Följande kandidatuppsats undersöker hur en elektronisk hälsoapplikation kan utformasför att öka medvetenheten om den personliga dagliga hälsan, fokuserat på huden och atthålla den frisk. Det sker genom att en prototyp har utformats där användaren genombilder samt text får instruktioner för att utföra en självkontroll. Prototypen innehållerockså en bildregistrering där användaren kan ladda upp bilder på en leverfläck ochgenom registreringen kan om leverfläcken utvecklas över tid. Syftet med prototypen äratt undersöka om en elektronisk hälsoapplikation utformad med fokus på återkopplingkan göra det möjligt för en person som inte är utbildad inom ämnet att undersöka sinhud samt se och följa förändring i en leverfläck genom bildanalys. Detta undersöktesgenom två tester. Ett frågeformulär där svarspersonen fick försöka avgöra om enleverfläck var frisk eller inte. Ett användartest där testpersonen fick testa bildanalysen,det som testades var om personen kunde ladda upp en bild samt se skillnad i bildernagenom bildregistreringen.Resultatet visar att majoriteten av enkätsvaren var korrekta svar, närmare bestämt 76,9procent. Personerna kunde identifiera om leverfläcken var frisk eller sjuk med hjälp avinformationen som tilldelades. Resultatet av användartesten visade att personerna kundeladda upp en bild på webbplatsen och sedan förstå bildanalysen. / This bachelor thesis examins how a electronic health application can be made toincrease awareness about personal daily health, with focus on individual skin andkeeping it healthy. This was made by creating a prototype where the user get usefulinformation on how to perform a self examination through text and images. Theprototype also contains functionality that allows the user to upload images of a moleand by an image registration follow possible changes over long periods of time. Thepurpose of the prototype is to investigate if an electronic health application with focuson feedback can make it possible for a person who is not educated in this area to examinthe skin and also discover possible changes over time with the image registration. Twotests were made to examin if this was possible. The first test was an questionnaire wherethe respondet tried to determine if a mole was healthy or not. The second test was a usertest where the test person got to try out the functionality with image registration in theprototype. The person got to upload an image and see the differences through the imageregistration.The results showed that the majority of the collected repsonses from the quetsionnairewas correct, with a percentage of 76,9 correct answers. The respondent could identify ifthe mole was healthy or not through the information that was presented. The results ofthe user test showed that all test persons could perform and understand the functionalityof uploading an image and then analyze the results throgh image registration.

Das translationell kontrollierte Tumorprotein (TCTP) ist ein hochkonserviertes, ubiquitär in Eukaryonten vorkommendes Protein. Seine Bezeichnung geht auf die erstmalige Beschreibung in Tumorzellen zurück und weist zugleich auf seine besondere translationelle Regulation hin. Das zugehörige Gen wird als TPT1 bezeichnet und befindet sich beim Menschen auf dem langen Arm des Chromosom 13. Eine pathophysiologische Bedeutung für TCTP wurde bei Tumorerkrankungen, Erkrankungen des allergischen Formenkreises sowie bei Infektionen durch Parasiten beschrieben. Für diese Arbeit wurde zur Untersuchung grundlegender Regulationsphänomene die TCTP-mRNA des Kaninchens als geeignetes Modell ausgewählt. Es wurden die volllangen TCTP-mRNA1 und 2, die sich in der Länge ihrer 3'UTR unterscheiden, sowie Deletionsvarianten, denen die UTR-Abschnitte fehlen, kloniert. In Proteinbindungsstudien (Electromobility Shift Assays, UV-Crosslinking-Experimente, RNA-Affinitätschromatographie) wurden potentielle Bindungsfaktoren der TCTP-UTRs analysiert. Die an der mRNA des Kaninchens erarbeiteten Ergebnisse wurden durch Untersuchungen an humanen Melanomzellen ergänzt. In in vitro Translationsexperimenten wurde gezeigt, dass die Regulation der TCTP-mRNA durch ihre 5'UTR und 3'UTR2 vermittelt wird. In RNA-Bindungsstudien konnte eine Reihe potentieller Bindungsfaktoren der UTRs charakterisiert werden. Bei Verwendung von Extrakten aus verschiedenen Kaninchengeweben zeigten sich deutliche gewebsspezifische Unterschiede. Frühere Untersuchungen hatten gezeigt, dass es in der Melanomzelllinie MeWo bei der Ausbildung einer Chemoresistenz zu einer Expressionssteigerung des TCTP kommt. In einem ersten Schritt wurde der Beitrag von Transkription und Translation in vergleichenden Northern und Western Blot Analysen untersucht. Auf mRNA-Niveau findet man in den resistenten Zellen eine deutliche Steigerung der Expression im Vergleich zu den sensiblen Zellen. Der mRNA-Menge in den chemosensiblen Zellen steht eine vergleichsweise geringe Menge an Protein gegenüber. Folglich liegt die mRNA in diesen Zellen in einem inaktiven Zustand vor. Es konnten drei Cytoskelettproteine gamma-Actin, beta-Tubulin und alpha-Actinin als Bindungspartner der TCTP-3'UTR in den Melanomzellen identifiziert werden. Eine Bedeutung von TCTP für die Entstehung der Chemoresistenz lässt sich aufgrund seiner anti-apoptotischen Wirkung vermuten. Die Regulation der TCTP-Translation stellt bei durch Cytostatika hervorgerufener Hemmung der Transkription einen wichtigen Pathomechanismus in chemoresistenten