Changes in the site distribution of common melanoma subtypes in Queensland, Australia over time: implications for public health campaigns

Abstract BACKGROUND: An examination of melanoma incidence according to anatomical region may be one method of monitoring the impact of public health initiatives. OBJECTIVES:   To examine melanoma incidence trends by body site, sex and age at diagnosis or body site and morphology in a population at high risk. MATERIALS AND METHODS:   Population-based data on invasive melanoma cases (n = 51473) diagnosed between 1982 and 2008 were extracted from the Queensland Cancer Registry. Age-standardized incidence rates were calculated using the direct method (2000 world standard population) and joinpoint regression models were used to fit trend lines. RESULTS:   Significantly decreasing trends for melanomas on the trunk and upper limbs/shoulders were observed during recent years for both sexes under the age of 40 years and among males aged 40-59years. However, in the 60 and over age group, the incidence of melanoma is continuing to increase at all sites (apart from the trunk) for males and on the scalp/neck and upper limbs/shoulders for females. Rates of nodular melanoma are currently decreasing on the trunk and lower limbs. In contrast, superficial spreading melanoma is significantly increasing on the scalp/neck and lower limbs, along with substantial increases in lentigo maligna melanoma since the late 1990s at all sites apart from the lower limbs. CONCLUSIONS:   In this large study we have observed significant decreases in rates of invasive melanoma in the younger age groups on less frequently exposed body sites. These results may provide some indirect evidence of the impact of long-running primary prevention campaigns.

The epidemiology of basal cell carcinoma

Basal cell carcinoma (BCC) is a skin cancer of particular importance to the Australian community. Its rate of occurrence is highest in Queensland, where 1% to 2% of people are newly affected annually. This is an order of magnitude higher than corresponding incidence estimates in European and North American populations. Individuals with a sun-sensitive complexion are particularly susceptible because sun exposure is the single most important causative agent, as shown by the anatomic distribution of BCC which is in general consistent with the levels of sun exposure across body sites. A distinguishing feature of BCC is the occurrence of multiple primary tumours within individuals, synchronously or over time, and their diagnosis and treatment costs contribute substantially to the major public health burden caused by BCC. A primary knowledge gap about BCC pathogenesis however was an understanding of the true frequency of multiple BCC occurrences and their body distribution, and why a proportion of people do develop more than one BCC in their life. This research project sought to address this gap under an overarching research aim to better understand the detailed epidemiology of BCC with the ultimate goal of reducing the burden of this skin cancer through prevention. The particular aim was to document prospectively the rate of BCC occurrence and its associations with constitutional and environmental (solar) factors, all the while paying special attention to persons affected by more than one BCC. The study built on previous findings and recent developments in the field but set out to confirm and extend these and propose more adequate theories about the complex epidemiology of this cancer. Addressing these goals required a new approach to researching basal cell carcinoma, due to the need to account for the phenomenon of multiple incident BCCs per person. This was enabled by a 20 year community-based study of skin cancer in Australians that provided the methodological foundation for this thesis. Study participants were originally randomly selected in 1986 from the electoral register of all adult residents of the subtropical township of Nambour in Queensland, Australia. On various occasions during the study, participants were fully examined by dermatologists who documented cumulative photodamage as well as skin cancers. Participants completed standard questionnaires about skin cancer-related factors, and consented to have any diagnosed skin cancers notified to the investigators by regional pathology laboratories in Queensland. These methods allowed 100% ascertainment of histologically confirmed BCCs in this study population. 1339 participants had complete follow-up to the end of 2007. Statistical analyses in this thesis were carried out using SAS and SUDAAN statistical software packages. Modelling methods, including multivariate logistic regressions, allowed for repeated measures in terms of multiple BCCs per person. This innovative approach gave new findings on two levels, presented in five chapters as scientific papers: 1. Incidence of basal cell carcinoma multiplicity and detailed anatomic distribution: longitudinal study of an Australian population The incidence of people affected multiple times by BCC was 705 per 100,000 person years compared to an incidence rate of people singly affected of 935 per 100,000 person years. Among multiply and singly affected persons alike, site-specific BCC incidence rates were far highest on facial subsites, followed by upper limbs, trunk, and then lower limbs 2. Melanocytic nevi and basal cell carcinoma: is there an association? BCC risk was significantly increased in those with forearm nevi (Odds Ratios (OR) 1.43, 95% Confidence Intervals (CI) 1.09-1.89) compared to people without forearm nevi, especially among those who spent their time mainly outdoors (OR 1.6, 95%CI 1.1-2.3) compared to those who spent their time mainly indoors. Nevi on the back were not associated with BCC. 3. Clinical signs of photodamage are associated with basal cell carcinoma multiplicity and site: a 16-year longitudinal study Over a 16-year follow-up period, 58% of people affected by BCC developed more than one BCC. Among these people 60% developed BCCs across different anatomic sites. Participants with high numbers of solar keratoses, compared to people without solar keratoses, were most likely to experience the highest BCC counts overall (OR 3.3, 95%CI 1.4-13.5). Occurrences of BCC on the trunk (OR 3.3, 95%CI 1.4-7.6) and on the limbs (OR 3.7, 95%CI 2.0-7.0) were strongly associated with high numbers of solar keratoses on these sites. 4. Occurrence and determinants of basal cell carcinoma by histological subtype in an Australian community Among 1202 BCCs, 77% had a single growth pattern and 23% were of mixed histological composition. Among all BCCs the nodular followed by the superficial growth patterns were commonest. Risk of nodular and superficial BCCs on the head was raised if 5 or more solar keratoses were present on the face (OR 1.8, 95%CI 1.2-2.7 and OR 4.5, 95%CI 2.1-9.7 respectively) and similarly on the trunk in the presence of multiple solar keratoses on the trunk (OR 4.2, 95%CI 1.5-11.9 and OR 2.2, 95%CI 1.1-4.4 respectively). 5. Basal cell carcinoma and measures of cumulative sun exposure: an Australian longitudinal community-based study Dermal elastosis was more likely to be seen adjacent to head and neck BCCs than trunk BCCs (p=0.01). Severity of dermal elastosis increased on each site with increasing clinical signs of cutaneous sun damage on that site. BCCs that occurred without perilesional elastosis per se, were always found in an anatomic region with signs of photodamage. This thesis thus has identified the magnitude of the burden of multiple BCCs. It does not support the view that people affected by more than one BCC represent a distinct group of people who are prone to BCCs on certain body sites. The results also demonstrate that BCCs regardless of site, histology or order of occurrence are strongly associated with cumulative sun exposure causing photodamage to the skin, and hence challenge the view that BCCs occurring on body sites with typically low opportunities for sun exposure or of the superficial growth pattern are different in their association with the sun from those on typically sun-exposed sites, or nodular BCCs, respectively. Through dissemination in the scientific and medical literature, and to the community at large, these findings can ultimately assist in the primary and secondary prevention of BCC, perhaps especially in high-risk populations.

