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The evolution of eukaryotic ciliaHodges, Matthew Edmiston January 2011 (has links)
Eukaryotic cilia are complex, highly conserved microtubule-based organelles with a broad phylogenetic distribution. Cilia were present in the last eukaryotic common ancestor and many proteins involved in cilia function have been conserved through eukaryotic diversification. The evolution of these ciliary functions may be inferred from the distribution of the molecular components from which these organelles are composed. By linking protein distribution in 45 diverse eukaryotes with organismal biology, I define an ancestral ciliary inventory. Analysis of these core proteins allows the inference that the cenancestor of the eukaryotes possessed a cilium for motility and sensory function. I show that the centriolar basal body function is ancestral, whereas the centrosome is specific to the Holozoa, and I use this information to predict a number of roles for proteins based on their phylogenetic profile. I also show that while remarkably conserved, significant divergence in ciliary protein composition has occurred in many lineages, such as the unusual centriole of Caenorhabditis elegans and the transitional changes throughout the land plants. I exemplify this divergence through ultrastructural studies of the fern Ceratopteris richardii and the liverwort Marchantia polymorpha both of which have cilia that exhibit a number of distinctive morphological features, the most conspicuous of which is a general breakdown of canonical microtubule arrangements. Cilia have also been lost multiple times in different lineages: at least twice within the land plants. During these evolutionary transitions proteins with ancestral ciliary functions may be lost or co-opted into different functions. I have interrogated genomic data to identify proteins that I predict had an ancestral ciliary role, but which have been maintained in non-ciliated land plants. I demonstrate that several of these proteins have a flagellar localisation in protozoan trypanosomes and I use expression data correlation to predict potential non-ciliary plant roles.
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Functional characterisation of synuclein-based novel genetic mouse modelsAnwar, Sabina Zareen January 2011 (has links)
Synucleins are highly conserved presynaptic proteins with unknown function. α-synuclein plays a key role regulating dopamine homeostasis and is intimately involved in Parkinson’s disease (PD) pathogenesis. However, the normal/pathological role of α-synuclein remains unidentified. Studies exploring its function are limited as current transgenic mouse models do not fully recapitulate PD pathology. This thesis reports the functional characterisation of two novel synuclein-based mouse models. I report the molecular and functional characterisation of transgenic mouse lines with wild-type or A30P-mutant human α-synuclein genomic locus carried within a bacterial artificial chromosome. SNCA-A30P<sup>+</sup>Snca-/- mice exhibited a highly physiologically relevant expression pattern of the transgene, including expression in the substantia nigra pars compacta (SNpc) and a specific, age-related loss of TH<sup>+</sup> cells in the SNpc, the key region of preferential cell loss in PD, compared with non-transgenic Snca -/- littermate controls. Analysis of dopamine signalling using fast-scan cyclic voltammetry (FCV) showed young adult SNCA-A30P<sup>+</sup>Snca-/- mice had an approximately 20% lower evoked extracellular dopamine concentration ([DA]o) compared with non-transgenic Snca -/- littermate controls, a decrease specific to the dorsal striatum. This difference diminished with age and could not be attributed to changes in dopamine reuptake/content. I detail the behavioural and neurochemical phenotype in mice lacking all three synucleins (α/β/γ). Functional compensation between synucleins emphasises the importance of studying their effects by removing all three proteins simultaneously. Triple-null mice exhibited hyperactivity in a novel environment reminiscent of a hyperdopaminergic-like phenotype, but showed no phenotype in anxiety or motor related tests. FCV revealed synuclein triple-null mice had a two-fold increase in [DA]o, specific to the dorsal striatum and not attributable to changes in dopamine reuptake/content, changes in striatal nicotinic receptor activity nor calcium-dependent changes in dopamine exocytosis. Together, the analysis from these two novel mouse models reveal synucleins play an important role in altering synaptic function in the dorsal striatum (the region selectively affected in PD) and contributes to growing evidence suggesting synucleins are negative regulators of synaptic dopamine release.
