Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 4 uppsatser.

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2007. / "May 2007." Includes bibliographical references (leaves 111-120).

No description available.

丹参是一种著名的传统中药，富含丹酚酸和丹参酮。其中，丹参酮的潜在抗肿瘤作用近年来引起众多关注。本研究评价了主要的丹参酮及其衍生物对结肠癌细胞的细胞毒性。结果显示DHTS具有最强的抗结肠癌活性和显著的肿瘤特异性细胞毒性，其细胞毒性主要由于凋亡诱导而不是引起坏死。初步的构效关系分析提示丹参酮母环结构中的A环和B环增加的离域性有助于提高其对结肠癌细胞的细胞毒性，而非二维结构及较小的D环也是进行结构改造的可能方向。 / 基于以上发现，本研究进一步探讨了DHTS的体内外抗肿瘤活性及内在机制。本研究发现DHTS的促凋亡活性并不依赖于p53的表达，而依赖于caspase活性及线粒体介导的细胞质中氧自由基 ROS及钙离子的聚集。DHTS可引起浓度及时间依赖caspase-9/-3/-7的活化而并未显著引起caspase-8的活化，这一现象发生于同样以浓度及时间依赖方式进行的线粒体中cytochrome c及AIF转位之后。在DHTS诱导的结肠癌细胞凋亡中，cytochrome c及caspase介导的凋亡通路及AIF介导的凋亡通路均被激活并显示出两条通路之间的交叉调控。 / 此外，线粒体在DHTS的促凋亡活性中的作用在本研究中被深入探讨。本研究发现线粒体可能是DHTS的一个直接靶点, 而氧化磷酸化复合体III则更可能是其作用位点。DHTS可以引起迅速而明显的线粒体功能障碍，随之引起细胞质中大量的氧自由基及钙离子聚集，诱导凋亡的产生。 / 与体外结果一致，本研究证实了DHTS对免疫缺陷小鼠中的结肠癌移植廇也具有明显的抗肿瘤作用。与溶媒对照组比较，DHTS治疗组中移植廇的增长显著被减缓，在治疗终点时的廇体积与重量也显著被降低。TUNEL检测确认DHTS诱导移植廇中癌细胞的显著凋亡。免疫荧光检测也发现DHTS诱导caspase-3及caspase-7在移植廇中癌细胞的明显活化。 / 综上所述，本研究提供了丹参酮抗结肠癌活性的一些初步构效关系的信息，为提高丹参酮抗结肠癌活性的结构改造提供一定的参考。更重要的是，本研究证明了DHTS的体内外抗结肠癌活性并探讨了其作用机制及可能靶点，为DHTS作为新的应用于抗结肠癌药物或辅助治疗用药提供了临床前研究证据。 / Salvia miltiorrhiza Bunge, also known as Danshen, rich in phenolic acid and tanshinones, has been widely used to treat various kinds of diseases including heart diseases and hepatitis in China with minimal side effects. Among the tanshinones, tanshinone I, tanshinone IIA, cryptotanshinone and dihydrotanshinone I are the major bioactive constituents in this herb. In this study, the anti-colon cancer potential of five tanshinones and six derivatives of tanshinone IIA were evaluated in several colon cancer cell lines. It was found that apoptosis but not necrosis contributed significantly to the cytotoxicity of the tanshinones. Dihydrotanshinone I (DHTS) was confirmed to be the most potent and selective anti-cancer compound among the tanshinones tested in this study. Preliminary SAR (structure activity relationship) of tanshinones reveals that the increase of delocalizability of A and B rings in the chemical structure of the tanshinones enhances their cytotoxicity on cancer cells, while compounds with a non-planar and small sized D ring region are better choices for anti-cancer effect. / The underlying mechanisms of the anti-colon cancer activity of DHTS were further studied. It was found that apoptosis induced by DHTS was p53 independent but caspase dependent, which was closely related to intracellular accumulation of ROS (reactive oxidant stress) and calcium mediated by mitochondria. A concentration- and time-dependent activation of caspase-9,-3,-7 but not caspase-8 by DHTS in HCT116 cells was detected after the translocation of cytochrome c and AIF (apoptosis inducing factor) from mitochondria. In this process, the crosstalk between the caspase-dependent and caspase-independent pathways was firstly shown in the apoptotic mechanism of DHTS. To this end, the release of cytochrome c happened first and the translocation of apoptosis inducing factor (AIF) was prevented by a pan caspase inhibitor. In the meantime, the release of cytochrome c and activation of caspase-9 and PARP (poly-ADP-ribose polymerase) cleavage were decreased after AIF knockdown. Especially, mitochondrion was suggested to be the direct target of DHTS and OXPHOS complex III but not OXPHOS complex I was probably the acting site of DHTS. / In accordance with the results obtained in vitro, the potential anti-colon cancer activity of DHTS was also observed in nude mice with xenograft tumors and the compound did not produce any observable systemic toxicity. DHTS efficiently delayed tumor growth by decreasing the tumor size and weight through the induction of apoptosis in cancer cells but not by inhibition of cell proliferation. In the same tissues, a distinct activation of caspase-3 and caspase-7 in tumor cells was also detected by immunofluorescence assay. / Collectively, the present study provides preliminary information about the SAR of the anti-colon cancer activity for tanshinones. It also confirms that DHTS is a promising compound for anti-cancer action both in vitro and in vivo. In addition, this study gives us a better understanding regarding the mechanisms of how DHTS induces apoptosis in cancer cells. All these findings could provide solid pre-clinical evidence to propel the development and application of DHTS and perhaps its derivatives as novel therapeutic or adjuvant agents for the treatment of colon cancer. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Wang, Lin. / Thesis (Ph.D.) Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 122-132). / Abstracts also in Chinese. / Wang, Lin.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Umeå : Umeå universitet, 2009. / Härtill 5 uppsatser. Även tryckt utgåva.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2009. / Härtill 5 uppsatser.