Furan substituted diketopyrrolopyrrole and thienylenevinylene based low band gap copolymer for high mobility organic thin film transistors

A novel solution processable donor-acceptor (D-A) based low band gap polymer semiconductor poly{3,6-difuran-2-yl-2,5-di(2-octyldodecyl)-pyrrolo[3,4- c]pyrrole-1,4-dione-alt-thienylenevinylene} (PDPPF-TVT), was designed and synthesized by a Pd-catalyzed Stille coupling route. An electron deficient furan based diketopyrrolopyrrole (DPP) block and electron rich thienylenevinylene (TVT) donor moiety were attached alternately in the polymer backbone. The polymer exhibited good solubility, film forming ability and thermal stability. The polymer exhibits wide absorption bands from 400 nm to 950 nm (UV-vis-NIR region) with absorption maximum centered at 782 nm in thin film. The optical band gap (Eoptg) calculated from the polymer film absorption onset is around 1.37 eV. The π-energy band level (ionization potential) calculated by photoelectron spectroscopy in air (PESA) for PDPPF-TVT is around 5.22 eV. AFM and TEM analyses of the polymer reveal nodular terrace morphology with optimized crystallinity after 200 °C thermal annealing. This polymer exhibits p-channel charge transport characteristics when used as the active semiconductor in organic thin-film transistor (OTFT) devices. The highest hole mobility of 0.13 cm 2 V -1 s -1 is achieved in bottom gate and top-contact OTFT devices with on/off ratios in the range of 10 6-10 7. This work reveals that the replacement of thiophene by furan in DPP copolymers exhibits such a high mobility, which makes DPP furan a promising block for making a wide range of promising polymer semiconductors for broad applications in organic electronics.

