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41	Farmacogenética do tratamento do hormônio de crescimento em pacientes com síndrome de Turner / Growth hormone pharmacogenetics in patients with Turner syndrome Adriana Farrant Braz 06 September 2013 (has links) A resposta individual ao tratamento com hormônio de crescimento recombinante humano (rhGH) na síndrome de Turner (ST) é muito variável. A falta de individualização da dose pode justificar a variabilidade de respostas e os resultados insatisfatórios de algumas pacientes mesmo quando diagnosticadas e tratadas em condições ideais. Como a resposta ao tratamento com rhGH reflete fatores genéticos e não genéticos, o objetivo do presente estudo é avaliar a influência de fatores genéticos no tratamento com rhGH das portadoras de ST. Foram estudadas 112 pacientes com ST, em tratamento ou que interromperam a terapia, após atingir a altura final. O DNA genômico de todas as pacientes foi obtido para estudo de três polimorfismos em genes envolvidos na ação do GH: a presença ou ausência do éxon 3 do receptor do GH (GHR), VNTR presente na região promotora do gene do fator de crescimento insulina-símile-1(IGF1) e polimorfismo de único nucleotídeo (SNP) presente na região promotora do gene da Proteína 3 de Ligação a Fator de Crescimento Insulina-símile (IGFBP3). Os achados moleculares foram correlacionados com a velocidade de crescimento no primeiro ano de tratamento (n=112) e com altura adulta (n=65)) após uso de rhGH por meio de análises de regressão linear simples e múltipla, ajustadas para as demais variáveis clínicas relacionadas à resposta ao tratamento com rhGH em ST. Dois desses polimorfismos - a presença (GHR-fl) ou ausência (GHR-d3) do éxon 3 do GHR e o polimorfismo - 202 A/C IGFBP-3- influenciaram de forma independente e interativa a capacidade de resposta ao tratamento com rhGH em pacientes com ST; e o VNTR de repetições (CA)n da região promotora do IGF1 não demonstrou influência sobre nenhum dos parâmetros analisados. Pacientes carreadoras de, pelo menos, um alelo GHR-d3 apresentaram melhor velocidade de crescimento e maior altura final após tratamento com rhGH do que as homozigotas para o alelo GHR-fl. Similarmente, as carreadoras de, pelo menos, um alelo -202 A-IGFBP3 apresentaram melhor velocidade de crescimento e maior altura final após tratamento com rhGH, além de maiores concentrações séricas de IGFBP-3, do que as homozigotas para o alelo -202 CIGFBP3. Finalmente, a análise conjunta dos genótipos GHR-éxon 3 e -202 A/C IGFBP3 mostrou uma clara influência epistática, parcialmente aditiva, desses dois polimorfismos comuns na altura adulta de pacientes com ST tratadas com rhGH (efeito isolado do GHR-éxon 3, R2 = 0,27; efeito isolado do -202 A/C IGFBP3, R2 = 0,24; influência combinada desses polimorfismos, R2 = 0,37). Em conjunto com as variáveis clinicas, altura ao início do tratamento (p<0,001) e idade cronológica ao início da puberdade (p<0,001), estes dois polimorfismos são capazes de predizer 61% da variabilidade da altura adulta, após uso de rhGH. Embora estudos de validação sejam ainda necessários, acredita-se que as informações geradas por este e outros estudos - direcionados a um melhor entendimento das bases moleculares envolvidas na capacidade de resposta ao tratamento com rhGH - possam servir no futuro como importante ferramenta de individualização do tratamento com rhGH / Individual response to treatment with recombinant human growth hormone (rhGH) in Turner syndrome (TS) is very variable. The lack of individualization of rhGH dosing may explain the variability of response and the unsatisfactory results for some patients even when diagnosed and treated in ideal conditions. As the response to treatment with rhGH reflects genetic and nongenetic factors, the objective of this study is to evaluate the influence of genetic factors on rhGH treatment of patients with TS. We studied 112 patients with TS in rhGH therapy or who have discontinued therapy after adult height. Genomic DNA from all patients was obtained for the study of three polymorphisms in genes involved in GH action: the presence or absence of éxon 3 of the GH receptor (GHR), VNTR in the promoter region of the gene for insulin-like growth factor- 1 (IGF1) and a single nucleotide polymorphism (SNP) in the promoter region of the gene insulin-like growth factor-binding protein 3 (IGFBP3). Molecular findings were correlated with the first-year growth velocity (n = 112) and adult height (n = 65)) after rhGH therapy using simple and multiple linear regressions analysis adjusting for other clinical variables related to the response to rhGH treatment on TS. Two of these polymorphisms - the presence (GHR-fl) or absence (GHR-d3) of the GHR éxon 3 polymorphism and -202 A / C IGFBP-3 independently and interactively influenced the response to rhGH treatment in patients with TS, whereas the VNTR in the promoter region of the gene for IGF1 showed no influence on any of the parameters analyzed. Patients carrying at least one d3-GHR allele have better first-year growth velocity and greater adult height after rhGH treatment than those homozygous for GHR-fl allele. Similarly, the carriers of at least one -202 A-IGFBP3 allele showed better first-year growth velocity and greater adult height after rhGH treatment, besides higher serum IGFBP-3 levels, than those homozygous for -202 C-IGFBP3 allele. Finally, the combined