Orientador : Luiz Sergio Leonardi / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-07-28T04:00:19Z (GMT). No. of bitstreams: 1 Zanotelli_MariaLucia_D.pdf: 26872542 bytes, checksum: 6975c4712bd44542658a9f202285198a (MD5) Previous issue date: 2000 / Resumo: Introdução: A preservação da veia cava retro-hepática durante a hepatectomia do receptor no transplante hepático é uma modificação da técnica clássica, tendo sido empregada pela primeira vez por Sir Roy Calne em 1968. Porém veio a ser difundida posteriormente, em 1989, por Andreas Tzakis com o nome de piggyback. As vantagens desse procedimento são inúmeras. Entretanto parece haver uma potencialidade para causar obstrução da drenagem venosa hepática, sendo discutida na literatura a melhor forma de reconstrução da veia cava supra-hepática quando essa técnica é adotada. Objetivos: Comparar três diferentes tipos de anastomose da veia cava suprahepática no transplante hepático pela técnica depiggyback. Métodos: Foram estudados prospectivamente, de forma randomizada, 29 pacientes adultos portadores de hepatopatia crônica e submetidos ao transplante hepático no período de agosto/98 a outubro/99. Os receptores foram distribuídos em três grupos de acordo com o tipo de anastomose da veia cava supra-hepática realizada: 1 - término-terminal com o óstio comum entre as veias hepáticas direita, média e esquerda - 10 pacientes; 2 - término-terminal com o óstio comum entre as veias hepáticas média e esquerda - 9 pacientes; 3 - cava-cava látero-lateral - 10 pacientes. Os cuidados perioperatórios foram realizados de maneira semelhante entre os grupos. Foram estudados o tempo de cirurgia e isquemia total do enxerto, consumo de hemoderivados, comportamento hemodinâmico intra-operatório em quatro fases distintas - durante a hepatectomia, na fase anepática, após a reperfusão e no final do procedimento e pós-operatório até 48 horas, evolução laboratorial nos dois primeiros dias após o transplante, assim como complicações venosas relacionadas à formação de ascite. Resultados: A técnica de piggyback pôde ser empregada em todos os casos. As reconstruções da veia cava supra-hepática foram de acordo com as propostas pelo estudo, com exceção de um paciente sorteado para a anastomose com as três veias e que foi excluído por ser inviável a realização da mesma sem o clampeamento total da veia cava inferior, devido à localização anatômica da veia hepática direita. Os três grupos foram homogêneos em relação às características demográficas e clínicas, embora tenha ocorrido um predomínio de mulheres na anastomose com as veias hepáticas média e esquerda. Os tempos cirúrgico e de isquemia total do enxerto foram maiores nos pacientes com anastomose com as três veias, mas sem relevância clínica. O consumo de sangue e derivados foi similar. Independentemente da técnica adotada, os distúrbios hemodinâmicos foram toleráveis, entretanto os pacientes submetidos à anastomose com as três veias apresentaram pressão arterial média diminuída na fase anepática. Após a reperfusão, a pressão venosa central foi menor no grupo cava-cava, permanecendo em níveis mais baixos até o término do transplante. A pressão da artéria pulmonar mostrou-se elevada na fase final do procedimento nos pacientes que fizeram anastomose com as três veias. No pósoperatório, ascite volumosa foi mais freqüente nos receptores com anastomose cava-cava e com as três veias. Um paciente do grupo cava-cava necessitou tratamento cirúrgico para resolução da ascite. Conclusão: Os três tipos de reconstrução da veia cava supra-hepática tiveram resultados semelhantes, embora não tenha sido possível incluir a veia hepática direita na anastomose em um caso. Apesar do clampeamentoparcial da veia cava inferior, a manutenção hemodinâmica foi adequada entre os grupos, no entanto os pacientes com anastomose com as veias hepáticas média e esquerda que permaneceram com a veia cava inferior livre apresentaram menos distúrbios hemodinâmicos. Ascite volumosa foi mais freqüente nas anastomoses cava-cava e com as três veias, apesar do diâmetro maior / Abstract: Introduction: The retrohepatic vena cava preservation during the recipient hepatectomy on liver transplantation is a variant of the classical technique. It was reported at the first time by Sir Roy Calne in 1968 but was popularized by Andreas Tzakis in 1989 with the name of piggyback. There are many advantages to use this technique. However the best way to