Tesi sul tema "Biopsie – analyse"
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1
DUMAZER, PHILIPPE. "La biopsie du rein : analyse critique des indications, complications et resultats a propos d'une serie consecutive de 1000 biopsies renales". Toulouse 3, 1988. http://www.theses.fr/1988TOU31302.
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DOP, EPRINCHARD MIREILLE. "Analyse de 285 ponctions biopsies renales percutanees : resultats et apport de l'echographie". Nice, 1989. http://www.theses.fr/1989NICE6577.
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Hunckler, Franck. "Analyse épidémiologique rétrospective des biopsies rénales en Guadeloupe sur une période de 20 ans (1974-94)". Saint-Etienne, 1995. http://www.theses.fr/1995STET6236.
4
Karnoukian, Marc. "Imagerie spectro-polarimétrique : système, algorithmes et biopsie optique". Thesis, Strasbourg, 2017. http://www.theses.fr/2017STRAD001/document.
Abstract (sommario):
Le cancer est une pathologie que l’on se doit de détecter le plus tôt possible si l’on veut accroître les chances de guérison. Ces travaux étudient l’apport de la signature polarimétrique à la caractérisation et l’identification des tissus cancéreux. Il s’agit d’extraire des images multidimensionnelles de polarisation des informations physiques qui caractérisent les constituants de l’objet bien au-delà de l’information visuelle des images d’intensité. Durant cette thèse, un imageur de Mueller, POLARIS, a pu être mis en place ainsi que les outils de traitement et de calibration adaptés. Une méthode de segmentation d’images de Mueller en condition d’éclairement non homogène a été proposée. Une première base d’images multi-spectrales polarimétriques de tissus sains et pathogènes chez la souris a été constituée. Une approche originale a enfin été proposée en se basant sur les forêts aléatoires pour extraire parmi un ensemble de paramètres physiques un jeu de paramètres permettant de différencier les zones saines des zones pathogènes aux différentes longueurs d’ondes de travail. Une comparaison est proposée avec la littérature et permet de valider l’approcheCancer is a pathology that must be detected as soon as possible in order to increase the chances of recovery. These studies investigate the contribution of polarimetric signature to the characterization and identification of cancerous tissues. It is a matter of extracting multidimensional polarization images of the physical information which characterize the constituents of the object well beyond the visual information of the intensity images. During this thesis, a Mueller imager, POLARIS, was set up, as well as the appropriate processing and calibration tools. A method of Mueller images segmentation in non-homogeneous illumination has been proposed. A first database of polarimetric multi-spectral images of healthy and pathogenic tissues in mice was constructed. An original approach was finally proposed based on random forests to extract from a set of physical parameters a set of parameters allowing to differentiate the healthy zones from the pathogenic zones at different working wavelengths. A comparison is proposed with the literature and validates the approach
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Schilling, Anne. "Die Endometriumbiopsie bei der Stute- eine Analyse der histologischen Befunde zwischen 1992- 2012 am Leipziger Institut für Veterinär- Pathologie". Doctoral thesis, Universitätsbibliothek Leipzig, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-224653.
Abstract (sommario):
In der Arbeit wurden die histopathologischen Untersuchungsbefunde von 15795 Uterusbiopsien, welche am Institut für Veterinär- Pathologie der Universität Leipzig von 1992 bis 2012 befundet wurden, aufgearbeitet und statistisch ausgewertet. Ziel der Arbeit war es, zu untersuchen, welche pathologischen Veränderungen des Endometriums im gesamten Untersuchungsgut vorkommen (Endometritis, Angiose, Lymphangiektasien, Endometrose, endometriale Differenzierungsstörungen) und welche Veränderungen in bestimmten, nach unterschiedlichen Gesichtspunkten festgelegten Untersuchungsgruppen dominieren. Weiterhin wurde geprüft, ob und inwiefern bestimmte pathologische Veränderungen miteinander korrelieren und ob sie von anderen Faktoren, wie etwa der Parität oder dem Alter der Stute abhängig sind. 11698 Datensätze von Erstbiopsien lagen nach der Aufarbeitung der Datei zur Untersuchung vor. Bei 9120 Bioptaten konnte auf das Stutenalter geschlossen werden, bei 6049 Bioptaten auf den Reproduktionsstatus der Stute. Bei 4719 Bioptaten liegen vorberichtliche Angaben zur Güstzeit der Stute vor. Die Auswertung der Befunde erfolgte deskriptiv nach Überarbeitung der Datensätze mit Microsoft Access. Mittels SPSS für Windows (Version 22.0) wurde auf Signifikanz geprüft. Die kategorisierten Daten wurden mit Hilfe des Chi-Quadrat-Tests bzw. des exakten Tests nach Fisher ausgewertet.
6
Fahr, Florian. "Zeitliche und räumliche Analyse histomorphologischer Befunde aus Eigennierenbiopsien im Raum Leipzig über einen Zeitraum von 20 Jahren". Doctoral thesis, Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-216027.
Abstract (sommario):
Hintergrund und Zielsetzung: Jährlich erkranken in Westeuropa 4% der Gesamtbevölkerung an Akutem Nierenversagen (ANV). Zudem leiden 8,5% der Bevölkerung an einer Chronischen Niereninsuffizienz (CNI). Valide epidemiologische Daten über Erkrankungen der Niere existierten für Deutschland jedoch nicht, da zu diesem Zeitpunkt Erkrankungsfälle noch nicht flächendeckend systematisch erfasst wurden und das Deutsche Nierenregister noch im Aufbau war. Die vorliegende retrospektive Analyse untersucht und dokumentiert räumliche und zeitliche Veränderungen des histomorphologischen Befundspektrums aus Eigennierenbiopsien im Großraum Leipzig über den Zeitraum 1993-2012. Methoden: Als Grundlage der Arbeit dient ein zeitlich und geographisch strukturiertes Nierenbiopsieregister, welches für die vorliegende Arbeit aus den gesammelten histologischen Eigennierenbiopsiebefunden erstellt wurde. Zu jedem Fall wurde zur räumlichen Zuordnung, wenn ermittelbar, die Postleitzahl (PLZ) des Wohnortes des jeweiligen Patienten eingetragen. Bei einer annähernd vollständigen Erfassung der PLZ wurde für den jeweiligen Zeitraum für das Stadtgebiet Leipzig eine Inzidenzberechnung durchgeführt. Für das Leipziger Umland war dies nicht vorgesehen, da von einer unvollständigen Erfassung auszugehen war. Die statistische Auswertung erfolgte über Kontingenztafeln per Chi-Quadrat-Test oder per Varianzanalyse. Ergebnisse: In die Analyse des erstellten Biopsieregisters wurden n=943 Erstbiopsien eingeschlossen, unter vorherigem Ausschluss pädiatrischer Fälle und Folgebiopsien. Die IgA-Nephropathie (IgANP) war mit 19,5% die häufigste gestellte Diagnose, gefolgt von der Hypertensiven Nephropathie (HZNP) bzw. der Fokal-Segmentalen Glomerulosklerose (FSGS) und der Granulomatose mit Polyangiitis (GPA). Die räumliche Verteilung innerhalb der Untersuchungsregion unterlag teilweise großen Schwankungen. Die IgANP wurde im Leipziger Umland 36% häufiger beobachtet als im Leipziger Stadtgebiet. Auch im Zeitverlauf waren Schwankungen zu beobachten. Im Zeitraum 2009-2012 war die HTNP/FSGS mit 18.9% die häufigste Diagnose, gefolgt von der GPA mit 17,8% und der IgANP mit 15,6%. Zudem nahm die Häufigkeit der Glomerulopathie der dünnen Basalmembran (TBMD) bzw. des Alport-Syndroms stark ab. Auch die regionale Verteilung schwankte im Zeitverlauf stark. Auf Basis der ermittelten Postleitzahlen wurden für den Leipziger Stadtraum für den Zeitraum 2001-2009 jährliche Inzidenzen berechnet. Am Häufigsten trat dabei die GPA mit 0,9 (0,0-2,2) Fällen pro 100.000 Einwohner auf, gefolgt von der HTNP/FSGS mit 0,8 (0,2-2,2) und der IgANP mit 0,8 (0,2-1,4). Schlussfolgerung: Das Nephropathiespektrum im Großraum Leipzigs deckt sich, soweit konsolidierte Vergleichszahlen existieren, mit der bestehenden Literatur. In den Vergleichsstudien zeigte sich eine große Heterogenität. Einige Schwankungen, wie bei der HTNP/Alport-Syndrom oder bei der diabetischen Nephropathie (DNP) beobachtet, sind klar auf Variabilitäten in der Indikationsstellung zurückzuführen. Andere mögliche Einflussfaktoren wurden diskutiertBackground and Objectives: Annually, 4% of Western Europe\'s population fall ill with acute kidney injury (AKI). Furthermore, 8.5% of the same population are affected by chronic kidney disease (CKD). In Germany, valid nationwide epidemiological data on renal pathology didn\'t exist at the time of this study, although progress has been made with creating the German kidney biopsy register. This study analyzes temporal and spatial variances in the histomorphological spectrum of renal diseases of native kidney biopsies in the metropolitan area of Leipzig, Germany, from 1993 through 2012. Methods: For this study, a temporally and spatially structured kidney biopsy register was created from nephro-pathologic biopsy results. Spatial analysis was implemented by giving every entry its corresponding postal code. Unidentifiable entries were omitted. If the postal code was determined for every case within a timeframe, incidences for the city of Leipzig were calculated for the timeframe. Incidence for the surrounding areas were not calculated, because coverage was expected to be incomplete. Statistical analysis was done via Chi-Squared-Test or analysis of variances. Results: For this study n=943 cases were analyzed, omitting pediatric and follow-up biopsies. The leading diagnosis was IgA nephropathy (IgANP) with 19.5% (male: 22.1%, female: 15.4%), followed by hypertensive nephropathy (HTNP) resp. focal-segmental glomerulosclerosis (FSGS) and granulomatosis with polyangiitis (GPA). Spatial variance between the analyzed regions was high. Compared to the city of Leipzig, IgANP was observed one third more frequently in the surrounding regions. High temporal variance was also observed. From 2009 through 2012, HTNP/FSGS became leading diagnosis with 18.9%, followed by GPA with 17.8% and IgANP with 15.6%. Furthermore, frequency of thin base membrane disease (TBMD) resp. Alport\'s syndrome decreased sharply. Variance in spatial distribution was also observed over time. On the basis of determined postal codes, incidences for the city of Leipzig were calculated for the years 2001 through 2009. Highest annual incidence was observed in GPA with 0.9 (0.0-2.2) cases per 100 000 people, followed by HTNP/FSGS with 0.8 (0.2-2.2), IgANP with 0.8 (0.2-1.4). Conclusions: The spectrum of kidney pathology for the metropolitan area of Leipzig is in accordance with the data in literature, as far as consolidated figures were available. Results in compared studies were highly heterogenous. Some differences, e.g. decrease in TBMD resp. Alport\'s Syndrome or fluctuation of DNP, can be attributed to variance in indication for biopsy. External factors were discussed
7
Liuu, Sophie. "Analyse protéomique ciblée à haute résolution : un outil puissant pour le diagnostic clinique à partir de prélèvements de tissus amyloïdes bruts". Thesis, Paris 6, 2014. http://www.theses.fr/2014PA066373/document.
Abstract (sommario):
L'amylose une maladie rare, caractérisée par des agrégats insolubles de protéines extracellulaires. Trente types d'amyloses sont répertoriés et différenciés par la protéine amyloïdogène associée. Leur identification repose sur l'analyse immunohistochimique du tissu malade. Cependant, l'interprétation peut être ambigüe. La micro-dissection laser (LCM) et la spectrométrie de masse sont une alternative prometteuse. Nous avons développé une approche protéomique ciblée à partir de tissus traités par ultrasons. Nous avons montré que les biopsies prélevées chez des patients atteints de différents types d'amyloses peuvent être protéolysées sous ultrasons, ce qui augmente l'efficacité et réduit le temps de la digestion (90s au lieu de 15h), tout en minimisant la quantité de matériel nécessaire. Après une première étape de protéomique sans a priori pour le diagnostic clinique des patients présentant une amylose dans différents organes/tissus (reins, poumons, glandes salivaires, testicule, humeur vitrée et rate), nous avons optimisé une méthode de criblage dédiée à un transfert technologique vers les départements cliniques français. Pour cela, deux méthodes montrent des résultats très encourageants : la SRM (selected reaction monitoring) sur un spectromètre de masse à basse résolution, disponible dans certains laboratoires cliniques et la PRM (parallel reaction monitoring) accessible sur les instruments de dernière génération à très haute résolution, qui fournit rapidement des résultats. En conclusion, nous proposons ici un protocole spécifique pour le diagnostic robuste et la classification rapide des amyloïdosesAmyloidosis is rare disease that appears as an insoluble deposition of specific extracellular proteins. Thirty classes of amyloidosis have been reported and their diagnosis relies on the identification of the associated proteins by immunohistochemistry analysis of the affected tissues. However, its interpretation is highly dependent on the pathologist and can be ambiguous. Laser capture micro-dissection (LCM) and mass spectrometry are a promising alternative. We have developed a targeted proteomics approach from raw tissues treated with ultrasound. We showed that the biopsies taken from patients presenting different classes of amyloidosis can be proteolysed by ultrasonic treatment. This technique increases the efficiency and reduces the time of digestion (90s instead of 15h), while minimizing the amount of material needed. After a first unbiased proteomics study for clinical diagnosis of patients with amyloidosis in various organs/tissues (kidney, lung, salivary glands, testicle, vitreous humor and spleen), we have optimized a dedicated screening method for a technological transfer to the French clinical departments. For this, two methods show very promising results: SRM (selected reaction monitoring) on a low-resolution mass spectrometer, available in some clinical laboratories, and PRM (parallel reaction monitoring) available on the latest generation of high-resolution instruments which provide fast results. In conclusion, we propose here a specific protocol for a robust diagnosis and rapid classification of amyloidoses
8
El, Sissy Carine. "Analyse de la composante immunitaire des cancers colorectaux et de son impact potentiel sur les stratégies thérapeutiques". Electronic Thesis or Diss., Sorbonne université, 2021. https://accesdistant.sorbonne-universite.fr/login?url=https://theses-intra.sorbonne-universite.fr/2021SORUS404.pdf.
Abstract (sommario):
Dans ce travail de thèse, j’ai analysé la qualité de l’infiltrat immunitaire des cancers du rectum localement avancés (LARC) et montré qu’une adaptation du test Immunoscore aux biopsies diagnostiques (ISB : infiltration tumorale en lymphocytes T CD3+ et CD8+) était réalisable. Sur deux cohortes (n1 = 131, n2=118) de patients LARC traités par radiochimiothérapie néoadjuvante (nRCT) avant chirurgie, j’ai observé que la qualité de l’infiltrat immunitaire, évalué par ISB, avait une valeur pronostique en termes de survie sans récidive [HR= 0.21 ; 95%CI 0.06-0.78, P=0.009], et était prédictive de la qualité de la réponse à la nRCT (P<0.001). Les analyses transcriptomiques et protéiques tumorales ont montré une hétérogénéité de réponse immunitaire locale à la nCRT. Une augmentation significative du niveau d’expression de gènes impliqués dans la cytotoxicité (GZMA, GZMH, GZMK, PRF-1), la réponse Th1 (TBX21, STAT4), l’activation (CD69) et la co-stimulation inhibitrice (CTLA-4, LAG3) était observée chez les patients répondeurs. Le statut d’activation immunitaire post-nCRT, était corrélé à l’ISB initial. L’ISB couplé aux examens d’imagerie post-nRCT améliore la prédiction de réponse complète histologique à la nRCT, et donc la sélection de patients éligibles à une stratégie de conservation d’organe (Watch&Wait, W&W). Sur 2 cohortes indépendantes de patients W&W, un ISB High prédisait un faible risque de récidive à 5 ans (3% ; CI95% 0-10%). Enfin, nous avons montré que les patients répondeurs à la nRCT pourraient présenter des signes de stimulation immunitaire adaptative T et B, soulignant le bénéfice immunitaire d’une préservation d’organe (et des ganglions drainants) en situation de réponse à la nCRTIn this work, I analyzed the quality of the immune infiltrate of locally advanced rectal cancer (LARC) and showed that an adaptation of the Immunoscore test to diagnostic biopsies (ISB: tumor infiltration in T cells CD3+ and CD8+) was feasible. In two cohorts (n1=131, n2=118) of LARC patients treated with neoadjuvant radiochemotherapy (nRCT) before surgery, I observed that the quality of the immune infiltrate, assessed by ISB, had a prognostic value in terms of recurrence-free survival [HR= 0.21; 95%CI 0.06-0.78, P=0.009], and was predictive of the quality of the response to nRCT (P<0.001). Tumor transcriptomic and protein analyses showed heterogeneity in local immune response to nCRT. A significant increase in the expression level of genes involved in cytotoxicity (GZMA, GZMH, GZMK, PRF-1), Th1 response (TBX21, STAT4), activation (CD69) and inhibitory costimulation (CTLA-4, LAG3) was observed in responder patients. The post-nCRT immune activation status correlated with the initial ISB. ISB coupled with post-nRCT imaging improves the prediction of histological complete response to nRCT, and thus the selection of patients eligible for an organ preservation strategy (Watch&Wait, W&W). In 2 independent cohorts of W&W patients, a High ISB predicted a low risk of recurrence at 5 years (3%; CI95% 0-10%). Finally, we showed that nRCT responder patients could show evidence of adaptive T and B immune stimulation, highlighting the immune benefit of organ (and draining lymph node) preservation in the nRCT response setting
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Orczyk, Clément. "Modélisation du cancer de la prostate par l'imagerie : détection, stratification, planning thérapeutique et suivi en 3D d'une thérapie focale basés sur le recalage-fusion d'image en multi modalité". Thesis, Normandie, 2017. http://www.theses.fr/2017NORMC405/document.
