Metabolic syndrome in young adults – prevalence, childhood predictors and association with subclinical atherosclerosis

Background: Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors including central obesity, insulin resistance, impaired glucose tolerance, hypertension and dyslipidemia. The prevalence of MetS is increasing worldwide in all age groups. MetS is associated with increased risk of cardiovascular disease and type 2 diabetes mellitus. Aims: The aim of the present study was to investigate the prevalence, secular trends and childhood predictors of MetS in young adults. Furthermore, the relations between MetS and subclinical atherosclerosis were studied and whether apolipoproteins (apo) B and A-I, C-reactive protein (CRP) and type II secretory phospholipase A2 (sPLA2) were associated with MetS, and to what extent the atherogenicity of MetS was explained by these factors. Participants and Methods: The present thesis is part of the large scale population-based, prospective study, the Cardiovascular Risk in Young Finns Study. The first cross-sectional study was conducted in 1980 and included 3,596 participants aged 3-18 years. Carotid and brachial ultrasound studies were performed for 2,283 of these participants in 2001 and 2,200 of these participants in 2007. Results: The overall prevalence of MetS in young adults aged 24-39 years in 2001 was 10-15 % and 6 years later in 30-45 year-old adults it was 15-23 % depending on the MetS definition used. Between the years 1986 and 2001, MetS prevalence increased from 1.0 % to 7.5 % (p<0.0001) in 24-year-old participants that was mostly driven by the increased central obesity. Participants with MetS had increased carotid intima-media thickness (cIMT) and decreased carotid elasticity compared to those without the syndrome. Impaired brachial flow-mediated dilatation (FMD) was not related to MetS but it modified the relationship between MetS and cIMT (P for interaction 0.023). High levels of apoB, CRP, sPLA2 and low levels of apoA-I associated with MetS in young adults. In prospective analysis both MetS and high apoB predicted (P<0.0001) incident high cIMT, defined as cIMT>90th percentile and/or plaque. The association between MetS and incident high cIMT was attenuated by ~40 % after adjustment with apoB. Conclusions: MetS is common in young adults and increases with age. Screening for risk factors, especially obesity, at an early life stage could help identify children and adolescents at increased risk of developing MetS and cardiovascular disease later in life. MetS identifies a population of young adults with evidence of increased subclinical atherosclerosis. Impaired brachial endothelial response is not a hallmark of MetS in young adults, but the status of endothelial function modifies the association between metabolic risk factors and atherosclerosis. In addition, the atherogenicity of MetS in this population assessed by incident high cIMT appears to be substantially mediated by elevated apoB.

Identification of novel regulators for tumor progression in breast cancer

Breast cancer is the most frequent solid tumor among women and the leading cause of cancer related death in women worldwide. The prognosis of breast cancer patients is tightly correlated with the degree of spread beyond the primary tumor. In this thesis, the aim was to identify novel regulators of tumor progression in breast cancer as well as to get insights into the molecular mechanisms of breast cancer progression and metastasis. First, the role of phospholipid remodeling genes and enzymes important for breast cancer progression was studied in breast cancer samples as well as in cultured breast cancer cells. Tumor samples displayed increased de novo synthesized fatty acids especially in aggressive breast cancer. Furthermore, RNAi mediated cell based assays implicated several target genes critical for breast cancer cell proliferation and survival. Second, the role of arachidonic acid pathway members 15-hydroxyprostaglandin dehydrogenase (HPGD) and phospholipase A2 group VII (PLA2G7) in tumorigenesis associated processes was explored in metastatic breast cancer cells. Both targets were found to contribute to epithelial-mesenchymal transition related processes. Third, a high-throughput RNAi lysate microarray screen was utilized to identify novel vimentin expression regulating genes. Methylenetetrahydrofolate dehydrogenase 2 (MTHFD2) was found to promote cellular features connected with metastatic disease, thus implicating MTHFD2 as a potential drug target to block breast cancer cell migration and invasion. Taken together, this study identified several putative targets for breast cancer therapy. In addition, these results provide novel information about the mechanisms and factors underlying breast cancer progression.

