Clark, Gene C
01 January 2015
Prostate cancer is one of the most challenging global medical issues today. In 2011, prostate cancer was the most diagnosed malignancy in the United States, making up 29% of new cancer cases. In that year it was the second leading cause of cancer related deaths among men in the USA and the second most common cause of cancer related death overall from the EU. The prostate remains, however, an under studied organ, making insights into the anatomy and biology of prostate cancer difficult to achieve. After 30 years, PSA screening of men of the appropriate age is still the first step in prostate cancer diagnosis, usually followed by a manual prostate exam which may lead to a transrectal biopsy. This study makes use of Next Generation Sequencing to successfully identify a superior miRNA based urinary assay for the detection of prostate cancer. A receiver operating curve AUC of 0.90 was achieved for patients vs. non-patients using an additive risk model defined by empirically derived critical threshold values of eight urinary miRNAs identified with this method. This is superior to the PSA blood test’s AUC of 0.66 which illustrates that a miRNA profile such as this has the potential to surpass protein biomarkers such as PSA in terms of specificity and sensitivity. It was also demonstrated that a geometric mean of three urinary miRNAs were useful for endogenous normalization. One significant risk factor for prostate cancer is being African American. Again using Next Generation Sequencing technology, we have established a miRNA expression profile for the stages of a prostate cancer cell line progression model derived from the normal prostate epithelium of an African American man. Normal prostate epithelium was immortalized only with SV40 large T antigen (P69) and passaged three times in nude mice, producing the highly aggressive and metastatic M12 cell line. The M2182 cell line is an intermediate between the P69s and M12s having only been passaged twice and not yet having acquired metastatic potential. The F6 cell line was derived by reintroducing a copy of chromosome 19 missing from the M12 cell line via microcell mediated chromosome transfer. These profiles show a large downregulation of miRNAs early in tumorigenesis (from P69 toM2182) affecting the DLK1-DIO3 megacluster and the miR-200 family. The later acquisition of metastatic potential (from M2182 to M12) is concomitant with the upregulation of specific miRNAs including the HOX gene miRNAs miR-10a and miR-196 and miR-9. Thus, the analysis of this progression model has uncovered relevant miRs and genes the dysregulation of which contribute to prostate tumorigenesis.
脈症從捨的判辨輔助及相關概念的釋疑與發微. / Expatiation and determination on pulse-or-symptom selection and its related concepts / Mai zheng cong she de pan bian fu zhu ji xiang guan gai nian de shi yi yu fa wei.January 2009 (has links)
陳宇傑. / "2009年9月". / "2009 nian 9 yue". / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 166-176). / Abstracts in Chinese and English. / Chen Yujie. / 中文摘要 --- p.i / Abstract (英文摘要) --- p.iii / 鳴謝 --- p.v / 目錄 --- p.vi / 表格索引 --- p.ix / 圖表索引 --- p.xi / Chapter 第一章 --- 引言 --- p.1 / Chapter 1.1 --- 研究背景 --- p.1 / Chapter 1.1.1 --- 脈症從捨釋名 --- p.1 / Chapter 1.1.2 --- 歷代文獻回顧 --- p.6 / Chapter 1.1.3 --- 當代期刊、論文發表狀況 --- p.9 / Chapter 1.1.4 --- 脈症從捨之重要性及困難度 --- p.11 / Chapter 1.2 --- 研究目的 --- p.14 / Chapter 1.3 --- 研究範圍與方法 --- p.15 / Chapter 第二章 --- 判辨從捨之輔助途徑 --- p.18 / Chapter 2.1 --- 各種病情資料與從捨之對應規律 --- p.18 / Chapter 2.1.1 --- 病程與體質 --- p.19 / Chapter 2.1.2 --- 脈、症、舌 --- p.22 / Chapter 2.1.3 --- 八綱 --- p.25 / Chapter 18.104.22.168 --- 虛實 --- p.26 / Chapter 22.214.171.124 --- 表裏寒熱 --- p.29 / Chapter 126.96.36.199 --- 正邪盛衰與脈病陰陽 --- p.32 / Chapter 2.1.4 --- 特殊病證 --- p.33 / Chapter 2.2 --- 脈症易得真象之處 --- p.37 / Chapter 2.2.1 --- 診脈沉取、久按與脈力 --- p.37 / Chapter 2.2.2 --- 關鍵症狀 --- p.43 / Chapter 2.3 --- 脈症之程度與數量 --- p.50 / Chapter 2.4 --- 尋找脈症不符之原因 --- p.53 / Chapter 2.4.1 --- 診斷未真詳 --- p.58 / Chapter 2.4.2 --- 理解未確切 --- p.61 / Chapter 2.4.3 --- 治療措施影響 --- p.63 / Chapter 2.4.4 --- 生活、環境因素影響 --- p.65 / Chapter 2.4.5 --- 體質禀賦 --- p.68 / Chapter 2.4.6 --- 機體功能受損，不能正常反應病理變化 --- p.71 / Chapter 2.4.7 --- 沉痼之疾 --- p.73 / Chapter 2.4.8 --- 夙有宿疾，復感新病 --- p.74 / Chapter 2.4.9 --- 病情有時間性變化 --- p.76 / Chapter 188.8.131.52 --- 一時脈症惟顯病情一隅 --- p.76 / Chapter 184.108.40.206 --- 病情先顯於脈症一端 --- p.79 / Chapter 2.4.10 --- 