Melanomzellen dar. / The translationally controlled tumor protein (TCTP) is a highly conserved protein expressed in all eukaryotic organisms. It was first described in tumor cells showing a special regulation of translation. The chromosomal localisation of the respective human gene TPT1 has been determined (13q14). TCTP has been implicated in cellular processes such as cell growth and apoptosis. Its medical importance has been shown in malignant transformation, allergic reactions and immunity against parasitic organisms. In order to investigate basic mechanisms of translational regulation the rabbit TCTP-mRNA was chosen due to its high homology to its human counterpart. The TPT1 gene is transcribed into two TCTP-mRNAs differing in the length of their 3'untranslated regions. These two mRNAs and variants missing the untranslated regions were cloned into expression vectors. In Electro mobility shift assays, UV-crosslinking assays and RNA affinity purification several TCTP-mRNA binding factors were characterised. Furthermore, the role of TCTP in human chemoresistant melanoma cells was investigated. In cell-free translation assays the importance of the 5'UTR and 3'UTR2 was shown. However, in wheat germ extracts the regulation of the TCTP-mRNA mediated by its 5'UTR is less important. In Electro mobility shift assays and UV-crosslinking assays with radiolabelled transcripts of the untranslated regions great variations in tissue-specific protein binding were found. Recently, TCTP had been implicated in the development of chemoresistance in the human melanoma cell line MeWo. As a first step, the contribution of transcriptional and translational regulation was analysed by comparing TCTP-expression in Northern and Western blot assays. Transcription of the TPT1 gene is increased in chemoresistant melanoma cells whereas translation is inhibited in those cells susceptible to chemotherapeutic agents. Three proteins, gamma-actin, beta-tubulin and alpha-actinin, were identified as factors binding to the TCTP-3'UTR in melanoma cells. For the interaction of these cytoskeleton components their ability to bind intracellular calcium ions could be of great importance. The role of TCTP in the development of chemoresistance can be explained by its anti-apoptotic function. In conclusion, the regulation of TCTP-translation when transcription is blocked by inhibitors of DNA-function is an important mechanism to overcome the effect of these anti-proliferative agents.

Every year approximately 2800 Swedes are diagnosed with malignant melanoma, the form of cancer that is most rapidly increasing in incidence in the Western world. The earlier we can identify and diagnose a malignant melanoma, the better is the prognosis. In Sweden, 155 000 benign naevi, harmless skin tumours or moles, are surgically excised each year, many of them because melanoma cannot be dismissed by non-invasive methods. The excisions result in substantial medical costs and cause unrest and suffering of the individual patient. For untrained physicians, it is often difficult to make an accurate diagnosis of melanoma, thus a tool that could help to strengthen the diagnosis of suspected melanomas would be highly valuable. This thesis describes the development and assessment of a non-invasive method for early skin cancer detection. Using near infrared (NIR) and skin impedance spectroscopy, healthy and diseased skin of various subjects was examined to develop a new instrument for detecting malignant melanoma. Due to the complex nature of skin and the numerous variables involved, the spectroscopic data were analysed multivariately using Principal Component Analysis (PCA) and partial leas square discriminant analysis (PLS-DA). The reproducibility of the measurements was determined by calculating Scatter Values (SVs), and the significance of separations between overlapping groups in score plots was determined by calculating intra-model distances. The studies indicate that combining skin impedance and NIR spectroscopy measurements adds value, therefore a new probe-head for simultaneous NIR and skin impedance measurements was introduced. Using both spectroscopic techniques it was possible to separate healthy skin at one body location from healthy skin at another location due to the differences in skin characteristics at various body locations. In addition, statistically significant differences between overlapping groups of both age and gender in score plots were detected. However, the differences in skin characteristics at different body locations had stronger effects on the measurements than both age and gender. Intake of coffee and alcohol prior to measurement did not significantly influence the outcome data. Measurements on dysplastic naevi were significantly separated in a score plot and the influence of diseased skin was stronger than that of body location. This was confirmed in a study where measurements were performed on 12 malignant melanomas, 19 dysplastic naevi and 19 benign naevi. The malignant melanomas were significantly separated from both dysplastic naevi and benign naevi. Overall, the presented findings show that the instrument we have developed provides fast, reproducible measurements, capable of distinguishing malignant melanoma from dysplastic naevi and benign naevi non-invasively with 83% sensitivity and 95% specificity. Thus, the results are highly promising and the instrument appears to have high potential diagnostic utility.

