Thesis (PhD)--Stellenbosch University, 2012. / See full text for abstract. / Sien volteks vir opsomming

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: In this thesis, the recovery of RhIII from both synthetically prepared and authentic industrial PGM-containing solutions was systematically investigated via organic precipitation methods using several commercially available, N-containing organic receptors including (amongst others) diethylenetriamine (Deta), triethylenetetramine (Teta), tetraethylenepentamine (Tepa) and tris(2-aminoethyl)amine (Tren). These organic receptors act as precipitating agents in the presence of an appropriate protonating agent (HCl) by lowering the solubility of the PGM chlorido-anions through an ion-pairing mechanism. The recovery of RhIII from synthetically prepared PGM (RhIII and PtIV) containing solutions using these precipitants was excellent, while poor Rh recovery from authentic industrial process solutions was achieved. The poor Rh recovery from these process solutions was ascribed to the species distribution of the [RhCln(H2O)6-n]3-n complexes. In order to validate the proposition that RhIII speciation effects are responsible for the poor Rh recovery observed during the precipitation studies, attempt were made to describe the species distribution of the [RhCln(H2O)6-n]3-n (n=3-6) by means of high-resolution 103Rh NMR spectroscopy. A detailed high-resolution 103Rh NMR spectroscopic study of the series of [RhCln(H2O)6-n]3-n (n=3-6) complexes was conducted. During this study, all six RhIII aqua chlorido-complexes have unambiguously been characterized by means of high-resolution 103Rh NMR spectroscopy, proving the powerful analytical capability of this technique. Characterization of these complexes is based on the detailed analysis of the 35Cl/37Cl isotope effects which is observed in the 19.11 MHz 103Rh NMR resonances of the [RhCln(H2O)6-n]3-n (n=3-6) complexes in aqueous HCl solutions at 292 K. These resonances show that the “finestructure” of each of the 103Rh resonances may be understood in terms of its unique isotopologue, and in certain cases, the isotopomer distribution of each complex, which manifests as a result of its statistically expected 35Cl/37Cl isotopologue and isotopomer distributions. As a result, the 103Rh NMR resonance structure serves as a unique “NMRfingerprint”, which allows for the unambiguous assignment of [RhCln(H2O)6-n]3-n (n=3-6) complexes, without the reliance on accurate δ(103Rh) chemical shifts. Furthermore, this study reports the first direct species distribution diagram for the [RhCln(H2O)6-n]3-n (n=3-6) series of complexes (in aqueous HCl solutions at 292 K) as a function of the “free” (unbound) chloride concentration, constructed from 103Rh NMR measurements. The need for a revised speciation diagram of [RhCln(H2O)6-n]3-n (n=3-6) complexes is clearly reflected by the vast differences observed in the literature reported species distribution diagrams, which makes it difficult to decide which set of experimental conditions (if any) is required for the quantitative and “selective” recovery of RhIII from aqueous HCl solutions containing associated PGMs (Pt, Pd, Ir, Ru) as well as other transition metals. The documented species distribution diagrams for RhIII have been generally constructed via data from indirect (kinetic and spectrophotometric) measurements using dilute RhIII solutions at relatively high HCl concentrations, which implies that the RhIII:Clmole ratio is higher than what may be expected in authentic process solutions – an important aspect to consider when optimizing RhIII recovery methods. In addition, RhIII kinetic investigations reported in this study shows that ionic strength and temperature effects are important factors that dramatically influences the rate of RhIII ligand exchange (i.e. RhIII aquation reactions) which, in turn, have contributing effects on the species distribution of [RhCln(H2O)6-n]3-n complexes. Notable differences exist between the speciation diagram reported in this study and those documented in literature, especially at a “free” chloride concentration of 1.0 M. At this “free” chloride concentration, the [RhCl5(H2O)]2- complex anion was found to have an abundance of 34%, while literature reports an abundance of 80%. In order to ascertain its practical relevance, the proposed 103Rh NMR speciation method was extended, for the first time, to authentic industrial Rh feed solutions (Anglo Platinum PLC). Each of the 103Rh resonances was unambiguously assigned, and each species quantified. Moreover, the RhIII species distribution of the industrial Rh feed solution was accurately predicted by the “direct” speciation diagram constructed form 103Rh NMR measurements. After careful optimization of the Heraeus industrial feed solutions (optimal chloride concentration followed by thermal treatment for enhancing RhIII chloride anation reactions), the recovery of Rh via precipitation was repeated. In this instance, Rh recovery improved dramatically, with up to 95% of Rh removed from solution. This improvement is ascribed primarily to the increased “free” (unbound) chloride concentration. The presence of associated PGMs as well as other transition metals would lower the effective “free” chloride concentration, since these metals would act as “chloride binders”. By adjusting the total chloride concentration, RhIII chloride anation reactions is enhanced which leads to the [RhCln(H2O)6-n]3-n (n=5,6) complex anions being the dominant species in solution, therefore leading to improved Rh recovery. Moreover, it was shown that, under carefully controlled conditions, “selective” recovery of Rh is achieved using tris(2-aminoethyl)amine (Tren). Considering the fact that Rh is the last precious metal recovered in all PGM refineries, this can possibly provide a cost-effective route for the “upfront” (early stage) recovery of Rh from industrial PGM feed solutions. / AFRIKAANSE OPSOMMING: In hierdie tesis word die herwinning van RhIII uit laboratorium voorbereide sowel as ware industriële PGM-bevattende oplossings sistematies ondersoek