Made available in DSpace on 2014-06-11T19:32:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-10-20Bitstream added on 2014-06-13T20:42:40Z : No. of bitstreams: 1 silva_mm_dr_araca.pdf: 1081492 bytes, checksum: c4ef331b4c72ec8c91c608a5a7c7204b (MD5) / Fundação para o Desenvolvimento da UNESP (FUNDUNESP) / O queratocisto odontogênico paraqueratinizado foi recentemente reclassificado pela Organização Mundial de Saúde como tumor odontogênico queracístico (TOQ), sendo atualmente considerado uma neoplasia benigna com alta atividade proliferativa e marcada tendência à recidiva. O cisto odontogênico ortoqueratinizado (COO) ainda é classificado como cisto odontogênico, pois apresenta um crescimento mais lento e ausência de recidivas. A opção por um tratamento mais radical ou mais conservador para estas lesões depende destas variações microscópicas. Uma vez que microscopicamente ambas as lesões possuem algumas características em comum, é de interesse clínico e científico o estudo aprofundado delas, incluindo as suas casuísticas. O presente trabalho teve por objetivo realizar um estudo da casuística, histoquímico com AgNOR e imuno-histoquímica com marcadores de proliferação celular (PCNA, Ki-67 e P53) e citoqueratinas (K7, K10-13, K15, K18 e K19) dos casos de TOQ, recidivas desta lesão e COO diagnosticados no Laboratório de Patologia da Faculdade de Odontologia do Campus de Araçatuba, UNESP. Com base nos resultados observados e nas condições em que o trabalho foi desenvolvido, concluiu-se que a maior parte dos TOQs e todos COOs ocorreram preferencialmente em pacientes jovens da raça branca, com lesões assintomáticas, radiolúcidas uniloculares, localizadas principalmente na região posterior de mandíbula. Quanto ao comportamento clínico e características imuno-histoquímicas, o TOQ apresentou maior proliferação celular em relação ao COO, condizente com sua suposta natureza neoplásica, com destaque aos casos com história de recidiva, que apresentaram quantidade maior de células Ki-67 positivas / The odontogenic keratocyst was recently reclassified by the World Health Organization as a keratocystic odontogenic tumor (KCOT), being currently considered a benign neoplasia with high proliferative activity and a marked tendency to recur. The orthokeratinized odontogenic cyst (OOC) is still classified as an odontogenic cyst, since it shows slower growth and no recurrence. Opting for a more radical or more conservative treatment for those lesions depends on those microscopic variations. Once microscopically those lesions have some common features, it is of clinical and scientific interest to study them in depth, including their casuistics. This study aimed to analyze the casuistics of KCOTs, of the recurrences of those lesions, and od OOC diagnosed at the Pathology Laboratory of Araçatuba Dental School, UNESP, as well as to conduct histochemical characterization of those lesions with AgNOR and immunohistochemical analysis with cell proliferation markers (PCNA, Ki-67 and P53) and cytokeratins (K7, K10-13, K14, K18 and K19). Based on the results observed and on the conditions under which the study was carried out, it was concluded that most KCOTs and OOCs occurred preferentially in young white patients, with asymptomatic radiolucent unilocular lesions, located mainly in the posterior mandible. As for the clinical and immunohistochemical features, KCOTs showed greater cell proliferation as compared to OOCs, consistent with their supposed neoplastic nature, especially in the cases with history of recurrence, which showed larger amount of positive Ki-67 cells

O objetivo desse estudo foi avaliar as características do tecido conjuntivo de 11 folículos pericoronários, 12 cistos dentígeros e de 14 tumores odontogênicos ceratocísticos (TOCs). A amostra foi submetida às técnicas de Hematoxilina e Eosina, Tricrômico de Masson, Picrosírius, Direct Blue e Orceína. Tricrômico de Masson foi utilizado para avaliação de diferenças de densidade e de paralelismo das fibras colágenas, bem como presença de infiltrado linfoplasmocitário. Picrosírius serviu para mensuração da quantidade de fibras colágenas; Direct Blue e Orceína, para identificação do sistema de fibras elásticas. Lâminas coradas por essas três últimas técnicas foram visualizadas em microscopia confocal a laser. Os resultados mostraram semelhança entre o folículo pericoronário e o TOC: paralelismo de fibras colágenas arranjadas em um padrão eminentemente denso, podendo conter uma camada de densidade frouxa junto ao tecido epitelial. As cápsulas de cistos dentígeros eram compostas por fibras colágenas desorganizadas, ou não paralelas, em um arranjo frouxo com presença de infiltrado linfoplasmocitário. Não foi observada marcação para fibras do sistema elástico. Com base nos resultados, conclui-se que a cápsula do TOC representa o estroma da lesão, desempenhando função de suporte e que, diferentemente, o tecido conjuntivo do cisto dentígero é parte da resposta inflamatória. / The aim of this study was to evaluate the connective tissue features of pericoronal follicles, dentigerous cysts and keratocystic odontogenic tumor. The sample was submitted to Hematoxylin-eosin, Masson Trichrome, Picrosirius, Direct Blue and Orcein stains. Masson Trichrome was performed to distinguish collagen fibers density and parallelism, as well as chronic infiltrate presence. Picrosirius was performed to collagen fibers quantification; Direct Blue and Orcein, to elastic system fibers identification. Picrosirius, Direct Blue and Orcein staining slides were observed by means confocal laser scanning microscope. Results showed similar features between pericoronal follicle and keratocystic odontogenic tumor: parallel collagen fibers, more tightly packed collagen fibers, and sometimes a soft layer beneath epithelial tissue. Dentigerous cyst capsule was composed by wound collagen fibers, soft packed, associated to chronic inflammatory infiltrate. It was not observed elastic system fibers labeling. Based on results, it was concluded that keratocystic odontogenic tumor capsule represent the lesion stroma, playing a support role. This finding is different from dentigerous cyst where connective tissue is produced by inflammatory response.