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Role of G1 phase regulators during corticogenesis / Rôle des régulateurs de la phase G1 du cycle cellulaire dans la corticogenèsePilaz, Louis-Jan 15 December 2009 (has links)
Les mécanismes développementaux qui spécifient le nombre et le phénotype laminaire des neurones du cortex cérébral jouent un rôle essentiel dans l’établissement de la cytoarchitecture corticale. Le nombre de neurones dans chaque couche d'une aire donnée est déterminé par le taux de production neuronale, qui dépend étroitement de l'équilibre entre les divisions prolifératives et différenciatives. Des observations clés suggèrent que la durée de la phase G1 (TG1) ferait partie intégrante d'un mécanisme cellulaire régulant le mode de division des précurseurs du cortex. Nous avons testé cette hypothèse par l'accélération expérimentale de la progression dans la phase G1 de précurseurs corticaux de souris in vivo, via la surexpression des cyclines E1 et D1. A E15, la réduction de TG1 promeut la rentrée dans le cycle cellulaire aux dépens de la différenciation neuronale, résultant en une modification de la cytoarchitecture du cortex adulte. Des données de modélisation confirment que les effets induits par la réduction de TG1 sont médiés par des changements du mode de division. Les effets de la surexpression des cyclines E1 et D2 à E13 sont plus modérés qu'à E15, indiquant des différences intrinsèques entre les précurseurs corticaux précoces et tardifs. La mesure des phases du cycle cellulaire des populations de précurseurs corticaux à l’aide de différentes techniques révèle un niveau important d’hétérogénéité et souligne la nécessité de prendre en compte la diversité des précurseurs co‐existant dans les zones germinales du télencéphale. / In the cerebral cortex, area‐specific differences in neuron number and phenotype are distinguishing features both within and across species. The developmental mechanisms that specify the number of neurons and their laminar fate are instrumental in specifying cortical cytoarchitecture. Neuron number in layers and areas correlate with changes in the rate of neuron production, largely determined by the balance between proliferative and differentiative divisions in cortical precursors. Key observations suggest a concerted regulation between the duration of the G1 phase (TG1) and mode of division and have led to the hypothesis that TG1 could be an integral part of a cellular mechanism regulating the mode of division of cortical precursors. To test this hypothesis we experimentally accelerated TG1 in mouse cortical precursors in vivo, via the forced expression of cyclinE1 and cyclinD1. At E15, TG1 reduction promoted cell‐cycle re‐entry at the expense of differentiation and led to cytoarchitectural modifications. Modeling confirms that the TG1‐induced changes in neuron production and laminar fate are mediated via the changes in the mode of division. Forced expression of G1 cyclins was also applied to early cortical precursors. The effects of cyclinD1 and cyclinE1 up‐regulation at E13 were milder than those observed at E15, pointing to intrinsic differences between early and late cortical precursors. The used of various techniques to measure cell‐cycle kinetics in distinct precursor populations underlined the necessity of taking the full diversity of neural precursors co‐existing in the GZ of the telencephalon into account when performing cellcycle kinetics analysis.
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Koncept bazální stimulace z pohledu sester pracujících na anesteziologicko-resuscitačním oddělení / The concept of basal stimulation from the point of view of nurses working on Anaesthesiology and Resuscitation FacilityKycltová, Pavlína January 2016 (has links)
Introduction: The dissertation of "The concept of basal stimulation from the point view of nurses working on Anaesthesiology and Resuscitation facility", discusses the matters of specifics and issues when it comes to providing a basal stimulation process within patient's hospitalization in a resuscitation unit. Patients in very complicated health conditions are hospitalized in a resuscitation unit, very often with symptoms of impaired consciousness. The concept of basal stimulation could very likely help patients' communication with other environment, with accepting and perceiving the actual situation as well as with recovering itself. The point of this dissertation is to chart the real and actual problematics of the basal stimulation used within resuscitation units, and also how nurses working in these units are bringing the concept to bear within their practice. Research methods and results: There are qualitative results posted within the empiric part of the research, as well as interviews with ten general educated nurses working in a resuscitation unit. All the results are collated and analysed in the final discussion after literal transcription of all the interviews. The result of which is, that the general educated nurses see the biggest issue when it comes to providing a basal stimulation...
