Thesis (Ph.D.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (p. 218-235). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Tong Hoi Yee. / "July, 2003." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (p. 237-253). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Geologic storage of anthropogenic carbon dioxide (CO2) by injection into underground porous sandstone reservoirs has been proposed as a method for the reduction of anthropogenic greenhouse gas emissions. Upwards migration and leakage of injected fluids along natural fault and fracture networks is a key risk factor for potential injection locations. We examine exposed natural analogs to evaluate the impacts of faulting and fracturing on reservoir and top-seal pairs and to evaluate evidence for paleomigration of fluids along the fault zone. We examine the Iron Wash fault, a 25-km long normal fault which cuts Jurassic sedimentary rocks and has throws that range from 20-120 m, to examine how a fault may affect seal integrity. Field mapping, kinematic analysis, petrographic analysis, characterization of the fault zone facies and fault architecture, analysis of altered and mineralized rocks in and around the fault zone, and modeling of fault seal capacity was conducted to provide an understanding of the Iron Wash fault zone. Field data and observations were combined with well log and borehole data to produce three types of models for the Iron Wash fault: 1) geometric model of the fault in the subsurface, 2) predictive models of fault zone behavior and fault seal analysis, and 3) predictive geomechanical models of the response of the fault zone to an imposed stress field and increasing the effective stress on the fault. We conclude that the Iron Wash fault zone has low sealing capacity and will likely not behave as a seal for fluids against the fault zone due primarily to modest throw on the fault and high frequency of fractures associated with the fault zone. Analysis of fluid alteration and mineralization around the fault zone indicates that the fault zone was conduit for paleo-fluids. We conclude that the fault is not likely to develop a sealing membrane and therefore will most likely fail as a seal to fluids moving through the reservoirs modeled here. Modeling results indicate that a reduction in the effective normal stress on fault surfaces may induce failure of faults resulting in earthquakes or increased hydraulic conductivity of fractures.

Aromatase is an enzyme that facilitates the conversion of androgens to estrogens and may play a role in mood and mental status. The main theme of this thesis is the imaging of brain aromatase by use of the PET technique. The PET tracer for aromatase, 11C-labeled vorozole (VOZ) was developed and evaluated by with in vitro and in vivo methods. In vitro experiments using rat brain showed that VOZ was distributed in the medial amygdala, bed nucleus of the stria terminalis and medial preoptic area, regions of the brain known to be rich in aromatase and the KD value was determined to be 0.60 nM. The in vivo PET study in rhesus monkey brain revealed that VOZ penetrated the blood-brain barrier and accumulated in the amygdala and hypothalamus. Taken together, VOZ is a good PET tracer for in vivo aromatase imaging with high affinity and high sensitivity. This technique was applied to an investigation of brain aromatase under the physiological conditions simulating anabolic-androgenic steroid abuse. A significant increase in VOZ binding by anabolic-androgenic steroids was observed in the bed nucleus of stria terminalis and medial preoptic area in the rat brain. In contrast, no significant change in binding was observed in the medial amygdala. These results indicate that the manner of regulation of aromatase expression might be different in the bed nucleus of stria terminalis and medial preoptic area compared with that in the medial amygdala. The aromatase expression was suggested to be regulated through androgen receptors, as indicated in a study with flutamide treatment. The increased aromatase expression was seen in neurons. The PET study with anabolic steroid-treated rhesus monkeys also showed increased VOZ binding in the hypothalamus but not in the amygdala. The alteration of density of aromatase binding in the hypothalamic area could explain some psychological features of anabolic-androgenic steroid abusers. Novel PET tracers for aromatase were developed and examined. The two newly synthesized 18F-labeled vorozole analogs, [18F]FVOZ and [18F]FVOO, displayed different characteristics. Both tracers showed similar binding pattern as VOZ; however, [18F]FVOO was metabolized very quickly, meaning that this tracer is not suitable as a PET tracer. On the other hand, [18F]FVOZ can be an appropriate PET tracer. The role of aromatase in the human brain has not been clarified yet. To approach this problem by in vivo methods, we have just started PET studies to explore aromatase expression in humans.