病情輕淺不顯 --- p.81 / Chapter 2.4.11 --- 病有主次標本兼夾 --- p.82 / Chapter 2.4.12 --- 邪氣壅遏 --- p.86 / Chapter 2.4.13 --- 元氣發露 --- p.91 / Chapter 2.4.14 --- 脈症不符原因總結及討論 --- p.95 / Chapter 第三章 --- 張錫純脈症從捨治例三則探討 --- p.99 / Chapter 3.1 --- 治例一 --- p.99 / Chapter 3.2 --- 治例二 --- p.105 / Chapter 3-3 --- 治例三 --- p.110 / Chapter 第四章 --- 理論探討 --- p.117 / Chapter 4.1 --- 真假、從捨之爭議與混淆 --- p.117 / Chapter 4.1.1 --- 假象緣於診斷未真詳、理解未確切之商榷 --- p.117 / Chapter 4.1.2 --- 假象實為病機本質之反映 --- p.120 / Chapter 4.1.3 --- 四診合參與脈症從捨理應相得益彰 --- p.123 / Chapter 4.1.4 --- 脈症關係是否平行對等 --- p.128 / Chapter 4.1.5 --- 爭議之結論與建議之芻探 --- p.129 / Chapter 4.2 --- 相關概念、關係之義蘊 --- p.133 / Chapter 4.2.1 --- 真假、不符與從捨密切相關 --- p.133 / Chapter 4.2.2 --- 真假與脈症不符之定義 --- p.134 / Chapter 4.2.3 --- 與真假、從捨相關之常規 --- p.136 / Chapter 4.2.4 --- 廣義狹義之分及概念間之關係 --- p.139 / Chapter 4.3 --- 從捨之價值、作用及定位 --- p.148 / Chapter 4.3.1 --- 從捨之價值與作用 --- p.148 / Chapter 4.3.2 --- 從捨概念之定位 --- p.151 / Chapter 4.3.3 --- 「從」、「捨」（執行動作)之涵蘊及實際運用 --- p.153 / Chapter 第五章 --- 總結 --- p.160 / 參考書目 --- p.166 / 附錄 --- p.175
Physical diagnosis of children that the dentist should know a dissertation [sic] submitted in partial fulfillment ... children's dentistry ... /Stulberg, Samuel. January 1939 (has links)
Thesis (M.S.)--University of Michigan, 1939.
Use or nonuse of the Papanicolaou test in a selected group of women on the Ball State University campusFerguson, Carl E. January 1974 (has links)
The purpose of the study was to learn more about the use or non use of the Papanicolaou Test (referred to hereafter as the Pap test) among a selected population of women on the Ball State University Campus.The author was concerned with the fact that, according to projections of the American Cancer Society, 12,000 women die each year of uterine cancer. Many of these deaths could have been avoided if women would have availed themselves yearly of a simple testing device known as the Pap test.After considerable research and discussions with Ball State University women of all ages, it was obvious that many women do not take advantage of this cancer detection device. It became this author's desire to discover why the Pap test is overlooked by so many women. Research pointed out several reasons for this phenomenon, namely: 1) length of time required for the test, 2) inability to afford the Pap test, 3) fear of the results and 4) lack of prior experience with the Pap test combined with a feeling of wellness. latter reason was summarized in the general statement: "Have never had the Pap test and I am fine, so why bother?".Also appearing in this research was the subtle hint that perhaps the medical profession itself was partly to blame for the nonuse of the test. Overworked physicians and understaffed laboratories were cited as possible reasons why doctors were not encouraging their patients to avail themselves of the Pap test.Previous studies on this subject have been conducted in lower socioeconomic populations in San Diego, California, and Baltimore, Maryland. The above named reasons for not having the yearly Pap test were the conclusions of these studies also. The author felt that a study of women representing a different segment of society possibly would be of help in this area of cancer research and control.A questionnaire was developed and distributed to the female residents in all the Ball State University married students' housing units. This selected group of women represented a fairly homogeneous population with an assumed similar type of background and education.A total of 670 questionnaires were distributed and 535 were completed and returned for an 80 per cent rate of response.Following are some of the significant results of the survey:83 per cent of the women had a complete physical examination within the last year.96 percent of the women had a Pap test within the last year.74 per cent of the women indicated their desire for a "clean bill of health" which prompted yearly Pap tests.89.9 per cent stated they were not afraid to learn the results of the Pap test.41 per cent of the women revealed that their first knowledge of the Pap test came through the news media.92 per cent of the women felt their husbands were more aware of the benefits of the Pap test than they themselves. The results of this study indicated that these women, as a group, were concerned about their health and were eager to seek out proper medical care in order to safeguard themselves.