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Stimulace tělesně postiženého jedince s využitím tance a jeho technik / Stimulation of physically disabled individuals using dance and its techniquesHrubcová, Zuzana January 2013 (has links)
This thesis consists of two parts - theoretical and practical. The theoretical part deals with individuals with physical disabilities and limitations resulting therefrom, characteristics of selected types of physical disability and dance as a therapeutic method. The practical part consists of the possibility of applying dance techniques for clients with physical disabilities and the possibility of conducting a dance lesson. The following is part of the research that deals with dance as a means of stimulation and its effects on people with physical disabilities. Keywords: physical disability, stimulation, basal stimulation, dance, scenic dance, movement
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Flooding Effects On Tree-Ring Formations Of Riparian Eastern White-Cedar (Thuja occidentalis L.), Northwestern Quebec, CanadaDenneler, Bernhard, Bergeron, Yves, Bégin, Yves 01 1900 (has links)
Tree-ring formation of eastern white-cedar (Thuja occidentalis L.) at a boreal lake in northwestern Quebec, Canada, was monitored using manual band dendrometers to (i) retrace cambial activity phases, (ii) evaluate the effects of flooding on radial growth, and (iii) analyze the relationships
with meteorological factors. The daily circumferential activity of four trees at each of two sites, a
riparian and an upland site, was recorded during the growing season of 1996, a year with an extreme spring flood. First cambium cell divisions occurred near June 9, followed by a distinct and sustained upward trend in the stem basal area until mid-July that reflected the earlywood formation. The strongly synchronous circumferential activity at both sites suggests no adverse flooding effect on growth of the riparian trees, which is explained by the rapid retreat of the water just before growth initiation in early June. The following month until mid-August was characterized by strong short-term fluctuations caused by alternating drought and rain periods and a slight downward trend of the basal area for six of the eight banded white-cedars. The dendrometers of two trees, the closest to the lake, showed a slight upward trend probably reflecting latewood formation. Pearson correlation with meteorological data indicated that precipitation was positively related to the daily changes in basal area of all trees except during the period of earlywood formation, which probably resulted from the high soil moisture after spring snow-melting. Mean and minimum air humidity were positively related and maximum temperature negatively related to the daily variations in stem circumference during the whole monitoring period, emphasizing the importance of the internal water status on stem size.
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Rôle du système cholinergique striatal dans la physiopathologie des dystonies : un modèle expérimental chez le primate non-humain / Role of striatal cholinergic system in pathophysiology of dystonia : an experimental model in non-human primateRibot, Bastien 20 September 2018 (has links)
Introduction : La dystonie est définie comme un syndrome de cocontractions musculaires soutenues aboutissant à des mouvements répétitifs et des postures anormales. Cependant la physiopathologie des dystonies reste mal comprise. Les études menées chez l’homme soulignent le rôle crucial des ganglions de la base dans la physiopathologie des dystonies. Des données récentes obtenues chez le rongeur suggèrent l’implication d’un désordre de la transmission cholinergique striatale mais es modèles qu’ils soient génétiques ou pharmacologiques n’aboutissent pas toujours à un phénotype de dystonie. C’est pourquoi il était important de proposer une étude chez le primate non humain, visant