Magister Scientiae Dentium - MSc(Dent) (Community Oral Health) / The aim of this study was to establish whether there is any association between developing maxillary canine ectopia and various other dental anomalies using panoramic radiographs in the mixed dentition stage of development.

Abstract Heart rate variability (HRV) is used in the assessment of cardiovascular health. However, often contradictory results have impeded the efficient use of HRV in clinical practice. HRV signals can contain artifacts leading to errors in the interpretation of HRV results. Various methods have been used for artifact editing, but there is relatively little information on how the actual editing can influence the HRV measures. The main aim of this thesis was to improve the reliability of HRV analysis by concentrating on the HRV signal preprocessing methods. The effects of three editing methods on the HRV of short (512 R-R) and long-term (24-hour) R-R interval data were studied with non-edited and edited data from healthy subjects (n=10) and patients with acute myocardial infarction (AMI) (n=10). The effects of ectopic beats on short (α1) and long-term (α2) fractal scaling exponents were studied by inserting artificial ectopic beats into the HRV signals of 20 healthy subjects and 20 AMI patients. The prognostic significance of edited and non-edited α1 and α2 was studied in random elderly (n=84) and post-AMI (n=84) populations. A new method to quantify respiratory sinus arrhythmia (RSA) was developed based on the HRV signals of 13 healthy subjects. A new measure, the RSA index, was defined to evaluate the risk to sudden cardiac death (SCD) in 1631 AMI patients. Lastly, a new algorithm was developed in order to edit heart rate (HR) turbulence occurring immediately after a ventricular premature beat (VPB). The effects of HR turbulence editing on the HRV analysis were studied in 267 AMI patients. Editing had distinct effects on the HRV analysis depending on the editing method and data type. Deletion editing was found to be unsuitable for the HRV spectrum analysis. There was no universal editing method for the time and frequency domain HRV analyses. Unedited ectopic beats increased the randomness of short-term R-R interval dynamics, especially in AMI patients. However, unedited α1 differed significantly between survivors and those who died during the follow-up. Ectopic beats do not necessarily need to be edited if fractal analysis is used in the risk evaluation. A depressed RSA index was found to be a strong predictor of SCD but a weak predictor of non-SCD in AMI patients. Editing of HR turbulence affected differently the various HRV measures. ULF and VLF components were most clearly influenced by HR turbulence removal. The amount of VBPs had an important impact on the results. When the VBPs/hour were >50, ULF and VLF were >30% lower after turbulence removal. The results of this thesis highlight the importance of editing the erroneous or irrelevant R-R interval oscillation in an HRV analysis. The careful choice of preprocessing method is essential if one wishes to obtain reliable HRV analyses for clinical purposes.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22724号 / 医博第4642号 / 新制||医||1045(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 戸井 雅和, 教授 小川 修, 教授 黒田 知宏 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

The Wnt signaling pathway represents the principal evolutionarily conserved signaling cascade found in all multicellular organisms. It plays a key role not only in many processes during embryogenesis, but also in maintaining tissue homeostasis and regeneration. By contrast, mutations in genes encoding components of the pathway often result in increased activation of Wnt signaling and underlie onset of many human diseases, particularly cancer. The canonical Wnt signaling pathway is essential for proliferation and maintenance of the pluripotent state of intestinal stem cells and thus for homeostatic renewal of the intestinal epithelium. However, aberrant (hyper)activation of the Wnt signaling pathway is the initial step in development of intestinal neoplasia. Understanding the causes and identifying the consequences of the Wnt signaling hyperactivation is crucial for deciphering mechanisms leading to malignant transformation. Although the canonical Wnt signaling pathway has been the subject of scientific studies for several decades, all regulatory mechanisms and consequences of its hyperactivation have not been completely elucidated yet. During my PhD studies, I focused on understanding function(s) of some components and target genes of this signaling cascade. In this theses, results of my first...