O Cisto Ósseo Simples (COS) ou Cisto Ósseo Traumático (COT), é uma cavidade óssea não epitelizada, de conteúdo fluido sero-sanguinolento ou vazia. Muito se discute sobre sua etiopatogenia que ainda continua incerta. O tratamento de escolha ainda é a exploração cirúrgica, embora haja vários casos de sucesso descritos na literatura nos quais escolheu-se a proservação após criteriosa avaliação clínica e radiográfica. A porposta deste trabalho foi: 1) Analisar o estado atual de remodelação óssea espontânea em casos diagnosticados clínica e radiograficamente, sem cirurgia, que estão sendo seguidos por diferentes períodos de tempo (proservados). 2) Analisar a contribuição da Tomografia Computadorizada de Feixe Cônico (TCFC) no diagnóstico imaginológico do COS. 3) Comparar características do COS na radiografia panorâmica com as características encontradas no exame tomográfico. Foram selecionados 22 pacientes diagnosticados com COS e em acompanhamento clinico e radiográfico, segundo protocolo proposto por Damante et al. (2002). Dos 22 pacientes, 13 foram avaliados clinica e radiograficamente e nove pacientes foram avaliados apenas radiograficamente, através do banco de imagens do Departamento de Estomatologia. Foram avaliados 7 exames tomográficos, sendo que 6 deles também estavam disponíveis no banco de imagens. Três examinadores avaliaram as radiografias panorâmicas dos 22 pacientes e apenas 1 examinador avaliou as tomografias computadorizadas. Foi realizado o teste Kappa para calibração intra e interexaminador e aplicada uma estatística indutiva e descritiva aos resultados. Apenas um paciente apresentou resposta positiva à palpação e percussão dos dentes na região afetada. A concordância intra e interexaminador foi calculada pelo teste Kappa e valores satisfatórios foram encontrados. A maioria dos cistos avaliados foram classificados nas categorias 3, 4 ou 5 (em involução, quase completamente resolvido ou completamente resolvido, respectivamente). Das 7 TCFCs analisadas 6 demonstraram presença de adelgaçamento e perfuração de pelo menos uma das corticais. A amostra estudada evidenciou um processo de resolução espontânea do COS, uma vez que a maioria das lesões encontrou-se em processo de regressão ou já resolvidos, após diferentes períodos de acompanhamento. Isso reafirma as hipóteses presentes na literatura, sobre a possível resolução espontânea do COS, diante da qual a cirurgia torna-se desnecessária, uma vez que em sua maioria, são assintomáticos e não apresentam sinais clínicos. O exame tomográfico forneceu maiores detalhes imaginológicos do COS em relação à radiografia panorâmica, uma vez que foi possível detectar a presença de adelgaçamento e perfuração das corticais ósseas em 86% dos casos. / Simple Bone Cyst (SBC) or Traumatic Bone Cyst (TBC) is a non- epithelialized bone cavity, with sero-bloody fluid or empty content. There is debate regarding its pathogenesis that still remains unclear. The treatment of choice is still the surgical exploration, although there are successful cases described in the literature in which just the follow-up with clinical and radiographic evaluation were done. 1)To analyze the current state of spontaneous bone remodeling (self-healing) in cases diagnosed clinically and radiographically without surgery, being followed by different periods of time. 2) Analyze the contribution of Cone Beam Computed Tomography (CBCT) imaging in the diagnosis of SBC. 3) To compare the characteristics of SBC panoramic radiograph with features found on CT scan. Twenty-two patients diagnosed with SBC without surgery and submitted to Damante et al. protocol of follow-up (2002), were selected. Thirteen patients (13/22) were evaluated clinically and radiographically and nine patients (9/22) were evaluated only radiographically. Of these 22 patients, 7 patients had CT scans in the images database and these exams were evaluated too. Three observers evaluated the panoramic radiographs of 22 patients and only one examiner evaluated the CT scans. Kappa test was performed for intra and inter-calibration and inductive an descriptive statistics was applied to the results. Only one patient had a positive response to palpation and percussion of the teeth in the cyst area. The intra and inter agreement was calculated by Kappa test and values were found satisfactory. Most of the cysts evaluated were rated as 3, 4 or 5 (\"remodeling,\" \"almost completely resolved\" or \"completely resolved,\" respectively). Six of the 7 TCFCs analyzed showed the presence of thinning and perforation of at least one bone cortical. The study showed a process of spontaneous resolution (self-healing) of the SBC, since most cysts found in the regression process and resolved after different follow-up periods. This reaffirms the assumptions in the literature about the spontaneous resolution of the SBC, since the majority are asymptomatic and do not exhibit clinical signs. A CT scan can give new information about the imaging aspects of SBC, since it was possible to detect the presence of thinning and perforation of cortical bone in 86% of cases.

