Made available in DSpace on 2014-06-12T15:49:45Z (GMT). No. of bitstreams: 2 arquivo1527_1.pdf: 1835283 bytes, checksum: 1f1ad67f95038279850ea3b3eec8c441 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2008 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O câncer cervical tem sido uma patologia grave no Brasil e no mundo com cerca de 18.680 mulheres infectadas anualmente. O Papilomavírus Humano (HPV) tem sido biologicamente associado ao desenvolvimento de lesões cervicais, devido a sua capacidade de infectar células epiteliais, e progressão ao câncer do colo de útero. O diagnóstico tardio pode inviabilizar o tratamento e levar a óbito muitas mulheres. Este diagnóstico poderia ser antecipado pelo uso de biossensores de DNA, que são dispositivos analíticos que resultam da integração entre uma sonda seqüência específica e um sinal transdutor. Entre outras técnicas eletroquímicas, os biossensores amperométricos têm sido descritos como atrativos devido à sua simplicidade, baixos custos de instrumentação, possibilidade de realização em tempo real e geralmente alta sensibilidade. Neste trabalho, foi desenvolvido um genossensor para detecção de seqüências do vírus HPV usando azul de metileno (AM) como mediador químico. Os sinais biológicos captados foram transduzidos por Voltametria de Pulso Diferencial (VPD). Os eletrodos de trabalho e referência foram produzidos através de técnica de impressão sob uma superfície de polivinil álcool. Os mesmos foram constituídos de carbono e Ag\AgCl, respectivamente. O eletrodo de trabalho foi modificado com quitosana para a imobilização de pequenas seqüências de DNA para hibridização com uma seqüência alvo. A seqüência alvo usada para hibridização foi o gene E6 do HPV18, uma cadeia extensa com 500 pares de bases disponíveis para anelamento com seqüências de 20 bases. Análises de bioinformática foram realizados para verificar possíveis regiões de anelamento destas seqüências curtas ao genoma viral. Os resultados demonstraram um aumento no sinal do AM quando a hibridização ocorreu, evidenciado pelo aumento dos picos de corrente de VPD analisados graficamente. As diferenças entre os sinais emitidos a partir de um eletrodo contendo reações de hibridização e outro isento das mesmas, foi usada para detectar seqüências de DNA viral obtidas de amostras clínicas. Os resultados indicaram ser o método passível de aplicações em diagnósticos clínicos, e a técnica de impressão, um instrumento viável para a construção dos biossensores de DNA utilizando o azul de metileno como indicador de sinais de hibridização

Made available in DSpace on 2014-06-12T16:28:31Z (GMT). No. of bitstreams: 2 arquivo5644_1.pdf: 4391035 bytes, checksum: 187ae162cac5b6548c286ff025a2af9f (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2007 / As fraturas do processo odontóide aumentam sua freqüência a partir da idade adulta, chegando a ser a fratura mais freqüente da coluna vertebral após os 80 anos de idade. Seu tratamento exige conhecimento detalhado da anatomia vertebral para se obter uma fixação adequada e menor imobilização pósoperatória, reduzindo a morbidade e a mortalidade. O objetivo do estudo foi a mensuração direta do processo odontóide e a sua relação com a vértebra C2 em cadáveres adultos. Foram analisadas 64 vértebras C2 de cadáveres adultos, pertencentes ao acervo do Departamento de Anatomia do Centro de Ciências da Saúde da Universidade Federal de Pernambuco, no período de outubro de 2006 a fevereiro de 2007. Sendo 32 vértebras de indivíduos do gênero masculino e 32 do feminino, que foram submetidas mensurações diretas com paquímetro de precisão para altura do odontóide e suas relações com o corpo de C2, os diâmetros coronais e sagitais maiores e menores e sua angulação em relação ao corpo de C2 através de radiografias. As dimensões dos processos odontóide são variáveis, sendo a altura média no grupo feminino igual a 14,16 ± 1,10mm e no masculino igual a 15,21 ± 1,15mm. O diâmetro transverso menor foi 8,81 ± 0,47mm para o grupo feminino, enquanto que foi 9,38 ± 0,84mm para o masculino. O ângulo de inclinação variou de 0 a 26º no sentido posterior para os dois grupos. Foram observados dois grupos morfologicamente distintos de processo odontóide classificados de base estreita e corpo alargado e base larga e corpo estreito. Pode-se concluir que a morfometria, morfologia e a angulação dos processos odontóides são variáveis: a altura média do processo odontóide está abaixo de 15mm; o diâmetro transverso do processo odontóide é menor do que o ântero-posterior; as médias das circunferências do corpo do odontóide são significantemente maiores do que as da base, tanto no tipo pediculado quanto no séssil. A fixação do odontóide exige planejamento tomográfico prévio