reconstruct the recipient suprahepatic vein is still discussed due the potentiality of the procedure cause obstruction to the hepatic outflow. Purpose: Comparison of three different types of vena cava reconstruction in piggyback technique Methods: Twenty nine adults patients with chronic liver disease were prospectively studied and randomized at the moment of the surgery in 3 groups according to different types ofvena cava reconstruction during the period of august/98 to october/99: 1 - donor suprahepatic vena cava end-to-end to the recipient right, middle and left suprahepaticvein cuff - 10patients; 2 - donor suprahepatic vena cava end-to-end to the recipient middle and left suprahepatic vein cuff - 9 patients; 3 - donor retrohepatic vena cava side-to-side to the recipient inferior vena cava - 10patients. All patients had the same care during the perioperative course. The groups were compared in relation to the surgical and total graft ischemic time, blood component requirements, hemodynamic alterations, laboratories files and venous complications with ascites presentation. Results: Piggyback technique could be used in alI cases. Except in one patient of group 1 the vena cava reconstruction was possible according to previous selection. The recipients were similar in relation of demography and clinical characteristics excluding the majority of women in group 2. Surgical and total graft ischemic time was higher in the patients with three veins anastomosis but without clinical significance. The blood components requirements were homogeneous between the groups. The hemodynamic alterations were tolerable but the recipients with three veins anastomosis had median arterial pressure decreased at anhepatic phase. The central venous pressure was lower in the ( cavacaval reconstruction at the time of reperfusion and kept this until the end of the transplant. The pulmonary arterial pressure was higher at the end of the surgery in the group 2. Voluminous postoperative ascites was more frequently in the three veins and cavacaval reconstruction. One patient of Group 3 had to be operated to treat ascites. Conclusions: The three types of vena cava reconstruction had similar results. One patient randomized to three veins anastomosis was exc1udedbecause the right hepatic vein couldn't be use due anatomicallimits. The hemodynamic alterations were acceptable in all recipients despite partial inferior vena cava occ1usion during the anhepatic phase. However the patients ofmiddle and left hepatic vein group had more stability. Voluminous ascites was more often in the cavacaval and three veins anastomosis despite of the bigger size of them / Doutorado / Cirurgia / Mestre em Cirurgia

Orientador : Antonio Fernando da Conceição Passos / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Artes / Made available in DSpace on 2018-08-03T00:58:50Z (GMT). No. of bitstreams: 1 Oliveira_JulianaVeruscade_M.pdf: 492463 bytes, checksum: d1d22037625f67d12f652ea782905db7 (MD5) Previous issue date: 2002 / Mestrado

Orientador: Sara Teresinha Olalla Saad / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-07-24T18:02:04Z (GMT). No. of bitstreams: 1 Luzo_AngelaCristinaMalheiros_M.pdf: 5297367 bytes, checksum: d3b52afb5390f0980ee7b267c74e7bfe (MD5) Previous issue date: 1998 / Resumo: Nos últimos anos, o sangue de cordão umbilical humano (scuh) vem se tornando fonte alternativa viável, para obtenção de célula precursora de linhagem hematopoiética devido à facilidade em ser obtido, manipulado e rico em células precursoras. Estas células são mais imaturas que as da medula óssea, tendo grande capacidade de proliferação, replicação e transfecção. Apresenta, quando transfectada, maior expressão do material introduzido. No intuito de estudar a viabilidade destas células para reconstituir linhagem hematopoiética, analisamos sua capacidade de proliferação em cultura em meio de metilcelulose, antes e após criopreservação e transplantando-as em camundongos portadores de imunodeficiência severa combinada (SCID), irradiados. Foram coletadas, no período de junho de 1996 a agosto de 1998, 75 bolsas de scuh. Houve uma variação no volume de sangue coletado de 1 a 120 ml com média de 57 ml. O número médio de células viáveis foi de 119 x105 /ml de sangue de cordão. Nos estudos clonogênicos as médias observadas foram 216 colônias de CFU/BFU-E, 134 colônias de CFU-GM e 22 colônias de CFU-GEMM. Durante o estudo notamos uma