Final publication is available at http://onlinelibrary.wiley.com/doi/10.1002/art.38173/abstract;jsessionid=DA29F0C067C89EC1147E79EE7380D21A.f01t04?systemMessage=Wiley+Online+Library+will+be+disrupted+on+24th+October+2015+at+10%3A00-10%3A30+BST+%2F+05%3A00-05%3A30+EDT+%2F+17%3A00-17%3A30++SGT++for+essential+maintenance.++Apologies+for+the+inconvenience / 京都大学 / 0048 / 新制・論文博士 / 博士(医科学) / 乙第13003号 / 論医科博第3号 / 新制||医科||5(附属図書館) / 32931 / (主査)教授 杉田 昌彦, 教授 生田 宏一, 教授 三森 経世 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Graviditetsförlust i form av tidiga missfall är en vanlig diagnos i sjukvården. En mer sällsynt diagnos är utomkvedshavandeskap som kan ha ett dramatiskt förlopp och vara direkt livshotande. Sjuksköterskan kan inom flera olika områden i sjuk-vården träffa på kvinnor som har råkat ut för någon av dessa förluster och behöver omvårdnad. Syftet med litteraturöversikten var att ta reda på vad eventuell forsk-ning visade angående kvinnors känslomässiga upplevelser vid graviditetsförlust samt att ur ett omvårdnadsperspektiv belysa kvinnors reaktioner på vården. För att uppnå syftet gjordes en litteraturöversikt enligt Friberg (2006). Resultatet ledde fram till tre teman; Känslomässiga upplevelser, Hur dessa hanterades och Reak-tioner på omvårdnaden. Kvinnorna upplevde graviditetsförlusten olika men gemensamt för dem var att bemötandet från vårdpersonalen hade betydelse för hur de känslomässigt hanterade situationen. Om vårdpersonalen var sympatisk, enga-gerad och hade tid för dem klarade de av att hantera situationen på ett bättre sätt än när personalens bemötande upplevdes känslokallt och rutinmässigt. Resultatet diskuterades i förhållande till Travelbees omvårdnadsfilosofi. Kvinnorna behöver ges omvårdnad utgående från varje enskild individs unika situation. Det är en patientkategori som oftast har kort vårdtid vilket gör det till en utmaning för sjuk-sköterskor att i omvårdnaden hinna bemöta dem individuellt och uppfatta deras behov. / Pregnancy loss and early miscarriage are common adverse outcome in pregnancy. A more rare diagnosis is ectopic pregnancy that can be very dramatic and life-threatening. Nurses from different areas in hospitals meet women in need of care after such a loss. The purpose of this literature review was to find out what the research show about women’s emotional experience of pregnancy loss and from a nursing view find out how the women experienced the care they received. To reach the purpose, a literature review was done according to Friberg (2006). The results showed three different themes; Emotional experiences, How the women coped with the emotional experiences and How the women reacted to the care given. The women experienced the pregnancy loss differently but they had one thing in common: The way they handled the situation depended on how the health professional treated them. If the caregivers were sympathetic, compassionate and gave time to the women they coped a lot better than if the caregivers were insensi-tive, callous and showed a matter of fact attitude. The result is discussed in rela-tion to Travelbees nursing philosophy. The women need to be provided with targeted care. The care must be based on every woman’s individual needs. These patients often spend a very short time at the hospital with short time for treatment witch leads the nurses to a challenge of how to get the time to treat every woman individually. This would lead to a better understanding for the women’s needs

No description available.

