Thesis (doctoral)--University of Göteborg, 1992. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.

Thesis (doctoral)--University of Göteborg, 1992. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2010. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Washington, 2005. / Vita. Includes bibliographical references (leaves 83-91).

Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.

Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 55-62).

Primary cardiac neoplasms (PCNs) represent the rarest form of neoplastic growths worldwide with an incidence ranging from 0.001 - 0.3% in autopsy series (Yu et al., 2014) ("Primary Cardiac Neoplasms," 2014). The rarity of these tumors has contributed to the challenges associated with their diagnosis and treatment ("Primary Cardiac Neoplasms," 2014). Primary heart tumors are generally classified as benign or malignant based on whether or not the tumors cells invade their surrounding tissue. Primary benign heart tumors can be further sub-classified as non-complicated or complicated. Non-complicated tumors are those that are stable, occur alone, and do not invade the cardiac conduction system. Conversely, complicated primary benign cardiac neoplasms are those that tend to break off into systemic circulation increasing the risk for embolization, have multicentered origins within the heart and/ or invade the cardiac conduction system which may lead to heart block and sudden death ("Cardiac Tumors: Merck Manual Professional," n.d.). These distinctions have been shown to significantly impact the efficacy of treatment. Primary tumors in general tend to involve either the myocardium, i.e. the heart muscle itself, or the endocardium; i.e. the membrane that lines the heart cavities. In either case, the tumors most often appear in the left atrium (Roberts, 2001). Among primary cardiac neoplasms, myxomas (a type of non-cancerous heart tumor) are the most common accounting for approximately 40-50% of these growths ("Primary Cardiac Neoplasms," 2014). Clinicians tend to rely heavily on imaging procedures for the diagnosis of primary heart tumors because there are no characteristic clinical signs exclusive to primary cardiac neoplasms (Bartoloni & Pucci, 2013). Further, these growths have a tendency to mimic the symptomology of other better known conditions such as heart failure, stroke, and coronary artery disease ("Cardiac Tumors: Merck Manual Professional," n.d.). The mean age of diagnosis for these tumors is approximately 50 years of age but many PCNs have been identified in children (Bartoloni & Pucci, 2013; "Primary Cardiac Neoplasms," 2014). Further, sources disagree on the relative incidence of these neoplasms among men and women. Some report a higher prevalence in women while others hold that the frequencies are equal for both sexes and across all races (Bartoloni & Pucci, 2013; "Primary Cardiac Neoplasms," 2014). The standard of care for the treatment of primary cardiac neoplasms are; as with other neoplastic conditions; radiation therapy, chemotherapy, surgical resection, and; in some instances; cardiac transplantation. However, due to the differences in tumor histology, i.e. the structure and molecular characteristics of tumor cells, many of the current treatment options available to and considered curative in patients with non-complicated benign PCNs do not confer the same survival benefits in patients with complicated benign PCNs nor in patients with malignant PCNs. With treatment, the prognosis associated with primary cardiac neoplasms is heavily dependent upon the type of tumor. Primary benign non-complicated neoplasms tend to have very positive prognoses. Even with incomplete resection, reports have shown no evidence of recurrence in patients with this tumor type (Jr et al., 1987). On the other hand, primary malignant neoplasms of the heart are associated with the poorest prognoses. The longest reported median survival time is only 16.5 - 17 months after diagnosis and surgical excision of the primary tumor (Chahinian, Gutstein, & Fuster, 2000; Ostrowski, Marcinkiewicz, Kooemider, & Jaszewski, 2014; Simpson et al., 2008). In this thesis we examine the reported outcomes of the above four forms of treatment that are regarded as the standard of care for primary cardiac neoplasms. We do this by reviewing the currently available literature characterizing the results of these respective courses of therapy. We then evaluate the efficacy of these treatments relative the definition of effective treatments developed herein. Finally, based on the evidence, we conclude that effective treatments do exist for approximately 38% of people with PCNs. This minority represents the people with primary benign non-complicated cardiac neoplasms. We also regrettably conclude that for the other 62% (37% with benign complicated cardiac neoplasms and 25% with malignant cardiac neoplasms) of people with primary cardiac tumors effective treatments do not exist. For this reason, we propose the further investigation of two promising therapies. These are cardiac autotransplantation and targeted gene therapy. We believe that elucidating the possible advantages of these therapies in the heart will lead to treatments that can be deemed effective in treating complicated primary benign cardiac neoplasms as well as primary malignant cardiac neoplasms.