Abstract (sommario):
Dénommée multiparamétrique par adjonction de séquences fonctionnelle aux conventionnelles, L’IRM de prostate a montré ses performances pour la détection du cancer de prostate par un score radiologique visuel, subjectif. D’autres applications sont en cours d’investigations comme la stratification, le planning thérapeutique ou encore le suivi oncologique.La première partie s’attache à décrire, élaborer et appliquer une méthodologie de recalage non rigide en 3D entre l’histologie du spécimen de prostatectomie totale et les différentes séquences de l’IRMmp. Après avoir capturé une déformation et un changement de volume de la prostate entre les états in vivo et ex vivo par IRM, la méthode de recalage multimodalité appliquée à une population de prostatectomie totale précédée d’une IRM démontre une sous-estimation du volume de cancer par l’IRM, sujette à une stratification. Les implications se trouvent dans la détection, la stratification et le planning thérapeutique. La deuxième partie propose une analyse de texture des différentes séquences et cartographies quantitatives en diffusion et perfusion pour la détection et la stratification du cancer. Cette approche multiparamétrique de « Score d’Entropie » est testée dans une population pilote au moment des biopsies et présente des performances diagnostique pour sélectionner les lésions à biopsier. Ce score d’entropie participe de la stratification du cancer en corrélant positivement avec le score de Gleason et la longueur de cancer biopsique.La troisième partie explore le rôle de l’IRM dans le suivi d’une thérapie émergente, dite focale, du cancer. Il s’agit d’un travail de recalage non-rigide longitudinal sur une cohorte de patients traités par thérapie focale en vue de compenser les déformation focalement induites. Il apparaît que ce type de recalage peut permettre un suivi objectif des résultats d’ablation et potentiellement élaborer une cible biopsique et radiologique dans le suivi oncologiqueConventional prostate MRI, enhanced by diffusion and perfusion sequences, and then named multiparametric, showed high performances for detection of prostate cancer using visual scoring. Indications in stratification, prognosis, treatment planning and follow up are currently under investigations.First part of this work attached itself to describe, elaborate and use a non-rigid image fusion method in 3D between gold standard histology of radical prostatectomy and MRI. Investigations captured the significant differences in shape and volume of in vivo and ex vivo prostate using MRI. The developed multimodality fusion method was applied to a cohort of patients who underwent MRI prior surgery. Results showed a stratified underestimation of cancer volume by MRI. Clinical output resides in detection, stratification and surgical planning.The second part proposed some texture analysis of sequences and quantitative maps. As a multiparametric approach, the Entropy Score is applied in a pilot cohort at time of biopsy and showed some potential usefulness to select MRI targets without compromising detection of significant cancer. By positively correlating with the Gleason Score and the maximal core length of cancer, Entropy Score participates of stratification of cancer.The third part explored application of image registration in the longitudinal follow up of an emergent therapy, said focal (FT). As a conservative approach, FT induces very local deformation of the gland which appears to be appropriately modelled by non-rigid registration, then opening possibilities to guide further control biopsy and radiologic assessment
10
Bonnel, David. "Développements et applications d'approches protéomiques pour la recherche de cibles du cancer de l’ovaire et de la prostate". Thesis, Lille 1, 2010. http://www.theses.fr/2010LIL10078/document.
Abstract (sommario):
Mon travail de thèse a été consacré à l’optimisation et l’utilisation de techniques en protéomique clinique, et plus particulièrement de l’imagerie MALDI, pour la recherche et l’identification de marqueurs pathologiques. C’est pourquoi nous avons, dans un premier temps, développé et appliqué des outils d'analyse statistique basés sur la PCA et la classification hiérarchique, appelés PCA-SDA. Ceux-ci offraient une combinaison intéressante avec l'imagerie MALDI et permettaient une simplification des données, une recherche fine des variations moléculaires au sein du tissu et une classification sur la base des profils moléculaires obtenus localement sur les tissus. Appliquée ensuite sur des études de biopsies de cancer de l’ovaire, cette approche nous a permis de détecter et d’identifier plusieurs marqueurs potentiels jouant un rôle dans la réponse du système immunitaire, l’adhésion et l’invasion tumorale. Or, ces mécanismes sont connus pour impliquer des protéases, les proprotéines convertases, dans la maturation des différentes protéines impliquées dans le développement tumoral. Dans ce contexte, nous avons étudié leur expression dans le cancer de la prostate. Il s’est avéré que seule PACE4 était surexprimée dans cette pathologie et nous avons pu établir son rôle primordial à la fois dans la prolifération cellulaire à l’aide d’études in vitro, et dans l’évasion apoptotique par approche protéomique, suite à l’identification de TRPS1, un facteur de transcription impliqué dans l’apoptose. Le rôle prépondérant de PACE4 fait de cette enzyme une cible thérapeutique potentielle du cancerMy PhD’s work has been completely devoted to the optimization and the use of technologies in clinical proteomics, especially MALDI imaging, for research and identification of disease markers. Therefore we have initially developed and applied the tools of statistical analysis based on PCA and hierarchical clustering, called PCA-SDA, which offered an interesting combination with MALDI imaging and allow simplification of data, fine search of molecular changes within the tissue and a classification based on molecular profiles obtained locally on the tissues. Then applied on ovarian cancer biopsies study, this approach allowed us to detect and identify several potential markers playing a role in immune response, adhesion and tumor invasion. However, these mechanisms are known to involve proteases, like proprotein-convertases, in the maturation of various proteins implicated in tumor development. In this context, we studied their expression in prostate cancer. It pointed that only PACE4 was over-expressed in this disease and we were able to establish its role in cell proliferation using in vitro analysis and in apoptotic evasion with the identification of TRPS1, a transcription factor involved in apoptosis, by proteomics approach. So, PACE4 is a potential therapeutic target for cancer due to its leading role in tumor cell capacities
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Raoul, Gwénaël. "Plasticité du masseter humain : relation entre les chaînes lourdes de myosine et la dysmorphose dento-maxillo-faciale". Thesis, Lille 1, 2008. http://www.theses.fr/2008LIL10124/document.
Abstract (sommario):
Les 161 recueils de masséter (161 gauche 36 droite) ont intéressé des patients lors du traitement chirurgical de leur malocclusion. Les 161 patients sont regroupés selon l'analyse céphalométrique de Delaire informatisée. L'étude des chaînes lourdes de myosine a été effectuée sur 28 échantillons par électrophorèse (SDS-PAGE) et western-blot. L'immunomarquage a été réalisé sur les 197 biopsies (côté gauche 161 et côté droit 36) et permet d'identifier 4 groupes de fibres du masséter humain (l, Hybride, II, NéoAtrial) selon leur pourcentage et leur surface moyenne. Nous avons réalisé des tests de Student apparié et de Wilcoxon pour comparer les résultats des 28 échantillons selon l'immunomarquage et l'électrophorèse, et les deux côtés pour les patients déviés ou non. Nous avons réalisé un test d'ANOVA entre chaque type de fibre et les groupes. Les résultats de l'électrophorèse et de l'immunomarquage sont identiques, validant la faible variabilité intrinsèque à l'échelle de la biopsie. La comparaison des patients déviés conclut à une différence significative du côté homolatéral à la déviation chez les patients déviés (pourcentage de fibres de type II p=0,0286). Le morphotype deepbite est associé à une élévation du pourcentage des fibres de type II (p=0,0073) et à une baisse de la surface moyenne des NéoAtriale (p=0,0401). Le morphotype classe II apparait associé à une augmentation du pourcentage de fibres hybrides (p=0,0419) et une baisse du pourcentage de fibres de type II (p=0,0234) par rapport à la classe Ill. La position absolue de la mandibule par rapport à la base du crâne est liée au pourcentage (p=0,0023) et la surface moyenne (p=0,0387) des fibres de type Hybride (augmentation dans les pro et rétro-mandibulie, baisse dans les normo-mandibulie) CONCLUSION La hauteur faciale et la latérodéviation sont liées au pourcentage de fibres de type II et à la surface moyenne des fibres NéoAtriales. La position sagittale de la mandibule est liée au pourcentage et la surface moyenne des fibres Hybrides, et au pourcentage de fibres de type IIMasseter biopsies (161left, 36 right).were performed on 161 subjects undergoing surgical treatment of malocclusion. Patients were classified according to computer-assisted Delaire cephalometric analysis. The 36 patients with both side biopsies were separated into 2 groups: with or without lateral deviation. SDS-PAGE was performed on 28 biopsies to identify myosin heavy chain content. Immunostaining with myosin-isoform-specific antibodies was performed on 197 biopsies to identify 4 fiber types (l, Hybrid, II, NéoAtrial). For each fiber type, percent occupancy and mean area were calculated. Student and Wilcoxon tests were used to compare electrophoresis and immunostaining results from 28 cases, and fibre type compositions on the two sides in 36 patients. An ANOVA test was done to identify correlation between percent occupancy and mean area of each fiber type versus cephalometric classification for aIl 161 left samples. Electrophoresis and immunostaining analysis of slow and fast (lIa & IIx) myosin heavy chains gave equivalent results. Lateral deviation patients showed an increase of type II fiber occupancy (p=0,0286) on the same side as the deviation (short side). Deep bite is associated with an increase of type II fiber occupancy (p=0,0073) and decrease of NeoAtrial mean fiber area (p=0,0401). Class II is significantly associated with an increase in occupancy of hybrid fibers (p=0,0419) and decrease of type II (p=O,0234) as compared with Class Ill. Mandibular position in relation to the skull base trend is associated with an increase of percent occupancy (p=0,0023) and mean area (p=0,0387) of hybrid fibers in case both forward and backward position. CONCLUSION Facial vertical dimension and mandibular lateral deviation is significantly linked to type II fiber percentage occupancy and NeoAtrial mean fiber area. Saggital mandibular position is linked to mean fiber area and percent of hybrid fibers, and percent occupancy of type II fibers
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Pesonen, Izabell, e Midia Ismail. "Immunhistokemisk (IHC) analys av låggradigt inflammerade biopsier med apikal parodontit -en pilotstudie". Thesis, Malmö universitet, Odontologiska fakulteten (OD), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-42574.
Abstract (sommario):
Syfte: Att ta reda på hur relationen ser ut för B- respektive T-lymfocyter i biopsier av rotfyllda tänder med apikal parodontit med bedömd låggradig inflammation. Denna studie kommer även att analysera hur den inflammatoriska bilden ser ut i förhållande till beskrivna symtom i dessa biopsier. Material & metod: En pilotstudie utfördes på 10 biopsier från rotfyllda tänder med apikal parodontit med bedömd låggradig inflammation enligt Danesh et al 2019 klassificeringssystem. Biopsierna hämtades från Malmö universitets biobank. Immunhistokemisk infärgning av antigenerna CD20+ och CD3+ utfördes samt analyserades med hjälp av digitalmikroskop. Jämförelsen av symtomen från remisserna skedde efter att de histologiska resultaten sammanställts. Resultat: Det fanns fler T-lymfocyter än B-lymfocyter i 6 stycken av biopsierna. I de resterande 4 biopsierna var de lika många. I remisserna hade symtombilden inte angetts föralla biopsier. Slutsats: Enligt vår pilotstudie ser vi tendenser till att T-lymfocyter är fler än B-lymfocyter eller att de är lika många. Inga slutsatser kunde dras gällande symtombilden. Ett större material från olika remittenter krävs för definitiva slutsatser. En vidare infärgning av CD4+ samt CD8+ skulle vara intressant.Aim: To investigate the relation between B- and T- lymphocytes in biopsies of root-filled teeth with apical periodontitis with assessed low-grade inflammation. This study will also analyse what the inflammation looks like in relation to the symptoms described in these biopsies. Study design: A pilot study was performed on 10 biopsies of root-filled teeth with apical periodontitis with assessed low-grade inflammation according to the classification system of Danesh et al 2019. The biopsies were collected from Malmö University's biobank. An immunohistochemical staining of antigens CD20+ and CD3+ were performed and analysed by a digital microscope. A comparison of the symptoms from the referrals were performed once the histological results were compiled. Results: There were more T-lymphocytes than B-lymphocytes in 6 of the biopsies. In the remaining 4 biopsies there were an equal amount of B- and T-lymphocytes. The symptoms were not stated for all biopsies in the referrals. Conclusion: According to our pilot study, we see tendencies that T lymphocytes are more than B lymphocytes or that they are equal. No conclusions could be drawn regarding the symptom picture. Larger material from different referrers is required for definitive conclusions. A further staining of CD4 + and CD8 + would be interesting.
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Scola, Rosana Herminia 1959. "Estudo dos vacuolos sugestivos de corpos de inclusão citoplasmatica na biopsia muscular : analise clinica, laboratorial, eletroneuromiografica, histoquimica, imunocitoquimica e ultra-estrutural de 16 casos". reponame:Repositório Institucional da UFPR, 2017. http://hdl.handle.net/1884/43840.
