Dieses Manuskript entstand aus Vorlesungen über Geodätische Berechnungen an der Hochschule für Technik und Wirtschaft Dresden. Da diese Lehrveranstaltung im ersten oder zweiten Semester stattfindet, werden noch keine Methoden der höheren Mathematik benutzt. Das Themenspektrum beschränkt sich deshalb weitgehend auf elementare Berechnungen in der Ebene.:0 Vorwort 1 Ebene Trigonometrie 1.1 Winkelfunktionen 1.2 Berechnung schiefwinkliger ebener Dreiecke 1.3 Berechnung schiefwinkliger ebener Vierecke 2 Ebene Koordinatenrechnung 2.1 Kartesische und Polarkoordinaten 2.2 Erste Geodätische Grundaufgabe 2.3 Zweite Geodätische Grundaufgabe 3 Flächenberechnung und Flächenteilung 3.1 Flächenberechnung aus Maßzahlen. 3.2 Flächenberechnung aus Koordinaten 3.3 Absteckung und Teilung gegebener Dreiecksflächen 3.4 Absteckung und Teilung gegebener Vierecksflächen 4 Kreis und Ellipse 4.1 Kreisbogen und Kreissegment 4.2 Näherungsformeln für flache Kreisbögen 4.3 Sehnen-Tangenten-Verfahren 4.4 Grundlegendes über Ellipsen 4.5 Abplattung und Exzentrizitäten 4.6 Die Meridianellipse der Erde 4.7 Flächeninhalt und Bogenlängen 5 Ebene Einschneideverfahren 5.1 Bogenschnitt 5.2 Vorwärtsschnitt 5.3 Anwendung: Geradenschnitt 5.4 Anwendung: Kreis durch drei Punkte 5.5 Schnitt Gerade ⎼ Kreis oder Strahl ⎼ Kreis 5.6 Rückwärtsschnitt 5.7 Anwendung: Rechteck durch fünf Punkte 6 Ebene Koordinatentransformationen 6.1 Elementare Transformationsschritte 6.2 Rotation und Translation. 6.3 Rotation, Skalierung und Translation 6.4 Ähnlichkeitstransformation mit zwei identischen Punkten 6.5 Anwendung: Hansensche Aufgabe 6.6 Anwendung: Kleinpunktberechnung 6.7 Anwendung: Rechteck durch fünf Punkte 6.8 Ebene Helmert-Transformation 6.9 Bestimmung der Parameter bei Rotation und Translation 6.10 Ebene Affintransformation 7 Lösungen / This manuscript evolved from lectures on Geodetic Computations at the University of Applied Sciences Dresden (Germany). Since this lecture is given in the first or second semester, no advanced mathematical methods are used. The range of topics is limited to elementary computations in the plane.:0 Vorwort 1 Ebene Trigonometrie 1.1 Winkelfunktionen 1.2 Berechnung schiefwinkliger ebener Dreiecke 1.3 Berechnung schiefwinkliger ebener Vierecke 2 Ebene Koordinatenrechnung 2.1 Kartesische und Polarkoordinaten 2.2 Erste Geodätische Grundaufgabe 2.3 Zweite Geodätische Grundaufgabe 3 Flächenberechnung und Flächenteilung 3.1 Flächenberechnung aus Maßzahlen. 3.2 Flächenberechnung aus Koordinaten 3.3 Absteckung und Teilung gegebener Dreiecksflächen 3.4 Absteckung und Teilung gegebener Vierecksflächen 4 Kreis und Ellipse 4.1 Kreisbogen und Kreissegment 4.2 Näherungsformeln für flache Kreisbögen 4.3 Sehnen-Tangenten-Verfahren 4.4 Grundlegendes über Ellipsen 4.5 Abplattung und Exzentrizitäten 4.6 Die Meridianellipse der Erde 4.7 Flächeninhalt und Bogenlängen 5 Ebene Einschneideverfahren 5.1 Bogenschnitt 5.2 Vorwärtsschnitt 5.3 Anwendung: Geradenschnitt 5.4 Anwendung: Kreis durch drei Punkte 5.5 Schnitt Gerade ⎼ Kreis oder Strahl ⎼ Kreis 5.6 Rückwärtsschnitt 5.7 Anwendung: Rechteck durch fünf Punkte 6 Ebene Koordinatentransformationen 6.1 Elementare Transformationsschritte 6.2 Rotation und Translation. 6.3 Rotation, Skalierung und Translation 6.4 Ähnlichkeitstransformation mit zwei identischen Punkten 6.5 Anwendung: Hansensche Aufgabe 6.6 Anwendung: Kleinpunktberechnung 6.7 Anwendung: Rechteck durch fünf Punkte 6.8 Ebene Helmert-Transformation 6.9 Bestimmung der Parameter bei Rotation und Translation 6.10 Ebene Affintransformation 7 Lösungen