O objetivo desse estudo foi avaliar as características do tecido conjuntivo de 11 folículos pericoronários, 12 cistos dentígeros e de 14 tumores odontogênicos ceratocísticos (TOCs). A amostra foi submetida às técnicas de Hematoxilina e Eosina, Tricrômico de Masson, Picrosírius, Direct Blue e Orceína. Tricrômico de Masson foi utilizado para avaliação de diferenças de densidade e de paralelismo das fibras colágenas, bem como presença de infiltrado linfoplasmocitário. Picrosírius serviu para mensuração da quantidade de fibras colágenas; Direct Blue e Orceína, para identificação do sistema de fibras elásticas. Lâminas coradas por essas três últimas técnicas foram visualizadas em microscopia confocal a laser. Os resultados mostraram semelhança entre o folículo pericoronário e o TOC: paralelismo de fibras colágenas arranjadas em um padrão eminentemente denso, podendo conter uma camada de densidade frouxa junto ao tecido epitelial. As cápsulas de cistos dentígeros eram compostas por fibras colágenas desorganizadas, ou não paralelas, em um arranjo frouxo com presença de infiltrado linfoplasmocitário. Não foi observada marcação para fibras do sistema elástico. Com base nos resultados, conclui-se que a cápsula do TOC representa o estroma da lesão, desempenhando função de suporte e que, diferentemente, o tecido conjuntivo do cisto dentígero é parte da resposta inflamatória. / The aim of this study was to evaluate the connective tissue features of pericoronal follicles, dentigerous cysts and keratocystic odontogenic tumor. The sample was submitted to Hematoxylin-eosin, Masson Trichrome, Picrosirius, Direct Blue and Orcein stains. Masson Trichrome was performed to distinguish collagen fibers density and parallelism, as well as chronic infiltrate presence. Picrosirius was performed to collagen fibers quantification; Direct Blue and Orcein, to elastic system fibers identification. Picrosirius, Direct Blue and Orcein staining slides were observed by means confocal laser scanning microscope. Results showed similar features between pericoronal follicle and keratocystic odontogenic tumor: parallel collagen fibers, more tightly packed collagen fibers, and sometimes a soft layer beneath epithelial tissue. Dentigerous cyst capsule was composed by wound collagen fibers, soft packed, associated to chronic inflammatory infiltrate. It was not observed elastic system fibers labeling. Based on results, it was concluded that keratocystic odontogenic tumor capsule represent the lesion stroma, playing a support role. This finding is different from dentigerous cyst where connective tissue is produced by inflammatory response.

