Orientador: Maria Alice Rostom de Mello / Banca: Eliete Luciano / Banca: Carlos Alberto da Silva / Banca: Maria Esméria C. do Amaral. / Banca: Silvia Cristina Crepaldi Alves / Resumo: Este estudo visou analisar o metabolismo da glicose no músculo sóleo de ratos submetidos a desnervação bem como a resposta do animal como um todo à insulina exógena e ao exercício. Os animais foram tratados de acordo com o Guide for care use of laboratory animals. (National Research Council, 1996). Para isso foram realizados 3 experimentos. No primeiro, ratos adultos (3 a 5 meses) foram submetidos à secção do nervo isquiático da pata direita. Observou-se redução da captação de glicose pelo músculo sóleo isolado da pata desnervada após 3 e 7 dias mas não após 28 dias em relação a animais controles íntegros. Não houve diferença após 3 e 7 dias na captação de glicose pelo músculo sóleo da pata contralateral em relação ao animal controle. Houve aumento da captação de glicose na pata contralateral 28 dias após a desnervação. Verificou-se que após 28 dias de desnervação, não houve reinervação do nervo isquiático. A taxa de remoção da glicose em resposta à insulina exógena após 28 dias de desnervação foi superior à de animais controle íntegros e aquela observada após 3 e 7 dias de desnervação. No segundo, ratos nas mesmas condições, após 48 h de desnervação iniciaram programa de natação 1h/dia, 5dias/semana, durante 28 dias. Ratos desnervados submetidos ao exercício mostraram maior taxa de remoção da glicose sangüínea em resposta à insulina exógena comparados aos sedentários e a animais controle íntegros. O exercício elevou a captação e a oxidação da glicose pelo músculo contralateral e pelo desnervado assim como pelo músculo de animais controles íntegros. Esses resultados sugerem que alterações restritas do metabolismo glicídico muscular influenciam a homeostase glicêmica do animal. Além disso, o exercício melhora o aporte e a utilização da glicose no músculo desnervado... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This study aimed to analyze the metabolism of glucose in the soleus muscle of rats submitted to denervation, as well as the response of the animal as a whole to exogenous insulin and to exercise. To do this, 3 experiments were carried out. In the first, adult rats (3 to 5 months old) were submitted to section of the sciatic nerve in the right paw. A reduction was observed in the uptake of glucose by the isolated soleum muscle of the denervated paw after 3 and 7 days, but not after 28 days in relation to the whole control animals. There was no difference after 3 and 7 days in glucose uptake by the soleum muscle of the opposite paw in relation to the control animal. There was increased glucose uptake in this same paw 28 days after denervation. The rate of glucose removal in response to exogenous insulin after 28 days of denervation was higher than that of whole control animals and those observed after 3 and 7 days of denervation. In the second experiment, rats in the same conditions, after 48 h of denervation started a swimming program 1h/day, 5day/week, for 28 days. The denerved rats submitted to exercise showed a higher blood glucose removal rate in response to exogenous insulin compared to the sedentary and whole control animals. Exercise raised the uptake and oxidation of glucose by the opposite muscle and by the denervated one, as well as by the muscles of the whole control animals. These results suggest that restricted alterations of the muscular glucose metabolism influenced the glycemic homeostasis of the animal. Furthermore, exercise improved the uptake and use of glucose in the denerved muscle. In the third experiment, adult rats in the same conditions as in the first study, had an assessment made of their insulin secretion by isolated pancreatic islets, incubated in the presence of growing concentrations of glucose (2.8; 5.6; 8.3 and 16.7 mM)... (Complete abstract, access undermentioned electronic address) / Doutor

The human body consists of about 40 % skeletal muscles which control the body’s movement, ability to stand up, force generation, locomotion, heat production and are also the body’s protein reservoir. Muscle mass is controlled by the relationship between protein synthesis and protein degradation. Atrophy, a decrease in muscle mass, can be trigged by disuse, immobilization, inflammation and cancer. Hypertrophy, an increase in muscle mass, can occur after increased mechanical load, high usage and/or anabolic stimulation. The aim of this thesis was to investigate changes in expression and post translational modifications of some factors involved in the regulation of protein synthesis and protein degradation in 6-days denervated atrophic hind-limb muscles (anterior tibial and pooled gastrocnemius and soleus muscles) and in 6-days denervated hypertrophic hemidiaphragm muscle in mice. Protein expression and post translational modifications were studied semi-quantitatively using Western blots with whole muscle homogenates and separated nuclear and cytosolic fractions from both innervated and denervated muscles.  An increase in protein synthesis after denervation in both atrophic and hypertrophic muscles was suggested after studies of factors downstream of mTOR (paper I).  Other results suggest that FoxO1 and MuRF1 (paper II) participate in the tissue remodeling that occurs after denervation. A differential response of MK2 phosphorylation in denervated hypertrophic and atrophic muscles was confirmed (paper III). An increase in phosphorylation of the MK2 substrate Hsp 25 in all denervated muscles studied (paper III) indicates that other factors than MK2 are involved in regulating this phosphorylation. eIF4G phosphorylation at S1108 was investigated (paper IV) and a decrease was observed in atrophic muscle but an increase in hypertrophic muscle. The results in this thesis suggest that there are several factors that control protein degradation and protein synthesis in denervated atrophic and hypertrophic skeletal muscles. This is an intricate labyrinth with many different cell signaling factors, the function of which are still far from fully understood.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 6 uppsatser.

