Browsing by Subject "EMPHASIS"

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  • Etminan, Nima; Beseoglu, Kerim; Barrow, Daniel L.; Bederson, Joshua; Brown, Robert D.; Connolly, E. Sander; Derdeyn, Colin P.; Haenggi, Daniel; Hasan, David; Juvela, Seppo; Kasuya, Hidetoshi; Kirkpatrick, Peter J.; Knuckey, Neville; Koivisto, Timo; Lanzino, Giuseppe; Lawton, Michael T.; LeRoux, Peter; McDougall, Cameron G.; Mee, Edward; Mocco, J.; Molyneux, Andrew; Morgan, Michael K.; Mori, Kentaro; Morita, Akio; Murayama, Yuichi; Nagahiro, Shinji; Pasqualin, Alberto; Raabe, Andreas; Raymond, Jean; Rinkel, Gabriel J. E.; Ruefenacht, Daniel; Seifert, Volker; Spears, Julian; Steiger, Hans-Jakob; Steinmetz, Helmuth; Torner, James C.; Vajkoczy, Peter; Wanke, Isabel; Wong, George K. C.; Wong, John H.; Macdonald, R. Loch (2014)
  • Juvela, Seppo; Poussa, Kristiina; Lehto, Hanna; Porras, Matti (2013)
  • Kinkar, Liina; Laurimae, Teivi; Sharbatkhori, Mitra; Mirhendi, Hossein; Kia, Eshrat Beigom; Ponce-Gordo, Francisco; Andresiuk, Vanessa; Simsek, Sami; Lavikainen, Antti; Irshadullah, Malik; Umhang, Gerald; Oudni-M'rad, Myriam; Acosta-Jamett, Gerardo; Rehbein, Steffen; Saarma, Urmas (2017)
    Cystic echinococcosis, a zoonotic disease caused by Echinococcus granulosus sensu lato (s.l.), is a significant global public health concern. Echinococcus granulosus s. l. is currently divided into numerous genotypes (G1-G8 and G10) of which G1-G3 are the most frequently implicated genotypes in human infections. Although it has been suggested that G1-G3 could be regarded as a distinct species E. granulosus sensu stricto (s. s.), the evidence to support this is inconclusive. Most importantly, data from nuclear DNA that provide means to investigate the exchange of genetic material between G1-G3 is lacking as none of the published nuclear DNA studies have explicitly included G2 or G3. Moreover, the commonly used relatively short mtDNA sequences, including the complete coxl gene, have not allowed unequivocal differentiation of genotypes G1-G3. Therefore, significantly longer mtDNA sequences are required to distinguish these genotypes with confidence. The main aim of this study was to evaluate the phylogenetic relations and taxonomy of genotypes G1-G3 using sequences of nearly complete mitogenomes (11,443 bp) and three nuclear loci (2984 bp). A total of 23 G1-G3 samples were analysed, originating from 5 intermediate host species in 10 countries. The mtDNA data demonstrate that genotypes G1 and G3 are distinct mitochondrial genotypes (separated by 37 mutations), whereas G2 is not a separate genotype or even a monophyletic cluster, but belongs to G3. Nuclear data revealed no genetic separation of G1 and G3, suggesting that these genotypes form a single species due to ongoing gene flow. We conclude that: (a) in the taxonomic sense, genotypes G1 and G3 can be treated as a single species E. granulosus s. s.; (b) genotypes G1 and G3 should be regarded as distinct genotypes only in the context of mitochondrial data; (c) we recommend excluding G2 from the genotype list. (C) 2017 Elsevier B.V. All rights reserved.
