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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Avaliação prognóstica de pacientes com plexopatia braquial obstétrica: comparação entre a avaliação clínica e o estudo da condução motora / Prognostic evaluation of patients with obstetric brachial plexopathy: value of motor nerve conduction studies compared to the clinical evaluation.

Heise, Carlos Otto 22 August 2007 (has links)
O desenvolvimento de um método eficiente de avaliação prognóstica precoce seria de grande utilidade na seleção de lactentes com plexopatia braquial obstétrica para cirurgias de reconstrução do plexo braquial. Realizamos estudos de condução motora em 54 pacientes entre 10 e 60 dias de vida. Foram comparadas lado a lado as amplitudes dos potenciais de ação musculares compostos dos nervos axilar (músculo deltóde), musculocutâneo (músculo bíceps), radial proximal (músculo tríceps), radial distal (músculo extensor comum dos dedos), mediano (eminência tenar) e ulnar (eminência hipotenar). A relação entre a amplitude do potencial motor do lado lesado sobre o lado são foi chamada de Índice de Viabilidade Axonial (IVA), sendo este calculado tanto a partir da amplitude negativa como da amplitude pico-a-pico. Os pacientes foram seguidos clinicamente e classificados em três grupos: Grupo A, com recuperação total até os seis meses de vida; Grupo B, recuperação satisfatória até os doze meses de vida, e Grupo C, recuperação insatisfatória até os doze meses de vida. Analisamos a curva ROC (Receive Operator Characteristic Curve) de cada IVA para definir o melhor ponto de corte para detecção dos pacientes do Grupo C (mau prognóstico). Para o nervo axilar, o ponto de corte ideal foi IVA menor que 10%, com sensibilidade de 88,2% e especificidade de 89,2% ou 91,9%. Para o nervo musculocutâneo, o ponto de corte foi a ausência de potencial de ação motor, com sensibilidade de 88,2% e especificidade de 73,0%. Para o nervo radial proximal, o ponto de corte foi IVA menor que 20%, com sensibilidade de 82,4% ou 94,1% e especificidade de 97,3% ou 100%. Para o nervo radial distal, o ponto de corte foi IVA menor que 50%, com sensibilidade de 76,5% ou 82,4% e especificidade de 97,3%. Para o nervo ulnar, o ponto de corte foi IVA menor que 50%, com sensibilidade de 58,8% e especificidade de 97,3% ou 100%. O IVA do nervo mediano teve um desempenho ruim e seu uso não pode ser recomendado. Os IVAs dos nervos radial proximal, radial distal e ulnar apresentaram maior especificidade do que o critério clínico mais utilizado para a avaliação prognóstica, ou seja, ausência de função bicipital aos três meses de vida. A sensibilidade dos IVAs dos nervos axilar, musculocutâneo, radial proximal e radial distal foram equivalentes à do critério clínico. A utilização do estudo de condução motora entre 10 e 60 dias de vida forneceu uma avaliação prognóstica mais precoce e mais específica do que o critério clínico, podendo ser utilizada para indicação cirúrgica destes pacientes. / Early prognostic assessment of obstetric brachial plexopathies would be a major step for rational selection of infants for brachial plexus surgery. We performed nerve conduction studies in 54 patients from 10 to 60 days of life. We compared sideto-side the compound muscle action potentials amplitudes from the axillary (deltoid muscle), musculocutaneous (biceps), proximal radial (triceps), distal radial (extensor digitorum communis), median (thenar eminence) and ulnar nerves (hypothenar eminence). The ratio between the amplitude of the affected limb and that of the healthy side was called Viability Axonal Index (VAI), which was calculated using both the negative and the peak-to-peak amplitudes. The patients were followed-up and classified in three groups: Group A, with full recovery at six months of age; Group B, with satisfactory recovery at twelve months of age, and Group C, with poor recovery at twelve months of age. We analyzed the ROC (Receive Operator Characteristic) curve of each VAI to define the best cut-off point for detection of Group C patients (bad prognosis). The best cut-off point for the axillary nerve was a VAI of less than 10%, whith sensibility of 88.2% and specificity of 89.2% or 91.9%. For the musculocutaneous nerve, the cut-off point was an absent motor action potential, with sensibility of 88.2% and specificity of 73.0%. For the proximal radial nerve, the cut-off point was a VAI of less than 20%, with sensibility of 82.4% or 94.1% and specificity of 97.3% or 100%. For the distal radial nerve, the cut-off point was a VAI of less than 50%, with sensibility of 76.5% or 82.4% and specificity of 97.3%. For the ulnar nerve, the cut-off point was a VAI of less than 50%, which sensibility of 58.8% and specificity of 97.3% or 100%. The VAI from the median nerve had a poor performance and its use could not be recommended. The VAIs from proximal radial, distal radial and ulnar nerves had better specificities compared to the most used clinical criterion: absence of biceps function at three months of age. The VAIs sensitivities from axillary, musculocutaneous, proximal radial and distal radial nerves were equivalent to the clinical criterion. The use of motor conduction studies between 10 and 60 days of age yielded an earlier and more specific prognostic estimation than the clinical criterion, and could be used for indication of surgery in these patients.
12

A role for potassium channels in sensory signaling in the mouse inner ear /

Risner, Jessica Ruth. January 2008 (has links)
Thesis (Ph. D.)--University of Virginia, 2008. / Includes bibliographical references. Also available online through Digital Dissertations.
13

Control of multistability in neural feedback systems with delay /

Foss, Jennifer M. January 1999 (has links)
Thesis (Ph. D.)--University of Chicago, Committee of Neurobiology, December 1999. / Includes bibliographical references. Also available on the Internet.
14

Avaliação prognóstica de pacientes com plexopatia braquial obstétrica: comparação entre a avaliação clínica e o estudo da condução motora / Prognostic evaluation of patients with obstetric brachial plexopathy: value of motor nerve conduction studies compared to the clinical evaluation.