Studies on hypomethylation of liver DNA during early stages of chemical carcinogenesis in rat liver

Our finding that the inhibitors of DNA methylation, 5-azacytidine, 5-azadeoxycytidine or adenosine dialdehyde, given after a carcinogen all potentiated initiation suggested that hypomethylation of DNA during repair synthesis of DNA might play a role in the initiation of the carcinogenic process. To examine this aspect further, we have asked the question, do the nodules which develop from initiated cells after promotion with 1% orotic acid exhibit an altered methylation pattern in their DNA? The methylation status of the DNA from nodules has been examined using the restriction endonucleases HpaII/MspI and HhaI which distinguish between methylated and unmethylated cytosines in their nucleotide recognition DNA 5'-CCGG and 5'-GCGC respectively. The proto-oncogenes, c-myc, c-fos and c-Ha-ras, in the DNA were primarily studied in this investigation because of their possible involvement in cell proliferation and/or in cell transformation and tumorigenesis. The results indicate that in the nodule DNA, c-myc and c-fos are hypomethylated in the sequence of CCGG while the c-Ha-ras shows hypomethylation in the alternating GCGC sequence. This methylation pattern seen in the nodule DNA is not found in the DNA of the non-nodular surrounding liver or liver tissue after exposure to promoter or carcinogen alone. It is also not found in the DNA of regenerating liver. It is particularly significant that the methylation patterns in the c-myc and c-Ha-ras regions are similar to those found in several cancer tissues. The results suggest that this methylation pattern is acquired early in the carcinogenic process and raises the question whether it has any bearing on the process.

Formation and preservation of pedogenic carbonates in South India, links with paleo-monsoon and pedological conditions: Clues from Sr isotopes, U-Th series and REEs

The influence of the pedogenic and climatic contexts on the formation and preservation of pedogenic carbonates in a climosequence in the Western Ghats (Karnataka Plateau, South West India) has been studied. Along the climosequence, the current mean annual rainfall (MAR) varies within a 80 km transect from 6000 mm at the edge of the Plateau to 500 mm inland. Pedogenic carbonates occur in the MAR range of 500-1200 mm. In the semi-arid zone (MAR: 500-900 mm), carbonates occur (i) as rhick hardpan calcretes on pediment slopes and (ii) as nodular horizons in polygenic black soils (i.e. vertisols). In the sub-humid zone (MAR: 900-1500 mm), pedogenic carbonates are disseminated in the black soil matrices either as loose, irregular and friable nodules of millimetric size or as indurated botryoidal nodules of centimetric to pluricentimetric size. They also occur at the top layers of the saprolite either as disseminated pluricentimetric indurated nodules or carbonate-cemented lumps of centimetric to decimetric size. Chemical and isotopic (Sr-87/Sr-86) compositions of the carbonate fraction were determined after leaching with 0.25 N HCl. The corresponding residual fractions containing both primary minerals and authigenic clays were digested separately and analyzed. The trend defined by the Sr-87/Sr-86 signatures of both labile carbonate fractions and corresponding residual fractions indicates that a part of the labile carbonate fraction is genetically linked to the local soil composition. Considering the residual fraction of each sample as the most likely lithogenic source of Ca in carbonates, it is estimated that from 24% to 82% (55% on average) of Ca is derived from local bedrock weathering, leading to a consumption of an equivalent proportion of atmospheric CO2. These values indicate that climatic conditions were humid enough to allow silicate weathering: MAR at the time of carbonate formation likely ranged from 400 to 700 mm, which is 2- to 3-fold less than the current MAR at these locations. The Sr, U and Mg contents and the (U-234/U-238) activity ratio in the labile carbonate fraction help to understand the conditions of carbonate formation. The relatively high concentrations of Sr, U and Mg in black soil carbonates may indicate fast growth and accumulation compared to carbonates in saprolite, possibly due to a better confinement of the pore waters which is supported by their high (U-234/U-238) signatures, and/or to higher content of dissolved carbonates in the pore waters. The occurrence of Ce, Mn and Fe oxides in the cracks of carbonate reflects the existence of relatively humid periods after carbonate formation. The carbonate ages determined by the U-Th method range from 1.33 +/- 0.84 kyr to 7.5 +/- 2.7 kyr and to a cluster of five ages around 20 kyr, i.e. the Last Glacial Maximum period. The young occurrences are only located in the black soils, which therefore constitute sensitive environments for trapping and retaining atmospheric CO2 even on short time scales. The maximum age of carbonates depends on their location in the climatic gradient: from about 20 kyr for centimetric nodules at Mule Hole (MAR = 1100 mm/yr) to 200 kyr for the calcrete at Gundlupet (MAR = 700 mm/yr, Durand et al., 2007). The intensity of rainfall during wet periods would indeed control the lifetime of pedogenic carbonates and thus the duration of inorganic carbon storage in soils. (C) 2010 Elsevier Ltd. All rights reserved.