à vérifier notre hypothèse de travail, à savoir : est-ce qu’une augmentation de la transmission cholinergique dans le putamen est capable d’induire un phénotype clinique de dystonie similaire à celui rencontré chez l’homme.Méthodes : Nous avons réalisé des infusions chroniques d’un agoniste muscarinique non sélectif (Oxotremorine) au sein du territoire sensori-moteur du striatum chez le primate non-humain. Les symptômes cliniques induits par ce produit ont été évalués à l’aide de l’échelle de Burke-Fahn-Marsden (BFM) adaptée à l’animal. Nous avons également utilisé une approche électromyographique pour caractériser l’activité musculaire en lien avec la clinique ainsi que des enregistrements de l’activité Multi-Unitaire et Unitaire au sein des ganglions de la base afin d’établir des corrélations électro-cliniques.Résultats : Les infusions d’Oxotremorine nous ont permis d’observer : (i) des postures et des mouvements anormaux similaires aux mouvements dystoniques rencontrés en pathologie humaine ; (ii) une fréquence de décharge neuronale anormalement basse dans le GPi (13,5Hz) et un pattern de décharge de type « bursty » principalement lorsque les symptômes sont sévères ; (iii) une activité oscillatoire (28-30Hz) au sein du putamen, du GPe et du GPi; (iv) l’absence de cohérence de l’activité oscillatoire entre ces structures ; (v) que le GPi est la seule structure à présenter une cohérence de l’activité oscillatoire.Conclusion : Nos travaux démontrent pour la première fois qu’un modèle de dystonie chronique peut être obtenu chez le primate non humain par augmentation du tonus cholinergique dans le putamen. Ce travail valide l’hypothèse de l’implication des interneurones cholinergiques dans la physiopathologie des dystonies. Ils confortent l’idée qu’une augmentation du tonus cholinergique peu à elle seule induire un phénotype de dystonie. / Introduction: Dystonia is defined as a syndrome of sustained muscular cocontractions leading to repetitive movements and abnormal postures. However, the pathophysiology of dystonia remains poorly understood. Studies in humans emphasize the crucial role of basal ganglia in the pathophysiology of dystonia. Recent data in rodents suggest the involvement of a disorder in the striatal cholinergic transmission. But these genetic or pharmacological rodent models do not always express the phenotype of dystonia. Therefore, it was important to propose a primate study to test whether an increase of cholinergic transmission within the putamen is able to induce a clinical phenotype of dystonia similar to that seen in humans.Methods: To verify our hypothesis, we chronically infused non-selective muscarinic agonist (Oxotremorine) in the sensory-motor striatum in non-human primates. Dystonic clinical symptoms induced by this drug were assessed using the Burke-Fahn-Marsden (BFM) scale adapted to animals. We used electromyographic approach to characterize muscular activity linked to clinical symptoms, and we recorded Multi-Unit and Single-Unit neuronal activity in basal ganglia to establish electro-clinical correlations.Results: The infusions of Oxotremorine allowed us to observe: (i) abnormal postures and movements similar to the dystonic movements encountered in human pathology; (ii) an abnormally low neuronal firing frequency in the GPi (13.5Hz) and a bursty firing pattern mainly when the symptoms where severe; (iii) oscillatory activity (28-30Hz) within the putamen, GPe and GPi; (iv) the lack of coherence of the oscillatory activity between these structures; (v) that the GPi is the only structure to present a coherence of the oscillatory activity.Conclusion: We have demonstrated for the first time that a model of chronic dystonia can be obtained in non-human primates by increasing cholinergic tone in the putamen. This work validates the hypothesis of an involvement of cholinergic interneurons and striatal acetylcholine levels in the pathophysiology of dystonia.