The investigation of genetic alterations in cancer-relatedgenes is useful for research, prognostic and therapeuticpurposes. However, the genetic heterogeneity that often occursduring tumour progression can make correct analysischallenging. The objective of this work has been to develop,evaluate and apply techniques that are sufficiently sensitiveand specific to detect and analyse genetic alterations in skintumours as well as in normal skin. Initially, a method based on laser-assisted microdissectionin combination with conventional dideoxy sequencing wasdeveloped and evaluated for the analysis of the p53 tumoursuppressor gene in small tissue samples. This method was shownto facilitate the analysis of single somatic cells fromhistologic tissue sections. In two subsequent studies themethod was used to analyse single cells to investigate theeffects of ultraviolet (UV) light on normal skin. Single p53immunoreactive and nonimmunoreactive cells from differentlayers of sunexposed skin, as well as skin protected fromexposure, were analysed for mutations in the p53 gene. Theresults revealed the structure of a clandestine p53 clone andprovided new insight into the possible events involved innormal differentiation by suggesting a role for allele dropout.The mutational effect of physiological doses of ultravioletlight A (UVA) on normal skin was then investigated by analysingthe p53 gene status in single immunoreactive cells at differenttime-points. Strong indications were found that UVA (even atlow doses) is indeed a mutagen and that its role should not bedisregarded in skin carcinogenesis. After slight modifications, the p53 mutation analysisstrategy was thenused to complement an x-chromosomeinactivation assay for investigation of basal cell cancer (BCC)clonality. The conclusion was that although the majority ofBCC’s are of monoclonal origin, an occasional tumour withapparently polyclonal origin exists. Finally, apyrosequencing-based mutation detection method was developedand evaluated for detection of hot-spot mutations in the N-rasgene of malignant melanoma. More than 80 melanoma metastasissamples were analysed by the standard approach of single strandconformation polymorphism analysis (SSCP)/DNA sequencing and bythis pyrosequencing strategy. Pyrosequencing was found to be agood alternative to SSCP/DNA sequencing and showed equivalentreproducibility and sensitivity in addition to being a simpleand rapid technique. <b>Keywords:</b>single cell, DNA sequencing, p53, mutation,UV, BCC, pyrosequencing, malignant melanoma, N-ras

<p>The investigation of genetic alterations in cancer-relatedgenes is useful for research, prognostic and therapeuticpurposes. However, the genetic heterogeneity that often occursduring tumour progression can make correct analysischallenging. The objective of this work has been to develop,evaluate and apply techniques that are sufficiently sensitiveand specific to detect and analyse genetic alterations in skintumours as well as in normal skin.</p><p>Initially, a method based on laser-assisted microdissectionin combination with conventional dideoxy sequencing wasdeveloped and evaluated for the analysis of the p53 tumoursuppressor gene in small tissue samples. This method was shownto facilitate the analysis of single somatic cells fromhistologic tissue sections. In two subsequent studies themethod was used to analyse single cells to investigate theeffects of ultraviolet (UV) light on normal skin. Single p53immunoreactive and nonimmunoreactive cells from differentlayers of sunexposed skin, as well as skin protected fromexposure, were analysed for mutations in the p53 gene. Theresults revealed the structure of a clandestine p53 clone andprovided new insight into the possible events involved innormal differentiation by suggesting a role for allele dropout.The mutational effect of physiological doses of ultravioletlight A (UVA) on normal skin was then investigated by analysingthe p53 gene status in single immunoreactive cells at differenttime-points. Strong indications were found that UVA (even atlow doses) is indeed a mutagen and that its role should not bedisregarded in skin carcinogenesis.</p><p>After slight modifications, the p53 mutation analysisstrategy was thenused to complement an x-chromosomeinactivation assay for investigation of basal cell cancer (BCC)clonality. The conclusion was that although the majority ofBCC’s are of monoclonal origin, an occasional tumour withapparently polyclonal origin exists. Finally, apyrosequencing-based mutation detection method was developedand evaluated for detection of hot-spot mutations in the N-rasgene of malignant melanoma. More than 80 melanoma metastasissamples were analysed by the standard approach of single strandconformation polymorphism analysis (SSCP)/DNA sequencing and bythis pyrosequencing strategy. Pyrosequencing was found to be agood alternative to SSCP/DNA sequencing and showed equivalentreproducibility and sensitivity in addition to being a simpleand rapid technique.</p><p><b>Keywords:</b>single cell, DNA sequencing, p53, mutation,UV, BCC, pyrosequencing, malignant melanoma, N-ras</p>

No description available.