Made available in DSpace on 2014-06-11T19:23:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-02-13Bitstream added on 2014-06-13T20:30:03Z : No. of bitstreams: 1 000721466.pdf: 9088901 bytes, checksum: 463739c9fc1e4be4c244e2e9b3af0588 (MD5) / There are several degenerative diseases causing symptoms due to nerve trauma peripherals that can lead to muscle atrophy. Parasitic diseases such as trypanosomiasis, highly contagious viral diseases such as distemper, and trauma - such as falls, motor vehicle collisions, among others - that cause nerve compression disorders, crushing or even cause total breakdown in atrophy, affecting both slow muscle fibers as rapid, resulting in decreased diameter of these fibers and muscle strength. When injury occurs spinal motoneurons or motor nerves will be rapid loss of muscle mass. The main features of the changes in the musculoskeletal system relate to decreased muscle and bone mass, as there are strong association between these forces and significant evidence that an environment devoid of mechanical stimulus produces direct effects on their structures and functions. The relationship between activity modeling of bone and muscle pumping action can be calculated from experiments with denervation and devascularization. In contrast to muscle atrophy, electrotherapy and hydrotherapy are proven methods of physiotherapy. This study is hypothesis that denervation causes muscle atrophy, and electrotherapy and hydrotherapy can restore the damage caused by this denervation. Thus, aim of this study is to test these hypotheses by histomorphometry of the long digital extensor muscles and superficial digital flexor tibia and biomechanically relevant. Were utilized of 40 Wistar rats (Rattus norvegicus Albinus), divided into: GC - control; GD - subjected to denervation; GH - subjected to denervation and hydrotherapy; GHE - subjected to denervation, electrotherapy and followed by hydrotherapy, GE...

Orientador: Mario Jefferson Quirino Lousada / Banca: José Carlos Silva Camargo Filho / Banca: Roberto Carvalhal / Resumo: Várias são as doenças causadoras de sintomas degenerativos devido a traumas de nervos peroféricos que podem levar a atrofia muscular. Doenças parasitárias como a Tripanossomíase, doenças virais altamente contagiosas como a cinomose, além de traumatismos - como quedas, atropelamentos, entre outros - que causam distúrbios nos nervos por compressão, esmagamento ou até mesmo ruptura total acarretam em atrofia, afetando tanto fibras musculares lentas quanto rápidas, resultando na diminuição do diâmetro destas fibras e da força muscular. Quando ocorre lesão dos motoneurônios espinhais ou dos nervos motores, haverá perda rápida de massa muscular. As principais características das alterações no sistema musculoesquelético dizem respeito à diminuição da massa muscular e óssea, pois há grande associação entre essas forças e evidências significativas de que um ambiente destituído de estímulo mecânico produza efeitos diretos em suas estruturas e funções. As relações existentes entre atividade de modelamento do osso e ação bombeadora dos músculos pode ser calculada a partir de experimentos com denervação e desvascularização. Em contrapartida à atrofia muscular, a eletroterapia e hidroterapia são métodos fisioterápicos de eficiência comprovada. Este estudo tem como hipótese que a denervação causa atrofia muscular, e que a eletroterapia e a hidroterapia podem restaurar os danos causados por esta denervação. Assim, é objetivo deste estudo testar estas hipóteses pela histomorfometria dos