Objetivos: Avaliar a reprodutibilidade dos critérios de cistos minimamente complexos, diagnosticados pela ultrassonografia, bem como sua história natural e necessidade de estudo complementar. Materiais e métodos: Levantamento dos cistos renais diagnosticados por US no Centro de Ciências da Imagem e Física Médica (CCIFM) da faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo (USP), no período de janeiro de 2003 a julho de 2014, num total de 2.259 casos. Dentre estes, 143 foram descritos como cistos complexos ou minimamente complexos. Após aplicação dos critérios de inclusão e exclusão, 99 cistos foram selecionados para análises das imagens, evolução natural e levantamento de dados clínicos, que foram realizados por dois observadores principais e outros três colaboradores. Resultados: Entre as 99 lesões analisadas, 51 (51,5%) foram consideradas como cistos minimamente complexos e 48 (48,5%) como complexos. A concordância interobservador, avaliada pelo método de Kappa foi de 0.704, com intervalo de confiança de 95% entre 0.517 e 0.892, p< 0.001 (tabela 1). A idade média dos pacientes foi de 59,2 anos, variando de 21 a 93 anos. 40 pacientes eram do gênero masculino (78,4%) e 11 do gênero feminino (21,6%). Dos 51 cistos classificados como minimamente complexos, 11 foram classificados como Bosniak I pela TC/RM, 27 como Bosniak II e 6 como Bosniak 2F. Sete lesões não tiveram correlação com métodos de imagem, porém foram seguidas por pelo menos 3 anos. 25 lesões foram acompanhados por pelo menos 3 anos e nenhuma das lesões apresentou crescimento significativo no período ou mudança em sua arquitetura interna. Conclusão: Os resultados apontam que a avaliação de cistos minimamente complexos, pela US, tem boa reprodutibilidade e a complementação desta avaliação pela tomografia computadorizada ou pela ressonância magnética não é necessária, bastando o seguimento ultrassonográfico, considerando-se a evolução natural destas lesões e a melhor resolução de contraste da US em relação à TC para caracterização dos septos finos. / Objectives: To evaluate the reproducibility of minimally complex cysts criteria, diagnosed by ultrasound as well as its natural history and the need for further study. Methods: Survey of renal cysts diagnosed by US found in Centro de Ciências da Imagem e Física Médica (CCIFM) da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo (USP), from January 2003 to July 2014, in a total of 2259 study cases. Among these, 143 cases were described as complex or minimally complex cysts. After applying the inclusion and exclusion criteria, 99 cysts were selected to image analyses, natural history and clinical data, that were performed by two main observers and three cooperators. Results: The mean age of patients was 59.2 years, ranging from 21 to 93 years. 40 patients were male (78.4%) and 11 were females (21.6%). Among the 99 analyzed lesions, 51 (51.5%) were considered as minimally complex cysts and 48 (48.5%) as a complex. The interobserver agreement assessed by the Kappa method was 0.704, with a 95% confidence interval between 0.517 and 0.892, p <0.001 (Table 1). Of the 51 cysts classified as minimally complexes, 11 were classifieds as Bosniak I by CT/ MRI, 27 as Bosniak II and 6 as Bosniak IIF. Seven cysts were not correlated with crosssectional methods, however were followed for at least 3 years. Twenty-five lesions were followed for at least three years and none of the injuries showed significant growth or internal architecture changes. Conclusion: Our results show that the evaluation of minimally complex cysts, by US, showed good reproducibility and the completion of this evaluation by CT scan or MRI is not required, since a follow up using ultrasound is safe, in view of the low malignancy rate of these lesions and US better contrast resolution compared to CT for thin septa (hair-like) characterization.

O tumor odontogênico queratocístico (TOQ) é uma neoplasia cística benigna, que apresenta controvérsias no seu diagnóstico e no tratamento. Propôs-se analisar 24 TOQs, correlacionando seus aspectos clínico-imaginológicos, histopatológicos e cirúrgicos, para aplicação no diagnóstico, prognóstico e tratamento racional. As análises foram submetidas ao teste do qui-quadrado (2) de Yates, com nível de significância de 5%. O abaulamento lingual foi presente em 100% dos casos no ramo mandibular. O padrão radiográfico unilocular e o deslocamento dental tiveram prevalências de 79,2% e 70%, respectivamente. A ocorrência de fluido queratinóide foi de 50% e mostrou correlação significativa com a síndrome do carcinoma nevóide de células basais (SCNCB). Nos demais fluidos (translúcido, citrino, sanguinolento e turvo), 63,6% apresentaram precipitado queratinóide. Fenestrações ósseas chegaram a 80% no ramo mandibular e 100% na tuberosidade maxilar. Inflamação ocorreu em 85,7% dos casos, com alterações epiteliais em 88,9% deles. A prevalência de microcistos satélites foi de 66,6%, com maior freqüência na SCNCB, no contorno festonado e no