The prognostic and predictive value of selected biomarkers in colorectal cancer

Tissue-based biomarkers are studied to receive information about the pathologic processes and cancer outcome, and to enable development of patient-tailored treatments. The aim of this study was to investigate the potential prognostic and/or predictive value of selected biomarkers in colorectal cancer (CRC). Group IIA secretory phospholipase A2 (IIA PLA2) expression was assessed in 114 samples presenting different phases of human colorectal carcinogenesis. Securin, Ki-67, CD44 variant 6 (CD44v6), aldehyde dehydrogenase 1 (ALDH1) and β-catenin were studied in a material including 227 rectal carcinoma patients treated with short-course preoperative radiotherapy (RT), long-course preoperative (chemo)RT (CRT) or surgery only. Epidermal growth factor receptor (EGFR) gene copy number (GCN), its heterogeneity in CRC tissue, and association with response to EGFR-targeted antibodies cetuximab and panitumumab were analyzed in a cohort of 76 metastatic CRC. IIA PLA2 expression was decreased in invasive carcinomas compared to adenomas, but did not relate to patient survival. High securin expression after long-course (C)RT and high ALDH1 expression in node-negative rectal cancer were independent adverse prognostic factors, ALDH1 specifically in patients treated with adjuvant chemotherapy. The lack of membranous CD44v6 in the rectal cancer invasive front associated with infiltrative growth pattern and the risk of disease recurrence. Heterogeneous EGFR GCN increase predicted benefit from EGFR-targeted antibodies, also in the chemorefractory patient population. In summary, high securin and ALDH1 protein expression independently relate to poor outcome in subgroups of rectal cancer patients, potentially because of resistance to conventional chemotherapeutics. Heterogeneous increase in EGFR GCN was validated to be a promising predictive factor in the treatment of metastatic CRC.

Kipulääkkeiden käyttö kissalla : kirjallisuuskatsaus : [osa] 2 : opioidit ja a2-agonistit

Summary: Use of analgesics in cats : a literature study : [part] 2 : opioids and a2-agonists

Karta öfver Finland (Sektionen A2)

1 kartta :, vär. ;, 50,6 x 43 cm, lehti 58 x 50,3 cm

Konnektorer i inlärarsvenska på CEFR-nivåerna A1, A2 och B1 – en longitudinell analys ur ett funktionellt perspektiv

Syftet med avhandlingen har varit att granska finska inlärares konnektorbruk på CEFR-nivåerna A1, A2 och B1 longitudinellt ur ett funktionellt perspektiv. Jag har studerat vad som är kännetecknande för konnektorbruket på dessa CEFR-nivåer och i vilken funktion konnektorerna har använts på dessa nivåer. Vidare har jämförts konnektorbruket i materialet med det som sägs i CEFR-kriterierna. Slutligen har jag också granskat hur konnektorbruket utvecklas. Som material har jag använt berättande texter (n=303) skrivna av 101 finskspråkiga grundskolelever och gymnasister. Materialet ingår i projektet Topling – Inlärningsgångar i andraspråket vid Jyväskylä universitet. I avhandlingen har använts såväl kvantitativa som kvalitativa metoder. Jag har räknat konnektorernas och konnektorkategoriernas frekvenser samt analyserat i vilka funktioner konnektorerna har använts. I den funktionella analysen har använts systemisk-funktionell lingvistik (Halliday & Matthiessen 2004) samt Labovs (1972) modell om berättelsestrukturen. Analysen har visat att konnektorbruket skiljer sig mellan CEFR-nivåerna A1, A2 och B1. Antalet konnektorer ökar såväl från nivå A1 till A2 som från nivå A2 till nivå B1 och andelen additiva och målspråksavvikande konnektorer minskar medan andelen temporala, kausala och komparativa konnektorer samt att ökar. Konnektorerna har använts först och främst i deras prototypiska funktioner på alla dessa CEFR-nivåer. Vissa konnektorer (när, eftersom, att) verkar även ha en funktion i berättelsestrukturen. Om man jämför konnektorbruket med CEFR-kriterierna kan man konstatera att inlärare på nivå A1 använder pronomenet den i stället för sedan även om denna konnektor nämns i CEFR-kriterierna på nivå A1. Konnektorbruket verkar utvecklas på det sättet att antalet konnektorer samt andelen additiva, temporala och komparativa konnektorer samt att ökar. Andelen additiva konnektorer och målspråksavvikande konnektorer minskar. Vidare börjar inlärare använda mera olika konnektorer och på nivå B1 även mindre frekventa konnektorer som om och fast. I fortsättningen borde man granska konnektorbruket i olika texttyper samt studera om explicit undervisning påverkar inlärares konnektorbruk.