Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2005. xvii, 109 leaves : ill. ; 30 cm / The paucity of clinical research into the cause of canine hip dysplasia, efficacy and effects of the different treatment protocols available for the management of symptoms, as well as the differing presentations, has led to a continued variation in standardized care for this condition. The aim of this study was to contribute further information on the use of instrument manipulation as an alternative or adjunctive means of managing the symptoms of canine hip dysplasia. Both manual and instrument manipulation have effectively been used in the short-term management of human musculoskeletal pconditions, it was hypothesized that the use of instrument manipulation would benefit the canine patient. The use of human based studies was a guideline, as no previous chiropractic studies have been conducted on the canine subject.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Epilepsy is the most common neurologic condition seen in children. Focal cortical dysplasia (FCD), a seizure disorder characterized by abnormal cortical laminar development, comprises approximately 75% of medically intractable epilepsies in the pediatric population. A greater appreciation of the pathology and intrinsic properties of the epileptogenic zone may help in understanding why FCD lesions are drug‐resistant, and could potentially lead to more effective treatments in the pediatric population. Neuronal support cells such as microglia and astrocytes have shown to have a role in FCD pathology. These cells are also activated during aging and traumatic brain injury as evidence by morphological change. This study aims to characterize the spatial distribution of microglia and astrocytes using immunohistochemistry in dysplastic tissue of eight male pediatric patients diagnosed with FCD. Cortical specimens from patients who underwent surgical resection of focally dysplastic cortex at Phoenix Children’s Hospital between 2008 and 2014 were examined using immunohistochemistry. Primary antibodies against GFAP and Iba1, as well as structural staining using hematoxylin and eosin (H&E), were incubated on sections and further analyzed using bright‐field microscopy. A pattern of perivascular activated microglia was observed in five patients around at least one blood vessel, while a pattern of non‐localized ramified microglia was observed in the other three patients. No identifiable pattern of astrocytic distribution was found. Thus, distinct patterns of microglia, rather than astrocytes, suggest dual underlying mechanisms of epileptogenesis.

The master thesis focuses on dysplasia of the hip joint in relation to the physical activities of an infant under one year. The thesis contains three sections. The theoretical part informs about dysplasia of the hip and physical activities jointed to this infliction. The special part defines suitable and unsuitable physical activities of an infant under one year with dysplasia of the hip. The research deals with hypothesis, problem's questions and goals. The methods used are anamnesis, experiment, interviews and casuistry. On the basis of experiment was difined short-term and a long-term exercise's plan for infant under one year with dysplasia of the hip. The research was conducted at the patient K. V. from birth to one year of age. Were applied the selected physical activities that demonstrate their significant impact on the reporting of disability. Medical reports suggest that the degree of disability investigated patients improved more than one level. It was also found that there are differences of opinion between medical approaches and treatment by specialists. Even parents have a different attitude to medical recommendations and some seek the views of other experts. Conclusion contains a summary of the facts and submitted to the positive impact of alternative approaches to influence child...

