Cette thèse s’inscrit dans la démarche de caractérisation mécanique des tissus mous du vivant in situ et in vivo par un dispositif de succion utilisable en salle opératoire. L’objectif est de fournir au chirurgien un outil simple, efficace, et si possible de coût réduit, pour estimer les propriétés mécaniques spécifiques au patient et en temps réel afin guider leur décisions. Malheureusement, les structures biologiques sont souvent hétérogènes due à leur composition (peau, muqueuse, fibres musculaires, matière adipeuse, fascias, vascularisation, …). En particulier, ces structures biologiques présentent un gradient de propriétés mécanique dans la profondeur. Il s’agit donc de répondre à un problème complexe, d’autant plus qu’il est nécessaire de proposer une méthode non destructive adaptée à une mesure in situ et in vivo en salle opératoire.Parmi les procédés de caractérisation mécanique rencontrés, les méthodes basées sur la succion sont courantes. Ce procédé de mesure consiste à aspirer un volume de tissu mou à travers une ouverture en mesurant simultanément la pression et la hauteur de tissu dans l’enceinte. Une procédure d’identification inverse est ensuite mise en place pour identifier les propriétés mécaniques du tissu. Cette mesure de hauteur étant généralement effectuée à l’aide d’une caméra, le design des systèmes rencontrés reste cependant délicat, en particulier pour respecter les contraintes d’encombrement et de stérilisation des systèmes.Au cours de ce travail, la méthode d’aspiration a été revisitée en remplaçant la mesure de hauteur par une mesure de volume. L’extrémité du dispositif d’aspiration se réduit maintenant à un simple tube : le système fourni est donc facilement stérilisable, le diamètre et la géométrie de l’ouverture peuvent être choisis en fonction des objectifs des mesures à effectuer. Il semble donc difficile d’imaginer un système plus simple, d’encombrement plus réduit et de coût inférieur à celui-ci.Plusieurs problématiques ont été étudiées autour de ce nouveau système :les précisions de mesures obtenues par volume ou, plus classiquement, par caméra ont été confrontées. Au bilan, la mesure de volume présente un ratio signal/bruit similaire ou inférieur aux mesures de volume obtenues par caméra. L’impact de différents paramètres expérimentaux a été évalué et quantifié, permettant d’optimiser la qualité des mesures.les résultats d’identification inverse ont été validés sur des échantillons en silicone. Leur matériau constitutif a été caractérisé pour référence en traction uniaxiale et par bulge test. Les modules de Young obtenus par identification inverse sur le test d’aspiration (calcul itératif par Elements Finis) montrent une sur-estimation de 7% au maximum avec les résultats des tests de référence. Ce résultat est une amélioration significative par rapport aux sur-estimations de 30% rencontrées dans la littérature.les caractéristiques du système ont été mises à profit pour mesurer directement l’épaisseur et les propriétés mécaniques de couches superficielles de tissus multicouches sans autre système de mesure. La preuve de concept a été effectuée expérimentalement sur un échantillon artificiel constitué de deux silicones différents. Au bilan, l’épaisseur de la couche supérieure a été identifiée avec une erreur inférieure à 4% , les modules de Young des deux matériaux avec une erreur inférieure à 8%. Ces résultats sont jugés très encourageants pour une future application de la méthode à des tissus du vivant.une méthode d’identification inverse des propriétés mécaniques en temps réelle a été développée. Cette procédure est basée sur une réduction de modèle et fournit également des indications sur la sensibilité de l’identification aux différents paramètres expérimentaux. L’utilisation de cette méthode d’inversion a montré une erreur d’identification de 10 et 12% par rapport aux valeurs de références sur les spécimens constitués de deux couches de silicones. / In-vivo characterization of biological soft tissues is a key step toward patient-specific biomechanical simulation and planning of intra-operative assisted surgery. These tissues’ structures are usually highly heterogeneous due to the variety of their constituents (skin, mucosa, muscle fibers, fat, fascia, vascularization, etc.). In particular, their local mechanical properties may change with depth.Among various characterization techniques, aspiration method is a standard due to its simplicity: tissue is aspirated through a hole while measuring the negative pressure and the associated apex height. An inverse problem is then solved to identify the material mechanical properties. In the literature, the apex height was usually measured using a camera, which induced design difficulties, in particular regarding the required sterilization process for in-vivo measurements.This thesis aims at developing