Hörntänderna i maxillan är efter visdomständerna de tänder som oftast blir retinerade. Prevalensen varierar mellan 1-3%. En retinerad överkäkshörntand har ofta en ektopisk placering. Detta kan leda till att eruptionsriktningen blir felaktig och därmed kan tanden orsaka skador på de angränsande incisivernas rötter. För att minska risken för detta krävs tidig diagnostik, i 9-11 års ålder.Den vanligaste åtgärden för palatinalt displacerade hörntänder är extraktion av mjölkhörntänderna för att underlätta spontaneruption av de efterföljande permanenta hörntänderna. Om enbart denna behandling inte är tillräcklig eller om den permanenta hörntanden ligger för djupt måste kirurgisk friläggning ske. Detta sker i kombination med efterföljande ortodontisk behandling.I Sverige används idag två typer av kirurgisk friläggning; öppen och sluten. Vilken typ av friläggning som används tycks vara lokalt betingat. I Malmöregionen används oftast öppen friläggning medan i Jönköpingsregionen sluten friläggning är vanligast.I denna studie jämförs behandlingsutfallet hos patienter där öppna och slutna friläggningar gjorts. Framförallt utvärderas om det finns någon signifikant skillnad i behandlingstid, från friläggning till dess att den ortodontiska behandlingen är färdig. Hänsyn tas till typ av friläggning och om tanden ligger palatinalt eller buckalt retinerad. Det undersöks även vid vilken ålder friläggning gjorts samt vilken typ av retentionapparatur som använts.I gruppen med öppen friläggning var patienterna i genomsnitt 15,2 år respektive 12,9 år i gruppen med sluten friläggning. Den totala behandlingstiden från friläggning till avlägsnande av apparatur visade sig vara signifikant kortare i gruppen som fick öppen friläggning jämfört med gruppen som fick sluten friläggning. / The maxillary canines are after the third molars, the most frequently impacted teeth. The incidence varies between 1-3%. Impacted maxillary canines are often related to ectopic position, which can lead to an incorrect direction of eruption and thus cause damage to the adjacent incisors roots.The most common treatment for palatally displaced canines is extraction of the primary canines to facilitate spontaneous eruption of the succeeding permanent teeth. If this treatment is not sufficient or if the permanent canine lies too deep, surgical exposure is needed. This occurs in combination with orthodontic treatment.In Sweden two types of surgical exposures are practiced; open and closed. Which type of exposure is used seems to be locally induced. In Malmö the open exposure is most frequently practiced while in Jönköping the closed exposure is the treatment of choice.The aim of this study is to compare the treatment outcome in two groups of patients, treated either with an open or a closed exposure. It was evaluated whether any significant difference was found in the overall treatment time, from exposure until completed orthodontic treatment. Consideration was given to type of exposure and weather the tooth was palatally or buccally impacted. The age of the patients when the exposures occurred and the type of retention used in the different groups were also examined.The mean age for the patients treated with an open exposure was 15.2 years compared to 12.9 years in the other group. The total time of treatment from exposure to removal of the appliances was significantly shorter in the group with open exposure.

Identifikační záznam: ŠEBESTOVÁ, Marcela. Náhlé příhody břišní v gynekologii pohledem sestry v intenzivní péči. [Acute Severe Abdominal Pain in Gynaecology from the Point of View of a Nurse in the Intensive Care Unit]. Praha, 2011. 68 s., 10 příl. Diplomová práce (Mgr.). Univerzita Karlova v Praze, 1. lékařská fakulta, Ústav teorie a praxe v ošetřovatelství. Vedoucí práce Mgr. Kulhavá, Miluše. Abstrakt Diplomová práce je zaměřena na náhlé příhody břišní v gynekologii pohledem sestry intenzivní péče. Teoretická část je věnována anatomii a fyziologii ženského reprodukčního systému. Velkou část práce zaujímají náhlé příhody břišní v gynekologii a to především mimoděložní těhotenství, tedy stav, se kterým se může setkat každá žena ve svém reprodukčním období. Empirická část práce je věnována kvalitativnímu výzkumu se zaměřením na zjištění spokojenosti respondentek s poskytovanou ošetřovatelskou péčí po operaci mimoděložního těhotenství. Pohled na hospitalizaci ze strany pacientek je velice cenný, protože dokládá výsledky zdravotnické, v tomto případě ošetřovatelské práce jinak, než běžné statistiky. Výzkumný soubor je tvořen pěti ženami v reprodukčním věku, které byly hospitalizovány na gynekologicko-porodnické klinice s diagnózou ektopická gravidita. Práce shromažďuje co nejvíce informací o mimoděložním...