Abstract (sommario):
Orientador: Lineu Cesar WerneckContem 33 fots. coladas
Dissertação (mestrado) - Universidade Federal do Parana, Setor de Ciencias da Saude, Programa de Pós-Graduação em Medicina Interna
Resumo: Os vacúolos são formações anormais encontradas nas fibras musculares, podendo ser classificados morfologicamente quanto ao tamanho, número, posição, forma, presença de membranas e se marginados ou não. Os vacúolos marginados, podem ser encontrados em diversas doenças, entre elas a miosite com corpos de inclusão citoplasmática. Esta é caracterizada clinicamente como uma polimiosite crônica tendo na histologia do músculo a presença dos vacúolos marginados, e denominados histologicamente de corpos de inclusão citoplasmáticos, podendo ter filamentos intranucleares e intracitoplasmáticos. Com o objetivo de estudar os vacúolos com aspecto histológico de corpos de inclusão citoplasmática, foram estudados todos os casos entre 1400 biópsias musculares que apresentaram os mesmos, procurando correlacionar com os dados clínicos laboratoriais, afim de verificar a sua especificidade para determinadas doenças. Foram encontrados 16 casos. Dos 16 casos, a idade média foi de 36.0 anos, o início da doença teve a média de 20.5 anos e o tempo de doença de 5.5 anos. Os casos foram classificados conforme a história clínica, hereditariedade, dados laboratoriais, eletrofisiológicos, histoquünicos, imunocitoquímicos e microscopia eletrônica em miosite com corpos de inclusão citoplasmática (4 casos), atrofia muscular espinhal juvenil (6 casos), miopatias distais (3 casos), distrofia de cinturas pélvica e escapular (2 casos) e polineuropatia periférica (1 caso). As enzimas musculares, mais especificamente a creatinoquinase mostrou-se elevada em dez casos. Apenas um caso mostrou moderada redução nas conduções nervosas. A eletromiografia esteve alterada em todos os casos sendo que, em cinco, casos a mesma mostrou sinais de desinervação (ativa e ou crônica), oito foram miopáticos e em dois casos mista (neuromiopática). A biópsia muscular pela histoquímica em cinco casos mostrou histologicamente uma miopatia (ativa e ou crônica); em sete casos, elementos para miopatia e desinervação (misto); em dois casos, desinervação; e em dois casos, miopatia inflamatória. Todos os casos mostravam vacúolos marginados. O estudo imunocitoquímico demonstrou predomínio de linfócitos CD8+ no interstício na maioria dos casos, e ocasionalmente nas regiões perivasculares e no interior das fibras musculares. As miosites por corpos de inclusão citoplasmática tiveram importante aumento de linfócitos CD8+, em relação a outras doenças. A detecção de imunoglobulinas e complemento foram mais evidentes na miosite com corpos de inclusão citoplasmática, embora não demonstre uma diferença marcante, exceto na polineurite em que não teve nenhuma célula ou deposição de imunoglobulina. A microscopia eletrônica demonstrou a presença de filamentos nucleares e dispersos no citoplasma em cinco casos, um caso demontrou a presença de filamentos no núcleo e região subsarcolemal, dois casos mostraram filamentos na região subsarcolemal e citoplasma. Em um caso, os filamentos estavam dispersos no citoplasma e núcleo, sendo que em sete casos não foram observados filamentos intracitoplasmáticos q u intranucleares. Foi concluído que: 1) Os filamentos intracitoplasmáticos e intranucleares não são específicos para uma única entidade; 2) A presença de reação inflamatória auxilia na diferenciação das outras doenças com miosite com corpos de inclusão citoplasmática; 3) A creatinaquinase e eletromiografia não são úteis para diferenciar a miosite com corpos de inclusão citoplasmática das outras entidades; 4) Existe um predomínio de linfócitos T no interstício nas miopatias com corpos de inclusão citoplasmática; 5) Foi notado importante aumento de linfócitos CD8+ no interstício, sugerindo relação com o complexo maior de histocompatibilidade 1 (MCH1); 6) Houve inversão da proporção de linfócitos CD4+/CD8+, sugerindo processo mediado pelo MCH1; 7) As imunoglobulinas e complemento foram detectadas com maior freqüência nas miosites com corpos de inclusão citoplasmática; 8) Os corpos de inclusão citoplasmática ocorrem em diversas entidades, com patogenia e patologia global diferente, sugerindo se tratar de uma reação celular inespecífica, talvez relacionada com tempo de agressão crônica da fibra muscular, tanto nos processos de origem muscular primaria, como de origem neurogênica. VI
Abstract: The vacuoles are abnormal structures of the muscle fibers, who can be morphological classified according the size, number, location, shape, presence of membranes or if they are rimmed. The rimmed vacuoles can be find in several diseases, mainly in the inclusion body myositis. This disease can be presented as chronic polymyositis with rimmed vacuoles in the histology, also called cytoplasmatic inclusion body, with cytoplasmatic or nuclear filaments. With the objectives to study the histopathological aspects of the cytoplasmatic inclusion bodies, we select all the cases who presented rimmed vacuoles among 1400 muscle biopsies, who had the clinical history and laboratory investigation available. We found 16 cases, with mean age of 36.0 years, whose disease started at 20.5 and a mean disease time 5.5 years. The cases where classified regarding the clinical history, hereditary pattern, serum laboratory determinations, electrophysiological tests, histochemical and immunocytochemical analysis and electron microscopic findings in inclusion body myositis (4 cases), juvenile spinal muscular atrophy (6 cases), distal myopathy (3 cases), limb-girdle muscular dystrophy (2 cases) and peripheral neuropathy of unknown etiology (1 case). The serum enzymes, specially the creatinekinases, was increased in ten cases. Only one case had reduced nerve conduction velocity. The electromyography was abnormal in all cases with denervation pattern in five and myopathic pattern in eight and in two cases had a mixed pattern (myopathic and denervation). The muscle biopsy histochemistry had the diagnosis of myopathy (active and chronic) in seven cases, mixed (myopathy and denervation findings) in two cases, denervation in two and inflammatory myopathy in two. All the cases had rimmed vacuoles. The immunocytocheinical analysis showed CD8+ lymphocytes in the interstitial in most cases, occasionally ip the perivascular region and rarely inside the muscle fibers. The inclusion body myositis cases had increased of CD8+ lymphocytes comparing with the other diseases. The immunoglobulins and complement deposition were slight more intense in the inclusion body myositis, comparing with the other diseases. The peripheral neuropathy had no cells or immunoglobulins found any time. The electron microscopy detected filaments in the nucleus and diffusely in the cytoplasm in five cases, one case only in the nucleus and sub-sarcolemmal region, two cases with filaments in the sub-sarcolemmal and cytoplasm. One case had filaments where dispersed in the cytoplasm and nucleus. Seven cases had no filaments found in nucleus or cytoplasm. The following conclusion was drawn: 1) The intracytoplasmic or intranuclear filaments is not specific for only one disease. 2) The inflammatory reaction help in the differentiation of the inclusion body myositis from the other diseases studied. 3) The creatinekinase and electromyography where useless in the differentiation the inclusion body myositis from other diseases. 4) A predominance of T lymphocytes was found in the interstitial tissue in the cases of inclusion body myositis. 5) Was noted an important increased of the CD8+ lymphocytes in the interstitial tissue, suggesting a relationship with the major histocompatibilty 1 complex (MCH1). 6) An inversion of the CD4+/CD8+ lymphocyte's proportion was found , suggesting a mediation by the MCH1. 7) The immunoglobulins and complement deposition were found with major frequency in the inclusion body myositis. 8) The cytoplasmatic inclusion bodies can be found in several diseases with different pathogenesis and pathology, suggesting a non specific cellular reaction, maybe related with the time of the chronic aggression to the muscle tissue, who can be similar in the primary muscle lesion and neurogenic etiology.
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CARRIER, JEAN-BAPTISTE. "Cytoponction et microbiopsie echoguidees des masses abdominales : interet de l'association des analyses cytologique et histologique : a propos de 60 observations". Lyon 1, 1989. http://www.theses.fr/1989LYO1M111.
15
LECRIVAIN, CHIRI FRANCOISE. "Analyse en imagerie par resonance magnetique des osteonecroses de hanches forees". Aix-Marseille 2, 1993. http://www.theses.fr/1993AIX20820.
16
Bovey, D. "The artist biopic : a historical analysis of narrative cinema, 1934-2010". Thesis, University of Westminster, 2015. https://westminsterresearch.westminster.ac.uk/item/9w77z/the-artist-biopic-a-historical-analysis-of-narrative-cinema-1934-2010.
Abstract (sommario):
The thesis provides an historical overview of the artist biopic that has emerged as a distinct sub-genre of the biopic as a whole, totalling some ninety films from Europe and America alone since the first talking artist biopic in 1934. Their making usually reflects a determination on the part of the director or star to see the artist as an alter-ego. Many of them were adaptations of successful literary works, which tempted financial backers by having a ready-made audience based on a pre-established reputation. The sub-genre’s development is explored via the grouping of films with associated themes and the use of case studies. These examples can then be used as models for exploring similar sets of data from other countries and time periods. The specific topics chosen for discussion include the representation of a single painter, for example, Vincent Van Gogh, to see how the treatment of an artist varies across several countries and over seventy years. British artist biopics are analysed as a case study in relation to the idea of them posing as a national stereotype. Topics within sex and gender studies are highlighted in analysis of the representation of the female artist and the queer artist as well as artists who have lived together as couples. A number of well-known gallery artists have become directors of artist biopics and their films are considered to see what particular insights a professional working artist can bring to the portrayal of artistic genius and creation. In the concluding part of the thesis it is argued that the artist biopic overall has survived the bad press which some individual productions have received and can even be said to have matured under the influence of directors producing a quality product for the art house, festival and avant-garde distribution circuits. As a genre it has proved extremely adaptable and has reflected the changing attitudes towards art and artists within the wider community. It has both encouraged renewed interest in the work of established national artists and also raised the profile of those relatively obscure such as Séraphine de Senlis and Pirosmani.
17
Lammers, Christina [Verfasser], e Matthias [Akademischer Betreuer] Paul. "Morphometrische Analyse des prozentualen Anteils und des Verteilungsmusters rechtsventrikulärer Lipomatose in Endomyokard-Biopsien von Patienten mit arrhythmogener rechtsventrikulärer Kardiomyopathie / Christina Lammers. Betreuer: Matthias Paul". Münster : Universitäts- und Landesbibliothek der Westfälischen Wilhelms-Universität, 2012. http://d-nb.info/1027022081/34.
18
Gulley-Stahl, Heather Jane. "An Investigation into Quantitative ATR-FT-IR Imaging and Raman Microspectroscopy of Small Mineral Inclusions in Kidney Biopsies". Miami University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=miami1272042834.
19
Laplatine, Loïc. "Résolution spatiale en microscopie par résonance de plasmon de surface à couplage par prisme". Thesis, Grenoble, 2014. http://www.theses.fr/2014GRENY044/document.
Abstract (sommario):
La microscopie par résonance de plasmon de surface (SPR) à couplage par prisme a vu le jour à la fin des années 60. Le principal avantage de cette technique d'imagerie optique réside dans sa très grande sensibilité à de faibles variations d'indice optique ou d'épaisseurs à la surface d'un métal. De ce fait, le suivi d'interactions biologiques peut se faire en temps réel sans avoir recours à l'utilisation de marqueurs fluorescents ou enzymatiques. Depuis plus de 30 ans, la microscopie SPR s'est imposée comme la technique de référence de biodétection sans marquage. Ses champs d'application vont de la détermination de constantes d'affinité à la détection de bactéries pathogènes, en passant par la biologie cellulaire. Jusqu'à présent, on pensait la résolution spatiale limitée par la longueur de propagation des plasmons de surface. Or, de nombreux exemples ne corroborent pas cette hypothèse. Dans cette thèse, nous montrons qu'à ce phénomène de propagation se rajoute des aberrations optiques induites par l'utilisation d'un prisme pour coupler la lumière et les plasmons de surface. Nous expliquons ainsi pourquoi les résolutions expérimentales étaient souvent bien moins bonnes que celles attendues. Par l'analyse de la formation des images et la quantification des aberrations, nous aboutissons à deux nouvelles configurations optiques optimisées pour la résolution. Nous analysons ensuite quel métal offre le meilleur compromis entre longueur de propagation et sensibilité. Expérimentalement, nous obtenons une résolution comprise entre 1,5 et 4 μm suivant la direction, sur des champs de vision de plusieurs mm2, et ce, avec une sensibilité standard en biodétection. Nous sommes ainsi en mesure d'observer simultanément plusieurs milliers de cellules individuelles, eucaryotes et procaryotes. Finalement, nous développons un prototype dédié au suivi en temps réel de sécrétions de protéines par des cellules immunitaires. Les limites de la microscopie SPR et les solutions qui permettraient de faire aboutir ce type d'étude sont examinées. Des études préliminaires sont aussi menées sur l'amélioration de la détection de bactériesPrism-based surface plasmon resonance (SPR) microscopy is an optical imaging technique invented in the late 60s'. Its main advantage lies in its high sensitivity to optical index or thickness variations at a metal surface. Therefore, the monitoring of biological reactions can be performed in real-time without labeling agent such as fluorescence or enzymes. Over the last 30 years, SPR microscopy has become the major technique in label-free biodetection. The field of application range from the determination of affinity constant in biochemistry to the detection of pathogenic bacteria via cellular biology. Until now, the propagation length of the surface plasmons has been considered as the spatial resolution limit. However, many examples do not support this statement. In this PhD thesis, we demonstrate that the resolution is also limited by optical aberrations induced by the prism used to couple light and surface plasmons. Thus, we are able to explain why the experimental resolution was usually worse than the predicted one. The analysis of the image formation and the quantification of aberrations lead us to suggest two new optical configurations optimized for resolution. We also analyze which metal exhibits the better trade-off between propagation length and sensitivity. Experimentally, we obtain a resolution between 1.5 and 4 μm depending on the direction, on field-of-view up to several mm2, and with a standard sensitivity for biodetection (monolayer of DNA). We are then able to observe simultaneously several thousands of individual eukaryote and prokaryote cells. Finally, we develop a prototype dedicated to the real-time monitoring of protein secretion by immune cells. The limits of SPR microscopy and the solutions which could allow this kind of study are discussed. Preliminary results on the improvement of bacterial detection are also presented
20
Clavadetscher, Katarzyna Barbara. "Korrelation zwischen klinischen Risikofaktoren, radiologischen Veränderungen und Histologie von nicht-palpablen Befunden in der Mamma : eine Analyse von 183 lokalisierten Biopsien an der Universitäts-Frauenklinik Bern /". [S.l.] : [s.n.], 2002. http://www.stub.unibe.ch/html/haupt/datenbanken/diss/bestell.html.
21
Robert, Michèle. "Etude quantitative des constituants épithéliaux et mésenchymateux dans l'hypertrophie bénigne de la prostate : comparaison des résultats obtenus sur pièces d'adénomectomie et biopsies uniques et multiples". Montpellier 1, 1995. http://www.theses.fr/1995MON1T038.
22
SPAGNOLO, FRANCESCO. "Analisi fenotipica e funzionale dell’infiltrato linfocitario in biopsie di metastasi di melanoma, in pazienti in terapia con farmaci a bersaglio molecolare e/o inibitori dei checkpoint immunologici". Doctoral thesis, Università degli studi di Genova, 2020. http://hdl.handle.net/11567/1009806.
Abstract (sommario):
Le terapie a bersaglio molecolare (targeted therapies, TT) e l’immunoterapia con anticorpi immunomodulanti (immune checkpoint blockers, ICB) hanno rivoluzionato la terapia del melanoma metastatico (MM). Sebbene con utilizzo delle TT siano stati ottenuti tassi di risposta superiori al 70%, il tasso di recidiva e lo sviluppo di resistenze è ancora molto alto. Gli ICB, in particolare gli anticorpi monoclonali anti-PD-1, producono risposte durature, ma solo meno del 40% dei pazienti ottiene una risposta. La maggior parte dei pazienti trattati con questi farmaci va incontro a progressione della malattia dovuta a resistenza primaria o acquisita. Inoltre, poiché queste nuove terapie sono efficaci solo su una frazione di pazienti, vi è la necessità di identificare biomarcatori associati alla risposta.
Gli obiettivi del presente studio sono: i) Identificare nuovi bersagli molecolari per la terapia del MM attraverso la caratterizzazione esaustiva in vitro e in vivo di mutazioni riscontrate nei campioni bioptici; ii) Correlare le varianti geniche di PD-1/PD-L1/PD-L2/CTLA-4 e il profilo immunologico (immunoscore) del microambiente tumorale, con la sopravvivenza (overall survival) dei pazienti sottoposti a targeted therapy (TT) e terapie immunomodulanti (ICB); iii) Analizzare gli effetti immunomodulanti esercitati dalle targeted therapies (TT) e dagli anticorpi monoclonali (ICB) sulle cellule NK e sulle interazioni NK-melanoma.