proliferação intensa nas culturas de sangue de cordão de prematuros quando comparados com os neonatos de termo. Os prematuros apresentaram um maior número de células precursoras viáveis (371 x 105/ ml de sangue de cordão) que os de termo (74 células. x 105/ ml de sangue de cordão) Na leitura feita no 8° dia de cultura, encontramos 284 CFU/BFU-E nos prematuros e 19 colônias nos de termo (p=0,003). Em relação às CFU-GM os prematuros apresentaram 196 colônias/ml de sangue de cordão e os de termo 15 colônias Iml (p=0,003). Foram encontradas 29 colônias de CFU-GEMMM nos prematuros e nenhuma colônia nos de termo (p=0,003) No 14° dia, os prematuros apresentaram 358 colônias de CFU/BFU-E e os de termo 216 colônias (p=0,061); 219 colônias de CFU-GM e os de termo 120 colônias (p=0,075); 41 colônias de CFU-GEMM e os de termo 23 colônias (p=0,040). Tal fato poderia estar relacionado com o maior número de células precursoras existente em prematuros que se relaciona com a ontogenia da hemopoiese. Entretanto a diferenciação nos diferentes tipos de colônia se encontra também acelerado. As culturas dos prematuros no 8° dia foram semelhantes às de termo no 14° dia, já apresentando grande quantidade de CFU-GEMM. As culturas do 14° dia já apresentavam BFU-E, as quais, só aparecem nas de termo no 21° dia, apresentando também, intensa proliferação celular, dificultando a contagem. Provavelmente as células dos prematuros analisados (idade gestacional entre 20 e 32 semanas) devem entrar em ciclo celular antes que as de termo. Este achado está sendo objeto de estudo o estudo da viabilidade das células após o congelamento demonstrou que elas permaneceram viáveis após a crio preservação, mantendo, nos estudos clonogênicos, sua capacidade proliferativa e na imunofenotipagem, a proporção de células CD34+ foi semelhante à realizada pré- congelamento. O transplante foi realizado em 20 camundongos de linhagem SCID/SCID, após terem sido irradiados com 300 rads de fonte de Césio, injetando-se 1,0 x 10 7 células mononucleares de scuh em veia orbitária. Concomitantemente, num dos experimentos foi sacrificado um animal sem ser irradiado e transplantado, sendo feita a avaliação do mesmo modo que para avaliar a pega dos transplantados. Para avaliação da pega, os camundongos foram sacrificados 8 semanas após transplante, sendo feita cultura de lavado de medula óssea dos camundongos em meio sem i-sólido de metilcelulose com fatores estimulantes de crescimento recombinantes, específicos para linhagem celular humana e análise através de imunofenotipagem por citometria de fluxo com anticorpos monoclonais para células humanas. Foram obtidas amostras de sangue periférico, macerado de pulmão, baço e de lavado de medula óssea A pega na 8a semana pós transplante ocorreu em 6 dos 21 camundongos; 15 animais morreram na 1 a semana pós, irradiação, o que pode acontecer pois a linhagem SCID é mais sensível que as outras linhagens. Houve intensa proliferação nas culturas, dificultando a contagem das CFU-C. A análise através da citometria de fluxo foi positiva em 3 dos 6 casos. Foram analisados 6.000 a 10.000 eventos. A porcentagem encontrada de células captadas pelos anticorpos foi expressa em relação ao campo de linfócitos. Foram encontradas, no sangue periférico, 400 células com 26,03% de CD45, 4,50% de CD2, 30,14% de CD3, 1,03% de CD19. No pulmão, 2500 células com 18,65% de CD45, 16,32% de CD3 e 0,37% de CD19. Na medula óssea, 1000 células, com 12,80% de CD45, 4,45% de CD3, 0,855 de CD8, 0,03% de CD34. No baço, haviam 2300 células sendo 36,84% de CD45, 28,27% de CD3, e 1,62% de CD19. No camundongo sem transplante não houve marcação para células humanas. Mediante os dados apresentados, que se relacionam com os da literatura, as células precursoras do sangue de cordão são capazes de reconstituir a linhagem hematopoiética após ablação da medula e devido às suas caracteristicas, imaturidade, grande capacidade de proliferação e autogeração podem ser adequadas para terapia gênica / Abstract: During the past 14 years, human umbilical cord blood (UCB) has become an important source of hematopoietic stem cells The collection and manipulation of UCB is easy and due to the rich content of progenitors cells, when cultured, these cells provide a high enough number of GM-CSF colonies to allow recovery of the hematopoietic lineage. UCB progenitor cells display a great ability to proliferate and self-renewal and are capable of multilineage