The natural history of localized prostate cancer is not fully understood. In most patients the tumor will never progress to a lethal disease, while a subset of patients will ultimately die of the disease. Efficient tools to separate indolent from lethal disease is currently lacking which means that many patients will be offered treatment without any benefit, but still be at risk of experiencing treatment related side effects. The aims of these studies were to get more insight into the natural history of untreated localized prostate cancer, to assess the prognostic value of established clinical parameters such as Gleason score, nuclear grade and tumor volume and, moreover, some new prognostic markers Ki-67, AMACR and MUC-1. We also aimed to study time trends in the detection of incidental tumors in Sweden. Patients with localized disease (n=223) and no initial treatment were followed for 21 years. Most patients had a favorable outcome. However, a subset of patients developed lethal disease even beyond 15 years of follow-up and these patients define the group that may benefit most from treatment with curative intent. Patients with poorly differentiated tumors experienced a 9 time higher risk of dying in prostate cancer. The studies on prognostic markers are based on a cohort of patients (n=253) with incidental prostate cancer detected by transurethral resection for presumed benign hyperplasia. All patients were left without initial treatment. Gleason grade, nuclear grade and tumor volume turned all out to be independent prognostic factors. MUC-1, AMACR and Ki-67 also carried prognostic information. However, after adjustment for Gleason grade, nuclear grade and tumor volume only MUC-1 and AMACR remained as statistically significant prognostic factors. When tested for sensitivity and specificity they all failed and, consequently, they seem to be of less value in daily practice for cancelling an individual patient regarding the choice of treatment. Time trends in incidental prostate tumors in Sweden were analyzed in a cohort of patients with prostate tumors detected by transurethral resection (TUR-P). Through linkage of the national registration number (NRN) with several registers, e.g. the Swedish Cancer Registry, the National Inpatient registry and the Cause of Death Registry we identified, during the period 1970 through 2003, in total 23288 patients with incidental prostate cancer, who constituted the study group. As comparison group we choose all patients diagnosed with prostate cancer between 1970-2003 excluding those with incidental cancer, in total 112204 patients. Our result confirms earlier findings that there has been a dramatic change over time in incidence of incidental prostate cancers in Sweden, which parallels the introduction of prostate specific antigen. We also found that the cumulative incidence of prostate cancer death is high in the incidental group, opposing earlier findings that incidental tumours are a non-lethal disease.

Background: Prostate Cancer (PC) is a common and highly variable disease. Using current diagnostic methods, the prostate specific antigen (PSA) blood test and histological grading of prostate tissue needle biopsies, it is often difficult to evaluate whether the patient has a PC that requires active treatment or not. The absolute majority of all 10,000 cases of PCs diagnosed annually in Sweden have tumours graded as Gleason score (GS) 6-7 and a PSA value in blood below 10. Many of these are harmless and can be left without active treatment and hence spared problematic post-therapy side-effects, others are highly malignant and require early diagnosis and treatment. Better prognostic markers are needed and the aim of this study was to evaluate prognostic markers and to test if these markers could identify patients with indolent tumours. Methods: We have studied tumour material from 419 men consecutively diagnosed with PC at transurethral resection (1975-1990). The majority of these patients (295) had no metastasis at diagnosis and was not given any curative treatment and only hormonal treatment upon symptoms from metastatic progression. Standard histological sections and tissue microarrays (TMA) from these tumours and surrounding normal prostate tissue were stained and evaluated for cell proliferation (Ki67), blood vessels (endoglin and von Willebrand factor, vWf) and the extracellular matrix component hyaluronan (HA). An orthotopic rat PC model was used to explore hyaluronan staining, hyaluronic acid synthase (HAS)-1 mRNA levels and the effect of local HA treatment on tumour growth. Results: Tumour cell proliferation (Ki67) and the density of intra-tumoural endoglin stained blood vessels were independent prognostic markers (i.e. they added prognostic information to the conventional prognostic markers; clinical stage and GS). None of the GS 6 patients with low staining for both Ki67 and endoglin died of PC within 15 years of follow-up. High HA staining in the tumour epithelium and stroma was a negative prognostic marker of cancer specific survival but they were not independent of GS. High HA staining and high vascular density in the stroma of the surrounding morphologically normal prostate were prognostic for short cancer specific survival. Implantation of tumour cells in the normal rat prostate resulted in an increase in HA and HAS-1 mRNA levels in the prostate tissue surrounding prostate tumours. Concurrently intra-prostatic injection of HA also stimulated tumour growth. Conclusions: By evaluating both tumour cell proliferation (Ki67) and vascular density, it is possible to identify patients with very low risk of cancer specific death in the absence of active treatment. Prostate tumours influence the surrounding non-malignant prostate tissue, for example they cause an increased angiogenesis and synthesis of hyaluronan. Such responses can possibly be used to diagnose PC and to evaluate PC aggressiveness.