Objetivo: Avaliar a função da coluna cervical, utilizando testes clínicos cervicais em indivíduos com e sem Disfunção Temporomandibular (DTM) associados ou não ao relato de dor de cabeça. Métodos: Estudo Transversal. Foram avaliadas 57 mulheres com idade de 18 a 60 anos, divididas em dois grupos: DTM (n=40), e controle (n=17). Dada a alta frequência de relato de dor de cabeça a amostra de DTM foi estratificada em DTM com cefaleia (n=25) e DTM sem cefaleia (n=15). A incapacidade cervical foi avaliada pelo Índice de Incapacidade Cervical (NDI) e a dor na ATM pela Escala Visual Analógica de dor (EVA). A avaliação funcional da coluna cervical foi conduzida uma única avaliação por um examinador fisioterapeuta experiente e foi constituída pelos testes clínicos: análise da Amplitude de Movimento Ativa da Coluna Cervical (ADM); realização do Flexion-Rotation Test (FRT) e Cranio-Cervical Flexion Test (CCFT). Os sujeitos com DTM que relataram a presença de dores de cabeça foram instruídos a responder um questionário sobre as principais características da cefaleia referida. Para comparações entre os grupos foram aplicados ANOVA one way seguida por teste Post Hoc de Tukey ou por Teste Kruskall Wallis quando necessário. Para a análise de associação entre as variáveis categóricas foram aplicados Teste chi-quadrado ou Teste Exato de Fisher quando apropriado e para a análise de associação entre variáveis ordinais/contínua foram aplicados Testes de Correlação de Spearman. Resultados: Os indivíduos com DTM independente do relato de dor de cabeça apresentaram menor mobilidade no plano sagital, menores valores no FRT e apresentaram pior performance dos flexores profundos cervicais comparados aos controles (p<0.05). Além disso, os dados de ADM, FRT e CCFT foram associados com a intensidade de dor na ATM e a incapacidade cervical (p<0.01). Conclusão: Pacientes com DTM independente do relato de cefaleia apresentaram limitação na amplitude de flexão/extensão e do segmento C1-C2 da coluna cervical, além do menor desempenho dos músculos flexores profundos. Adicionalmente, a incapacidade cervical e a dor na ATM apresentaram correlação moderada com os testes funcionais cervicais nos indivíduos com DTM. / Objective: To evaluate the function of the cervical spine, using cervical clinical tests in individuals with and without Temporomandibular Disorders (TMD)associated or not to the report of headache. Methods: Were analyzed 57 women with age between 18 and 60 years, divided in two groups: TMD (n=40) and control (n=17). Given the high frequency of headache report, the TMD sample was stratified into TMD with headache (n=25) and TMD without headache (n=15). Cervical disability was assessed by the Neck Disability Index (NDI) and TMJ pain by the Visual Analogue Scale of pain (VAS). The functional evaluation of the cervical spine was conducted by a physiotherapeutic examiner with 10 years of experience and was constituted by the clinical tests: Analysis of the Cervical Range of Motion (CROM); Flexion-Rotation Test (FRT) and Craniocervical Flexion Test (CCFT). Subjects with TMD who reported the presence of headaches were instructed to answer 11 questions that contained the main characteristics of referred headache. For comparisons between control groups, TMD with Headache and TMD without Headache, ANOVA was applied one way followed by Tukey\'s Post Hoc test or by Kruskall Wallis test when necessary. For the analysis of association between the categorical variables, chi-square test or Fisher\'s exact test were applied when appropriate and for analysis of association between ordinal / continuous variables, Spearman\'s Correlation Tests were applied. Results: Individuals with TMD independent of headache report showed less mobility in the sagittal plane, lower values in FRT and showed worse performance of the deep cervical flexors compared to Controls (p<0.05). In addition, CROM, FRT and CCFT were associated with an intensity of TMJ pain and cervical disability (p <0.01). Conclusion: Patients with TMD independently of the headache report showed limited flexion / extension range and C1-C2 segment of the cervical spine, as well as deficits in the performance of the deep flexor muscles. In addition, a cervical disability and TMJ pain report showed a moderate correlation with the functional tests of FRT and CCFT in individuals with TMD.