Characterization of phase transformation behaviour and microstructural development of electroless Ni-B coating

Phase transformation behaviour of amorphous electroless Ni-B coating with a targeted composition of Ni-6wt% B is characterized in conjunction with microstructural development and hardness. Microscopic observations of the as-deposited coating display a novel microstructure which is already phase separated at multiple length scales. Spherical colonies of similar to 5 mu m consist of 2-3 mu m nodular regions which are surrounded by similar to 2-3 mu m region that contains fine bands ranging from 10 to 70 nm in width. The appearance of three crystalline phases in this binary system at different stages of heat treatment and the concomitant variation in hardness are shown to arise from nanoscale fluctuations in the as-deposited boron content from 4 to 8 wt%. High temperature annealing reveals continuous crystallization up to 430 degrees C, overlapping with the domain of B loss due to diffusion into the substrate. The implications of such a microstructure for optimal heat treatment procedures are discussed. (C) 2011 Elsevier B.V. All rights reserved.

Autocatalytic duplex Ni-P/Ni-W-P coatings on AZ31B magnesium alloy

Autocatalytic duplex Ni-P/Ni-W-P coatings were deposited on AZ31B magnesium alloy using stabilizer free nickel carbonate bath. Some of the coated specimens were passivated in chromate solution with and without heat treatment. Plain Ni-P coatings were also prepared for comparison. Coatings were characterized for their surface morphology, composition and corrosion resistance. Energy dispersive analysis of X-ray (EDX) showed that the phosphorous content in the Ni-P coating is 6 wt.% and for Ni-W-P it reduced to 3 wt.% due to the codeposition of tungsten in the Ni-P coating. Marginal increase in P and W contents was observed on passivated coupons along with Cr (0.18 wt.%) and O (2.8 wt.%) contents. Field emission scanning electron microscopy (FESEM) examination of these coating surfaces exhibited the nodular morphology. Chromate passivated surfaces showed the presence of uniformly distributed bright Ni particles along with nodules. Potenfiodynamic polarization and electrochemical impedance spectroscopy (EIS) studies were carried out in deaerated 0.15 M NaCI solution to find out the corrosion resistance of the coatings. Among the coatings developed, duplex-heat treated-passivated (duplex-HIP) coatings showed lower corrosion current density (i(corr)) and higher polarization resistance (R-p) indicating the improved corrosion resistance. The charge transfer resistance (R-ct) value obtained for the duplex-HIP was about 170 times higher compared to that for Ni P coating. (c) 2013 Elsevier B.V. All rights reserved.

CHARACTERIZATION AND MICROHARDNESS OF ELECTRODEPOSITED Ni-W COATINGS OBTAINED FROM GLUCONATE BATH

Ni-W alloy coatings are electrodeposited with direct and pulse current using gluconate bath at pH5. Effects of direct current (DC) and pulse current (PC) on structural characteristics of the coatings have been investigated by energy dispersive X-ray spectroscopy (EDXS), X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), differential scanning calorimetry (DSC) and X-ray photoelectron spectroscopy (XPS). EDXS shows that W contents are 13.3 and 12.6 at.% in DC and PC (10:40) Ni-W coatings, respectively. FESEM analysis exhibits the homogeneous coarse nodular morphology in DC plated deposits. DSC studies reveal that Ni-W coatings are thermally stable up to 400 degrees C. XPS studies demonstrate that DC plated coating has significant amount of Ni and W in elemental form along with their respective oxidized species. In contrast, mainly oxidized metals are present in the as-deposited coatings prepared with PC plating. The microhardness of pulse current (100:400) deposited Ni-W coating is about 750HK that is much higher than DC plated coating (635 HK). Heat treatment of the deposits carried out at different temperatures show a significant increase in microhardness which can be comparable with hard chromium coatings.