new practical aspiration techniques and inverse analyze techniques to deal with these challenges.First, the aspiration method is revisited, replacing the apex height optical measurement by the measurement of the aspirated tissue volume. In the proposed method the system head was reduced to a simple tube: sterilization becomes easy and the aspiration aperture diameter can be changed according to experimental requirements. The proposed system is thus probably among the simplest, lightest and most inexpensive devices one could achieve.Then, many studies are developed: (i) a comparison of this volume-based method with classical techniques based on optical measurements, (ii) the validation of the volume-based aspiration device and inverse identification on soft homogeneous synthetic materials, (iii) the development of a method for in-vivo identification of multi-layered soft tissues and its validation on two-layer synthetic samples, and (iv) a method for real-time inverse mechanical identification of constitutive materials using the aspiration results.The experimental signal-to-noise ratio in raw volume measurements obtained either optically or by the volume-based method were compared. The effects on the accuracy of various experimental parameters were investigated and quantified: the volume measurement was proved to present the same order or even better accuracy compared to optical measurements.To validate the inverse identifications using the volume-based aspiration method, silicone samples were then made and characterized using (1) aspiration, and, as references, two standard tests such as (2) uniaxial and (3) equibiaxial extension tests. Performing a Finite Element (FE) inverse identification on the experimental results provided Young’s moduli similar to classical tests with about 7% maximum overestimation for the silicones. This underlines a significant improvement of the measurement method accuracy compared to the literature (about 30% relative overestimation).In the proposed device, the aspiration aperture diameter can be easily changed. This feature was used to develop a new method to characterize the mechanical properties as well as the superficial layers’ thicknesses in multi-layer soft tissues. A proof of concept was experimentally validated on two-layer artificial soft silicone specimens. As a conclusion, the superficial layer thicknesses and the materials Young’s moduli were identified with a maximum error of 4 and 8%, respectively. Such results thus provide encouraging perspectives for the in-vivo characterization of two-layer anatomical structures such as skin and sub-dermal tissues.Eventually, a Design Of Experiment (DOE) method was applied to drastically decrease the computation time involved during the inverse identification step, which is a prerequisite for any use in a clinical routine. The identifications using the DOE method were compared with the reference characteristics of the investigated silicones and maximum errors of 10 and 12% were obtained for the homogeneous and two-layer samples, respectively.

Submitted by Rafael Bispo Paschoalini (rbpaschoalini@gmail.com) on 2016-03-08T04:00:33Z No. of bitstreams: 1 Dissertação de mestrado - Rafael Bispo Paschoalini.pdf: 2764983 bytes, checksum: 576265167e590acb2641a540cda6283a (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-03-09T16:26:52Z (GMT) No. of bitstreams: 1 paschoalini_rb_me_bot.pdf: 2764983 bytes, checksum: 576265167e590acb2641a540cda6283a (MD5) / Made available in DSpace on 2016-03-09T16:26:52Z (GMT). No. of bitstreams: 1 paschoalini_rb_me_bot.pdf: 2764983 bytes, checksum: 576265167e590acb2641a540cda6283a (MD5) Previous issue date: 2016-02-26 / O carcinoma de mama é uma doença heterogênea. Pode ser classificado em fenótipos, com diferentes prognósticos, com base na expressão de determinadas proteínas. O fenótipo luminal é o mais frequente, correspondendo a cerca de 70% dos casos, sendo que tratamentos específicos para este fenótipo de carcinoma de mama já estão em estudo, com melhora promissora do prognóstico das pacientes acometidas. Entretanto, ainda não foram definidos critérios citológicos que pudessem predizer este fenótipo no material obtido pela punção aspirativa por agulha fina (PAAF). OBJETIVO: Investigar critérios citológicos individuais presentes na PAAF que possam se associar com o diagnóstico do fenótipo luminal do carcinoma de mama. MÉTODOS: Trata-se de estudo tipo corte-transversal, com componente descritivo e comparativo. As lâminas de PAAF e espécimes de carcinomas de mama invasivos ductais e lobulares, do período de 2000 a 2005, foram selecionados do arquivo do Laboratório de Patologia do Hospital Amaral Carvalho de Jaú/São Paulo, totalizando 297 casos. Dos blocos doadores foram extraídos cilindros de 2mm de diâmetro e depositados nos blocos de parafina receptores, usando Tissue