Department of Obstetrics and Gynaecology University of the Witwatersrand Johannesburg February 2015 A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Masters in Medicine, in the branch of Obstetrics and Gynaecology. / HIV accelerates the development of cervical cancer by up to15 years. South Africa is currently in the midst of an HIV epidemic. With limited facilities for colposcopy it is vital to identify risk factors within the HIV positive population resulting in positive margins after Large Loop Excision of the Transformation Zone (LLETZ) and persistence of cytological abnormalities on follow-up Pap smears. Objective: The primary objective was to determine the patient risk factors, pre and during colposcopy and LLETZ biopsy, which resulted in the histological involvement of margins of the LLETZ biopsy and persistent cervical dysplasia on follow-up Pap smears. Secondary objectives included determining follow up rate of patients at the clinic as well as the correlation between the original Pap smear cytology grade and the histological grade found on histology of the LLETZ biopsy. Methods: A retrospective review of the files of HIV seropositive patients was done at the colposcopy clinic at Charlotte Maxeke Johannesburg Academic Hospital after the roll out of antiretroviral treatment for the period 1 April 2004 to 31 October 2012. Patients with abnormal pap smears during this time were referred to the colposcopy clinic where a colposcopy and LLETZ biopsies were done. Demographic and clinical data in regards to age, gravidity, contraception, CD4 count, antiretroviral usage, and referral time was collected. Data from the clinical description of the colposcopy and histology of the LLETZ biopsy was also collected. Patients followed up again after 6 months when a repeat pap smear was done. The results of these Pap smears were also collected. Data was then analysed and variate and multivariate logistical regression was used to find statistically significant correlations. Results: A total of 480 files were found to have complete clinical records. One hundred and sixty eight (42.71%) patients had both endo and ectocervical margins clear. Predictive factors for the involvement of endocervical margins was the doctor performing the procedure (p-value <0.01) cytology of the original Pap smear (p value <0.01) and the grade of histological abnormality found at time of LLETZ (p-value <0.01). The statistically significant predictive factors for ectocervical margin involvement was the visualization of the transformation zone at colposcopy (p-value <0.01), the size of lesion found at colposcopy (p-value <0.01), the use of combined oral contraceptive pill (OCP) (p-value 0.02) and the histological grade of abnormality found on the LLETZ biopsy. Age, parity, CD4 count, use of antiretroviral drugs, length of time from Pap smear to colposcopy and use of contraception other than OCP were not found to be statistically significant in our sample population for the involvement of either endo or ectocervical margins. Statistically significant risk factors for the recurrence of intraepithelial lesions on follow up Pap smear was having both endo and ectocervical margin involvement on histology (p-value 0.01) The Ectocervical margin alone was found to have a p-value of <0.01. Abnormal cytology on follow up Pap smear was found in 58.69% of patients. The follow up rate at the clinic was 46.04%. Correlation of cytological grade and histological grade of cervical intraepithelial neoplasm in our sample population was found to be adequate (p-value <0.01). Conclusion: Incomplete incision of the intraepithelial lesion was found to be a significant risk factor for the recurrence of cytological abnormality in patients undergoing LLETZ biopsy. Identifying patients at increased risk for recurrence is important to ensure close follow up in this patient population.

INTRODUCTION: Approximately 6 million couples in the United States experience infertility. Because few risk factors for infertility are known, identification of modifiable determinants is an important public health goal. Cervical intraepithelial neoplasia, CIN, occurs when the surface cells of the cervical tissue begin to change, and is caused by infection with a high-risk type of human Papillomavirus (HPV). CIN may affect the cervix’s immunological function, resulting in changes in mucus production, reduced protection against infections, and alterations in sperm transport through the cervical canal. CIN can also progress to invasive cervical cancer. There are four main CIN treatment procedures that aim to remove pre-cancerous cells from the cervix; loop excisions, commonly known as electrosurgical excision procedure (LEEP) or large loop excision of the transformative zone (LLETZ); cryosurgery; conization; and laser ablation. Because the goal of these procedures is to remove abnormal cells, healthy cervical cells may inadvertently be removed as well, leading to further changes in cervical mucus