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Relations entre le statut utérin, les paramètres biochimiques du sérum et du liquide de lavage utérin et la production d’embryons chez les vaches laitières après surovulationRasolomboahanginjatovo, Hasina Santatriniaina 03 1900 (has links)
Le développement et la survie de l’embryon dépendent des nutriments fournis par les sécrétions utérines. Les objectifs de cette étude étaient de déterminer l’effet de la surovulation (SOV) sur la bactériologie et cytologie utérine et sur les paramètres biochimiques utérin et sérique et leurs effets sur le nombre d’embryons transférables (ET). Deux groupes de vaches Holstein (groupe I, non lactante, n=7 et groupe II, lactante, n=28) ont été respectivement induites en chaleur ou surovulées et ensuite inséminées. Au jour 7 du cycle œstral (J7) et lors du jour de la récolte (JR), un prélèvement individuel de sang et de liquide de lavage utérin a été fait pour l’analyse du statut bactériologique et cytologique de l’utérus et la mesure de la concentration de plusieurs paramètres biochimiques présélectionnés. Les embryons récoltés ont été évalués selon les critères de l’IETS. La SOV a donnée une moyenne de 7.39 ± 6.22 ovocytes/embryons dont 3.32 ± 4.81 ET. Il n’y avait pas de variation significative de la bactériologie et cytologie utérine des deux groupes entre J7 et JR. La concentration sérique de l’urée (P=0.0001), d’E2 (P=0.006); la concentration utérine du Glu (P=0.002), de Ck (p=0.0007), de LDH (P <0.0001), de PT (P=0.004), de P4 (P=0.008), de PGFM (P<0.0001) du groupe I et la concentration sérique de P4 (P<0.0001), de PGFM (P<0.0001); la concentration utérine de LDH (P=0.002), de PGFM (P<0.0001) du groupe II ont été significativement élevées à JR qu’à J7. La concentration utérine et sérique de l’urée (P<0.0001 et P<0.0001), de LDH (P<0.0001 et P=0.008), la concentration sérique de P4 (P=0.0002) et la concentration utérine de PT (P=0.0003) à JR du groupe II étaient différente du groupe I. Il n’y avait pas d’association entre la bactériologie et cytologie utérine et le nombre d’ET. Cependant, le nombre d’ET a été positivement corrélé avec la concentration sérique d’IGF-1 à J7 (r=0.45; P=0.001) et la concentration sérique de P4 à JR (r=0.43; P<0.05) et négativement corrélé avec la concentration utérine et sérique de PGFM à la fois à J7 (r=-0.54; P<0.005 et r=-0.67; P<0.001) et à JR (r=-0.48; P<0.01 et r=-0.57; P<0.002). Ces résultats suggèrent que la SOV induit des changements au niveau sérique et utérin qui affectent le nombre d’ET récoltés. / The developing embryo is dependent on the nutrients provided by the oviduct and the uterine fluid. The objectives of this study were to determine the effect of SOV on uterine bacteriology and cytology, on serum and uterine biochemical parameters and consequently on the number of TE. Non-lactating (n=7) and lactating (n=28) Holstein cows were synchronized for estrus and superovulated respectively and were inseminated twice. Uterine bacteriology and cytology and various uterine and serum biochemical parameters were measured at day 7 of estrus cycle (D7, starting day of the SOV protocol) and at the designated day of embryo recovery (DER). Harvested embryos were evaluated according to IETS’s criteria. Superovulated cows produced an average of 7.39 ± 6.22 ova/embryos of which 3.32 ± 4.81 were TE. There were no significant variations of uterine bacteriology and cytology between D7 and DER within the two groups. Serum urea (P=0.0001), E2 (P=0.006); uterine Glu (P=0.002), Ck (P=0.0007), LDH (P<0.0001), TP (P=0.004), P4 (P=0.008), PGFM (P<0.0001) in group I and serum P4 (P<0.0001), PGFM (P<0.0001); uterine LDH (P=0.002), PGFM (P<0.0001) in group II were significantly higher at DER than at D7. At DER, group I was different to group II’ uterine and serum urea (P<0.0001 and P<0.0001), LDH (P<0.0001 and P=0.008), PGFM (P=0.002 and P=0.009), serum P4 (P=0.0002) and uterine TP (P=0.0003). There was no association between uterine bacteriology and cytology and the number of TE. However, TE was positively correlated with serum IGF-1 at D7 (r=0.45; P=0.001) and P4 at DER (r=0.43; P<0.05) and negatively correlated with both serum and uterine PGFM respectively at D7 (r=-0.54; P<0.005 and r=-0.67; P<0.001) and DER (r=-0.48; P<0.01 and r=-0.57; P<0.002). The present results infer that changes following SOV in both serum and uterine secretion may affect the number of TE.
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Barriers to breast and cervical cancer screening among migrant and seasonal farmworker women in the Lower Rio Grande Valley, Texas.Saavedra-Embesi, Monica. McFall, Stephanie L. Fernandez, Maria E., Bradshaw, Benjamin S. January 2008 (has links)
Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-05, page: 2671. Advisers: Stephanie L. Mc Fall; Maria E. Fernandez. Includes bibliographical references.
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Regulation of parathyroid-hormone related peptide in a squamous cervical carcinoma cell line, CaSki /Buckle, Joy Ann, January 1999 (has links)
Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 1999. / Bibliography: leaves 118-138.
