Bradyarrhythmias are common clinical findings consisting of physiologic and pathologic conditions (sinus node dysfunction and atrioventricular [AV] conduction disturbances). Bradyarrhythmias can be benign, requiring no treatment; however, acute unstable bradycardia can lead to cardiac arrest. In patients with confirmed or suspected bradycardia, a thorough history and physical examination should include possible causes of sinoatrial node dysfunction or AV block. Management of bradycardia is based on the severity of symptoms, the underlying causes, presence of potentially reversible causes, presence of adverse signs, and risk of progression to asystole. Pharmacologic therapy and/or pacing are used to manage unstable or symptomatic bradyarrhythmias.

This thesis explores how to best choose data when curve fitting using power exponential functions. The power exponential functions used are μ(b; x)=(xe1-x)b and Φ(ρ; x)=((1-x)ex)ρ . We use a number of designs such as the equidistant design, the Chebyshev design and the the D-optimal design to compare which design gives the best fit. A few examples including the logistic and the heidler function are looked at during the comparison. The measurement of the errors were made based on the sum of least squares errors in the first part and the maximum error in the second part. MATLAB was used in this comparison.

Master of Science / Department of Industrial and Manufacturing Systems Engineering / Todd Easton / Graph theory is a widely researched topic. A graph contains a set of nodes and a set of edges. The nodes often represent resources such as machines, employees, or plant locations. Each edge represents the relationship between a pair of nodes such as time, distance, or cost. Integer programs are frequently used to solve graphical problems. Unfortunately, IPs are NP-hard unless P = NP, which implies that it requires exponential effort to solve them. Much research has been focused on reducing the amount of time required to solve IPs through the use of valid inequalities or cutting planes. The theoretically strongest cutting planes are facet defining cutting planes. This research focuses on the node packing problem or independent set problem, which is a combinatorial optimization problem. The node packing problem involves coloring the maximum number of nodes such that no two nodes are adjacent. Node packings have been applied to airline traffic and radio frequencies. This thesis introduces a new class of graphical structures called suns. Suns produce previously undiscovered valid inequalities for the node packing polyhedron. Conditions are provided for when these valid inequalities are proven to be facet defining. Sun valid inequalities have the potential to more quickly solve node packing problems and could even be extended to general integer programs through conflict graphs.

Wireless Vision Sensor Networks (WVSNs) is an emerging field which has attracted a number of potential applications because of smaller per node cost, ease of deployment, scalability and low power stand alone solutions. WVSNs consist of a number of wireless Vision Sensor Nodes (VSNs). VSN has limited resources such as embedded processing platform, power supply, wireless radio and memory.  In the presence of these limited resources, a VSN is expected to perform complex vision tasks for a long duration of time without battery replacement/recharging. Currently, reduction of processing and communication energy consumptions have been major challenges for battery operated VSNs. Another challenge is to propose generic solutions for a VSN so as to make these solutions suitable for a number of applications. To meet these challenges, this thesis focuses on energy efficient and programmable VSN architecture for machine vision systems which can classify objects based on binary data. In order to facilitate generic solutions, a taxonomy has been developed together with a complexity model which can be used for systems’ classification and comparison without the need for actual implementation. The proposed VSN architecture is based on tasks partitioning between a VSN and a server as well as tasks partitioning locally on the node between software and hardware platforms. In relation to tasks partitioning, the effect on processing, communication energy consumptions, design complexity and lifetime has been investigated. The investigation shows that the strategy, in which front end tasks up to segmentation, accompanied by a bi-level coding, are implemented on Field Programmable Platform (FPGA) with small sleep power, offers a generalized low complexity and energy efficient VSN architecture. The implementation of data intensive front end tasks on hardware reconfigurable platform reduces processing energy. However, there is a scope for reducing communication energy, related to output data. This thesis also explores data reduction techniques including image coding, region of interest coding and change coding which reduces output data significantly. For proof of concept, VSN architecture together with tasks partitioning, bi-level video coding, duty cycling and low complexity background subtraction technique has been implemented on real hardware and functionality has been verified for four applications including particle detection system, remote meter reading, bird detection and people counting. The results based on measured energy values shows that, depending on the application, the energy consumption can be reduced by a factor of approximately 1.5 up to 376 as compared to currently published VSNs. The lifetime based on measured energy values showed that for a sample period of 5 minutes, VSN can achieve 3.2 years lifetime with a battery of 37.44 kJ energy. In addition to this, proposed VSN offers generic architecture with smaller design complexity on hardware reconfigurable platform and offers easy adaptation for a number of applications as compared to published systems.