production, sperm motility, and reduced protection against infection. Because of the changes to the cervical tissue and its function, CIN and its surgical treatments may affect fecundability. METHODS: We analyzed data from Pregnancy Study Online (PRESTO), a preconception cohort of 5,594 North American pregnancy planners enrolled and followed between 2013 and 2018. At baseline, participants reported whether they had abnormal Pap tests and their age at their first abnormal Pap test, as well as cervical procedures and their age at the procedure. We estimated fecundability ratios (FR) and 95% confidence intervals (CI) using proportional probabilities models adjusted for sociodemographics, smoking, number of sexual partners, history of sexually transmitted infections/ pelvic inflammatory disease, and HPV vaccination. RESULTS: A history of abnormal Pap test, which we used as a proxy for cervical dysplasia, was positively associated with current and past smoking, gravidity, parity, irregular menses, number of sexual partners, history of chlamydia, genital warts and herpes, as well as a history of pelvic inflammatory disease. Of the women with an abnormal Pap test, the average age at first abnormal Pap test was 23.0 (std=4.5) years and the average number of abnormal Pap tests was 2.1 (std=1.7). We found little association overall between a history of abnormal Pap test and fecundability (FR=1.03, 95% CI: 0.96, 1.11). The results did not differ when the data were examined by number of abnormal Pap tests, or type of procedure. There was also little association between time since the diagnosis or procedure and pregnancy attempt and fecundability. There was however a slight decrease in fecundability within the first 2 years of diagnosis/ procedure, with FRs that tended to increase with increasing time since diagnosis/procedure. DISCUSSION: We found little association overall between a history of abnormal Pap test or cervical dysplasia, including excisional surgeries, and fecundability. These results are consistent with most other studies demonstrating no clear adverse effects of CIN and treatments. Recency of diagnosis or procedure did not appreciably affect these findings. Although we found a very slight decrease in fecundability within the first two years since diagnosis or procedure, fecundability became similar to that of undiagnosed/untreated women after 2 years, and then increased slightly. CONCLUSION: We found little association between a history of abnormal Pap and CIN treatments and fecundability. A major limitation of our study is that the data were self-reported, which may have resulted in non-differential exposure misclassification.

Skeletal dysplasias and dysostoses are a genotypically and phenotypically diverse group of disorders that affect the growth, development and maintenance of cartilage and bone. General disorders of bone affecting bones and cartilage throughout the body have been referred to as skeletal dysplasias, whereas defects that selectively affect certain bones or bone groups are called skeletal dysostoses. Despite this distinction, modern molecular techniques are showing that this division is somewhat superficial, given the similarity in their underlying causes. Although the rate of disease gene discovery has grown substantially since the advent of next-generation sequencing technologies, most of the disorders have unknown molecular defects. Skeletal dysostoses are rarely observed, occurring at such low incidence levels that no comprehensive study has ascertained their frequency. The effects range from mild growth inhibition to complete absence of entire bone groups. The axial skeleton is most often involved in skeletal dysostoses with common symptoms including poorly formed cranial bones, mandible, ribs and vertebrae. Several important signaling pathways control the migration and formation of mesodermal cells, which eventually differentiate into many elements of the vertebral column. The importance of these pathways, namely the T-box transcription factors, Wnt, Notch, and Smad pathways are integrally involved in the very early stages of vertebral development. Currently, the most cost-effective method of pathogenic gene discovery for rare genetic diseases is exome sequencing. Utilizing this technology, as well as SNP arrays for identity-by-descent loci mapping, two independent skeletal dysostosis cases with similar phenotypes were studied to determine pathogenic candidate genes. Next-generation sequencing and identity-by-descent analysis revealed a possible candidate gene, PM20D2, in one proband. The gene includes peptidase dimerization, peptidase M20/M25/M40, and N-myristolylation domains based on predicted functional analysis. It is implicated in various metabolic activities, having hydrolase, protein binding, and metallopeptidase molecular functions. Further investigation into this gene, as well as further studies of these probands is needed to understand the role, if any, the defect plays in the disease.