Western health professions have historically struggled with the notion that spirituality could be studied empirically. This trend has changed in recent decades with there being a marked increase in the health literature pertaining to spirituality. For indigenous people spirituality is a fundamental attribute of their worldviews. Mäori, as the Indigenous people of Aotearoa, have always acknowledged the importance of wairua, (spirituality as defined by Mäori worldviews) to their health and well-being. This thesis aims to explore wairua as an important aspect of Mäori well-being from a psychological perspective. Two research goals underpin this thesis. The first goal involved developing an understanding of what Mäori mean when they talk about wairua. This was achieved through a qualitative study. While there are implicit shared understandings among Mäori regarding the nature of wairua, this study was one of the first attempts to make some of those shared understandings more explicit. The second goal involved investigating the relationship between an orientation to wairua and Mäori well-being using a newly developed measure. This was a quantitative study. Conceptualisations of wairua fell into four themes; direct descriptions, personal experiences, personal beliefs and Mäori worldviews. According to the qualitative information, wairua was described as a fundamental attribute that enables Mäori to engage with their reality; an intuitive consciousness. Through wairua Mäori identity is expressed, relationships are forged, balance is maintained, restrictions and safety are adhered to, healing is transmitted, and the connection between te ao wairua and te ao Mäori are maintained. These aspects of Mäori reality are inclusive and interconnected. The qualitative study information led to the formation of a 30 item self report measure named the Kia Ngawari ki te Awatea Orientation to Wairua measure. This measure was used to investigate the relationship between an orientation to wairua and Mäori health and well-being. The results showed that orientations to wairua had relatively modest associations with wellbeing when conceptualised and measured in a variety of ways. Due to the variability in the results, support for the overarching hypothesis of a relationship between wairua and well-being was mixed. A number of limitations were acknowledged with recommendations for future research offered. The findings of these studies have a number of implications for clinical psychological practice with Mäori clients.

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

Thesis (M.SP)--Unitec New Zealand, 2008. / Cardsort is a generic name for any process that uses statements written on cards and has participants sieve, cluster or rank ideas or statements. When the participants themselves create the statements in question this process is consensus cardsort. Includes bibliographical references (leaves 134-145).

The thesis deals with festivals and industry activities supporting the training of film professionals in the Czech Republic. It conducts a survey of the important industry platforms and engages in an example of film festival Finale Plzen and its platform Industry Days which was established in 2012. It deals with the conception of the Industry Days and their position in the Czech environment . The last part outlines the future direction of training programs for professionals.