Small intestinal neuroendocrine tumor (SI-NET) is the most common small bowel tumor in Europe and USA, with an annual incidence of around 0.3-1.3/100000 persons. SI-NETs are the most common type of gastroenteropancreatic NETs (GEP-NETs), and they are known for their ability to produce hormones such as tachykinins and serotonin, as well as for their favorable long-term prognosis in comparison to gastrointestinal adenocarcinoma. The overall aim of the thesis was to investigate unknown or unclear aspects of SI-NET disease, in connection with prognosis, treatment and follow-up. Paper I confirmed several known negative prognostic factors and also showed, for the first time, that para-aortal lymph node metastases and peritoneal carcinomatosis were associated with worse survival by multivariable analyses. Locoregional surgery was associated with a low post-operative mortality, and a prolonged long-term survival by multivariable analysis. In Paper II we continued to investigate peritoneal carcinomatosis and found it be a risk factor not only for death, but also for emergency re-surgery. Furthermore, genetic analyses of samples from primary tumors in patients with and without peritoneal carcinomatosis showed a difference in the DNA between these two groups. In Paper III the outcome after liver surgery and/or radiofrequency ablation of liver metastases was investigated. To summarize, no difference in survival was seen in patients treated with surgery/radiofrequency ablation in comparison with matched controls. However, a superior radiological response of liver metasases and lower U-5-HIAA values were seen in patients subjected to liver surgery and/or radiofrequency ablation compared to matched controls. Paper IV compared ultrasonography, computed tomography and 11C-5HTP-PET in the follow-up after radiofrequency ablation of NET liver metastases. The study concluded that 11C-5HTP-PET depicted all residual tumors after RFA and that it, if used, should be combined with computed tomography for easier interpretation, as RFA areas are not clearly distinguishable with 11C-5HTP-PET alone. Paper V studied gallstone complications after somatostatin analog treatment in SI-NET patients, and concluded that there was a rather high risk to be subjected to a cholecystectomy due to biliary colic, cholecystitis, cholangitis or pancreatitis after primary surgery in somatostatin analog treated patients.

Diss. (sammanfattning) Linköping : Univ., 2001. / Härtill 4 uppsatser.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2014-10-29T13:42:36Z No. of bitstreams: 1 Maria Isabel Magalhães Santos Perfil das....pdf: 1133942 bytes, checksum: bcc264f7cc24ec022846c05825fd31cf (MD5) / Made available in DSpace on 2014-10-29T13:42:36Z (GMT). No. of bitstreams: 1 Maria Isabel Magalhães Santos Perfil das....pdf: 1133942 bytes, checksum: bcc264f7cc24ec022846c05825fd31cf (MD5) Previous issue date: 2014 / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Introdução: A doença causada pelo vírus da hepatite B (HBV) é um problema de saúde pública mundial. No Brasil, o sistema único de saúde (SUS) tem disponibilizado drogas antivirais para o tratamento de hepatite B crônica há mais de 10 anos, mas um sistema para o monitoramento e avaliação de resistência a estas drogas ainda não está disponível. Objetivo: Este estudo teve como objetivo determinar o perfil de mutações do HBV associadas com a resistência aos análogos de nucleos(t)ídeos entre 81 pacientes com infecção crônica pelo HBV: virgens de tratamento para hepatite B e tratados com diferentes análogos de nucleosídeos e nucleotídeos, no Hospital Professor Edgar Santos (HUPES-UFBA)- Salvador-BA. Metodologia: O HBV-DNA foi isolado de amostras de soro, amplificado por nested-PCR, utilizando-se primers deduzidos da região flaqueadora da domínio rt do gene P e sequenciados (ABI Prism 3730, Applied Biosystems, EUA). Duas a seis sequências de cada isolado foram alinhados e os sítios conflitantes foram resolvidos usando o software CLC Main Workbench v. 5.0 por inspeção visual dos eletroferogramas. As sequências consenso tinham um tamanho de 1032 pb (compreendendo os aminoácido 1-344 da rt). Estas sequências foram submetidas ao banco de dados HBVrt DB (Stanford University, EUA) para a análise de cada mutação de acordo com o genótipo e tratamento. Resultado: O genótipo A1 foi o mais prevalente (85,2%) seguido pelo genótipo A2 (4,9%) F (6,2%) e C1, D2 e D4 (1,2% cada). Seis pacientes (7 %) apresentaram mutações de resistência para LAM, ETV, TDF: dois com o padrão L180M + M204V e quatro com padrões diversos (L80I + L180M + M204I ;L80V + L180M + M204V; M204I; A194T). Todas estas mutações foram associadas ao genótipo A (quatro