A avaliação de linfonodos é parte importante do estadiamento das neoplasias mamárias, muito comum em cadelas, podendo auxiliar no estabelecimento do prognóstico e na escolha da melhor conduta terapêutica. Neste trabalho, dentre as várias técnicas de exame que permitem a avaliação de linfonodos, foi utilizada a ultra-sonografia. A avaliação ultra-sonográfica em modo B possibilitou avaliar tamanho, contorno, borda, forma, arquitetura, ecotextura e ecogenicidade do parênquima dos linfonodos e, em modo Doppler, a quantidade e distribuição dos seus vasos internos. Os objetivos deste trabalho foram identificar as características ultra-sonográficas mais importantes utilizadas para classificar os linfonodos em metastáticos e não-metastáticos, estabelecer elementos de confiabilidade do ultra-som como ferramenta para diferenciar linfonodos metastáticos de não-metastáticos e estabelecer procedimentos que permitam ao exame ultra-sonográfico de linfonodos, para essa classificação, ser reprodutível. Foram examinados 63 linfonodos inguinais superficiais de 30 cadelas com tumor em pelo menos uma das mamas inguinais ou abdominais caudais. Após o exame, cada linfonodo foi classificado como metastático ou não-metastático. A impressão diagnóstica do exame ultra-sonográfico foi associada aos resultados do exame histopatológico dos linfonodos obtendo-se uma taxa de concordância de 92,5%, índice de sensibilidade de 94,1%, índice de especificidade de 92%, valor preditivo positivo de 0,8 e valor preditivo negativo de 0,9787. As principais características ultra-sonográficas que classificaram um linfonodo inguinal superficial como metastático foram o contorno irregular, forma arredondada com razão C/E menor que dois, arquitetura desorganizada, ecotextura homogênea ou heterogênea, ecogenicidade alterada, vascularização elevada e de localização periférica. Quanto aos linfonodos não-metastáticos, as principais características ultra-sonográficas identificadas foram contorno regular, forma ovalada com razão C/E maior que dois, arquitetura preservada, ecotextura preservada, ecogenicidade normal, vascularização discreta a pequena e de localização hilar. O exame ultra-sonográfico dos linfonodos regionais constitui importante ferramenta na detecção de metástase e sugere-se incluí-lo como rotina do estadiamento de neoplasias mamárias em cadelas. / The evaluation of lymph nodes is an important part of the staging in case of mammary tumors, which are very common in female dogs. It can help in establishing a prognosis and chosing the best therapeutic procedures. In this study we used ultrasonography to assess lymph nodes within a variety of imaging techniques. B mode ultrasonography was used to provide information on size, edge, nodal borders, shape, architecture, echotexture and echogenivity of lymph nodes and Doppler ultrasonography to evaluate the quantity and distribution of the intranodal vessels. The objectives of this work were to identify which features in an ultrasound image can be associated to the metastatic or non-metastatic character of a lymph node; to establish the accuracy of the ultrasound as a tool to differentiate between metastatic and non-metastatic behavior and to establish procedures that permit the reproducibility of the results. Sixty three lymph nodes in thirty female dogs with mammary tumors were examined. We chose female dogs that had involvement of at least one of the inguinal or caudal abdominal mammary glands. Ultrasound imaging and histopathological exams were performed for each lymph node. Based on its ultrasound imaging, each lymph node was classified as metastatic or non-metastatic. When the ultrasound diagnostic was matched to the results of the histopathologic exam it was found that the classification of the lymph nodes using ultrasound imaging was correct in 92.5% of the cases, with sensibility of 94.1%, specificity of 92%, positive predictive value of 0.8 and negative predictive value of 0.9787. The main features in an ultrasound image associated with a metastatic superficial inguinal lymph node were irregular edge, round shape with long to short axis ratio lower than 2, loss of internal structure, homogeneous or heterogeneous echotexture, alteration of the echogenicity and high and peripheral vascularity. Relating to non metastatic lymph nodes, the main ultrasonographic characteristics were regular edge, oval shape with long to short axis ratio higher than 2, maintenance of internal structure, normal echo genetics and low hilar vascularity. The ultrasound imaging of regional lymph nodes is an important tool to detect metastasis and it is suggested that it becomes a regular procedure in the staging of canine mammary tumors.