padrão multilocular. Dois casos submetidos à excisão tegumentar evidenciaram microcistos na mucosa. Num período médio de 25,5 meses, apenas um caso (4,2%) recorreu. A exérese por curetagem ocorreu em 17,4% dos casos, sem nenhuma correlação com infecção secundária, atrofia epitelial e inflamação. Todos os casos marsupializados apresentaram microcistos na lesão residual. As deiscências relacionadas à solução de Carnoy ocorreram em 75% dos casos marsupializados e em 11,1% dos demais. Parestesias relacionadas à aplicação da substância na área posterior da mandíbula ocorreram em 30,8%, com diferença significativa nos casos com e sem exposição nervosa. Conclui-se que: 1) o abaulamento lingual é característico no ramo mandibular; 2) a unilocularidade e o deslocamento dental são freqüentes; 3) o fluido queratinóide é freqüente na SCNCB e o precipitado é aplicável no diagnóstico diferencial; 4) as fenestrações corticais são prevalentes na tuberosidade maxilar e no ramo mandibular; 5) a inflamação interfere no diagnóstico histopatológico; 6) os microcistos satélites são prevalentes na SCNCB, relacionados à multilocularidade e presentes nos tecidos moles; 7) a curetagem é determinada por fatores técnicos; 8) a exérese é recomendável depois da marsupialização; 9) as deiscências são influenciadas pela marsupialização; e 10) as parestesias dependem do contato da solução de Carnoy com o epineuro. / The keratocystic odontogenic tumor (KOT) is a cystic benign neoplasm, which presents controversies about its diagnosis and treatment. It was proposed to analyze 24 KOTs, correlating their clinical, image, histological and surgical aspects with application to diagnosis, prognosis and rational treatment. The data were submitted to the chi-square test (2) from Yates, with significance level of 5%. The lingual cortical expansion was present in 100% of the cases in the mandibular ramus. The unilocular radiograph pattern and the dental displacement had prevalence of 79.2% and 70%, respectively. The occurrence of keratin-like fluid was 50% and this was significantly correlated with the nevoid basal cell carcinoma syndrome (NBSCS). For the other fluids (translucid, citrin, bloody and cloudy), 63.6% presented keratin-like precipitation. Bone fenestrations achieved 80% of the mandibular ramus and 100% at the maxillary tuberosity. Inflammation occurred in 85.7% of the cases, with epithelial alterations in 89% of them. The satellite microcysts prevalence was 66.6%, with higher frequency in the NBSCS, at the fenestrated contour and at the multilocular pattern. Two cases submitted to tegument excision showed microcysts in the mucosa. In a mean period of 25.5 months, only one case (4.2%) recurred. The excision by curettage occurred in 17.4% of cases, without any specific correlation to the secondary infection, epithelial atrophy or inflammation. All marsupialized cases displayed microcysts in the residual lesion. The dehiscence related to the use of Carnoy solution occurred in 75% of the marsupialized cases and 11.1% of the others. Paresthesia related to the use of this solution in the posterior region of the mandible occurred in 30.8% of the cases, with significant difference among cases with and without nerve exposure. It can be concluded that: 1) the lingual cortical expansion is characteristic in the mandibular ramus; 2) the unilocular aspect and dental displacement are frequent; 3) the keratin-like fluid is frequent in the NBSCS and the precipitation in appliable for differential diagnosis; 4) the cortical fenestrations are prevalent in the maxillary tuberosity and at the mandibular ramus; 5) the inflammation interferes in the histopathologic diagnosis; 6) the satellite microcysts are prevalent in the NBSCS, related to multilocular aspect and present in soft tissues; 7) the curettage is determined by technical facts; 8) the exeresis is recommended after marsupialization; 9) the dehiscence is influenced by marsupialization; and 10) the paresthesia depends of the contact of Carnoy solution with the epineurium.

Orientador: Marcio Ajudarte Lopes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-26T08:07:55Z (GMT). No. of bitstreams: 1 Alves_DanielBerrettaMoreira_D.pdf: 1871672 bytes, checksum: 565afdfdcd334dfd3ba59f1c44238377 (MD5) Previous issue date: 2014 / Resumo: A radiografia panorâmica (RP) é um importante exame de imagem que tem sido rotineiramente utilizado na prática odontológica por apresentar baixa exposição à radiação, facilidade de execução da técnica, tempo do exame reduzido, boa aceitação pelo paciente, acessibilidade e disponibilidade para a maioria dos cirurgiões dentistas. A tomografia computadorizada (TC) é uma importante ferramenta para o diagnóstico de lesões da região maxilofacial, proporcionado aos profissionais, acesso a uma imagem tridimensional, volumétrica e de ótima qualidade. O diagnóstico de cistos e tumores odontogênicos baseado nos achados de imagem pode ser muito dificil mesmo para um profissional treinado, devido a grande