Sono stati arruolati 48 pazienti con melanoma avanzato non pretrattato o resistente a precedente terapia con ICB o TT. Sono state analizzate 33 biopsie di metastasi di melanoma cutaneo appartenenti a 29 pazienti, trattati, secondo pratica clinica, con inibitori di BRAF e MEK e/o con anticorpi anti-PD-1. I risultati ottenuti indicano che l’espressione di TIM3 correla con i livelli di espressione di PD-1 in quanto è esclusivamente espresso dai T CD8+/PD-1 high, mentre sia GmzB che Eomes risultano espressi anche da cellule T CD8+/PD-1 low. Inoltre, le cellule T CD8+/PD-1 high mostrano anche una più alta espressione di Ki67 suggerendo che queste cellule sono in grado di proliferare all’interno del tumore. Inoltre, i linfociti T CD8+/PD-1 neg/low sono in grado di produrre sia IFN che TNF dopo stimolazione policlonale, mentre i linfociti T CD8+/PD-1 high producono bassi livelli di TNF, pur mantenendo la capacità di rilasciare IFN. La correlazione dell’infiltrato linfocitario con le varianti geniche di PD-1 e PD-L1 ha evidenziato un ruolo degli SNV PD1.5C>T e PD-L1C>T rs2297136 nel reclutamento, nelle biopsie cutanee, di linfociti T CD8+ esprimenti vari livelli di PD-1. In particolare, i genotipi portatori della variante allelica T+ modificano sia la percentuale di linfociti T CD8+ PD-1 high che l’intensità di espressione di PD-1 high (aumentate per il primo SNV e diminuite per il secondo rispettivamente), rispetto ai genotipi wild type.Targeted therapies (TT) and immune checkpoint inhibitors immunotherapy (ICB) has dramatically changed the treatment of metastatic melanoma (MM). Although targeted therapy achieved a response rate as high as 70%, most patients ultimately develop resistance and progressive disease. Immune checkpoint inhibitors, especially with anti-PD-1 monoclonal antibodies, achieve durable responses, but in less than 40% of patients. The majority of patients receiving these treatments ultimately face progressive disease due to the development of primary of secondary resistance. Since only a fraction of patients achieve a durable benefit, the identification of predictive biomarkers is an unmet need. The objectives of our present study are: i) Identification of new molecular targets through the extensive in vitro and in vivo characterization of tumor biopsies; ii) Investigation of associations between PD-1/PD-L1/PD-L2/CTLA-4 variants and tumor microenvironment immunoscore with overall survival of patients receiving TT and ICB; iii) Analysis of the immune effects of TT and ICB on NK cells and their interaction with melanoma cells. Forty-eight patients with advanced melanoma were enrolled and 33 tumor biopsies from 29 patients were analyzed. Patients received TT and/or anti-PD-1 drugs. We observed that TIM3 expression is associated with PD-1 expression, as it is exclusively expressed in CD8+/PD-1 high T cells, while both GmzB and Eomes are also expressed by CD8+/PD-1 low cells. Moreover, CD8+/PD-1 high T cells show a higher Ki67 expression, suggesting that these cells may proliferate within the tumor. CD8+/PD-1 neg/low T cells are able to produce both IFN and TNF after polyclonal stimulation, while CD8+/PD-1 high cells produce low levels of TNF, maintaining the ability to release IFN. The association between PD-1/PD-L1 variants with immune infiltrate highlighted the role of PD1.5C>T and PD-L1C>T rs2297136 SNV in CD8+ cells recruiting. In particular, genotypes harboring the allelic variant T+ modify both the rate of CD8+ PD-1 high cells and the intensity of PD-1 high expression, compared with wild type genotypes.
23
von, Below Catrin. "PET and MRI of Prostate Cancer". Doctoral thesis, Uppsala universitet, Radiologi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-300940.
Abstract (sommario):
Prostate cancer (PCa) is the most common non-skin malignancy of men in developed countries. In spite of treatment with curative intent up to 30-40% of patients have disease recurrence after treatment, resulting from any combination of lymphatic, hematogenous, or contiguous local spread. The concept of early detection of PCa offer benefits in terms of reduced mortality, but at the cost of over-diagnosis and overtreatment of indolent disease. This is largely due to the random nature of conventional biopsies, with a risk of missing significant cancer and randomly hitting indolent disease. In the present thesis, diagnostic performance of MRI DWI and 11C Acetate PET/CT lymph node staging of intermediate and high risk PCa, was investigated, and additionally, predictive factors of regional lymph node metastases were evaluated. Further, additional value of targeted biopsies to conventional biopsies, for detection of clinically significant PCa, was investigated. In paper one and two, 53 and 40 patients with predominantly high risk PCa underwent 11C Acetate PET/CT and 3T MRI DWI, respectively, for lymph node staging, before extended pelvic lymph node dissection (ePLND). The sensitivity and specificity for PET/CT was 38% and 96% respectively. The sensitivity and specificity for MRI DWI was 55% and 90% respectively. In paper three, 53 patients with newly diagnosed PCa were included. All patients underwent multi-parametric MRI, followed by two cognitive targeted biopsies. Five more clinically significant cancers were detected by adding targeted biopsies to conventional biopsies. In paper four the value of quantitative and qualitative MRI DWI and 11C Acetate PET/CT parameters, alone and in combination, in predicting regional lymph node metastases were examined. ADCmean in lymph nodes and T-stage on MRI were independent predictors of lymph node metastases in multiple logistic regression analysis. In conclusion the specificity of diffusion weighted MRI and 11C Acetate PET/CT for lymph node staging was high, although the sensitivity was low. Predictive factors of regional lymph node metastases could be retrieved from diffusion weighted MRI and 11C Acetate PET/CT. By combining targeted biopsies with conventional biopsies the detection rate of clinically significant PCa could be increased.
24
Nguyen, Thi Quynh Huong. "Insuffisance rénale chronique : épidémiologie de l'insuffisance rénale chronique chez l'enfant à l'Hôpital national pédiatrique de Hanoi et analyse histologique de l'expression du récepteur B1 de la bradykinine sur des biopsies de transplants rénaux". Toulouse 3, 2009. http://thesesups.ups-tlse.fr/918/.
Abstract (sommario):
L'incidence de l'insuffisance rénale chronique terminale (IRCT) augmente régulièrement en France et dans l'ensemble des pays développés, représentant un problème majeur de santé publique. Cependant, comme dans la plupart des pays en voie de développement, des données épidémiologiques sur l'incidence des maladies rénales chroniques manquent fortement au Vietnam, surtout chez l'enfant. L'Hôpital National Pédiatrique de Hanoi est le seul centre de traitement des maladies rénales chroniques pour les enfants du Nord et du Centre du Vietnam. Ce travail a permis de mettre en évidence que l'incidence d'IRC chez l'enfant est de 5. 1 par million. Les enfants sont hospitalisés très tardivement et le taux de refus de traitement est très élevé, surtout dans les familles non couvertes par la sécurité sociale (39% chez les bénéficiaires contre 72% chez les non-bénéficiaires). Les patients en IRCT nécessitent un traitement de suppléance à la fois lourd et coûteux, la dialyse ou la transplantation. La transplantation rénale, quand elle est possible, est le meilleur traitement pour les patients atteints d'une IRCT. Cependant malgré les progrès et l'amélioration régulière de la survie des greffes rénales, la plupart des greffons développent à long terme une altération progressive de leur fonction causée par le développement et l'installation chronique d'une inflammation et d'une fibrose interstitielle. Les mécanismes du développement de la néphropathie chronique du greffon constituent un large domaine de recherche en uro-néphrologie. Le récepteur B1 de la bradykinine est un récepteur pro-inflammatoire, peu exprimé à l'état physiologique et induit lors de l'inflammation chronique. L'objectif de cette seconde partie est l'étude chez l'Homme des variations de l'expression du récepteur B1 de la bradykinine au cours des épisodes de rejets pouvant survenir dans la première année post-greffe. Ce travail montre que, chez ces patients, l'expression du RB1 est significativement corrélé au taux de créatininémie (µmol/l) (p<0. 05), à l'hypertension artérielle systolique (p<0. 05) et enfin, à l'inflammation interstitielle (p<0. 01). Ces résultats encourageants pourraient ainsi déboucher sur de nouvelles voies thérapeutiques dans les néphropathies chroniques d'allogreffe. Cette thèse axée sur deux thèmes majeurs de l'insuffisance rénale, l'épidémiologie et les mécanismes physiopathologiques a été réalisée en parallèle à l'Hôpital National Pédiatrique de Hanoi, Vietnam et à l'unité INSERM U858 de Toulouse, FranceThe incidence of end stage renal disease (ESRD) has steadily increased in France and in all developed countries, representing a major public health problem. However, as in most developing countries, epidemiological data on the incidence of chronic kidney disease are greatly lacking in Vietnam, especially in children. The National Paediatric Hospital in Hanoi is a unique centre for treating chronic kidney diseases of all children from northern and central Vietnam. This work has revealed that the incidence of chronic renal failure in children is 5. 1 per million. Children are admitted to hospital very late and the rate of refusal of treatment is very high, especially in families not covered by social security (39% among beneficiaries against 72% among non-beneficiaries). The ESRD patients need replacement therapy, dialysis or transplantation, Kidney transplantation, when possible, is the best treatment for patients with ESRD. But despite the progress and steady improvement in the survival of kidney transplants, most of them develop long-term progressive deterioration of function due to the development and installation of chronic inflammation and interstitial fibrosis. The mechanism of the development of chronic kidney graft is a broad field of research in uro-nephrology. The bradykinin B1-receptor (B1R) is a pro-inflammatory receptor, hardly expressed in physiological conditions and induced in a large variety of tissues during chronic inflammation. The objective of this second part is to study the variation of the B1R expression during the first year following kidney graft by using an immunohistological analysis approach. This work shows that in these patients, the B1R expression is significantly correlated to the rate of creatinine (p <0. 05), the systolic blood pressure (p <0. 05) and finally to interstitial inflammation (p <0. 01). These encouraging results could lead to new therapeutic strategies in chronic allograft nephropathy. This thesis carried out in parallel to the National Paediatric Hospital in Hanoi, Vietnam and INSERM 858 unity, Toulouse, France, focuses on two major fields of kidney failure: epidemiology and physiological mechanisms
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Obeid, Sameh. "Analyse quantitative et qualitative sur puce de vésicules extracellulaires en milieux complexes au sein d'une plateforme nanobioanalytique". Thesis, Bourgogne Franche-Comté, 2017. http://www.theses.fr/2017UBFCD009/document.
Abstract (sommario):
Les vésicules extracellulaires (VEs) sont des nanovésicules circulantes (30 à 100nm de diamètre) libérées dans l'espace extracellulaire par la plupart des cellules humaines, suite à leur activation ou à leur apoptose. Les VEs se divisent en 3 grandes catégories ; les exosomes (Exo), les microparticules (MPs) et les corps apoptotiques (cAPO). Les VEs sont présentes à l'état physiologique dans les différents fluides biologiques du corps humain et jouent un rôle majeur dans différents processus physio-pathologiques. De nos jours, plusieurs techniques, certaines en routine, sont utilisées pour étudier les VEs. Cependant, aucune d'entre elles ne permet de déterminer à la fois leur concentration, leur taille et leurs caractéristiques biochimiques. Un consensus existe sur la nécessité de combiner des techniques pour disposer enfin d'une caractérisation fine et complète des VEs. Il est d'un intérêt majeur de développer des plateformes analytiques dédiées à ces VEs en vue d'améliorer la qualification des échantillons biologiques et de découvrir de nouveaux biomarqueurs de pathologies humaines ou de bio-indicateurs de suivi thérapeutique.Notre projet consiste à développer une plateforme NanoBioAnalytique (NBA) combinant trois techniques : l'imagerie par Résonance des Plasmons de Surface (SPRi), la Microscopie à Force Atomique (AFM) et la Spectrométrie de Masse (MS). L'enjeu est de développer une interface biopuce-instruments qui permettra d'effectuer des investigations multiphysiques et multiéchelles apportant, en une stratégie globale, les informations plus complètes sur les différentes populations de VEs.[...]Ces travaux ont montré la capacité de notre plateforme à détecter sélectivement, et simultanément, différentes sous-populations des VEs co-existantes dans un échantillon complexe tel que du plasma, en s'appuyant sur l'expression différentielle des marqueurs protéiques membranaires. Les taux de capture se sont avérés être directement corrélés à la concentration des vésicules dans l'échantillon injecté. L'analyse AFM a permis de déterminer la distribution en taille de différentes sous-populations de VEs et permettre une analyse différentielle de la distribution en taille sur la gamme 20 nm - 1000 nm. Enfin, des études protéomiques "sur-puce" ont été également engagées afin de caractériser la composition en protéines des VEs libérées sous différentes conditions. Cette analyse a permis d'établir des premiers profils protéomiques différentiels des VEs dans les échantillons étudiés.La plateforme NBA est une méthode efficace pour caractériser et quantifier les VEs, sans marquage et avec une grande sensibilité, sur une large gamme dynamique (environ 10(7) à 10(12) particules/mL) cohérente avec celle existante en fluide physiologique et sur une plage de taille couvrant 2 décades. Elle s'inscrit parmi les approches les plus prometteuses pour l'investigation des VEs en complément de la cytométrie en flux. La grande adaptabilité de cette méthode d'analyse des VEs ouvre de larges perspectives de déploiement dans les secteurs de la Santé, de l'Environnement et de l'Agro-alimentaireExtracellular vesicles (EVs) are small vesicles (30 to 1000 nm) released from different cell types, upon activation or apoptosis, and present in most body fluids (Blood, Urine….). Based on the current state of knowledge of their biogenesis and biochemical properties, EVs can be devided into three distinct populations: exosomes (EXO), microparticles (MPs) and apoptotic bodies (APOb). EVs have been found to play important biological roles and are also biomarkers of different pathologies. […] The first step consists of the injection of the samples containing EVs onto the biochip surface. This step is accomplished by SPR technique that allows label-free monitoring of EVs immunocapture onto the surface of a biochip presenting different specific bioreceptors. Following the capture of EVs, a nanometrological investigation of the biochip surface by AFM is engaged to characterize the physical properties of captured vesicles (size, morphology, etc..). Owning a nanometrical resolution, AFM can discriminate between individual EVs and vesicles or protein aggregates, leading to an accurate characterization of individual vesicles. The coupling of SPR technique with AFM was adapted to offer a representative global view of each array of bioreceptors and to measure the size of thousands of individual EVs. A proteomic investigation was also engaged to characterize the proteomic compositions of the different subpopulations of EVs. Such an investigation could contribute to the understanding of EVs biogenesis, biology and pathophysiology. To evaluate the potential of our platform to detect, quantify and characterize nanoparticles, two calibration particles, which cover the lower and upper size range of EVs, were chosen: (i) virus-like particles of 50 nm of diameter, also called CP50, and (ii) protein-functionnalized synthetic beads of 920 nm of diameter, called CP920. The capture tests in SPR showed a specific capture of these two calibration particles with their specific bioreceptors, immobilized onto the biochip surface, regardless the complexity of the media in which they were diluted. Also, a positive correlation was obtained between the capture level, measured by SPR, and the particle 9
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Rimkevičius, Arvydas. "The Damage in Dermal Blood Vessels and Connective Tissue during Systemic Sclerosis (Histopathological and immunohistochemical biopsy analysis)". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2010. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2010~D_20100204_100416-45604.
Abstract (sommario):
Dissertation topic: the damage to dermal blood vessels and connective tissue during systemic sclerosis.
The aim of this dissertation was to determine the sequence in the development of vascular damage and fibrosis by studying vascular changes in the skin and connective tissue of systemic sclerosis patients with vascular atresia characteristic of this pathology and by comparing it with other conditions, where there is no vascular atresia (systemic lupus erythematosus), and with conditions, which are characterised by vascular function instability (Raynaud’s phenomenon). This was a retrospective study, which analysed 60 patients with the aforementioned diseases, 20 with each disease, and a control group of 20 skin biopsies. In addition to routine histochemical stains, a series of immunohistochemical signs and electron microscopic examination were used. It was determined that damage to the vascular endothelium and increased permeability of the vascular walls appear earlier than expressed fibrosis in the skin of systemic sclerosis patients and that the abundant expression of vascular endothelial growth factor (VEGF)-A and its receptor FLT-1 and especially HSP-47 (heat shock protein, a collagen-specific chaperone that induces fibrosis) and eNOS endothelial nitric oxide synthase are immunohistochemical signs of endothelial injury in the early stage of systemic sclerosis. It was determined that in the pathogenesis of the early stage of systemic sclerosis, damage to the small blood... [to full text]Disertacijos tema: Odos kraujagyslių ir jungiamojo audinio pažeidimai sergant sistemine skleroze. Disertacijos tikslas buvo nustatyti kraujagyslių pažeidimo ir fibrozės vystymosi eiliškumą, ištiriant kraujagyslių pakitimus odoje ir jungiamajame audinyje sergantiems sistemine skleroze , su šiai patologijai būdinga kraujagyslių atrezija, bei palyginant su kitomis būklėmis, kurių metu kraujagyslių atrezijos nėra (sistemine raudonaja vilklige), bei su būklėmis, kurioms būdingas kraujagyslių funkcinis nestabilumas (Reino sindromas). Tai retrospektyvus tyrimas, analizuota po 20 kiekvienos iš minėtų ligų sergančių ligonių ir kontrolinės grupės odos biopsijų. Be rutinių histocheminių dažymų naudata eilė imunohistocheminių žymenų ir elektroninės mikroskopijos tyrimas. Nustatyta, kad sergantiems sistemine skleroze odoje ankščiau, negu išreikšta fibrozė pasireiškia kraujagyslių endotelio pažeidimai ir padidėjęs kraujagyslių sienelės pralaidumas, kad kraujagyslių endotelio augimo veiksnio VEGF-A ir jo receptoriaus FLT-1, ir ypač HSP-47 (terminio šoko baltymo, kolagenams specifinio šaperono skatinančio fibrozę), bei eNOS (endotelio azoto sintazės) gausi ekspresija yra ankstyvos sisteminės sklerozės stadijos endotelio pakenkimo imunohistocheminiai žymenys. Nustatyta, kad ankstyvosios sisteminės sklerozės stadijos patogenezėje odoje vyrauja smulkių kraujagyslių pažeidimai ir į tą tikslinga atsižvelgti skiriant patogeneze pagristą sisteminės sklerozės gydymą Rekomenduota naudoti odos... [toliau žr. visą tekstą]
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Kuhlmann, Jan Dominik [Verfasser], Sabine [Akademischer Betreuer] Kasimir-Bauer, Stephan [Akademischer Betreuer] Hahn e Ralf [Akademischer Betreuer] Küppers. "Identifizierung neuer Biomarker für das Ovarialkarzinom – : Primärtumorbasierte Analysen und blutbasierte „Real-Time-Liquid-Biopsy“ / Jan Dominik Kuhlmann. Gutachter: Stephan Hahn ; Ralf Küppers. Betreuer: Sabine Kasimir-Bauer". Duisburg, 2013. http://d-nb.info/1035066416/34.