A linfocintilografia tem contribuído muito para a visualização da drenagem linfática e linfonodo sentinela (LNS) acometido e o estado patológico do LNS é considerado o fator prognóstico mais importante do melanoma. Os objetivos deste trabalho foram descrever os padrões de drenagem linfática em pacientes operados por melanoma, avaliar as características clínicas, demográficas e cirúrgicas destes pacientes, assim como a contribuição da Linfocintilografia na localização dos LNS com vistas à biópsia do mesmo. Foram avaliados 29 pacientes com melanoma operados, e a Linfocintilografia pré-operatória foi realizada após 60 minutos da injeção de Fitato marcado com Tecnécio 99m (99mTc), em 4 pontos cardeais a 1,0 cm da lesão. Encontramos maior acometimento por melanoma na população feminina e idosa, maioria em região de tronco posterior. A maioria (37,04%) drenou para 2 LNS/LNNS, 88,89% dos pacientes drenaram apenas para região ipsilateral à lesão, e 88,89% também drenaram apenas para um único território de drenagem. Encontramos padrões de drenagem linfática inesperados em melanoma localizados nas regiões de cabeça e pescoço, tronco anterior e tronco posterior. A técnica de linfocintilografia foi eficaz para evidenciar LNS/LNNS em 93,10% dos pacientes e dos 23 exames anatomopatológicos realizados, 6 (26,09%) apresentaram comprometimento metastático nos LNS. / Lymphoscintigraphy has contributed much to the visualization of lymphatic drainage and sentinel lymph node (SLN) and involved SLN pathological state is considered the most important prognostic factor of melanoma. Our objectives were to describe the lymphatic drainage patterns, to evaluate the clinical, demographic, and surgical data, as well as assessing the contribution of lymphoscintigraphy for SLN localization in a sample of patients operated for melanoma. We evaluated 29 patients operate with melanoma, and the Preoperative lymphoscintigraphy was performed after 60 minutes of injection of phytate labeled with Technetium 99m (99mTc) in 4 cardinal points to 1,0 cm of the lesion. We found greater involvement by melanoma in the elderly female population and, most located in the posterior trunk region. The majority (37.04%) drained for 2 SLN/ SLNN, 88.89% of the patients drained only to the ipsilateral region, and also 88,89% had lymphatic drainage to only a single drainage area. We found unexpected lymphatic drainage patterns in melanoma localized in head and neck, trunk, anterior and posterior trunk. The technique of lymphoscintigraphy was effective to show SLN/SLNN in 93.10% of patients, and from 23 pathological examinations performed, 6 (26.09%) exhibited metastatic involvement in the SLN.