Made available in DSpace on 2014-06-11T19:23:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-18Bitstream added on 2014-06-13T18:19:50Z : No. of bitstreams: 1 geller_ff_me_botfmvz.pdf: 3538341 bytes, checksum: 405b2f41489e8f8a15293e95ec501cd7 (MD5) / Universidade Estadual Paulista (UNESP) / O linfoma canino é uma das neoplasias mais frequentes na medicina veterinária e podendo acometer vários órgãos, tanto linfonodos superficiais como profundos, bem como o baço, fígado, tonsilas, medula óssea, podendo ainda apresentar massas tumorais nos pulmões e coração. O exame ultrassonográfico tem grande importância na detecção das alterações que essa doença produz. O presente estudo teve por objetivo avaliar as alterações ultrassonográficas dos órgãos abdominais em animais com diagnóstico citológico de linfoma pela citologia, bem como agrupar os padrões de imagem a elas relacionados. Foram reavaliadas as imagens ultrasssonográficas abdominais de 70 cães com diagnóstico de linfoma, assim como os seus exames laboratoriais e suas características. Dos animais analisados, houve predomínio de cães sem raça definida, sem predileção por sexo, com ampla variação de peso e de faixa etária de 4 a 11 anos, e presença de elevação da fosfatase alcalina. Das alterações ultrassonográficas podemos salientar o maior envolvimento dos linfonodos ilíacos mediais, 54,2% hepatomegalia e 51,4% de esplenomegalia. Dos animais que foram submetidos à citologia dos linfonodos superficiais, 64 cães apresentavam alterações ultrassonográficas compatíveis com linfoma hepático, enquanto que 55 cães apresentavam alterações ultrassonográficas compatíveis com linfoma esplênico. Destes 82,8% apresentaram alterações ultrassonográficas difusas no fígado e 54,5% tinham a aparência ultrassonográfica normal no baço. Diante dos resultados apresentados, podemos concluir que o linfoma canino é uma doença complexa e que necessita de vários exames complementares para o correto diagnóstico e prognóstico da doença. Assim, o exame ultrassonográfico, em conjunto com a avaliação citologia ou histologia dos órgãos acometidos... / Canine lymphoma is one of the most frequent cancer in veterinary medicine and it can affect many organs, such as superficial and deep lymph nodes, and organs like the liver, spleen, tonsils, bone marrow, it may also make tumor masses in the lungs and heart. The ultrasound examination is a valuable procedure to diagnose the lesions produced by this disease. This study aimed to evaluate the ultrasonographic alterations of the abdominal organs in animals with cytologic diagnosis of lymphoma by and to assembly image patterns related to them. We reviewed the abdominal ultrasonographic images of 70 dogs diagnosed with lymphoma, as well as their laboratory and their clinic history. There was a predominance of mixed breed dogs with no gender preference, wide variation between the weight, age ranged 4 to 11 years, and with a predominant elevation of alkaline phosphatase. It was observed a frequently involvement of the medial iliac lymph nodes, hepatomegaly (54.2%) and splenomegaly (51,4%). Of the animals that were submitted to the cytology of superficial lymph nodes, 64 dogs had ultrasound changes consistent with hepatic lymphoma, whereas 55 dogs had ultrasound changes consistent with splenic lymphoma. Of these 82.8% had ultrasound changes in diffuse liver and 54.5% had a normal ultrasound appearance in the spleen. Considering the results presented we can conclude that the canine lymphoma is a complex disease and requires several laboratory tests for the diagnosis and prognosis of the disease. So the ultrasound examination in association with cytology or histological assessment of the lesions, can provide information of the involved organs and assist in the staging and prognosis of the treatment of sick animals.

Abstract Interactive image-guided neurosurgery for the resection of brain tumors was developed within the last 10 years at different neurosurgical centers around the world to improve the safety of the surgery and the functional outcome of the patients. Since 1987, the Oulu Neuronavigator System, consisting mainly of a mechanical arm, visualization software, an ultrasound transducer and a computer, was developed at the Neurosurgical Research Unit, University of Oulu, Finland. It was the first system to incorporate the principle of the common surgical axis for visualization, including intraoperative ultrasonography. A precommercial version of the device was jointly developed with Elekta Ab, Stockholm, Sweden, as a public project under EUREKA and introduced into a clinical beta-phase trial in 1994 as the Leksell Index System™. A total of 19 operations were performed at the Oulu University Hospital between September 1994 and September 1996 for patients harboring different kinds of intracranial tumors, especially cerebral gliomas. This thesis gives a comprehensive review of the literature from the roots of stereotaxy to the latest developments in interactive image-guided neurosurgery and discusses the advantages and disadvantages of the Leksell Index System™ with special reference to the clinical series that was performed at our institution. Future therapy strategies for the treatment of patients with cerebral gliomas, especially glioblastoma multiforme are envisioned, focusing on the further improvement of surgical interventions. The clinical trial proved that the employed neuronavigator system is versatile and safe and that there are no adverse effects, complications or surgical mortality due to the device. It enabled the surgeon to plan smaller sized and better centered skin incisions and craniotomies and to approach the target lesion with less dissection of intact brain tissue. Despite more radical removal of lesions the overall invasiveness of the operation was decreased in 63.2% of the cases, the duration of the procedure was decreased in 78.9%, and the surgeon's feeling of safety could be improved in 89.5% of the operations. Due to the use of intraoperative imaging (with ultrasound) the experience provides a unique basis for next generation neuronavigators and also for interventional MRI.