Base teórica: doenças linfoproliferativas crônicas de linhagem B (DLPC-B) são neoplasias clonais que afetam linfócitos B maduros. A tirosina quinase de Bruton (do inglês Bruton’s tyrosine kinase, BTK) é uma proteína essencial para o desenvolvimento, diferenciação e sinalização nos linfócitos B. Ki-67 é uma proteína nuclear associada à proliferação celular. A avaliação de proteínas envolvidas nas vias de sinalização oncogênicas pode levar ao aprimoramento do diagnóstico, tratamento e definição de prognóstico das DLPC-B. Objetivo: avaliar a expressão de BTK e Ki-67 em linfócitos de portadores de DLPC-B. Métodos: para avaliação de BTK foi realizado um estudo transversal; foi avaliada a expressão de BTK em amostras de pacientes saudáveis e de pacientes com diagnóstico de DLPC-B. Para avaliação de Ki-67 foi realizado um estudo transversal. As amostras foram marcadas com CD45 FITC e CD19 APC para identificação dos linfócitos B. Após a lise das hemácias, foi realizada marcação citoplasmática de BTK PE e/ou Ki-67 PerCP-Cy5.5. O percentual de expressão e a intensidade de fluorescência média (IFM) dos marcadores avaliados foram determinados nos linfócitos B. A análise estatística foi realizada com testes de correlação de Pearson e Spearman entre BTK ou Ki-67 e as demais variáveis clínicas e laboratoriais, e ANOVA seguido por teste post hoc de Bonferroni para comparações entre grupos. Foi considerado resultado significante quando P < 0,05. Resultados: não foram observadas diferenças na expressão de BTK e não houve associação entre a expressão de BTK e as variáveis clínicas avaliadas. A expressão de Ki-67 foi maior nos grupos linfoma do manto, linfoma de Burkitt e linfoma difuso de grandes células B em relação aos demais; após análise multivariada, a IFM de Ki-67 foi associada à IFM de CD38. Conclusão: no presente trabalho, a expressão de BTK em DLPC-B foi similar a de linfócitos B normais e a expressão de Ki-67 foi maior nas DLPC-B com curso clínico mais agressivo. / Background: mature B-cell neoplasms (MBCN) are clonal neoplasms that affect mature B-cell lymphocytes. Bruton’s tyrosine kinase (BTK) is an essential protein for the development, differentiation and signaling in B-cell lymphocytes. Ki-67 is a nuclear protein associated to cellular proliferation. Evaluation of proteins involved in oncogenic signaling pathways can lead to improvement in the diagnosis, treatment and prognosis definition in MBCN. Objective: to evaluate the expression of BTK and Ki-67 in lymphocytes of MBCN patients using flow cytometry. Methods: a cross-sectional study was conducted for BTK assessment; BTK expression was assessed on healthy patients samples and MBCN samples. For evaluation of Ki-67 a cross-sectional study was conducted. Samples were stained with CD45 FITC and CD19 APC for identification of B-cell lymphocytes. After lysis of red blood cells, cytoplasmic staining of BTK PE and/or Ki-67 PerCP-Cy5.5 was performed. Percentage of expression and mean fluorescence intensity (MFI) of the markers were determined in B-cell lymphocytes. Statistical analysis was performed with Pearson and Spearman correlation tests between BTK and Ki-67 and the other clinical and laboratory variables, and ANOVA followed by post-hoc Bonferroni test for comparisons between groups. Results were considered significant when P < 0.05. Results: no differences in BTK expression were identified and there was no association between BTK expression and clinical variables evaluated. Ki-67 expression was higher in mantle cell lymphoma, Burkitt lymphoma and diffuse large B-cell lymphoma cases; after multivariate analysis, MFI of Ki-67 was associated with MFI of CD38. Conclusions: in this study, BTK expression in B-cell neoplasms was similar to that of normal B-cell lymphocytes and Ki-67 expression was higher in MBCN with more aggressive clinical courses.