Este estudo teve o objetivo de avaliar a eficácia da movimentação precoce do braço, no controle da formação de seroma, em mulheres com câncer de mama submetidas a linfadenectomia axilar (LA). Foi realizado um estudo comparativo com a participação de 39 mulheres, com diagnóstico de câncer de mama, unilateral de qualquer extensão, submetidas à cirurgia com LA. A coleta dos dados foi realizada de julho de 2004 à janeiro de 2005, Setor de Onco-ginecologia e Mastologia do Departamento de Ginecologia e Obstetrícia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP). As mulheres foram divididas, aleatoriamente, em dois grupos: Grupo Movimento (GM) e Grupo Controle (GC). No GC, as 20 mulheres receberam as orientações rotineiras da unidade e no GM, as 19 mulheres foram orientadas à movimentação precoce e sistemática do braço, com um programa específico de movimentos iniciados antes da alta hospitalar e continuando no domicílio. Todas as participantes foram avaliadas antes da cirurgia, no primeiro dia pós operatório, de 5 a 10 dias e de 30 a 40 dia depois da cirurgia. Através do teste estatístico de Mann-Whitney observou-se que os grupos foram homogêneos para as variáveis idade e índice de massa corpórea, apesar de o número de sujeitos não ter sido estatisticamente significante. O tempo de permanência do dreno e o volume drenado, foram menores no GM. A incidência de seroma foi igual para os dois grupos, mas a resolução foi mais rápida e menos invasiva no GM. Pode-se assim concluir que apesar de a amostra não ter sido estatisticamente significante, a movimentação precoce e sistematizada favoreceu uma melhor absorção do seroma e não esteve associada a outras complicações cirúrgicas. / This study aimed to evaluate the efficacy of early arm movement in the control of seroma formation, in women who underwent complete axillary lymphadenectomy (AL) due to breast cancer. A comparative study involved 39 women with diagnosis of unilateral breast cancer of any extension who underwent LA. Data were collected between July 2004 and January 2005, at the onco-gynecology and mastology sector - Gynecology and Obstetric Department of the University of São Paulo at Ribeirão Preto Medical School Hospital das Clínicas. Participants were randomly distributed in two groups: Movement Group (MG) and Control Group (CG). In the CG, 20 women received routine orientation while, in the MG, 19 women were oriented towards systematic early arm movement, with a specific movement program initiated before hospital discharge and continued at home. All women were evaluated the day before surgery, the first day after surgery, 5-10 days and 30-40 days after surgery. The Mann-Whitney statistical test revealed that the groups were homogeneous in terms of age and body mass index, although the number of subjects was found statistically insignificant. The permanence of the drain and the volume drained were lower in MG. Incidence levels of seroma were equal in the two groups, but the resolution was faster and less invasive in MG. In spite of a statistically insignificant number of subjects, early and systematic arm movement provided better seroma absorption and was not associated with other surgical complications.

Le système nerveux consiste en plusieurs types cellulaires quels interagissent avec eux-mêmes pour conduire des potentiels d’action du soma au travers l’axone vers la synapse. Dans les nerfs périphériques, les cellules de Schwann interagissent avec les neurones par enrouler autour l’axone et créer une gaine de myéline. Cette gaine de myéline permit une conduction rapide des potentiels d’action de nœud de Ranvier vers nœud de Ranvier, quels sont petits régions non-myélinisés de l’axone. En plus, les cellules de Schwann transportent du lactate vers le neurone et le neurone utilise ce lactate pour la production d’énergie sous la forme d’ATP. Cette production est nécessaire, parce que beaucoup de processus dans des cellules, comme la conduction des potentiels d’action, ont besoin d’ATP. Trois mécanismes sont impliqués à la production d’ATP : la glycolyse dans le cytosol et le cycle de Krebs et la chaîne de transport d'électrons dans les mitochondries. Par contre, la production d’ATP par des mitochondries résulte en la production du dérivés réactifs de l'oxygène (DRO), quels provoquent du stress oxydative. DRO peuvent être présent en plusieurs formes et ces formes différentes ont des traits spécifiques, mais tous les formes peuvent endommager la cellule. Par exemple, l’ion superoxyde est très réactif donc ils agissent extrêmement vite avec les molécules dans son environnement. Par contre, peroxyde d'hydrogène est un type de DRO quel est moins réactif, mais peut diffuser à plus longue distances et peut oxyder des cibles plus distales. Heureusement, les cellules sont équipées avec un système antioxydant compétant en consistent une groupe d’enzymes antioxydant, quels réduisent du DRO à l’eau. Si les mitochondries dysfonctionnent ou si l’équilibre entre DRO et antioxydants devient en disbalance, des neuropathies pourraient se développer, comme sclérose latérale amyotrophique (SLA), sclérose en plaques (SEP), maladie d'Alzheimer et maladie de Parkinson. Au SNP, des neuropathies périphériques comme la maladie Charcot-Marie-Tooth (CMT) peuvent se développer en raison d’excès du DRODans cette thèse, je présente un modèle élaboré pour la production d’ATP et DRO par les mitochondries in vivo. Je montrerai comment les cellules de Schwann utilisent l’effet Warburg, la transition de métabolisme de phosphorylation oxydative à glycolyse, pour la production de lactate, quel est transporté vers le neurone pour la production d’énergie. Je montrerai aussi que sans l’effet Warburg dans des cellules de Schwann, le métabolisme neuronal est détérioré menant à la production d’ATP diminué, déficits neuronales et des problèmes moteurs. Suite à l’activité nerveuse, la production d’ATP par des mitochondries augmente, mais aussi la production de DRO. Pourtant les deux productions ne sont pas en parallèle. En plus, je montre que la physiologie mitochondriale est affectée par des neuropathies. Aux souris avec défectueux mitofusin2, un modèle pour CMT2A, le contact entre le réticulum endoplasmique et les mitochondries est diminué, à côté d’un changement de morphologie et fonction mitochondriale. En plus, démyélinisation résulte dans des déficits de la production ATP et DRO, montrent une dissociation pathologique entre la production d’ATP et DRO.Pour obtenir ces résultats, des techniques d'imagerie avancées étaient utilisé pour imager les nerfs périphériques des souris transgéniques. Ces transgènes sont introduit dans les souris par injection des vecteurs virales, quels induisent l’expression des sondes fluorescents dans les cellules neuronales. Ces sondes fluorescentes étaient détectées par microscopie multiphotonique. En plus du modèle de la production d’ATP et DRO dans des nerfs périphériques, je présente un protocole pour introduire des vecteurs viraux dans le nerf sciatique. / The nervous system consists of several cell types that interact with each other in order to conduct action potentials from the neuronal soma through axons to the synapse. In peripheral nerves, Schwann cells interact with neurons by wrapping around the axon and creating a myelin sheath. This myelin sheath allows for fast conduction of action potentials from node of Ranvier to node of Ranvier, which are small unmyelinated areas of the axon. In addition, Schwann cells transfer lactate to the neuron, which the axonal mitochondria use to produce energy in the form of ATP. This is necessary, because many cellular processes, such as the conduction of action potentials use ATP. The production of ATP involves three mechanisms: anaerobic glycolysis in the cytosol and the Kreb’s cycle and electron transport chain within mitochondria. However, the production of ATP by mitochondria also results in the production of reactive oxygen species (ROS), which cause cell damage. ROS can be present in several different forms and these different forms have specific properties. For example, superoxide anions are highly reactive and subsequently react rapidly with the molecules in their environment. Hydrogen peroxide on the other hand is less reactive but hence can diffuse over longer distances and react with their targets more distally. Fortunately, the cell contains a competent antioxidant system, which can reduce ROS to water. When mitochondria malfunction or when the equilibrium between ROS and antioxidants becomes in disbalance, neuropathies can develop, such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Alzheimer’s disease or Parkinson’s disease. In the PNS, peripheral neuropathies can develop such as Charcot-Marie-Tooth disease as a result from an excess of ROS.In this thesis, I will provide an elaborate model for ATP and ROS production by axonal mitochondria in vivo. I will show how Schwann cells use the Warburg effect, the shift in metabolism from oxidative phosphorylation to anaerobic glycolysis, to produce lactate, which is then transported to the neuron for energy production. I also demonstrate that without the Warburg effect in Schwann cells neuronal metabolism would be impaired, leading to impaired ATP production, neuronal deficits and motor problems. Following action potential firing, not only ATP is produced by mitochondria, but also ROS, although with independent dynamics. In addition, I show that mitochondrial physiology is affected by several neuropathologies. In mitofusin2 deficient mice, a model for CMT2A, contact between the endoplasmic reticulum and mitochondria is impaired next to affected mitochondrial morphology and function. Also demyelination causes deficits in mitochondrial ATP and ROS production, showing a pathologic decoupling between ATP and ROS.To obtain these results, advanced imaging techniques were used to image peripheral nerves of transgenic mice. These transgenes were introduced in mice via injection of viral vectors which induce expression of fluorescent probes in neuronal cells. These fluorescent probes were detected via multiphoton microscopy. Next to the model for ATP and ROS production in peripheral nerves, I provide a protocol for introducing viral vectors into mouse sciatic nerves.