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Brychta, Nora [Verfasser], Matthias U. [Gutachter] Kassack e Nikolas Hendrik [Gutachter] Stoecklein. "Analyse tumorspezifischer Mutationen in der Flüssigbiopsie (liquid biopsy) - Vergleich von zirkulierenden Tumorzellen und zirkulierender Tumor-DNA für die Frühdiagnose im Pankreaskarzinom / Nora Brychta ; Gutachter: Matthias U. Kassack, Nikolas Hendrik Stoecklein". Düsseldorf : Universitäts- und Landesbibliothek der Heinrich-Heine-Universität Düsseldorf, 2017. http://d-nb.info/1149330546/34.
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Zani, Emerson Luís 1975. "Profilaxia antibiótica na biópsia prostática transretal = revisão sistemática com metanálise". [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308531.
Abstract (sommario):
Orientadores: Carlos Arturo Levi D'Ancona, Nelson Rodrigues Netto JúniorTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A biópsia prostática transretal (BPTR) é um procedimento bem estabelecido utilizado para a obtenção de tecido para o diagnóstico histológico do carcinoma da próstata. Apesar do fato de a BPTR ser geralmente considerada um procedimento seguro, ela pode ser acompanhada por complicações infecciosas e traumáticas. Embora as complicações infecciosas após a BPTR sejam bem conhecidas, há incerteza sobre a necessidade e a eficácia do antibiótico profilático de rotina e uma clara falta de padronização na profilaxia antibiótica para BPTR. O objetivo foi realizar uma revisão sistemática de ensaios clínicos randomizados sobre a profilaxia antibiótica em BPTR para avaliar a eficácia e os efeitos adversos do tratamento antibiótico profilático nessa situação. A pesquisa abrangeu as principais bases eletrônicas: MEDLINE, EMBASE, LILACS e Cochrane Central Register of Controlled Trials (CENTRAL). Especialistas foram consultados e referências de artigos relevantes foram obtidas. Todos os estudos randomizados e controlados (ERCs) de homens que se submeteram à BPTR e receberam antibióticos profiláticos ou placebo / nenhum tratamento foram selecionados, e também todos os ERCs avaliando um tipo de antibiótico contra outro, incluindo doses, vias de administração, freqüência de administração e duração do tratamento antibiótico. A revisão sistemática foi conduzida na Colaboração Cochrane. No geral, mais de 3500 referências foram analisadas e dezenove artigos originais com um total de 3599 pacientes foram incluídos. Nove estudos analisaram antibióticos versus placebo / nenhum tratamento, com todos os resultados favorecendo significativamente o uso de antibióticos (P <0,05 (I2=0%)), incluindo bacteriúria (risco relativo (RR) 0,25 (intervalo de confiança (IC) de 95% de 0,15 a 0,42), bacteremia (RR 0,67, IC 95% 0,49-0,92), febre (RR 0,39, IC 95% 0,23-0,64), infecção do trato urinário (RR 0,37 (IC 95% 0,22-0,62) e hospitalização (RR 0,13 (IC 95% 0,03-0,55)). Diversas classes de antibióticos foram efetivas profilaticamente para a BPTR, e a classe das quinolonas foi a melhor classe analisada, com o maior número de estudos (cinco) e de pacientes (1188). Na comparação "antibiótico versus enema", foram analisados quatro estudos com um número limitado de pacientes. As diferenças entre os grupos não foram significativas. Para "antibiótico versus antibiótico + enema", apenas o risco de bacteremia (RR 0,25, IC 95% 0,08-0,75, P = 0,01) foi reduzido no grupo "antibiótico + enema". Sete estudos relataram os efeitos de antibiótico de curta duração (um dia) versus curso de longa duração (três dias). O uso de antibióticos por longo curso foi significativamente melhor do que o tratamento de curta duração apenas para bacteriúria (RR 2,09, IC 95% 1,17-3,73, P = 0,01 (I2=34%)). Para "dose única versus múltiplas doses", houve maior risco de bacteriúria com dose única (RR 1,98, IC 95% 1,18-3,33, P <0,05 (I2%=7)). Comparando-se a administração oral versus sistêmica - injeção intramuscular (IM) ou intravenosa (IV) - dos antibióticos, não houve diferenças significativas entre os grupos para bacteriúria, febre, ITU e hospitalização. A profilaxia antibiótica é eficaz na prevenção de complicações infecciosas após BPTR. Diversas classes de antibióticos são eficazes profilaticamente para a biópsia da próstata e a classe das quinolonas foi a classe melhor analisada, com o maior número de estudos e de pacientes. Não há dados definitivos para confirmar que os cursos antibióticos de longa duração (três dias) sejam superiores aos tratamentos de curta duração (um dia), ou que o tratamento com doses múltiplas seja superior ao de uma dose única
Abstract: Transrectal prostate biopsy (TRPB) is a well established procedure used to obtain tissue for the histological diagnosis of carcinoma of the prostate. Despite the fact that TRPB is generally considered a safe procedure, it may be accompanied by traumatic and infective complications. Although infective complications after TRPB are well known, there is uncertainty about the necessity and effectiveness of routine prophylactic antibiotics and a clear lack of standardization in antibiotic prophylaxis for TRPB. The objective was to conduct a systematic review of randomized controlled trials on antibiotic prophylaxis in TRPB to evaluate the effectiveness and adverse effects of prophylactic antibiotic treatment in this situation. The search covered the principal electronic databases: MEDLINE, EMBASE, LILACS and the Cochrane Central Register of Controlled Trials (CENTRAL). Experts were consulted and references from the relevant articles were scanned. All randomized, controlled trials (RCTs) of men who underwent TRPB and received prophylactic antibiotics or placebo/no treatment were selected, and all RCTs looking at one type of antibiotic versus another, including comparable dosages, routes of administration, frequency of administration, and duration of antibiotic treatment. The systematic review was conducted in Cochrane Collaboration. Overall, more than 3500 references were considered and nineteen original reports with a total of 3599 patients were included. There were nine trials analyzing antibiotics versus placebo/no treatment, with all outcomes significantly favoring antibiotic use (P < 0.05 (I2 = 0%)), including bacteriuria (relative risk (RR) 0.25 (95% confidence interval (CI) 0.15 to 0.42), bacteremia (RR 0.67, 95% CI 0.49 to 0.92), fever (RR 0.39, 95% CI 0.23 to 0.64), urinary tract infection (RR 0.37 (95% CI 0.22 to 0.62), and hospitalization (RR 0.13 (95% CI 0.03 to 0.55)). Several classes of antibiotics were effective prophylactically for TRPB, and the quinolones were the best analyzed class, with a higher number of studies (five) and patients (1188). For 'antibiotic versus enema', we analyzed four studies with a limited number of patients. The differences between groups were not significant. For "antibiotic versus antibiotic + enema", only the risk of bacteremia (RR 0.25, 95% CI 0.08 to 0.75, P = 0.01) was diminished in the "antibiotic + enema" group. Seven trials reported the effects of short-course (1 day) versus long-course (3 days) antibiotics. Long course was significantly better than short-course treatment only for bacteriuria (RR 2.09, 95% CI 1.17 to 3.73, P = 0.01 ( I2 = 34%)). For "single versus multiple dose", there was significantly greater risk of bacteriuria for singe-dose treatment (RR 1.98, 95% CI 1.18 to 3.33, P < 0.05 (I2 = 7%)). Comparing oral versus systemic administration - intramuscular injection (IM), or intravenous (IV) - of antibiotics, there were no significant differences in the groups for bacteriuria, fever, UTI and hospitalization. Antibiotic prophylaxis is effective in preventing infectious complications following TRPB. Several classes of antibiotics are effective prophylactically for prostate biopsy and the quinolones were the best analyzed class, with a higher number of studies and patients. There is no definitive data to confirm that antibiotics for long-course (three days) are superior to short-course treatments (one day), or that multiple-dose treatment is superior to single-dose
Doutorado
Fisiopatologia Cirúrgica
Doutor em Ciências
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Corrêa, Maria Elvira Pizzigatti. "A mucosa oral e glandulas salivares acessorias na doença do enxerto contra o hospedeiro cronica pos transplante de medula ossea : estudo prospectivo dos primeiros 63 transplantes de medula ossea : analise comparativa com parametros clinicos e biopsia de pele Hemocentro/Unicamp". [s.n.], 1999. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311043.
Abstract (sommario):
Orientadores: Maria Leticia Cintra, Konradin MetzeDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A Doença do Enxerto contra o Hospedeiro representa uns dos fatores de maior morbidade e mortalidade pós transplante alogênico de medula óssea (TMO). Lesões na cavidade bucal e em glândulas salivares menores são achados comuns na GVHDc, manifestando-se através de xerostomia e lesões liquenóides. O objetivo deste trabalho foi estudar, prospectivamente, os aspectos clínicos e histopatológicos da mucosa bucal e glândulas salivares acessórias no dia +100 (coletados necessariamente, conforme protocolo) e no momento do diagnóstico da GVHDc feitao posteriormente ao dia 100 pós TMO, para: avaliar a especificidade e sensibilidade da análise histopatológica protocolar do dia +100; estudar a freqüência de acomentimento da pele, mucosa bucal e glândula salivar na GVHD crônica; determinar os parfun.etros clínicos associados à sobrevida pós transplante; determinar os parâmetros clínicos preditivos de GVHD crônica e detenninar o valor da análise da mucosa bucal e glândula salivar acessória na sobrevida pós transplante de medula óssea. Foram coletadas ao redor do dia +100, amostras de pele e mucosa bucal incluindo glândula salivar menor de 45 pacientes submetidos ao TMO alogênico HLA-idêntico. Uma segunda biópsia foi realizada em 25 pacientes que desenvolveram ou mantiveram sintomas sugestivos de GVHDc. As amostras foram analisadas e classificadas de acordo com o proposto por HORN (1995). Os resultados foram analisados estatisticamente pelo modelo tmivariado da regressão de azares proporcionais de COX Para avaliar as variáveis significativas em conjunto, foi utilizado o modelo multivariado de regressão de azares proporcionais de COX (regressão stepwise). Para análise de sobrevida foram construídas curvas de Kaplan-Meir. Do total de 63 transplantes realizados no Serviço de Transplante de Medula Óssea do Hemocentro da Unicamp entre setembro de 1993 a maio de 199~, 45 pacientes entraram no estudo, por sobreviverem mais que 100 dias pós transplante. Todos os pacientes receberam transplante alogênico, HLA-idêntico. Desses 45 pacientes, 32 receberam enxertos coletados por aspiração da medula óssea (MO) e 13 por células progenitoras periféricas (CPP). Do grupo, 19 pacientes eram mulheres 26 homens, com idade mediana de 36 anos (4 - 57). Os resultados do exame histológico no dia 100 não demonstraram valores preditivos para o diagnóstico para o GVHDc. O tipo de transplante realizâdo, CPP (p=0,023), a presença anterior da GVHD aguda (p=O,OO16) e doadoras femininas para receptores masculinos (p=O,031) demonstraram ser fatores preditivos para a GVHD crônica. Em relação à sobrevida, o tipo de transplante, CPP (p=0,017), a antecedência da forma aguda da GVHD (p=0016) e o nível sérico maior de ciclosporina (p=O,0031) foram correlacionados a um pior prognóstico. A segunda biópsia foi realizada num intervalo entre 104 a 304 dias pós TMO (mediana de 195 dias). Dezoito pacientes apresentaram GVHDc extensa, 4 localizada e 3 não apresentaram GVHDc. Onze pacientes morreram depois da segunda avaliação, sendo que 7 por GVHDc, 3 por recaída da leucemia e um por causa não relativa ao TMO. Nesse período, os achados histológicos positivos para GVHDc em mucosa bucal e glândula salivar menor foram estatisticamente significativos em relação à sobrevida dos pacientes. Os achados foram classificados em 3 grupos de gravidade da GVHDc, de acordo com a classificação de Hom (Grau I, 11, III-IV). A mucosa bucal (p=O,02) e a glândula salivar menor (p=O,OO9) demonstraram ter valor preditivo para a sobrevida dos pacientes. Apesar do pequeno número de pacientes, nossos dados sugerem que as biópsias protocolares no dia + 1 00 não são adequadas ao diagnóstico de GVHDc. A glândula salivar revela com maior freqüência a agressão linfocitária da GVHDc que a pele ou mesmo a mucosa bucal. A presença da fase aguda da GVHD, assim como doadoras femininas e o tipo de transplante realizado demonstraram ser fatores importantes no prognóstico menor de sobrevida. A GVHD aguda, assim como o tipo de transplante (CPP), e o sexo do doador (feminino) demonstraram ser importantes fatores preditivos de desenvolvimento da GVHD crônica. Os achados histológicos positivos para GVHDc em glândula salivar juntamente com os de mucosa bucal podem refletir em pior prognóstico (sobrevida)
Abstract: Chronic graft-vs-host disease (cGVHD) is an important cause of morbity and mortality after allogeneic bone marrow transplants. Lesions ofthe oral mucosa and salivary glands are common features of cGVHD, manifesting as xerostomia, lichenoid lesions or even severe mucositis. The biopsy of specimens of the oral mucosa, collected on day +100, is commonly used as a screening test for the diagnosis af cGVHD. The aim of our study was to evaluate the screening test for diagnosis of cGVHD on day +100 post BMT, the predictive factors of diagnosis for cGVHD, the incidence of skin and oral cGVHD manifestation and the use of findings of the histologycal specimens as a predictor of shorter survival in patients with cGVHD. Data were initially analyzed from 45 patients who had received unrnodified allogeneic marrow grafts in the Bone Marrow Transplantation Hospital Service / Hematology and Hemotherapy Center of the State University ofCampinas, UNICAMP, between September 1993 to May 1995 and who had survived for over 100 days. Ofthese 45 patients, 32 received grafts collected byaspiration (bone marrow - BM) and 13 peripheric bone progenitors cells (pBPC), from HLA-identical siblings. Biopsies of the skin and labial mucosa, including representative samples of minor salivary gland (MSG), were collected on day +100. A second biopsy was performed at a later time in 25 patients (BM=16, PBPC=9) who had developed or sustained signs or symptoms suggestive of cGVHD. All specimens were analised by 2 examiners (MEPC and MLC) separately for later comparison. Hom pathological staging score was used for the histological classification of the oral and salivary gland findings. Univariate and multivariate Cox proportional hazard regression models, and the Kaplan-Meir method were used to determine the overall survival. Sixty-three allogeneic BMT wesre performe~ between September 1993 and May 1995 in the Bone Marrow Service of the Hemocentro / Unicamp. Forty-five patients suvived for over 100 days and the histological findings were analised. Df these patients, 32 received bone marrow transplantation (BMT) and 13 received peripheral bane progenitor cells (PBPC). Nineteen patients were women and 26 men and the median age was 36 years (4 - 57 years old). The histological findings, obtained at the +100 day did not show any predictive value for cGVHD diagnosis. PBPC (p=0,023) transplant, acute GVHD,.sphO,0016) and female donors (p=0,031) were predictive factors for cGVHD on the 100 day post BMT. The PBPC (p=O,Ol7) transplant, acute GVHD (p=O,0016) and the leveI of cysclosporin (p=0,0031) were predictive factors for a worst prognostic of overall survival. The second time biopsies were performed from 104 to 304 days after BMT (median 195 days). Eighteen patients showed extensive cGVHD, 4 localized cGVHD and 3 no formof cGVHD. Eleven patients died after the second biopsy, 7 due to cGVHD, 3 due to leukemia relapse and one due to no transplant reason. The skin histological fmdings did not show any prognostic value. The results of histologicaloral mucosa and minor salivary gland fmdings showed statistical importance. We stratified patients into three groups of scale cGVHD severity, using the HORN pathological staging score (1, 11 and III-IV). For oral mucosa, the statistical value was p=0,02 for and the minor salivary gland it was p=0,009. Despite the small number of patients, our results suggest that severe histologic lesions in MSG specimens obtained beyond day +100 correlate with higher mortality in patients suffering from cGVHD. There is a greater frequency of lymphocyte infiltration in minor salivary gland than in the oral mucosa or skin. The histological findings on the 100 dayafter BMT, did not show any prognostic value for diagnosis of cGVHD. The female danors and the type oftransplantation showed important value in the prognostic for overall survival for BMT patients. The aGVHD, the BMT type and the sex of the donor were important factors for prognostic of cGVHD
Mestrado
Anatomia Patologica
Mestre em Ciências Médicas
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Barbosa, Hugo Perazzo Pedroso. "O diagnóstico da cirrose hepática: comparação da laparoscopia com a histologia". Universidade do Estado do Rio de Janeiro, 2009. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=2157.