músculos extensor digital longo e flexor digital superficial e biomecanicamente as tíbias correspondentes. Foram utilizados 40 ratos Wistar (Rattus novergicus albinus), dividido em: GC - controle; GD - submetido a denervação; GH - submetido a denervação e hidroterapia; GHE - submetido a denervação, hidroterapia seguida de eletroterapia e GE... (para acesso ao resumo completo acessar link abaixo) / Abstract: There are several degenerative diseases causing symptoms due to nerve trauma peripherals that can lead to muscle atrophy. Parasitic diseases such as trypanosomiasis, highly contagious viral diseases such as distemper, and trauma - such as falls, motor vehicle collisions, among others - that cause nerve compression disorders, crushing or even cause total breakdown in atrophy, affecting both slow muscle fibers as rapid, resulting in decreased diameter of these fibers and muscle strength. When injury occurs spinal motoneurons or motor nerves will be rapid loss of muscle mass. The main features of the changes in the musculoskeletal system relate to decreased muscle and bone mass, as there are strong association between these forces and significant evidence that an environment devoid of mechanical stimulus produces direct effects on their structures and functions. The relationship between activity modeling of bone and muscle pumping action can be calculated from experiments with denervation and devascularization. In contrast to muscle atrophy, electrotherapy and hydrotherapy are proven methods of physiotherapy. This study is hypothesis that denervation causes muscle atrophy, and electrotherapy and hydrotherapy can restore the damage caused by this denervation. Thus, aim of this study is to test these hypotheses by histomorphometry of the long digital extensor muscles and superficial digital flexor tibia and biomechanically relevant. Were utilized of 40 Wistar rats (Rattus norvegicus Albinus), divided into: GC - control; GD - subjected to denervation; GH - subjected to denervation and hydrotherapy; GHE - subjected to denervation, electrotherapy and followed by hydrotherapy, GE... / Mestre

No description available.

Die Osteoarthrose (OA) des Ellbogengelenks ist eine der wichtigsten Gelenkerkrankungen des Hundes, die sich aufgrund erblich bedingter Fehlstellung der Gelenke sekundär häufig schon bei sehr jungen Hunden entwickelt und zu einer verminderten Lebensqualität der Tiere führt. Im Laufe der Erkrankung kommt es zu einer Schädigung des Gelenkknorpels, der an Elastizität und Spannkraft verliert und seine Funktion, nicht mehr ausüben kann. Eine Ablösung von Knorpelfragmenten und Entzündungen im Gelenk können die Zerstörung des Gelenkknorpels beschleunigen. Die OA ist nicht heilbar. Das Therapieziel ist eine möglichst vollständige Schmerzreduktion und die Verbesserung der Lebensqualität. Eine chirurgische Denervation ist im Ellbogengelenk des Hundes ohne Traumatisierung anatomischer Strukturen nicht möglich. Ziel der vorliegenden Arbeit war es, erstmalig einen experimentellen Ansatz zur chemischen Denervation sensibler Gelenkafferenzen im Ellbogengelenk beim Beagle mit dem Neurotoxin OX7-Saporin durchzuführen. Zusätzlich wurden Substanzen aus der Humanmedizin zur Schmerzreduktion und symptomatischen Therapie der OA am Hund erprobt und der Therapieerfolg evaluiert. Im Rahmen eines Therapieversuches in der Klinik für Kleintiere der Universität Leipzig wurde bei zwei, an OA erkrankten Hunden Capsaicin einmalig intraartikulär injiziert. Der erste Hund erhielt intraartikulär 250 mg Capsaicin. Dieser Patient zeigte