Introdução: Atualmente a ressecção hepática é o melhor tratamento para metástases de câncer colorretal. Diversos fatores prognósticos foram estudados e muitos estudos têm demonstrado que metástases nos linfonodos hilares constituem um fator prognóstico adverso. Este estudo avaliou a frequência e as características do envolvimento linfonodal hilar microscópico, através de linfadenectomia sistemática, com pesquisa de micrometástases em pacientes submetidos à hepatectomia por metástases colorretais. Métodos: Os critérios de exclusão foram: irressecabilidade detectada no pré e intraoperatório, condições clínicas e fatores intraoperatórios que exigiam menor tempo cirúrgico, metástases linfonodais macroscópicas confirmadas por exame de congelação e menos de três linfonodos no produto da linfadenectomia. De 38 pacientes iniciais, 28 foram submetidos ressecção hepática em associação com linfadenectomia sistemática do hilo, apresentando três ou mais linfonodos dissecados. Os linfonodos negativos ao método convencional de hematoxilina e eosina foram avaliados através de cortes seriados com intervalos de 100 m associada à imunoistoquímica com anticorpos contra pancitoqueratinas humanas AE1/AE3. Resultados: Em média, 6,18 linfonodos foram dissecados por paciente. A linfadenectomia aumentou o tempo operatório em 48 minutos, no entanto, não houve morbimortalidade associada a este procedimento. Dois pacientes (7,2%) apresentaram metástase linfonodal microscópica ao exame convencional com hematoxilina e eosina. Quando aplicado os cortes seriados associados à imunoistoquímica, três pacientes adicionais (10,8%) foram identificados como portadores de micrometástases linfonodais. Conclusão: A frequência global de metástases microscópicas, incluindo micrometástases foi de 18%. Não houve correlação estatística entre outros fatores prognósticos e a presença de metástases microscópicas. A linfadenectomia sistemática associada à pesquisa de micrometástases ampliou a detecção de envolvimento linfonodal microscópico, contribuindo assim, com o estadiamento de doença extra-hepática / Introduction: Currently, hepatectomy is considered the best treatment of metastatic colorectal cancer. Several prognostic factors have been investigated, and many studies have shown that the involvement of regional lymph nodes at the hepatic hilum represents a negative prognostic factor. The present study investigated the frequency and characteristics of microscopic involvement of hilar lymph nodes, through systematic lymphadenectomy and analysis of micrometastases in patients undergoing hepatectomy due to colorectal metastases. Methods: Exclusion criteria were: no resectable disease detect in the pre or intra-operative; clinics conditions and intraoperative factors what required minor surgical time; macroscopic hepatic lymph node metastases, confirmed by frozen section and less of three lymph nodes resected for patient. Of the 38 patients, 28 underwent hepatic resection in association with systematic lymphadenectomy of the hepatic hilum, with three or more lymph nodes resected for patient. Lymph nodes considered negative by conventional hematoxylin and eosin staining were analyzed by serial sectioning with 100 m intervals and immunohistochemistry with antibodies to cytokeratins AE1/AE3. Results: In average, 6.18 lymph nodes were dissected per patient. Lymphadenectomy increased surgical time by 48 minutes in average, but no morbi-mortality was associated to the procedure. In two of the patients (7,2%), conventional hematoxylin and eosin analysis showed the presence of microscopic lymph node metastases. Immunohistochemistry analysis of serial sections allowed the identification of three other patients with lymph node micrometastases (10,8%). Conclusion: The overall frequency of microscopic metastases, including micrometastases, was 18%. No statistically significant relationships were observed between other prognostic factors and the presence of microscopic metastases. Systematic lymphadenectomy with inclusion of micrometastases protocols improved the detection of microscopic lymph node involvement, resulting in more accurate staging of extrahepatic disease