Base teórica: doenças linfoproliferativas crônicas de linhagem B (DLPC-B) são neoplasias clonais que afetam linfócitos B maduros. A tirosina quinase de Bruton (do inglês Bruton’s tyrosine kinase, BTK) é uma proteína essencial para o desenvolvimento, diferenciação e sinalização nos linfócitos B. Ki-67 é uma proteína nuclear associada à proliferação celular. A avaliação de proteínas envolvidas nas vias de sinalização oncogênicas pode levar ao aprimoramento do diagnóstico, tratamento e definição de prognóstico das DLPC-B. Objetivo: avaliar a expressão de BTK e Ki-67 em linfócitos de portadores de DLPC-B. Métodos: para avaliação de BTK foi realizado um estudo transversal; foi avaliada a expressão de BTK em amostras de pacientes saudáveis e de pacientes com diagnóstico de DLPC-B. Para avaliação de Ki-67 foi realizado um estudo transversal. As amostras foram marcadas com CD45 FITC e CD19 APC para identificação dos linfócitos B. Após a lise das hemácias, foi realizada marcação citoplasmática de BTK PE e/ou Ki-67 PerCP-Cy5.5. O percentual de expressão e a intensidade de fluorescência média (IFM) dos marcadores avaliados foram determinados nos linfócitos B. A análise estatística foi realizada com testes de correlação de Pearson e Spearman entre BTK ou Ki-67 e as demais variáveis clínicas e laboratoriais, e ANOVA seguido por teste post hoc de Bonferroni para comparações entre grupos. Foi considerado resultado significante quando P < 0,05. Resultados: não foram observadas diferenças na expressão de BTK e não houve associação entre a expressão de BTK e as variáveis clínicas avaliadas. A expressão de Ki-67 foi maior nos grupos linfoma do manto, linfoma de Burkitt e linfoma difuso de grandes células B em relação aos demais; após análise multivariada, a IFM de Ki-67 foi associada à IFM de CD38. Conclusão: no presente trabalho, a expressão de BTK em DLPC-B foi similar a de linfócitos B normais e a expressão de Ki-67 foi maior nas DLPC-B com curso clínico mais agressivo. / Background: mature B-cell neoplasms (MBCN) are clonal neoplasms that affect mature B-cell lymphocytes. Bruton’s tyrosine kinase (BTK) is an essential protein for the development, differentiation and signaling in B-cell lymphocytes. Ki-67 is a nuclear protein associated to cellular proliferation. Evaluation of proteins involved in oncogenic signaling pathways can lead to improvement in the diagnosis, treatment and prognosis definition in MBCN. Objective: to evaluate the expression of BTK and Ki-67 in lymphocytes of MBCN patients using flow cytometry. Methods: a cross-sectional study was conducted for BTK assessment; BTK expression was assessed on healthy patients samples and MBCN samples. For evaluation of Ki-67 a cross-sectional study was conducted. Samples were stained with CD45 FITC and CD19 APC for identification of B-cell lymphocytes. After lysis of red blood cells, cytoplasmic staining of BTK PE and/or Ki-67 PerCP-Cy5.5 was performed. Percentage of expression and mean fluorescence intensity (MFI) of the markers were determined in B-cell lymphocytes. Statistical analysis was performed with Pearson and Spearman correlation tests between BTK and Ki-67 and the other clinical and laboratory variables, and ANOVA followed by post-hoc Bonferroni test for comparisons between groups. Results were considered significant when P < 0.05. Results: no differences in BTK expression were identified and there was no association between BTK expression and clinical variables evaluated. Ki-67 expression was higher in mantle cell lymphoma, Burkitt lymphoma and diffuse large B-cell lymphoma cases; after multivariate analysis, MFI of Ki-67 was associated with MFI of CD38. Conclusions: in this study, BTK expression in B-cell neoplasms was similar to that of normal B-cell lymphocytes and Ki-67 expression was higher in MBCN with more aggressive clinical courses.