Microarrays (Bencher Instruments®, Silver Spring, Maryland). Nestes cortes, foi feita a pesquisa imunoistoquímica para diferenciação dos fenótipos do carcinoma de mama, segundo a Classificação Molecular. As lâminas obtidas por PAAF, foram revisadas em microscópio de multiobservação (BX50 Olympus®, Japan), por dois médicos patologistas (RMD e FMN), sendo estudados individualmente os cinco critérios citológicos: celularidade, coesão celular, necrose, nucléolo e atipia nuclear. Utilizou-se o teste exato de Fisher para testar a associação entre os critérios citológicos e os fenótipos do carcinoma de mama. RESULTADOS: Dos 297 casos selecionados, 169 foram incluídos, resultando nos seguintes fenótipos - luminal A: 107 (63.3%), luminal B: 39 (23.1%), superexpressão de HER2: 8 (4.7%), e triplo negativo: 15 (8.9%). Os critérios citológicos que se associaram ao fenótipo luminal foram: celularidade baixa ou moderada (40.4%) (OR = 7.12, IC95%: 1.61 - 31.52), nucléolo inconspícuo ou presente (55.5%) (OR = 8.31, IC95%: 2.36 - 29.19) e atipia nuclear discreta ou moderada (44.5%) (OR = 8.42, IC95%: 1.90 - 37.25). Os critérios citológicos associados ao fenótipo luminal A foram: nucléolo inconspícuo ou presente (62.6%) (OR = 2.99, IC95%: 1.39 – 6.41), menor perda de coesão celular (OR = 0.46, IC95%: 0.24 - 0.88), mostrando grupamentos com coesão celular moderada a intensa, e ausência de necrose (40.2%) (OR = 0.32, IC95%: 0.15 – 0.68). CONCLUSÃO: Os critérios citológicos presentes nas lâminas obtidas por PAAF, e que mais se associaram ao fenótipo luminal do carcinoma de mama foram celularidade baixa e moderada, nucléolos inconspícuos ou pequenos e atipia nuclear leve a moderada. Cabe destacar, que para o fenótipo luminal A, os critérios citológicos que mais se associaram foram: nucléolos inconspícuos ou pequenos, coesão celular moderada a intensa e ausência de necrose. A distinção do fenótipo luminal é de relevância clínica, por apresentar melhor prognóstico, relacionado a menor mortalidade e menores taxas de metástase. / Breast carcinoma is a heterogeneous disease. It can be classified into phenotypes based on the expression of certain proteins, with differences in prognosis. The luminal phenotype is the most common, accounting for about 70% of cases. Some specific treatments for this phenotype of breast carcinoma are already being studied, which could improve prognosis of affected patients. However, there is currently no consensus on which cytological criteria could predict the luminal phenotype. OBJECTIVE: To evaluate which cytological criteria in fine-needle aspiration (FNA) biopsy are related with the luminal phenotype of breast carcinoma. METHODS: This was a cross-sectional study with descriptive and comparative component from cases of breast carcinomas, from the Laboratory of Pathology, Hospital Amaral Carvalho de Jaú / São Paulo. FNA biopsy specimens and tissue sections (mastectomy specimens) of invasive ductal and lobular carcinomas of the breast, retrieved from 2000 to 2005, were selected and classified into phenotypes by immunohistochemistry, using tissue microarray technology (Bencher Instruments®, Silver Spring, Maryland): luminal A and B, HER2 overexpression and triple negative. The cytological criteria for all cases were reviewed blindly by two pathologists using a multiobserver microscope (BX50 Olympus®, Japan), according to five cytological criteria: cellularity, cell cohesion, necrosis, nucleoli and nuclear atypia. Exact Fisher test was used to test the association between cytological criteria and phenotypes of breast carcinoma. RESULTS: From 297 selected patients, 169 were included, resulting in the following phenotypes - luminal A: 107 (63.3%), luminal B: 39 (23.1%), HER2 overexpression: 8 (4.7%), and triple negative: 15 (8.9%). The luminal phenotype showed mild or moderate cellularity (40.4%) (OR = 7.12, 95% CI: 1.61 - 31.52), inconspicuous or present nucleoli (55.5%) (OR = 8.31, 95% CI: 2.36 - 29.19) and mild or moderate nuclear atypia (44.5%) (OR = 8.42, 95% CI: 1.90 - 37.25). Inconspicuous or present nucleoli (62.6%) (OR = 2.99, 95% CI: 1.39 - 6.41), less dishesive cells (OR = 0.46, 95% CI: 0.24 - 0.88), showing clusters with moderate to intense cell cohesion (54.2%), and absence of necrosis (40.2%) (OR = 0.32, 95% CI: 0.15 - 0.68) were associated with luminal A phenotype. CONCLUSION: The individual FNA cytological criteria that might indicate the luminal phenotype of breast cancer were mild to moderate cellularity, inconspicuous or little nucleoli and mild to moderate nuclear atypia. Inconspicuous or little nucleoli, moderate to intense cell cohesion and absence of necrosis were associated with luminal A phenotype. The distinction of luminal phenotype of breast carcinoma is clinically relevant, since it has better prognosis, related to lower mortality and lower metastases rate.