deur middel van organiese neerslag metodes, deur gebruik te maak van verskeie kommersieël beskikbare, Nbevattende organiese reseptore insluitende dietileentriamien (Deta), tri-etileentetramien (Teta), tetra-etileenpentamien (Tepa) en tris(2-aminoetiel)amien (Tren). Hierdie organiese reseptore tree op as neerslag-agente in die teenwoordigheid van 'n geskikte protoneringsagent (in hierdie geval HCl) deur 'n verlaging van die oplosbaarheid van die PGM chloriedanione deur middel van 'n ioon parings meganisme. Die herwinning van RhIII vanuit laboratorium voorbereide PGM (RhIII en PtIV) oplossing met behulp van hierdie organiese neerslag-agente was uitstekend, terwyl Rh herwinning vanuit ware industriële oplossings swak was. Die onvolledige Rh herwinning uit hierdie industriële oplossings word toegeskryf aan die spesie-verspreiding van die [RhCln(H2O)6-n]3-n komplekse. Ten einde die effek van RhIII spesie-verspreiding op die herwinning van Rh te bestudeer, is gepoog om die spesieverspreiding van [RhCln(H2O)6-n]3-n (n=3-6) komplekse, deur middel van hoë resolusie 103Rh KMR spektroskopie, te beskryf. 'n Gedetailleerde hoë resolusie 103Rh KMR spektroskopiese studie van die reeks van [RhCln(H2O)6-n]3-n (n=3-6) komplekse was uitgevoer. Tydens hierdie studie was al ses RhIII aqua chlorido-komplekse ondubbelsinnig gekarakteriseer deur middel van hoë resolusie 103Rh KMR spektroskopie, wat bewys lewer van die kragtige analitiese vermoë van hierdie tegniek. Karakterisering van hierdie komplekse is gebaseer op die gedetailleerde analise van die 35Cl/37Cl isotoop effekte wat waargeneem word in die 19.11 MHz 103Rh KMR resonansies van die [RhCln(H2O)6-n]3-n (n=3-6) komplekse in HCl oplossings by 292 K. Hierdie resonansies toon dat die "fyn struktuur" van elk van die 103Rh resonansies verstaan kan word in terme van die unieke isotopoloog, en in sekere gevalle, die isotopomeer verspreiding van elke kompleks, wat manifesteer as 'n gevolg van die die statisties verwagte 35Cl/37Cl isotopoloog en isotopomeer verspreiding. Die 103Rh KMR resonansie-struktuur kan sodoende dien as 'n unieke "KMR-vingerafdruk", wat voorsiening maak vir die ondubbelsinnige karakterisering van [RhCln(H2O)6-n]3-n (n=3-6) komplekse, sonder om vertroue op akkurate δ(103Rh) chemiese verskuiwings te plaas. Hierdie studie rapporteer verder die eerste direkte spesie-verspreiding-diagram vir die [RhCln(H2O)6-n]3-n (n=3-6) reeks komplekse (in HCl oplossings by 292 K) as 'n funksie van die "vrye"(ongebonde) chloried-konsentrasie, verkry van 103Rh KMR metings. Die behoefte vir 'n aangepasde spesiasie-diagram vir die [RhCln(H2O)6-n]3-n (n=3-6) komplekse word duidelik weerspieël deur die groot verskille waargeneem in die literatuur gerapporteerde verspreidings diagramme, wat dit moeilik maak om te besluit watter stel eksperimentele toestande (indien enige) benodig word vir die kwantitatiewe en “selektiewe” herwinning van RhIII in HCl oplossings in die teenwoordigheid van gepaardgaande PGM (Pt, Pd, Ir, Ru) sowel as ander oorgangsmetale. Die gedokumenteerde spesie-verspreiding-diagramme vir RhIII is oor die algemeen verkry via data vanaf indirekte (kinetiese en spektrofotometriese metings) deur gebruik te maak van verdunde RhIII oplossings in relatiewe hoë HCl konsentrasies, wat impliseer dat die RhIII:Cl mol verhouding hoër is as wat verwag kan word in ware industriële proses oplossings - 'n belangrike aspek om te oorweeg gedurende die optimalisering van RhIII herwinning-metodes. Verder, die RhIII kinetiese ondersoeke gerapporteer in hierdie studie toon dat ioniese sterkte sowel as temperatuur effekte belangrike faktore is wat die tempo van RhIII ligand uitruiling (d.w.s. RhIII “aquation” reaksies), wat ‘n betekenisvolle invloed hê op die spesie-verspreiding van [RhCln(H2O)6-n]3-n komplekse. Aansienlike verskille bestaan tussen die spesiasie-diagram gerapporteer in hierdie studie en dit gedokumenteer in die literatuur, veral by 'n "vrye" chloried-konsentrasie van 1.0 M. By hierdie "vrye" chloried-konsentrasie was die [RhCl5(H2O)]2- komplekse anioon gevind om in 34% teenwoordig te wees (hierdie studie), terwyl die publiseerde verslae 80% rapporteer. Ten einde die praktiese toepaslikheid van die voorgestelde 103Rh KMR spesiasiemetode te bepaal, was (vir die eerste keer) ware industriële Rh oplossings (Anglo Platinum PLC) gebruik. Elk van die 103Rh resonansies was ondubbelsinnig gekarakteriseer, en elke Rh spesie teenwoordig gekwantifiseer. Daarbenewens is die RhIII spesie-verspreiding van die industriële Rh oplossing deur die "direkte" spesiasie-diagram saamgestel vanuit 103Rh KMR metings akkuraat voorspel. Die berekende RhIII spesie-verspreiding van die industriële Rh oplossings was akkuraat voorspel deur die voorgestelde “direkte” spesiasie-diagram soos saamgestel vanuit die 103Rh KMR metings. Na deeglike optimalisering van Heraeus industriële oplossings (optimale chloriedkonsentrasie gevolg deur termiese behandeling vir effektiewe RhIII chloried anasie reaksies), is die herwinning van Rh via neerslag metodes herhaal. In hierdie geval, het die Rh herwinning dramaties verbeter, met tot 95% van die Rh uit oplossing verwyder. Hierdie verbetering is hoofsaaklik toegeskryf aan die verhoogde "vry" (ongebonde) chloriedkonsentrasie. Die teenwoordigheid van geassosieerde PGM's sowel as ander oorgangsmetale sal die effektiewe "vrye" chloried-konsentrasie verlaag, aangesien hierdie metale sou optree as "chloried-binders". Deur die aanpassing van die totale chloried-konsentrasie, word RhIII chloried anasie reaksies verbeter, wat daartoe lei dat [RhCln(H2O)6-n]3-n (n = 5,6) komplekse anione die dominante spesies in oplossing word, en dus lei tot verbeterde Rh herwinning. Daarbenewens word verder aangetoon dat, onder noukeurig gekontroleerde voorwaardes, "selektiewe" herwinning van Rh bereik word deur gebruik te maak van tris(2-aminoetiel)amien (Tren). Met inagneming van die feit dat Rh die laaste edelmetaal is wat verhaal word in alle PGM-raffinaderye, kan dit 'n koste-effektiewe roete word vir die "vooraf" (vroeë-stadium) herwinning van Rh vanuit industriële PGM bevattende oplossings.

