京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19274号 / 医博第4038号 / 新制||医||1011(附属図書館) / 32276 / 京都大学大学院医学研究科医学専攻 / (主査)教授 渡邉 大, 教授 吉村 長久, 教授 影山 龍一郎 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Zugl.: Wien, Univ. für Bodenkultur, Diss., 2005

Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2017-11-28T18:15:11Z No. of bitstreams: 1 Tese-MC.pdf: 2529108 bytes, checksum: d7557f03bd9245db7376252ca33303d0 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-12-04T12:45:28Z (GMT) No. of bitstreams: 1 Tese-MC.pdf: 2529108 bytes, checksum: d7557f03bd9245db7376252ca33303d0 (MD5) / Made available in DSpace on 2017-12-04T12:47:32Z (GMT). No. of bitstreams: 1 Tese-MC.pdf: 2529108 bytes, checksum: d7557f03bd9245db7376252ca33303d0 (MD5) Previous issue date: 2017-07-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction-objective: Cystic fibrosis is the most common genetic disease in the Caucasian population. The reduction in life expectancy is due to progressive lung disease, characterized by severe changes in the pulmonary structure, more precisely, bronchiectasis and air catabolization. Computed tomography of the chest is considered the most sensitive method to monitor lung disease in cystic fibrosis. The main disadvantage is the patient's exposure to radiation. Magnetic resonance imaging of the chest, a radiation-free technique, has been introduced as an alternative to computed tomography. Magnetic resonance has been compared to computed tomography in several studies using various sequences, but none have used the combined sensing, parallel imaging, and golden-angle radial sampling technique. The aim of this study was to evaluate the combined golden-angle radial technique of magnetic resonance imaging in patients with cystic fibrosis in relation to conventional magnetic resonance imaging and computed tomography of the chest. Cystic fibrosis has been compared to computed tomography in several studies using various sequences, but none have used the combined sensing, parallel imaging, and golden-angle radial sampling technique. The aim of this study was to evaluate the combined radial-angle golden-angle technique of magnetic resonance imaging in patients with cystic fibrosis in relation to conventional magnetic resonance imaging and computed tomography of the chest. Methods: Computed tomography and magnetic resonance of the chest were performed in 29 patients with cystic fibrosis who were followed at the pediatric pulmonology outpatient clinic of the S?o Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul. The Cartesian K-space sampling and, after the free-breathing magnetic resonance techniques, using the Golden_Angle Radial Sparse Parallel technique. Magnetic resonance imaging and computed tomography of the chest were evaluated by two independent observers using the Helbich-Bhalla score. Intraclass correlation coefficient and Bland-Altman analysis were used to assess agreement and reproducibility in the Helbich-Bhalla severity score. No patient was sedated or used contrast medium. Results: Intraclass correlation coefficients and the Bland-Altman graphical model between the Helbich-Bhalla scores and the evaluated methods, computed tomography, magnetic resonance and free breating magnetic resonance , showed very strong correlations in all comparisons of the total scores (ICCCT -RM = 97%, ICCCT-FB-RM = 96% and ICCCT-FB-RM = 99%). The association of the Helbich-Bhalla score of both computed tomography and magnetic resonance with pulmonary function tests were significant, mainly in relation to the severity of bronchiectasis and thickening of the bronchial walls. Conclusion: This study demonstrated that the new technique of free-breathing magnetic resonance and combination of compressed sensing, parallel imaging and radial golden-angle sampling, showed a good concordance with computed tomography in the assessment of pulmonary alterations in cystic fibrosis. The combined golden-angle radial technique can be used in clinical practice to monitor fibrocystic lung disease, and demonstrates particular value for patients who can not hold their breath during the examination. / Introdu??o-objetivo: Fibrose c?stica ? a doen?a gen?tica mais comum na popula??o caucasiana. A redu??o da expectativa