4 resultados para multifocal lens

em AMS Tesi di Dottorato - Alm@DL - Università di Bologna


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In this investigation I look at patents and software agents as a way to study broader relation between law and science (the latter term broadly understood as inclusive of science and technology). The overall premise framing the entire discussion, my basic thesis, is that this relation, between law and science, cannot be understood without taking into account a number of intervening factors identifying which makes it necessary to approach the question from the standpoint of fields and disciplines other than law and science themselves.

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Like other vascular tumors, epithelioid hemangioendothelioma (EHE) is multifocal in approximately 50% of cases, and it is unclear whether the separate lesions represent multifocal disease or metastases. We hypothesized that the identification of an identical WWTR1-CAMTA1 rearrangement in different EHEs from the same patient supports the monoclonal origin of EHE. To test our hypothesis, we undertook a molecular analysis of two multicentric EHEs of the liver, including separate tumor samples from each patient. Matherial and Methods: We retrieved two cases of EHE with available tissue for molecular analysis. In both cases, fluorescence in situ hybridization (FISH) was performed to identify the presence of the WWTR1-CAMTA1 rearrangement to confirm the histologic diagnosis of EHE, as previously described. The reverse transcription-polymerase chain reaction (RT-PCR) products were analyzed by electrophoresis and the RT-PCR–amplified products were sequenced using the Sanger method. Results: FISH analysis revealed signal abnormalities in both WWTR1 and CAMTA1. Combined results confirmed the presence of the t(1;3)(1p36.23;3q25.1) translocation in both cases of EHE. Using RT-PCR analysis, we found that the size of the rearranged bands was identical in the different tumors from each patient. The sequence of the fusion gene confirmed a different WWTR1-CAMTA1 rearrangement in each patient, but an identical WWTR1-CAMTA1 rearrangement in the different lesions from each patient. Discussion: Because of its generally indolent clinical course, EHE is commonly classified as a multifocal, rather than metastatic, disease. In this study, we examined two cases of multifocal liver EHE and found an identical WWTR1-CAMTA1 rearrangement in each lesion from the same patient, but not between the two patients. These findings suggest that multifocal EHE arises from metastasis of the same neoplastic clone rather than from the simultaneous formation of multiple neoplastic clones, which supports the monoclonal origin of multifocal EHE.

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The aim of this dissertation is to improve the knowledge of knots and links in lens spaces. If the lens space L(p,q) is defined as a 3-ball with suitable boundary identifications, then a link in L(p,q) can be represented by a disk diagram, i.e. a regular projection of the link on a disk. In this contest, we obtain a complete finite set of Reidemeister-type moves establishing equivalence, up to ambient isotopy. Moreover, the connections of this new diagram with both grid and band diagrams for links in lens spaces are shown. A Wirtinger-type presentation for the group of the link and a diagrammatic method giving the first homology group are described. A class of twisted Alexander polynomials for links in lens spaces is computed, showing its correlation with Reidemeister torsion. One of the most important geometric invariants of links in lens spaces is the lift in 3-sphere of a link L in L(p,q), that is the counterimage of L under the universal covering of L(p,q). Starting from the disk diagram of the link, we obtain a diagram of the lift in the 3-sphere. Using this construction it is possible to find different knots and links in L(p,q) having equivalent lifts, hence we cannot distinguish different links in lens spaces only from their lift. The two final chapters investigate whether several existing invariants for links in lens spaces are essential, i.e. whether they may assume different values on links with equivalent lift. Namely, we consider the fundamental quandle, the group of the link, the twisted Alexander polynomials, the Kauffman Bracket Skein Module and an HOMFLY-PT-type invariant.

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Background. Clinical significance of multifocal pulmonary neuroendocrine proliferations (MNEP), including tumorlets and pulmonary neuroendocrine cell hyperplasia, in association with Typical Carcinoid (TC), is still debated. Methods. A large retrospective series of TC with long-term follow-up data prospectively collected from two institutions was evaluated. Recurrence or new TC development was followed-up. Patients with TC alone and MNEP+TC were compared. Results. 234 TC patients undergone surgery were included: 41 MNEP+TC (17.5%) and 193 TC alone (82.5%). In the MNEP+TC group older age (p<0.001), peripheral tumors (p=0.0032), smaller tumor size (p=0.011) and lymph-nodal spread (p=0.02) were observed in comparison with TC group. Relapses occurred in 8 patients (19.5%) in the MNEP+TC group and in 7 (3.6%) of the TC group. The 10-years progression-free survival were 96.1% in TC and 83.8% in MNEP+TC (p<0.001). After matching, in 36 pairs of patients a significantly higher 5-years progression-free survival was calculated for TC group (p<0.01). Furthermore the odds of belonging to MNEP+TC group was higher with work-related exposure to inhalant agents (p=0.008), asthma/bronchitis (p=0.002), emphysema, fibrosis and inflammatory status (p=0.032), micronodules on the chest CT scan and respiratory insufficiency (p=0.036). Conclusions. The identification of MNEP requires careful pathological examination and postoperative follow-up. MNEP seems to be an adverse prognostic factor in patients with synchronous TC. Therefore, suspicion of MNEP during the pre-operative assessment should not be underestimated, enabling changes in the surgical strategy.