expression in secondary colony cultures. In addition, UCB cells can be efficiently infected with retroviruses and provide a high level of expression of the introduced sequence. So, UCB cells can also be used in gene therapy. To evaluate the proliferative potential of UCB stem cells to recover hematopoietic lineage, we collected between june, 1996 to august 1998, 75 UCB bags and analyzed, before and after cryopreservation, their viability and proliferative capacity in methylcellulose culture, we also performed transplantation of these cells into SCIO mice in order to recover bone marrow after ablative irradiation. The collected volume medium was 57ml, the medium viable number of mononuclear cells was 119 x105/ml of cord blood. The medium CFU-C founded in clonogenic studies were: 216. CFU-E, 134 CFU-GM and 22 CFU-GEMM. During our study we discovered that cultures from UCB cells of premature neonates had an early growth of CFU-E/BFU-E, CFU-GM and CFU-GEMM, on the 8th day of culture, and that the number and morphological characteristics of these colonies were comparable to those from fuI! term neonates obtained on the 14th day. The prematures presented, on the 8th day of culture, 284 CFU/BFU-E while, in full term neonates there were 19 colonies (p=O,003). We found 196 CFU-GM colonies in the premature group and 15 colonies in the full term group (p=O,OO3), 27 CFU-GEMM colonies in the premature group and none in the full term group (p=O,OO3). On the 14th day of culture the results were as following: CFU/BFU-E - premature 358 x full term 216 (p=O,061), CFU-GM - premature 219 x full term 120 (p=O,075) and CFU-GEMM - premature 41 x fuIl term 23 (p=0,040). These results indicated that premature UCB cells have a higher proliferative potential, this capacity may not be only related to their higher concentration of primitive hematopoietic progenitor cells, but rather to a different timing to entry into the cell cycle. The study about cryopreservation demonstrated that the viability and clonogenic results were comparable with the results before cryopreservation. In order to evatuate the viabiity of UCB cells to recover hematopoieic lineage, fractioned UCB cells were transplanted' into sublethaly irradiated severe combined immunodeficient (SCIO) mice. We transplanted 21 mice, 6 engrafted and 15 dead during the fist week post transplantation, probably by the fact that SCIO lineage had great irradiation sensibiliy than the others mice lineages, even when we use 300 rads .The engrafted group demonstrated multilineage engraftment, analyzed by fluorescenceactivated-cell sorting (FACS) with monoclonal antibody for human cells, and clonogenic studies with mice bone marrow cells, in methylcellulose culture with human recombinant stimulating factors. Our FACS results were: peripheral blood, 400 cells with 26,03% of C045, 4,50% of C02, 30,14% of CD3, 1,03% of CD19; lung, 2500 cells with 18,65% of C045, 16,32% C03 and 0,37% of CD19; bone marrow,1000 cells with 12,80% of C045, 4,45% of C03, 0,855 of C08 and 0,03% of C034; spleen, 2300 cells with 36,84% of C045, 28,27% of C03, and 1,62% of CD19. We had done the same analysis with one untransplanted mouse. There was not any positive cell in the F ACS analysis with monoclonal antibody for human cells. These results demonstrated that umbilical cord blood cells were capable to recover bone marrow after ablative. therapies and might be in the future, the ideal source of progenitors cells for transplantation and gene therapy / Mestrado / Clinica Medica / Mestre em Ciências Médicas

Orientador: Jose Francisco Figueiredo / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-07-13T23:35:36Z (GMT). No. of bitstreams: 1 Silva_LiliaAparecidaColettoVieirada_M.pdf: 2117253 bytes, checksum: cc7c809ea85efdf54cfcf971b6aee284 (MD5) Previous issue date: 1991 / Resumo: Neste trabalho, estudamos o efeito das soluções de Collins e Euro-Collins sobre as pars recta do túbulo proximal de coelhos isolados e perfundidos ¿in vitro¿, empregando-se várias manobras de conservação. Esta técnica permite avaliar diretamente a ação dos constituintes químicos de soluções conservadoras sobre aspectos de interesse da fisiologia tubular. Em uma de nossas manobras experimentais, o estado funcional do túbulo é previamente determinado, antes da conservação, de tal modo que cada experimento se torna seu próprio controle ... Observação: O resumo, na íntegra, poderá ser visualizado no texto completo da tese digital / Abstract: Not informed. / Mestrado / Fisiologia / Mestre em Ciências Biológicas