Nebenwirkungen in Form einer Herz- und Atemfrequenzerhöhung, starker Schmerzhaftigkeit und neurologischen Symptomen. Der zweite Hund wurde mit 83 mg Capsaicin behandelt und zeigte keine Nebenwirkungen. Sowohl die Bewertung der Besitzer als auch die orthopädische Untersuchung ergaben keine Verbesserung der Lahmheit. Vier kranken Hunden wurde ebenfalls im Rahmen eines Therapieversuches Botox (Botulinumtoxin A) intraartikulär einmalig injiziert. Drei Hunde wurden mit 50 Einheiten, ein Hund mit 100 Einheiten Botox behandelt. Die Applikation von Capsaicin und Botox führten zu keiner Verbesserung der Symptomatik. In der Humanmedizin ist die Schmerzbehandlung mit Capsaicin und Botox erfolgreich. Deshalb sollten diese Therapieansätze auch für die Anwendung beim Hund weiter optimiert werden. Das Neurotoxin OX7-Saporin wurde in einer Dosierung von 100 µg erstmalig in das Ellbogengelenk von drei Beagle-Hündinnen appliziert, um eine sensible Denervation des Gelenkes zu erreichen. Der retrograde Transport des Ribosomen-inaktivierenden Proteins in die Perikarya der Spinalganglienzellen, die das Ellbogengelenk sensibel innervieren, sollte eine selektive Zerstörung der Neurone durch das Neurotoxin bewirken. Der retrograde Tracer Fluoro-Gold wurde, zur Kontrolle der Wirkung des Neurotoxins, nach einer Wartezeit von 15 Tagen intraartikulär in das linke und das rechte Ellbogengelenk appliziert. Fluoro-Gold kann ausschließlich von intakten Nervenfasern transportiert werden. Die Ganglien C4 - Th3 wurden bilateral zur histologischen Auswertung entnommen und in Paraffin eingebettet. Zur Bestimmung der Gesamtneuronenanzahl wurden alle Neurone in jedem dritten Schnitt eines Ganglions gezählt. Die Summe dieser Nervenzellen ergab die Gesamtneuronenanzahl eines Ganglions. Die Einlagerung von Lipofuszin führte zu einer starken Autofluoreszenz im Zytoplasma der Neuronen. Alle Schnitte wurden mit Sudan-Schwarz gefärbt, um die Autofluoreszenz von der retrograden FG-Markierung zu unterscheiden. Die FG-Markierung konnte nur in den Ganglien C6 und Th1 im Zytoplasma sehr weniger Neuronen dokumentiert werden. Der histologische Nachweis einer Neurodegeneration nach Applikation des Neurotoxins OX7-Saporin in das linke Ellbogengelenk war negativ. In den untersuchten Spinalganglien wurden intakte Nervenzellen nachgewiesen. Auch die bilaterale intraartikuläre Injektion des retrograden Tracers FG war nicht erfolgreich. Aus den Ergebnissen dieser experimentellen Ansätze wird zusammenfassend geschlussfolgert: Ø Vor der Durchführung zukünftiger experimenteller Untersuchungen beim Hund muss die optimale Konzentration und die Wartezeit für das Neurotoxins OX7-Saporin ermittelt werden. Ø Die Rezeptoren für OX7-Saporin müssen an den Nervenzellen des Hundes zweifelsfrei nachgewiesen werden, bevor das Neurotoxin im caninen Tiermodell eingesetzt werden kann. Ø Die optimale Konzentration des Fluoreszenzfarbstoffes FG für intraartikuläre Injektionen und dessen retrograde Transportgeschwindigkeit beim Hund müssen ermittelt werden, bevor dieser Tracer wieder im Tierexperiment eingesetzt werden kann. Ø FG wurde als 1,8%ige Lösung in das Ellbogengelenk beim Beagle appliziert. Diese Konzentration war wahrscheinlich zu gering, um eine retrograde Markierung der sensiblen Neurone in den entsprechenden Spinalganglienzellen nachzuweisen. Ø Die intraartikuläre Applikation des Neurotoxins OX7-Saporin führte nicht zur selektiven Neurodegeneration. Eine Aussage zur Schmerzausschaltung und symptomatischen Therapie der OA des Hundes mit OX7-Saporin ist deshalb nicht möglich.