Submitted by Aelson Maciera (aelsoncm@terra.com.br) on 2017-06-23T19:17:36Z No. of bitstreams: 1 TeseLRRF.pdf: 1828970 bytes, checksum: f6d92256401223cfcfe780c5b3b0194a (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-06-28T08:52:33Z (GMT) No. of bitstreams: 1 TeseLRRF.pdf: 1828970 bytes, checksum: f6d92256401223cfcfe780c5b3b0194a (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-06-28T08:52:45Z (GMT) No. of bitstreams: 1 TeseLRRF.pdf: 1828970 bytes, checksum: f6d92256401223cfcfe780c5b3b0194a (MD5) / Made available in DSpace on 2017-06-28T08:57:02Z (GMT). No. of bitstreams: 1 TeseLRRF.pdf: 1828970 bytes, checksum: f6d92256401223cfcfe780c5b3b0194a (MD5) Previous issue date: 2017-03-07 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / This dissertation seeks to understand what I call the aspiration horizons of women from brazilian popular classes and how the access to digital media allows a sociality around the negotiation of the limits and possibilities of such horizons. The objective was to show the context of housing, leisure and work of the subjects, in order to understand that the digital media are mobilized according to social relations established beyond them. This work is in agreement with the theories of the social modeling of technology to understand that both the nature of digital media and the needs and desires of users shape the meaning and utility of a technology in a given historical moment and context. In this sense, technologies are used according to social class relations, gender, sexuality, generational issues, among other aspects that need to be understood. In the same way, the media interfere in the daily life of the subjects, transforming their relations and, sometimes, increasing the possibility of access to diverse cultural repertoires. The empirical field was built on the Internet through Social Networking Service Platforms such as Facebook and Whatsapp, seeking to observe the network sociality of women in the research, their postings, shares, likes and exposure dynamics; outside of the Internet, I did an ethnography in the Baixada Fluminense and in the popular classes of the West Zone of Rio de Janeiro in order to access their daily lives, their places of residence, their structure of access to technology, their circulation throughout the city and their moments of recreation. / Esta tese busca compreender o que chamo de horizontes de aspiração das mulheres das classes populares brasileiras e de que forma o acesso às mídias digitais permitem uma socialidade em torno da negociação dos limites e possibilidades de ampliação de tais horizontes. O objetivo consistiu em mostrar o contexto de moradia, lazer e trabalho dos sujeitos da pesquisa, de forma a compreender que as mídias digitais são mobilizadas de acordo com relações sociais estabelecidas para além delas. Este trabalho se mostra de acordo com as teorias da modelagem social da tecnologia que nos ajudam a compreender que tanto a natureza da mídia como as necessidades e desejos dos usuários moldam o significado e a utilidade de um determinado meio digital em um dado momento histórico e contexto. Nesse sentido, as tecnologias são usadas de acordo com relações de classe social, gênero, sexualidade, questões geracionais, dentre outros aspectos que precisam ser entendidos. Da mesma forma, as mídias interferem no cotidiano dos sujeitos, transformando suas relações e, por vezes, ampliando a possibilidade de acesso à repertórios culturais diversos. O campo empírico foi construído, na internet, por meio de Plataformas de Serviços de Redes Sociais como o Facebook e Whatsapp com vistas a observar a socialidade em rede das mulheres da pesquisa, suas postagens, compartilhamentos, curtidas e dinâmicas de exposição; fora da internet realizei etnografia na Baixada Fluminense e em regiões de classes populares da Zona Oste do Rio de Janeiro de forma a acessar os cotidianos dessas pessoas, seus locais de moradia, sua estrutura de acesso à tecnologia, sua circulação pela cidade e seus momentos de lazer.