A1 e dois A2). Além disso, foi encontrado um paciente com HBV genótipo C típico do leste da Ásia. Destes pacientes, dois foram virgens de tratamento e quatro tinham histórico de tratamento para HIV ou HBV. Foram detectadas quatro mutações no gene S (três casos com a mutação sI195M e um a mutação sW196L) associadas às mutações do domínio rt do gene P, correspondendo à uma taxa de 6% de mutações de escape vacinal. A prevalência das mutações de resistência às drogas antivirais variou de acordo com a duração do tratamento e com o nível da barreira genética da droga utilizada. Neste estudo, foi encontrada uma forte associação entre a ocorrência de mutações de resistência do HBV e positividade para o AgHBe, co-infecção com o HIV e histórico de tratamento para HBV e/ou HIV. Conclusão: Antes da terapia ser iniciada é extremamente importante o monitoramento da carga viral e a identificação destas mutações para suportar decisões clinicas sobre o manejo dos pacientes e prevenir a emergência de vírus multi- resistentes. / Introduction: Hepatitis B virus (HBV) infection is a public health issue. The Brazilian public health system (SUS) has provided antiviral drugs for chronic hepatitis B treatment for over 10 years, but a system for monitoring for drug-related resistance mutations is not available. Objective: This study aims to determine the presence of HBV mutations associated with resistance to nucleos(t)ide analogs among 81 patients with chronic HBV infection-naïve and treated from University Hospital Professor Edgard Santos, Salvador-BA (HUPES-UFBA). Methods: Briefly, HBV-DNA was PCR amplified with primers deduced from the flanking of the rt domain at the HBV P gene and sequenced using ABI Prism 3730 (Applied Biosystems, USA). From two to six forward and reverse sequences of each isolate were assembled and conflicting sites were resolved using software CLC Main Workbench v. 5.0 by visual inspection of the electropherograms. Consensus sequence extended 1032 bp and encompassed the entire rt domain (from amino acid 1 to 344). Those sequences were submitted to the HBV drug resistance database (HBVrt DB, Stanford University, USA) to retrieve each mutation according to genotype and treatment. Results: HBV genotype A1 (85.2%) was the most prevalent followed by genotype A2 (4.9%), F (6.2%), and C1, D2 and D4 (1.2% each). Six patients (7%) exhibited resistance mutations to LAM, ETV and TDF: two with patterns L180M + M204V and four with other different patterns: L80I + L180M + M204I; L80V + L180M + M204V; M204I; A194T. All of these mutations were present in patients with genotype A (four A1 and two A2). Furthermore, this study found one patient with genotype C, common in East Asian. Of these patients, two were naïve and four had a history of treatment for HIV or HBV. In addition, four mutations in gene S (sI195M three cases with the mutation and one with the mutations W196L) associated with mutations in the rt domain of the P gene were detected, corresponding to a rate of 6% of vaccine escape mutations. Prevalence of drug-related resistance mutations varied according to treatment duration and the level of genetic barrier for the drugs used. Conclusion: In this study a strong association was found between the occurrence of HBV resistance mutations and HBeAg positivity, co-infection with HIV and a history of treatment for HBV and / or HIV. Once the drug therapy is initiated it is extremely important to monitor viral load and identify those mutations in order to support clinical decisions about patient management and also to prevent the emergence of multidrug-resistant viruses.

O objetivo deste estudo foi avaliar a influência de dois aditivos, propionaldehyde (propanal aldeído) e 2,3-butanedione (diquetona diacetil), nas propriedades de comonômeros, copolímeros e resinas compostas à base de Bis-GMA, quando diluído com TEGDMA, Bis-GMA propoxilado (CH3Bis-GMA) e Bis-GMA propoxilado fluorinado (CF3Bis-GMA). Comonômeros, copolímeros e compósitos experimentais foram preparados combinando Bis-GMA com TEGDMA, CH3Bis-GMA, CF3Bis-GMA e, aldeído (24 e/ou 32 mol%) e diquetona (24 e/ou 32 mol%). No caso dos compósitos, partículas híbridas silanizadas (bário aluminosilicato; 60 peso%) foram adicionadas aos comonômeros. Para a fotopolimerização, adicionou-se canforoquinona (0,2 peso%) e N,N-dimetil-p-toluidina (0,2 peso%). Os comonômeros e copolímeros experimentais tiveram as seguintes propriedades avaliadas: viscosidade, contração de polimerização, grau de conversão, ângulo de contato (em esmalte, dentina e vidro), temperatura de transição vítrea (DSC e equação de Fox), microdureza, alteração de rugosidade superficial e desgaste por abrasão. Os