Evaluación de cinco cepas de Rhizobium leguminosarum bv. phaseoli en el cultivo del frijol (Phaseolus vulgaris L.) var. Rev. 84

Esta investigación se realizó en el Centro Experimental "La Compañía" ubicada en San Marcos, Carazo, con el objetivo de evaluar la adaptabilidad de las cepas en las condiciones estudiadas, determinar cuál de las cepas es la más infectiva y efectiva en cuanto a la nodulación y determinar su efecto en el crecimiento y rendimiento del cultivo del frijol (Phaseolus vulgaris L.) var. Rev. 84. Los factores evaluados fueren 5 cepas de Rhisoblum leguminosearum by. phaseoli y 3 testigos: 1 Testigo Absoluto (no inoculado. no fertilizado) Y 2 Testigos Relativos (no inoculados y fertilizados). El diseño experimental utilizado fue el de bloques completos al azar (SCA), con 4 repeticiones. La parcela experimental del ensayo fue de 32 (8 m x 4 m), la distancia de siembra fue de 0.1 m entre plantas y 0.4 m entre surcos. Las variables analizadas fueron: número; eficiencia y peso seco de nódulos por planta, peso seco de área foliar y rendimiento. Los datos se procesaron usando análisis de varianza (AHUEVA) y se utilizó la prueba de rangos múltiples de DUNCAN (P ≤ 0. 05). No se observó diferencias significativas para las variables de nodulación y rendimiento, determinándose efecto significativo sólo para el peso seco de área foliar en la I y II etapa de evaluación Sin embargo, se determinó quo la cepa CR-436 fue la que presentó mayor infectividad en el sistema radicular y la cepa CIAT-899, la que presentó el mejor porcentaje de efectividad nodular y con la que se obtuvo el mayor promedio de peso seco de área foliar. El mejor rendimiento fue obtenido con la cepa CR-436.

Estudio de la eficacia y seguridad de un dispositivo intraoral de avance mandibular en pacientes roncadores habituales con síndrome de apnea-hipopnea de carácter leve-moderado

184 p. : il.

Metasomatism and magmatic assimilation at a gabbro-limestone contact, Christmas Mountains, Big Bend region, Texas

A composite stock of alkaline gabbro and syenite is intrusive into limestone of the Del Carmen, Sue Peake and Santa Elena Formations at the northwest end of the Christmas Mountains. There is abundant evidence of solution of wallrock by magma but nowhere are gabbro and limestone in direct contact. The sequence of lithologies developed across the intrusive contact and across xenoliths is gabbro, pyroxenite, calc-silicate skarn, marble. Pyroxenite is made up of euhedral crystals of titanaugite and sphene in a leucocratic matrix of nepheline, Wollastonite and alkali feldspar. The uneven modal distribution of phases in pyroxenite and the occurrence' of nepheline syenite dikes, intrusive into pyroxenite and skarn, suggest that pyroxenite represents an accumulation of clinopyroxene "cemented" together by late-solidifying residual magma of nepheline syenite composition. Assimilation of limestone by gabbroic magma involves reactions between calcite and magma and/or crystals in equilibrium with magma and crystallization of phases in which the magma is saturated, to supply energy for the solution reaction. Gabbroic magma was saturated with plagioclase and clinopyroxene at the time of emplacement. The textural and mineralogic features of pyroxenite can be produced by the reaction 2( 1-X) CALCITE + AN_XAB_l-X = (1-X) NEPHELINE+ 2(1-X) WOLLASTONITE+ X ANORTHITE+ 2(1-X) CO₂. Plagioclase in pyroxenite has corroded margins and is rimmed by nepheline, suggestive of resorption by magma. Anorthite and wollastonite enter solid solution in titanaugite. For each mole of calcite dissolved, approximately one mole of clinopyroxene was crystallized. Thus the amount of limestone that may be assimilated is limited by the concentration of potential clinopyroxene in the magma. Wollastonite appears as a phase when magma has been depleted in iron and magnesium by crystallization of titanaugite. The predominance of mafic and ultramafic compositions among contaminated rocks and their restriction to a narrow zone along the intrusive contact provides little evidence for the generation of a significant volume of desilicated magma as a result of limestone assimilation.

Within 60 m of the intrusive contact with the gabbro, nodular chert in the Santa Elena Limestone reacted with the enveloping marble to form spherical nodules of high-temperature calc-silicate minerals. The phases wollastonite, rankinite, spurrite, tilleyite and calcite, form a series of sharply-bounded, concentric monomineralic and two-phase shells which record a step-wise decrease in silica content from the core of a nodule to its rim. Mineral zones in the nodules vary 'with distance from the gabbro as follows:

0-5 m CALCITE + SPURRITE + RANKINITE + WOLLASTONITE
5-16 m CALCITE + TILLEYITE ± SPURRITE + RANKINITE + WOLLASTONITE
16-31 m CALCITE + TILLEYITE + WOLLASTONITE
31-60 m CALCITE + WOLLASTONITE
60-plus CALCITE + QUARTZ

The mineral of a one-phase zone is compatible with the phases bounding it on either side but these phases are incompatible in the same volume of P-T-X_CO2.