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Introduktion: Ameloblastom (AB), adenomatoid odontogen tumör (AOT), ameloblastiskt fibrom (AF) och odontogent fibrom (OF) är odontogena tumörer som innehåller epiteliala komponenter. Frekvensen av recidiv hos dessa varierar från låg förekomst till relativt hög förekomst. Syftet med denna studie är att undersöka om Ki-67, p53 och BRAF kan användas som prognostiska markörer i recidivmönstret hos dessa tumörer.Material och metod: Studien genomfördes genom immunohistokemi med monoklonala antikroppar av Ki-67, p53 och BRAF på respektive tumör. Tumörerna hämtades från avdelningen för Oral patologi på Malmö högskola. En statistisk analys utfördes med hjälp av Kruskal-Wallis envägs-ANOVA.Resultat: I de tio AB-fallen kunde en hög proliferation och en hög prevalens av muterade p53 ses. I de sju fallen av AOT kunde en måttligt hög proliferation och en generellt hög prevalens av muterade p53, jämförbara med värden för AB, ses. De sju fallen med AF och de fem fallen med OF visade båda en låg proliferation och en låg förekomst av muterade p53. Skillnaden mellan gruppen AB och AOT och gruppen AF och OF visade en signifikant högre infärgningsintensitet för både Ki-67 (p<0.001) och p53(p=0.001) för gruppen med AB och AOT.Konklusion: Proliferations index med Ki-67 och förekomst av p53-mutationer kan användas som en prognostisk markör för recidiv hos AB och AOT. Det är å andra sidan inte tillämpbart för AF och OF. / Introduction: Ameloblastoma (AB), adenomatoid odontogenic tumour (AOT), ameloblastic fibroma (AF) and odontogenic fibroma (OF) are all odontogenic tumours with an epithelial component. The recurrence rate for these odontogenic tumours varies from low frequencies to quite high frequencies. The aim of this study is to evaluate the expression of Ki-67, p53 and BRAF and the possibility of these antibodies acting as prognostic markers in the recurrence pattern of odontogenic tumours.Material and method: An immunohistochemical study using Ki67, p53 and BRAF monoclonal antibodies was performed on 29 paraffin blocks from the respective tumours obtained at the department of Oral Pathology in the Faculty of Odontology at Malmö University. Statistical analysis was performed with Kruskal-Wallis one-way ANOVA.Results: In the series of ten AB cases high proliferation activity and a high prevalence of p53 mutations was observated. In the seven AOT cases a moderately high proliferative activity as well as a generally high prevalence of p53 mutation, comparable to AB, was observed. The seven cases of AF and the five cases of OF demonstrated a low proliferative activity and a low prevalence of p53 mutation. The difference between AB and AOT versus AF and OF as two separate groups, showed a significantly higher staining intensity for both Ki-67 (p < 0.001) and p53 (p = 0.001) in AB and AOT as a group.Conclusion: Ki-67 proliferation index and p53-mutation status can be considered to be a prognostic marker for AB and AOT recurrence. This is, however, not applicable to AF and OF.