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Avaliação do Programa Nacional de Controle do Câncer do Colo do Útero no Estado de Mato Grosso: impacto sobre o perfil da doença / Evaluation of the National Program for the Prevention of Cervical Cancer: impact on the disease profileNakagawa, Janete Tamami Tomiyoshi [UNIFESP] 28 October 2010 (has links) (PDF)
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Previous issue date: 2010-10-28 / Em 2002, o Estado de Mato Grosso aderiu à segunda fase de intensificação Programa Nacional de Controle do Câncer do Colo do Útero (PNCCU) como medida de enfrentamento das altas taxas da doença e de morte por neoplasia cervical. Com o objetivo de analisar os principais resultados do PNCCU, foi feito um estudo em duas partes. A primeira parte teve como objetivo levantar o perfil da doença e a cobertura do exame rastreamento pelo PNCCU no Estado. Os objetivos da segunda parte foram: analisar o seguimento clínico da população rastreada, analisar as diferentes características evolutivas da doença associadas aos fatores sócio-demográficos e clínicos, bem como analisar o risco de óbito e a taxa de sobrevida estratificada pelas variáveis sócio-demográficas e clínicas das mulheres que apresentaram carcinoma invasivo. Na primeira parte, foi utilizado estudo do tipo transversal e na segunda parte, foi realizado um estudo de coorte. O período do estudo compreendeu de 2002 a 2007 e abrangeu todos os municípios do Estado de Mato Grosso. A população estudada na primeira fase do estudo correspondeu todas as mulheres que fizeram o exame de rastreamento no ano de 2002. Na segunda parte do estudo, a população correspondeu a uma amostra aleatória representativa das mulheres que apresentaram alterações citológicas na primeira fase do estudo, totalizando 323 mulheres. A fonte de dados utilizada foi o sistema de informação oficial de saúde, dentre eles o SISCOLO, SIM, APAC, além de dados oficiais da Secretaria Estadual de Saúde/MT (SES/MT), dados disponíveis no site do INCA e do DATASUS e prontuários clínicos. Para análise estatística dos dados foram utilizadas técnicas descritivas e inferenciais. Na parte descritiva foram utilizados tabelas, gráficos e medidas de posição e de dispersão. Para avaliar a o risco de adoecer por carcinoma cervical invasor foi utilizado regressão logística univariada e multivariada. Para analisar a taxa de sobrevida global foi utilizado o estimador de Kaplan-Meier e para analisar os fatores prognósticos, foi utilizado o modelo de riscos proporcionais de Cox. Dentre os principais resultados, destaca-se que no período estudado, Mato Grosso apresentou taxas de incidência elevadas, acima da média nacional. Os dados do seguimento clínico mostraram os diferentes desfechos, dentre eles, destaca-se que: entre as 323 mulheres, 18 (6,2%) foram a óbito tendo o câncer do colo do útero como causa básica da morte. Foi analisado o risco de a doença evoluir para o carcinoma invasor, segundo as variáveis sócio-demográficas e clínicas, sendo que as variáveis: faixa etária, estado civil, tabagismo, menarca e município foram as que apresentaram forte associação com a doença na fase invasora. Já na análise de sobrevivência, a taxa de sobrevida global em 60 meses, estimada pelo método de Kaplan-Meier, foi de 66,7%. No modelo final de risco proporcional de Cox, as variáveis com maior risco de óbito foi o estágio avançado da doença e a raça/cor. Estes dados levam a concluir que a doença no Estado de Mato Grosso tem uma determinação social muito grande, considerando a dificuldade de acesso aos serviços de saúde da população desfavorecida pelas condições raciais, sócio-econômicas, e chegam aos serviços com a doença em fase adiantada, quando a chance de sobrevivência é muito pequena. Conclui-se que para o efetivo combate a doença são necessárias políticas governamentais, como o PNCCU, que garantam a universalidade da assistência, principalmente da população desfavorecida socialmente. / In 2002, the State joined the second phase of intensification of the National Program for the Control of Cervical Cancer (PNCCU) as a measure to deal with the high rates of the disease and of death by cervical neoplasia. With the aim of analyzing the main PNCCU results, a two-stage study was carried out. The first phase aimed at presenting the disease profile and the coverage of the screening exam by the PNCCU in the State. The aims of the second phase were to analyze the clinical follow-up of the population that was screened, analyze the different evolutionary characteristics of the disease associated to socio-demographic and clinic factors, as well as analyze the factors associated to death risk and the stratified survival rate by the socio-demographic and clinical variables of women that presented invasive carcinoma. In the first part, the cross-sectional study was used and a cohort study was used in the second phase. The period of study was from 2002 to 2007 and comprised all the municipalities of the State of Mato Grosso. The population studied in the first phase of the study was all the women who had undergone the screening test in 2002. The population used in the second phase of the study was a representative random sample of those that presented cytological alterations in the first phase of the study, a total of 323 women. The source of data used was the official health information system, among them the SISCOLO, SIM, APAC, and also the official data of the State Health Department/MT (SES/MT), data available in the INCA and DATASUS sites and medical records. For the statistical