'What service settings and anthems were sung in Canterbury Cathedral during 1873- 1988' is a straightforward question to answer. The significance of the practice of choral music making in Canterbury Cathedral in the restoration and growth of Cathedral worship and early music repertoire deserves close examination through the information discovered in that first answer. The implication is that reinstatement of the worship and development of early music, following a period of impoverishment, was necessary. Investigation of the nature of changes made in Canterbury Cathedral, together with the progress of expansion of that worship, through music, becomes a challenging essential. Regeneration describes the breathing of new life, as in recovery from serious illness, which was shown to be necessary in the music and worship of the early 19th century, following the vicissitudes of disagreement, war and apathy regarding style of worship in general and the role and compositional characteristics of music in particular. Preservation implies maintenance and safeguarding something of value, which had been hard won, in the battle for wellcrafted music that conveyed and supported the meaning of the words that the music carried. Sustenance speaks of active feeding and nurture of something that has been made healthy, on a daily basis, so that it will have future life. The churchmanship evident in regular choral services in Canterbury Cathedral is middle to high, as is that of the writer, (akin to the Via Media recommended by John Henry Newman, between 'the superstitions of Rome ... and the errors of Protestantism'). The Cathedral building, its people and its musical life were historically damaged by those of excessive Puritanism. A teenage exposure to The Wilderness: John Goss, made a deep and life-changing impression on the writer; in later years serving as Organist and Choir Master of an Anglo-Catholic church choir, together with singing in a national chamber choir in Cathedral services made a significant contrast to the crushing puritanism experienced in childhood and also to some extent the low Anglican church services of early adulthood. However, a respect for those with different approaches to spirituality and worship remains an essential component of the Cathedral ethos and the views of the writer. The knowledge of the Real Presence of Christ in the Eucharist has given purpose to the writer's life, especially when combined with well-crafted music, and in its original language wherever possible. One of the chief roles of this study is to demonstrate the way in which Canterbury Cathedral's music has been an essential part of the movement towards reconciliation of the differing tenets of Roman Catholicism and Protestantism.

M.Ed. (Education Management) / Participation in an extra curricular activity is today no superfluous luxury, but an imperative social establishment, because, not only does it afford pupils the opportunity to enhance their cultural and educational development, it also presents the school with the opportunity to render a most important service in the task of educating the child to his/her full potential. It also affords the pupil the opportunity for relaxation and this in turn promotes academic progress and has a beneficial effect on the child's self esteem. Extra curricular activity also implies that pupils are enabled to equip themselves for two important dimensions of their adult lives, namely labour and leisure time and it therefore constitutes a indispensable part of the pupils' educational experience. Participation in extra curricular activities thus forms an important basis for socialisation and contributes towards the overall growth of the pupil. Teachers are best qualified to cultivate the potential of pupils, not only in the classroom, but also on the sport field. It is therefore essential that teachers, and not outside persons, be utilized to develop the full potential of pupils, also in the field of extra curricular activities. Teachers have in the past assumed the responsibility of training and coaching pupils. The organized teaching profession has, however, also in the past paid homage to the view that a teacher is a professional person, who receives an all inclusive remuneration for his or her services as professionals practitioner.