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Caracterização da próstata canina quanto a aspectos envolvidos na evolução para o carcinoma prostático / Characterization of canine prostate in relation to evolution to prostatic carcinomaTerazaki, Patricia Matsuzaki 09 June 2009 (has links)
O cão é a única espécie, além do homem, em que o câncer de próstata (CP), a neoplasia intraepitelial prostática (PIN) e a hiperplasia prostática benigna (HPB) ocorrem espontaneamente, permitindo dessa forma que se realize estudo comparativo de afecções benignas e malignas da próstata. Acredita-se que a existência de stem cells malignas, localizadas na camada de células basais da próstata, seja um dos fatores responsáveis pelo insucesso da terapia por ablação androgênica que ocorre na maioria dos carcinomas prostáticos avançados. O objetivo deste estudo foi caracterizar a próstata canina quanto a aspectos envolvidos na evolução para o carcinoma prostático, tentando identificar a origem celular e as alterações das lesões pré-neoplásicas. Foram obtidas 44 próstatas na necrópsia. Amostras prostáticas foram fixadas em metacarne, embebidas em parafina e seccionadas a 5µm para a coloração com hematoxilina eosina (HE) e avaliadas em relação à presença de hiperplasia, prostatite, PIN e neoplasia. Além disso, cortes corados em HE representando cada afecção foram utilizados na determinação da área nuclear média por morfometria computadorizada. Cortes histológicos obtidos em lâminas silanizadas foram utilizados na imunoistoquímica para células basais (p63 e 34E-12), conexinas 32 e 43, receptor de andrógeno (AR) e antígeno nuclear de proliferação celular (PCNA). Amostras foram coletadas também em nitrogênio líquido e mantidas a 80o C para a realização do PCR quantitativo em tempo real, para a determinação da expressão do RNAm do AR, e para a realização do Western blot, para a determinação da expressão da conexina 43. As afecções mais freqüentes foram a prostatite e a hiperplasia prostática benigna. Foi observada uma maior porcentagem de células basais e um alto índice proliferativo, como demonstrado pela imunoistoquímica para o PCNA, na neoplasia intraepitelial prostática. Além disso, observou-se nessas lesões marcação nuclear heterogênea para o AR, menor em relação à dos ácinos benignos. Ao contrário do observado na próstata humana, não foi observada expressão das conexinas 32 e 43 na próstata canina (normal ou com PIN). A área nuclear média, obtida pela morfometria computadorizada, foi maior em células epiteliais de ácinos apresentando PIN e/ou neoplasia em relação à de células epiteliais de ácinos benignos. Observou-se expressão variável do RNAm para o AR nas PINs e neoplasias, utilizando-se o PCR em tempo real. Estes achados sugerem que células basais malignas desempenham papel na origem da neoplasia intraepitelial prostática e possuem capacidade de proliferar a despeito da expressão heterogênea do receptor de andrógeno. / Dogs are the only animal other than man to develop prostate cancer, prostatic intraepithelial neoplasia (PIN) and benign prostatic hyperplasia (HPB) spontaneously, allowing the comparison between benign and malignat affections of prostate. Malignant stem cells among the basal cell layer of the prostate are believed to play an important role in the failure of androgen-ablation therapy that occurs in most advanced prostate cancer. The goal of this study was to characterize the canine prostate in relation to evolution to prostatic carcinoma, trying to identify the cellular origin and the alterations of pre-neoplastic lesions. Forty-four canine prostates were obtained at necropsy. Prostatic samples were fixed in methacarn, embedded in paraffin wax and sectioned into 5µm-thick slices for hematoxylin eosin (HE) staining and evaluated for the presence of hyperplasia, prostatitis, PIN and neoplasia. Moreover, HE stained sections representing each affection were used to determine the mean nuclear area by computerized morphometry. Tissue sections obtained in silanized slides were used in immunohistochemical staining for basal cells (p63 and 34E-12), connexins 32 and 43, androgen receptor (AR) and proliferating-cell nuclear antigen (PCNA). Quantitative real-time PCR to determine the expression level of AR at the mRNA level and Western blot to protein levels of connexin 43 were examined in samples collected using liquid nitrogen and kept at 80o C. The most common lesions were prostatitis and benign prostatic hyperplasia. The prostatic intraepithelial neoplasia exhibited a higher percent of basal cells and was highly proliferative, as demonstrated by PCNA immunohistochemistry. Moreover, these lesions exhibited heterogeneous nuclear AR staining, lower in comparision with benign acini. In contrast to human prostate, the canine prostate (normal or harboring PIN) did not express the connexins 32 and 43. The mean nuclear area measured by computerized morphometry was greater in epithelial cells of PIN and neoplastic acini than that of benign acini. We found variable RNAm AR expression in prostatic intraepithelial neoplasia and neoplasia by real-time PCR. These findings suggest that malignant basal cells may play a role in the origin of PIN and can proliferate despite the heterogeneous AR expression.