analysis of the data, descriptive and inferential techniques were used. In the descriptive part, tables, graphics and position and dispersion measures were used. In order to evaluate the risk of being sick due to invasive cervical carcinoma, the univariate and multivariate logistic regression analysis was used. The Kaplan-Meier estimator was used to analyze the survival rate and to analyze the prognostic factors, the Cox proportional hazards model was used. Among the main results it is highlighted that in 2002, Mato Grosso presented high incidence rates, above the national average. The data of the clinical follow up showed the different clinical outcomes, among the 323 women, 18 (6,2%) died having as the basic cause of death the cervical cancer. The risk of the disease developing into the invasive carcinoma was analyzed according to the socio-demographic and clinical variables, and the variables: age group, marital status, smoking history, menopause and municipality were those that presented a strong association with the disease in the invasive phase. However, in the survival analysis, the global survival rate in 60 months, estimated by the Kaplan-Meier method, was of 66,7%. In the final Cox proportional hazards model, the variables with higher death risk was the advanced stage of the disease and the race/color. These data lead to a conclusion that the disease in the State of Mato Grosso has a very large social determination, considering the difficulties in the access to the health services by the population affected by racial, socio-economic conditions that arrive in the health services with the disease in an advanced stage, when the survival probability is very small. The conclusion is that for the effective fight against the disease governmental policies such as the PNCCU are necessary, and that the universality of the assistance be guaranteed, mainly to the socially disadvantaged population. / TEDE / BV UNIFESP: Teses e dissertações
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DEVELOPMENT OF A DOMESTIC ANIMAL MODEL OF ENDOMETRIOSIS2016 January 1900 (has links)
Endometriosis is a reproductive disease affecting women in their prime reproductive years characterized by the presence of endometrial glands and stroma in ectopic locations. Animal models have been proven to be indispensable not only for the study of the disease but also to develop better non-invasive diagnostic imaging modalities. A major limitation with the diagnosis of endometriosis is the lack of a specific and sensitive non-invasive diagnostic test. Our objective was to develop a domestic animal model of endometriosis suitable for serial diagnostic imaging procedures and assessment of therapies. Two major studies were conducted to achieve this objective.
First study involved in vitro whole tissue-explant culture and surgical induction of endometriosis in dog, pig and sheep to choose the most suitable model. For in vitro co-culture, dog, pig and sheep endometrium was placed on visceral peritoneum for 24 to 72 h to assess the degree of attachment and adhesion characteristics of endometrium (epithelium, glandular and stromal cells). Surgical induction of endometriosis was tested in dog, sheep (n=5 each) and pig (n=4) using autologous endometrial (n=4 grafts per animal) and fat grafts sutured to visceral (urinary bladder surface in dog and pig, uterus in sheep) and parietal (abdominal wall) peritoneum. Sham surgeries were performed in control group animals (dog and sheep n=5, pig n=3) using fat grafts alone. Animals were euthanized between 80-110 days post-surgery. Size, gross characteristics and histopathologic features of endometriotic lesions were recorded. During in vitro explant culture, surface epithelial, stromal and glandular cells of endometrium were capable of attaching to visceral peritoneum within 24 hours with and without an intact layer of mesothelial lining in dog, pig and sheep. The proportion of successful endometrial attachments were greater at 24h compared to 72h (15/18 vs. 7/18, p=0.008; data combined among species) with intermediate attachment at 48h (12/15). Following surgical induction, there was no difference (p>0.05) in proportion of successful tissue grafts placed on serosal surface of visceral vs. parietal peritoneum in dog (10/10 vs. 10/10), pig (7/8 vs. 8/8) or sheep (7/10 vs. 8/10). A variety of outcomes (endometriotic cysts with sero-sangunous fluid, solid lesions, vesicles, absence of lesions) were found. The proportion of cystic lesions was greater (p<0.01) in dog (19/20 grafts) than in pig (8/16) and sheep (5/20). Further, the area of endometriotic lesions at euthanasia was larger (0.89 ± 0.11 cm2) compared to that at the time of surgery (0.50 ± 0.09 cm2) in dog, whereas, the size of lesions decreased by half or more (p<0.05) in pig and sheep. Combined among grafting sites (visceral and parietal peritoneum) and species, a greater proportion (p=0.015) of surgical sites had adhesions in treatment (12/14) versus control group animals (5/13). The wall of majority of endometrial cysts in dogs were characterized by simple cuboidal/columnar epithelium, endometrial glands (normal, dilated and cystic), subepithelial capillary network and presence of stromal and smooth muscle cells. Hemorrhage and/or hemosiderin-laden macrophages were observed in the cystic lesions in dog. Development of a greater proportion of growing lesions in the form of endometriotic cysts in dogs compared to sheep and pig led us to conclude dog as a better suitable domestic animal model for endometriosis than sheep and pig.