Trata-se de um estudo de abordagem qualitativa sob a perspectiva antropológica, que teve como objetivo apreender os sentidos da experiência cirúrgica de ressecção do câncer colorretal (CCR) e suas consequências na perspectiva do paciente. Utilizou-se o referencial teórico da antropologia interpretativa e o método etnográfico para apreender a experiência de treze pacientes em tratamento cirúrgico por CCR, que foram entrevistados em dois momentos, no pré e pós-operatórios, na unidade de internação de um hospital terciário. A coleta de dados ocorreu no período de junho a dezembro de 2012, por meio de entrevistas semiestruturadas gravadas em áudio, observações participantes e anotações em um diário de campo, cujos dados foram analisados por meio da análise de conteúdo indutiva. Os dados foram decodificados em dois núcleos temáticos, denominados de \"Esperança de cura pelo tratamento cirúrgico\" e \"Busca de confirmação de cura pela cirurgia\". No primeiro núcleo temático, da experiência de adoecimento relatada pelos pacientes foram extraídos os principais aspectos como o momento do aparecimento dos sintomas e do problema, a busca por atendimento à saúde e a suspeita do câncer, a notícia do diagnóstico oncológico, as expectativas e preocupações sobre o tratamento cirúrgico indicado, as consequências, os insucessos dos tratamentos prévios e a possibilidade da estomia intestinal. Com a interpretação destes dados verificamos que, independente dos acontecimentos, os pacientes buscam agregar informações, comportamentos e fatos para a manutenção da esperança de cura com a ressecção do CCR e consideram a estomia intestinal como uma necessidade para a possibilidade de cura. No segundo núcleo temático abordamos a experiência com o tratamento cirúrgico, no qual emergiram as expectativas em relação à ressecção do CCR, a utilização de estratégias de enfrentamento como redes de apoio, suporte profissional e atitudes otimistas na busca por confirmação de cura do câncer com a cirurgia e a estomia intestinal determina a gravidade do seu problema de saúde, contudo conseguem voltar a pensar em projetos de vida futuros. Com a interpretação destes dois núcleos temáticos, apreendemos que a cirurgia é considerada a única chance de cura para conseguirem retomar a sua vida familiar e cotidiana, e para tanto, buscam superar o estigma do câncer e todos os acontecimentos decorrentes do tratamento cirúrgico e do ambiente hospitalar, com canalização dos seus esforços para manter a esperança de que tudo dará certo. No pós-operatório, os pacientes buscam pistas sobre o sucesso da cirurgia e a sua evolução clínica passa a ser o indicativo da obtenção de cura para a nova chance de vida e surge a preocupação de aprendizagem dos cuidados com a estomia intestinal. Os resultados deste estudo poderão contribuir na melhoria do planejamento da assistência perioperatória ao paciente com CCR, com atendimento das suas necessidades / This is a qualitative study from the perspective of anthropology, which aimed to understand the meanings of the experience of surgical resection of colorectal cancer (RCC) and its impact on the patient\'s perspective. The theoretical framework of interpretive anthropology and ethnographic method to capture the experience of thirteen patients in surgical treatment for RCC has been used, who were interviewed on two occasions, before and after surgery, in the inpatient unit of a tertiary hospital. Data collection occurred from June to December 2012, through semi-structured interviews recorded on audio, participant observations and notes in a diary, and data were analyzed using inductive content analysis. The data were decoded in two thematic groups, called \"Hope for healing through surgical treatment\" and \"Seeking confirmation f the cure by surgery.\" \". In the first thematic group, the experience of illness reported by patients, the main aspects such as time of onset of symptoms and the problem were extracted, the search for health care and suspicion of cancer, the news of the cancer diagnosis, expectations and concerns about surgical treatment indicated, the consequences of the failure of previous treatments and the possibility of permanent intestinal ostomy. With the interpretation of these data it was found that regardless the events, patients seek to add information, facts and behaviors to maintain hope of cure with resection of RCC and consider the intestinal ostomy a necessity for the possibility of healing. In the second thematic group the experience with surgical treatment in which emerged the expectations for resection of RCC was addressed, the use of coping strategies such as support networks, professional support and optimistic attitudes in seeking confirmation of curing cancer with ostomy surgery and determine the severity of the health problem, however patients can think about future life plans again. With the interpretation of these two theme groups, we can see that the surgery is considered the only chance of cure and this way patients will be able to have their family life back, and therefore, they seek to overcome the stigma of cancer and all events resulting from surgical treatment and hospital environment, thus, channeling their efforts to keep the hope that everything will be alright. Postoperatively, patients seek clues about the success of surgery and clinical evolution becomes the target of achieving cure for the new chance of life and the concern of ostomy care occurs. The results of this study will contribute to the improvement of perioperative care planning for patients with RCC, with their needs attended