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\"Comparação entre presença e distribuição de proteínas da matriz extracelular e graduação histológica de malignidade da fronte de invasão no carcinoma epidermóide de lábio\" / Comparison between presence and distribution of the extracellular matrix proteins and malignancy histological grading in the lip SCC invasive frontCandido, Adriano Pires 12 March 2007 (has links)
As interações entre as células neoplásicas e o estroma têm um papel central na progressão tumoral Crescimento e invasão das neoplasias depende de modificações controladas dos componentes da matriz extracelular. A fronte de invasão tem sido considerada a região mais agressiva das neoplasias malignas, pois suas células são as que apresentam a maior habilidade de invadir os tecidos adjacentes. Por essa razão, a região da fronte de invasão é a área mais crucial da interface tumorhospedeiro. O objetivo deste trabalho é investigar, através de imunoistoquímica, a expressão e distribuição das proteínas da membrana basal laminina e colágeno tipo IV e da matriz extracelular colágeno tipo III, fibronectina e tenascina, na região de fronte de invasão do carcinoma epidermóide de lábio, a neoplasia maligna mais freqüente na cavidade oral. Os achados foram comparados à graduação histológica de malignidade da fronte de invasão. Vinte casos de carcinoma epidermóide de lábio, todos apresentando elastose solar ? que evidencia a participação da radiação ultravioleta do sol no processo ? foram estudados. A graduação histológica de malignidade da fronte de invasão foi feita de acordo com os critérios propostos por Bryne et al. (1989), usando-se cortes de 5 ?m corados por hematoxilina e eosina. As reações imunoistoquímicas foram realizadas em cortes de 3 ?m obtidas a partir de material fixado em formol e emblocado em parafina e usando-se o método da estreptavidina-bioina e anticorpos apropriados. Dos 20 casos estudados, 10 foram graduados como bem diferenciados (BD), 7 moderadamente diferenciados (MD) e 3 pobremente diferenciados (PD). Tanto laminina quanto colágeno tipo IV tiveram resultados semelhantes, apresentando descontinuidade da marcação com freqüência. Quase todos os casos mostraram algum grau de descontinuidade na fronte de invasão para esses dois antígenos. Alguns poucos casos revelaram, inclusive, a perda total da marcação nessa área. Não foi possível relacionar-se a graduação histológica de malignidade com o grau de descontinuidade da membrana basal. Dezessete casos mostraram perda total do colágeno tipo III na região da fronte de invasão. Dentre os 3 casos que apresentaram marcação para a proteína , dois eram BD e 1 MD. A fibronectina foi muito abundante em todos os casos estudados. Essa proteína estava presente em uma área espessa de marcação iniciando-se na região de membrana basal. A marcação para a tenascina foi muito variável dentre os casos e não estava relacionada com a graduação histológica de malignidade ou com a intensidade da resposta inflamatória. Em conclusão: os resultados para laminina, colágeno IV e III sugerem uma importante atividade invasiva na fronte de invasão da neoplasia. Embora o padrão de expressão das proteínas estudadas estava alterada na região de fronte de invasão em comparação com o epitélio normal da região, não houve correlação com o grau histológico de malignidade. / Interaction between tumor cells and stroma plays a central role in cancer progression. Local growth and invasion of neoplasms depend on the controlled modification of components of the extracellular matrix. The invasive front has been considered the most aggressive part of a tumor whose cells have the greatest ability to invade surrounding tissue. Therefore, this is the most crucial area at the tumourhost interface. The aim of this study was to investigate the immunohistochemical expression and distribution of the basement membrane proteins laminin and collagen type IV, and the extracellular matrix proteins collagen type III, fibronectin and tenascin, in the invasive front region of lip SCC, the most frequent malignancy of the oral cavity, and compare the findings to the histological malignancy grading of the invasive front. Twenty cases of lip SCC, all showing solar elastosis, were studied. Histological grading of the invasive front was carried out according to the criteria proposed by Bryne et al. (1989), using 5?m sections stained with H&E. Immunohistochemistry reactions were performed in 3?m sections obtained from formalin-fixed, paraffin-embedded tissue, using the streptavidin-biotin-peroxidase method and appropriate antibodies. Of the 20 cases studied, 10 were graded welldifferentiated (WD), 7 moderately-differentiated (MD) and 3 poorly-differentiated (PD). Both laminin and collagen IV had similar results presenting frequent discontinuity. Almost every case showed at least some discontinuity in the invasive front. A few cases have showed a total loss of immunostaining in the area. It was not possible to determine a correlation between histological grade and degree of basement membrane discontinuity. Seventeen cases have shown total loss of collagen III expression in the invasive front. The three cases that presented positivity were represented by 2 WD and 1 MD SCC. Fibronectin was very abundant in all cases. It was present in a thick area starting from the basement membrane. Staining for tenascin was very variable among the cases and it was not correlated to the histological grading or intensity of inflammatory response. The results for laminin, collagen IV and III suggest invasive activity in the tumoral invasive front. Although the pattern of the proteins were altered in the invasive front of lip SCC in comparison to normal lining epithelium, these changes were not correlated to histological malignancy grade.