Second study involved assessing the usefulness and limitations of ultrasonography, magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) in detecting cystic endometriotic lesions in dog and sheep. Surgical induction of endometriois was performed in dogs (n=5) and sheep (n=5) using autologous endometrial grafts (n=4 grafts per animal) and fat grafts sutured to visceral peritoneum (urinary bladder in dogs, uterus in sheep) and parietal peritoneum (ventral abdominal wall). Weekly ultrasonography was performed from Week 1-9 post-surgery and day of euthanasia (Week 14-15). T1 and T2 weighted weighted MRI images (n=2 each for dog and sheep) and PET-CT (n=3 dog, n=1 sheep) using 18F-fluorodeoxyglucose (18F-FDG) as radiolabel was performed between Week 13-15 post-surgery in dog and sheep. Gray-scale B-mode ultrasonography was able to detect endometriotic cysts (0.25-1.75cm) on urinary bladder and abdominal wall in dogs; endometrial grafts Week 1 post-surgery appeared as a homogenous, hypoechoic masses, following which they grew larger with evidence of cyst formation by Week 5. Cysts were undetectable from Week 10-13, whereas they appeared as homogenous masses with a hypoechoic fluid-filled cavity with diffuse hyperechoic echoes and low vascularisation (Color-Doppler imaging) by Week 14-15. In sheep, endometrial grafts were detected as hypoechoic masses Week 1 post-surgery that became smaller until no detectable lesions were visible beyond Week 6-7. Cysts in dogs and sheep appeared hyperintense on T2 and hypointense on T1 weighted images. 18F -FDG PET-CT did not show hypermetabolic activity in endometriotic cysts in dogs and sheep. In conclusion, MRI appeared to provide the most definitive diagnostic images of endometriotic cysts in dogs and sheep, particularly for lesions in sheep which were not evident by ultrasonography. However, ultrasonography was sufficient to characterize most endometriotic cysts in dogs. Further research needs to be carried out to develop specific PET tracers for endometriosis.
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Development of a magnetic intra-uterine manipulatorDoll, Stefan 03 1900 (has links)
Thesis (MScEng)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Uterine manipulation is integral to obtaining adequate access to the uterus
during a laparoscopic procedure. A variety of mechanical manipulators have
been developed to aid the surgeon with the dissection of the uterus during
laparoscopic hysterectomies. Limitations of existing manipulators are that
they require an additional assistant during surgery, are expensive and may
cause tissue trauma to the vaginal or cervical canal. This study introduces the
novel concept of a magnetic uterine manipulator, intended to overcome existing
devices’ shortcomings and enabling non-invasive uterine manipulation.
The first goal of the study was to investigate the strengths and weaknesses of
existing mechanical manipulators and compare them to those of a magnetic
device. Analysis showed that a magnetic manipulator would not be able to
compete in terms of the range of motion of existing devices. A limited anteriorsagittal
rotation range of 60 was seen in the magnetic manipulator compared
to a range of 140 in mechanical devices. However, the magnetic manipulator
could eliminate the need for an extra assistant, is reusable and thus also more
economical. The second goal was to investigate which type of setup would be
most successful at effective uterine manipulation. Through concept analysis a
cart-on-arch system was deemed most effective. To lift an effective load of 1
N over an air-gap of 150 mm rare-earth N38 Neodymium (NdFeBr) magnets
showed the most promise as magnetic actuators. FEA (Finite Element Analysis)
simulations of the magnetic setup were validated experimentally which
produced an acceptable MAE (mean absolute error) of 0.15 N. Furthermore,
a comparative simulation study of shielded and unshielded magnets was done
which concluded that shielded magnets produce a slightly higher attraction
force and would be safer to use due to less magnetic flux fringing. Thirdly and
lastly, potential safety hazards and risks of using magnetic actuators in surgical environments were identified. The literature research revealed that connections
between magnetic fields and health risks to patients have not been conclusively
proven in clinical studies to date, but nonetheless, great care should be taken
in situations where the patient has a pace-maker or orthopaedic implants, as
these might interact with the magnetic field. Recommendations for future
work include further research into the geometry and scaling effects of magnetic
shielding as well as electromagnetic actuator design. Electromagnetic
actuators could replace rare-earth magnets, if coil and cooling systems are optimized,
resulting in magnets that can be reversed or switched off and which
are therefore easier to control and safer to handle. / AFRIKAANSE OPSOMMING: Ontwikkeling van ’n Magnetiese Intra-Uteriene Manipuleerder
Baarmoedermanipulasie is van uiterste belang om sodoende voldoende toegang
te kry tot die baarmoeder gedurende ’n laparoskopiese prosedure. Daar
is reeds ’n verskeidenheid meganiese manipuleerders ontwikkel as hulpmiddel
vir die chirurg in die ontleding van die uterus tydens laparoskopiese histerektomies.