Clinically relevant postoperative pancreatic fistula (CR-POPF) is a common severe surgical complication after pancreatic surgery. Current risk stratification systems mostly rely on intraoperatively assessed factors like manually determined gland texture or blood loss. We developed a preoperatively available image-based risk score predicting CR-POPF as a complication of pancreatic head resection. Frequency of CR-POPF and occurrence of salvage completion pancreatectomy during the hospital stay were associated with an intraoperative surgical (sFRS) and image-based preoperative CT-based (rFRS) fistula risk score, both considering pancreatic gland texture, pancreatic duct diameter and pathology, in 195 patients undergoing pancreatic head resection. Based on its association with fistula-related outcome, radiologically estimated pancreatic remnant volume was included in a preoperative (preFRS) score for POPF risk stratification. Intraoperatively assessed pancreatic duct diameter (p < 0.001), gland texture (p < 0.001) and high-risk pathology (p < 0.001) as well as radiographically determined pancreatic duct diameter (p < 0.001), gland texture (p < 0.001), high-risk pathology (p = 0.001), and estimated pancreatic remnant volume (p < 0.001) correlated with the risk of CR-POPF development. PreFRS predicted the risk of CR-POPF development (AUC = 0.83) and correlated with the risk of rescue completion pancreatectomy. In summary, preFRS facilitates preoperative POPF risk stratification in patients undergoing pancreatic head resection, enabling individualized therapeutic approaches and optimized perioperative management.

Introdução: A HD está presente em aproximadamente 50% dos pacientes com OIV devido HPB e 30% dos casos não apresentarão melhora após o tratamento cirúrgico. Até o momento, nenhuma característica clínica pode predizer acuradamente quais pacientes serão beneficiados. Neste estudo nós analisamos o papel de seis marcadores moleculares na resolução da HD após a RTUP. Método: Um estudo prospectivo e controlado analisou 43 pacientes com OIV devido HPB, submetidos a RTUP de 2011 a 2012. O grupo controle foi composto por espécimes de músculo vesical de 10 pacientes com menos de 60 anos, submetidos a prostatectomia radical devido câncer de próstata, apresentando IPSS menor que 8 e volume prostático menor que 30 gramas. Todos os pacientes realizaram estudo urodinâmico no pré-operatório e com 6 meses de pós-operatório. Nós analisamos a presença, o período de início (primeira vs segunda metade do enchimento vesical) e a amplitude ( 40 cmH2O) das CVIs, assim como sua resolução após 6 meses de tratamento cirúrgico. Uma biópsia de músculo vesical foi efetuada no final da RTUP para análise do perfil de expressão gênica do NGF, NGFr, VEGF, CD-105, CHRM2 e CHRM3. Para este propósito foi utilizado a técnica de qRT-PCR. Além disso, correlacionamos variáveis clínicas pré-operatórias com a evolução da HD no pós-operatório. Resultados: A idade média dos pacientes foi 63 anos (50 a 75). A HD estava presente em 21 (48,8%) pacientes. De acordo com aferições pré-operatórias, a média de expressão gênica do NGF foi 3,3 vezes maior nos pacientes que iniciaram CVI precocemente quando comparados àqueles que iniciaram as contrações na fase final de enchimento vesical (p=0,047). A presença e a amplitude das CVIs não apresentaram correlações estatísticas com os genes estudados. Em relação a resolução da HD, a média de expressão de CHRM2 foi 2 vezes maior entre os pacientes que evoluíram com melhora da HD (p=0,072). Após 6 meses da RTUP, 77,8% dos pacientes que possuíam expressão aumentada (maior que a mediana) de CHRM2 CHRM3 evoluíram com resolução da HD (p=0,030). Além disso, pacientes com menos de 60 anos obtiveram uma probabilidade 5 vezes maior de evoluírem com melhora da HD (p=0,056) após 6 meses do tratamento cirúrgico. Conclusão: Vias neuronais parecem estar relacionadas com o período de início das CVIs durante a fase de enchimento vesical. A idade dos pacientes e a expressão de receptores muscarínicos pode ter um papel prognóstico na resolução da hiperatividade após o tratamento cirúrgico. A análise de um número maior de pacientes é necessário para confirmar estes