INTRODUÇÃO: O câncer gástrico precoce que invade a submucosa pode apresentar acometimento linfonodal em torno de 20% dos casos. O tratamento cirúrgico clássico com gastrectomia e linfadenectomia D2 é um procedimento não isento de mortalidade e morbidade. Determinar quais pacientes têm maior risco de acometimento linfonodal permitiria tratamentos com menores complicações. Recentemente diversos autores relatam maior expressão imuno-histoquímica de p53 e p21ras em tumores avançados e com pior prognóstico. Tem sido relatada também perda da expressão de p21waf1, p27kip1 e p16ink4a nos tumores avançados e algumas publicações relatam também relação entre a expressão dos marcadores e acometimento linfonodal. MÉTODOS: Foram estudados retrospectivamente 81 pacientes submetidos à gastrectomia com linfadenectomia D2 no período de 1971 a 2004 no Serviço de Cirurgia do Estômago e Intestino Delgado do Departamento de Gastroenterologia do HC-FM/USP. Os blocos de parafina contendo fragmentos dos tumores foram recuperados e novo exame histopatológico confirmou o diagnóstico. Selecionaram-se áreas representativas de mucosa normal, mucosa metaplásica e tumor para confecção de novos blocos de tissue microarrays. Foi avaliada a expressão imuno-histoquímica de p21ras, p53, p21waf1/cip1, p27kip1 e p16ink4a nos tecidos. Foram investigadas as correlações entre a expressão dos marcadores e as características clínico-patológicas dos pacientes. A análise da associação entre os dados clínicos e a positividade dos marcadores foi realizada pelo teste Qui-quadrado. RESULTADOS: Na mucosa normal, metaplásica e tumoral p53 apresentou positividade em 53%, 87,3% e 87,1% dos casos respectivamente. Nos mesmos tecidos p21ras apresentou positividade de 85,3%, 86% e 96,8%. Para p16ink4a a positividade foi de 46,3%, 91,1% e 86%. Para p27kip1 a positividade foi de 60%, 94,7% e 95,3%. Para p21waf1/cip1 a positividade foi 32,4%, 72,7% e 71,4%. Todos os tumores tiveram alguma positividade para p53. Os tumores com acometimento linfonodal apresentaram hiper-expressão(+4) de p53 em 47% dos casos contra 17% nos pacientes que não tinham acometimento. Nenhum tumor com positividade para p53 baixa(0 e +1) teve linfonodos acometidos. Nenhum tumor com p21ras negativo apresentou linfonodos acometidos. Nos pacientes com acometimento linfonodal p21ras teve positividade intensa(+2 e +3) em 88% dos casos contra 50% dos casos sem acometimento linfonodal. Houve positividade intensa(+2,+3 e +4) de p21waf1/cip1 em 71% dos tumores com acometimento linfonodal contra 28% nos pacientes sem acometimento. Não observamos perda de expressão de p21waf1, p27kip1 e p16ink4a nos tumores com acometimento linfonodal. Na mucosa normal p16ink4a foi hiper-expresso (+4) em 20% dos casos com infiltração perineural contra 0% nos casos sem acometimento. O mesmo marcador foi hiperexpresso em 50% dos casos com infiltração vascular contra 0% dos casos sem infiltração. Os tumores com padrão de infiltração Sm2 tiveram pouca positividade(0 e +1) de p27kip1 na mucosa normal em 89% dos casos contra 55% dos casos Sm1. CONCLUSÕES: Maior expressão de p53, p21ras e p21waf1/cip1 no tumor teve relação estatística significante com acometimento linfonodal. Ocorre aumento da expressão imuno-histoquímica de todos os marcadores da mucosa normal para o tumor. A maior hiper-expressão de p16ink4a na mucosa normal de pacientes tem relação com infiltração perineural e vascular nos tumores. A expressão dos marcadores é diferente nas raças estudadas. As