Beperkings van bestaande manipuleerders is dat ’n bykomende assistent
tydens chirurgie benodig word. Die manipuleerders is ook duur en kan weefseltrauma
veroorsaak aan die vaginale of servikale kanale. Die studie stel ’n nuwe
konsep bekend: ’n magnetiese baarmoedermanipuleerder, gemik daarop om
bestaande toestelle se tekortkominge te oorkom en nie-indringende baarmoedermanipulasie
moontlik te maak. Die eerste doel van die studie was om die
voordele en nadele van bestaande meganiese manipuleerders te ondersoek en
dit te vergelyk met dié van die magnetiese toestel. Analise het getoon dat
’n magnetiese manipuleerder nie met bestaande toestelle sal kan kompeteer
waar dit gaan om beweegruimte nie. Daar is ’n beperkte anterior-sagitale rotasiespeling
van 60 in die magnetiese manipuleerder, terwyl die meganiese
toestel ’n rotasiespeling van 140 het. Die magnetiese manipuleerder kan egter
die nodigheid van ’n bykomende assistant uitskakel, is herbruikbaar en dus
ook meer ekonomies. Die tweede doel van die studie was om die tipe opstelling
wat meer suksesvol sal wees tydens doeltreffende baarmoeder manipulasie te
ondersoek. Konsep-analise het getoon dat ’n "cart-on-arch"stelsel die beste sal
werk. N38 Neodimium (NdFeBr) magnete het die beste vertoon as magnetiese
aandrywer om ’n werklike belasting van 1 N oor ’n lugspasie van 150 mm te
lig. EEA (Eindige Element Analise) simulasies van die magnetiese opstelling is eksperimenteel bekragtig en het ’n aanvaarbare gemene absolute fout (GAF)
van 0.15 N gelewer. ’n Vergelykende simulasie studie het verder gewys dat
beskutte magnete ’n effens hoër aantrekkingskrag oplewer en sal dus veiliger
wees om te gebruik vanweë die verminderde magnetiese stromingsrand. Derdens
en laastens is potensiële veiligheidsrisikos en gevare in die gebruik van
magnetiese drywers in chirurgiese omgewings geïdentifiseer. Literatuurnavorsing
het onthul dat die verband tussen magneetvelde en gesondheidsrisikos
aan pasiënte nog nie voldoende bewys is in kliniese studies tot op datum nie.
Gevalle waar pasiënte ’n pasaangeër of ortopediese inplantings het moet met
groot sorg hanteer word aangesien dit dalk kan reageer met die magneetvelde.
Aanbevelings vir toekomstige werk sluit verdere navorsing in in die rigting
van die geometrie en die afskilferingseffek van magnetiese beskutting en ook
elektromagnetiese drywer ontwerp. Elektromagnetiese drywers kan moontlik
rou aarde magnete vervang indien winding en afkoelstelsels ge-optimeer word
wat kan lei tot magnete wat omgekeer of afgeskakel kan word en dus makliker
beheerbaar is en veiliger om te hanteer.
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Embolização de malformações arteriovenosas periféricas com uso de cateter-balão de duplo lúmen / Peripheral arteriovenous malformations embolization with dual-lumen balloon catheterStamoulis, Dimitrius Nikolaos Jaconi 11 June 2018 (has links)
Introdução: As malformações arteriovenosas são lesões congênitas caracterizadas por uma rede capilar malformada (nidus) que comunica o sistema arterial e venoso em um mecanismo de shunt arteriovenoso não irrigando tecido normal. Devido ao shunt arteriovenoso as MAVs apresentam alto fluxo sanguíneo, podem ser assintomáticas ou sintomáticas dependendo de sua localização. O tratamento das MAV busca a exclusão circulatória completa do nidus o que pode ser alcançado por meio de ressecção cirúrgica, radiocirurgia ou embolização endovascular. Objetivo: descrição técnica de uma série de dois casos de MAVs de localização periférica (fora do sistema nervoso central), que foram tratadas através da embolização com uso de cateter-balão de duplo lúmen. Materiais e métodos: Trata-se de estudo retrospectivo que avaliou os pacientes submetidos a embolização com cateter-balão de duplo lúmen para o tratamento das MAVs periféricas pelo Setor de Radiologia Intervencionista do HCFMRP-USP. Resultados: Os achados encontrados foram consistentes com a literatura atual demonstrando altas taxas de sucesso técnico e clínico, sem complicações inerentes ao procedimento. Conclusão: O uso destes dispositivos se mostrou mais eficaz em obliterar completamente o nidus deste tipo de lesão, além de reduzir o tempo de procedimento, a exposição à fluoroscopia. Neste estudo foi obtida a exclusão angiográfica completa das MAV em uma única sessão de embolização e não foram descritas complicações relacionadas ao tratamento. / Introduction: Arteriovenous malformations are congenital lesions characterized by a malformed capillary network (nidus) that communicates the arterial and venous system in an arteriovenous shunt mechanism and does not irrigate normal tissue. Due to the arteriovenous shunt AVMs present high blood flow, they may be asymptomatic or symptomatic depending on their location. The AVM treatment seeks the complete circulatory exclusion of the nidus which can be achieved by means of surgical resection, radiosurgery or endovascular embolization. Objectives: A technical description of a series of two cases of peripheral AVMs that were treated through embolization using a dual-lumen balloon catheter. Materials and methods: This is a retrospective study that evaluated patients undergoing embolization with a double-lumen balloon catheter for the treatment of peripheral AVMs by the Interventional Radiology Sector of HCFMRP-USP. Results: The findings were consistent with the current literature demonstrating high rates of technical and clinical success, without complications inherent to the procedure. Conclusion: The use of these devices has been shown to be more effective in completely obliterating the nidus of this type of lesion, in addition to reducing the procedure time, exposure to fluoroscopy. In this study complete angiographic exclusion of AVM was obtained in a single embolization session and no complications related to treatment were described.