Résumé : Le muscle squelettique étant d’une grande plasticité, il peut être la cible lors de thérapies en réhabilitation motrice. Toutefois, les structures neurales impliquées dans cette plasticité sont encore peu connues. Afin de déterminer si un mécanisme spinal est suffisant pour induire une plasticité musculaire, le nerf innervant le gastrocnémien latéral et le soleus a été sectionné unilatéralement chez 4 chats ayant retrouvé une locomotion au niveau des pattes arrières suite à une spinalisation complète. Des enregistrements électromyographiques et cinématiques ont été enregistrés avant et jusque 8 semaines après dénervation chez ces chats. Des analyses histologiques ont été réalisées pour les deux gastrocnémiens médial et latéral chez les 4 chats spinalisés et chez 4 chats intacts servant de contrôle. Chez les chats spinaux, la durée de cycle pour la patte ispilatérale et controlatérale à la dénervation pouvait être diminuée ou augmentée par rapport aux valeurs de pré-dénervation. Pour la durée de la phase d’appui, elle était généralement augmentée pour la patte controlatérale et diminuée pour la patte ipsilatérale. L’amplitude EMG du MG était augmentée bilatéralement après la dénervation et est restée élevée 8 semaines post dénervation. Concernant le poids des muscles, chez les chats spinaux, le LG ipsilatéral était significativement plus petit que le LG controlatéral alors que le MG ipsilatéral était plus gros que le MG controlatéral. Les analyses histologiques ont montré une plus grande aire pour les fibres de type IIa pour le MG ipsilatéral pour 3 des 4 chats. La densité de capillaires sanguins dans le MG ipsilatéral était aussi plus élevée que dans le MG controlatéral. Pour les chats intacts, aucune différence n’a été observée pour le poids, l’aire des fibres ou la densité capillaire entre les 2 MG. Ces résultats montrent que le muscle squelettique peut s’adapter même après une lésion de la moelle épinière, ce qui souligne l’importance de son utilisation en réhabilitation motrice. / Abstract : Skeletal muscle is highly plastic and can be targeted for motor rehabilitation. Although neural activity potently regulates muscle phenotype, the neural structures required are poorly defined. To determine if a spinal mechanism is sufficient for adaptive muscle plasticity, the nerve supplying the lateral gastrocnemius and soleus muscles was sectioned unilaterally in four cats that had recovered hindlimb locomotion following spinal transection. In these spinal cats, kinematics and electromyography (EMG) were collected before and for 8 weeks after denervation. Muscle histology was performed on the lateral (LG) and medial (MG) gastrocnemii bilaterally in four spinal and four intact cats. In spinal cats, cycle duration for the hindlimb ipsilateral or contralateral to the denervation could be increased or decreased compared to pre-denervation values. Stance duration was generally increased and decreased for the contralateral and ipsilateral hindlimbs, respectively. The EMG amplitude of MG was increased bilaterally following denervation and remained elevated 8 weeks post-denervation. In spinal cats, the ipsilateral LG was significantly smaller than the contralateral LG whereas the ipsilateral MG weighed significantly more than the contralateral MG. Histological characterizations revealed significantly larger fiber areas for Type IIa fibers of the ipsilateral MG in three of four spinal cats. Microvascular density in the ipsilateral MG was significantly higher than the contralateral MG. In intact cats, no differences were found for muscle weight, fiber area or microvascular density between homologous muscles. Results show that skeletal muscle remains remarkably adaptable after complete spinal cord injury, highlighting its importance to maximize force production in motor rehabilitation.

A elevada prevalência da hipertensão arterial sistêmica e as reduzidas taxas de controle tensional obtidas com o tratamento farmacológico despertaram interesse por estratégias alternativas. A denervação simpática renal percutânea surgiu como perspectiva no tratamento de pacientes com hipertensão arterial resistente. As vantagens do cateter irrigado nas ablações cardíacas fomentaram a hipótese de que esse também poderia ser benéfico no contexto da denervação renal. Objetivos: Avaliar a factibilidade e a segurança da denervação simpática renal com cateter irrigado em pacientes com hipertensão arterial resistente. Métodos: O objetivo primário do estudo foi a análise de segurança do procedimento avaliada pela: 1) quantificação de eventos adversos vasculares (em sítio de punção e artéria renal) periprocedimento; 2) Comprometimento da função renal durante o seguimento; 3) ocorrência de estenose/aneurisma da artéria renal, seis meses após a intervenção. Os objetivos secundários foram avaliar: 1) o efeito da denervação renal no comportamento da pressão arterial (aferida em consultório e na MAPA) e no número de anti-hipertensivos, seis meses após a intervenção; 2) o efeito do procedimento na qualidade de vida, aos três meses de seguimento. As variáveis contínuas, ao longo do tempo, foram comparadas utilizando-se os testes t de Student pareado ou Wilcoxon. Para a análise dos dados, utilizaram-se os programas SPSS e STATA11 SE. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados: Vinte pacientes (idade 50 ± 9,8 anos, 75% mulheres) foram submetidos à denervação renal. As médias das pressões arteriais sistólica e diastólica aferidas no consultório foram de 194,8 ± 36,5mmHg e 112 ± 16,8mmHg, respectivamente. As médias das pressões arteriais sistólica e diastólica aferidas na MAPA foram de 168,4 ± 22,2mmHg e 101,3 ± 19,1mmHg, respectivamente. O número médio de antihipertensivos foi de 7,1 ± 1,5. O procedimento foi realizado sem complicações em 95% dos casos. Em um caso, houve dissecção da artéria renal por trauma mecânico causado pela bainha introdutora. Não foram observadas complicações relacionadas à punção femoral ou elevação dos níveis séricos de creatinina no seguimento. Após seis meses, todos os pacientes foram submetidos à avaliação da integridade vascular. Houve um caso de estenose significativa em artéria renal esquerda, sem repercussão clínica. Ao final de seis meses, observou-se redução de 29,7 ± 33,1mmHg na PAS (p = 0,001) e 14,6 ± 18,9mmHg na PAD (p = 0,003) aferida em consultório, respectivamente. A redução na média da PAS e da PAD, aferida na MAPA, foi de 17,4 ± 33,4mmHg (p = 0,03) e 10,0 ± 21,3mmHg (p = 0,05), respectivamente. Em média, houve redução de 2,6 ± 2,0 anti-hipertensivos (p < 0,01). Antes do procedimento, o valor médio atribuído ao estado de saúde foi de 37,5 ± 22,7 e aumentou para 70,5 ± 20,9 (p = 0,01), três meses após a intervenção. Pacientes que experimentaram redução no número de anti-hipertensivos relataram melhora do estado de saúde. Conclusões: A denervação simpática renal com cateter irrigado é factível e segura. Hipertensos resistentes têm baixos escores do estado de saúde e de qualidade de vida. Os resultados sugerem que esse procedimento reduz os valores pressóricos e melhora a qualidade de vida, na maioria dos pacientes. / The high prevalence of hypertension and reduced blood pressure control obtained with pharmacological treatment aroused interest in alternative therapies. Percutaneous renal sympathetic denervation has emerged as an alternative in the treatment of resistant hypertension. The benefits of irrigated catheter in cardiac ablations fostered the hypothesis that these catheters may also be beneficial for renal denervation. Objectives: To evaluate the feasibility and safety of renal sympathetic enervation for resistant hypertension using an irrigated catheter. Methods: The primary endpoint was the safety of the procedure by means of: 1) periprocedural adverse vascular (puncture site and renal artery) events; 2) changes on renal function during follow-up; 3) evidence of renal artery stenosis/aneurysm at 6 months post-intervention. Secondary objectives were to assess the effects of renal denervation on: 1) blood pressure (difference on office and ABPM between baseline and 6 months of follow-up); 2) number of antihypertensive drugs (difference between baseline and 6 months post-intervention); 3) quality of life (comparison between baseline and 3 months). Continuous variables were compared using the paired Student t test or Wilcoxon test. Data was examined using the SPSS software and STATA11 SE. P values < 0.05 were considered statistically significant. Results: 20 patients (age 50 ± 9.8 years, 75% female) underwent renal denervation. Mean office systolic and diastolic blood pressure was 194.8 ± 36.5mmHg and 112.0 ± 16.8mmHg, respectively. Mean blood pressure on 24 hour ABPM was 168.4 ± 22.2mmHg e 101.3 ± 19.1mmHg, respectively. The mean number of anti-hypertensive drugs was 7.1 ± 1.5; 95% of cases were performed without complications. In one patient, there was a renal artery dissection by mechanical trauma caused by the sheath, resulting in stent implantation. There were no complications related to femoral puncture or elevation of creatinine values during the follow up. All patients were evaluated for vascular integrity at 6months. In one patient, significant left renal artery stenosis was diagnosed. At 6 months, office systolic and diastolic blood pressure reduced 29.7 ± 33.1mmHg (p = 0.001) and 14.6 ± 18.9mmHg (p = 0.003) respectively; Systolic and diastolic blood pressure on ABPM reduced 17.4 ± 33.4mmHg (p = 0.03) and 10.0 ± 21.3mmHg (p = 0.05), respectively. On average, there was a reduction of 2.6 ± 2.0 (p < 0.01) antihypertensive drugs. Before the procedure, the average value attributed to health status was 37.5 ± 22.7 and improved significantly at 3 months (70.5 ± 20.9, p = 0.01). Patients who experienced a reduction in the number of antihypertensive drugs reported improved health status. Conclusions: Renal sympathetic denervation with irrigated catheter is feasible and safe. Hypertensive patients have low quality of life scores. Comparison to post-renal denervation results showed a reduction in blood pressure and better quality of life in most patients.