Abstract (sommario):
O diagnóstico de cirrose em pacientes portadores de hepatopatia crônica é fundamental para o manejo dos pacientes. Estudos demonstraram que o uso de sinais clínicos, laboratoriais e/ou ultra-sonográficos subestimam a presença de cirrose. Através do diagnóstico histológico exclusivo também é possível subestimar a presença de cirrose em até 32% dos casos. Avaliar o valor da laparoscopia no diagnóstico da cirrose hepática e a segurança deste procedimento: a)medir a taxa de acréscimo no diagnóstico de cirrose proporcionada pela laparoscopia. b)determinar a concordância inter-observador no diagnóstico macroscópico de cirrose pela laparoscopia. c)determinar a influência do tamanho do fragmento obtido na biópsia hepática laparoscópica no diagnóstico de cirrose. d)descrever a prevalência das principais complicações da laparoscopia e biópsia hepática laparoscópica. Foram incluídos pacientes portadores de hepatite crônica submetidos à biópsia hepática laparoscópica. As laparoscopias foram realizadas com sedação consciente e a biópsia hepática feita com agulha 14G. Dois examinadores independentes, sem conhecimento dos dados dos pacientes, definiram a conclusão da laparoscopia em 4 classes: normal, aspecto inespecífico, hepatopatia crônica e cirrose hepática. O diagnóstico histológico de cirrose foi definido pela presença de fibrose ≥ 5 pela classificação de Ishak, por um patologista, sem o conhecimento dos dados dos pacientes. Foram determinados valores de sensibilidade, especificidade, acurácia, valor preditivo positivo (VPP) e negativo (VPN) da laparoscopia e histologia no diagnóstico da cirrose hepática. Foram incluídos 84 pacientes, 55% do sexo masculino, 85% portadores de hepatite crônica C e média de idade de 47 11 anos. A média do tamanho do fragmento de biópsia foi de 2,9 1,0 cm e do número de espaços-porta foi de 12 5. Em comparação com o diagnóstico histológico, a análise do aspecto macroscópico por laparoscopia mostrou sensibilidade de 71% x 89%, valor preditivo negativo de 83% x 92%, e acurácia de 88% x 95%. O índice de concordância Kappa no diagnóstico de cirrose hepática na laparoscopia entre os dois examinadores foi de 0,80. Os pacientes cirróticos apresentaram amostras mais fragmentadas (p = 0,048) e maiores (p = 0,05). Já os portadores de fibrose leve na histologia (F0-F2) apresentaram menor quantidade de espaços-porta (8 4 x 13 4 p< 0,001) e fragmentos menores (p = 0,036) em comparação com os portadores de fibrose moderada e grave (F3-F6). Não houve complicações precoces da laparoscopia. O sangramento no sítio da biópsia hepática foi a única complicação observada em 6% dos pacientes. Tivemos 9,6% de complicações tardias, diretamente relacionadas à laparoscopia e ao surto de micobacteriose atípica que acometeu o estado do Rio de Janeiro durante o estudo. Houve acréscimo de 5% proporcionado pela visão laparoscópica ao diagnóstico de cirrose obtido pela histologia, porém o fragmento hepático tem grande influência no estadiamento da fibrose, com fragmentos maiores favorecendo a histologia. A concordância inter-observador no diagnóstico macroscópico de cirrose pela laparoscopia foi excelente. A biópsia hepática laparoscópica é um procedimento seguro.The diagnosis of hepatic cirrhosis is very important in the management of patients with chronic liver diseases. Retrospective series reported percutaneous liver biopsy to miss cirrhosis in about 30%. The aim of this study was to compare the accuracy of liver descriptions made during laparoscopy with liver histology found by laparoscopic biopsy in patients with chronic hepatitis. We also described the complications rates of the laparoscopic liver biopsy, estimated the influence of the length of liver fragment and the Kappas índice in the diagnosis of cirrhosis. Consecutive patients were prospectively submitted to laparoscopic liver biopsy (14G needle) by two independent investigators blind to clinical, laboratorial and ultra-sonographic findings. Liver specimens were assessed blindly according to the modified Ishak score. The sensitivity, specificity, accuracy, positive and negative predictive values were evaluated for the laparoscopy and histology in the diagnosis of cirrhosis. A p-value of 0.05 was considered statistically significant. Eighty-four patients were included, 55% male sex, 85% with chronic HCV infection, median age 47 11 years. The median length of the biopsy sample and the numbers of portal tracts was 2.9 1,0 cm and 12 5, respectively. The histological sensitivity (89% x 71%), negative predictive value (92% x 83%) and accuracy (95% x 88%) were better in comparison with laparoscopy in cirrhosis diagnosis. The Kappas indices for cirrhosis diagnosis between the two investigators was 0.80. Cirrhotic patients had more fragmented (p= 0,048) and bigger samples (p=0.05) than non-cirrhotics. Patients with mild disease in microscopic analysis (F ≤ 2) had less numbers of portal tracts (8 4 x 13 4 p<0.001) and smaller samples size (p=0.036) than those with moderate/severe disease. There were no earlier complications related to the laparoscopy and 9.6% of late complications, all of that associated with a endemic outbreak of atypical micobacteriosis that happened in Rio de Janeiro during this study. There were 6% of hepatic biopsys minor complications, all bleeding at the biopsy site controlled during the laparoscopy. There were no major complications. There was 5% of gain made by liver laparoscopic evaluation in the cirrhosis diagnosis. The length of the hepatic fragment, however, had great influence in the diagnosis of cirrhosis. Probably our big sample size (2,9 1,0 cm) surpass the problem of understaging of the liver biopsies. The Kappas indices between the investigators were excellent. The laparoscopic liver biopsy is a safe procedure.
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Ronkainen, J. (Johanna). "Costs in today's radiology:aBC analysis of typical situations in the transitional period". Doctoral thesis, University of Oulu, 2007. http://urn.fi/urn:isbn:9789514284816.
Abstract (sommario):
Abstract
The purpose of this study was to analyze the costs incurred during the transitional period when a radiology department is gradually digitalized and magnetic resonance imaging (MRI) is gaining ground as guidance for interventions. The specific aims were: to compare the costs of computed (CR) radiography with the costs of conventional radiography, to analyze the cost structures of procedures and the effects of procedure volumes in a multipurpose interventional MRI (IMRI) unit, to compare the costs of MRI and computed tomography (CT)-guided bone biopsies, and to compare the costs of MRI-guided laser ablation and surgery in the treatment of osteoid osteoma.
34 140 plain-film examinations were analyzed; 3/4 of them were CR and 1/4 conventional radiography. The costs of CR were 9% higher compared to conventional radiography, due to the higher capital cost.
In the IMRI unit, 563 diagnostic MRI examinations, 89 MRI-guided interventions, and 39 MRI-guided neurosurgical operations were performed. The cost analyses of the alternative simulation models of IMRI usage showed that the volume of diagnostic imaging had an effect on the unit costs of these procedures. Volume was not such a deterministic factor in interventions due to the high material costs. The volume of the neurosurgical use of IMRI had a major effect on the costs of radiological procedures.
The costs of 18 MRI-guided and 12 CT-guided bone biopsies were compared. The cost of MRI-guided biopsy was 2.55-fold compared to CT-guided biopsy, due to the longer procedure time and the expensive MRI-compatible instrumentation.
The costs of 7 MRI-guided laser ablations and 6 surgical treatments of osteoid osteoma were compared. The cost of laser ablation was higher than the cost of excision of a superficial osteoid osteoma. The cost of excision of a deep osteoma with metallic fixation was considerably higher, due to the higher material, personnel, and ward costs. Laser ablation diminishes the need for sick days and the duration of restricted weight bearing.
In conclusion, a higher cost of a new method should be anticipated. The use of a new method should be justified by other factors, such as better efficiency, accuracy, lack of radiation, or mini-invasiveness.
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Offranc, Piret Gaëlle. "Nanofils de silicium pour analyse sensible de biomolécules par spectrométrie de masse et pour l'adressage fluidique de cellules en vue des applications laboratoires sur puce et biopuces". Phd thesis, Université des Sciences et Technologie de Lille - Lille I, 2010. http://tel.archives-ouvertes.fr/tel-00491178.
Abstract (sommario):
Ce travail porte sur la fabrication d'un support inorganique de nanofils de silicium dédié à la détection sensible de biomolécules par désorption/ionisation laser (LDI) en spectrométrie de masse (MS). Cette technique, contrairement à l'analyse LDI assistée par matrice (MALDI), permet de s'affranchir des ions parasites de la matrice organique qui interfèrent avec les molécules de masses inférieures à 700 Da. La littérature fait état de la difficulté à déterminer les paramètres liés à la performance de la technique : nous avons varié la morphologie, la composition, la chimie de surface des nanofils de silicium et nous avons discuté de l'importance des propriétés optiques et thermiques, de la mouillabilité de surface et de l'accessibilité des molécules au faisceau laser. Le support de nanofils optimal montre une haute sensibilité de détection des molécules de petites masses (50 fois supérieure au MALDI), il s'adapte à des analyses protéomiques et nous a permis d'instaurer un contrôle complémentaire au suivi de la réaction de méthylation pour la conception d'une biopuce à peptides. Nous avons finalement travaillé sur l'intégration de ce support dans un laboratoire sur puce. Une goutte d'1 µL d'un mélange de peptide (50.10-15M) a été déplacée par microfluidique discrète (électromouillage sur diélectrique) puis analysée avec succès par LDIMS. Finalement, nous avons développé une méthode originale combinant la chimie et la topographie de surface des nanofils de silicium à des techniques de lithographie optique : des zones de différentes tensions de surface liquide/solide sont ainsi créées et sont favorables à l'adhésion localisée de protéines, de cellules et de bactéries.
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Rimkevičius, Arvydas. "Odos kraujagyslių ir jungiamojo audinio pažeidimai sergant sistemine skleroze (Histopatologiniai ir imunohistocheminiai bioptatų tyrimai)". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2010. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2010~D_20100204_100318-37216.
Abstract (sommario):
Disertacijos tema: Odos kraujagyslių ir jungiamojo audinio pažeidimai sergant sistemine skleroze.
Disertacijos tikslas buvo nustatyti kraujagyslių pažeidimo ir fibrozės vystymosi eiliškumą, ištiriant kraujagyslių pakitimus odoje ir jungiamajame audinyje sergantiems sistemine skleroze , su šiai patologijai būdinga kraujagyslių atrezija, bei palyginant su kitomis būklėmis, kurių metu kraujagyslių atrezijos nėra (sistemine raudonaja vilklige), bei su būklėmis, kurioms būdingas kraujagyslių funkcinis nestabilumas (Reino sindromas). Tai retrospektyvus tyrimas. Analizuota po 20 kiekvienos iš minėtų ligų sergančių ligonių ir kontrolinės grupės odos biopsijų. Be rutininių histocheminių dažymų, naudata eilė imunohistocheminių žymenų ir elektroninis mikroskopinis tyrimas. Nustatyta, kad sergantiems sistemine skleroze odoje ankščiau, negu išreikšta fibrozė pasireiškia kraujagyslių endotelio pažeidimai ir padidėjęs kraujagyslių sienelės pralaidumas. Nustatyta, kad kraujagyslių endotelio augimo veiksnio VEGF-A ir jo receptoriaus FLT-1, ir ypač HSP-47 (terminio šoko baltymo, kolagenams specifinio šaperono skatinančio fibrozę), bei eNOS (endotelio azoto sintazės) gausi ekspresija yra ankstyvos sisteminės sklerozės stadijos endotelio pakenkimo imunohistocheminiai žymenys. Taip pat nustatyta, kad ankstyvosios sisteminės sklerozės stadijos patogenezėje odoje vyrauja smulkių kraujagyslių pažeidimai. Rekomenduota naudoti odos biopsiją kaip pagalbinį diagnostinį metodą diferencijuojant tarp... [toliau žr. visą tekstą]Dissertation topic: the damage to dermal blood vessels and connective tissue during systemic sclerosis. The aim of this dissertation was to determine the sequence in the development of vascular damage and fibrosis by studying vascular changes in the skin and connective tissue of systemic sclerosis patients with vascular atresia characteristic of this pathology and by comparing it with other conditions, where there is no vascular atresia (systemic lupus erythematosus), and with conditions, which are characterised by vascular function instability (Raynaud’s phenomenon). This was a retrospective study, which analysed 60 patients with the aforementioned diseases, 20 with each disease, and a control group of 20 skin biopsies. In addition to routine histochemical stains, a series of immunohistochemical signs and electron microscopic examination were used. It was determined that damage to the vascular endothelium and increased permeability of the vascular walls appear earlier than expressed fibrosis in the skin of systemic sclerosis patients and that the abundant expression of vascular endothelial growth factor (VEGF)-A and its receptor FLT-1 and especially HSP-47 (heat shock protein, a collagen-specific chaperone that induces fibrosis) and eNOS endothelial (nitric oxide synthase) are immunohistochemical signs of endothelial injury in the early stage of systemic sclerosis. It was determined that in the pathogenesis of the early stage of systemic sclerosis, damage to the small blood... [to full text]
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Choi, JungHun. "Design and Development of a Minimally Invasive Endoscope: Highly Flexible Stem with Large Deflection and Stiffenable Exoskeleton Structure". Diss., Virginia Tech, 2006. http://hdl.handle.net/10919/26218.
Abstract (sommario):
Colonoscopy provides a minimally invasive tool for examining and treating the colon without surgery, but current endoscope designs still cause a degree of pain and injury to the colon wall. The most common colonoscopies are long tubes inserted through the rectum, with locomotion actuators, fiber optic lights, cameras, and biopsy tools on the distal end. The stiffness required to support these tools makes it difficult for the scopes to navigate the twisted path of the colon without damaging the inside wall of the colon or distorting its shape. In addition, little is known about how sharp and forceful endoscopes can be without accidentally cutting into tissue during navigation.
In order to solve the requirements of stiffness (to support tools) and flexibility (to navigate turns), we expanded on a design by Zehel et al. [49], who proposed surrounding a flexible endoscope with an external exoskeleton structure, with controllable stiffness. The exoskeleton structure is comprised of rigid, articulating tubular units, which are stiffened or relaxed by four control cables. The stiffened or locked exoskeleton structure aids navigation and provides stability for the endoscope when it protrudes beyond the exoskeleton structure for examination and procedures. This research determined the design requirements of such an exoskeleton structure and simulated its behavior in a sigmoid colon model.
To predict just how pointed an endoscope can be without damaging tissue under a given force, we extrapolated a strength model of the descending colon from published stress-strain curves of human colon tissue. Next we analyzed how friction, cable forces, and unit angles interact to hold the exoskeleton structure in a locked position. By creating two- and three-dimensional models of the exoskeleton structure, we optimized the dimensions of the units of an exoskeleton structure (diameter, thickness, and leg angle) and cable holders ( cable attachment location) to achieve the turns of the sigmoid colon, while still remaining lockable. Models also predicted the loss of force over the exoskeleton structure due to curving, further determining the required cable angles and friction between units. Finally we determined how the stiffness of the endoscope stem affected locking ability and wear inside the exoskeleton structure.Ph. D.