Το κακόηθες μελάνωμα του δέρματος είναι το αποτέλεσμα της κακοήθους εξαλλαγής των μελανοκυττάρων της επιδερμίδας και χαρακτηρίζεται απο συνεχώς αυξανόμενη επίπτωση και θνησιμότητα παγκοσμίως. Η αξιοσημείωτη δε ανθεκτικότητα που επιδεικνύει το προχωρημένο μεταστατικό μελάνωμα στα χημειοθεραπευτικά σχήματα και στην ακτινοθεραπεία κάνει επιτακτική την ανάγκη για νέους, πιο αποτελεσματικούς θεραπευτικούς παράγοντες. Ένας αυξανόμενος όγκος δεδομένων υποστηρίζει τη παρουσία και ενεργό συμμετοχή καρκινικών κυττάρων με ιδιότητες stem κυττάρων (cancer stem cells, CSCs) στην ανάπτυξη και μετάσταση του μελανώματος. Οι μεταγραφικοί παράγοντες EZH2, SOX2 και Oct4 αποτελούν μόρια – κλειδιά στον έλεγχο του ρυθμιστικού δικτύου του stemness των εμβρυϊκών stem κυττάρων (ESCs). Είναι πλέον γνωστό ότι η χρωματίνη στα ESCs περιλαμβάνει περιοχές με «αντιμαχόμενες» τροποποιήσεις ιστονών (bivalent domain), οι οποίες φυσιολογικά σχετίζονται είτε με ενεργή (Η3Κ4me3) ή με ανενεργή κατάσταση της χρωματίνης (H3K27me3), ενώ η απορρύθμιση των επιγενετικών μηχανισμών ελέγχου σε συγκεκριμένους γονιδιακούς τόπους έχει συσχετισθεί με τη καρκινογένεση στον άνθρωπο. Σημαντικό ρόλο στη ρύθμιση αυτών των bivalent domain φαίνεται να έχουν οι πρωτεΐνες της οικογένειας Polycomb, και ιδιαίτερα ο EZH2 που δρα σαν μεθυλοτρανσφεράση στην επιγενετική τροποποίηση H3K27. Πρόσφατα, μια σειρά από μελέτες έδειξαν ότι CScs στη διηθητική παρυφή του όγκου ενδέχεται να συμμετέχουν ενεργά στη καρκινογένεση. Επιπλέον, η ανακάλυψη ότι η βιολογική διαδικασία της επιθηλιο-μεσεγχυματικής μετάβασης (EMT) οδηγεί υποπληθυσμούς καρκινικών κυττάρων εντός του όγκου να αποκτήσουν ιδιότητες stem κυττάρων, φαίνεται να αποτελεί τον σύνδεσμο μεταξύ μετάστασης και κατάστασης πολυδυναμίας (stemness). Σύμφωνα λοιπόν με τη θεώρηση αυτή, είναι πιθανό τα CSCs να εντοπίζονται κυρίως στη διηθητική παρυφή ενός όγκου, ενώ επιπλέον οι ιδιότητες stem κυττάρων που έχουν αποκτήσει είναι το αποτέλεσμα κυρίως της ΕΜΤ. Σε αυτό το πλαίσιο, παρουσιάζει επομένως εξαιρετικό ενδιαφέρον η προσεκτική και στοχευμένη εκτίμηση της ανοσοϊστοχημικής έκφρασης παραγόντων που σχετίζονται με τα stem κύτταρα στην διηθητική παρυφή του μελανώματος, και αυτός ήταν ένας από τους στόχους της παρούσας διαδακτορικής διατριβής. Σκοπός. Ο σκοπός της παρούσας διδακτορικής διατριβής είναι η μελέτη της έκφρασης των μεταγραφικών παραγόντων EZH2, Oct4, SOX2 όπως επίσης και την παρουσία των επιγενετικών τροποποιήσεων H3K4me2 and H3K27me3 (bivalent domain) στο κακόηθες μελάνωμα του δέρματος. Παράλληλα, μελετήθηκε η πιθανότητα αναγνώρισης και στοχοποίησης καρκινικών κυττάρων με ιδιότητες stem κυττάρων, με ιδιαίτερη έμφαση στη διηθητική παρυφή του όγκου. Υλικό και μέθοδος. Το ποσοστό κυττάρων με ανοσοθετικότητα για τα αντισώματα έναντι των μεταγραφικών παραγόντων EZH2, SOX2 και Oct4 όπως επίσης και των επιγενετικών τροποποιήσεων H3K4me2 and H3K27me3 εκτιμήθηκε σε 89 δείγματα ιστών από 79 ασθενείς με κακόηθες μελάνωμα 250 του δέρματος, εφαρμόζοντας τη μέθοδο της ανοσοϊστοχημείας. Για την επιλογή των κατάλληλων δειγμάτων έγινε ανασκόπηση των αρχείων του εργαστηρίου Παθολογικής Ανατομικής του Πανεπιστημιακού Γενικού Νοσοκομείου Πατρών των ετών 2001 έως 2010. Από αυτό το σύνολο των 89 δειγμάτων τα 70 αφορούν πρωτοπαθές μελάνωμα δέρματος, ενώ τα υπόλοιπα 19 προέρχονται από υλικό που εξαιρέθηκε κατά τη χειρουργική εκτομή του μεταστατικού μελανώματος. Επιπλέον 14 δείγματα περιείχαν εκτός από καρκινικά κύτταρα μελανώματος και κύτταρα σπίλων. Στην παρούσα μελέτη χρησιμοποιήθηκε το σύστημα ανίχνευσης EnVision (Envision, Dako, USA) ή MACH4 Universal HRP-Polymer Detection (Biocare Medical, USA) και πρωτογενή αντισώματα έναντι των EZH2 (Novocastra Laboratories Ltd, UK), SOX2 (R&D Systems, Inc.), Oct4 (Santa Cruz Biotechnology, Inc), H3K4me2 (Cell Signaling Technology, USA) και H3K27me3 (Cell Signaling Technology, USA). Σε κάθε περιστατικό και για κάθε δείκτη εκτιμήθηκε το ποσοστό των καρκινικών κυττάρων που εμφάνιζαν θετική ανοσοχρώση (Labeling Index, LI). Η καταμέτρηση των θετικών κυττάρων πραγματοποιήθηκε σε μεγάλης μεγέθυνσης πεδίο (400X). Η στατιστική ανάλυση έγινε με τη χρήση του SPSS στατιστικού πακέτου (SPSS©, Release 19.0). Τιμές p<0.05 θεωρήθηκαν ως στατιστικά σημαντικές. Αποτελέσματα. Πυρηνική χρώση ανιχνεύθηκε για τα αντισώματα έναντι των EZH2, H3K4me2 και H3K27me3, ενώ αντίθετα βρέθηκε πυρηνική και κυτταροπλασματική έκφραση για τους παράγοντες SOX2 και Oct4. Παρατηρήθηκε ανομοιογενές προφίλ ανοσοθετικότητας στα κύτταρα μελανώματος με σημαντικά αυξημένο ποσοστό καρκινικών κυττάρων με θετική ανοσοχρώση H3K4me2 και H3K27me3 στη διηθητική παρυφή του όγκου. Αντίστοιχη τάση για αυξημένη έκφραση έδειξε και ο μεταγραφικός παράγοντας EZH2, χωρίς όμως η διαφορά να είναι στατιστικά σημαντικά, ενώ παρατηρήθηκε και σε ορισμένες μεμονωμένες περιπτώσεις με τον SOX2. Όσον αφορά τον ΕΖΗ2, βρέθηκε σημαντική αύξηση των επιπέδων του παράγοντα στα κύτταρα μελανώματος σε σχεση με τα σπιλοκύτταρα (p=0.02). H πυρηνική έκφραση SOX2 ήταν σημαντικά υψηλότερη στα κύτταρα μελανώματος σε σχέση με τα κερατινοκύτταρα της βασική στιβάδας (p=0.02), όπως επίσης και στα σπιλοκύτταρα συγκριτικά με τα κερατινοκύτταρα της βασικής (p=0.0016) και της υπερβασικής στιβάδας (p=0.027). Η συσχέτιση της πυρηνικής έκφρασης με διάφορες παραμέτρους των ασθενών έδεξε υψηλότερα επίπεδα SOX2 στα πρωτοπαθή σε σχέση με τα μεταστατικά μελανώματα (p=0.045), στα κύτταρα μελανώματος με πάχος όγκου κατά Breslow <1mm (p=0.023), χωρίς εξέλκωση (p=0.009) και με αριθμό μιτώσεων ≤6 μιτ/mm2 (p=0.016). Τα επίπεδα πυρηνικής έκφρασης Oct4 βρέθηκαν υψηλότερα στα σπιλοκύτταρα σε σχέση με τα κερατινοκύτταρα (p<0.001) αλλά και με τα κύτταρα μελανώματος (p=0.004). Η μελέτη ωστόσο της κυτταροπλασματικής ανοσοθετικότητας έδειξε σημαντική μείωση των επιπέδων Oct στα κύτταρα μελανώματος σε σχέση με τα κερατινοκύτταρα της υπερβασικής στιβάδας (p<0.001), όπως επίσης στα μεταστατικά σε σχέση με τα πρωτοπαθή μελανώματα (p=0.025). Αξιοσημείωτο είναι επίσης ότι το προφίλ έκφρασης του Oct4 βρέθηκε σε ορισμένες περιπτώσεις να αυξάνεται τοπικά στα ενδοθηλιακά κύτταρα αγγείων εντός των μελανωμάτων. Τα μελανώματα με υψηλό επίπεδο διήθησης κατά Clark (IV-V) (p=0.038) ή μεγάλο 251 πάχος όγκου κατά Breslow (>1mm) (p<0.001) εμφάνισαν χαμηλότερο ποσοστό καρκινικών κυττάρων με ανοσοθετικότητα για το αντίσωμα H3K4me2 σε σχέση με τους όγκους με μικρότερο βαθμό διήθησης. Επιπλέον, παρατηρήσαμε ότι οι μεταστατικοί όγκοι είχαν χαμηλότερα ποσοστά θετικής ανοσοχρώσης και για τις δύο επιγενετικές τροποποιήσεις, H3K4me2 και H3K27me3, συγκριτικά με τους πρωτοπαθείς όγκους (p=0.0065 και p=0.027 αντίστοιχα). Τέλος, η ανάλυση της παράλληλης ανοσοϊστοχημικής έκφρασης στα κύτταρα μελανώματος έδειξε θετική συσχέτιση των δύο επιγενετικών τροποποιήσεων (p<0.01), όπως επίσης και μεταξύ του EZH2 και της επιγενετικής τροποποίησης H3K27me3 (p=0.03). Ισχυρή συσχέτιση βρέθηκε παρομοίως μεταξύ των επιπέδων έκφρασης Oct4 και SOX2, τόσο για την πυρηνική όσο και την κυτταροπλασματική εντόπιση (p<0.001 και p<0.001 αντίστοιχα). Συμπεράσματα. Λαμβάνοντας υπόψη τη λειτουργική σημασία των τριών υπό μελέτη μεταγραφικών