Made available in DSpace on 2014-06-12T18:07:49Z (GMT). No. of bitstreams: 2 arquivo791_1.pdf: 2469303 bytes, checksum: a30380766a6dd8b30b3e15c833890a0f (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2009 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / A prevalência dos tipos de papilomavírus (HPV) relacionados ao câncer cervical apresenta variações geográficas. Em todo o mundo, o HPV 16 é mais freqüente nos casos de câncer cervical, seguido do tipo 18. No Brasil, apesar de o HPV 16 ser o tipo predominante, existem variações regionais importantes com relação a outros tipos. O HPV 18 é o segundo tipo mais freqüente nas regiões Norte, Sudeste e Sul, entretanto, no Nordeste e Centro-Oeste, há uma maior prevalência dos HPVs 31 e 33, depois do HPV 16. Uma atenção especial é necessária aos tipos de HPV mais relevantes em determinadas regiões, permitindo a inclusão dessas vacinas em um amplo e efetivo programa de vacinação. Devido ao custo proibitivo em países em desenvolvimento das vacinas disponíveis até então, assim como à variação na distribuição dos tipos de HPV, este trabalho teve como objetivo a expressão do gene L1 de papilomavírus humano tipos 18 e 33 em levedura Pichia pastoris. Os genes L1 foram amplificados através de PCR com enzima de alta fidelidade e clonados no vetor de expressão pPICZA. Pichia pastoris foi transformada com as construções pPICZL1H18 e pPICZL1H33 e os clones recombinantes selecionados por resistência à Zeocina. A integração dos genes foi confirmada por PCR de colônia com os primers AOX1 e os clones transcrevendo RNAm de L1 foram analisados quanto à produção da proteína. Os lisados celulares foram usados em ensaios de dot blot com os anticorpos anti-L1 e anti-His. Todas as amostras testadas apresentaram resultado positivo, indicando expressão da proteína L1. Entretanto, nas condições utilizadas, o rendimento da produção da proteína L1 de HPV foi abaixo do esperado. A otimização em diversas etapas do processo (o uso de genes sintéticos otimizados, por exemplo) deverá mostrar-se uma solução para a utilização do sistema de células de P. pastoris para a expressão heteróloga da proteína L1

M.Ing. / Automatic classification of images has always been an important part of pattern recognition. The segmentation and classification of MRI images has always been a challenge. A segmented image is often a very important input to the classification process. Many classification techniques use segmented images as input to the classification process. Certain segments or areas of an image serve as important features that will be used for classification. Important information can be derived from the features that are present in the segmented image. Sometimes there might be a need to extract a certain object from an image to do classification on the object. In the case of MRI images, certain structures of the human body like organs and tissue can be isolated by the segmentation process. These objects of interest (001) can give vital information for the identification of medical abnormalities (anomalies) and diseases. Segmented objects can play an important role to assist medical practitioners in the diagnosis and treatment of medical problems. I would like to test the performance of the watershed segmentation algorithm on MRI images of the cervical (C) spine. Much work has been done on the segmentation and classification of MRI images. Various techniques have been generated and tested over the past decades. Segmentation techniques like thresholding, convolution, pyramid segmentation and morphological