Le CD81 est une molécule de surface appartenant à la superfamille des tetraspanines. Son rôle pronostique a été précédemment étudié dans les pathologies lymphoïdes, dont le myélome multiple où son expression est associée à un pronostic péjoratif. A ce jour, ce marqueur n'a pas été étudié dans les leucémies aiguës myéloïdes (LAM). Nous avons étudié l'expression membranaire du CD81 sur les blastes de LAM au diagnostic, son association aux autres caractéristiques des LAM et sa potentielle influence sur la survie des patients sur une cohorte de 134 patients traités par chimiothérapie intensive.Le CD81 a été retrouvé chez 92 patients sur 134 (69%). Les patients exprimant ce marqueur avaient une leucocytose initiale plus élevée (p=0.02) et présentaient une cytogénétique intermédiaire ou défavorable (p<0.001). L'expression du CD81 avait un impact négatif sur la survie des patients (survie sans évènements (EFS), survie globale (OS), survie sans rechute (RFS)) en analyse uni- (p<0.001) et multivariées (p=0.003, 0.002 and <0.001 respectivement).De plus, le CD81 avait un impact négatif sur l'OS des patients avec une mutation de NPM1 (p=0.01) et chez les patients du groupe cytogénétique favorable (p=0.002) selon la classification ELN.Les anomalies du cycle cellulaire étant associées à la chimiorésistance, la croissance tumorale et l'agressivité de la pathologie, nous avons étudié l'expression du Ki67 sur les blastes de LAM au diagnostic. Ainsi, 10 prélèvements médullaires de patients avec une faible expression du CD81 par les blastes (moins de 20% de positivité) et 10 prélèvements avec une forte expression du marqueur ont été étudiés. Nous avons pu démontrer une expression significativement inférieure du Ki67 sur les blastes CD81 positifs par rapport aux blastes CD81 négatifs (p<0.001), suggérant ainsi un rôle potentiel du CD81 dans le contrôle du cycle cellulaire. De plus, nous nous sommes intéressés au rôle du CD81 dans la chimiorésistance et sur les différentes voies de signalisation cellulaire en étudiant le profil d'expression génique.En conclusion, le CD81 semble être un nouveau marqueur pronostique des LAM ainsi qu'une cible potentielle de traitement de ces pathologies. / CD81 is a cell surface protein which belongs to the tetraspanin family. While in multiple myeloma its expression on plasma cells is associated with worse prognosis, this has not yet been explored in acute myeloid leukemia (AML). We measured membrane expression of CD81 on AML cells at diagnosis, evaluated its association with AML characteristics and its influence on patient outcome after intensive chemotherapy in a cohort of 134 patients. CD81 was detected in 92/134 (69%) patients. Patients with AML expressing CD81 had elevated leukocyte count (p=0.02) and were more likely classified as intermediate or adverse-risk by cytogenetics (p<0.001). CD81 expression had a negative impact on survival (event-free [EFS], overall [OS] and relapse-free survival [RFS]) in univariate (p<0.001) and in multivariate analyses (p=0.003, 0.002 and <0.001, respectively). CD81 has a negative impact on OS in patients with NPM1 mutation (p=0.01) and in favorable risk patients by European Leukemia Net (ELN) classification (p=0.002).Since aberrations in cell cycle signaling can cause drug resistance, tumor growth and aggressiveness we measured Ki67 on primary blast cells from AML patients. We considered 10 bone marrow samples from AML patients with either weak CD81 expression (less than 20% of blast cells) or 10 bone marrow samples with strong CD81 expression on blasts. We found a significant lower ki67 expression on blast cells from CD81 positive patients compared with those from CD81 negative patients (p<0.001), indicating a potential role of CD81 in cell cycle control. Furthermore, we investigated the role of CD81 in chemotherapy resistance and investigated potentially implicated signaling pathways by gene expression profiling.In conclusion, the cell surface marker CD81 may be a new prognostic marker for diagnostic risk classification and a new potential therapeutic target for drug development in AML.

This study presents a comparative approach between the time of the Belgic Confession and of the Korean Church under Japanese rule. Both the early Low Countries and Korea received Protestantism through martyrdom and persecution. During the sixteen century the Low Countries were under the Spanish rule. The Low Countries were deeply influenced by the Reformation. Many historians have noted that the people in the Low Countries suffered persecutions on the basis of their nationality and religious beliefs by the Roman Catholic Church and the Spanish government. The heroes of the Low Countries were William of Orange, the political leader of his native country, and Guido de Bres a religious leader. William of Orange, and his son, Maurice of Orange, accomplished their country’s political independence with outstanding leadership. Guido de Bres was a travelling preacher who preached the gospel in the Low Countries. He drafted the Belgic Confession. It is authorized as one of the most wonderful Reformed confessions. Korea received the gospel through the Western missionary R. J. Thmoas. Korea was under Japanese rule since the end of the nineteen century. Korean Christianity helped the Korean people when the Koreans were oppressed. From the late 1920s, the Japanese forced Koreans in Shinto Shrine Worship. Shinto Shrine Worship was the worship of the King of Japan. The Korean people could not accept Shinto Shrine Worship. Korean Christians judged Shinto Shrine Worship to be idol worship and opposed it. However, Korean Protestants abandoned their faith, due to the Japanese’ threat of military power. Some pastors resisted Shinto Shrine Worship. Pastor Joo Ki-Chul was a leader of the resistance and died for his faith. There are similarities and differences between the struggle of the Low Countries and Korea. Both the early Low Countries and early Korean Church produced spiritual martyrs like Guido de Bres and Joo Ki-Chul. They were martyrs, patriots and preachers. In both countries Christians faced horrible persecutions by the ruling tyrants. But while the Low Countries struggled for their independence to the end, most Korean Christians had to desert their faith in the face of continued pressure from the Japanese. In spite of this some Korean Christians remained strong till the bitter end. The Low Countries’ religious persecution came to an end, but North Korea’s Christians are still suffering under the communist regime. In spite of terrible persecution by the communist government, there are many Christians in underground churches who long for religious and political freedom. / Dissertation (MA(Theol))--University of Pretoria, 2011. / Church History and Church Policy / unrestricted