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ARAUJO, RENATO M. "Caracterização clínica e epidemiológica da neoplasia prostática nos anos de 2012 a 2014 em um Centro de Oncologia do leste de Minas Gerais". reponame:Repositório Institucional do IPEN, 2017. http://repositorio.ipen.br:8080/xmlui/handle/123456789/28020.
Abstract (sommario):
Submitted by Pedro Silva Filho (pfsilva@ipen.br) on 2017-11-17T17:09:23Z
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O câncer de próstata (CaP) é a segunda causa mais comum de câncer em homens. De acordo com o INCA, no Brasil, em 2016, estimam-se aproximadamente 61.200 novos casos de câncer de próstata. Objetivo: Identificar as características demográficas e epidemiológicas, bem como dados do estadiamento tumoral dos pacientes com CaP atendidos na Unidade de Oncologia do Hospital Marcio Cunha na cidade de Ipatinga-MG nos anos de 2012, 2013 e 2014. Metodologia: Trata-se de um estudo retrospectivo e descritivo onde foram analisados 668 prontuários de pacientes, com registro do diagnóstico anatomopatológico, atendidos nos anos de 2012, 2013 e 2014, conforme lista fornecida pela instituição, com diagnóstico de CaP cadastrados com CID-10 - C 61. As variáveis analisadas foram: procedência, ano do diagnóstico, faixa etária, raça autodeclarada, fatores de risco como tabagismo, etilismo, história familiar de CaP, PSA total ao diagnóstico, tipo histológico da biópsia, score de Gleason da biópsia, tipo histológico da peça cirúrgica, score de Gleason da peça cirúrgica. Os dados foram analisados empregando-se estatística descritiva e inferencial, utilizando o software SPSS, versão 19.0. Resultados: A maior incidência de casos de CaP foram provenientes das cidades mais populosas da microrregião de saúde analisada e faixa etária mais prevalente foi entre 61 e 80 anos com prevalência em pardos e brancos e com histórico familiar de 17,2% de parentes de primeiro grau; com o pai em 37,3%, o irmão em 60,8% e filho em 1,9%. Apenas 165 (25,9 %) eram fumantes e 20,8% etilistas. Os níveis de PSA ficaram entre 4,1ng/ e 10ng/ml (49,5%) e quanto maior a faixa etária maiores os valores do PSA. Pacientes pardos apresentaram PSA total mais elevado. Ao avaliarmos se existia relação entre os níveis de PSA total com fatores de risco como tabagismo, etilismo e histórico familiar, somente houve relação estatisticamente significativa com o etilismo. Houve concordância do score de Gleason entre biópsia e peça cirúrgica em 70%, subgraduação em 18,7% e supergraduação em 11,3%. Comparando a idade dos pacientes com Score de Gleason, quanto maior a idade do paciente maior foi o Score de Gleason do material obtido pela biópsia via transretal Pacientes tabagistas e etilistas apresentaram Score de Gleason da peça cirúrgica mais elevados. Conclusão: A concordância entre o Score de Gleason da biópsia e o Score de Gleason da peça cirúrgica foi de 70%; etilistas apresentaram PSA mais elevados; quanto maior foi a faixa etária, mais indiferenciado foi o tumor ( biópsia); pacientes tabagistas e etilistas apresentaram tumores mais indiferenciados na peça cirúrgica; este é o primeiro estudo epidemiológico de CaP desenvolvido na região do Vale do Aço, a caracterização sócio demográfica e as associações aqui encontradas podem contribuir com programas para desenvolver ações de controle do CaP nesta região.
Dissertação (Mestrado em Tecnologia Nuclear)
IPEN/D
Instituto de Pesquisas Energéticas e Nucleares - IPEN-CNEN/SP
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Fahr, Florian [Verfasser], Franz Maximilian [Akademischer Betreuer] Rasche, Joachim [Akademischer Betreuer] Beige, Christian [Gutachter] Wittekind e Matthias [Gutachter] Girndt. "Zeitliche und räumliche Analyse histomorphologischer Befunde aus Eigennierenbiopsien im Raum Leipzig über einen Zeitraum von 20 Jahren : Temporal and spatial analysis of renal biopsy data collected in the metropolitan area of Leipzig during a time frame of 20 years / Florian Fahr ; Gutachter: Christian Wittekind, Matthias Girndt ; Franz Maximilian Rasche, Joachim Beige". Leipzig : Universitätsbibliothek Leipzig, 2016. http://d-nb.info/1240696124/34.
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FRANCONE, ELISA. "MiRNAs’ characterization in metastatic colorectal cancer: a multicenter prospective translational study". Doctoral thesis, Università degli studi di Genova, 2020. http://hdl.handle.net/11567/1002660.
Abstract (sommario):
Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths worldwide. Biology and evolutive stage of the disease are responsible for prognosis, treatment and follow-up. Since in early stages 5y-OAS is close to 90% while in advanced CRC it is comprised between 12 and 17%, screening programs and preventative measures are widely adopted in an effort to anticipate the diagnosis; nevertheless, about 50-60 % of patients with CRC will develop liver metastases in the course of their disease, primary factor of long-term survival.
At present, decision making depends on the TNM staging system of the American Joint Committee on Cancer, which allocates patients in different protocols of treatment and follow-up depending on their stage. Several limits of this system have been recently questioned and updates have been performed, nonetheless, current prognostic features don’t seem to be unfailingly efficient in identifying patients with early-stage disease at higher risk for relapse, likely to receive benefit from adjuvant chemotherapy.
Since their aberrant expression showed to be connected with cancer development, progression and even with treatment response, micro-RNAs (miRNAs) have been widely and still are investigated as a new class of biomarkers, valuable in a number of neoplasms including CRC.
This PhD project aims to investigate miRNAs expression in both liquid and solid biopsies of metastatic vs non-metastatic CRC patients candidate for surgery, in order to identify reliable biomarkers suitable for prognosis, treatment and patient’s monitoring.
Materials and methods: Blood sampling from each patient was obtained at the time of admission and on fifth postoperative day. Circulating exosomal RNA was extracted from plasma, isolated and RNA profiles analyzed. RNA from solid tumors, sampled immediately after surgery, was extracted and quantified. Samples were then processed and subjected to microarray analysis.
Results: Globally, 25 patients have been enrolled in the study, in between whom 10 non-metastatic and 15 metastatic. No significant differences in terms of demographics were observed between the two groups. Colorectal resections were conducted by laparoscopy and no conversion to open surgery occurred. Any significant difference in perioperative outcomes was noticed.
Liquid biopsies estimate of small non-coding RNA concentration revealed a high percentage of miRNAs. Bioinformatic analysis of solid biopsies identified 16 dysregulated miRNAs differently expressed in metastatic vs non-metastatic patients, 11 upregulated and 5 downregulated. Bibliographic research focused on these 16 selected miRNAs was conducted. Three miRNAs overexpressed in our casuistic haven’t been associated with CRC before; all the remains have been already reported in the literature as linked to CRC, even if with discordant expression between different experiences and different queries, possibly misleading.
Conclusion: Since the biology of the primary tumor is responsible for the disease aggressiveness, the knowledge of tumor’s genomic expression is the key to propose treatment and follow-up protocols tailored on individual cancer characteristics, overcoming staging systems and prognostic scores commonly used in clinical practice, which suffer from important limits bound to imaging discrimination rather than bias related to surgical sampling or anatomopathological analyses. This project leads to identify 16 miRNAs capable to distinguish metastatic from non-metastatic CRC. In the future, if real-time PCR of circulating exosomal miRNA isolated from blood samples will confirm miRNAs expression of solid biopsies, we would be able to add important prognostic information in the expanding field of liquid biopsies’ in the management of metastatic cancer.
39
Kollander, Barbro. "Inductively Coupled Plasma Atomic Emission Spectrometry : Exploring the Limits of Different Sample Preparation Strategies". Doctoral thesis, Uppsala universitet, Analytisk kemi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-150861.
Abstract (sommario):
This thesis describes two different sample preparation strategies for inductively coupled plasma atomic emission spectrometry (ICP-AES), and their ability regarding multi element quantification in complex samples. Sensitivity, repeatability, reproducibility and accuracy were investigated. The aim was to increase the over all efficiency, the speed of analysis, and/or the sensitivity of the analytical method. The intention was to measure analytes with concentrations ranging from ng/g to mg/g simultaneously. The aim was additionally to study chemical and physical processes occurring during the sample preparation, the sample transport to the plasma, and the atomization therein. In the first sample preparation strategy, a hydrophilic highly cross-linked iminodiacetate-agarose adsorbent, IDA-Novarose, was used for preconcentration of metal ions, and matrix elimination in natural water samples. The sorbent was synthesized with different binding capacities. The effect of the capacity on preconcentration, matrix elimination, and uptake capability at high flow rates was studied. For a high capacity IDA-Novarose (≥ 45 µmole/ml) quantitative uptake was seen even at high flow rates (100 ml/min) for Cu2+ with a high affinity to the adsorbent, and for Cd2+ with a moderate affinity. For lower capacities the uptake of Cd2+ was affected by the sample matrix and the flow rate. A method based on the determination of the conditional stability constant of the metal sorbent complex was suggested for the prediction of the sorbent capacity needed to obtain quantitative recovery and optimal matrix elimination. The sorbent was used in a flow system with online buffering for the analysis of a certified riverine water (SLRS-3), tap water and lake water. With few exceptions the results obtained by ICP-AES after preconcentration agreed well with the certified concentrations and results obtained by ICP-MS. The other sample preparation strategy discussed is a method for non digested biological samples from different animal organs for the multi element analysis by ICP-AES. This “mix and measure method” consists of a simple homogenization of the sample with a mixing rod in a small amount of neutral media, followed by dilution and direct measurement with ICP-AES. The total time of analysis is only a few minutes. The ability of this fast method to accurately quantify some elements of toxic, environmental, and/or physiological concern with the lowest possible sample dilution and the highest possible plasma load was evaluated. In 10 % liver slurry Cd, Co, and Sr, at concentration levels around 0.05 µg/g were quantified simultaneously with P and K around 2000 µg/g and with several other elements in between (Al, Ca, Cu, Fe, Mg, Mn, Pb, and Zn). The relative standard deviation of repeated measurements of samples was around 5 - 6 % for regardless of the concentration of the element. The method was also used for fast screening of the elemental distribution in mice organs (brain, heart, kidney, liver, lung and spleen).
40
Gerin, Chloé. "Modélisation et étude histologique de gliomes diffus de bas grade". Phd thesis, Université Paris-Diderot - Paris VII, 2012. http://tel.archives-ouvertes.fr/tel-00820353.
Abstract (sommario):
Les gliomes diffus de bas grade (GBG) sont des tumeurs cérébrales primaires. Après une phase de croissance lente, ils évoluent en gliomes de haut grade, entrainant une issue fatale. Ce sont des tumeurs très diffuses donc difficiles à traiter. Une meilleure connaissance de ces tumeurs pourrait permettre de les guérir ou, à défaut, d'optimiser les traitements. Nous avons étudié la croissance des GBG grâce à un modèle mathématique simple, ce qui nous a amené à spéculer (i) qu'ils surviennent à l'adolescence, (ii) que l'âge de la tumeur au moment du diagnostic peut être calculé facilement et (iii) que la vitesse de croissance est un fac- teur pronostique important. Cette dernière prédiction concorde avec les observations cliniques. Pour vérifier ce modèle spatial, nous avons caractérisé quantitativement des tissus de biopsies étagées de GBG humains, en particulier la présence d'œdème. L'analyse de ces données micro- scopiques étaie l'idée que l'œdème est à l'origine de l'anomalie de signal IRM en séquence T2. Pour prendre en compte ce résultat nouveau, nous avons incorporé l'œdème au modèle initial comme conséquence de la présence de cellules tumorales. Ce modèle permet d'expliquer la longue décroissance du rayon tumoral pendant des dizaines de mois après la radiothérapie : les cellules tumorales désormais moins nombreuses, le drainage de l'œdème devient prédominant. Ce mo- dèle, qui ne comprend que trois paramètres libres, a été validé grâce à des données cliniques sur une vingtaine de patients.
41
Nunes, Vera Lopes. "O papel do acúmulo do colágeno miocárdico intersticial na sobrevida dos pacientes com miocardiopatia dilatada idiopática e chagásica". Universidade de São Paulo, 2004. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-19032007-160751/.
Abstract (sommario):
As miocardiopatias dilatadas representam 87% das miocardiopatias e apresentam evolução adversa com grande morbi-mortalidade. Vários marcadores de prognóstico são bem definidos, entretanto, um marcador estrutural se faz necessário. Estudamos através da realização da biópsia endomiocárdica e exame ecocardiográfico, 9 indivíduos sem doença estrutural miocárdica (controle) e 45 pacientes com miocardiopatia dilatada grave de etiologia idiopática (MCDI) e chagásica (MCDC). Observamos se havia relação entre a quantidade de colágeno miocárdico intersticial (FVCI) e a sobrevida destes pacientes, se a FVCI diferia entre as etiologias, e se a fibrose interferia na função e geometria do miocárdio. Observamos que a FVCI foi 15x maior nos miocardiopatas em relação ao grupo controle, mas não diferiu em relação às MCDI e MCDC (FVCI % MCDC = 6,83 ± 5,47; MCDI = 5,75 ± 4,45; controle = 0,42 ± 0,14*; p<0,001). Não houve relação da FCVI com a sobrevida dos pacientes com miocardiopatias (MCDI-FVCI £5,53 (20,0%) ou >5,53 (0,0%) (p=0,249), e na MCDC-FVCI £5,53 (0,0%) ou >5,53 (7,7%) (p=0,587) e apenas na MCDI a fração de ejeção do ventrículo esquerdo (FEVE) teve relação com a FVCI. O diâmetro diastólico final do ventrículo esquerdo não se correlacionou com a FCVI nas duas etiologias. Conclusão: a fibrose miocárdica não diferiu entre as duas etiologias, não se correlacionou com o prognóstico das MCDC e MCDI e apenas na MCDI ela se correlacionou com a FEVE.Dilated cardiomyopathies represent 87% of all cardiomyopathies and they have adverse prognosis with high morbidity and mortality. There are several prognostic markers, however, a structural one has not been described yet. Seems to be very important to find out whether morphological changes upon myocardial structure would affect the prognosis. We studied, using endomyocardial biopsy and 2D-echocardiogram, 9 patients with no structural myocardial changes (control) and 45 patients with severe dilated cardiomyopathies. They were divided according the etiology of cardiomyopathy into idiopathic group (IDCM) or Chagas group (CDCM). We analyzed the correlation between interstitial myocardial collagen (ICVF) and survival rates. We also evaluated the difference of ICVF between these groups and whether it correlates with geometric and functional changes of the heart. We observed that ICVF was 15 times higher in cardiomyopathies patients than in control group, but it did not differ between CDCM and IDCM (ICVF% CDCM = 6.83 ± 5.47; IDCM = 5.75 ± 4.45; control = 0.42 ± 0.14*; p<0.001). The ICVF did not correlate to survival rate in cardiomyopathies patients (IDCM-ICVF £5.53 (20.0%) or >5.53 (0.0%) (p=0.249), and CDCM-ICVF £5.53 (0.0%) or >5.53 (7.7%) (p=0.587). We observed a significant correlation between ICVF and left ventricular ejection fraction (LVEF) only on DMC, the ICVF did not correlate to left ventricular diastolic diameter in either etiology. Conclusion: the myocardial fibrosis did not differ between these two etiologies, it did not correlate to prognosis either in the IDCM or CDCM and only in the IDCM the ICVF correlated to the LVEF.
42
Cowan, Nigel Christopher. "The development of CT urography for investigating haematuria". Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:284084de-2a71-4e35-8342-41f039b03df1.