segmentation have been utilised. All these techniques have their advantages and disadvantages. The pre-processing of an image plays a very important role in the success of the segmentation process. Histogram manipulation, filtering, thresholding and edge detection are important pre-processing techniques to yield good segmentation results. Many segmentation and classification techniques have been implemented on MRI images. The latest techniques include support vector machines (SVMs), neural networks (NNs), statistical methods, threshold techniques and normalised cuts. Segmentation of bony structures plays an important role in image guided surgery of the spine [1]. Physicians have commonly relied on computed tomography (CT) images to support their decisions in the diagnosis, treatment, and surgery of different pathologies of the spine due to the high resolution and good visualization of bone offered by this medical imaging modality. CT relies on the use of ionizing radiation, and does not depict soft tissue pathology, unlike magnetic resonance imaging (MRI) [1]. While the segmentation of vertebral bodies from CT images Segmentation Of C-Spine MRI Images Using The Watershed Transform Page 6 University of Johannesburg of the spine has commonly been accomplished with seed growing segmentation techniques [1], this task is more difficult in MRI, with variations in soft tissue contrast, and with the RF inhomogeneities, which increase the level of complexity. The primary goal of this project is to develop segmentation techniques for C-spine MRI images. This method will also be compared against other methods like pyramid segmentation and morphological segmentation. The watershed segmentation will be implemented and tested as the final step of the segmentation process. This project will try to use a combination of techniques, rather than to implement and evaluate one single method. It has been learned from literature and also from experience that the pre-processing of the raw data plays a crucial role in the quality of the segmentation process. Therefore, some attention will be given to the pre-processing of the images as part of the segmentation process.

Background: Based primarily on studies concerning early-stage tumours (treated surgically), and locally advanced disease (treated with chemoradiation), the prognosis for women with adenocarcinoma (AC) or adenosquamous (AS) carcinoma has been reported to be poorer than those with squamous cell carcinoma (SCCA) of the cervix. It is unclear whether differences in prognosis also persist in the setting of recurrent or metastatic disease treated using chemotherapy doublets with or without bevacizumab. Methods: Cases were pooled from three Gynaecologic Oncology Group randomised phase III trials of chemotherapy doublets. Pearson's test was used to evaluate response rate (RR) of AC/AS vs SCCA, Kaplan-Meier method to estimate progression-free survival (PFS) and overall survival (OS), and Cox proportional hazards model to estimate the impact of histology on PFS and OS. Results: Of 781 evaluable patients, 77% (N = 599) had SCCA and 23% (N = 182) AC/AS. There were no significant differences in RRs between histologic subgroups. The adjusted hazard ratio (HR) for death for SCCA vs AC/AS was 1.13 (95% CI 0.93, 1.38 P = 0.23). When comparing SC/AS (N = 661, 85%) to AC alone (N = 120, 15%), the adjusted HR for death was 1.23 (95% CI 0.97, 1.57, P = 0.09). Conclusions: AC/AS and SCCA have similar survival in recurrent or metastatic cervical carcinoma when treated with chemotherapy doublets.