παραγόντων και του ρόλου των επιγενετικών μηχανισμών στην καρκινογένεση, τα ευρήματα μας εισηγούνται ότι οι ΕΖΗ2, SOX2, Oct4 όπως επίσης και οι επιγενετικές τροποποιήσεις Η3Κ4me3 και H3K27me3 αποτελούν εν δυνάμει δείκτες καρκινικών stem κυττάρων στο κακόηθες μελάνωμα, και ιδιαίτερα στη διηθητική παρυφή του όγκου. Η υπόθεση αυτή πρέπει να διεριευνηθεί περαιτέρω, καθώς θα μπορούσε να αποτελέσει, σε συνδυασμό και με άλλες μελέτες, ένα μικρό βήμα προς τη κατεύθυνση της στοχευμένης αντικαρκινικής θεραπείας του μελανώματος στα πλαίσια της Ιατρικής του μέλλοντος. / Cutaneous malignant melanoma originates from melanocytes and is characterized by constantly growing incidence and mortality rates world-wide. The substantial unresponsiveness of advanced metastatic melanomas to most forms of chemotherapy and radiation indicates an urgent need for more effective agents to overcome chemoresistance. Accumulating evidence strongly suggests the presence and involvement of cancer cells with properties of stem cells (CSCs) in the initiation, progression and metastasis of malignant melanoma. EZH2, SOX2 and Oct4 represent crucial components of the reciprocal regulatory circuit that controls stemness. Genome-wide analyses of chromatin states of embryonic stem and progenitor cells suggest a ‘bivalent’ colocalization of the activating H3K4 methylation and the repressive H3K27me3 in development-associated genes, while the misregulation of histone modifications on specific residues actively contributes to human cancer. PcG proteins and mainly EZH2 are responsible for maintaining the balance of the bivalent chromatin domain through the methylation of H3K27. Recently a number of studies have shown that cancer cells with properties of stem cells at the tumor invasion front might be involved in the development of metastasis. The discovery that the epithelial to mesenchymal transition (EMT) generates cells with properties of stem cells and a more invasive and metastatic phenotype, brings a connection between metastasis and stem-cell state. According to this model, cells with stem cell properties are located predominantly at the invasion front of the tumor and can derive through the acquisition of transient EMT phenotype. In this context, a comparative analysis of the expression profile of putative CSC markers between the invasion front and the inner tumor mass could test this hypothesis in the case of cutaneous melanoma as well. Purpose. Taking these data into account, we performed the current study in order to evaluate the immunohistochemical expression of EZH2, SOX2 and Oct4 as well as H3K4me2 and H3K27me3, which constitute stem cell-like "bivalent"domains, in cutaneous malignant melanoma, investigating besides the potential identification of cancer cells with stem cells properties at the invasion front of the tumor. Materials and methods. Expression of EZH2, SOX2, Oct4, H3K4me2 and H3K27me3 was evaluated in 89 malignant melanoma (MM) lesions, deriving from 79 patients, using immunohistochemistry, on formalin-fixed paraffin-embedded tissue sections. The analyzed cases were accessioned over the time interval 2001-2010 and retrieved from an electronic database maintained by the Department of Pathology of the University General Hospital of Patras (Rion, Greece). The sample consists of 70 primary and 19 metastatic specimens. 