Medicine and Health Sciences Commons^™

A Randomized Controlled Trial Of A Modified Cystoscopy Technique, Khalil Hetou

Electronic Thesis and Dissertation Repository

Introduction

Pain, anxiety and embarrassment are well documented feelings in patients undergoing ambulatory diagnostic cystoscopy. In this study, we explored utilizing Peak-end theory in improving pain perception in patients undergoing diagnostic cystoscopy.

Materials and Methods

We conducted a randomized clinical trial at the London Health Sciences Center for patients undergoing an ambulatory diagnostic cystoscopy for the first time. Males and females as well as allocation ratios were 1:1. The control arm received a standard cystoscopy. In the intervention arm the cystoscope was left for additional 2 minutes without further manipulation in the bladder before scope removal. The primary outcome was …

Retrospective Motion Correction In Magnetic Resonance Imaging Of The Brain, Patricia Johnson

Electronic Thesis and Dissertation Repository

Magnetic Resonance Imaging (MRI) is a tremendously useful diagnostic imaging modality that provides outstanding soft tissue contrast. However, subject motion is a significant unsolved problem; motion during image acquisition can cause blurring and distortions in the image, limiting its diagnostic utility. Current techniques for addressing head motion include optical tracking which can be impractical in clinical settings due to challenges associated with camera cross-calibration and marker fixation. Another category of techniques is MRI navigators, which use specially acquired MRI data to track the motion of the head.

This thesis presents two techniques for motion correction in MRI: the first is …

Investigating The Practical And Clinical Effectiveness Of Applying Current Steering To Deep Brain Stimulation For Parkinsonian Gait Therapy, Daphne Hui

Electronic Thesis and Dissertation Repository

Multiple neural network integration, influence of bradykinesia and rigidity, and bias of upper limb symptom improvement during deep brain stimulation implementation may attribute to the variable responsiveness of Parkinsonian gait therapy. Current steering (CS) addresses variability through fractionating current to fine-tune the stimulation field shape. It was hypothesized that CS would exhibit greater gait improvements and lower the total electrical energy delivered (TEED), which reduces power consumption and battery drainage. Divisions of 70/30 and 50/50 and single-contact stimulation modelled CS and conventions, respectively. Overall ambulation improved with TEED reduction; further, bilateral CS improved step time and length but left CS …

In Vivo Tracking Of Tumour Associated Macrophages In Breast Cancer With Magnetic Resonance Imaging, Ashley V. Makela

Electronic Thesis and Dissertation Repository

Introduction: The environment in which a tumour exists and functions is called the tumour microenvironment (TME). In breast cancer, the presence of tumour associated macrophages (TAMs) in the TME is associated with tumour aggressiveness and poor outcomes. Despite evidence for a link between TAM content and outcome, there are few strategies to measure TAMs and no in vivo approach. Iron or fluorine-19 (¹⁹F)-based MRI can be used to detect macrophages post intravenous injection of either an iron or perfluorocarbon (PFC) agent. Iron-based MRI is sensitive but difficult to quantify. ¹⁹F MRI is specific and signal is proportional …

Tibiotalar Arthrodesis: Development Of A Novel Jig And Alignment Guide, Adam Mathew Ropchan

Electronic Thesis and Dissertation Repository

Tibiotalar arthrodesis is a surgical procedure, used for the treatment of end-stage ankle arthrosis and instability. There are dozens of described procedures in the literature, all with varying rates of success. Two of the most common reasons for reoperation in tibiotalar arthrodesis are nonunion and infection; few studies have established any associations between patient/surgical factors and reoperation for nonunion and infection.

The first part of this thesis focuses on determining the rate of reoperation to the ipsilateral lower limb and if any patient/surgical factors are associated with reoperation for nonunion and infection. The second part of this thesis turns attention …

The Use Of Current Steering During Subthalamic Deep Brain Stimulation To Alleviate Upper Limb Symptoms Of Parkinson's Disease, Shabna Iftikar Mohideen

Electronic Thesis and Dissertation Repository

Subthalamic (STN) deep brain stimulation (DBS) is an established treatment to alleviate the appendicular motor symptoms of Parkinson's Disease (PD). Current steering during DBS allows the unequal fractionation of current between two electrodes on the lead, resulting in a non-spherical electrical field. It is hypothesized that the way the electrical field is shaped will affect a patient’s upper limb symptom alleviation. Seven PD patients who underwent bilateral STN-DBS were tested over four weeks post-operation. 16 current fractionation settings were tested each week at an amplitude that increased weekly. Optimal setting was defined as the setting that provided the best …

7t Magnetic Resonance Spectroscopy Of Non-Lesional Temporal Lobe Epilepsy, John Robert Adams

Electronic Thesis and Dissertation Repository

Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy, and one that is generally amenable to surgical treatment when surgery is necessary. Unfortunately, roughly 25-30% of the patient population have no visible lesions on clinical MRI scans. Without anatomical abnormalities to help guide surgical resection, the success of surgical treatment decreases substantially. However, metabolic abnormalities may exist that could allow for accurate localization of epileptic tissue in this cohort. Magnetic resonance spectroscopy (MRS) is a technique that can detect and measure the concentration of metabolically important molecules within tissue, giving insight into the underlying cellular metabolism.

In …

Investigating The Pathogenesis Of Staphylococcus Aureus In Periprosthetic Joint Infections, Santiago L. Iglesias

Electronic Thesis and Dissertation Repository

The most challenging complication after total joint replacement is the periprosthetic joint infection (PJI). Staphylococcus aureus is a commensal bacterium and a human pathogen. It is responsible for more than half of the PJI. We demonstrated that synovial fluid has antimicrobial properties against S. aureus and the iron restriction is one of the mechanisms used for the host to prevent bacterial growth, and is even able to increase killing of S. aureus. We have shown a clear role of transferrin as a restrictive factor in synovial fluid that functions by iron starving the bacteria and sensitizing them to killing …

Kallikrein-Related Peptidases Are Dysregulated In Pleomorphic Adenoma, Matthew D. Morrison

Electronic Thesis and Dissertation Repository

Objectives: Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. Kallikrein-related peptidases (KLKs) have been identified as biomarkers in many human tumors and may influence tumor behavior. We investigated KLK1-15 messenger ribonucleic acid (mRNA) and proteins in PA specimens to determine a KLK expression profile for this tumor.

Methods: Fresh frozen PA tissue specimens (n = 26) and matched controls were subjected to RT-qPCR to detect KLK1-15 mRNA. Expression of KLK1, KLK12, KLK13 and KLK8 proteins were then evaluated via immunostaining techniques. Statistical analyses were performed with the level of significance set at P < .05.

Results: We observed downregulation …