compósitos experimentais, tiveram avaliadas as seguintes propriedades: resistência flexural, módulo de elasticidade, tração diametral, módulo de resiliência, microdureza, alteração de rugosidade superficial e desgaste por abrasão. Os sistemas Bis-GMA/TEGDMA e Bis-GMA/CH3Bis-GMA tiveram suas propriedades significantemente alteradas pela incorporação de aditivos (propanal ou diquetona). Os aditivos (propanal/diquetona) não influenciaram de forma significante as propriedades do sistema Bis-GMA/CF3Bis-GMA. O efeito dos aditivos nas propriedades dos materiais analisados relaciona-se à sua abilidade em aumentar o grau de conversão de alguns sistemas resinosos / The purpose of this study was to evaluate the effect of two additives, propionaldehyde (aldehyde) and 2,3-butanedione (diketone), on the properties of Bis-GMA based comonomer, copolymer and composites when diluted with TEGDMA, propoxylated Bis- GMA (CH3Bis-GMA) and propoxylated fluorinated Bis-GMA (CF3Bis-GMA). Experimental comonomer/copolymer/composites were prepared combining Bis-GMA and TEGDMA, CH3Bis-GMA, CF3Bis-GMA, with aldehyde (24 and/or 32 mol%) and diketone (24 and/or 32 mol%). For composites, hybrid treated filler (barium aluminosilicate glass; 60 wt%) was added to monomer mixtures. Photopolymerization was effected by using camphorquinone (0.2 wt%) and N,N-dimethyl-p-toluidine (0.2 wt%). Experimental comonomer/copolymers viscosity, polymerization shrinkage, degree of conversion, contact angle (enamel, dentin and glass surfaces), glass transition temperature (DSC and Fox equation), microhardness, surface roughness changes and wear were evaluated. Experimental composites, flexural strength, modulus of elasticity, diametral tensile strength, modulus of resilience, microhardness, surface roughness changes and wear were also assessed. Bis-GMA/TEGDMA and Bis- GMA/CH3Bis-GMA systems had properties significantly influenced by incorporation of additives (either propanal or diketone). Additives (propanal/diketone) did not significantly influence on Bis-GMA/CF3Bis-GMA system properties. The effect of additives on the evaluated material properties is mainly attributed to their ability in improving some resin systems degree of conversion

Introdução: A acromegalia é uma doença rara, caracterizada pela produção aumentada de hormônio do crescimento, causada geralmente por um adenoma hipofisário, ocasionando uma série de comorbidades como apneia do sono e resistência insulínica que acarretam um aumento na mortalidade e redução da expectativa de vida. Objetivo: O objetivo deste estudo foi avaliar o impacto da terapêutica da apneia do sono com um dispositivo de pressão positiva contínuas nas vias aéreas (CPAP) e avaliar o impacto desta terapêutica na resistência insulínica pela realização do clamp euglicêmico hiperinsulinêmico (CEH). Pacientes: De 156 acromegálicos regularmente atendidos na unidade de Neuroendocrinologia do HC-FMUSP, foram selecionados 12 indivíduos com apneia do sono de moderada a grave em uso de análogos da somatostatina (AS). Método: Os pacientes foram randomizados em dois grupos com seis integrantes. O grupo A iniciou o tratamento com CPAP, e o grupo B, um adesivo dilatador nasal com efeito de placebo. A avaliação basal incluiu a polissonografia, determinação do GH, IGF-1, HbA1c, ácidos graxos livres, lípides, CEH, bem como os índices de resistência periférica à insulina (HOMA, HOMA2 e QUICKI). Após 3 meses de tratamento, os pacientes foram reavaliados pelos mesmos exames, sendo trocado o tratamento entre os grupos e feita nova avaliação, após mais 90 dias. Resultados: Analisando os resultados finais de todos os pacientes que fizeram uso do CPAP, foi observada uma redução significante na resistência periférica à insulina, verificada pelo índice de sensibilidade derivado do clamp (ISCLAMP, pré e pós- CPAP, 3,83 versus 6,11, p=0,032). Esta redução não foi observada no grupo que fez uso do adesivo nasal (ISCLAMP, pré e pós-adesivo, 5,53 versus 5,19, p=0,455). Não houve diferença significante nos níveis de lípides, HbA1c nem nos índices de resistência periférica à insulina. Conclusão: O tratamento da apneia do sono moderada a grave com CPAP, em pacientes acromegálicos em uso de AS, levou a uma redução da resistência periférica à insulina aferida pelo CEH, dado não observado por meio dos índices HOMA, HOMA2 e QUICKI / Introduction. Acromegaly is a rare disease, characterized by the production of high GH levels usually by pituitary adenoma leading to comorbidities as sleep apnea and insulin resistance, bringing increase of mortality and life span reduction. Objective: This study aims to assess the impact of treatment of sleep apnea with a continuous positive air