resultados / Objective: Non-inhibited contractions (NIC) are present in about 50% of patients with bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH) and 30% of cases persist after surgery. To date, no clinical characteristic can predict accurately which patients are going to improve. We analyzed the role of six detrusor molecular markers in the resolution of NIC after transurethral resection of the prostate (TURP). Methods: We performed a prospective and controlled analysis of 43 patients with BOO due to BPH who underwent TURP from 2011 to 2012. The control group comprised 10 bladder specimens from patients younger than 60 years who underwent radical prostatectomy with an IPSS < 8 and prostate volume < 30 grams. All patients underwent urodynamic analysis pre and post operatively after 6 months. We analyzed the presence, time to occurrence (first vs second half of the filling phase) and grade (40 cmH2O) of NIC as well as its resolution after 6 months of surgery. A biopsy of the bladder muscle was performed at the end of TURP for analysis of nerve growth factor receptor (NGFr), nerve growth factor (NGF), vascular endothelial growth factor (VEGF), endoglin (CD105), muscarinic cholinergic receptor 2 (CHRM2) and muscarinic cholinergic receptor 3 (CHRM3) genes expression. For this purpose, we used the quantitative real time polymerase chain reaction method (qRT-PCR). Results: Mean patient age was 63 years (50 to 75). NIC were present in 21 (48.8%) patients. According to pre-operative measures, NGF gene expression was 3.3 times greater in patients who presented early NIC as compared to those who presented late contractions (p=0.047). The presence or grade of NIC failed to present statistical correlations with the genes. With regard to the outcome, CHRM2 expression was 2.0 times greater among patients who presented resolution of NIC (p=0.072). After 6 months of TURP, 77,8% of patients with DO resolution had increased expression of CHRM2 and CHRM3 genes compared with others cases (p=0,030). Additionally, patients younger than 60 years obtained a 5.0 times more likely to evolve with improved NIC (p=0,056). Conclusion: Neural pathways seem to be more important in the time to NIC occurrence during the filling phase. Muscarinic cholinergic receptors seem to have a prognostic value in the resolution of NIC after surgery. Analysis of greater number of patients is necessary to confirm these results

INTRODUÇÃO: A HD está presente em aproximadamente 50% dos pacientes com OIV devido HPB e 30% dos casos não apresentarão melhora após o tratamento cirúrgico. Até o momento, nenhuma característica clínica pode predizer acuradamente quais pacientes serão beneficiados. Há espaço para o aprimoramento de novos métodos diagnósticos não invasivos capazes de discriminar quais os melhores candidatos à cirurgia. Neste estudo nós analisamos o papel de cinco biomarcadores urinários moleculares associados à HD e à OIV em pacientes com HPB que serão submetidos à RTUP. MÉTODOS: Um estudo prospectivo e controlado analisou 71 pacientes candidatos à RTUP devido HPB, submetidos ao procedimento cirúrgico entre 2011 a 2016. O grupo controle foi composto por pacientes assintomáticos apresentando IPSS menor que 6, volume prostático menor que 30 gramas, ausência de resíduo pósmiccional e fluxometria máxima >= 15ml/s. Todos os pacientes do grupo de estudo realizaram estudo urodinâmico no pré-operatório e 63 pacientes no período pósoperatório. Nós analisamos a presença, o período de início (primeira vs segunda metade do enchimento vesical) e a amplitude ( 40 cmH2O) das CVIs, assim como o grau de obstrução infravesical. A coleta da urina foi realizada no pré-operatório para os pacientes do grupo de estudo. A urina foi analisada para 5 quimiocinas, citocinas e fatores de crescimento usando teste de ELISA. Os valores de concentração das proteínas foram analisados de forma absoluta e normalizados para os níveis de creatinina (/Cr). RESULTADOS: A idade média dos pacientes foi 67 anos (50 a 88). A HD estava presente em 39 (54,9%) pacientes. De acordo com aferições pré-operatórias, a média da concentração urinária de IL-6/Cr (p=0,007), MCP-1(p=0,000), MCP-1/Cr (p=0,000), EFG/Cr (p=0,044) e