Thesis (PhD)--Stellenbosch University, 2013. / Please refer to full text to view abstract.

<div>Recent advances in Magnetic Resonance Imaging (MRI), a noninvasive imaging technique, have spurred the exploration of poorly understood physiological phenomena <i>in vivo</i>. Applications of MRI vary greatly, from anatomical evaluation to complex functional analysis. The body of this dissertation presents four applications of MRI: 1) investigation of a novel traumatic brain injury (TBI) biomarker, 2) analysis of position-specific head acceleration events on neurometabolic profiles in high school football athletes, 3) the first reporting of neurometabolic changes in middle school football athletes, and 4) a novel application of diffusion-weighted imaging (DWI) to characterize implantable drug-delivery depots (Appendix A).</div><div> </div><div>Magnetic resonance spectroscopy (MRS) is an MRI method used to evaluate the metabolic profiles of tissues. Certain brain metabolites (N-acetyl aspartate, <i>myo</i>-inositol, choline, creatine, and glutamate/glutamine) offer unique information regarding brain homeostasis following TBI. When coupled with additional metrics, such as head acceleration events recorded during collision-sport participation, the mechanisms of neurophysiological changes can be further elucidated. Here, player position-specific neurometabolic changes were evaluated in high school and middle school football athletes. Striking differences were noted between linemen and non-linemen as well as high school and middle school athletes.</div><div> </div><div>However, in most clinical cases of TBI, information regarding head acceleration events is unknown and baseline scans are not available.Therefore, it is critical to evaluate candidate biomarkers which increase solely in response to injury. Acrolein, a toxic reactive oxygen species, has been shown to increase following injury to the central nervous system in animal models. Hence, acrolein is a prime TBI biomarker candidate and has been investigated using nuclear magnetic resonance and MRS at 7 Tesla.</div><div> </div><div>Applications of MRI are not limited to the brain, or even tissues. Studies have reported that up to 50% of patients fail to take their medications correctly - resulting in disease progression and medication waste. <i>In situ</i> forming implants (ISFIs) offer an alternative to oral dosage regimens but have not been validated <i>in vivo. </i>Using DWI, ISFIs can be characterized noninvasively and their design can be refined, ultimately improving patient outcomes.</div><div> </div><div>Taken together, MRI is powerful tool that can be used to investigate a wide range of physiological questions. Chapters 2-4 will emphasize efforts to improve TBI diagnostics and better understand neurometabolic changes in youth football athletes. Appendix A offers insights into the DWI-guided characterization of <i>in situ</i> forming implants.</div>

A esteatose hepática, que se caracteriza pelo acúmulo excessivo de gordura nas células do fígado, é um problema que vem preocupando a comunidade médico-científica, pois sua incidência vem aumentando a nível global, com expectativa de se tornar a doença crônica hepática de maior predominância em várias partes do mundo. Apesar de ser considerada uma doença benigna, a esteatose pode evoluir para doenças mais graves como cirrose, fibrose avançada, esteato hepatite (com ou sem fibrose) ou carcinoma. Entretanto, é potencialmente reversível, mesmo em quadros mais graves, o que reforça a urgência de se desenvolver métodos confiáveis para detecção e avaliação, inclusive ao longo de tratamento. Os métodos atuais para diagnóstico e quantificação da gordura hepática ainda são falhos: com a ultrassonografia não se é capaz de realizar quantificação; a tomografia computadorizada faz uso de radiação ionizante; a punção (biópsia), considerada o padrão ouro, é precisa, mas invasiva e pontual. A Ressonância Magnética (RM), tanto com espectroscopia (MRS) como com imagem (MRI), são alternativas completamente não invasivas, capazes de fornecer o diagnóstico e quantificação da gordura infiltrada no fígado. Entretanto, os trabalhos encontrados na literatura utilizam sequências de pulsos desenvolvidas especialmente para esse fim, com métodos de pós-processamento extremamente rebuscados, o que não é compatível com o estado atual dos equipamentos encontrados em ambientes clínicos nem mesmo ao nível de experiência e conhecimento das equipes técnicas que atuam em clínicas de radiodiagnóstico. Assim, o objetivo central do presente trabalho foi avaliar o potencial