de vida ? devido ? doen?a pulmonar progressiva, caracterizada por mudan?as severas na estrutura pulmonar, mais precisamente, bronquiectasias e alcaponamento de ar. A tomografia computadorizada de t?rax ? considerada o m?todo mais sens?vel para monitorar a doen?a pulmonar na fibrose c?stica. A principal desvantagem ? a exposi??o do paciente ? radia??o. A resson?ncia magn?tica de t?rax, t?cnica livre de radia??o, tem sido introduzida como uma alternativa ? tomografia computadorizada. A resson?ncia magn?tica tem sido comparada ? tomografia computadorizada em v?rios estudos usando v?rias sequ?ncias, mas, nenhuma utilizou a t?cnica de sensoriamento comprimido, imagem paralela e amostragem golden-angle radial combinada. O objetivo deste estudo foi avaliar a t?cnica de golden-angle radial combinada de resson?ncia magn?tica de t?rax em pacientes com fibrose c?stica em rela??o ? tomografia computadorizada e a resson?ncia magn?tica convencional de t?rax. M?todos: Foram realizados exames de tomografia computadorizada e resson?ncia magn?tica de t?rax em 29 pacientes com fibrose c?stica que eram acompanhados no ambulat?rio de pneumologia pedi?trica do Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. Os exames, foram realizados utilizando, primeiro, a amostragem de K-espa?o cartesiano e, ap?s, as t?cnicas de resson?ncia magn?tica com respira??o livre, utilizando a t?cnica Golden_Angle Radial Sparse Parallel. As imagens de resson?ncia magn?tica e tomografia computadorizada de t?rax foram avaliadas por dois observadores independentes utilizando o escore de Helbich-Bhalla. Coeficiente de correla??o intraclasse e an?lise de Bland-Altman foram usados para avaliar a concord?ncia e a reprodutibilidade no escore de severidade de Helbich-Bhalla. Nenhum paciente foi sedado ou usado meio de contraste. Resultados: Os coeficientes de correla??o intraclasse e o modelo gr?fico de Bland-Altman entre os escores de Helbich-Bhalla e os m?todos avaliados, tomografia computadorizada, resson?ncia magn?tica e resson?ncia magn?tica de respira??o livre, evidenciaram, em todas as compara??es dos escores totais, correla??es muito fortes (ICCCT-RM = 97%; ICCCT-FB-RM = 96% e ICCCT- FB-RM=99%). A associa??o do escore de Helbich-Bhalla, tanto da tomografia computadorizada como das imagens de resson?ncia magn?tica, com os testes de fun??o pulmonar foram significativas, principalmente, em rela??o ? severidade das bronquiectasias e espessamento das paredes br?nquicas. Conclus?o: Este estudo demonstrou que a nova t?cnica de resson?ncia magn?tica com respira??o livre e combina??o de sensoriamento comprimido, imagem paralela e amostragem golden-angle radial, mostrou uma boa concord?ncia com a tomografia computadorizada na avalia??o das altera??es pulmonares na fibrose c?stica. A t?cnica de golden-angle radial combinada pode ser utilizada na pr?tica cl?nica para acompanhamento de doen?a pulmonar fibroc?stica, e demonstra particular valor para os pacientes que n?o conseguem suspender a respira??o durante o exame.

Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2017-10-09T17:27:41Z No. of bitstreams: 1 Disserta??o Cristina Manera.pdf: 1861857 bytes, checksum: 55d02acda533fde326a0ac0a092db0ed (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-10-10T13:01:18Z (GMT) No. of bitstreams: 1 Disserta??o Cristina Manera.pdf: 1861857 bytes, checksum: 55d02acda533fde326a0ac0a092db0ed (MD5) / Made available in DSpace on 2017-10-10T13:03:42Z (GMT). No. of bitstreams: 1 Disserta??o Cristina Manera.pdf: 1861857 bytes, checksum: 55d02acda533fde326a0ac0a092db0ed (MD5) Previous issue date: 2016-08-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Objective: To evaluate the technical quality of low-dose computed tomography without contrast and without the use of anesthesia in the diagnosis of lung diseases in children Materials and Methods: It reviewed 86 chest CT scans performed due to clinical indications of acute or chronic inflammatory lung diseases, cancer or congenital malformations in patients from 1 to 18 years of age who were subjected to a low dose of radiation dose bellow the dose recommended by the ALARA and using interactive image reconstruction filters performed without the use of anesthesia or sedation. The exams will be evaluated by two reviewers and age, gender, the radiation dose, image quality and image noise will be assessed. Image analysis will be quantitative. The variables will be the outside Roi diameter of trachea divided by the Roi of trachea, the percentage of axial images with motion artifacts, and identification of the tracheal, the main and segmental bronchi? 