Made available in DSpace on 2014-06-11T19:29:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-06-27Bitstream added on 2014-06-13T18:58:52Z : No. of bitstreams: 1 ferreira_rm_me_jabo.pdf: 499475 bytes, checksum: adcc6fc6d838f270b207706f21c18463 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Os objetivos do estudo foram: avaliar o efeito antioxidante do Trolox® 1) no meio de manutenção de embriões sobre as taxas de concepção (25 e 46 dias) e a perda gestacional de receptoras bovinas Holandesas repetidoras de serviço, em dois períodos (abril-junho/setembro-novembro) e 2) no meio de transporte de oócitos bovinos aspirados de ovários de abatedouro sobre as taxas de clivagem, blastocisto e eclosão in vitro. No Experimento 1, doadoras de embriões foram superovuladas e submetidas à lavagem uterina. Os embriões colhidos foram divididos em dois grupos, deixados em meio com ou sem antioxidante, por 2 a 6h. No Experimento 2, folículos foram aspirados e os complexos cumulus-oócito grau I e II foram divididos em quatro grupos: Controle 8h, Antioxidante 8h, Controle 20h e Antioxidante 20h. Então, foram mantidos em uma transportadora de oócitos (37ºC) por 8 ou 20 horas. Após a maturação, fecundação e cultivo in vitro, as taxas de clivagem (D3), blastocisto (D6, 7 e 9) e eclosão (D11) foram avaliadas. Alíquotas de 200 μL do meio de transporte foram retiradas em cada momento experimental (0, 8 e 20h) para realização dos testes de capacidade antioxidante total (CAT). No Experimento 1, não houve efeito de tratamento sobre as variáveis avaliadas. Foi verificado efeito de período experimental (P=0,001), categoria da doadora (P<0,05), qualidade embrionária (P=0,049) e intervalo Divisão dos Grupos-Inovulação (P<0,0001). No Experimento 2, não houve efeito de tratamento sobre as taxas analisadas. No entanto, houve redução das taxas de clivagem e blastocisto (D7 e 9) nos grupos 20 horas. Ainda, no D6 foram obtidas taxas de blastocisto semelhantes nos grupos Antioxidante 8 e 20h. A análise da CAT evidenciou que o Trolox® auxiliou o combate às ROS. / The objectives of the present study were to evaluate the effect of the addition of an antioxidant (Trolox®) 1) to a holding media for bovine in vivo produced embryos, on conception rates 25 and 46 days of pregnancy and pregnancy loss, in Holstein bovine recipients at 4th or more service, during two periods of the year (April-June/September-November) and 2) to a transport media for bovine oocytes aspirated from slaughter house ovaries, on in vitro cleavage, blastocyst and hatching rates. In Experiment 1, donor cows were superovulated and submitted to uterine flushings. The recovered embryos were divided into two groups, kept in holding media with or without antioxidant, for 2-6h. In Experiment 2, follicles were aspirated and cumulus-oocyte complexes grade I and II were divided into four groups: Control 8h, Antioxidant 8h, Control 20h and Antioxidant 20h. Oocytes were kept in a transportable machine (37ºC) for 8 or 20 hours. After in vitro maturation, fertilization and culture, cleavage (D3), blastocyst (D6, 7 and 9) and hatching rates (D11) were evaluated. Samples (200 μL) of the transport media were collected in each experimental moment (0, 8 e 20h) for total antioxidant capacity assay (TACA). In Experiment 1, no effect of treatment was observed. Effects of experimental period (P=0.001), donor category (P<0.05), embryo quality (P=0.049) and interval Group division-embryo transfer (P<0.0001) were detected. In Experiment 2, no effect of treatment was found on the analyzed rates. However, reduction on cleavage and blastocyst (D7 e 9) rates was detected on Groups 20h. Also, on D6 similar blastocyst rates were observed in Groups Antioxidant 8 and 20h. The analysis of TACA evidenced that Trolox® collaborated with the combat against the ROS.

Orientador: Paulo Henrique Franceschini / Banca: Antônio Cláudio Tedesco / Banca: Francisco Guilherme Leite / Resumo: Os objetivos do estudo foram: avaliar o efeito antioxidante do Trolox® 1) no meio de manutenção de embriões sobre as taxas de concepção (25 e 46 dias) e a perda gestacional de receptoras bovinas Holandesas repetidoras de serviço, em dois períodos (abril-junho/setembro-novembro) e 2) no meio de transporte de oócitos bovinos aspirados de ovários de abatedouro sobre as taxas de clivagem, blastocisto e eclosão in vitro. No Experimento 1, doadoras de embriões foram superovuladas e submetidas à lavagem uterina. Os embriões colhidos foram divididos em dois grupos, deixados em meio com ou sem antioxidante, por 2 a 6h. No Experimento 2, folículos foram aspirados e os complexos cumulus-oócito grau I e II foram divididos em quatro grupos: Controle 8h, Antioxidante 8h, Controle 20h e Antioxidante 20h. Então, foram mantidos em uma transportadora de oócitos (37ºC) por 8 ou 20 horas. Após a maturação, fecundação e cultivo in vitro, as taxas de clivagem (D3), blastocisto (D6, 7 e 9) e eclosão (D11) foram avaliadas. Alíquotas de 200 μL do meio de transporte foram retiradas em cada momento experimental (0, 8 e 20h) para realização dos testes de capacidade antioxidante total (CAT). No Experimento 1, não houve efeito de tratamento sobre as variáveis avaliadas. Foi verificado efeito de período