da RM como candidato a método de diagnóstico e de quantificação de gordura em ambientes clínicos, utilizando, para isso, sequências de pulsos convencionais, disponíveis em qualquer sistema comercial de RM, com protocolos de aquisição e processamento compatíveis com àqueles realizados em exames clínicos, tanto no que se refere à simplicidade como ao tempo total de aquisição. Foram avaliadas diferentes abordagens de MRS e MRI utilizando a biópsia hepática como padrão de referência. Foram avaliados pacientes portadores de diabetes tipo II, que apresentam alta prevalência de esteatose hepática não alcoólica, além de grande variabilidade nos percentuais de gordura. Foram realizadas medidas de correlação, acurácia, sensibilidade e especificidade de cada uma das abordagens utilizadas. Todos os métodos avaliados apresentaram alto grau de correlação positiva (> 87%) com os dados obtidos de maneira invasiva, o que revela que os valores obtidos utilizando RM estão de acordo com aquilo observado pela biópsia hepática. Muito embora os métodos de processamento utilizados não sejam tão complexos quanto seriam necessários caso uma quantificação absoluta fosse desejada, nossas análises mostraram alta acurácia, especificidade e sensibilidade da RM na avaliação da esteatose. Em conclusão, a RM se apresenta, de fato, como uma excelente candidata para avaliar, de forma não invasiva, a fração de gordura hepática, mesmo quando se considera as limitações impostas por um ambiente clínico convencional. Isso sugere que essas novas metodologias podem começar a migrar para ambientes clínicos sem depender das sequências complexas e dos processamentos exóticos que estão descritos na literatura mais atual. / Hepatic steatosis is a disease characterized by excessive accumulation of fat in liver cells. Its incidence is increasing and it is expected to become the chronic liver disease with the highest prevalence worldwide, which became a major concern to medical and scientific community. Although considered a benign disease, fatty liver can evolve to more serious diseases such as cirrhosis, advanced fibrosis, steatohepatitis (with or without fibrosis) or carcinoma. However, it is potentially reversible, even in the most severe cases, which reinforces the urgent need to develop reliable methods for detection and evaluation, including throughout treatment. Current methods for diagnosis and measurement of liver fat are still flawed: ultrasound is not able to perform quantification; CT uses ionizing radiation; biopsy, considered the gold standard, is accurate but invasive and focal. Magnetic resonance imaging (MRI) and spectroscopy (MRS) are completely non-invasive alternatives capable of providing diagnosis and quantification of infiltrated fat in the liver. However, studies in the literature frequently employ pulse sequences especially developed for this purpose, with extremely elaborate post-processing methods, which are not compatible with the current state of the art of typical clinical scanners or even with the level of experience and knowledge of technical staff working in radiology clinics. Thus, the main goal of this study was to evaluate the potential of MRI as a candidate for diagnosing and quantifying fat liver in clinical settings, using conventional pulse sequences, acquisition and post-processing protocol, compatible with those performed in clinical examinations in both simplicity and total acquisition time. We investigated different approaches of MRI and MRS using liver biopsy as reference standard. We evaluated patients with type II diabetes, which have a high prevalence of non-alcoholic fat liver disease, and great variability in the percentage of fat. Correlation, accuracy, sensitivity and specificity measurements of each of the approaches used were performed. All evaluated methods highly correlated (> 87%) with the data obtained from invasive measurement, which shows that the values obtained using MRI are consistent with that observed for liver biopsy. Although the processing methods used are not as complex as would be required if an absolute quantification was desired, our analyzes showed high accuracy, sensitivity and specificity of MRI in the evaluation of steatosis. In conclusion, MRI is an excellent candidate to assess liver fat fraction in a non-invasive way, even when considering the limitations imposed by conventional clinical setting. This suggests that these new methods may begin to migrate to clinical environments without relying on complex sequences and exotic post-processing techniques that are described in the current literature.