14 specimens contained both melanoma cells and nevus cells. Analysis and comparative studies were carried out on the expression of the proteins tested in nevus cells (where existed), melanoma cells, melanoma cells at the invasion front, basal and suprabasal 253 keratinocytes as well. Polymer based technique (Envision, Dako, USA) or MACH4 Universal HRPPolymer Detection (Biocare Medical, USA) and primary antibodies against EZH2 (Novocastra Laboratories Ltd, UK), SOX2 (R&D Systems, Inc.), Oct4 (Santa Cruz Biotechnology, Inc), H3K4me2 (Cell Signaling Technology, USA) and H3K27me3 (Cell Signaling Technology, USA) were used. In each case, the percentage of cells exhibiting positive staining was determined. Cell counts were performed at a 400X magnification. Data were analyzed using the SPSS statistical package (SPSS©, Release 19.0). The level of significance was set at p-value <0.05. Results. The three markers studied, EZH2, H3K4me2 and H3K27me3, were identified in the cell nuclei of melanoma cells, nevus cells and normal epidermal keratinocytes, while SOX2 και Oct4 showed nuclear as well as cytoplastik expression. A specific distribution pattern of H3K4me2 and H3K27me3 was found, as stronger levels were localized at the invasion front of the tumor (p=0.034 and p<0.01 respectively). A similar trend was also observed for EZH2, whithout achieving however statistical significance (p=0.08), and similarly for SOX2 in a few sporadic cases. Significantly increased EZH2 immunohistochemical expression was observed in melanoma cells with respect to nevus cells (p=0.02). Nuclear SOX2 levels were also higher in melanoma cells than basal keratinocytes (p=0.02) and in nevus cells than basal keratinocytes (p=0.0016) and suprabasal keratinocytes (p=0.027). Furthermore LIs in melanoma cells presented significantly higher values in primary with respect to metastatic malignant melanoma lesions (p=0.045) as well as in melanoma cells with low Breslow’s depth (≤1mm) (p=0.023), under the absence of ulceration (p=0.009) and with low (≤6/mm2) mitotic rate (p=0.016). As well as nuclear expression of Oct4 is concerned, it was found increased in nevus cells with compared to keratinocytes (p<0.001) and melanoma cells (p=0.004). Cytoplastic expression of Oct4 followed an opposite trend, with decreasing levels in melanoma cells with respekt to suprabasal keratinocytes (p<0.001) and in metastic compared to to primary melanoma cases (p=0.025). Remarkably occasionally increased Oct4 expression in endothelial cells of the tumor microvasculature in melanoma tissues was observed. Furthermore, H3K4me2 and H3K27me3 levels were lower in metastatic with respect to primary melanoma cases (p=0.0065 and p=0.027 respectively). Advanced melanoma demonstrated significantly lower H3K4 immunohistochemical expression than cases of lowest Clark’s level (I) (p=0.038) or low Breslow’s depth (≤1 mm) (p<0.001). Moreover, EZH2 expression in melanoma cells was higher compared to nevus cells (p=0.02). Finally statistical analysis further revealed a positive correlation in melanoma cells betwenn EZH2 and H3K27me3 (p=0.03), H3K4me2 and H3K27me3 (p<0.01), as well as between Oct4 and SOX2 for both nuclear and cytoplastik expression (p<0.001 and p<0.001 respektively). Conclusions. Our results suggest the possibility that combined immunohistochemical expression of EZH2, SOX2, Oct4, H3K4me2 and H3K27me3 might identify cancer cells with potential stem cell properties, particularly at the invasion front of this malignancy. This hypothesis should be further investigated, as many of the epigenetic changes are reversible via pharmacologic manipulations and new CSC-directed therapies, overpassing the resistance of advanced melanoma, may be developed.