MMP-1/Cr (p=0,043) estavam respectivamente cerca de 4,5x, 7,1x, 23x, 1,7x e 2,2x vezes significativamente aumentadas em relação aos controles assintomáticos. O nível de EGF foi 1,3 vezes maior nos pacientes que iniciaram CVI tardiamente quando comparados àqueles que iniciaram as contrações na fase inicial de enchimento vesical (p=0,044). A amplitude das CVIs, o fluxo urinário, a complacência, o índice de contratilidade, e o schafer não apresentaram correlações estatísticas com as proteínas estudadas. Em relação a presença de HD, os níveis urinários de IL-6 (p=0,003), MCP-1(p=0,002), e MCP-1/Cr (p=0,002) foram respectivamente 1,8x, 2x, e 2,7 vezes aumentados em relação aos pacientes submetidos à cirurgia sem HD ao estudo urodinâmico. O MCP-1/Cr foi o marcador com melhores propriedades diagnósticas para HD, apresentando área sob a curva (AUC) de 0,71 (95% CI 0,59 a 0,84). A dosagem do MCP-1 não ajustada pela creatinina apresentou uma AUC de 0,71 (95% CI 0,59 a 0,83). A IL-6, por sua vez, teve uma AUC de 0,70 (95% CI 0,58 a 0,82). Todos os outros biomarcadores apresentaram propriedades inadequadas neste cenário para avaliação da HD e OIV. Em relação à resolução ou persistência da HD após 12 meses de tratamento cirúrgico, os níveis dos biomarcadores NGF/Cr (p=0.005) e MMP-1/Cr (p=0.021) foram superiores entre os pacientes que não obtiveram interrupção das CVIs no pós-operatório. Demonstraram serem úteis para predizer a persistência da HD no pós-operatório, o NGF/Cr com AUC de 0,77 (95% CI 0,62 à 0,92) (p=0,006) e o MMP-1/Cr com AUC de 0,72 (95% CI 0,56 à 0,88) (p=0,022). CONCLUSÕES: Vias neuronais parecem estar relacionadas com o período de início das CVIs durante a fase de enchimento vesical. A presença de níveis elevados na urina de biomarcadores inflamatórios e de reparo tecidual sugere um papel da inflamação na gênese da HD, e pode ajudar no diagnóstico não invasivo deste achado no pré-operatório. MCP-1, MCP-1 /Cr e IL-6 foram associados a presença de de HD ao estudo urodinâmico em pacientes com HPB candidatos a RTUP. O nível de EGF/Cr foi associado a contrações vesicais tardias. O MMP-1/Cr foi relacionado a maior pressão detrusora. O biomarcador MCP-1/Cr demonstrou-se ser útil no diagnóstico de HD nos pacientes com HPB. NGF/Cr e MMP-1/Cr demonstraram-se ser úteis para predizer a persistência da HD no pós-operátorio / INTRODUCTION: Detrusor hyperactivity (DH) is present in approximately 50% of patients with bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH), and 30% of the cases will not show improvement after surgical treatment. To date, no clinical feature can accurately predict which patients will benefit from surgical treatment. This rate can be improved because new noninvasive diagnostic methods are capable of determining the best candidates for surgery. In this study, we analyzed the role of five molecular biomarkers in urine associated with DH and BOO in patients with BPH undergoing transurethral resection of the prostate (TURP). METHODS: This prospective and controlled study analyzed 71 patients who were candidates for TURP due to BPH and underwent surgery between 2011 and 2016. The control group consisted of asymptomatic patients with International Prostate Symptom Scores (IPSSs) less than 6, prostate volume less than 30 grams, absence of estimated postvoid residual volume and a maximum flow rate >= 15 ml/s. All patients in the study group underwent a preoperative urodynamic study, with 63 patients undergoing a repeat urodynamic study during the postoperative period. We analyzed the presence, onset period (first vs second half of bladder filling) and amplitude ( 40 cmH2O) of the involuntary detrusor contractions (IDCs), as well as the degree of BOO. Urine was collected preoperatively from patients in the study group. The urine was analyzed for five chemokines, cytokines and growth factors using ELISAs. The protein concentrations were analyzed as absolute and creatinine (/Cr)-adjusted values. RESULTS: The mean age of the patients was 67 years (50 to 88). DH was present in 39 (54.9%) patients. According to preoperative measurements, the mean urine concentrations of IL-6/Cr (p = 0.007), MCP-1 (p = 0.000), MCP-1/Cr (p = 