pacientes do sexo feminino apresentam maior positividade de p21waf1 na mucosa normal. Pacientes com história familiar de câncer gástrico apresentam maior positividade de p16ink4a na mucosa normal, menor positividade de p21waf1/cip1 e p21ras na mucosa metaplásica. Maior positividade na mucosa normal de p21waf1/cip1 relaciona-se a sexo feminino e infiltração tipo Sm1 / INTRODUCTION: Early gastric cancer that invades the submucosa might have a lymphonodal involvement in about 20% of the cases. Gastrectomy and D2 linfadenectomy is a procedure that has presented mortality and morbidity. Determining which patients would have a greater risk of lymphonodal involvement would allow treatments with fewer complications. Recently, several authors reported a greater immunohistochemical expression of p53 and p21ras in advanced tumors with worst prognosis. It has also been reported the expression loss of p21wafl, p27kip1, and p16ink4a in advanced tumors, and, some studies also observed the relationship between the markers expression and lymphonodal involvement. METHODS: Eightyone patients who had undergone gastrectomy with D2 linfadenectomy from 1971 to 2004 were retrospectively studied. A new histopathological exam confirmed the diagnosis. Representative areas of both normal and metaplastic mucosa and of the tumor were selected for obtaining new blocks of tissue microarrays. The immunohistochemical expression of p21ras, p53, p21waf1/cip1, p27kip1 and p16ink4a in the tissues was evaluated. RESULTS: In normal, metaplastic and tumoral mucosa, p53 showed positivity in 53%, 87.3%, and 87.1% of the cases, respectively. In the same tissues, p21ras showed positivity in 85.3%, 86%, and 96.8%, respectively. The positivity of p16ink4a was 46.3%, 91.1%, and 86%, respectively. p27kip1 showed a positivity of 60%, 94.7%, and 95.3%, respectively. p21wafl/cip1 presented a positivity of 32.4%, 72.7%, and 71.4%, respectively. All tumors showed positivity for p53. Tumors with lymphonodal involvement presented hyperexpression (+4) of p53 in 47% of the cases versus 17% in patients who had not showed any involvement. No tumor with low positivity (0 and +1) of p53 showed lymphonodal involvement. No tumor with negative p21ras showed lymphonodal involvement. In patients with lymphonodal involvement, p21ras presented strong positivity (+2 and +3) in 88% of the cases versus 50% of the cases without lymphonodal involvement. There was a strong positivity (+2,+3, and +4) of p21wafl/cip1 in 71% of the tumors with lymphonodal involvement versus 28% in patients without involvement. It was not observed an expression loss of p21waf1, p27kip1 e p16ink4a in tumors with lymphonodal involvement. In normal mucosa, p16ink4a showed a hyper-expression (+4) in 20% of the cases with perineural invasion versus 0% of the cases without invasion. This same marker showed a hyper-expression in 50% of the cases with vascular invasion versus 0% of the cases without invasion. Tumors with Sm2 invasion pattern showed low positivity (0 and +1) of p27kip1 in normal mucosa in 89% of the cases versus 55% of the cases of Sm1 tumors. CONCLUSIONS: Higher expression of p53, p21ras, and p21wafl/cip1 in tumor showed a significant statistical relationship with lymphonodal involvement. A higher hyper-expression of p16ink4a in patients normal mucosa was related to perineural and vascular invasion of tumors