Growth of a monomineralio zone is initiated by reaction between minerals of adjacent one-phase zones which become unstable with rising temperature to form a thin layer of a new single phase that separates the reactants and is compatible with both of them. Because the mineral of the new zone is in equilibrium with the phases at both of its contacts, gradients in the chemical potentials of the exchangeable components are established across it. Although zone boundaries mark discontinuities in the gradients of bulk composition, two-phase equilibria at the contacts demonstrate that the chemical potentials are continuous. Hence, Ca, Si and CO₂ were redistributed in the growing nodule by diffusion. A monomineralic zone grows at the expense of an adjacent zone by reaction between diffusing components and the mineral of the adjacent zone. Equilibria between two phases at zone boundaries buffers the chemical potentials of the diffusing species. Thus, within a monomineralic zone, the chemical potentials of the diffusing components are controlled external to the local assemblage by the two-phase equilibria at the zone boundaries.

Mineralogically zoned calc-silicate skarn occurs as a narrow band that separates pyroxenite and marble along the intrusive contact and forms a rim on marble xenoliths in gabbro. Skarn consists of melilite or idocrase pseudomorphs of melili te, one or two . stoichiometric calcsilicate phases and accessory Ti-Zr garnet, perovskite and magnetite. The sequence of mineral zones from pyroxenite to marble, defined by a characteristic calc-silicate, is wollastonite, rankinite, spurrite, calcite. Mineral assemblages of adjacent skarn zones are compatible and the set of zones in a skarn band defines a facies type, indicating that the different mineral assemblages represent different bulk compositions recrystallized under identical conditions. The number of phases in each zone is less than the number that might be expected to result from metamorphism of a general bulk composition under conditions of equilibrium, trivariant in P, T and u_CO2. The "special" bulk composition of each zone is controlled by reaction between phases of the zones bounding it on either side. The continuity of the gradients of composition of melilite and garnet solid solutions across the skarn is consistent with the local equilibrium hypothesis and verifies that diffusion was the mechanism of mass transport. The formula proportions of Ti and Zr in garnet from skarn vary antithetically with that of Si Which systematically decreases from pyroxenite to marble. The chemical potential of Si in each skarn zone was controlled by the coexisting stoichiometric calc-silicate phases in the assemblage. Thus the formula proportion of Si in garnet is a direct measure of the chemical potential of Si from point to point in skarn. Reaction between gabbroic magma saturated with plagioclase and clinopyroxene produced nepheline pyroxenite and melilite-wollastonite skarn. The calcsilicate zones result from reaction between calcite and wollastonite to form spurrite and rankinite.

Prevalência de doença celíaca em pacientes dispépticos sem diarreia atendidos na Disciplina de Gastroenterologia e Endoscopia Digestiva do Hospital Universitário Pedro Ernesto da UERJ