Abstract (sommario):
This thesis addresses the three principal questions concerning the development of CT urography for investigating haematuria and each question is the subject of a separate chapter. The questions are: What is the reasoning behind using CT urography? What is the optimum diagnostic strategy using CT urography? What are the problems with using CT urography and how may solutions be provided? Haematuria can signify serious disease such as urinary tract stones, renal cell cancer, upper tract urothelial cancer (UTUC) and bladder cancer (BCa). CT urography is defined as contrast enhanced CT examination of kidneys, ureters and bladder. The technique used here includes unenhanced, nephrographic and excretory-phases for optimized diagnosis of stones, renal masses and urothelial cancer respectively. The reasoning behind using excretory-phase CT urography for investigating haematuria is based on results showing its high diagnostic accuracy for UTUC and BCa. Patients with haematuria are classified as low risk or high risk for UTUC and BCa, by a risk score, determined by the presence/absence of risk factors: age > 50 years, visible or nonvisible haematuria, history of smoking and occupational exposure. The optimum diagnostic strategy for patients at high risk for urothelial cancer, uses CT urography as a replacement test for ultrasonography and intravenous urography and as a triage test for flexible and rigid cystoscopy, resulting in earlier diagnosis and potentially improving prognosis. For patients at low risk, ultrasonography, unenhanced and nephrographic-phase CT urography are proposed as initial imaging tests. Problems with using CT urography include false positive results for UTUC, which are eliminated by retrograde ureteropyelography-guided biopsy, an innovative technique, for histopathological confirmation of diagnosis. Recommendations for the NHS and possible future developments are discussed. CT urography, including excretory-phase imaging, is recommended as the initial diagnostic imaging test before cystoscopy for patients with haematuria at high risk for urothelial cancer.
43
Schilling, Anne. "Die Endometriumbiopsie bei der Stute- eine Analyse der histologischen Befunde zwischen 1992- 2012 am Leipziger Institut für Veterinär- Pathologie". Doctoral thesis, 2016. https://ul.qucosa.de/id/qucosa%3A15630.
Abstract (sommario):
In der Arbeit wurden die histopathologischen Untersuchungsbefunde von 15795 Uterusbiopsien, welche am Institut für Veterinär- Pathologie der Universität Leipzig von 1992 bis 2012 befundet wurden, aufgearbeitet und statistisch ausgewertet. Ziel der Arbeit war es, zu untersuchen, welche pathologischen Veränderungen des Endometriums im gesamten Untersuchungsgut vorkommen (Endometritis, Angiose, Lymphangiektasien, Endometrose, endometriale Differenzierungsstörungen) und welche Veränderungen in bestimmten, nach unterschiedlichen Gesichtspunkten festgelegten Untersuchungsgruppen dominieren. Weiterhin wurde geprüft, ob und inwiefern bestimmte pathologische Veränderungen miteinander korrelieren und ob sie von anderen Faktoren, wie etwa der Parität oder dem Alter der Stute abhängig sind. 11698 Datensätze von Erstbiopsien lagen nach der Aufarbeitung der Datei zur Untersuchung vor. Bei 9120 Bioptaten konnte auf das Stutenalter geschlossen werden, bei 6049 Bioptaten auf den Reproduktionsstatus der Stute. Bei 4719 Bioptaten liegen vorberichtliche Angaben zur Güstzeit der Stute vor. Die Auswertung der Befunde erfolgte deskriptiv nach Überarbeitung der Datensätze mit Microsoft Access. Mittels SPSS für Windows (Version 22.0) wurde auf Signifikanz geprüft. Die kategorisierten Daten wurden mit Hilfe des Chi-Quadrat-Tests bzw. des exakten Tests nach Fisher ausgewertet.
44
Tabet, Paul. "Masses kystiques latérales du cou : une analyse comparative des approches diagnostiques". Thèse, 2019. http://hdl.handle.net/1866/23670.
Abstract (sommario):
Les masses kystiques latérales du cou (MKLC) bénignes et malignes sont difficiles à différencier
cliniquement. L’utilité des modalités d’imagerie et de prélèvement doit être clarifiée.
Une revue rétrospective de cas entre 2010 et 2016. Les données d’imagerie ont été récoltées et
plusieurs variables propres à la masse furent analysées. Les rapports de cytoponction à l’aiguille
fine (CAAF), de la biopsie au trocart (BT) et des examens extemporanés (EE) ont été analysés. La
sensibilité, la spécificité, la valeur prédictive positive (VPP) et la valeur prédictive négative (VPN)
pour prédire la malignité ont été calculées pour toutes les variables comparées entre les masses
kystiques bénignes et malignes.
Aucune variable d’imagerie n’a pu différencier les masses kystiques bénignes de malignes. La
sensibilité de la CAAF est plus basse que celle de la BT (59% vs 83%; p=0.036) et de l’EE (59% vs
93%; p=0.01). L’EE a une meilleure VPN que la CAAF (92% vs 40%; p<0.001) et que la BT (92% vs
50%; p=0.062). La VPP et la spécificité étaient similaires dans tous les groupes.
Les cliniciens ne peuvent pas se fier uniquement à l’imagerie pour différencier les masses
bénignes des masses malignes. Vu sa VPP adéquate (92%), la CAAF devrait être utilisée
initialement pour tous les patients avec une MKLC. Si la CAAF s’avère négative, la BT devrait être
utilisée vu sa meilleure sensibilité. Un examen extemporané devrait toujours suivre une BT
négative vu la faible VPN de la BT. Un résultat positif à l’une des trois modalités de prélèvement
indique la présence de malignité.Benign and malignant lateral cystic neck masses (LCNM) are difficult to distinguish clinically. The usefulness of imaging and sampling modalities in clarifying the diagnosis remains unclear. Retrospective review of cases between 2010 and 2016. Imaging data was reviewed and the variables pertaining to the mass were assessed including the following: size, nodal level, fat stranding, extracapsular spread, calcifications, vascularity, necrosis and standardized uptake value. Sampling reports of fine-needle aspiration (FNA), core-needle biopsy (CNB) and frozen section (FS) were also assessed. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for predicting malignancy were calculated for all variables and compared between benign and malignant cystic neck masses. Ultrasound was used in 47.2% and CT-Scan in 90.5% of patients. No variables on imaging could definitely differentiate benign from malignant LCNM. FNA had a lower sensitivity then CNB (59% vs 83%; p=0.036) and FS (59% vs 93%; p=0.01). FS had a better NPV when compared to FNA (92% vs 40%; p<0.001) and CNB (92% vs 50%; p=0.062). Specificities and PPV were similar among all groups. Clinicians cannot rely on imaging to differentiate benign from malignant LCNM. Given its adequate PPV (92%), FNA should be used initially on lateral cystic neck masses. Because of its high sensitivity, CNB should be considered if FNA is not diagnostic of malignancy. FS should always follow a CNB not indicative of malignancy, because of the low NPV. Any result diagnostic of malignancy on either FNA, CNB or FS strongly indicates presence of malignancy.
45
Bratu, Vlad Antonio [Verfasser]. "Histopathological morphometry of human endobronchial biopsies : a comparison of conventional quantitative analyses and stereological designs / vorgelegt von Vlad Antonio Bratu". 2008. http://d-nb.info/999867547/34.
46
"Novel methods for specific detection and quantification of covalently closed circular DNA in sera and biopsies of hepatitis B patients". Thesis, 2011. http://library.cuhk.edu.hk/record=b6075203.
Abstract (sommario):
In conclusion, two new methods of cccDNA quantitation were developed and validated. The two assays are complementary to each other and may be used in patients with extreme HBV DNA levels. These cccDNA assays should be further validated in larger studies and may become important tests for diagnostic, prognostic and treatment monitoring purposes.Over 350 million people worldwide suffer from chronic hepatitis B virus (HBV) infection, which leads to many cases of cirrhosis and hepatocellular carcinoma. HBV covalently closed circular DNA (cccDNA) is a critical intracellular replicative intermediate and cannot be eliminated during antiviral therapy. Current methods for cccDNA detection are limited by false positive detection due to the interference by HBV relaxed circular DNA (rcDNA). The tests also have limited sensitivity to detect cccDNA at low concentrations. Hence, we aimed to develop a highly sensitive and highly specific assay for cccDNA detection with wide linear range.
The modified Bowden's assay had the highest intrahepatic cccDNA detection rate (60 positive results out of 61 cases). The detection rate of the modified Bowden's assay is significantly higher than that of the Bowden's assay. On the other hand, the cccDNA detection rate in serum samples was low at 20--27% by all 3 assays. In 5 samples in which cccDNA was undetectable by the Bowden's assay but detectable by the other two assays, a point mutation in the HBV genome was found in the forward primer binding site of the Bowden's assay. This partly explained the false negative results.
The quantification result of cccDNA by the bisulfite conversion assay was significantly lower than that by the Bowden's assay assay (P=0.001) and the modified Bowden's assay (P=0.003). When the total HBV DNA was higher than 107 copies/ml, the serum cccDNA level detected by the bisulfite conversion assay was significantly lower than that detected by the Bowden's assay (P=0.008) and the modified Bowden's assay (P=0.046). When the total HBV DNA is less than 107 copies/ml, there were no significant differences. This suggests that the bisulfite conversion assay was less affected by rcDNA even in samples containing a high viral load.
With this background, two new cccDNA assays were developed and optimized. Bowden's assay was used as a standard to evaluate the performance of new assays. The first new assay (modified Bowden's assay) involved the use of new primers and probes that targeted more conserved regions in the HBV genome. The second assay adopted the bisulfite conversion method, which introduced gene sequence changes into the HBV genome and thereby enhance the specificity of the assay. Capillary sequencing was performed to find mutations in primers and probe range of different assays.
Yu, Ling.
Advisers: Vincent Wai-Sun Wang; Joseph Jao-Yiu Sung.
Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: .
Thesis (Ph.D.)--Chinese University of Hong Kong, 2011.
Includes bibliographical references (leaves 105-111).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract also in Chinese.
47
Conradi, Lena-Christin [Verfasser]. "Prädiktives und prognostisches Potential der Thymidylatsynthase als Biomarker im multimodalen Therapiekonzept 5-FU-basierter Radiochemotherapie des lokal fortgeschrittenen Rektumkarzinoms : immunhistochemische Analyse prätherapeutischer Biopsien und korrespondierenden residuellen Tumorgewebes / vorgelegt von Lena-Christin Conradi". 2010. http://d-nb.info/1008992038/34.
48
Čuperková, Romana. "Optimalizace postupů pro kvantifikaci miRNA z tenkojehlových bioptických vzorků karcinomu pankreatu". Master's thesis, 2014. http://www.nusl.cz/ntk/nusl-337129.
Abstract (sommario):
Pancreatic cancer (PC) is extremely severe malignant disease with a five-year survival of less than 5%. Currently there is no reliable tool for the diagnosis of PC in its early stages. At the time of clinical symptoms most patients are in an advanced stage of the disease and the treatment does not usually have a significant effect. For these reasons emphasis is gradually shifting to the search for the suitable molecular markers for improvement of the diagnosis and assessment of the survival prognosis with respect to a possibility of surgical treatment. MiRNA represent one of the most promising markers, although, their examination in pancreatic tissue is a complicated process. One of the reasons is the very small amount of the source material coming from a fine needle biopsy. A second cause of problems is the subtle character of the pancreatic tissue resulting in significantly lower yields of molecular genetic analysis when compared to other epithelial tissues. An additional negative factor is heterogeneity of the tissue resulting in disproportionate representation of tumor cells within the sample. A suitable choice of procedures for isolation of nucleic acids (NA) and subsequent analysis including quantification of tumor cells is critical for accurate evaluation of the miRNA levels. This work is...
49
Wells, Bryan John. "A Comparison of the Costs of Sentinel Lymph Node Biopsy and of Axillary lymph Node Dissection in the Management of Early-stage Breast Cancer in Ontario". Thesis, 2009. http://hdl.handle.net/1807/18993.
Abstract (sommario):
Objective: To complete a cost-minimization analysis (CMA) of the cost of sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) in the management of early-stage breast cancer (ESBC) in a hypothetical Ontario hospital setting.
Methods: Decision-analysis modeling, with a decision-tree and Markov states, was used to estimate hospital costs for the two treatment options. The model was populated with data from the literature and costs from the Ontario Case Costing Initiative, a publicly accessible, government-sponsored, costing database. Model variability and parameter uncertainty were quantified by probabilistic sensitivity analysis (PSA).
Results: The SLNB treatment algorithm was cost-minimizing compared to the ALND-only treatment option. The costs of treating postoperative complications did not contribute to the incremental average cost.
Conclusion: A treatment algorithm that involves SLNB as the initial axillary-staging procedure in the setting of ESBC offers a cost-savings over the ALND-only option. This result is generalizable to all Ontario hospitals.
50
Lemos, Mariana Timóteo. "Biópsia de gânglio sentinela em melanomas espessos: estudo clínico retrospetivo". Master's thesis, 2015. http://hdl.handle.net/10316/30572.
Abstract (sommario):
Trabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra.Introdução: A biópsia de gânglio sentinela (BGS) é uma técnica utilizada rotineiramente no estadiamento de doentes com melanoma cutâneo, estando o seu valor prognóstico e terapêutico bem definido nos melanomas de espessura intermédia (1-4 mm). Contudo, nos melanomas espessos (>4 mm) existe ainda alguma controvérsia quanto à sua utilidade. Objetivo: Avaliar o valor prognóstico do status do gânglio sentinela em doentes com melanomas espessos. Material e Métodos: Utilizando curvas de Kaplan-Meier e o modelo de regressão de Cox calcularam-se o tempo livre de doença (TLD) e o tempo de sobrevivência global (TSG) numa amostra de doentes com diagnóstico de melanoma espesso. O efeito de variáveis como idade, sexo, espessura do melanoma, presença de ulceração, tipo e localização do melanoma, no TSG e no TLD destes doentes também foi avaliado. Resultados: Estudaram-se 43 doentes com melanoma espesso (21 do sexo feminino e 22 do sexo masculino), com uma média etária de 63,88 anos. A BGS revelou-se positiva em 20 doentes (46.5%) e negativa em 23 (53.5%). O tempo médio de seguimento foi de 40 meses. Um total de 15 doentes (35%) morreram em relação com a progressão do melanoma e 22 doentes (51%) sofreram recidiva, não havendo diferença estatisticamente significativa entre o grupo de BGS positiva e o grupo de BGS negativa. A TSG foi tendencialmente menor nos doentes com BGS positiva (taxa de sobrevivência aos 5 anos de 52% versus 79% no grupo de BGS negativa). No entanto, esta tendência não atingiu significado estatístico. Os doentes com BGS negativa apresentaram um maior TLD, em comparação com os doentes com BGS positiva (taxa de sobrevivência livre de doença aos 5 anos de 63% versus 19%, respetivamente, com significado estatístico). A única variável que demonstrou influenciar o TSG e o TLD foi a espessura do melanoma. Conclusão: Este trabalho demonstrou que a BGS não prediz o tempo de sobrevivência global em melanomas espessos, provavelmente devido ao elevado risco de disseminação hematogénea. Contudo, o estado do gânglio sentinela contribui com importante informação prognóstica, uma vez que é um importante preditor do tempo livre de doença. Por este motivo, a biópsia do gânglio sentinela deve ser recomendada a todos os doentes com melanoma espesso.
Background: Sentinel-node biopsy (SNB) is a widely accepted technique in the staging and management of patients with malignant melanoma. Its prognostic value is well established in intermediate-thickness melanomas (1-4 mm). However, its use in the management of patients with thick melanoma (> 4 mm) is still controversial. Objective: To assess the prognostic value of sentinel node status in patients with thick melanoma. Patients and Methods: The disease free survival (DFS) and the overall survival (OS) were estimated using Kaplan-Meier curves and Cox regression model in a sample of patients with thick melanoma. The influence of other parameters such as patient's age and sex, melanoma thickness, ulceration, type and location over the DFS and OS were also assessed. Results: Twenty-one (48.8%) out of 43 patients with thick melanoma were female and 22 (51.2%) were male, with a mean age of 63.88 years. SNB was positive in 20 (46.5%) patients and negative in 23 (53.5%) patients. Mean follow-up time was 40 months. Overall, 15 (35%) patients suffered a melanoma-related death, and 22 (51%) patients had a disease relapse, with no significant differences between patients with positive BGS and patients with negative BGS. The 5 year overall survival rate was tendentiously lower (52%) in patients with positive BGS than in patients with negative BGS (79%), but lacking statistic significance. Patients without sentinel node metastases had a 5-year disease survival rate significantly higher 63% than those with positive SNB (19%). Despite the sentinel node status, the only parameter which showed significant influence in OS and DFS was tumor thickness. Conclusion: This study showed SNB does not predict overall survival in patients with thick melanoma, probably due to the high risk of hematogenous spread. However, sentinel-node biopsy provides important prognostic information, since it predicts disease free survival in patients with thick melanomas, and therefore it should be recommended to all patients with thick melanoma.