Abstract Epidemiological and experimental studies indicate a causative role of viruses in malignancies. Recently, a link between bacterial infections and the development of cancer has been suggested. The purpose of this study was to evaluate the association between chlamydial infection and cancer. The association between C. trachomatis infection and cervix cancer was analysed in a prospective study. The presence of IgG antibodies to C. trachomatis and C. pneumoniae was determined from the serum samples of 182 Nordic women with invasive cervical carcinoma and 538 matched cancer-free controls by the microimmunofluorescence (MIF) method. Serum antibodies to C. trachomatis were associated with an increased risk for cervical squamous cell carcinoma (SCC) (OR 2.2, 95% CI 1.3-3.5), but not for cervical adenocarcinoma (OR 0.4, 95% CI 0.1-1.7). C. trachomatis serotype G was highly significantly associated with an increased risk for SCC (adjusted OR 6.6, 95% CI 1.6-27). The presence of serum IgG antibodies to more than one serotype of C. trachomatis, on the other hand, also increased the risk of SCC. The association between C. pneumoniae infection and lung cancer was analysed separately in men and women. C. pneumoniae-specific antibodies and immune complexes (IC) were analysed from 230 Finnish smoking males with lung cancer and their matched controls using serum samples collected before the lung cancer diagnosis. Suggestive chronic C. pneumoniae infection was associated with an increased risk for lung cancer (OR 1.6; 95% CI 1.0-2.3). The risk was increased especially in men younger than 60 years (OR 2.9; 95% CI 1.5-5.4), but not in the older age group (OR 0.9; 95% CI 0.5-1.6). Chlamydial antibodies and chlamydia-specific ICs were analysed from serum samples of 29 Finnish women with lung cancer and 87 matched cancer-free controls by MIF. The mean follow-up from serum sampling to cancer diagnosis was 6.7 years. IgG class antibodies to C. pneumoniae were common in pregnant Finnish women (66% among cases, 62% among controls), whereas IC-bound C. pneumoniae IgG antibodies were rare. No additional risk for lung cancer in association with chlamydial antibodies was found among women. The association between chlamydial infections and lymphomas was evaluated in a cross-sectional study. Seventy-two lymphoma patients from Tampere University Hospital and 72 matched controls were selected, and IgG antibodies and ICs to C. pneumoniae and C. trachomatis were analysed from their serum samples by MIF and enzyme immunoassay (EIA). The serological markers suggesting chronic chlamydial infection were associated with an increased risk for malignant lymphoma. The association was most evident for the presence of C. pneumoniae-specific ICs in non-Hodgkin's lymphoma (OR = 7.3, 95% CI 2.2-25) and appeared to be limited to men. Infection with C. trachomatis was found to increase the risk of subsequent development of invasive cervical SCC. Chronic C. pneumoniae infection was also found to be a new independent risk factor for lung cancer in males. Serological markers suggestive of chronic chlamydial infection were associated with lymphomas, proposing that chlamydial infection may have a similar role as H. pylori in the pathogenesis of lymphomas.

M.Tech. (Chiropractic) / This study aims to compare full spine manipulation versus cervical spine manipulation in the treatment of acute cervical facet syndrome with regards to pain, disability, cervical spine range of motion and pain threshold. This study was a comparative study that consisted of two groups of fifteen participants each. The participants were between the ages of eighteen and forty with an equal male to female ratio. The potential participants were examined and accepted according to the inclusion and exclusion criteria for the study. The method of treatment that was administered was determined by group allocation. Group 1 received Chiropractic manipulative therapy delivered to restriction(s) throughout the different regions of the spine and Group 2 received Chiropractic manipulative therapy delivered to restriction(s) of the cervical spine only.