A Doença Celíaca (DC) é uma doença autoimune que afeta o intestino delgado de indivíduos geneticamente susceptíveis após contato com o glúten. Diversos estudos têm relatado aumento da prevalência ao longo dos anos. Objetivo: Determinar a prevalência de DC em pacientes adultos sem diarreia encaminhados à Disciplina de Gastroenterologia do HUPE da UERJ para serem submetidos a Endoscopia Digestiva Alta (EDA).Comparar os resultados do histopatológico das biópsias duodenais com os resultados sorológicos, utilizando o anticorpo antitransglutaminase tecidual IgA (ATGt IgA). Métodos: Pacientes que foram encaminhados ao nosso serviço para serem submetidos a EDA entre Julho de 2008 e Julho de 2010, com idade entre 18 e 85 anos foram aceitos no estudo. Critérios de exclusão foram cirrose, neoplasias do trato gastrointestinal, HIV, uso de imunossupressores e anticoagulantes, diarreia, hemorragia digestiva e DC. Coleta de sangue para pesquisa do anticorpo ATGt IgA (utilizando KIT ORGENTEC - Alemanha), avaliação endoscópica e exame histopatológico das biópsias de segunda porção duodenal foram feitos para cada paciente. Biópsias foram avaliadas de acordo com o critério de Marsh modificado. Resultados: Trezentos e noventa e nove pacientes consecutivos (112 homens, 287 mulheres), média de idade 49,616,4 anos, variando de 18-85 anos, sem diarreia, foram prospectivamente aceitos. Os sintomas clínicos mais prevalentes foram dor abdominal em 99,5%, pirose em 41,1%, plenitude pós prandial em 30,6%, náuseas e vômitos em 21,3%. Os achados endoscópicos foram: normais em 41,6%, lesões pépticas (esofagite, gastrite, duodenite e úlceras) em 41,6%, hérnia hiatal em 5,5%, pólipos gástricos em 3%, neoplasias em 1,3% e miscelânea em 7%. DC foi endoscopicamente diagnosticada em 13 pacientes (3,3%) com mucosa duodenal exibindo serrilhamento das pregas em 8 (2%), diminuição do pregueado em 2 (0,5%) e mucosa exibindo padrão nodular e mosaico em 3 (0,75%). Os achados histopatológicos de duodeno foram normais em 96,7%, duodenites inespecíficas em 2,7% e 3 pacientes (0,75%) confirmaram DC pelos critérios de Marsh modificado (IIIa, IIIb e IIIc). O anticorpo ATGt IgA foi positivo (>10 U/ml) em 1,3% (5/399). Conclusão: Este estudo mostrou que a prevalência de DC em pacientes dispépticos sem diarreia atendidos na Disciplina de Gastroenterologia e Endoscopia do HUPE/UERJ foi de 0,75% (1:133). A acurácia diagnóstica do anticorpo ATGt IgA é boa para pacientes com Marsh III e achados endoscópicos sugestivos. Nenhum dos pacientes tinha alterações Marsh I ou II. A EDA se mostrou um excelente método de triagem para definir os pacientes com graus mais acentuados de atrofia e que se beneficiariam de biópsia e sorologia para confirmação diagnóstica. Os resultados obtidos neste trabalho não justificam uma triagem rotineira de DC.

离子束溅射法薄膜生长中结瘤微缺陷的生长机理

用离子束溅射法制备了锆单层薄膜．用设计新型夹具和预置种子方法，对薄膜中结瘤微缺陷的生长过程进行了研究．在高分辨率光学显微镜和扫描电子显微镜下观察发现，结瘤在其生长初期呈现出分形的特征．用分子动力学和薄膜生长的扩散限制聚集模型，薄膜中结瘤微缺陷成核时的分形现象得到了很好的解释．

Análise clínica e molecular em indivíduos com deficiência mental idiopática no Maranhão: diagnóstico diferencial da síndrome do X frágil

O retardo mental (RM) representa um problema de saúde pública mundial ainda negligenciado no Brasil e, em especial nas regiões mais pobres como o Nordeste. A síndrome do X frágil (SXF) é uma das formas mais estudadas de RM hereditário em seres humanos. Esta doença monogênica, de herança ligada ao X dominante, é decorrente de uma mutação no exon 1 do gene FMR1, localizado na região Xq27.3. A mutação no FMR1 se caracteriza pelo aumento de repetições de trinucleotídios CGG em tandem na região 5 UTR desse gene, sendo a expansão dessas trincas o principal evento mutacional responsável pela SXF. De maneira geral, os fenótipos cognitivos de indivíduos do sexo masculino com a síndrome incluem deficiência intelectual de moderada à grave. No presente trabalho, realizamos um estudo transversal da SXF em indivíduos portadores de retardo mental de causa desconhecida, engajados em Programas de Educação Especial e em instituições psiquiátricas de São Luís-MA, rastreando amplificações de sequências trinucleotídicas no gene FMR1. A amostra foi composta por 238 indivíduos do sexo masculino, não aparentados, na faixa etária de 4 a 60 anos (média = 21 9 anos). O DNA dos participantes foi obtido a partir de 5 mL de sangue coletados em tubos com anti-coagulante EDTA e a análise molecular da região gênica de interesse foi realizada através da reação em cadeia da polimerase, utilizando-se três primers. Dentre os indivíduos triados quanto à presença de mutações no gene FMR1, apenas um apresentou um resultado inconclusivo e 2 (0,84%) foram positivos para a SXF, sendo que um deles (3503) apresentou mais de 200 repetições CGG no locus FRAXA e o outro indivíduo (3660) apresentou uma deleção de ~197 pb envolvendo parte das repetições CGG e uma região proximal às repetições CGG. Ambos possuíam história familiar de RM ligado ao X. No indivíduo 3503 observamos as seguintes características clínicas: temperamento dócil, orelhas grandes, mandíbula proeminente e flacidez ligamentar. O indivíduo 3660 apresentava hiperatividade, contato pobre com os olhos, orelhas grandes, mandíbula proeminente, pectus excavatum, macroorquidismo e pouca comunicação. O esclarecimento sobre a doença oferecido às famílias de ambos contribuiu sobremaneira para o entendimento da condição, do prognóstico e dos riscos de recorrência. A prevalência da SXF em nossa amostra, 0,84%, embora relativamente baixa, encontra-se na faixa de incidência de casos diagnosticados em outras populações que, em sua maioria, relatam incidências variando de 0 a 3%. Em parte, atribuímos o percentual encontrado aos critérios de inclusão utilizados em nosso estudo. Concluímos que o protocolo de triagem molecular utilizado em nosso estudo se mostrou eficiente e adequado para a realidade do Maranhão, podendo constituir uma ferramenta auxiliar a ser aplicada na avaliação de rotina dos portadores de RM, com grandes benefícios para o Estado.

