Gastric adenocarcinoma: contribute of computed tomography in preoperative T nad N staging

RESUMO:Os recentes progressos na imagiologia médica possibilitaram um papel de destaque para a Tomografia Axial Computorizada Multicorte no estadiamento do carcinoma do estômago (GA). Foi objetivo deste estudo avaliar a acuidade desta técnica no estadiamento T (invasão mural) e N (ganglionar) e avaliar fatores de prognóstico como fatores de representação/substituição para melhorar a referida acuidade. Sessenta e nove pacientes operados a carcinoma gástrico (GA) entre Janeiro de 2010 e Julho de 2012 e avaliados por Tomografia Computorizada, a maioria recorrendo a técnica de multicorte com distensão gástrica, foram estadiados retrospetivamente por três imagiologistas. Utilizaram-se critérios de avaliação referidos na literatura especializada e fatores de substituição/representação nos estadios menos eficazes. O estadiamento T revelou acuidade de 66,7% e sensibilidade de 92% e a acuidade, sensibilidade e especificidade obtidas para o estadiamento N foram respetivamente 49%, 40,9% e 64%. Usando um fator de substituição de estadiamento diagnóstico T4/N2 para mudar o estadiamento N2 obtido por MDCT para estadiamento N3A aumentaria a acuidade do estadiamento N para 59% e a sensibilidade para 58,1% e baixaria a especificidade para 61,5%, embora essa mudança não fosse estatisticamente significativa (Teste exato de Fisher 0,159). Em conclusão a acuidade de uma técnica simples de MDCT com distensão gástrica no estadiamento T e N do GA está dentro dos valores citados na literatura e fatores de substituição/representação como o estadiamento T4 e o tipo Difuso da classificação de Lauren podem melhorar a acuidade do estadiamento N.-------------- ABSTRACT: Recent innovations in medical sectional imaging have allowed a major role of multi-detector computed tomography (MDCT) in staging of gastric adenocarcinoma (GA). The purpose of this study was to evaluate the accuracy of this technique in depth of mural invasion (T) and nodal (N) staging of GA and to evaluate prognostic factors as surrogate factors to improve such accuracy. Sixty nine patients operated to GA between January 2010 and July 2012 that underwent Computed Tomography, the majority through Multidetector Computed Tomography (MDCT) with gastric distention, were staged retrospectively by three imagiologists with state-of-the-art criteria and surrogate prognostic factors were analyzed for less accurate stages. MDCT T-staging was 66,7 % accurate with a sensibility of 92 % and there was a 49 % accuracy, 40,9 % sensibility and 64 % specificity for N Staging. Using a surrogate factor of T4/N2 diagnostic staging to change diagnostic MDCT N2 disease to N3A disease would increase accuracy of N staging to 59% and sensibility to 58,1% and would decrease specificity to 61,5 %, although that change was not statistically significant (Fisher´s Exact Test 0,159)In conclusion the accuracy of a simple hydro-MDCT technique in T and N staging of GA is in the range of values cited in the literature and surrogate factors as diagnostic T4 disease and diffuse type of Lauren´s Classification may improve the accuracy of N staging.

Clonagem funcional como metodologia na identificação de marcadores de virulência de Leishmania (Viannia) braziliensis

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Biotecnologia.

Bioremediation and CO2 scavenging using molybdenum-containing enzymes

Carbon dioxide valorization, will not only help to relieve the greenhouse effect but might also allow us to transform it in value-added chemicals that will help overcoming the energy crisis. To accomplish this goal, more research that focus on sequestering CO2 and endeavors through a carbon-neutral or carbon-negative strategy is needed in order to handle with the dwindling fossil fuel supplies and their environmental impact. Formate dehydrogenases are a promising means of turning CO2 into a biofuel that will allow for a reduction of greenhouse gas emissions and for a significant change to the economic paramount. The main objective of this work was to assess whether a NAD+-independent molybdenum-containing formate dehydrogenase is able to catalyze the reduction of CO2 to formate. To achieve this, a molybdenum-containing formate dehydrogenase was isolated from the sulfate reducing bacteria Desulfovibrio desulfuricans ATCC 27774. Growth conditions were found that allowed for a greater cellular mass recovery and formate dehydrogenase expression. After growth trials, kinetic assays for formate oxidation and CO2 reduction were performed and kinetic parameters determined. For the formate oxidation reaction, a KM of 49 μM and a turnover constant of 146 s-1 were determined. These kinetic parameters are in agreement with those determined by Mota, et al. (2011). Finally, we found that this molybdenum-containing enzyme was able to catalyze the reduction of CO2 to formate with a turnover constant of 4.6 s-1 and a KM of 13 μM. For the first time a NAD+-independent molybdenum-containing formate dehydrogenase was found to catalyze CO2 reduction, allowing its use as a biocatalyst in energetically efficient CO2 fixation processes that can be directed towards bioremediation or as an alternative and renewable energy source. Characterizing these enzymes may lead to the development of more efficient synthetic catalysts, make them readily available and more suited for practical applications.

Sol-gel entrapped biosystems: enzyme(s) and whole cells

In this work two different procedures to utilize the sol-gel technology were applied to immobilize/encapsulate enzymes and living cells. CO2 has reached levels in the atmosphere that make it a pollutant. New methods to utilize this gas to obtain products of added value can be very important, both from an environmentally point of view and from an economic standpoint. The first goal of this work was to study the first reaction of a sequential, three-step, enzymatic process that carries out the conversion of CO2 to methanol. Of the three oxidoreductases involved, our focus was on formate dehydrogenase (FateDH) that converts CO2 to formate. This reaction requires the presence of the cofactor β-nicotinamide adenine dinucleotide in reduced form (NADH). The cofactor is expensive and unstable. Our experiments were directed towards generating NADH from its oxidized form (NAD+), using glutamate dehydrogenase (GDH). The formation of NADH from NAD+ in aqueous medium was studied with both free and sol-gel entrapped GDH. This reaction was then followed by the conversion of CO2 to formate, catalysed by free or sol-gel entrapped FateDH. The quantification of NADH/NAD+ was made using UV/Vis spectroscopy. Our results showed that it was possible to couple the GDH-catalyzed generation of the cofactor NADH with the FateDH-catalyzed conversion of CO2, as confirmed by the detection of formate in the medium, using High Performance Liquid Chromatography (HPLC). The immobilization of living cells can be advantageous from the standpoint of ease of recovery, reutilization and physical separation from the medium. Also dead cells may not always exhibit enzymatic activities found with living cells. In this work cell encapsulation was performed using Escherichia coli bacteria. To reduce toxicity for living organisms, the sol-gel method was different than for enzymes, and involved the use of aqueous-based precursors. Initial encapsulation experiments and viability tests were carried out with E. coli K12. Our results showed that sol-gel entrapment of the cells was achieved, and that cell viability could be increased with additives, namely betaine that led to greater viability improvement and was selected for further studies. For an approach to “in-cell” Nuclear Magnetic Resonance (NMR) experiments, the expression of the protein ctCBM11 was performed in E. coli BL21. It was possible to obtain an NMR signal from the entrapped cells, a considerable proportion of which remained alive after the NMR experiments. However, it was not possible to obtain a distinctive NMR signal from the target protein to distinguish it from the other proteins in the cell.