  • Aro, Katri; Korpi, Jarkko; Tarkkanen, Jussi; Mäkitie, Antti; Atula, Timo (2020)
    Background: The nature of parotid tumors often remains unknown preoperatively and final histopathology may reveal unexpected malignancy. Still, the use of fine-needle aspiration cytology (FNAC) and imaging varies in the management of these tumors. Methods: We evaluated the preoperative examinations and management of all 195 parotid gland tumors diagnosed within our catchment area of 1.6 million people during 2015. Results: Altogether 171 (88%) tumors were classified as true salivary gland neoplasms. FNAC showed no false malignant findings, but it was false benign in 5 (2.6%) cases. Preoperative MRI was utilized in 48 patients (25%). Twenty (10%) malignancies included 16 salivary gland carcinomas. Pleomorphic adenomas accounted for 52% of all adenomas. For 24 (40%) Warthin tumors, surgery was omitted. Conclusion: The proportion of malignancies was lower than generally presented. Our proposed guidelines include ultrasound-guided FNAC with certain limitations. MRI is warranted in selected cases, but seems unnecessary routinely.
  • Zuurbier, Charlotte C.M.; Molenberg, Rob; Mensing, Liselore A.; Wermer, Marieke J.H.; Juvela, Seppo; Lindgren, Antti E.; Jääskeläinen, Juha E.; Koivisto, Timo; Yamazaki, Tomosato; Uyttenboogaart, Maarten; van Dijk, J. Marc C.; Aalbers, Marlien W.; Morita, Akio; Tominari, Shinjiro; Arai, Hajime; Nozaki, Kazuhiko; Murayama, Yuichi; Ishibashi, Toshihiro; Takao, Hiroyuki; Gondar, Renato; Bijlenga, Philippe; Rinkel, Gabriel J.E.; Greving, Jacoba P.; Ruigrok, Ynte M. (2022)
    Background and Purpose: In previous studies, women had a higher risk of rupture of intracranial aneurysms than men, but female sex was not an independent risk factor. This may be explained by a higher prevalence of patient- or aneurysm-related risk factors for rupture in women than in men or by insufficient power of previous studies. We assessed sex differences in rupture rate taking into account other patient- and aneurysm-related risk factors for aneurysmal rupture. Methods: We searched Embase and Pubmed for articles published until December 1, 2020. Cohorts with available individual patient data were included in our meta-analysis. We compared rupture rates of women versus men using a Cox proportional hazard regression model adjusted for the PHASES score (Population, Hypertension, Age, Size of Aneurysm, Earlier Subarachnoid Hemorrhage From Another Aneurysm, Site of Aneurysm), smoking, and a positive family history of aneurysmal subarachnoid hemorrhage. Results: We pooled individual patient data from 9 cohorts totaling 9940 patients (6555 women, 66%) with 12 193 unruptured intracranial aneurysms, and 24 357 person-years follow-up. Rupture occurred in 163 women (rupture rate 1.04%/person-years [95% CI, 0.89-1.21]) and 63 men (rupture rate 0.74%/person-years [95% CI, 0.58-0.94]). Women were older (61.9 versus 59.5 years), were less often smokers (20% versus 44%), more often had internal carotid artery aneurysms (24% versus 17%), and larger sized aneurysms (>= 7 mm, 24% versus 23%) than men. The unadjusted women-to-men hazard ratio was 1.43 (95% CI, 1.07-1.93) and the adjusted women/men ratio was 1.39 (95% CI, 1.02-1.90). Conclusions: Women have a higher risk of aneurysmal rupture than men and this sex difference is not explained by differences in patient- and aneurysm-related risk factors for aneurysmal rupture. Future studies should focus on the factors explaining the higher risk of aneurysmal rupture in women.