A presença de áreas displásicas em queilites actínicas constitui um fator preditivo importante para o câncer de lábio. Entretanto, a determinação histopatológica da presença e intensidade da displasia epitelial nestas lesões continua sendo um aspecto subjetivo para os patologistas. O objetivo do presente estudo foi verificar em 45 queilites actínicas e 20 carcinomas espinocelulares (CECs) de lábio tratados no Departamento de Otorrinolaringologia e Oftalmologia, da Faculdade de Medicina de Botucatu, UNESP, a expressão imuno-histoquímica da citoqueratina 10 (CK10) e citoqueratina 13 (CK13) na região labial e comparar a expressão dessas citoqueratinas com o índice de proliferação celular determinado pela imunomarcação com o Ki-67. A intensidade da displasia epitelial nas queilites actínicas foi determinada em coloração de Hematoxilina e Eosina com base nos critérios definidos pela Organização Mundial da Saúde. A associação entre a expressão da CK10 e da CK13 nas queilites actínicas com e sem displasia e nos CECs foi calculada pelo teste do qui-quadrado ou teste exato de Fisher, com nível de significância de 5%. Os resultados demonstraram uma positividade para CK13 no vermelhão do lábio e mucosa labial, com perda de expressão nas áreas displásicas das queilites actínicas e marcação heterogênea nos CECs de lábio. A imunomarcação da CK10 foi observada no vermelhão do lábio e epiderme, com ausência total de expressão nas áreas displásicas e nos CECs de lábio. Houve uma associação estatisticamente significante entre a expressão da CK10 nos CECs quando comparada às queilites actínicas com displasia epitelial (p<0,001) e sem displasia epitelial (p<0,001). Não houve diferença significativa (p=0,104) no índice de proliferação celular, determinado pela imunomarcação do Ki-67, nas queilites actínicas sem e com displasia epitelial e nos carcinomas espinocelulares de lábio. Assim como também não houve associação, estatisticamente significativa, entre a expressão das citoqueratinas 13 e 10 e os altos índices de proliferação celular, determinados pelo Ki-67, nas queilites actínicas sem e com displasia epitelial. Esses resultados sugerem que as citoqueratinas 13 e 10 participam do processo de malignização das queilites actínicas sendo a expressão alterada ou ausente destes biomarcadores indicativa de áreas displásicas ou carcinoma espinocelular invasivo na região de lábio inferior. / The presence of dysplastic areas in actinic cheilitis is an important predictive factor for lip cancer. However, the histopathologic evaluation of the presence and severity of epithelial dysplasia in these lesions remains subjective. The aim of this study was to evaluate the immunohistochemical expression of cytokeratin 10 (CK10) and cytokeratin 13 (CK13) in labial region and compare the expression of these cytokeratins with the cell proliferation index, which was determined by Ki-67 immunostaining. The sample was constituted by 45 cases of actinic cheilitis and 20 of squamous cell carcinomas (SCC) of the lip treated at the Department of Otorhinolaryngology and Ophthalmology of Botucatu School of Medicine, UNESP. The severity of epithelial dysplasia in actinic cheilitis was determined by hematoxylin and eosin staining based on World Health Organization criteria. The association between the expression of CK10 and CK13 in actinic cheilitis with and without dysplasia and SCC was calculated by Chi-square test or Fischer´s exact test, with significance level at 5%. The results showed positive correlation for CK13 in the lip vermilion and labial mucosa, with loss of expression in the dysplastic areas of actinic cheilitis, and heterogeneous positivity in SCC of the lip. There was a statistically significant association between the expression of CK10 in SCC and actinic cheilitis with epithelial dysplasia (p < 0.001) or without epithelial dysplasia (p < 0.001).There was not a statistically significant difference (p=0.104) for cell proliferation index in actinic cheilitis with and without dysplasia, and SCC. Furthermore, there was not a statistical association (p>0.05) between the expression of CK10 and CK13 and high cell proliferation index in actinic cheilitis with and without epithelial dysplasia. These results suggest that the cytokeratins 13 and 10 participate in the process of malignant transformation of actinic cheilitis, and absence or alteration of these biomarkers expression are indicative of dysplastic areas or invasive squamous cell carcinoma in the lower lip region.

by Tai Fai Fok. / Thesis (Ph.D.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (p. 211-215). / Microfiche. Ann Arbor, Mich. UMI, 1998. 3 microfiches ; 11 x 15 cm.

