The predictive value of the NMP22 bladdercheck test for bladder carcinoma in patients presenting with haematuria to a South African tertiary care centre

Thesis (MSc.Med.(Urology))--University of the Witwatersrand, Faculty of Health Sciences, 2014.Bladder cancer is the second commonest urological malignancy and haematuria is the commonest symptom. Cystoscopy and urine cytology are integral for the investigation of haematuria, while the role of molecular markers such as the NMP22 BladderChek test is still being defined. The BladderChek is a qualitative point of care test developed for the detection of the elevated urinary levels of NMP22 associated with bladder cancer. No studies have been performed in South Africa using the BladderChek nor considered using this test to increase the efficiency of the workup of patients with gross haematuria. The primary aim was to establish the percentage of office cystoscopies done as part of a gross haematuria workup at Charlotte Maxeke Johannesburg Academic Hospital that are unnecessary and may be avoided if the BladderChek is positive under defined conditions. A cross-sectional study of the BladderChek test using prospective consecutive sampling, with special care to limit false positives and negatives, of 64 patients with a history of gross haematuria was conducted. The sensitivity, specificity, positive predictive value and negative predictive value for the BladderChek and the urine cytology were 78.9%, 84.4%, 68.2%, 90.5% and 36.8%, 93.0%, 70.0%, 76.9% respectively. The performance of the BladderChek was not affected by the history of gross haematuria, the stage nor grade of malignancy. Urine cytology detected only one malignancy missed by the BladderChek. Approximately 12.6% of office cystoscopies may be avoided and 78.9% of bladder tumours detected if the BladderChek is selectively applied as in this study. This may “fast-track” patients for transurethral resection of bladder tumour. The BladderChek may be a cost-effective alternative to urine cytology

Quantifying Cerebellum Grey Matter and White Matter Perfusion Using Pulsed Arterial Spin Labeling

To facilitate quantification of cerebellum cerebral blood flow (CBF), studies were performed to systematically optimize arterial spin labeling (ASL) parameters for measuring cerebellum perfusion, segment cerebellum to obtain separate CBF values for grey matter (GM) and white matter (WM), and compare FAIR ASST to PICORE. Cerebellum GM and WM CBF were measured with optimized ASL parameters using FAIR ASST and PICORE in five subjects. Influence of volume averaging in voxels on cerebellar grey and white matter boundaries was minimized by high-probability threshold masks. Cerebellar CBF values determined by FAIR ASST were 43.8 ± 5.1 mL/100 g/min for GM and 27.6 ± 4.5 mL/100 g/min for WM. Quantitative perfusion studies indicated that CBF in cerebellum GM is 1.6 times greater than that in cerebellum WM. Compared to PICORE, FAIR ASST produced similar CBF estimations but less subtraction error and lower temporal, spatial, and intersubject variability. These are important advantages for detecting group and/or condition differences in CBF values

Advancing the Scholarship of Teaching Through Collaborative Self-Study

Self-study research is a mode of scholarly inquiry in which teachers examine their beliefs and actions as educators and explore pedagogical questions. A three-phase model of collaborative self-study research is offered as a framework for university faculty to engage in self-study for the purpose of improving teaching and creating new knowledge

Insights into the evolution of the Thomson Orogen from geochronology, geochemistry, and zircon isotopic studies of magmatic rocks

Zircon U–Pb ages, εHf(t), and δ18O isotopic data together with geochemistry and limited Sm–Nd results from magmatic rocks sampled in deep-basement drill cores from undercover parts of the Thomson Orogen provide strong temporal links with outcropping regions of the orogen and important clues to its evolution and relationship with the Lachlan Orogen. SHRIMP U–Pb zircon ages show that magmatism of Early Ordovician age is widespread across the central, undercover regions of the Thomson Orogen and occurred in a narrow time-window between 480 and 470 Ma. These rocks have evolved εHf(t)zrn (−12.18 to −6.26) and εNd (−11.3 to −7.1), and supracrustal δ18Ozrn (7.01–8.50‰), which is in stark contrast to Early Ordovician magmatic rocks in the Lachlan Orogen that are isotopically juvenile. Two samples have late Silurian ages (425–420 Ma), and four have Devonian ages (408–382 Ma). The late Silurian rocks have evolved εHf(t)zrn (−6.42 to −4.62) and supracrustal δ18Ozrn (9.26–10.29‰) values, while the younger Devonian rocks show a shift toward more juvenile εHf(t)zrn, a trend that is also seen in rocks of this age in the Lachlan Orogen. Interestingly, two early Late Devonian samples have juvenile εHf(t)zrn (0.01–1.92) but supracrustal δ18Ozrn (7.45–8.77‰) indicating rapid recycling of juvenile material. Two distinct Hf–O isotopic mixing trends are observed for magmatic rocks of the Thomson Orogen. One trend appears to have incorporated a more evolved supracrustal component and is defined by samples from the northern two-thirds of the Thomson Orogen, while the other trend is generally less evolved and from samples in the southern third of the Thomson Orogen and matches the isotopic character of rocks from the Lachlan Orogen. The spatial association of the Early Ordovician magmatism with the more evolved metasedimentary signature suggests that at least the northern part of the Thomson Orogen is underlain by older pre-Delamerian metasedimentary rocks