A doença de Parkinson (DP) é uma doença neurodegenerativa caracterizada pela progressiva depleção dos neurônios dopaminérgicos da substância negra (pars compacta). A DP não ocasiona apenas uma desordem motora, mas também pode provocar uma disautonomia cardiovascular. A DP com sintomas similares aos que ocorrem em humanos pode ser experimentalmente induzida em ratos e camundongos com a administração das neurotoxinas 1-metil-1-4-fenil-1,2,3,6-tetrahidropirimidina (MPTP), 6-hidroxidopamina (6-OHDA) e rotenona. Mais, na década de 90, camundongos transgênicos que expressam altos níveis de alfa-sinucleína mutante humana têm sido produzidos e utilizados para investigar a possível relação entre a agregação da proteína alfa-sinucleína e a DP, uma vez que em humanos, a alta expressão dessa proteína está relacionada ao desenvolvimento do parkinsonismo associado à desnervação cardíaca simpática. No entanto, a desnervação cardíaca e suas conseqüências no miocárdio na DP não estão claramente caracterizadas, pois na literatura os métodos quantitativos empregados para tal finalidade têm sua confiabilidade e acurácia questionáveis. Desta forma, avaliou-se, no modelo de indução neurotóxico (MPTP), o miocárdio de camundongos C57/BL aplicando-se métodos morfoquantitativos tridimensionais (estereológicos). Neste trabalho, observamos que o volume da parede ventricular, o volume e a densidade de volume do interstício cardíaco foram, respectivamente, 0,8%, 5,3% e 2,4% maior no grupo MPTP. O volume do lúmen ventricular, o volume ventricular, o volume das fibras musculares cardíacas e a sua densidade de volume foram, respectivamente, 11,7%, 0,9%, 2,3% e 1,7% maior no grupo controle. O número total de núcleos de cardiomiócitos foi 14,8% menor no grupo MPTP bem como o número total de cardiomiócitos que foi 19% menor também neste grupo. Houve diferença estatística significativa entre os grupos para o parâmetro número de cardiomiócitos. Não houve, porém, diferença estatística significativa para os outros parâmetros avaliados. / Parkinson´s disease (PD) is a neurodegenerative disorder mostly characterised by a profound reduction of dopamine in the striatum due to a dramatic loss of dopaminergic neurons in the substantia nigra (pars compacta). The disease is not only characterised by a motor disorder but also present cardiovascular dysautonomia. The disease has been chemically induced in rats and mice using neurotoxins such as 1-metyl-1-4-phenyl-1,2,3,6-tetrahydropyrimidina (MPTP), 6-OHDA and rotenone. In the nineties, transgenic &alpha;-synuclein mice have recently been used as a model of PD and alpha-synuclein aggregation, because the overexpression of this protein is related to the development of parkinsonism associated to the sympathetic cardiac denervation. Although, the cardiac denervation in PD and its consequences in myocardium is not well defined because the literature reports no reliable quantitative methods. Therefore, the myocardium of the C57/BL mice was investigated in the neurotoxin animal model (MPTP) applying tridimensional morphoquantitative methods (stereological). In this study, we observed an increase of 0,8%, 5,3% and 2,4% in ventricular wall volume, in cardiac interstitial volume and in cardiac interstitial volume density, respectively, in the MPTP group. The lumen ventricular volume, the ventricular volume, the cardiac muscle fibre and their volume density were, respectively, 11,7%, 0,9% , 2,3% and 1,7% larger in control group. The total number of cardiomyocyte nuclei was 14,8% lower in MPTP group as well as the total number of cardiomyocyte that was 19% lower for this group too. Significant difference was observed between the groups to the total number of cardiomyocyte. No significant difference, however, was detected for the others estimated parameters.