Avaliação tridimensional da sínfise mandibular em crânios secos e sua associação com diferentes classificações de tipos faciais

O objetivo deste trabalho foi desenvolver um estudo morfológico quantitativo e qualitativo da região da sínfise mandibular (SM), através da construção de modelos tridimensionais (3D) e avaliar o seu grau de associação com diferentes classificações de padrões faciais. Foram avaliados 61 crânios secos humanos de adultos jovens com oclusão normal, com idade entre 18 e 45 anos e dentadura completa. Tomografias computadorizadas de feixe cônico (TCFC) de todos os crânios foram obtidas de forma padronizada. O padrão facial foi determinado por método antropométrico e cefalométrico. Utilizando o critério antropométrico, tomando como referência o índice facial (IF), o padrão facial foi classificado em: euriprósopo (≤84,9), mesoprósopo (85,0 - 89,9) e leptoprósopo (≥90,0). Pelo critério cefalométrico, o plano mandibular (FMA) determinou o padrão facial em curto (≤21,0), médio (21,1 - 29,0) e longo (≥29,1); e o índice de altura facial (IAF) classificou a face em hipodivergente (≥0,750), normal (0,749 - 0,650) e hiperdivergente (≤0,649). A construção de modelos 3D, representativos da região da SM, foi realizada com o auxílio do software ITK-SNAP. Os dentes presentes nesta região, incisivos, caninos e pré-molares inferiores, foram separados do modelo por técnica de segmentação semi-automática, seguida de refinamento manual. Em seguida, foram obtidos modelos 3D somente com o tecido ósseo, possibilitando a mensuraçãodo volume ósseo em mm3 (VOL) e da densidade radiográfica, pela média de intensidade dos voxels (Mvox). No programa Geomagic Studio 10 foi feita uma superposição anatômica dos modelos 3D em bestfit para estabelecer um plano de corte padronizado na linha média. Para cada sínfise foi medida a altura (Alt), a largura (Larg) e calculado o índice de proporção entre altura e largura (PAL). A avaliação da presença de defeitos alveolares foi feita diretamente na mandíbula,obtendo-se a média de todas as alturas ósseas alveolares (AltOss) e a média da dimensão das deiscências presentes (Medef). O índice de correlação intra-classe (ICC) com valores entre 0,923 a 0,994,indicou alta reprodutibilidade e confiabilidade das variáveis medidas. As diferenças entre os grupos, determinados pelas classificações do padrão facial (IF, FMA e IAF), foram avaliadas através da análise de variância (oneway ANOVA) seguida do teste post-hoc de Tukey. O grau de associação entre o padrão facial e as variáveis Vol, Mvox, PAL, Alt, Larg, AltOss e Medef foi avaliado pelo coeficiente de correlação de Pearson com um teste t para r. Os resultados indicaram ausência de diferença ou associação entre o volume, densidade radiográfica e presença de defeitos alveolares da SM e o padrão facial quando determinado pelo IF, FMA e IAF. Verificou-se tendência de SM mais longas nos indivíduos com face alongada, porém a largura não mostrou associação com o padrão facial. Estes resultados sugerem que as classificações utilizadas para determinar o padrão facial não representam satisfatoriamente o caráter 3D da face humana e não estão associadas com a morfologia da SM.