20 segments, the main and lobar pulmonary arteries and the ascending aorta artery. The presence of pleural effusion and the identification of paratracheal and subcarinal lymph node chains will also be assessed. Data will be analyzed by for mean, standard deviation and the correlation of the data will be analyzed by tests of Pearson and Spearman, considering significant a p<0.05. Results: The average age of the patients was 5.5 years. LSD as well with the LID, LSE and LIE were displayed in all tests. The middle lobe in almost all (n = 85) apical segment and the medial basilar segment were seen in almost all of the scans (n = 84). The aorta and pulmonary arteries were distinguished on all tomography examinations. The percentage of images with motion artifact introduced an average of 0.8 with IC: 0-2.9 (P25-P75) with p < 0.001. The noise of the image showed an average of 45.5 with 12.4DP. How much ROI the trachea and main bronchi were seen in all the CT scans. The image quality was considered excellent and blurring that didn't compromise the evaluation in almost all the tests. The DLP in mGy dose presented an average of 27.5 with DP ? 11.1. Conclusion: The dose used was significantly lower than the one used in children and allowed the visualization of lung structures in almost all patients, enabling the final diagnosis of cystic fibrosis, bronchiolitis and congenital malformations without difficulty of diagnosis by image artifact / Objetivo: Avaliar a qualidade t?cnica da Tomografia Computadorizada de baixa dose sem contraste e sem anestesia no diagn?stico de doen?as pulmonares em crian?as e adolescentes. Materiais e m?todos: Estudo descritivo retrospectivo em que foram analisadas 86 Tomografias Computadorizadas de t?rax em pacientes pedi?tricos e adolescentes. Os exames foram realizados por indica??o clinica de suspeita de patologias pulmonares com baixa dose de radia??o e com filtro de reconstru??o interativa da imagem sem uso de anestesia ou seda??o. Estes exames foram analisados por dois avaliadores independentes e as vari?veis medidas foram idade, o sexo, a dose de radia??o, a qualidade da imagem, o ru?do de imagem, o ROI externo dividido pelo um ROI na traqueia, identifica??o da traqueia, dos br?nquios principais e segmentares-20 segmentos , das art?rias pulmonares principais e lobares, aorta ascendente, presen?a de derrame pleural, cadeias linfonodais paratraqueais e subcarinal Todas as imagens tamb?m foram medidas quanto a artefato de movimento e foram descritos em porcentagem comparando com o total de imagens. Os dados foram analisados com m?dia, desvio padr?o. Para a an?lise da correla??o foram usados os ?ndices de Pearson e de Spearman considerando um p < 0,01 como significativo. Resultados: A visualiza??o da traqueia e dos br?nquios principais foi poss?vel em 100% dos exames. Os linfonodos paratraqueais e os subcarinais foram visto em todos os exames na bronquiolite e na malforma??o cong?nita. Os lobos superior, m?dio e inferior direito foram visualizados na totalidade das Tomografias Computadorizadas com baixa dose de radia??o nos pacientes com fibrose c?stica e bronquiolite. Na malforma??o cong?nita os lobos superior e inferior direitos foram visualizados em todos exames. Os lobos superior e inferior esquerdos foram identificados em todas as an?lises por TC. Os segmentos apicais foram vistos em 100% das imagens na FC, BO e malforma??o cong?nita.O segmento basilar apical foi visto em todas as imagens na FC. As art?rias aorta e pulmonar foram distinguidas no total dos exames Em nenhum exame houve comprometimento da qualidade da imagem. Na malforma??o cong?nita a percentagem de imagem com excelente qualidade e borramento leve sem comprometimento da avalia??o foram encontradas em todos os exames tomogr?ficos. A porcentagem de artefato de imagem foi de 0,3% na fibrose c?stica, 1,3 % na bronquiolite e 1,1% na malforma??o cong?nita. Conclus?o A dose utilizada foi significativamente menor do que a utilizada em crian?as e permitiu a visualiza??o das estruturas pulmonares em quase todos os pacientes possibilitando o diagn?stico final da fibrose c?stica, da bronquiolite e das malforma??es cong?nitas sem dificuldade de diagn?stico por artefato de imagem.