A presença de áreas displásicas em queilites actínicas constitui um fator preditivo importante para o câncer de lábio. Entretanto, a determinação histopatológica da presença e intensidade da displasia epitelial nestas lesões continua sendo um aspecto subjetivo para os patologistas. O objetivo do presente estudo foi verificar em 45 queilites actínicas e 20 carcinomas espinocelulares (CECs) de lábio tratados no Departamento de Otorrinolaringologia e Oftalmologia, da Faculdade de Medicina de Botucatu, UNESP, a expressão imuno-histoquímica da citoqueratina 10 (CK10) e citoqueratina 13 (CK13) na região labial e comparar a expressão dessas citoqueratinas com o índice de proliferação celular determinado pela imunomarcação com o Ki-67. A intensidade da displasia epitelial nas queilites actínicas foi determinada em coloração de Hematoxilina e Eosina com base nos critérios definidos pela Organização Mundial da Saúde. A associação entre a expressão da CK10 e da CK13 nas queilites actínicas com e sem displasia e nos CECs foi calculada pelo teste do qui-quadrado ou teste exato de Fisher, com nível de significância de 5%. Os resultados demonstraram uma positividade para CK13 no vermelhão do lábio e mucosa labial, com perda de expressão nas áreas displásicas das queilites actínicas e marcação heterogênea nos CECs de lábio. A imunomarcação da CK10 foi observada no vermelhão do lábio e epiderme, com ausência total de expressão nas áreas displásicas e nos CECs de lábio. Houve uma associação estatisticamente significante entre a expressão da CK10 nos CECs quando comparada às queilites actínicas com displasia epitelial (p<0,001) e sem displasia epitelial (p<0,001). Não houve diferença significativa (p=0,104) no índice de proliferação celular, determinado pela imunomarcação do Ki-67, nas queilites actínicas sem e com displasia epitelial e nos carcinomas espinocelulares de lábio. Assim como também não houve associação, estatisticamente significativa, entre a expressão das citoqueratinas 13 e 10 e os altos índices de proliferação celular, determinados pelo Ki-67, nas queilites actínicas sem e com displasia epitelial. Esses resultados sugerem que as citoqueratinas 13 e 10 participam do processo de malignização das queilites actínicas sendo a expressão alterada ou ausente destes biomarcadores indicativa de áreas displásicas ou carcinoma espinocelular invasivo na região de lábio inferior. / The presence of dysplastic areas in actinic cheilitis is an important predictive factor for lip cancer. However, the histopathologic evaluation of the presence and severity of epithelial dysplasia in these lesions remains subjective. The aim of this study was to evaluate the immunohistochemical expression of cytokeratin 10 (CK10) and cytokeratin 13 (CK13) in labial region and compare the expression of these cytokeratins with the cell proliferation index, which was determined by Ki-67 immunostaining. The sample was constituted by 45 cases of actinic cheilitis and 20 of squamous cell carcinomas (SCC) of the lip treated at the Department of Otorhinolaryngology and Ophthalmology of Botucatu School of Medicine, UNESP. The severity of epithelial dysplasia in actinic cheilitis was determined by hematoxylin and eosin staining based on World Health Organization criteria. The association between the expression of CK10 and CK13 in actinic cheilitis with and without dysplasia and SCC was calculated by Chi-square test or Fischer´s exact test, with significance level at 5%. The results showed positive correlation for CK13 in the lip vermilion and labial mucosa, with loss of expression in the dysplastic areas of actinic cheilitis, and heterogeneous positivity in SCC of the lip. There was a statistically significant association between the expression of CK10 in SCC and actinic cheilitis with epithelial dysplasia (p < 0.001) or without epithelial dysplasia (p < 0.001).There was not a statistically significant difference (p=0.104) for cell proliferation index in actinic cheilitis with and without dysplasia, and SCC. Furthermore, there was not a statistical association (p>0.05) between the expression of CK10 and CK13 and high cell proliferation index in actinic cheilitis with and without epithelial dysplasia. These results suggest that the cytokeratins 13 and 10 participate in the process of malignant transformation of actinic cheilitis, and absence or alteration of these biomarkers expression are indicative of dysplastic areas or invasive squamous cell carcinoma in the lower lip region.