0.000), EGF/Cr (p = 0.044) and MMP-1/Cr (p = 0.043) were approximately 4.5, 7.1, 23, 1.7 and 2.2 times, respectively, those of asymptomatic controls (all significantly increased). The EGF level was 1.3 times higher in patients with late IDCs than in those whose contractions started in the early stage of bladder filling (p = 0.044). The IDC amplitude, urinary flow, compliance, bladder contractility index, and Schafer\'s grade were not significantly correlated with the proteins studied. In patients with DH, urinary levels of IL-6 (p = 0.003), MCP-1 (p = 0.002), and MCP- 1/Cr (p = 0.002) were 1.8, 2, and 2.7 times higher, respectively, than in patients without DH who underwent surgery, according to the urodynamic study. MCP- 1/Cr had the best diagnostic properties for DH, with an area under the curve (AUC) of 0.71 (95% CI: 0.59 to 0.84). The non-Cr adjusted MCP-1 concentration had an AUC of 0.71 (95% CI: 0.59 to 0.83). Additionally, IL-6 had an AUC of 0.70 (95% CI: 0.58 to 0.82). All other biomarkers were inadequate for DH and BOO evaluation. Regarding the resolution or persistence of DH 12 months after surgery, the NGF/Cr (0.13 vs 0.08, p = 0.005) and MMP-1/Cr (0.11 vs 0.04, p = 0.021) levels were higher in patients for whom the IDCs continued during the postoperative period. The following factors were shown to be useful for predicting the persistence of DH during the postoperative period: NGF/Cr, with an AUC of 0.77 (95% CI: 0.62 to 0.92) (p = 0.006), and MMP-1/Cr, with an AUC of 0.72 (95% CI: 0.56 to 0.88) (p = 0.022). CONCLUSIONS: Neural pathways appear to be related to the onset period of IDCs during bladder filling. The presence of high urinary levels of inflammatory and tissue repair biomarkers suggests a role of inflammation in the genesis of DH and may aid in the noninvasive diagnosis of this condition during the preoperative period. MCP-1, MCP-1/Cr and IL-6 were associated with the presence of DH in the urodynamic studies of patients with BPH who were candidates for TURP. The EGF/Cr level was associated with late detrusor contractions. MMP-1/Cr was associated with increased detrusor pressure. The MCP-1/Cr biomarker was shown to be useful for the diagnosis of DH in patients with BPH. NGF/Cr and MMP-1/Cr were shown to be useful in predicting the persistence of DH during the postoperative period

Introdução: A HD está presente em aproximadamente 50% dos pacientes com OIV devido HPB e 30% dos casos não apresentarão melhora após o tratamento cirúrgico. Até o momento, nenhuma característica clínica pode predizer acuradamente quais pacientes serão beneficiados. Neste estudo nós analisamos o papel de seis marcadores moleculares na resolução da HD após a RTUP. Método: Um estudo prospectivo e controlado analisou 43 pacientes com OIV devido HPB, submetidos a RTUP de 2011 a 2012. O grupo controle foi composto por espécimes de músculo vesical de 10 pacientes com menos de 60 anos, submetidos a prostatectomia radical devido câncer de próstata, apresentando IPSS menor que 8 e volume prostático menor que 30 gramas. Todos os pacientes realizaram estudo urodinâmico no pré-operatório e com 6 meses de pós-operatório. Nós analisamos a presença, o período de início (primeira vs segunda metade do enchimento vesical) e a amplitude ( 40 cmH2O) das CVIs, assim como sua resolução após 6 meses de tratamento cirúrgico. Uma biópsia de músculo vesical foi efetuada no final da RTUP para análise do perfil de expressão gênica do NGF, NGFr, VEGF, CD-105, CHRM2 e CHRM3. Para este propósito foi utilizado a técnica de qRT-PCR. Além disso, correlacionamos variáveis clínicas pré-operatórias com a evolução da HD no pós-operatório. Resultados: A idade média dos pacientes foi 63 anos (50 a 75). A HD estava presente em 21 (48,8%) pacientes. De acordo com aferições pré-operatórias, a média de expressão gênica do NGF foi 3,3 vezes maior nos pacientes que iniciaram CVI precocemente quando comparados àqueles que iniciaram as contrações na fase final de enchimento vesical (p=0,047). A presença e a amplitude das CVIs não apresentaram correlações estatísticas com os genes estudados. Em relação a resolução da HD, a média de expressão de CHRM2 foi 2 vezes maior entre os pacientes que evoluíram