O câncer colorretal (CCR) é a neoplasia mais prevalente no mundo e, cerca de 60% apresentarão metástases hepáticas, representando uma importante causa de mortalidade. Aproximadamente 35% dos pacientes apresentam metástases hepáticas no momento do diagnóstico do tumor primário ou desenvolverão metástases durante o primeiro ano após o tratamento da neoplasia colorretal, conhecidas como metástases sincrônicas. Inúmeros trabalhos têm demonstrado que as metástases sincrônicas representam importante fator prognóstico negativo na evolução destes pacientes, representando um grupo de pacientes que necessita uma abordagem multidisciplinar mais agressiva. O objetivo deste trabalho foi de avaliar os resultados do tratamento cirúrgico das metástases sincrônicas de CCR e determinar os possíveis fatores que pudessem interferir no prognóstico de sobrevida livre de doença e sobrevida atuarial. Entre maio de 1996 e dezembro de 2007, 59 pacientes submetidos à ressecção hepática por metástases sincrônicas foram avaliados retrospectivamente através de análise uni e multivariada. A mortalidade pós-operatória foi de 3,38%, e a morbidade pós-operatória de 30,50%. A sobrevida estimada em 5 anos foi de 38,45% e a sobrevida livre de doença no mesmo período foi de 23,96. O valor do antígeno carcinoembrionário igual ou superior a 50 ng/ml e o número de metástases hepáticas maior que três lesões representaram fatores prognósticos limitados da sobrevida livre de doença, porém sem interferir na sobrevida atual. Pacientes com metástases no fígado e com doença extra-hepática, selecionados para a ressecção, não apresentaram sobrevida livre de doença acima de 20 meses, porém sem impacto na sobrevida a longo prazo. Nenhum dos fatores prognósticos estudados interferiu na sobrevida atual tardia. Entretanto,não foi observada sobrevivência além de 40 meses em pacientes com mais de três metástases hepáticas. A ressecção de metástases sincrônicas de câncer colorretal pode propiciar sobrevida tardia em mais de um terço dos pacientes. O valor do CEA e do número de metástases representaram fatores prognósticos limitantes da sobrevida livre de doença / Colorectal cancer is the world´s most prevalent digestive neoplasia and about 60% of the patients will present liver metastases, representing an important cause of mortality. About 35% of the patients present hepatic metastases at the diagnosis of the colorectal tumor or will develop metastases during the first year after the treatment of the primary tumor, known as synchronous metastases. Innumerable studies have shown that synchronous metastases represent a negative prognostic factor in the evolution of these patients, representing a group of patients that need an aggressive multidisciplinary approach. The purpose of this study was to evaluate results of the surgical treatment of colorectal cancer synchronous metastases and to determine possible factors that might interfere in the prognosis of disease-free and actuarial survival. Between May 1996 and December 2007, 59 patients submitted to liver resection for synchronous metastases were retrospectively evaluated through univariate and multivariate analysis. Postoperative morbidity and mortality were 30.5% and 3.38%, respectively. Cumulative survival estimated in 5 years was 38.45% and disease-free survival in the same period was 23.96%. Levels of carcino-embrionary antigen (CEA) higher than 50 ng/ml and the number of hepatic metastases higher than three lesions represented negative prognostic factors limiting disease-free survival; however, with no impact on cumulative survival. Patients with liver metastases and extrahepatic disease selected for resection didnt present a disease-free survival above 20 months, yet without impact in global survival. None of the prognostic factors studied interfered in long term actuarial survival, however survival beyond 40 months in patients with more than three hepatic metastases was not observed. Resection of synchronous metastases of colorectal cancer may provide late survival in more than one third of the patients. CEA values and the number of metastases represented prognostic factors with negative impact on disease-free survival