analysis of GHR-éxon 3 and -202 A / C IGFBP3 genotypes have demonstrated a clear epistatic influence, partially additive, of these two common polymorphisms on adult height of patients with TS treated with rhGH (isolated effect of GHR-éxon 3, R2 = 0.27; isolated effect of the -202 A / C IGFBP3, R2 = 0.24; combined influence of these polymorphisms, R2 = 0.37). In conjunction with the clinical variables, baseline height (SDS) (p <0.001) and chronological age at onset of puberty (p <0.001), these two polymorphisms are able to predict 61% of the variability in adult height after rhGH therapy. Although validation studies are still needed, we believe that the information brought by this and other studies whose efforts are to understand the molecular basis involved in responsiveness to rhGH treatment can serve as an important tool in the future individualization of treatment with rhGH Farmacogenética Medicina individualizada Polimorfismo genético/efeitos de drogas Receptores da somatotropina/genética Síndrome de Turner Growth hormone Individualized medicine Insulin-like growth factor I Pharmacogenetics Polymorphism genetic Receptors somatomedin Turner syndrome
42	Ambivalent Ambiguity? : A study of how women with 'atypical' sex development make sense of female embodiment / Ambivalent tvetydighet? : En studie av hur kvinnor med ”otypisk” könsutveckling skapar mening kring kvinnlig kroppslighet Guntram, Lisa January 2014 (has links) Against a backdrop of feminist and social scientific research on sex, female embodiment, and normality this thesis aims to discern how young women, who in adolescence have learned that their bodies are developing in ways considered ‘atypical’ for the female sex, make sense of their bodies and their situation. In focus are the ways in which the women make sense of and negotiate female embodiment; how they, particularly in stories about their interactions with others, position their embodied selves; and how norms and beliefs about sexed embodiment, heterosexual practice, and in/fertility are strengthened and challenged in the interviewees’ sense-making. The data comprise 23 in-depth interviews with women who in adolescence have learned that they do not have a uterus and a vagina, or who have learned that they do not have two X chromosomes and have no, or non-functioning, ovaries. Through narrative and thematic analysis the thesis shows how the women’s sense-making can be obstructed by norms about female embodiment, heterosexual practice, and in/fertility, expressed through medical terminology and practice and in interaction with family, friends, and peers, as described by the interviewees. Concomitantly, as the thesis demonstrates, medical terminology can be experienced and function as a resource in the women’s sense-making. Diagnostic categories enable them to put the specificities of sex development into words and raise awareness about bodily variation. Furthermore, in their stories about others’ reactions to their bodies and about their experience and management of certain medical treatments, the women question norms about female embodiment, heterosexual practice, and in/fertility that were previously taken for granted. The complexity of the women’s sense-making is demonstrated through the ways in which the interviewees, on the one hand, align with norms about female embodiment, heterosexual practice, and in/fertility, and in which they, on the other hand, succeed in challenging the same. In this ‘juggling’ of reinforcement and resistance, the thesis argues, the women are found to expand rather than dismiss beliefs about female embodiment. Thus, the thesis contributes with deepened knowledge about what it can be like to live with these specific conditions and with problematizations of how norms about female embodiment can be enacted and questioned. / Mot bakgrund av feministisk och samhällsvetenskaplig forskning kring kön, kvinnlig kroppslighet och normalitet syftar avhandlingen till att undersöka hur unga kvinnor, som i tonåren fått reda på att deras kropp utvecklas på ett sätt som anses ”otypiskt” för det kvinnliga könet söker förstå och skapa mening kring sin kropp och situation. Framförallt undersöks dessa kvinnors meningsskapande, hur de i sina berättelser positionerar sig i relation till andra, och hur normer och föreställningar om kvinnlig kroppslighet, heterosexuell praktik och in/fertilitet förstås, förhandlas, stärks och ifrågasätts i berättelserna. Materialet som undersöks utgörs av 23 djupintervjuer med kvinnor som i tonåren fått reda på att de antingen inte har någon livmoder och vagina eller att de inte har två X kromosomer och inga eller icke-fungerade äggstockar. Genom narrativa och tematiska analyser visar avhandlingen hur kvinnornas meningskapande formas av normer kring kvinnlig kroppslighet, heterosexuell praktik och in/fertilitet, då de uttrycks i kvinnornas berättelser om sin situation i möten med andra och i relation till medicinsk praktik. Samtidigt, visar avhandlingen, kan medicinsk terminologi, specifikt diagnoser, och praktik utgöra resurser i kvinnornas meningsskapande som möjliggör för dem att sätta ord på och sprida kunskap om kroppslig variation. I kvinnornas berättelser om andras reaktioner på deras kroppar och om deras erfarenhet och hantering av specifika medicinska behandlingar utmanas vidare normer som kvinnorna tidigare har tagit för givet. Genom analysen framträder således