Hodková, Gabriela - Metabolic Effects Of Hyperthermic Isolated Limb Perfusion (HILP) in Malignant Melanoma Patients First Faculty of Medicine, Charles University in Prague, Praha 2, Kateřinská 32 Head of the work: Doc. MUDr. Michal Semrád, CSc. Supervisor - consultant: MUDr. Miroslav Špaček, Ph. D. The aim of the study is to assess the metabolic consequences of mechanical isolation and hyperthermic cytostatic perfusion in a limb affected by malignant process. The theoretical part refers to a topic of malignant melanoma, its clinical evaluation and treatment. Methods based on conservative and surgical treatment are described. The isolated hyperthermic cytostatic limb perfusion is a consecutive local treatment indicated in cases of recurrent malignant lesions following surgical resection, when next surgery is impossible. In the practical part, the laboratory samples and clinical data were recorded in patients who had undergone hyperthermic cytostatic limb perfusion in the 2nd Surgical Department of The General Teaching Hospital and First Faculty of Medicine, Charles University Prague. The affected limb was flushed with a warm oxygenated blood containing cytostatic drugs using an extracorporeal circuit apparatus. Selected arterial blood gas, metabolic and hematologic parameters were studied intra and...

This diploma thesis dealt with the comparison of different methods of amination of polycaprolcatone in terms of their effectiveness for tissue engineering. A polycaprolactone membrane was prepared by an electrospinning method, which was subsequently modified by three different amination methods. Selected types of amination were plasma polymerization with cyclopropylamine monomer, hybrid modification using plasma and N-allylmethylamine monomer, and chemical amination using aminolysis with diaminohexane. Surface amines were subsequently characterized by electron scanning microscopy (SEM), X-ray photoelectron spectroscopy (XPS), attenuated total reflection infrared spectroscopy (ATR-FTIR) and contact angle measurement. A cell culture designated A375 (Human malignant melanoma cell lines A375® CRL-1619®) was cultured on the thus modified membranes, which was analyzed by optical microscopy, and a proliferation assay was performed by determining the relative amount of ATP. Based on the experimental results, we can confirm the success for all types of amination. In terms of efficiency for tissue engineering, the amination method by plasma polymerization with the monomer cyclopropylamine has the most satisfactory results.

Major capside protein of Polyomaviridae family viruses is able to selfassemble into virus-like particle (VLP) even without the presence of minor proteins, bind exogenous DNA non-specifically and recognise the receptor on the cellular surface. These characteristics determine its use as vector in gene therapy or immunotherapy. It was discovered before that MPyV VLPs significantly stimulate immune system and have strong adjuvant effect. Chimeric VLP derived from mouse polyomavirus carrying exogenous antigene or epitop is supposed to elicit specifically targeted immune response after immunisation. The main obstacle is choice of immunogene that is strong enough to cause adequate immune response. The goal of this thesis was to construct chimeric particles carrying epitop of malignant melanoma, one of the most immunogenic tumours, on their surface, using methods of genetic engineering. For future research of particle's immunogenic properties three types of particles were developed - particles with human and mouse melanoma epitopes, respectively and control particles with ovalbumine epitop. For the purpose of production of chimeric protein was used baculovirus expression system. It was verified then, with the use of electron microscopy, that introduction of tumour antigen into one of surface loops of VP1...