Part of Thesis (Ph. D.)--University of Florida, 1964. / Cover title. Includes bibliographical references (p. 41-42).

Thesis (M.Sc.(Anatomy))--University of Pretoria, 2009. / Includes bibliographical references.

Thesis (M.S.)--Virginia Polytechnic Institute and State University. / Vita. Abstract. Includes bibliographical references (leaves 55-60). Also available via the Internet.

Merkel cell polyomavirus (MCPyV) is an oncogenic virus exist in about 80% of Merkel Cell Carcinoma (MCC), an aggressive human skin cancer. Evidence of MCPyV existing in other kind of skin neoplasms such as cutaneous squamous cell carcinomas (SCCs) has been reported. Since the major type of cervical cancer is SCCs, MCPyV may be associated with cervical cancer tumorigenesis. A Japanese research group has documented the presence of MCPyV DNA in both cervical SCCs and cervical adenocarcinomas (ACs) from Japanese patients. Nevertheless, the association between MCPyV and cervical cancer remains inconclusive and the prevalence of MCPyV in cervical cancer may show demographic variation. This study is aimed to examine whether MCPyV is present in some of the most common gynaecological cancers, namely cervical cancer, ovarian cancer, endometrial cancer, and gestational choriocarcinoma, in Hong Kong patients. Genomic DNA was obtained from 50 cases of cervical cancer, 20 cases of ovarian cancer, and 35 common gynaecological cancers cell lines. Genomic DNA extracted from four MCC samples were used as positive controls. The integrity of the samples was first checked by β-globin PCR. Detection of MCPyV was then performed by MCPyV Large T antigen (LT-ag) PCR. Our PCR analysis showed that only 1 out of 50 (2%) of the cervical cancer samples was positive for MCPyV DNA. The PCR product was purified and cloned for sequencing analysis. Comparing the LT-ag sequence obtained from the only MCPyV positive cervical cancer with reference sequence and with the MCPyV sequence from one of the control cases revealed the presence of different MCPyV variants in Hong Kong patients. None of the ovarian cancer, endometrial cancer, or choriocarcinoma was positive for MCPyV. Our data did not support the notion that MCPyV is associated with gynaecological malignancies. MCPyV may hence be a fairly specific oncogenic agent for Merkel cell carcinoma. / published_or_final_version / Pathology / Master / Master of Medical Sciences

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Recently, there has been extensive research in the area of diagnostic expertise. The model of diagnostic reasoning and clinical expertise has been well documented (Patel et al., in press). This study attempts to extend this research in order to include therapeutic reasoning. Using the expert-novice paradigm, this study attempts to investigate the use of knowledge, specifically, both biomedical and clinical sciences, and the directionality of reasoning during decision making about patient management and therapeutic planning in respiratory medicine. / Subjects at four levels of expertise were given two clinical problems with the diagnosis and asked (a) to provide therapeutic plans, and (b) describe the underlying pathophysiological explanations of the diseases. Think-aloud protocols were audio-taped and analyzed using methods of protocol analysis. The results showed that the use of basic medical sciences increased as a function of expertise in the procedure-oriented decision-making tasks. The novices generated rule-based prototypical textbook descriptions based on the clinical information, and the diagnosis given in the task. In contrast, the experts' therapeutic responses showed a predominance of causal-level inferences, reflecting more backward-directed inferences than novices. Although both the novices and experts generated forward-directed inferences, the novices were unable to provide accurate and adequate explanations for their decisions. Finally, the pathophysiological explanations of the disease were generated from a different knowledge source than that used to develop therapeutic decisions. / The implications of these findings for development of theory of expertise and for education in the medical domain are discussed.

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