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Marcadores preditivos do comprometimento das margens cirúrgicas do carcinoma basocelular / Predictive markers of surgical margins commitment in basal cell carcinomaBueno Filho, Roberto 04 November 2015 (has links)
O carcinoma basocelular (CBC) é malignidade de incidência elevada e crescente na população caucasiana, e sua expressiva prevalência nos serviços de saúde remete à necessidade de avaliação dos índices de cura. O presente estudo analisou marcadores clínicos preditivos do comprometimento das margens cirúrgicas do CBC, em conjunto com um painel de marcadores imuno-histoquímicos (IHQ). Analisou-se 1294 laudos histopatológicos de CBC, emitidos durante 2011, e incluídos 674 casos de excisão cirúrgica completa realizada por diferentes especialidades em hospital terciário. Foram selecionados 40 casos dos diferentes subtipos histológicos para realização de IHQ para os marcadores Ber-EP4, MNF116, E-Caderina e VEGF, analisados por sistema digital de captação de imagens e programa de computador. Na amostra, houve predomínio de homens (60,4%) com idade média de 68 anos, da localização cefálica (71%) e do subtipo nodular (61%); da ulceração (p= 0,003) e do diâmetro médio superior dos CBC nos homens (307,41 mm2 x 190,74 mm2; p< 0,001); do subtipo superficial de localização no tronco (p< 0,001) e em mais jovens (<73 anos; p= 0,001); do subtipo nodular (p< 0,001) e ulcerado (p= 0,05) no segmento cefálico. A especialidade Dermatologia foi responsável pela maioria das cirurgias (78%), cuja dimensão média e índice de margens cirúrgicas livres dos CBC excisados foram respectivamente 274 mm2 e 95%, seguida por 279 mm2 e 89% na Cirurgia Plástica, 218 mm2 e 60% na Cirurgia de Cabeça e Pescoço (CCP), 87 mm2 e 49% na Oftalmologia. O risco para desfecho em margens cirúrgicas comprometidas foi determinado para: subtipo micronodular (OR 3,41; IC 95% 1,71 6,80; p= 0,001); localização cefálica (OR 8,33 IC 95% 1,05 50; p= 0,045); excisões realizadas pelas especialidades Oftalmologia (OR 10,12; IC 95% 4,40 23,27; p= 0,001) e CCP (OR 9,67; IC 95% 5,14 18,21; p= 0,001). A imunomarcação pelo Ber-EP4, MNF116 e ECaderina foi homogênea e de intensidade moderada a acentuada nas células neoplásicas em todos os subtipos; os valores de intensidade da marcação, percentual de área e escore para o MNF116 discriminaram os CBC agressivos (esclerodermiforme e micronodular) daqueles não agressivos (nodular e superficial); e foram superiores para ECaderina no subtipo superficial; o percentual de células marcadas pelo VEGF foi superior nos tumores agressivos (p< 0,001). O segmento cefálico e o subtipo micronodular, seguido do esclerodermiforme, implicam em riscos elevados para o comprometimento das margens e merecem atenção quanto ao manuseio cirúrgico. A imunomarcação por Ber-EP4, MNF116 e E-Caderina pode auxiliar na identificação de ninhos tumorais multifocais no subtipo superficial, ou em meio ao processo inflamatório nos subtipos agressivos. A marcação da E-Caderina pode representar o padrão menos agressivo e de crescimento radial do subtipo superficial; e a do VEGF, nos tumores mais agressivos, ser indicativa do papel desta proteína no comportamento mais invasivo. A especialidade Dermatologia tem expressiva participação institucional e níveis de resolubilidade superiores, representada pelas maiores frequências de excisão de CBC e de margens cirúrgicas livres. O reconhecimento de fatores