Déficits cognitivos são frequentes em pacientes com esclerose múltipla (EM), especialmente a memória de longo prazo. Por outro lado, estudos de imagem por ressonância magnética têm correlacionado atrofia do hipocampo aos déficits mnésicos destes pacientes. Considerando-se a atrofia um marcador de dano neuronal tardio, justifica-se a investigação da fisiopatologia do dano hipocampal nas fases inicias da doença. Objetivo: Descrever os achados volumétricos e neuroquímicos da formação hipocampal de pacientes com EM recorrente-remitente (EMRR) em suas fases iniciais, comparando-os ao de um grupo de indivíduos saudáveis, e avaliar suas relações com a memória de longo prazo. Material e Métodos: Vinte e nove pacientes (19 mulheres, idade média 31 anos ± 8,7) com EMRR e um grupo controle composto por 26 indivíduos saudáveis (19 mulheres, idade média 30,7 anos ± 8,4) realizaram a 1H-ERM em magneto 3,0T. Foi utilizada técnica single-voxel e sequência PRESS com TR = 1500 ms, TE = 135 ms e dimensões fixas do voxel (6 cm3) localizado ao longo do hipocampo esquerdo para avaliação do N-acetil-aspartato (NAA), Colina (Cho) e Creatina (Cr), sendo a análise feita com o software LC Model. A avaliação volumétrica do encéfalo e da formação hipocampal foi realizada por meio do software FreeSurfer. Os indivíduos foram avaliados cognitivamente tendo sido criado um escore de memória verbal que avalia a evocação tardia (EMV-T), empregando-se a etapa de evocação tardia do Hopkins Verbal Learning Test-Revised e o Teste da Memória Lógica-II. Resultados: Observou-se atrofia em ambos os hipocampos dos pacientes com EM. Além disso, pacientes apresentaram menores níveis de NAA quando comparados aos do grupo de controles (F(1,51) = 4,089; p = 0,048), tendo sido observada correlação positiva entre NAA e o volume da formação hipocampal no grupo de pacientes (r = 0,372; p = 0,047). Por fim, pacientes apresentaram correlação negativa significante entre EMV-T e NAA (r = -0,408; p = 0,031), Cho (r = -0,509; p = 0,006) e Cr (r = -0,402; p = 0,034), enquanto que, nos controles, apenas foi observada leve tendência de correlação na direção oposta. Conclusões: Nossos resultados indicam, nas fases inicias da EM, atrofia e redução dos níveis de NAA na formação hipocampal, secundário à disfunção e/ou perda neuronal. O fato dos pacientes apresentarem relação entre metabólitos hipocampais e memória oposta ao que é esperado, para indivíduos saudáveis, está de acordo com a hipótese da presença de mecanismos compensatórios na função cognitiva de pacientes com EM / Cognitive deficits are common in patients with multiple sclerosis (MS), especially long-term memory. Moreover, magnetic resonance imaging studies have correlated hippocampal atrophy with mnemonic deficits in these patients. Considering atrophy a late marker of neuronal damage, investigation of the pathophysiology of hippocampal damage in the early stages of the disease is justified. Objective: Describe the volumetric and neurochemical findings of the hippocampal formation of early relapsing-remitting MS patients (RRMS), comparing it to a group of healthy subjects, and assess its relationships with long-term memory. Material and Methods: Twenty-nine patients (19 women, mean age 31 years ± 8,7) with RRMS and a control group of 26 healthy individuals (19 women, mean age 30,7 anos ± 8,4) underwent 1H-MRS in 3,0T scanner. Single-voxel PRESS sequence with repetition time of 1500 msec, echo time of 135 msec and fixed dimensions of the voxel (6 cm3) was located along the left hippocampus. Data were processed with LC Model software and the concentration of N-acetyl-aspartate (NAA), Choline (Cho) and Creatine (Cr) was calculated. Brain and hippocampal formation volumes were quantified using FreeSurfer software. Subjects were assessed cognitively and a verbal memory score assessing delayed recall (EMV-T) was developed, using Hopkins Verbal Learning Test-Revised delayed recall and Logical Memory-II test. Results: Atrophy was observed in both hippocampi of MS patients. In addition, MS patients had lower NAA levels compared to the control group (F (1,51) = 4,089, p = 0,048), and positive correlation between NAA and hippocampal formation volume was observed in patient group (r = 0.372, p = 0.047). Finally, patients showed a significant negative correlation between EMV-T and NAA (r = -0.408, p = 0.031), Cho (r = -0.509, p = 0.006) and Cr (r = -0.402, p = 0.034), while only a weak tendency to an association in the opposite direction was observed in the control group. Conclusion: Our results indicate, in early MS, atrophy and reduced levels of NAA in the hippocampal formation, secondary to neuronal loss and/or dysfunction. The fact that the observed relationship between hippocampal metabolites and memory was in the opposite direction as what it is expected for healthy subjects supports the hypothesis that compensatory mechanisms are present in cognitive function of MS patients