pressure device (CPAP) on the insulin resistance by performing the hyperinsulinemic euglycemic clamp (HEC). Patients: From 156 acromegalic patients regularly attended on Neuroendocrine Unit of the Hospital das Clínicas, University of São Paulo Medical School, 12 subjects on somatostatin analogs (SA) harboring moderate to severe sleep apnea were selected. Methods: Patients were randomized in two groups of six subjects. Group A started treatment with CPAP while group B started treatment using a nasal dilator adhesive with placebo effect. Basal assessment included polysomnography, determination of GH, IGF-1, HbA1c, free fat acids, lipids assays, HEC as well as insulin resistance indexes (HOMA, HOMA2 and QUICKI). Patients were reevaluated after three months of treatment by the same tests and then the treatment was switched between groups with new assessment 90 days later. Results: A significant reduction on insulin resistance determined by the clamp derived sensibility index was observed after assessing the final data of all patients on CPAP (SICLAMP, pre and post CPAP, 3,83 versus 6,11, p=0,032). This reduction was not seen in the nasal dilator adhesive group (SICLAMP, pre and post adhesive, 5,53 versus 5,19, p=0,455). There was no significant difference on lipids, HbA1c or on peripheral insulin resistance indexes. Conclusion: CPAP treatment of acromegalic patients on AS with moderate to severe sleep apnea leaded to significant reduction on peripheral insulin resistance assessed by the HEC. HOMA, HOMA2 and QUICK did not detect this data

Les traitements actuels contre le virus de l’hépatite B (VHB) combinent un ou plusieurs analogues de nucléos(t)ides qui inhibent directement la réplication virale en bloquant l’étape de transcription inverse. Ces traitements très efficaces sont pourtant confrontés à l’émergence de virus résistants à ces traitements. Ces résistances sont la conséquence de l’émergence et la sélection de mutants parfois complexes présentant des mutations à la fois dans le gène de la polymérase (pol) et de l’enveloppe virale. Les objectifs principaux de ce doctorat ont été d’étudier la sensibilité des variants résistants du VHB vis-à-vis d’analogues de nucléos(t)ides et de nouveaux composés nonnucléos(t)idiques agissant contre la nucléocapside, mais également de comparer les performances virales de différents mutants afin de comprendre le processus de sélection des mutants qui s’opère chez le patient sous pression thérapeutique. Ces études ont caractérisé la sensibilité de certaines mutations de résistance aux analogues de nucléos(t)ides, de souligner l’importance des modifications de l’enveloppe dues aux mutations de résistance dans le processus d’émergence et de sélection des variants dans la quasi-espèce virale et d’identifier de nouvelles molécules antivirales efficaces permettant, en combinaison avec les analogues de nucléos(t)ide, de diminuer fortement les phénomènes de résistance du VHB. Mieux comprendre les phénomènes de résistance, les procédés d’émergence, de sélection et de transmission des mutants du VHB pour élaborer les meilleures stratégies cliniques de combinaisons thérapeutiques peut réduire considérablement le nombre de personnes touchées par ce virus / Current therapies against the hepatitis B virus (HBV) combine one or more nucleoside analogues that directly inhibit viral replication by blocking reverse transcription step. These treatments are very effective, however, faced with the emergence of viruses resistant to these treatments. These resistances are the result of the emergence and selection of mutants with mutations can be complex in both the polymerase gene (pol) and the viral envelope. The main objectives of this PhD was to study the sensitivity of resistant HBV variants vis-à-vis similar nucleos(t)ides and new compounds non-nucleos(t)idic acting against the nucleocapsid, but also compare the performance of different viral mutants to understand the process of selection of mutants that occurs in patients under therapeutic pressure. These studies have characterized the sensitivity of some resistance mutations to nucleoside analogues, to highlight the importance of the envelope changes due to resistance mutations in the process of emergence and selection of variants in the quasispecies virus and to identify new effective antiviral drugs may allow, in combination with nucleoside analogues, to greatly reduce the phenomenon of HBV resistance. Better understanding the phenomenon of resistance, the processes of emergence, selection and transmission of HBV mutants to develop the best clinical strategies of combination therapy can significantly reduce the number of people affected by this virus