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Perfis endócrinos peri-ovulatórios influenciam o transporte, metabolismo e disponibilidade de aminoácidos no lúmen uterino de vacas de corte durante o diestro inicial / Pre-ovulatory endocrine profiles influence endometrial amino acids transport, metabolism and availability in the uterine lumen during early diestrus in beef cowsFrança, Moana Rodrigues 16 December 2016 (has links)
Em vacas de corte, folículos pré-ovulatórios (FPO) maiores, maiores concentrações de estradiol (E2) no proestro/estro e progesterona (P4) no diestro favorecem o crescimento do concepto e a fertilidade. Porém, os mecanismos mediados pelos esteroides femininos que influenciam a receptividade uterina ao embrião precisam ser esclarecidos. Os aminoácidos (AA) são componentes das secreções uterinas que são cruciais para a sobrevivência do embrião antes da implantação. A hipótese deste trabalho é que o tamanho do FPO e as concentrações de E2 e P4 modulam a abundância de transcritos relacionados ao transporte e metabolismo de AA no endométrio e afetam a concentração luminal de AA. Para isso, o crescimento folicular de vacas Nelore foi manipulado com o objetivo de formar dois grupos: FPO grande e CL grande (FG-CLG) e FPO pequeno e CL pequeno (FP-CLP). No Dia 4 (D4; Exp 1) e Dia 7 (D7; Exp 2) após a injeção de GnRH para indução da ovulação, foram coletados tecido endometrial e lavado uterino post-mortem. A abundância de transcritos foi avaliada por qRT-PCR e as concentrações de AA nos lavados foram quantificadas por HPLC. No Exp 1, o tamanho do FPO, concentrações plasmáticas de E2 no D-1 e de P4 no D4 foram 15,70mm±0,43 vs. 11,31mm±0,23 (p<0,01), 2,44pg/ml±0,19 vs. 0,65pg/ml (p<0,01) e 1,40ng/ml±0,23 vs. 0,80ng/ml±0,10 (p<0,01) para os grupos FG-CLG vs. FP-CLP, respectivamente. No Exp 2, o tamanho do FPO, concentrações plasmáticas de E2 no D-1 e de P4 no D7 foram 13,18mm±0,44 vs. 10,63mm±0,30 (p<0,01), 2,30pg/ml±0,57 vs. 0,50pg/ml±0,13 (p<0,01) e 3,68ng/ml±0,38 vs. 2,49ng/ml±0,43 (p=0,04) para os grupos FG-CLG vs. FP-CLP, respectivamente. No D4 a abundância de SLC1A4, SLC38A1, SLC6A6, SLC7A4 e SLCY e no D7, SLC1A4, SLC6A1, SLC6A14, SLC7A4, SLC7A8, SLC38A1, SLC38A7, SLC43A2 e DDO foi maior no endométrio dos animais do grupo FG-CLG (p<0,05). No D4, maiores concentrações de taurina, alanina e ácido α-aminobutírico foram observadas no grupo FP-CLP (p<0,05). Em contraste, menores concentrações de valina e cistationina foram encontradas nos lavados uterinos do D7 dos animais do grupo FP-CLP (p<0,05). No D4, os animais do grupo FG-CLG, associado a maior fertilidade, apresentaram menor quantidade de AA nas secreções uterinas, porém, a abundância dos transportadores de AA foi compatível com maior transporte em comparação aos animais do grupo FP-CLP. Esses resultados sugerem que antes do embrião se mover do oviduto ao útero, o transporte e metabolismo dos AA prioriza a preparação das células endometriais para receber o embrião e não o acúmulo nas secreções uterinas. Porém, no D7, quando o embrião está em contato direto com as secreções uterinas, os genes relacionados ao transporte de AA no endométrio e a concentração de AA no histotrofo são estimulados nas vacas do grupo FG-CLG. Portanto o metabolismo e transporte de AA no sentido das células endometriais ou das secreções uterinas pode ser um mecanismo importante para a receptividade materna. / In beef cattle, a large size of the pre-ovulatory follicle (POF) and resulting elevated proestrus/estrus estradiol (E2) and diestrus progesterone (P4) concentrations positively affect conceptus growth and fertility. However, sex-steroid-mediated mechanisms that influence uterine receptivity to the embryo need to be elucidated. Amino acids are important components of maternally-derived secretions that are crucial for embryo survival before implantation. The hypothesis is that the size of the POF, E2 and P4 concentrations modulate endometrial abundance of solute carrier proteins (SLC) transcripts related to AA transport and metabolism and subsequently affect lumenal amino acids concentrations. Therefore, follicle growth of Nelore cows was manipulated to produce two experimental groups: large POF and CL (LF-LCL group) and small POF and CL (SF-SCL group). On Day 4 (D4; Experiment 1) and Day 7 (D7; Experiment 2) post GnRH injection to induce ovulation, endometrial tissue and uterine washings were collected post-mortem. Transcript abundance was evaluated by qRT-PCR and amino acid concentrations were quantified in washings by HPLC. On Experiment 1, POF size, plasma E2 concentration on D-1, and plasma concentration of P4 on D4 were 15.70mm±0.43 vs. 11.31mm±0.23 (p<0.01), 2.44pg/ml±0.19 vs. 0.65pg/ml (p<0.01) and 1.40ng/ml±0.23 vs. 0.80ng/ml±0.10 (p<0.01) for the LF-LCL vs. SF-SCL groups, respectively. For Experiment 2, POF size, plasma E2 concentration on D-1 and plasma P4 concentration on D7 were 13.18mm±0.44 vs. 10.63mm±0.30 (p<0.01), 2.30pg/ml±0.57 vs. 0.50pg/ml±0.13 (p<0.01) and 3.68ng/ml±0.38 vs. 2.49ng/ml±0.43 (p=0.04) for the LF-LCL vs. SF-SCL groups, respectively. On D4, abundance of SLC6A6, SLC7A4, SLC17A5, SLC38A1, SLC38A7 and SLCY and on D7, SLC1A4, SLC6A1, SLC6A14, SLC7A4, SLC7A7, SLC7A8, SLC17A5, SLC38A1, SLC38A7, SLC43A2 and DDO was greater in the endometrium of cows from the LF-LCL group (p<0.05). On D4, higher concentrations of taurine, alanine and α-aminobutiric acid were observed in SF-SCL (p<0.05). In contrast, lower concentrations of valine and cystathionine were quantified in D7 uterine washings from SF-SCL cows (p<0.05). On D4, animals from LF-LCL group, associated with greater fertility, presented less amino acid content in uterine secretion but abundance of transporters was compatible to greater transport in comparison to animals from SF-SCL group. This suggests that before embryo moves from oviduct to uterus, amino acids transport and metabolism pathways prioritizes endometrium cells preparation for receiving the embryo but not accumulation in uterine secretions. However, on D7, when the embryo is in direct contact with uterine secretions, genes related to amino acids transport in endometrium and amino acids concentration in histotroph are up-regulated in LF-LCL cows. The latter insights indicate that amino acids metabolism and transport, towards endometrial cells or uterine secretions, might be mechanisms contributing to maternal receptivity.
