying from very severe, in some cases lethal forms to milder forms. NM is usually the consequence of a gene mutation and the mode of inheritance varies between NM subclasses and different families. Mutations in six genes are known to cause NM; nebulin (NEB), alpha-actin, alpha-tropomyosin (TPM3), troponin T1, beta-tropomyosin (TPM2) and cofilin 2, of which nebulin and -actin are the most common. One of the main interests of my research is NEB. Nebulin is a giant muscle protein (600-900 kDa) expressed mainly in the thin filaments of striated muscle. Mutations in NEB are the main cause of autosomal recessive NM. The gene consists of 183 exons. Thus being gigantic, NEB is very challenging to investigate. NEB was screened for mutations using denaturing High Performance Liquid Chromatography (dHPLC) and sequencing. DNA samples from 44 families were included in this study, and we found and published 45 different mutations in them. To date, we have identified 115 mutations in NEB in a total of 96 families. In addition, we determined the occurrence in a world-wide sample cohort of a 2.5 kb deletion containing NEB exon 55 identified in the Ashkenazi Jewish population. In order to find the seventh putative NM gene a genome-wide linkage study was performed in a series of Turkish families. In two of these families, we identified a homozygous mutation disrupting the termination signal of the TPM3 gene, a previously known NM-causing gene. This mutation is likely a founder mutation in the Turkish population. In addition, we described a novel recessively inherited distal myopathy, named distal nebulin myopathy, caused by two different homozygous missense mutations in NEB in six Finnish patients. Both mutations, when combined in compound heterozygous form with a more disruptive mutation, are known to cause NM. This study consisted of molecular genetic mutation analyses, light and electron microscopic studies of muscle biopsies, muscle imaging and clinical examination of patients. In these patients the distribution of muscle weakness was different from NM. Nemaline bodies were not detectable with routine light microscopy, and they were inconspicuous or absent even using electron microscopy. No genetic cause was known to underlie cap myopathy, a congenital myopathy characterised by cap-like structures in the muscle fibres, until we identified a deletion of one codon of the TPM2 gene, in a 30-year-old cap myopathy patient. This mutation does not change the reading frame of the gene, but a deletion of one amino acid does affect the conformation of the protein produced. In summary, this thesis describes a novel distal myopathy caused by mutations in the nebulin gene, several novel nebulin mutations associated with nemaline myopathy, the first molecular genetic cause of cap myopathy, i.e. a mutation in the beta-tropomyosin gene, and a founder mutation in the alpha-tropomyosin gene underlying autosomal recessive nemaline myopathy in the Turkish population.
Resumo:
Cardiovascular diseases (CVD) are major contributors to morbidity and mortality worldwide. Several interacting environmental, biochemical, and genetic risk factors can increase disease susceptibility. While some of the genes involved in the etiology of CVD are known, many are yet to be discovered. During the last few decades, scientists have searched for these genes with genome-wide linkage and association methods, and with more targeted candidate gene studies. This thesis investigates variation within the upstream transcription factor 1 (USF1) gene locus in relation to CVD risk factors, atherosclerosis, and incidence and prevalence of CVD. This candidate gene was first identified in Finnish families ascertained for familial combined hyperlipidemia, a common dyslipidemia predisposing to coronary heart disease. The gene is a ubiquitously expressed transcription factor regulating expression of several genes from lipid and glucose metabolism, inflammation, and endothelial function. First, we examined association between USF1 variants and several CVD risk factors, such as lipid phenotypes, body composition measures, and metabolic syndrome, in two prospective population cohorts. Our data suggested that USF1 contributes to these CVD risk factors at the population level. Notably, the associations with quantitative measurements were mostly detected among study subjects with CVD or metabolic syndrome, suggesting complex interactions between USF1 effects and the pathophysiological state of an individual. Second, we investigated how variation at the USF1 locus contributes to atherosclerotic lesions of the coronary arteries and abdominal aorta. For this, we used two study samples of middle-aged men with detailed measurements of atherosclerosis obtained in autopsy. USF1 variation significantly associated with areas of several types of lesions, especially with calcification of the arteries. Next, we tested what effect the USF1 risk variants have on sudden cardiac death and incidence of CVD. The atherosclerosis-associated risk variant increased the risk of sudden cardiac death of the same study subjects. Furthermore, USF1 alleles associated with incidence of CVD in the Finnish population follow-up cohorts. These associations were especially prominent among women, suggesting a sex specific effect, which has also been detected in subsequent studies. Finally, as some of the low-yield DNA samples of the Finnish follow-up study cohort needed to be whole-genome amplified (WGA) prior to genotyping, we evaluated whether the produced WGA genotypes were of good quality. Although the samples giving genotype discrepancies could not be detected before genotyping with standard laboratory quality control methods, our results suggested that enhanced quality control at the time of the genotyping could identify such samples. In addition, combining two WGA reactions into one pooled DNA sample for genotyping markedly reduced the number of discrepancies and samples showing them. In conclusion, USF1 seems to have a role in the etiology of CVD. Additional studies are warranted to identify functional variants and to study interactions between USF1 and other genetic or environmental factors. This USF1 study, and other studies with low DNA yield of some samples, can benefit from whole genome amplification of the low-yield samples prior to genotyping. Careful quality control procedures are, however, needed in WGA genotyping.