com melhora da HD (p=0,072). Após 6 meses da RTUP, 77,8% dos pacientes que possuíam expressão aumentada (maior que a mediana) de CHRM2 CHRM3 evoluíram com resolução da HD (p=0,030). Além disso, pacientes com menos de 60 anos obtiveram uma probabilidade 5 vezes maior de evoluírem com melhora da HD (p=0,056) após 6 meses do tratamento cirúrgico. Conclusão: Vias neuronais parecem estar relacionadas com o período de início das CVIs durante a fase de enchimento vesical. A idade dos pacientes e a expressão de receptores muscarínicos pode ter um papel prognóstico na resolução da hiperatividade após o tratamento cirúrgico. A análise de um número maior de pacientes é necessário para confirmar estes resultados / Objective: Non-inhibited contractions (NIC) are present in about 50% of patients with bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH) and 30% of cases persist after surgery. To date, no clinical characteristic can predict accurately which patients are going to improve. We analyzed the role of six detrusor molecular markers in the resolution of NIC after transurethral resection of the prostate (TURP). Methods: We performed a prospective and controlled analysis of 43 patients with BOO due to BPH who underwent TURP from 2011 to 2012. The control group comprised 10 bladder specimens from patients younger than 60 years who underwent radical prostatectomy with an IPSS < 8 and prostate volume < 30 grams. All patients underwent urodynamic analysis pre and post operatively after 6 months. We analyzed the presence, time to occurrence (first vs second half of the filling phase) and grade (40 cmH2O) of NIC as well as its resolution after 6 months of surgery. A biopsy of the bladder muscle was performed at the end of TURP for analysis of nerve growth factor receptor (NGFr), nerve growth factor (NGF), vascular endothelial growth factor (VEGF), endoglin (CD105), muscarinic cholinergic receptor 2 (CHRM2) and muscarinic cholinergic receptor 3 (CHRM3) genes expression. For this purpose, we used the quantitative real time polymerase chain reaction method (qRT-PCR). Results: Mean patient age was 63 years (50 to 75). NIC were present in 21 (48.8%) patients. According to pre-operative measures, NGF gene expression was 3.3 times greater in patients who presented early NIC as compared to those who presented late contractions (p=0.047). The presence or grade of NIC failed to present statistical correlations with the genes. With regard to the outcome, CHRM2 expression was 2.0 times greater among patients who presented resolution of NIC (p=0.072). After 6 months of TURP, 77,8% of patients with DO resolution had increased expression of CHRM2 and CHRM3 genes compared with others cases (p=0,030). Additionally, patients younger than 60 years obtained a 5.0 times more likely to evolve with improved NIC (p=0,056). Conclusion: Neural pathways seem to be more important in the time to NIC occurrence during the filling phase. Muscarinic cholinergic receptors seem to have a prognostic value in the resolution of NIC after surgery. Analysis of greater number of patients is necessary to confirm these results

This thesis deals with the fixation of lower jaw with bone tissue defect using commercially produced fixator. Large defects of bone tissue are mainly caused due to the removal of bone tissue affected by tumor. These topics have been researched on the basis of the literature. Subsequently, stress strain analysis of the lower jaw with the applied fixation plate was performed. This analysis was solved by using computational modeling with variational approach, ie the finite element method. The work also describes in detail the procedure of creating model of geometry, model of material, model of boundary conditions and loads with subsequent solution of several computational models. The stress strain analysis was done for lower jaw with varying size of the removed bone tissue with applied reconstruction plate made of CP-Ti Grade 4 and for the lower jaw with the plate, which is made of -Ti-Mo. Finally, the influence of the mechanical properties of the callus during formation of new bone tissue (callus healing) on the stress and deformation of the solved system was evaluated.