experimental (P=0,001), categoria da doadora (P<0,05), qualidade embrionária (P=0,049) e intervalo Divisão dos Grupos-Inovulação (P<0,0001). No Experimento 2, não houve efeito de tratamento sobre as taxas analisadas. No entanto, houve redução das taxas de clivagem e blastocisto (D7 e 9) nos grupos 20 horas. Ainda, no D6 foram obtidas taxas de blastocisto semelhantes nos grupos Antioxidante 8 e 20h. A análise da CAT evidenciou que o Trolox® auxiliou o combate às ROS. / Abstract: The objectives of the present study were to evaluate the effect of the addition of an antioxidant (Trolox®) 1) to a holding media for bovine in vivo produced embryos, on conception rates 25 and 46 days of pregnancy and pregnancy loss, in Holstein bovine recipients at 4th or more service, during two periods of the year (April-June/September-November) and 2) to a transport media for bovine oocytes aspirated from slaughter house ovaries, on in vitro cleavage, blastocyst and hatching rates. In Experiment 1, donor cows were superovulated and submitted to uterine flushings. The recovered embryos were divided into two groups, kept in holding media with or without antioxidant, for 2-6h. In Experiment 2, follicles were aspirated and cumulus-oocyte complexes grade I and II were divided into four groups: Control 8h, Antioxidant 8h, Control 20h and Antioxidant 20h. Oocytes were kept in a transportable machine (37ºC) for 8 or 20 hours. After in vitro maturation, fertilization and culture, cleavage (D3), blastocyst (D6, 7 and 9) and hatching rates (D11) were evaluated. Samples (200 μL) of the transport media were collected in each experimental moment (0, 8 e 20h) for total antioxidant capacity assay (TACA). In Experiment 1, no effect of treatment was observed. Effects of experimental period (P=0.001), donor category (P<0.05), embryo quality (P=0.049) and interval Group division-embryo transfer (P<0.0001) were detected. In Experiment 2, no effect of treatment was found on the analyzed rates. However, reduction on cleavage and blastocyst (D7 e 9) rates was detected on Groups 20h. Also, on D6 similar blastocyst rates were observed in Groups Antioxidant 8 and 20h. The analysis of TACA evidenced that Trolox® collaborated with the combat against the ROS. / Mestre

Orientador: Rozany Mucha Dufloth / Resumo: O carcinoma de mama é uma doença heterogênea. Pode ser classificado em fenótipos, com diferentes prognósticos, com base na expressão de determinadas proteínas. O fenótipo luminal é o mais frequente, correspondendo a cerca de 70% dos casos, sendo que tratamentos específicos para este fenótipo de carcinoma de mama já estão em estudo, com melhora promissora do prognóstico das pacientes acometidas. Entretanto, ainda não foram definidos critérios citológicos que pudessem predizer este fenótipo no material obtido pela punção aspirativa por agulha fina (PAAF). OBJETIVO: Investigar critérios citológicos individuais presentes na PAAF que possam se associar com o diagnóstico do fenótipo luminal do carcinoma de mama. MÉTODOS: Trata-se de estudo tipo corte-transversal, com componente descritivo e comparativo. As lâminas de PAAF e espécimes de carcinomas de mama invasivos ductais e lobulares, do período de 2000 a 2005, foram selecionados do arquivo do Laboratório de Patologia do Hospital Amaral Carvalho de Jaú/São Paulo, totalizando 297 casos. Dos blocos doadores foram extraídos cilindros de 2mm de diâmetro e depositados nos blocos de parafina receptores, usando Tissue Microarrays (Bencher Instruments®, Silver Spring, Maryland). Nestes cortes, foi feita a pesquisa imunoistoquímica para diferenciação dos fenótipos do carcinoma de mama, segundo a Classificação Molecular. As lâminas obtidas por PAAF, foram revisadas em microscópio de multiobservação (BX50 Olympus®, Japan), por dois médicos p... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Breast carcinoma is a heterogeneous disease. It can be classified into phenotypes based on the expression of certain proteins, with differences in prognosis. The luminal phenotype is the most common, accounting for about 70% of cases. Some specific treatments for this phenotype of breast carcinoma are already being studied, which could improve prognosis of affected patients. However, there is currently no consensus on which cytological criteria could predict the luminal phenotype. OBJECTIVE: To evaluate which cytological criteria in fine-needle aspiration (FNA) biopsy are related with the luminal phenotype of breast carcinoma. METHODS: This was a cross-sectional study with descriptive and comparative component from cases of breast carcinomas, from the Laboratory of Pathology, Hospital Amaral Carvalho de Jaú / São Paulo. FNA biopsy specimens and tissue sections (mastectomy specimens) of invasive ductal and lobular carcinomas of the breast, retrieved from 2000 to 2005, were selected and classified into phenotypes by immunohistochemistry, using tissue microarray technology (Bencher Instruments®, Silver Spring, Maryland): luminal A and B, HER2 overexpression and triple negative. The cytological criteria for all cases were reviewed blindly by two pathologists using a multiobserver microscope (BX50 Olympus®, Japan), according to five cytological criteria: cellularity, cell cohesion, necrosis, nucleoli and nuclear atypia. Exact Fisher test was used to test the association between cy... (Complete abstract click electronic access below) / Mestre