M.Tech. (Chiropractic) / Purpose: The aim of this study was to compare the effects of chiropractic adjustment versus mobilization to the cervical spine in participants with chronic cervical facet syndrome with regards to neck pain, cervical spine range of motion and position sense. Method: Thirty participants, male or female between the ages of 18 and 45 years, diagnosed with cervical facet syndrome were used in the study. The thirty participants were divided into two groups consisting of fifteen individuals each, ensuring equal male to female and age ratios. Group 1 received chiropractic adjustments over the restricted joints to the cervical spine. Group 2 received mobilization over the restricted joints to the cervical spine. The trial consisted of seven visits over a treatment period of three weeks, of which the first six visits the participants received treatment and the seventh visit served the purpose of obtaining the final data. The data was gathered on the first, fourth and seventh visits. Subjective data was obtained by using the Vernon-Mior Neck Pain and Disability Index and the Visual Analogue Scale for pain intensity. Objective data consisted of measuring cervical spine range of motion with a CROM instrument and Laser Pointer Device to measure head repositioning accuracy (position sense). Results: Subjective results indicated that group 1 (chiropractic adjustment) proved to be the most effective treatment protocol in decreasing neck pain intensity by 92%, and neck pain disability index by 65.7%. Group 2 (mobilization), also showed good results with a decrease in neck pain intensity by 53.9%,and neck pain disability index by 23.8%. Subjective results produced statistically significant results with VAS score (p= 0.000) for both groups and NDI score (p=0.000) for group 1 and (p=0.002) for group 2. Objective results also proved that chiropractic treatment was most effective in increasing cervical spine range of motion by 21.9% (right rotation) and 21.07% (left rotation). In group 2 by 9.93% (right rotation) and 12.72% (left rotation). Results were statistically significant for both groups with CROM score (p=0.002) for group 1 (right rotation) and (p= 0.000) (left rotation). Group 2 CROM score (p=0.040) (right rotation) and (p= 0.007) (left rotation). Objective results also proved that chiropractic adjustment was most effective in improving position sense by 76.54% (right rotation) and 72.06% (left rotation). In group 2 by 38.01% (right rotation) and 13.03% (left rotation). Results were statistically significant for group 1 with Kinesthetic Sensibility Test score (p=0.000) (right rotation) and (p=0.002) (left rotation). In group 2, the result for right rotation was statistically significant with (p=0.019) and not statistically significant for left rotation with (p=0.167). Both subjective and objective results showed that although group 2 produced statistically significant results, group 1 showed the best clinical results overall. Thus it was noted that in order to obtain a vii lasting increase in range of motion of the cervical spine, a decrease in neck pain and disability and an improvement in position sense, the treatment protocol used for group 1 should be the treatment of choice. Conclusion: Based on the results of the study, it was concluded that chiropractic adjustment was more effective than mobilization in the treatment of cervical facet syndrome. This conclusion is based on the results that chiropractic adjustment was more effective in all the objective and all the subjective measurements. However, this does not rule out mobilization as a treatment for neck pain, because mobilization treatment did show improvement in cervical spine ROM, a decrease in pain and slight improvement in position sense although not as efficiently as chiropractic treatment.

M.Tech. / It has been reported that the sympathetic nerve fibres coursing with the vertebral arteries may potentially be irritated by cervical pathology such as cervical dysfunction causing vasoconstriction of the vertebro-basilar arterial system leading to an ischaemic state in particular areas in the brain (Wingfield and Gorman, 2000). This arterial insufficiency to the brain has been shown to effect higher level complex brain functions (Terrett, 1995). The purpose of this research was to determine whether atlanto-occipital joint as well as atlanto-axial joint adjustments had an immediate effect on mental rotation ability in individuals with asymptomatic cervical facet joint dysfunction. Sixty male and female asymptomatic patients took part in this study. These patients were recruited by means of word of mouth and through the use of advertisements placed in the University of Johannesburg Chiropractic Day Clinic, Doornfontein Campus. Inclusion criteria required for patients to participate in the study included the patients (both male or female) be between the ages of 18 and 30 years, they presented with an asymptomatic cervical facet joint dysfunction at the atlantooccipital and or atlanto-axial joints, not have had either Chiropractic or any other form of treatment to the cervical spine for at least six days prior to involvement in the study, had normal or corrected to normal vision and no contraindications to cervical adjustments. vi Objective data was collected by means of a mental rotation reaction time test installed on a laptop computer which measured the patients mental rotation reaction time ability in both accuracy and time to complete each test. The objective results demonstrated that there was no statistically significant increase in mental rotation ability following the Chiropractic adjustments. In conclusion, it was shown that Chiropractic adjustments performed on patients presenting with asymptomatic cervical facet joint dysfunction at the atlantooccipital and/or the atlanto-axial joint complexes brought about no improvement in mental rotation ability.