Identifying schizotypal personality disorder using the Rust Inventory of Schizotypal Cognitions (RISC)Steuerwald, Brian L. January 1990 (has links)
Schizotypal Cognitions (RISC) were related to interview derived ratings of DSM-III-R schizotypal personality disorder and other personality disorders in a non-clinical college sample was examined. Moderate correlations between the RISC and schizotypal scores, but not between the RISC and other personality disorders, provided support for the validity and suggested reasonable specificity for the instrument. RISC scores correlated the greatest with schizotypal symptoms that reflect a strong cognitive component (e.g., perceptual illusions) but did not correlate with symptoms associated with social adaptation or interpersonal functioning (e.g., excessive social anxiety). Cutoff scores set at approximately 2 S.D. above the RISC mean best discriminated between non-cases and cases of subthreshold and definite schizotypal personality disorder. Limitations of the RISC and suggestions for future research are discussed. / Department of Psychological Science
Detection of clinically silent alpha-globin gene mutations in Chinese using high resolution melting analysisHo, Sophia KW, 何廣慧 January 2014 (has links)
α-thalassemia is an inherited globin gene disorder commonly found among the Chinese population. It is composed of both non-deletional and deletional α-globin gene mutations. Classical α-thalassemia presents with red cell microcytosis but silent cases with a normal mean corpuscular volume (MCV) are also seen. Routine laboratory testing methods for large-scale detection of silent α-thalassemia mutations are onerous and time-consuming. Furthermore, methods such as denaturing high performance liquid chromatography (HPLC) or denaturing gradient gel electrophoresis (DGGE) for scanning of point mutations are costly and they require post-PCR separation. High resolution melting (HRM) analysis is an economical, sensitive, and fast method for large scale point mutation scanning. Contamination is significantly reduced with HRM because the process is performed in a closed-tube environment and does not require post-PCR manipulation. We used HRM and multiplex gap-PCR analysis to determine the prevalence of silent α-thalassemia carriers in Hong Kong. Of the 223 hematologically normal blood samples scanned by Roche LightCycler 480®, HRM did not show any sample with a non-deletional α-globin gene mutation of clinical significance. α-multiplex gap-PCR analysis revealed 36 samples (16.1%) with single α-globin gene deletions. The detection of single α-globin gene deletions in samples with a MCV greater than 80 fL indicates that the previously reported prevalence of α-thalassemia mutations in our Chinese population based on MCV screening is under-estimated. The data also suggest that non-deletional α-thalassemia mutations presenting with a normal MCV are very rare, and they most likely present with microcytosis. The fact that most silent α-thalassemia mutations are due to large deletions supports the use of traditional molecular techniques such as gap-PCR for their detection. HRM can be used as an adjunct tool for large-scale population screening of non-deletional mutations. This study provides more accurate data on the prevalence of silent α-thalassemia carriers in the Hong Kong Chinese population. The information will facilitate genetic counseling and risk assessment in families carrying α-thalassemia mutations. / published_or_final_version / Pathology / Master / Master of Medical Sciences
Exploring the symptom dimensions as documented in case record of patients with first episode psychosis at the first interview in the early assessment service for young people with psychosis (EASY) clinicLuk, Yun-kin, 陸潤健 January 2014 (has links)
Objectives Severe mental illness is a debilitating condition affecting a wide range of functioning of an individual. Identification of signs and symptoms is part of clinical assessment which aids case formulation, making diagnosis, determine treatment planning and outcome. How the symptoms are documented in case record undoubtedly affect the decision and communication among mental health professionals, treatment protocol, potential outcome and prognosis. This is the first study in Hong Kong mental health service to overview the symptom dimensions documented by clinicians in case records. Currently, there is no clinical practice guideline to guide clinicians on symptom documentation. This study attempts to explore the symptom dimensions as documented in the first interview records of people with first episode psychosis in EASY clinic in a local hospital. The result will serve as preliminary reference material or the development of an appropriate documentation guideline or audit in future. Method A retrospective review of case records was conducted to evaluate the symptom documentation by clinicians. All first interview notes of patients suffering from schizophrenia spectrum disorder who attended the EASY clinic in 2012 were included.90 case records were identified. The symptoms characteristics were recorded into a template and categorized with reference to the domains of psychopathology in DSM-5, SAPS and SANS. A total of 29 items of symptom characteristics and related clinical features were identified and measured with descriptive statistics. Results All symptom characteristics and clinical features were reported in percentage. It was found that majority of interview notes(62%)had documented a range of 22-26items out of 29 items(76-90%) of symptom characteristics and clinical features observed from case records. Clinicians had demonstrated high proficiency in documenting a comprehensive range of psychiatric symptoms. Conclusion This paper aims to increase the awareness of clinicians on continuous evaluation of current practice on symptom documentation; to identify good practice or area for improvement; and initiate the development of standardized documentation guideline to guide future symptom documentation practice for betterment of quality patient care and service planning for people with first episode psychosis. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine
published_or_final_version / Medical Sciences / Master / Master of Medical Sciences
馬慰平, Ma, Victor.
published_or_final_version / Medical Sciences / Master / Master of Medical Sciences
Suen, Yiu-kwan, Edmond.
published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences
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