INTRODUÇÃO: As malformações do desenvolvimento cortical (MDC) resultam de distúrbios no dinâmico processo de corticogênese cerebral e são importante causa de epilepsia grave, atraso do desenvolvimento, déficits motores e cognitivos. O papel do metabolismo na epilepsia humana tem sido extensamente debatido, e há inúmeras evidências que apontam para disfunções bioenergéticas como fatores-chave na ictogênese. Distúrbios metabólicos foram identificados nas malformações corticais com outras modalidades de neuroimagem, tais como a espectroscopia de prótons por ressonância magnética. Para o nosso conhecimento, entretanto, o metabolismo de fósforo em pacientes com epilepsia secundária a MDC não foi extensamente investigado até o momento. OBJETIVOS: O objetivo deste estudo foi avaliar o metabolismo de fosfolipídios in vivo em uma série de pacientes com epilepsia e MDC. MÉTODO: Trinta e sete pacientes com MDC e 31 voluntários foram estudados usando espectroscopia de fósforo por ressonância magnética (31P-ERM) tridimensional em aparelho de 3,0 Tesla. Os voxels nas lesões foram comparados ao córtex frontoparietal dos controles (volumes efetivos de 12,5 cm3). O parênquima aparentemente normal foi avaliado em voxels homólogos de pacientes e controles, abrangendo cinco regiões cerebrais: regiões nucleocapsulares direita e esquerda, córtex frontoparietal parassagital, e centros semiovais direito e esquerdo. Foram utilizados métodos de quantificação para ajustar os dados no domínio do tempo para as seguintes ressonâncias: fosfoetanolamina (PE), fosfocolina (PC), glicerofosfoetanolamina (GPE), glicerofosfocolina (GPC), fosfato inorgânico (Pi), fosfocreatina (PCr), e a-, b- e g-adenosina trifosfato (ATP). Também foram calculados o ATP total (ATPt=a-+b-+g-ATP), fosfodiésteres (PDE=GPC+GPE), fosfomonoésteres (PME=PE+PC), e as razões PME/PDE, PCr/ATPt, e PCr/Pi. O magnésio (Mg2+) e os níveis de pH foram calculados com base nos desvios químicos da PCr, Pi, e -ATP. RESULTADOS: Comparativamente aos controles, e assumindo um valor de p < 0,05 estatisticamente significativo, as lesões apresentaram redução dos valores de pH e aumento de Mg2+. Também foram encontrados redução significativa de GPC e PDE, e aumento da relação PME/PDE nas MDC. O parênquima aparentemente normal também demonstrou redução dos valores de pH no córtex frontoparietal e no centro semioval bilateral. As diferenças nos valores de pH, tanto nas lesões como no parênquima aparentemente normal, permaneceram estatisticamente significativas nos subgrupos individuais de MDC (displasia cortical ou hemimegalencefalia; heterotopia; polimicrogiria e/ou esquizencefalia). Não houve correlação entre o tempo da última convulsão e as alterações do pH. CONCLUSÕES: O Mg2+ e o pH são parâmetros muito importantes na regulação bioenergética e estão envolvidos em múltiplas vias da atividade elétrica cerebral. Nossos dados corroboram a ideia de que distúrbios metabólicos ocorrem nas lesões focais de MDC, com propagação para áreas remotas aparentemente normais. As anormalidades de GPC, PDE, e da razão PME/PDE sugerem que há deficiências na renovação das membranas celulares nas lesões dos pacientes com epilepsia e MDC. / INTRODUCTION: Malformations of cortical development (MCD) result from disruptions in the dynamic process of cerebral corticogenesis and are important causes of severe epilepsy, neurodevelopmental delay, motor deficits and cognitive impairment. Metabolism in human epilepsy has been intensely debated, and there are several evidences pointing to brain bioenergetic disturbances as key factors in ictogenesis. Metabolic impairments in cortical malformations have been identified with other neuroimaging tools, such as proton magnetic resonance spectroscopy. To our knowledge, however, phosphorus metabolism in epilepsy caused by MCD has not been thoroughly investigated hitherto. OBJECTIVES: The aim of this study was to evaluate phospholipids metabolism in vivo in a series of patients with epilepsy and MCD. METHODS: Thirty-seven patients with MCD and 31 control subjects were studied using three-dimensional phosphorus magnetic resonance spectroscopy (31P-MRS) at a 3.0 T scanner. The voxels in the lesions were compared to the frontoparietal cortex of the control subjects (the effective volumes were 12.5 cm3). Normal appearing parenchyma was evaluated in homologous voxels of patients and controls encompassing five cerebral regions: right and left nucleocapsular regions, midline frontoparietal cortex and right and left semioval centers. Quantification methods were applied to fit the time-domain data to the following resonances: phosphoethanolamine (PE), phosphocholine (PC), glycerophosphoethanolamine (GPE), glycerophosphocholine (GPC), inorganic phosphate (Pi), phosphocreatine (PCr), and a-, b-, and g-adenosine triphosphate (ATP). We also estimated the total ATP (ATPt=a-+b-+g-ATP), phosphodiesters (PDE=GPC+ GPE), phosphomonoesters (PME=PE+PC), and the PME/PDE, PCr/ATPt, and PCr/Pi ratios. The magnesium (Mg2+) levels and pH were calculated based on PCr, Pi, and -ATP chemical shifts. RESULTS: Compared to controls and assuming that a p-value < 0.05 indicates significance, the MCD lesions exhibited lower pH values and higher Mg2+ levels. The lesions also presented significant reduction of GPC and PDE, and an increased PME/PDE ratio. The otherwise normal appearing parenchyma also demonstrated lower pH values in the frontoparietal cortex and bilateral centrum semiovale. The differences in pH values, both in the lesions and in the normal appearing parenchyma, remained statistically significant in individual subgroups of MCD (hemimegalencephaly or cortical dysplasia; heterotopia; polymicrogyria and/or schizencephaly). There was no correlation between the time of the last seizure and the pH abnormalities. CONCLUSIONS: Mg2+ and pH are very important in the regulation of bioenergetics and are involved in many electrical activity pathways in the brain. Our data support the idea that metabolic impairments occur in the lesions of MCD, with propagation to remote normal appearing parenchyma. The GPC, PDE, and PME/PDE abnormalities suggest that there are membrane turnover disturbances in MCD lesions.