semelhança entre essas lesões. O objetivo deste estudo foi analisar e comparar a acurácia da radiografia panorâmica e da TC para o diagóstico de cistos e tumores odontogênicos. Foram avaliadas a radiografia panorâmica e TC de 25 casos de cistos e tumores odontogênicos provenientes da clínica de Estomatologia (OROCENTRO) da Faculdade de Odontologia de Piracicaba (FOP-UNICAMP), do Hospital AC Camargo e de uma clínica de radiologia odontológica privada. As análises foram realizadas por oito profissionais treinados (dois especialistas em radiologia odontológica, dois estomatologistas, dois patologistas orais e dois cirurgiões bucomaxilofacial) sem conhecimento sobre o diagnóstico histopatológico (padrão ouro) das lesões. Os avaliadores analisaram as imagens de radiografia panorâmica, descreveram as características da lesão através do questionário e sugeriram o diagnóstico. Quatro semanas após essa primeira etapa, os avaliadores analisaram as imagens de TC dos mesmos casos, fizeram uma nova descrição e a sugestão do diagnóstico. Para avaliar a taxa de acerto do diagnóstico entre os exames de RP e TC, foi utilizado o teste de sensibilidade, especificidade, acurácia e análise de variância para experimento inteiramente casualizado com um fator (One-way ANOVA) com modelo linear generalizado misto. Os resultados demonstraram superioridade estatisticamente significante (p=0.0290) da TC em relação a RP para o diagnóstico correto de cistos e tumores odontogênicos. Ao avaliar as lesões separadamente, a TC apresentou diferença estatisticamente significativa (p=0.0024) para o diagnóstico correto do ameloblastoma. Em ambos os métodos, os resultados de sensibilidade foram baixos para o diagnóstico de ameloblastoma e tumor queratocisto odontogênico. Em conclusão, nosso estudo demonstrou que a tomografia computadorizada apresenta superioridade em relação à radiografia panorâmica para o diagnóstico de cistos e tumores odontogênicos, especialmente nos casos de ameloblastoma / Abstract: Panoramic radiography (PR) is an important imaging test that is routinely used in dental practice because it exposes patients to low levels of radiation, is easy to operate, fast, has good patient acceptability, and is accessible and affordable for most dentists. Computed tomography (CT) is an important tool for the diagnosis of maxillofacial lesions, and provides professionals access to a three-dimensional, volumetric and high quality image. Even for trained professionals, correctly diagnosing odontogenic cysts and tumors based on imaging findings is difficult due to the similarity among these lesions. The aim of this study was to analyze and compare the accuracy of panoramic radiography and CT for the diagnosis of odontogenic cysts and tumors. This study evaluated the panoramic radiographs and CT scans of 25 cases of odontogenic cysts and tumors from the Oral Diagnosis Clinic (OROCENTRO), Piracicaba Dental School (FOP-UNICAMP), AC Camargo Hospital, and a private dental radiology clinic. Analyses were carried out by eight trained professionals (two experts in dental radiology, two oral medicines, two oral pathologists and two maxillofacial surgeons) without knowledge of the histopathological diagnosis (gold standard) of the lesions. The evaluators analyzed the panoramic radiograph images, described the features of the lesion using a questionnaire and suggested the diagnosis. Four weeks after this first stage, the evaluators analyzed the CT images of the same cases, described the images once more and suggested the diagnosis. To compare the accuracy rate of the diagnosis between PR and CT exams, the sensibility, specificity, accuracy and analysis of variance test were used for the completely randomized experiment with one factor (One-way ANOVA) with a mixed generalized linear model. The results showed statistically significant superiority (p = 0.0290) of CT compared with PR for the correct diagnosis of odontogenic cysts and tumors. When evaluating the lesions separately, the CT presented a statistically significant difference (p=0.0024) for the correct diagnosis of ameloblastoma. In conclusion, this study demonstrated that CT is superior to PR for the diagnosis of odontogenic cysts and tumors, especially in cases of ameloblastoma / Doutorado / Patologia / Doutor em Estomatopatologia