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Variabilidade intratípica de HPV 16 em relação à origem étnica e HLA de uma população de alto risco para o câncer do colo do útero / Intratypical variability HPV-16 in relation to ethnic origin and HLA of a population at high risk for cervical cancerJunes, Katiana de Sales 04 August 2005 (has links)
A infecção por papilomavirus é a principal causa de desenvolvimento de neoplasias intraepiteliais cervicais (NIC) e câncer do colo do útero (CCU). Estudos epidemiológicos têm demonstrado que a persistência do genoma viral encontra-se associado a variantes moleculares específicas de papilomavirus humano (HPV) de alto risco. As moléculas HLA de classe II têm um importante papel na resposta imune. Associações entre HLA e CCU ou infecção por HPV tem sido demonstrado em diferentes populações. O nosso objetivo foi verificar se a variabilidade de HLA-DRB1 e DQB1 estavam associada ao CCU e NIC III em mulheres de Belém, uma população formada pelos 3 principais grupos étnicos humanos e uma área de alto risco para o CCU no Norte do Brasil. Foi investigada a existência de diferenças na distribuição de alelos HLA entre mulheres com CCU e NIC III portadoras de diferentes variantes de HPV-16 e mulheres citologicamente normais. Os genes HLA DQB1 e DRB1 foram tipados pelo método de PCR-SSO em 95 casos e 287 controles de mulheres com citologia normal atendidas em um centro de prevenção do colo do útero na mesma cidade. As variantes de HPV-16 foram tipadas por sequenciamento de um fragmento da região controladora do genoma viral (LCR). O polimorfismo na posição 350 do gene E6 foi tipado baseado em um protocolo de hibridização em pontos, para identificar a alteração na posição 350T→G. A magnitude das associações foi estimada por odds ratio (OR) e os respectivos intervalos de confiança (IC), ajustados para potenciais fatores de confusão. Uma associação positiva foi observada entre CCU e os haplótipos DRB1* 150 l-DQB1*0602, DRB1*04-DQB1*0301 e DRB1*1602-DQB1*0301. Ao contrário, DRB1*01-DQB1*0501 mostrou um efeito protetor. Os alelos DRB1*0804, DQB1*0402 apresentaram efeito protetor contra positividade por HPV. O alelo DQB1*0502 e o grupo DRB1*15 foram positivamente associados. Os nossos resultados mostram que as associações positivas de DRB1*1501 e DRB1*1602 podem ser atribuídas a variantes asiático-americanas quando comparado a variantes européias. O risco conferido a DRB1*1501 foi encontrado associado tanto a variantes E6350G quanto a variantes E6350T, entretanto, o maior efeito foi devido às variantes E6250T. A associação positiva de DRB1*1602 foi significativa somente no grupo de mulheres positivas para E6350G. Estes resultados estão de acordo com a composição étnica da população estudada bem como um maior potencial oncogênico de certas variantes. Nossos dados sugerem que a contribuição dos alelos HLA na susceptibilidade genética ao CCU difere de acordo com a distribuição das variantes de HPV em uma dada região geográfica ou grupo étnico. / Papillomavirus infection is the major cause for the development of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer (ICC) in humano Epidemiological studies have demonstrated that persistence of the viral genome and development of cervical cancer are associated with specific molecular variants of high-risk human Papillomavirus (HPV). Human leukocyte antigen (HLA) molecules play a role in immune response and associations between HLA and IeC or HPV infections have been reported in several populations. We aimed to verify if HLA-DRB1 and DQB1 variability is related to ICC and CIN III in women from Belem, a population formed by the three main human ethnic groups and a high-risk area for this disease in Northem Brazil. We also investigated if there are differences in the HLA class II alleles distribution between women with ICC and CIN III that harbor different HPV-16 variants and women without cancer. HLA DRB1 and DQB1 were typed by PCR-SSO based methods in 95 ICC cases and 287 controls consisting of normal cytology from women attending cervical cancer screening programs in the same city. HPV-16 variants were typed by sequencing a PCR-amplified fragment of long control region (LCR) of the viral genome. The E6350 polymorphism was typed on the basis of a dot blot protocol targeting a specific nucleotide alteration in the position 350T→G of the E6 gene. The magnitude of associations was estimated by odds ratio (OR) and the respective 95% confidence interval (CI), adjusted for potential confounder factors. A positive association was found between ICC cases and DRB1*150 l-DQB1*0602, DRB1*04-DQB1*0301 and DRB1*1602-DQB1*0301 haplotypes. Conversely, DRB1*01-DQB1*05 showed a protective effect. DRB1*0804, DQB1*0402 showed negative association against HPV infection. DQB1*0502 and DRB1*15 were positively associated with HPV infection. Our study showed that positive association of DRB1*1501 and DRB1*1602 alleles may be attributed to AsianAmerican then European variants. Furthermore, the DRB1*1501 was found associated with both women carrying E6350G or E350T, however, a higher effect was observed for E6350T variants carriers. The positive association of DRB1*1602 was significant for women harboring E6350G then E6350T variants. These data are in agreement with ethnical component of the studied population as well as a higher oncogenic potential of certain HPV variants. Our results also suggest that the contribution of HLA class II alieles to the genetic susceptibility to ICC differs depending on the HPV-16 variants distribution in a given geographic and ethnic group.