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-08-21T12:12:23Z No. of bitstreams: 1 LUCAS CAMILO SILVA.pdf: 1027283 bytes, checksum: 4d040e2a5bb41a7711feb0c0686ea851 (MD5) / Made available in DSpace on 2017-08-21T12:12:23Z (GMT). No. of bitstreams: 1 LUCAS CAMILO SILVA.pdf: 1027283 bytes, checksum: 4d040e2a5bb41a7711feb0c0686ea851 (MD5) Previous issue date: 2017-03-10 / The complexity of biodiesel production processes through alkaline transesterification generates undesirable components to the process and increases the cost of quality control. The objective of this study is to analyze the biodiesel production process throughout the intermediate stages and propose analytical methodologies based on Nuclear Magnetic Resonance (NMR) and spectroscopy since these demanding less time for analysis and provide reliable information on various parameters without requiring large laboratory structure. The residual fatty acids and glycerol produced during transesterification of oils to biodiesel production can be raw material for glycerides synthesis by esterification reaction, an alternative technology to aggregate the biodiesel market. This paper presents an alternative to add value to these two byproducts under reaction conditions to easy control. It was used glycerol and fatty acids derived from the production of biodiesel and pure soybean fatty acid and glycerol pharmaceutical standard for evaluation of esterification with glycerol of fatty acids. For analysis of the NMR results was used factorial experimental design where was confirmed the gradually increasing concentration of glycerides in all batches getting to have 94.65% of glycerides formation when the catalyst used Methanesulfonic acid (M.S.A.) for reaction between Soybean distilled fatty acids (A.G.D.S.) and pharmaceutical standard glycerol. Was evaluated the esterification of Methyl Esters (ME) present in olein where it was found that the use of glycerol and standard pharmaceutical M.S.A. was the best reaction route where only 16.50% of the ME was not consume to generate glycerides. There was evaluation of the stages of the biodiesel production process and analysis of quality parameters by NMR where was possible to find contaminants in the raw material and determine the biodiesel quality results. Was make analysis of the standard glycerol pharmaceutical by xiv spectroscopy. For the treatment of the spectroscopy data, the PLSR model assembled and the results verified by the RMSEP calculation. It verified that the use of 20 components to construct the model showed RMSEP values ranging from the highest value referring to Color parameter and the lowest for the acidity analysis being 0.5659 and 0.00115 respectively, low values indicating that the model was satisfactory for predicting the quality results. It concluded that the synthesis of glycerides through reaction between glycerol and fatty acids occurred significantly. NMR and Spectroscopy techniques present potential for quality evaluation and reaction route for biodiesel production and synthesis of glycerides through esterification of esters and fatty acids as well as for quality control analyzes of glycerol pharmaceutical standard. / A complexidade de processos de produção de biodiesel através de transesterificação alcalina gera compostos indesejáveis. O objetivo deste trabalho é analisar o processo de produção de biodiesel ao longo das etapas e propor metodologias analíticas baseadas em Ressonância Magnética Nuclear (NMR) e espectroscopia visto que estas demandam menor tempo para análise e forneçam informações confiáveis de vários parâmetros. Ácidos graxos residuais e glicerol produzido durante a transesterificação de óleos para produção de biodiesel podem ser matérias-primas para síntese de glicerídeos através de reação de esterificação, uma alternativa tecnológica para agregar valor ao biodiesel no mercado. Este trabalho apresenta uma condição reacional de fácil controle para síntese de glicerídeos. Utilizou-se glicerol e ácidos graxos oriundos da produção de biodiesel e ácido graxos puros de soja e glicerol padrão farmacêutico para avaliação da esterificação de ácidos graxos com glicerol. Para análise dos resultados de NMR fez-se planejamento fatorial onde confirmou-se aumento gradativo de concentração de glicerídeos em todas bateladas chegando a ter-se um total de 94,65% de formação de glicerídeos. Avaliou-se a esterificação de metilésteres (ME) presentes na oleína onde verificou-se que a utilização de glicerol padrão farmacêutico e Ácido Metatoluenosulfônico M.S.A. foi a melhor rota reacional onde apenas 16,50% do ME não foi consumido para geração de glicerídeos. Fez-se avaliação das etapas do processo de produção de biodiesel e análise de parâmetros de qualidade através de NMR onde foi possível encontrar contaminantes na matériaprima e determinar resultados de qualidade do biodiesel. Fez ainda análise de glicerol padrão farmacêutico por espectroscopia. Para tratamento dos dados de espectroscopia, montou-se modelo de Regressão por Mínimos Quadrados Parciais (PLSR) e verificou-se os resultados através do cálculo do Erro Médio Quadrático de Previsão xii (RMSEP).Verificou-se que a utilização de 20 componentes para construção do modelo observou-se valores de RMSEP variando entre o maior valor referente ao parâmetro cor e o menor para a análise de acidez sendo 0,5659 e 0,00115 respectivamente, valores baixos que indicam que o modelo apresentou-se satisfatório para predição dos resultados de qualidade. Concluiu-se que a síntese de glicerídeos através de reação entre o glicerol e ácidos graxos ocorreram de maneira significativa. Técnicas de NMR e Espectroscopia apresentam potencial para avaliação de qualidade e rota reacional para produção de biodiesel e síntese de glicerídeos através de esterificação de ésteres e ácidos graxos assim como para análises de controle de qualidade de glicerol padrão farmacêutico.