komplexiteten i kvinnornas meningskapande då de å ena sidan anammar förgivettagna normer om kvinnlig kroppslighet, heterosexuell praktik och infertilitet och å andra sidan utmanar de samma. I detta ”jonglerande” av anpassning till normer och motstånd mot desammasyns kvinnorna expandera snarare än avfärda föreställningar om kvinnlig kroppslighet. Avhandlingen fördjupar därmed kunskapen om hur det kan vara att leva med dess specifika tillstånd och till att problematisera hur normer om kvinnlig kroppslighet kan ta sig uttryck och ifrågasättas. Sex sex development ‘atypical’ sex development female embodiment adolescence women Sweden uterine and vaginal agenesis Turner syndrome intersex DSD qualitative methodologies sense-making narratives norms normality heteronormativity resistance relations sexual practice diagnosis treatment critique Kön könsutveckling kvinnlig kroppslighet ”otypisk” könsutveckling normalitet tonår kvinnor Sverige MRKH syndrom uterus och vaginal agenesi Turner syndrom intersex DSD meningskapande relationer kvalitativ metod narrativ normalitet heteronormativitet sexuell praktik normer ifrågasättande diagnos behandling kritik
43	Jesus Christ’s humanity in the contexts of the pre-fall and post-fall natures of humanity: a comparative and critical evaluative study of the views of Jack Sequeira, Millard J. Erickson and Norman R. Gulley Mwale, Emanuel 12 1900 (has links) Bibliography: leaves 653-669 / Before God created human beings, He devised a plan to save them in case they sinned. In this plan, the second Person of the Godhead would become human. Thus, the incarnation of the second Person of the Godhead was solely for the purpose of saving fallen, sinful human beings. There would have been no incarnation if human beings had not sinned. Thus, the nature of the mission that necessitated the incarnation determined what kind of human nature Jesus was to assume. It was sin that necessitated the incarnation – sin as a tendency and sin as an act of disobedience. In His incarnational life and later through His death on Calvary’s cross, Jesus needed to deal with this dual problem of sin. In order for Him to achieve this, He needed to identify Himself with the fallen humanity in such a way that He would qualify to be the substitute for the fallen humanity. In His role as fallen humanity’s substitute, He would die vicariously and at the same time have sin as a tendency rendered impotent. Jesus needed to assume a human nature that would qualify Him to be an understanding and sympathetic High Priest. He needed to assume a nature that would qualify Him to be an example in overcoming temptation and suffering. Thus, in this study, after comparing and critically evaluating the Christological views of Jack Sequeira, Millard J. Erickson and Norman R. Gulley, I propose that Jesus assumed a unique post-fall (postlapsarian) human nature. He assumed the very nature that all human beings since humankind’s fall have, with its tendency or leaning towards sin. However, unlike other human beings, who are sinners by nature and need a saviour, Jesus was not a sinner. I contend that Jesus was unique because, first and foremost, He was conceived in Mary’s womb by the power of the Holy Spirit and was filled with the Holy Spirit throughout His earthly life. Second; He was the God-Man; and third, He lived a sinless life. This study contributes to literature on Christology, and uniquely to Christological dialogue between Evangelical and Seventh-day Adventist theologians. / Philosophy, Practical and Systematic Theology / D. Phil. (Systematic Theology) Adoptionism Alleles Anhypostatic Christology Anthropotokos Alternative Christology Apollinarianism Apthartodocetism Arianism Augustinian model Autosomal chromosomes Autosomal inheritance Born-again Christology Chalcedonian creed Christology from above Christotokos Chromosomes Chromosomal abnormalities Cloning Co-dominance Communicatio idiomatum Complementary base pairing Cri-du-chat syndrome Deoxyribonucleic acid (DNA) Diploid cell Docetism Dominant gene Down syndrome Dynamic incarnation Dynamic monarchianism Eastern Orthodox Christology Ebionitism Embryogenesis Eutychianism Evangelical Christology Existential Christology Functional Christology Genes Gene mutation Gene expression Genome Genotype Gnosticism Hamartiology Haploid cell Heterozygous History of Jesus’ Christology Homoiousios Theology Homozygous Human cloning Immaculate conception Incarnation Incarnational life Inheritance Karyotype Kenoticism Klinefelter syndrome Logos-flesh Christology Meiosis Mitosis Modalistic monarchianism Monarchianism Monophysitism Mutation Nestorianism Nicene Creed One-nature Christology Ontological Christology Organogenesis Patripassianism Phenotype Polygenic inheritance Post lapsarian view/model Prelapsarian view/model Recessive gene Roman Catholic Christology Sabellianism Seventh-day Adventist Christology Sex chromosomes Sex-linked inheritance Speculative Christology Theotokos Turner syndrome Two-natures Christology Unique post-fall Christology Socinianism Soteriology Theotokos Turner syndrome Two-natures Christology Unique post-fall Christology Virginal conception 231.4 Seventh-Day Adventists -- Doctrines Salvation -- Seventh-Day Adventists Fall of man -- History of doctrines Jesus Christ -- History of doctrines Sequerra, Jack Erickson, Millard J. Gulley, Norman R.

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