L’angiographie par fluorescence au vert d’indocyanine (ICG-FA) est une technologie d’imagerie non-invasive ayant été validée pour évaluer la perfusion tissulaire, pour délimiter l’anatomie des voies biliaires extra-hépatiques et pour localiser les ganglions et les vaisseaux lymphatiques. Depuis les années 2000, son utilisation connaît une expansion dans diverses spécialités chirurgicales incluant la chirurgie pédiatrique. Ce mémoire explore les indications actuelles de l’angiographie par fluorescence au vert d’indocyanine en pédiatrie et son introduction lors de résections intestinales pédiatriques à l’aide d’un essai clinique prospectif de faisabilité. Alors que l’utilisation de l’ICG-FA est bien définie en chirurgie adulte, cette technologie demeure peu utilisée en pédiatrie. Une revue systématique avec synthèse narrative portant sur l’utilisation de la technologie en contexte périopératoire chez la population pédiatrique a été menée. La majorité des articles étaient des études de cas et des séries de cas (n=36 ; 56%). Aucun effet indésirable relié au vert d’indocyanine n’a été rapporté. Le risque de biais de sélection et d’information était élevé. Les résultats de la revue systématique indiquent que bien que les indications demeurent limitées en pédiatrie, un intérêt important pour la technologie est noté à travers l’augmentation du nombre de publications sur le sujet. L’ICG-FA est un outil fréquemment utilisé en chirurgie colorectale adulte pour évaluer la vascularisation intestinale. Un essai clinique prospectif de phase II a été mené afin d’établir la faisabilité et l’impact de l’utilisation de l’ICG-FA lors de chirurgies pédiatriques d’urgence et électives nécessitant une résection intestinale. Les résultats de l’étude prouvent que l’introduction de la technologie est faisable, sécuritaire et simple. Par ailleurs, 95% des membres de l’équipe chirurgicale considèrent la technologie sécuritaire. / Indocyanine green fluorescence angiography (ICG-FA) is a validated non-invasive imaging technology used to evaluate tissue perfusion, delineate biliary anatomy, and localize lymph nodes and lymphatic vessels. Since the 2000s, its use has grown in various surgical subspecialties including pediatric surgery. This thesis explores the current ICG-FA indications in pediatric surgical subspecialties and its introduction in pediatric bowel resections by the mean of a prospective feasibility clinical trial. While ICG-FA is well established in adult surgery, the technology remains sparsely used in pediatric surgery. A systematic review with narrative synthesis on the perioperative ICG-FA use in the pediatric population was conducted. Most articles were case reports and case series (n=36; 56%). No adverse event related to ICG occurred. Risk of selection and information biases was high. The results show that pediatric applications of ICG remain currently limited, but significant interest in the technology is seen with the rising number of publications on the subject. ICG-FA is a frequently used tool in adult colorectal surgery to determine intestinal perfusion. A prospective Phase II clinical trial was conducted to establish the feasibility and impact of ICG-FA use during emergency and elective pediatric surgeries requiring bowel resection. The study results indicate that the introduction of the technology is feasible, safe, and simple. They show that 95% of the surgical team agreed that ICG-FA was safe.