Os nódulos de tireoide são frequentemente encontrados na prática clínica e, com o auxílio de ultrassonografia de alta resolução, podem ser identificados em 17 a 67% da população. A alta prevalência desses nódulos causa preocupação frequente aos pacientes e aos clínicos devido ao risco de malignidade, o que, por sua vez, leva a investigações laboratoriais de alto custo, invasivas e, eventualmente, a cirurgias desnecessárias. A punção aspirativa com agulha fina (PAAF) é o método diagnóstico pré-operatório mais preciso para identificação de um nódulo maligno de tireoide, mas não consegue excluir malignidade nos casos de citologia inadequada, nódulos com diagnóstico citológico de lesão folicular ou atipia de significado indeterminado e nas citologias sugestivas de neoplasia folicular. O objetivo deste estudo foi analisar as características clínicas, laboratoriais, ultrassonográficas e citológicas de uma população de pacientes com nódulos de tireoide submetidos a tireoidectomia e a relação entre estes achados e o risco de malignidade. Além disto, em relação aos nódulos malignos, verificar se o valor de TSH esteve associado a um estadiamento mais avançado da doença. Foram avaliados prontuários de 353 pacientes submetidos a tireoidectomia, acompanhados no Hospital das Clínicas da FMUSP de São Paulo, no período de fevereiro de 2002 a abril de 2010. O número total de nódulos nestes pacientes foi 392. As características clínicas e laboratoriais analisadas em cada paciente foram idade, sexo, valores séricos de TSH e T4 livre, presença de anticorpo anti-tireoperoxidase (anti- TPO) e anti-tireoglobulina (anti-TG). Foram avaliadas a presença de características ultrassonográficas sugestivas de benignidade (presença de halo periférico hipoecoico, aparência espongiforme, aspecto isoecóico ou hiperecoico) e de malignidade (nódulo sólido hipoecoico, contornos irregulares, presença de microcalcificações). Baseados nestas características, os nódulos foram classificados em benignos, indeterminados e suspeitos para malignidade. O diagnóstico citológico foi classificado em benigno, indeterminado, suspeito e maligno, e a análise combinada das características ultrassonográficas e citológicas também foi avaliada. Ao exame histopatológico, 200 nódulos eram malignos e 192 nódulos eram benignos. Os nossos resultados mostraram que sexo, idade, valores séricos de TSH e T4 livre e presença de anticorpo anti-TPO e anti-TG não estiveram associados a uma maior chance de malignidade. O valor de TSH sérico também não esteve associado a maior risco de recorrência ou estadiamento mais avançado nos pacientes com câncer Os nódulos maiores estiveram mais associados a benignidade quando avaliamos toda amostra. Na análise multivariada de toda amostra, após regressão logística, apenas a citologia maligna, hipoecogenicidade e presença de microcalcificações foram associados a malignidade. Já, a classificação ultrassonográfica que não se baseia em apenas uma característica mas em um conjunto de características, apresentou um alto valor preditivo de benignidade e foi útil na identificação de nódulos com citologia indeterminada. A classificação ultrassonográfica tem o potencial de reduzir o número de cirurgias para nódulos com citologia indeterminada / Thyroid nodules are often encountered in clinical practice, and with the use of high-resolution ultrasound may be identified in 17 to 67% of the population. The high prevalence of these nodules cause frequent concern to patients and clinicians due to the risk of malignancy, wich in turn leads on costly investigations, use of invasive diagnostic methods and sometimes unnecessary surgeries. Fine needle aspiration biopsy (FNAB) is the most accurate preoperative diagnostic method to identify a malignant thyroid nodule. However, FNAB cannot rule out malignancy in cases of inadequate cytology, follicular lesions, atypia of undetermined significance, and in cytology suggestive of follicular neoplasm. The aim of this study was to analyze clinical, laboratory, ultrasound and cytopathologic characteristics of a group of patients with thyroid nodules undergoing thyroidectomy and the relationship between serum levels of TSH and the risk of malignancy. In nodules found to be malignant in this cohort, we analyzed the association of TSH levels with advanced disease stage and risk of recurrence. We analyzed the records of 353 patients who were followed at Hospital das Clínicas - São Paulo Medical School, between February 2002 and April 2010, and who subsequently underwent thyroidectomy. The total number of nodules in these patients was 392. The clinical and laboratory characteristics included in the analysis were age, gender, serum levels of TSH and free T4, and presence of serum thyroid anti-peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies. We evaluated the presence of ultrasonographic features suggestive of benignity (isoechoic or hyperechoic appearance, presence of hypoechoic peripheral halo, spongiform appearance) and malignancy (hypoechoic appearance, irregular border, presence of