preditivos para desfecho em margens cirúrgicas comprometidas é de fundamental relevância para o planejamento cirúrgico e obtenção das mais elevadas taxas de cura. / Basal cell carcinoma (BCC) is the most common human malignancy and it is increasing its incidence in the Caucasian population. The significant prevalence of cases in specialized health services indicates the need of assessment of cure rates. The present study analyzed clinical predictive markers of compromised surgical margins in BCC in association with a panel of Immunohistochemistry (IHC) markers. We analyzed 1294 BCC histopathological reports during 2011, and 674 cases of complete surgical excision performed by different specialties in a tertiary hospital were included. From the sample, 40 cases of different histological subtypes were selected to perform IHC markers Ber-EP4, MNF116, E-cadherin and VEGF, which were analyzed by digital image capture system and computer program. There was male predominance (60.4%) with mean age of 68 years, location at cephalic segment (71%) and nodular subtype (61%); ulceration (p= 0.003) and higher average size of CBC in men (307.41 mm2 x 190.74 mm2; p< 0.001); superficial subtype was more frequent on trunk (p< 0.001) and in younger than 73 years (p< 0.001); nodular subtype (p< 0.001) and ulceration (p= 0.05) at cephalic segment. The specialty Dermatology performed the majority of surgeries (78%), and the average size and the index of free surgical margins were 274 mm2 and 95% in Dermatology, 279 mm2 and 89% in Plastic Surgery, 218 mm2 and 60% in Head and Neck Surgery (HNS), 87 mm2 and 49% in Ophthalmology. The risk for compromised surgical margins was determined for: micronodular subtype (OR 3.41; 95% CI 1.71 6.80; p= 0.001); location at cephalic segment (OR 8.33; 95% CI 1.05 50; p= 0.045); excisions performed by Ophthalmology (OR 10.12; 95% CI 4.40 23.27; p= 0.001) and HNS (OR 9.67; 95% CI 5.14-18.21; p= 0.001). Immunostaining by Ber-EP4, MNF116 and E-cadherin was homogeneous and moderate to high intensity within the neoplastic cells in all BCC subtypes; values obtained from staining intensity, percentage of area and score for the MNF116 showed difference between aggressive BCC (morpheaform and micronodular) and non-aggressive (superficial nodular); and were higher for E-cadherin in superficial BCC; the percentage of marked cells by VEGF was higher in aggressive tumors (p< 0.001). The cephalic segment and micronodular subtype, followed by the morpheaform, imply high risks for compromised margins and deserve attention during the surgical treatment by trained experts. The immunohistochemistry markers Ber-EP4, MNF116 and E-cadherin may help the identification of multifocal tumor nests in superficial subtype or amid the inflammatory process in the aggressive subtypes. E-cadherin staining may represent the least aggressive and radial pattern of growth of superficial subtype. VEGF staining in peritumoral inflammatory cells of aggressive tumors may be indicative of the role of this protein in more invasive behavior of these subtypes of the BCC. Dermatology has significant institutional participation with highest resolution, represented by higher frequency of BCC excision and less compromised surgical margins. Knowing the predictive factors for compromised surgical margins is important for planning surgical treatment and obtaining the highest cure rates.
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