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-14T23:53:02Z No. of bitstreams: 1 DeniseMariaDeLimaESilva_DISSERT.pdf: 1159056 bytes, checksum: 10cee662ae220c63b1bf31c52cb4684b (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-16T23:11:31Z (GMT) No. of bitstreams: 1 DeniseMariaDeLimaESilva_DISSERT.pdf: 1159056 bytes, checksum: 10cee662ae220c63b1bf31c52cb4684b (MD5) / Made available in DSpace on 2017-03-16T23:11:31Z (GMT). No. of bitstreams: 1 DeniseMariaDeLimaESilva_DISSERT.pdf: 1159056 bytes, checksum: 10cee662ae220c63b1bf31c52cb4684b (MD5) Previous issue date: 2016-12-12 / A astaxantina ? encontrada naturalmente em res?duos de camar?o e pode ser extra?da de diversas formas, dentre elas tem-se a extra??o com ?leo vegetal, o qual contribui para a estabilidade, retardando a oxida??o. O ?leo de soja por sua vez apresenta como vantagens a excelente otimiza??o de extra??o e o baixo custo. Objetivou-se com esse estudo, avaliar as caracter?sticas f?sicas e f?sico-qu?micas e a capacidade antioxidante de ?leos vegetais pigmentados, oriundos da extra??o da astaxantina a partir do res?duo de camar?o (Litopenaeus vannamei). Os ?leos pigmentados do res?duo de camar?o (OR) e da farinha do res?duo de camar?o (OF) obtidos foram avaliados quanto ao teor de astaxantina, caracter?sticas f?sicas e f?sico-qu?micas e capacidade antioxidante. As amostras de OR e OF apresentaram um teor de astaxantina respectivamente de 70,9 e 264,7 ?g/g, sendo a desidrata??o a respons?vel por esse aumento de 3,7 vezes. Do mesmo modo, seu poder antioxidante est? diretamente associado com o teor de astaxantina. No teste da Capacidade de Absor??o de Radicais de Oxig?nio (ORAC), OR e OF exibiram uma atividade antioxidante de 0,4957 e 0,4840 ?mol eq trolox/g, respectivamente. Entretanto, algumas carater?sticas f?sicas e f?sico-qu?micas de OF apresentaram altera??es. Diante do exposto, os ?leos pigmentados oriundo dos res?duos de camar?o apresentam um significativo potencial para uso em alimentos como um antioxidante natural devido ao poder antioxidante, e ao baixo custo de obten??o. / Astaxanthin is found naturally in shrimp residues and can be extracted in varying ways. The extraction with vegetable oil contributes to stability from this carotenoid, retarding its oxidation. The advantages of the soybean oil are excellent extraction optimization and low cost.The objective of this study was to evaluate the physical and physical-chemical characteristics and the antioxidant capacity of the pigmented oils obtained from the extraction of astaxanthin from the shrimp waste (litopenaeus vannamei). The obtained pigmented oils of the shrimp waste (OW) and of the shrimp waste flour (OF) were evaluated for astaxanthin content, physical and physico-chemical characteristics and antioxidant capacity. The samples of OW and OF showed an astaxanthin content of 70.9 and 264.7 ?g / g, respectively, where the decrease in moisture was responsible for this increase of 3.7 times. Likewise, its antioxidant power is directly associated with the astaxanthin contente. In the Oxygen Radical Absorption Capacity (ORAC) test, OW and OF exhibited an antioxidant activity of 0.4957 and 0.4840 ?mol eq trolox / g, respectively. However, some physical and physico-chemical characteristics of OF presented changes. Therefore, the pigmented oils from shrimp waste present a significant potential for the use in food as a natural antioxidant due to its antioxidant power, as well as the low price to obtain it.

No description available.

Es wird die Entwicklung der Röntgenspektralanalyse und die Entdeckung der Röntgenfluoreszenzanalyse durch Georg von Hevesy und Richard Glocker mit ihren Assistenten in Freiburg i. Br. und in Stuttgart 1928 beschrieben. / The development of the x-ray chemical analysis and the discovery of the x-ray fluorescence analysis by Georg de Hevesy and Richard Glocker with their assistants in Freiburg i. Br. and in Stuttgard 1928 is described.