Lau Chui Pik. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 104-122). / Abstracts in English and Chinese. / Chapter Chapter 1 --- --- Introduction --- p.1 / Chapter 1.1 --- Importance of sinoatrial node in heart functions --- p.3 / Chapter 1.2 --- The importance of Adenosine 5'-triphosphate (ATP) --- p.5 / "ATP as a neurotransmitter, cotransmitter and neuromodulator" --- p.5 / Role of ATP in the heart --- p.7 / Chapter 1.3 --- Importance of delayed rectifier potassium channels (Ik) in the heart --- p.9 / Delayed rectifier potassium channel --- p.10 / Properties of Ik channels in the sinoatrial nodal (SAN)cells --- p.11 / Importance of Ik on heart function --- p.14 / Chapter 1.4 --- Drug/hormone/neurotransmitter modulation of Ik --- p.15 / Drugs modulations of Ik --- p.15 / Hormones/neurotransmitters modulations of Ik --- p.18 / Chapter 1.5 --- Problems encountered in using extracellular ATP on experiments --- p.23 / Chapter 1.6 --- Classification of P2-purinergic receptors --- p.24 / Major nucleotide receptors --- p.24 / p2X receptors --- p.26 / p2Y receptors --- p.28 / 1.7Objectives of the experiment --- p.30 / Chapter Chapter 2 --- --- Materials & Methods --- p.31 / Chapter 2.1 --- Materials --- p.32 / Chapter 2.1.1 --- Solutions --- p.32 / Chapter 2.1.2 --- Enzymes --- p.34 / Chapter 2.1.3 --- Drugs --- p.34 / Chapter 2.2 --- Methods --- p.35 / Chapter 2.2.1 --- Isolation of guinea pig SAN cells --- p.35 / Chapter 2.2.2 --- Identification of SAN region --- p.36 / Chapter 2.2.3 --- Obtaining of single SAN cells --- p.38 / Chapter 2.2.4 --- Preparation of micro-pipettes --- p.40 / Chapter 2.2.5 --- The Patch Clamp Technique --- p.40 / Recording configurations --- p.41 / Electrical recordings --- p.44 / Formation of gigaseal on cell membrane and the development of whole-cell configuration --- p.45 / The changing of bathing solution and addition of drugs --- p.46 / The voltage clamp protocol --- p.47 / Data acquisition and analysis --- p.48 / Statistics --- p.48 / Chapter Chapter 3 --- --- Results --- p.49 / Chapter 3.1 --- The modulatory effect of different concentrations of [ATP]0 on IKs in guinea pig SAN cells --- p.50 / Chapter 3.1.1 --- Characterization of IKs currents --- p.50 / Chapter 3.1.2 --- Stimulatory effect of extracellular A TP on IKs current --- p.51 / Chapter 3.1.3 --- Current-Voltage relationship of ATP on IKs current --- p.57 / Chapter 3.1.4 --- Percentage increase of IKs current in the presence of different [ATP] o --- p.63 / Chapter 3.2 --- Investigation on whether the enhancement effect on IKs is due to ATP or its metabolite adenosine --- p.71 / Chapter 3.2.1 --- Effect of 100 μMATP-γS and adenosine on IKs --- p.71 / Chapter 3.2.2 --- Percentage increase of IKs in the presence of adenosine and ATP-γS --- p.76 / Chapter 3.3 --- Investigation on whether or not G-protein signalling pathway involved in ATP-mediated response on SAN IKs --- p.80 / Chapter 3.3.1 --- Effects of GTP-γS alone on IKs --- p.80 / Chapter 3.3.2 --- Effect of 100 μM ATP in the presence of GTP-yS on IKs --- p.83 / Chapter Chapter 4 --- --- Discussion --- p.86 / Chapter 4.1 --- The modulatory effect of different concentrations of [ATP]0 on IKs in guinea pig SAN cells --- p.87 / Chapter 4.2 --- Investigation on whether the enhancement effect on IKs is due to ATP or its metabolite adenosine --- p.92 / Chapter 4.3 --- Investigation on whether or not G-protein signalling pathway involved in ATP-mediated response on SAN IKs --- p.97 / Chapter 4.4 --- Limitations of this study --- p.102 / Chapter 4.5 --- Future studies --- p.102 / Chapter Chapter 5 --- --- References --- p.104