A hiperplasia adrenocortical macronodular primária (PMAH) é uma causa rara de Síndrome de Cushing (SC). Apresenta como características macronódulos funcionantes em ambas as glândulas suprarrenais e uma produção variável de cortisol. Os nódulos apresentam uma produção ectópica de hormônio adrenocorticotrófico (ACTH) tornando a doença independente do ACTH hipofisário. Estudos independentes mostraram que mutações germinativas no gene armadillo repeat cointaining 5 (ARMC5) são uma causa frequente de PMAH. Além dessa mutação parece haver a participação de receptores hormonais ectópicos no córtex suprarrenal, que estimulariam a esteroidogênese e a hiperplasia da glândula. No entanto, os estudos sobre a relação entre o ARMC5 e a participação dos receptores aberrantes na produção de cortisol são incipientes. Portanto, temos como hipótese que as alterações no gene ARMC5 podem estar envolvidas no padrão celular e funcional das células que compõem os nódulos hiperplásicos na PMAH. Desta forma, nossos objetivos foram analisar: 1) a proporção de células espongiformes e compactas em cortes corados com hematoxilina e eosina; 2) a expressão gênica, nas células espongiformes e proteica de ambas as células, do ARMC5, das enzimas esteroidogênicas StAR, 3βHSD2 e CYP17A1, dos receptores da vasopressina (AVP1AR), serotonina (5HT4R) e do peptídeo inibidor gástrico (GIPR) e do ACTH ectópico e 3) a expressão do antígeno de proliferação celular, a proteína PCNA, para análise do padrão de proliferação em cortes histológicos de nódulos de hiperplasias de pacientes que apresentam mutações germinativas, mutações germinativas e somáticas ou não mutação no gene ARMC5. Os resultados mostraram que os nódulos hiperplásicos são compostos, na sua maioria, por células espongiformes, cujo padrão foi independente da presença de mutação. A expressão do ARMC5 nas células espongiformes foi maior em pacientes com mutação, e os receptores ectópicos apresentaram uma expressão maior no tecido de PMAH em relação à adrenal normal. A reação de imunoistoquimica revelou células positivas para a proteína ARMC5 e StAR, em ambos os tipos celulares, enquanto a enzima 3βHSD2 foi predominante nas células espongiformes e a enzima CYP17A1 nas células compactas. A expressão de AVP1AR, 5HT4R, e do ACTH ectópico foi positiva em ambos os tipos celulares e independente da presença ou não da mutação no gene ARMC5, bem como a expressão da proteína PCNA. Portanto, nossos resultados sugerem que a presença ou não de mutações no gene ARMC5 nas hiperplasias não está envolvida no padrão celular das células que compõem os nódulos. O mesmo para a presença dos receptores AVP1AR, 5HT4R e GIPR, do ACTH ectópico e da proteína PCNA. Como conclusão, os resultados dos parâmetros analisados sugerem que as alterações no gene ARMC5 não estão envolvidas no padrão celular e funcional das células que compõem os nódulos hiperplásicos na PMAH, e podem ter o mesmo grau de importância na formação desses nódulos. / The primary macronodular adrenal hyperplasia (PMAH) is a rare cause of Cushing\'s Syndrome (SC). It is characterized as macronodules in the adrenal gland and by variable production of cortisol. The nodules present an ectopic production of adrenocorticotrophic hormone (ACTH) pituitary-independent. Several studies showed that the germ mutations in armadillo repeat cointaining 5 (ARMC5) are a frequent cause of PMAH. In addition, there is a participation of ectopic hormonal receptors in the adrenal cortex, which promotes steroidogenesis and hyperplasia of the gland. However, studies on a relationship between ARMC5 and aberrant receptor involvement in cortisol production are incipient. Therefore, our hypothesis is that ARMC5 gene may be involved in the cellular and functional pattern of the cells in PMAH. Thus, the objectives were to analyzed: 1) the proportion of spongiform and compact cells in sections stained with hematoxylin and eosin; 2) the gene expression in the spongiform cells and the gene and protein expression in both cells types of the ARMC5, the steroidogenic enzymes StAR ,3βHSD2 e CYP17A1, and the ectopic receptors of vasopressin (AVP1AR), serotonin (5HT4R) and gastric inhibitory peptide (GIPR) also the ACTH ectopic and 3) the proliferating cell nuclear antigen (PCNA) that shows the proliferation pattern in patients PMAH that present germline, germinative and somatic mutations or no mutation in ARMC5 gene. We showed that the hyperplastic nodules are mainly composed by spongiform cells independent of the ARMC5 mutation. The expression of ARMC5 in spongiform cells was higher in patients with mutation, and PMAH tissue have a higher expression of the ectopic receptors when compared with normal adrenal. With the immunohistochemical labeling, we observed the ARMC5 and StAR protein expression in both cell types. The 3βHSD2 enzyme was predominant in spongiform cells and the CYP17A1 enzyme in the compact cells. The expression of AVP1AR, 5HT4R, and ectopic ACTH was positive in both cell types regardless of the presence of the ARMC5 mutation, as well as the expression of the PCNA protein. Therefore, the results suggest that the mutation in ARMC5 is not involved with spongiform and compact cell function. Moreover, the presence of the AVP1AR, 5HT4R and GIPR receptors, the ectopic ACTH and the PCNA protein was not related to the gene mutation. In conclusion, the alterations in the ARMC5 gene are not involved in the cell functional pattern in the PMAH and in the onset of the nodules.