Made available in DSpace on 2015-04-14T13:33:02Z (GMT). No. of bitstreams: 1 446507.pdf: 436565 bytes, checksum: 4c823a43f4c8a59fe78a718fa8291c1a (MD5) Previous issue date: 2013-03-04 / Aims: The aims of the study were to assess the necessity of lateral chest X-rays in newborns on mechanical ventilation in a neonatal intensive care unit, and to estimate the dose of radiation exposure during such exams. Methods: Cross-sectional study performed at the neonatal intensive care unit of a city hospital in Porto Alegre (Brazil). Patients were followed on daily basis, and all chest x-rays were registered while they were on mechanical ventilation, including the first day postextubation. Two experienced neonatologists were included as external observers, to assess, independently, the necessity of having performed each of the lateral views of chest x-rays all newborns had. Results: Sixty five newborns were included. There were 426 chest x-rays requisitions during the study period. Of these, 374 were antero-posterior plus lateral views and 52 were only antero-posterior views. The index of chest x-rays requisitions was of 0,8 x-rays per newborn per day, corresponding to 0,7 antero-posterior and lateral views per newborn per day and 0,1 antero-posterior x-rays per newborn per day. The use of the antero-posterior view associated with the lateral view compared to only the antero-posterior view increases three-fold the exposition of the newborn to ionizing radiation. Conclusion: We noticed the lack of well-defined guidelines on the use of the lateral view of chest x-rays in neonatal intensive care units. Many institutions, including ours, are performing chest-x-rays lateral views at a rate greater than needed. This behavior leads to an elevated exposition of radiation dose to the newborns, potentially leading to future consequences. / Objetivos: Os objetivos do presente estudo s?o avaliar a necessidade das radiografias de t?rax em perfil dos rec?m-nascidos submetidos ? ventila??o mec?nica de uma Unidade de Tratamento Intensivo Neonatal, bem como determinar a dose de exposi??o ? radia??o durante esses exames.M?todos: Estudo prospectivo, transversal, conduzido na Unidade de Tratamento Intensivo Neonatal de um hospital em Porto Alegre (Brasil). O estudo foi realizado entre 01 de dezembro de 2011 e 01 de junho de 2012. O paciente foi acompanhado diariamente, anotando-se todas as radiografias de t?rax realizadas durante o tempo em que permaneceu em ventila??o mec?nica at? o 1? dia p?s-extuba??o (inclusive). Participaram, como avaliadores externos, dois neonatologistas com longa experi?ncia na ?rea. Ambos avaliaram, de forma independente, a necessidade ou n?o de se realizar a radiografia de t?rax na posi??o em perfil para cada exame solicitado. Resultados: Sessenta e cinco crian?as foram inclu?das. Houve 426 requisi??es de radiografias de t?rax durante o per?odo do estudo. Dessas, 374 foram proje??es ?ntero-posteriores e perfil, enquanto que, em 52, foi realizado somente o ?ntero-posterior. O ?ndice de solicita??es de radiografias de t?rax equivaleu a 0,8 radiografias por crian?a por dia de interna??o, correspondendo a 0,7 radiografias ?ntero-posterior e perfil por crian?a por dia e 0,1 radiografia ?ntero-posterior por crian?a por dia. O fato de se realizar um exame de t?rax em ?ntero-posterior e perfil, comparado quando realizado apenas o ?ntero-posterior, aumenta em mais de 3 vezes a exposi??o do rec?m- nascido ? radia??o ionizante. Conclus?o: Observamos que n?o existem diretrizes bem definidas e claras sobre a realiza??o da radiografia de t?rax em perfil nas Unidades de Tratamento Intensivo Neonatais. Muitas institui??es, assim como a nossa, est?o realizando proje??es em perfil em uma frequ?ncia muito maior do que a necess?ria. Esse comportamento resulta em uma exposi??o de dose elevada para esses rec?m-nascidos, podendo gerar consequ?ncias futuras.

Es wird die Entwicklung der Röntgenspektralanalyse und die Entdeckung der Röntgenfluoreszenzanalyse durch Georg von Hevesy und Richard Glocker mit ihren Assistenten in Freiburg i. Br. und in Stuttgart 1928 beschrieben. / The development of the x-ray chemical analysis and the discovery of the x-ray fluorescence analysis by Georg de Hevesy and Richard Glocker with their assistants in Freiburg i. Br. and in Stuttgard 1928 is described.