Les rejets des eaux de ballast dans le port de Bizerte et les fermes conchylicoles installées au niveau de la lagune de Bizerte peuvent constituer des sources potentielles ayant un impact sur l’introduction des espèces de Dinoflagellés nuisibles, en particulier celles qui sont potentiellement toxiques telles que A. pacificum, A.pseudogonyaulax, A.minutum, A. affine et Polysphaeridium zoharyi, sans pour autant négliger le rôle des courants dans la distribution des kystes. L’étude du trafic maritime sur les 7 années précédant notre prospection a révélé que 14 % de la flotte qui accoste au port de Bizerte est en provenance de la voie maritime d’origine Pacifique. Afin d’identifier les espèces de Dinoflagellés produisant des kystes à l’origine des efflorescences potentiellement toxiques, un échantillonnage à grande échelle spatiale au niveau des sédiments superficiels a été effectué pour relever les densités des kystes en fonction des caractéristiques sédimentaires à savoir la teneur en eau, la matière organique, la granulométrie, l’abondance des formes végétatives ainsi que les facteurs environnementaux. Cette étude a permis l’identification de 48 morphotypes de kystes de Dinoflagellés, principalement dominés par Brigantidinium simplex, Votadinum spinosum, Alexandrium pacificum, Alexandrium pseudogonyaulax, et Lingulodinum machaerophorum. La densité des kystes a varié de 1276 à 20126 kystes g-1 sédiment sec. Des différences significatives portant sur la distribution des kystes ont été enregistrées, ce qui nous a permis de faire la distinction de deux zones dans la lagune de Bizerte. Un intérêt particulier a été porté au complexe Alexandrium tamarense dont fait partie l’espèce A. pacificum connue pour être à l’origine des efflorescences nuisibles (HABs). En outre, l’examen morphologique et le ribotypage des formes végétatives d’A. pacificum en provenance de cultures microalgales obtenues à partir de l’extraction, l’isolement des kystes de résistance en provenance du sédiment, et leur germination ont été réalisés pour l’obtention d’une culture cellulaire monospécifique ABZ1 qui se caractérise par un taux de croissance de µ= 0.33j-1 et un temps de génération T=2.1j. Le profil toxinique obtenu à partir d’un extrait de culture ABZ1, en phase exponentielle a révélé la présence de N-sulfocarbamoyl toxine C1 (9.82 pg toxin cell_1), la GTX6 (3.26 pg toxine cell_1) et la carbamoyl toxine Neo-STX (0.38 pg toxin cell_1), représentant 2,8% du total des toxines de cette souche. Une corrélation entre l’abondance des kystes d’Alexandrium pacificum et le pourcentage en eau ainsi que la matière organique a été relevée. Par ailleurs, la fraction sédimentaire <63µm s’est avérée potentiellement favorable à l’initiation des efflorescences du dinoflagellé Alexandrium pacificum au niveau de la lagune de Bizerte. Une différence significative dans le schéma de la distribution des kystes a été illustrée, mettant en évidence un zonage de la lagune avec une abondance plus importante au niveau des zones conchylicoles. / The ballast water discharges in Bizerte harbor and shellfish aquaculture farms in Bizerte lagoon can be potentials sources with an interest in the introduction of harmful species, especially those that are potentially toxic like A. pacificum, A. pseudogonyaulax, A.minutum, A.affine and Polysphaeridium zoharyi, without neglecting the role of currents in the distribution of cysts. The study of the vessel traffics for 7 years before our prospection in Bizerte harbour have showing that the percentage of vessels coming from the Pacific road is around 14%. In order to identify species of Dinoflagellates producing resting cysts incriminated on potentially toxic blooms, a high spatial resolution sampling of the surface sediment for the identification and counting of resistance cysts was carried out to estimate the cyst density based on sedimentary characteristics, water content, organic matter, granulometry, abundance of vegetative forms and environmental factors. This study allowed the identification of 48 morphotypes of dinoflagellate cysts, mainly dominated by Brigantidinium simplex, Votadinum spinosum, Alexandrium pacificum, Alexandrium pseudogonyaulax and Lingulodinum machaerophorum. The density of cysts ranged from 1276 to 20126 cysts g-1 dry sediment. Significant differences between cyst distributions were recorded, which enabled us to distinguish two areas in the Bizerte lagoon. Particular attention was given to the complex Alexandrium tamarense (HABs). In addition, morphological examination and ribotyping of vegetative cells obtained from microalgal cultures following extraction process, isolation of resistance cysts from sediment, and their germination led to the production of monospecific culture: ABZ1 characterized by a μ (growth rate) = 0.33 day-1 and a generation time T = 2.1 day. These reviews have confirmed the newly identified genus and species in the Mediterranean sea and mentioned specifically in the lagoon of Bizerte: Alexandrium pacificum. The toxin profile obtained from an extract of ABZ1 culture in exponential phase revealed the presence of N-sulfocarbamoyl toxin C1 (9.82 pg toxin Cell-1), the GTX6 (3.26 pg toxin Cell-1), carbamoyl and the Neo-STX toxin (0.38 pg cell toxin-1), representing 2.8% of total toxins of this strain.A correlation between the abundance of cysts of Alexandrium pacificum and water percentage well as organic matter was found. Moreover, sediment fraction <63μm proved potentially favorable to initiate Alexandrium pacificum blooms in Bizerte lagoon. A significant difference in the cyst distribution diagram was shown, highlighting a zoning of the lagoon with a greater abundance in shellfish farm areas.