  • Hallikainen, Joona; Pyysalo, Mikko; Keränen, Sara; Kellokoski, Jari; Koivisto, Timo; Suominen, Anna Liisa; Pussinen, Pirkko; Pessi, Tanja; Frosen, Juhana (2021)
    Background and purpose Periodontal infections are associated with the formation and rupture of intracranial aneurysms (IAs). This study investigated the role of two key periodontal pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Methods Immunoglobulin A (IgA) and IgG antibodies against P. gingivalis and A. actinomycetemcomitans were measured with enzyme immune assay from the serum of 227 IA patients, of whom 64 also underwent clinical oral examination. As a control group, 1096 participants in a cross-sectional health survey, Health 2000, underwent serological studies and oral examination. Logistic regression was used for multivariate analysis. Immunohistochemistry was performed to demonstrate bacteria-derived epitopes in the IA wall. Results Widespread gingivitis and severe periodontitis were more common in IA patients than in controls (2x and 1.5x, respectively). IgA antibodies against P. gingivalis and A. actinomycetemcomitans were 1.5x and 3-3.4x higher, respectively, in both unruptured and ruptured IA patients compared to controls (p
  • Juvela, Seppo (2019)
    Background and Purpose- The purpose was to obtain a reliable treatment score for unruptured intracranial aneurysms (UIAs) from variables known at baseline. Methods- The series included 142 patients with UIAs diagnosed between 1956 and 1978 when UIAs were not treated and were followed up until the first aneurysm rupture, death, or the last contact. Previously published UIA treatment score was recorded, and finally, a new treatment score was constructed. Results- The median follow-up time was 21.0 years (interquartile range, 10.4-31.8 years). A total of 34 patients had an aneurysm rupture during 3064 person-years of follow-up. The UIA treatment score differed slightly between those with and without an aneurysm rupture (9.4 +/- 2.8 versus 8.3 +/- 3.1, P=0.082). The receiver operating characteristics curve of the UIA treatment score for predicting rupture showed a modest area under the curve (AUC; 0.618, 95% CI, 0.502-0.733; P=0.059). The best new treatment score consisted of 4 variables: age = 7 mm (3 points), and location (anterior communicating artery, 5 points; internal carotid bifurcation, 4 points; and posterior communicating artery, 2 points). Scores of 5 to 12 points were associated with high cumulative UIA rupture rates (16%-60% at 10 years and 49%-80% at 30 years), favoring UIA treatment. Scores of 1 to 4 points (3% at 10 years and 18% at 30 years) favored conservative treatment and needed additional indications for treatment. Patients with a score of 0 points should not be treated (no ruptures during 513 follow-up years). The area under the curve for this scoring was 0.755 (95% CI, 0.657-0.853; P
  • Martignoni, Guido; Brunelli, Matteo; Segala, Diego; Munari, Enrico; Gobbo, Stefano; Cima, Luca; Borze, Ioana; Wirtanen, Tina; Sarhadi, Virinder Kaur; Atanesyan, Lilit; Savola, Suvi; Barzon, Luisa; Masi, Giulia; Fassan, Matteo; Eble, John N.; Bohling, Tom; Cheng, Liang; Delahunt, Brett; Knuutila, Sakari (2017)
    Clear cell papillary renal cell carcinoma (CCPRCC) is a recently recognised neoplasm with a broad spectrum of morphological characteristics, thus representing a challenging differential diagnosis, especially with the low malignant potential multicystic renal cell neoplasms and clear cell renal cell carcinoma. We selected 14 cases of CCPRCC with a wide spectrum of morphological features diagnosed on morphology and CK7 immunoreactivity and analysed them using a panel of immunohistochemical markers, focusing on 34 beta E12 and related CKs 1,5,10 and 14 and several molecular analyses such as fluorescence in situ hybridisation (FISH), array comparative genomic hybridisation (aCGH), VHL methylation, VHL and TCEB1 sequencing and multiplex ligation-dependent probe amplification (MLPA). Twelve of 13 (92%) CCPRCC tumours were positive for 34 beta E12. One tumour without 3p alteration by FISH revealed VHL mutation and 3p deletion at aCGH; thus, it was re-classified as clear cell RCC. We concluded that: (1) immunohistochemical expression of CK7 is necessary for diagnostic purposes, but may not be sufficient to identify CCPRCC, while 34 beta E12, in part due to the presence of CK14 antigen expression, can be extremely useful for the recognition of this tumour; and (2) further molecular analysis of chromosome 3p should be considered to support of CCPRCC diagnosis, when FISH analysis does not evidence the common loss of chromosome 3p.