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Utilização da ressonância magnética para o planejamento radioterápico dos tumores de colo de útero / Magnetic resonance imaging in the radiation treatment planning of uterine cervix cancersJustino, Pitagoras Baskara 28 March 2007 (has links)
OBJETIVOS: Verificar o índice de erros geográficos no planejamento radioterápico convencional de pacientes com carcinoma de colo uterino por meio da ressonância magnética (RM); comparar os dados de estadiamento da FIGO pelos exames físico e de RM e avaliar o estudo do Raio-X contrastado de reto na previsão do erro geográfico. MATERIAIS E MÉTODOS: Oitenta pacientes com diagnóstico histológico de carcinoma espinocelular de colo uterino, com indicação de radioterapia, foram analisadas. Após o estadiamento clínico (FIGO), foi realizada ressonância magnética da pelve e estas imagens comparadas aos campos clássicos de radioterapia, técnica de 4 campos em tijolo. Considerou-se erro geográfico, quando o volume alvo não foi englobado pelos campos, com margens mínimas de 1cm. Os dados de exame físico e RM foram comparados. RESULTADOS: Entre as 80 pacientes analisadas, os limites clássicos dos campos não foram adequados em 45 (56%). Os limites críticos foram as bordas anterior (1/3 anterior da sínfise púbica) ou posterior (limite em S2-S3) dos campos laterais de irradiação. Evidenciou-se grande discrepância entre o exame físico e a RM no que se refere à análise de informações para o estadiamento. Na maioria das vezes, o exame físico sub-estadiou as lesões, principalmente na detecção de doença vaginal e parametrial. Lesões com diâmetro antero-posterior maior que 6cm e volume acima de 100cm3 apresentaram correlação estatisticamente significante com o erro geográfico. O posicionamento da parede anterior do reto fora do limite posterior dos campos laterais, no raio-X contrastado mostrou correlação estatisticamente significante com o erro geográfico. CONCLUSÕES: Em relação aos limites dos campos de irradiação a RM foi decisória para adequação dos campos de radioterapia, na maioria das pacientes. O estadiamento por RM, comparado ao exame físico, mostrou-se preciso na avaliação de volume tumoral e extensão da doença. No presente estudo, a avaliação do deslocamento da parede anterior do reto na radiografia dos campos laterais de irradiação mostrou associação com o risco de erro geográfico. / OBJECTIVES The purposes of this study were to verify the chances of geographic miss in conventional 2-dimensional radiotherapy planning in patients with uterine cervix cancer, by means of magnetic resonance imaging (MRI); to compare the data from FIGO staging system with MRI findings; and to evaluate the influence of contrasted rectum X-ray in predicting geographic miss. MATERIAL AND METHODS: Eighty patients with uterine cervical carcinoma were analyzed. After clinical staging (FIGO), magnetic resonance imaging of the pelvis was performed. The images were compared to the classic 4-field technique (box) of radiotherapy. Geographic miss was considered when the tumor volume was not included in the irradiation fields with at least 1cm margins. Data of physical examination and RM were compared. RESULTS: In 45 (56,2%) of the 80 studied patients, fields? limits were not adequate. The anterior (anterior 1/3 of pubis) and posterior limits (S2-S3) of the lateral fields of irradiation were critical. Great discrepancy was observed when physical exam was compared to MRI findings. In most cases, physical exam tended to under-stage the tumors, mainly due to vaginal and parametrial extension. Tumors with antero-posterior diameter larger than 6cm and volume above 100cm3 presented statistically significant correlation with geographical miss. Displacement of the anterior rectal wall outside the posterior limit of the lateral fields in the contrasted X-ray was also significantly correlated with geographical miss. CONCLUSIONS: MRI findings detected and prevented geographic misses in the majority of the patients. When compared to physical examination, tumor volume and extension were better defined by MRI. In the present study, the evaluation of the anterior rectal wall displacement in the lateral x-ray of the irradiation fields was associated with the risk of geographical miss.
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