Indiana University-Purdue University Indianapolis (IUPUI) / Type II nephronophthisis (NPHP2) is an autosomal recessive renal cystic disorder characterized by mutations in the inversin gene. Humans and mice with mutations in inversin have enlarged cystic kidneys. Increased kidney size in NPHP2 may involve altered cell growth, apoptosis, electrolyte transport and fluid accumulation in the cysts. To test this hypothesis, histology and transcriptome analysis were performed on one-day old wild-type and inv/inv mice to uncover molecular pathways altered in the mutant mice. Histology of inv/inv mice kidneys showed dilated cystic tubules compared to wild type. Pathway analysis of transcriptome data showed that inversin exerts its effects on kidneys, at least in part, through the transcriptional regulation of genes implicated in inflammation, immune response, cellular metabolism, cell cycle and ion transport. Genes involved in inflammation or immune response were upregulated whereas the genes involved in cell cycle progression and ion transport were downregulated. To validate the array findings from inv/inv mice kidneys, functional consequence of inversin loss on transepithelial ion transport was measured by electrophysiological techniques in shRNA mediated inversin-depleted renal cell type isolated from mouse cortical collecting duct (mCCD). Depletion of inversin decreased vasopressin-induced Na+ absorption, but did not alter Cl- secretion in mCCD cells. Addition of amiloride, a specific blocker of the epithelial sodium channel (ENaC), abolished basal ion transport in both inversin knockdown and control cells indicating ENaC involvement. Loss of inversin decreased Na+ absorption and this effect, in part, was mediated by transcriptional and post-translational regulation of ENaC mediators. To better understand inversin function in renal cells, transcriptome analysis was performed in control and inversin-depleted mCCD cells. Pathway analysis showed that inversin-depletion altered the genes represented in cell cycle, cellular assembly and organization, DNA replication, cell proliferation and ion transport in this isolated renal cell type. In concordance with the array data from inv/inv mice kidneys, a decrease in the expression of cell cycle, ion transport and apoptotic genes were observed accompanied by an upregulation of genes implicated in inflammatory or immune response indicating a direct effect of inversin on renal cells. Together, this study utilized a combination of transcriptome and functional analyses to unravel the role of inversin in renal cells. These data demonstrate that loss of inversin can cause a delay in cell cycle progression with a decrease in cell proliferation and apoptosis which in turn can perturb the development of the renal tubule. Also, a decrease in Na+ reabsorption together with differential regulation of other ion transporters can result in altered electrolyte transport contributing to cystogenesis, cyst growth, fluid accumulation and cyst expansion in NPHP2.

This thesis contributes to the development of dinoflagellate cysts as indicators of past environmental change in the Northeastern Pacific coastal ocean, and investigates past variations in sea-surface temperature, salinity and primary productivity encoded in dinoflagellate cyst sedimentary records from the Santa Barbara Basin (SBB, southern California) and Effingham Inlet (Vancouver Island, British Columbia) over the last millennium. The dinoflagellate cyst records extracted from the SBB and Effingham Inlet predominantly laminated sediments and analysed at sub-decadal resolutions, constitute some of the most detailed records of cyst-producing dinoflagellate populations in the world. A two year-long sediment trap study from the SBB documents the seasonality in dinoflagellate cyst production for the first time on the Pacific coast of the United States. The study shows that dinoflagellate cyst data can be used as indicators of changes in sea-surface temperature and primary productivity associated with seasonal upwelling in the SBB. In particular, several dinoflagellate cyst taxa such as Brigantedinium spp. and Lingulodinium machaerophorum are identified as indicators of “active upwelling” (typically occurring in spring and early summer) and “relaxed upwelling” conditions (fall and early winter) at the site, respectively. Analysis of a dinoflagellate cyst record from the SBB spanning the last ~260 years at biannual resolution documents the response of cyst-producing dinoflagellates to instrumentally-measured warming during the 20th century, and reveals decadal scale variations in primary productivity at the site that are coherent with phases of the Pacific Decadal Oscillation (PDO). The cyst assemblages are dominated by cysts produced by heterotrophic dinoflagellates (in particular Brigantedinium spp.), but the turn of the 20th century is marked by an abrupt increase in concentrations of L. machaerophorum and Spiniferites ramosus, two cyst taxa of autotrophic affinity. Their increasing abundances during the 20th century are interpreted to reflect warmer conditions and possibly stronger stratification during summer and fall. The dinoflagellate cyst data suggest a warming pulse in the early 1900s and provide further evidence that persistently warmer and/or more stratified conditions were established by the late 1920s. The dinoflagellate cyst record from Effingham Inlet, spanning the last millennium, is characterized by the proportionally equal contribution of cysts produced by autotrophic and heterotrophic dinoflagellates in most samples. The cyst data indicate variations in sea-surface temperature, salinity and primary productivity that are associated with local expressions of the Medieval Climate Anomaly (from the base of the record to ~1230), the Little Ice Age (from ~1230 to ~1900) and warming during the second half of the 20th century. Both dinoflagellate cyst records reveal that since the beginning (in the SBB) and mid-20th century (in Effingham Inlet), autotrophic dinoflagellates contribute to a greater portion of the primary production in the region, whereas heterotrophic dinoflagellates, as indicators of diatom populations, decline. Variability in the dinoflagellate cyst data is coherent at both sites and suggest a reduced expression of decadal scale variability associated with the PDO during the 19th century. / Graduate / 0416 / 0427 / mbringue@uvic.ca