microcalcifications). Based on these ultrasonographic characteristics, we classified the nodules as benign, indeterminate or suspicious for malignancy. According to the FNAB cytology, we also subdivided the nodules into benign, indeterminate, suspicious and malignant. The combined analysis of ultrasonographic features and cytopathology was also evaluated. On histopathology, 200 nodules were malignant and 192 were benign. Our results showed that gender, age, serum levels of TSH and free T4, as well as the presence of anti-TPO and anti-TG were not associated with increased risk of malignancy. Similarly, serum TSH value was not associated with increased risk of recurrence or more advanced stage in patients with thyroid cancer. A large nodule size was associated with benignity. In multivariate analysis, after logistic regression, only malignant cytology, hypoechoic appearance and presence of microcalcifications were associated with malignancy. Furthermore, the ultrasonographic classification, wich was not based in only one feature but in a set of characteristics, showed a high predictive value for benignity and seems to be useful in identifying nodules with indeterminate cytology at risk for malignancy. The use of ultrassonographic classification has the potential to reduce the number of surgeries for nodules with indeterminate cytology

This study aims to explore if it is possible to form separate categories of aspirated voiceless stops in a second language, distinct from the equivalent categories in the native language, for native speakers of a language with an intermediate degree of aspiration, and if such category formation is eased by long-term exposure to another language in which aspirated voiceless stops exist. Two groups of adult native Japanese speakers who had lived in Sweden for a long and short time respectively were recorded when reading a list of sentences containing word-initial, utterance-medial /p t k/ in Japanese and English. Both groups produced higher VOT values for the English stops than for the Japanese stops. The results were significant for /t/ and /k/ and for the long-term residents' /p/, but not for the short-term residents' /p/, presumably because of a low number of tokens. The results are nevertheless interpreted as evident of the possibility of phonetic category formation even though there is only a small difference from the corresponding category in the native language. Since both groups had established new phonetic categories, degree of exposure to Swedish is interpreted as likely not to be a relevant factor.

For this study, two groups of native Icelandic speakers were compared in terms of the acoustic properties of their English pronunciation of two phonetic phenomena, plosives and pre-aspiration. In English, plosives with the same manner and place of articulation are distinguished by means of a voicing contrast, whereas in Icelandic, plosives are distinguished by means of an aspiration contrast. This study examines whether participants exhibit interlanguage features in their plosive contrasts in English, substituting unaspirated voiceless plosives for voiced counterparts. Furthermore, this study looks at pre-aspiration, a phonetic feature of Icelandic, characterized by glottal friction following a short vowel preceding a fortis plosive (VhC). Pre-aspiration is not a feature of standard English varieties such as general American (GA) or received pronunciation (RP), and as such this study examines whether participants retain pre-aspiration in their English pronunciation or not. Participants numbered 16 in total, and were all L1 speakers of Icelandic, with eight in each group, four male and four female. The groups were divided by means of age differences, with the first group consisting of participants aged 20-26, and the second group of participants aged 44-50. Participants were asked to partake in a short informal interview, to read a short written passage, and to read a word list. The interview and readings were recorded and analysed using spectrograms and waveforms, and subsequently compared with English and Icelandic reference values for voice onset time (VOT), which vary between the two languages, and pre-aspiration duration in Icelandic. The two groups were also compared to determine whether there were any lingering differences between them. The conclusions drawn are that VOT in English and Icelandic may be more similar than assumed, and that participants shorten pre-aspiration duration or neutralize pre-aspiration when speaking English. However, the English production of the features are more similar to Icelandic than English. Furthermore, the results do not indicate any differences between the two age groups in terms of English pronunciation.

The thesis describes the application of several methods of multicriterial evaluation of alternatives (MEoA) in various phases of the recruitment process for the position Corporate Account Manager in Telefónica O2 Czech Republic, a.s. In the first round, the group of all enrolled candidates is reduced using aspiration levels. In the second round, this narrowed down group goes through the Assessment Centre. Using other methods of MEoA, the most suitable candidate for the position is chosen.