Introdução: Atualmente há falta de consenso quanto à melhor estratégia diagnóstica não invasiva em pacientes com suspeita clínica de coledocolitíase. Duas revisões sistemáticas anteriores não demonstraram diferença estatisticamente significativa para detecção de coledocolitíase entre duas modalidades diagnósticas: Ecoendoscopia e Colangiorressonância Magnética Nuclear (CRMN). Entretanto, após a última revisão, outro estudo foi publicado resultando em um incremento significativo na amostra populacional a ser analisada. Objetivo: Comparar os resultados diagnósticos da Ecoendoscopia e da CRMN em pacientes com suspeita clínica de coledocolitíase por intermédio de revisão sistemática. Métodos: Realizou-se pesquisa nos bancos de dados eletrônicos da Medline, Embase, Cochrane, LILACS e Scopus em busca de estudos prospectivos que comparassem a Ecoendoscopia e CRMN na detecção de coledocolitíase, datados anteriormente a setembro de 2017. Todos os pacientes deveriam ter sido submetidos a teste padrão-ouro a fim de confirmação diagnóstica. Os estudos foram submetidos ao Quality Assessment of Diagnostic Accuracy Studies para análise de vieses. As variáveis analisadas e comparadas foram sensibilidade, especificidade, prevalência, valor preditivo positivo, valor preditivo negativo e acurácia. Resultados: Foram selecionados oito estudos prospectivos comparando Ecoendoscopia e CRMN no diagnóstico da coledocolitíase. Um total de 538 pacientes foram incluídos na análise. A probabilidade pré-teste para coledocolitíase foi 38,7%. As sensibilidades médias da Ecoendoscopia e da CRMN para detecção de coledocolitíase foram 93,7% e 83,5% respectivamente, e as especificidades foram 88,5% e 91,5%, respectivamente. As probabilidades pós-teste também foram calculadas: valores preditivos positivos de 89% e 87,8%, respectivamente, e valores preditivos negativos de 96,9% e 87,8%. As acurácias foram 93,3% e 89,7%, respectivamente. Conclusão: Para a mesma probabilidade pré-teste de coledocolitíase, a Ecoendoscopia demonstra maior sensibilidade e acurácia quando comparada à CRMN / Background: There is a lack of consensus about the optimal noninvasive strategy for patients with suspected choledocholithiasis. Two previous systematic reviews demonstrated no statistically significant difference between Endoscopic Ultrasound (EUS) and Magnetic Resonance Cholangiopancreatography (MRCP) for detection of choledocholithiasis. A recent publication provided new data to be analyzed. Objective: To compare the diagnostic results of Endoscopic Ultrasound and Magnetic Resonance Cholangiopancreatography in choledocholithiasis suspected patients. Methods: A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations including all published prospective trials. Medline, Embase, Cochrane, LILACS and Scopus databases were scanned until September 2017. All patients were submitted to a gold-standard method. The selected studies were submitted to Quality Assessment of Diagnostic Accuracy Studies. Aggregated variables such as sensitivity, specificity, prevalence, positive and negative predictive values and accuracy were analyzed. Results: A total of eight prospective trials comparing EUS and MRCP including 538 patients were analyzed. The pretest probability for choledocholithiasis was 38.7. The mean sensitivity of EUS and MRCP for detection of choledocholithiasis was 93.7 and 83.5, respectively; the specificity was 88.5 and 91.5, respectively. The positive predictive value was 89 and 87.8, respectively; the negative predictive value was 96.9 and 87.8 respectively. The accuracy was 93.3 and 89.7, respectively. Conclusion: For the same pretest probability of choledocholithiasis, EUS has higher sensitivity and accuracy compared to MRCP

Existe hoje uma grande diversidade de técnicas modernas na física médica que são fundamentadas na tecnologia de ressonância magnética nuclear. Dentre estas, a espectroscopia por ressonância magnética é utilizada para medir a concentração de determinados metabólitos no paciente, permitindo o diagnóstico de doenças através de anormalidades no resultado. Dadas as limitações experimentais para melhorar a aquisição do sinal, seja na parte instrumental ou ainda pela necessidade de minimizar o tempo total dos exames, a utilização de técnicas de processamento de sinais apresenta soluções para a melhor visualização e manipulação do sinal estudado. Dentre estas, está o uso de filtros para atenuar os impactos do ruído nos dados amostrados. Recentemente, diversas áreas que necessitam de processamento de sinais têm explorado implementações de filtros que utilizam a transformada wavelet, apresentando resultados promissores com esta nova abordagem. Partindo de estudos prévios na área de espectroscopia por ressonância magnética, implementamos neste trabalho filtros com transformada wavelet, utilizando a metodologia Wavelet Shrinkage Denoising (WSD). A etapa de maior importância deste procedimento é o cálculo do limiar, isto é, o valor a partir do qual os coeficientes devem ser considerados uma representação de ruído (e portanto atenuados); além do método descrito anteriormente na literatura, foram desenvolvidas neste trabalho outras duas novas formas para este cálculo, totalizando três filtros. O primeiro método utiliza a estimativa de risco não-enviesada de Stein (SURE), o segundo uma estimativa do desvio padrão característico do ruído, calculado em uma porção sem picos do espectro, e o terceiro, por fim, introduz informação do sinal à etapa de limiarização, utilizando um procedimento de fitting para estimar regiões do espectro a serem preservadas. A performance destes filtros foi comparada entre si, e também com um método de referência utilizando a transformada de Fourier, primeiro em sinais simulados, e em seguida em sinais in vivo experimentais. Os resultados apresentam uma grande melhora na performance anteriormente documentada, com proposições de novas formas de explorar o potencial de filtros baseados em transformada wavelet. / Many of today techniques in medical physics are based on nuclear magnetic resonance technology. Among these, magnetic resonance spectroscopy is used to measure the concentration of certain metabolites in the patient, allowing the diagnosis of diseases through abnormalities in the results. Given the experimental limitations to improve the quality of the acquired signal, either by instrumental methods or due to the need to minimize the total time elapsed on exams, employing signal processing techniques presents solutions for best visualization and manipulation of the studied signal. Among these, there is the development of filters to mitigate the impacts of noise on the sampled data. Recently, several areas that require signal processing have explored filter implementations that use the wavelet transform, presenting promising results with this new approach. Based on previous studies in the area of magnetic resonance spectroscopy, we implemented wavelet transform filters using the Wavelet Shrinkage Denoising (WSD) methodology. A crucial step in this procedure is the calculation of the threshold, as this value establishes which coefficients are to be considered a noise representation (and therefore attenuated); in addition to the method described previously in the literature, two other new proceedures were developed in this work, totaling three filters. The first method uses the Stein unbiased risk estimator (SURE), the second an estimate of the characteristic standard deviation of the noise, calculated in a portion without peaks of the spectrum, and the third, finally, inputs information from the signal at the thresholding using a fitting procedure to estimate regions of the spectrum that must be preserved. The performance of these filters was compared between each other, and also to a reference method using the Fourier transform, first on simulated signals, and then on experimental in vivo signals. Results show a great improvement compared to performance previously documented, bringing new ways to explore the potential of filters based on wavelet transform.