In chapter one of this work, as a preliminary to the formulation of the question that this thesis will attempt to answer, the changing understanding of the part played by the interpreter in the process of interpretation is discussed. This outline begins with the understanding of the role of the interpreter in liberal theology - where he is thought of as one who applies critical methods to the text in a detached and scientific way. After this the hermeneutic spiral is discussed - the formation of this model acknowledges to a greater degree the individual and human part played by the interpreter. This is followed by a brief examination of the most recent theories of interpretation in which meaning is regarded as residing not in the text but in the interpreter himself. The task of this thesis is to determine whether, as these recent theorists suggest, the reader creates meaning instead of reading out what somehow lies in the text itself. The task of this thesis is to ascertain, by studying the interpretationsof John's Prologue by Origen, Luther and Bultmann, whether the text does in fact operate as a series of sign-posts that pOint the interpreter to a destination within his own semantic universe. This may be determined by noting whether or not the contexts, i n the broadest sense, of these interpreters have played a formative part in their interpretations. contextual influences are regarded as existing wherever there is a procedure or meaning in the interpreter's commentary which one expe cts to find there as a result of one's knowledge of the interpreter's life and previous writings. Our research reveals that Orige n, Luther and Bultmann have produced three very different commentaries in which the common denominator is the formative influence of the interpreter's context. Each of these writers has produced an interpretation that is consistent, in both approach and theology, with their previous exegetical and theological thought. This indicates that contextual factors have played a significant part in determining their interpr etations of John 1 :1-18. It would appear that these interpreters have been led to find the meaning of John's Prologue not with reference to any new, unprecedented set of symbols, but with reference to their own, well-worn semantic universes. In the conclusion it is noted that this research appears to support what many modern theorists have said as to the locus of meaning in interpretation. In the conclusion it is also noted that many of the fears raised by these findings - that readers and writers, or speakers and hearers, may become so isolated and trapped in their own thought worlds that any real contact with the outside is impossible - may be groundless. These findings also point to a certain consistency between the interpreters and their communities. This refutes the fears as to the isolation and solitary development of the individual in that it points to a certain community or corporate aspect which plays a part in the development of the indivi dual's semantic universe . / KMBT_363 / Adobe Acrobat 9.53 Paper Capture Plug-in

[No abstract available] / Land and Food Systems, Faculty of / Graduate

Economic activity in the United States and Canada is predominantly performed by corporations. They are by far the largest private employers of workers, the biggest investors and the predominant instrument of production. They are rapidly growing in size, are generating sufficient funds internally to carry out most of their expansion programs, and are diversifying into unrelated activities. Their affairs are increasingly managed by professional executives who have little, if any, stake in the risk capital. The shareholders, who are legally presumed to exercise control over the powers and actions of corporate executives, are normally too numerous and scattered so as not to be in a position to have a significant influence on the policies of the corporations. The changing role of the corporations has led to considerable discussion about the legitimacy of corporate power and the accountability of corporations for their actions which affect others such as consumers, workers, suppliers and the public. As part of this general accountability, the question is raised about the type and extent of information that corporations should be required to disclose to persons and groups who save no contractual relationship with these corporations. Many businessmen, accountants, political theorists, economists, and lawyers have put forward their views about corporate disclosure which differ widely from one another. A principle reason for the divergent views about corporate disclosure is that they use different frames of references to base their arguments for or against disclosure of more information than is at present provided by corporations. This study is an attempt to use the normative model of 'Effective Competition' as a guide for the type and extent of disclosure to be made by corporations. An examination of current literature on competition suggested that the lines of demarcation for the normative model of 'Effective Competition' can be defined by reviewing the national objectives of the United States and Canada which form the framework for the model and by examining the main characteristics in the economy which reflect the structure of the model. The informational requirements of the main actors in the economy namely consumers, employers, workers, creditors, investors, government-run corporations, foreign firms dealing with the countries and various government agencies whose actions have a direct effect on other actors form the basis of specific recommendations made about the type and extent of disclosure that should be required from corporations operating in Canada. / Business, Sauder School of / Graduate

M.Phil. (Greek) / Please refer to full text to view abstract