Carlos Otto Heise 22 August 2007 (has links)
O desenvolvimento de um método eficiente de avaliação prognóstica precoce seria de grande utilidade na seleção de lactentes com plexopatia braquial obstétrica para cirurgias de reconstrução do plexo braquial. Realizamos estudos de condução motora em 54 pacientes entre 10 e 60 dias de vida. Foram comparadas lado a lado as amplitudes dos potenciais de ação musculares compostos dos nervos axilar (músculo deltóde), musculocutâneo (músculo bíceps), radial proximal (músculo tríceps), radial distal (músculo extensor comum dos dedos), mediano (eminência tenar) e ulnar (eminência hipotenar). A relação entre a amplitude do potencial motor do lado lesado sobre o lado são foi chamada de Índice de Viabilidade Axonial (IVA), sendo este calculado tanto a partir da amplitude negativa como da amplitude pico-a-pico. Os pacientes foram seguidos clinicamente e classificados em três grupos: Grupo A, com recuperação total até os seis meses de vida; Grupo B, recuperação satisfatória até os doze meses de vida, e Grupo C, recuperação insatisfatória até os doze meses de vida. Analisamos a curva ROC (Receive Operator Characteristic Curve) de cada IVA para definir o melhor ponto de corte para detecção dos pacientes do Grupo C (mau prognóstico). Para o nervo axilar, o ponto de corte ideal foi IVA menor que 10%, com sensibilidade de 88,2% e especificidade de 89,2% ou 91,9%. Para o nervo musculocutâneo, o ponto de corte foi a ausência de potencial de ação motor, com sensibilidade de 88,2% e especificidade de 73,0%. Para o nervo radial proximal, o ponto de corte foi IVA menor que 20%, com sensibilidade de 82,4% ou 94,1% e especificidade de 97,3% ou 100%. Para o nervo radial distal, o ponto de corte foi IVA menor que 50%, com sensibilidade de 76,5% ou 82,4% e especificidade de 97,3%. Para o nervo ulnar, o ponto de corte foi IVA menor que 50%, com sensibilidade de 58,8% e especificidade de 97,3% ou 100%. O IVA do nervo mediano teve um desempenho ruim e seu uso não pode ser recomendado. Os IVAs dos nervos radial proximal, radial distal e ulnar apresentaram maior especificidade do que o critério clínico mais utilizado para a avaliação prognóstica, ou seja, ausência de função bicipital aos três meses de vida. A sensibilidade dos IVAs dos nervos axilar, musculocutâneo, radial proximal e radial distal foram equivalentes à do critério clínico. A utilização do estudo de condução motora entre 10 e 60 dias de vida forneceu uma avaliação prognóstica mais precoce e mais específica do que o critério clínico, podendo ser utilizada para indicação cirúrgica destes pacientes. / Early prognostic assessment of obstetric brachial plexopathies would be a major step for rational selection of infants for brachial plexus surgery. We performed nerve conduction studies in 54 patients from 10 to 60 days of life. We compared sideto-side the compound muscle action potentials amplitudes from the axillary (deltoid muscle), musculocutaneous (biceps), proximal radial (triceps), distal radial (extensor digitorum communis), median (thenar eminence) and ulnar nerves (hypothenar eminence). The ratio between the amplitude of the affected limb and that of the healthy side was called Viability Axonal Index (VAI), which was calculated using both the negative and the peak-to-peak amplitudes. The patients were followed-up and classified in three groups: Group A, with full recovery at six months of age; Group B, with satisfactory recovery at twelve months of age, and Group C, with poor recovery at twelve months of age. We analyzed the ROC (Receive Operator Characteristic) curve of each VAI to define the best cut-off point for detection of Group C patients (bad prognosis). The best cut-off point for the axillary nerve was a VAI of less than 10%, whith sensibility of 88.2% and specificity of 89.2% or 91.9%. For the musculocutaneous nerve, the cut-off point was an absent motor action potential, with sensibility of 88.2% and specificity of 73.0%. For the proximal radial nerve, the cut-off point was a VAI of less than 20%, with sensibility of 82.4% or 94.1% and specificity of 97.3% or 100%. For the distal radial nerve, the cut-off point was a VAI of less than 50%, with sensibility of 76.5% or 82.4% and specificity of 97.3%. For the ulnar nerve, the cut-off point was a VAI of less than 50%, which sensibility of 58.8% and specificity of 97.3% or 100%. The VAI from the median nerve had a poor performance and its use could not be recommended. The VAIs from proximal radial, distal radial and ulnar nerves had better specificities compared to the most used clinical criterion: absence of biceps function at three months of age. The VAIs sensitivities from axillary, musculocutaneous, proximal radial and distal radial nerves were equivalent to the clinical criterion. The use of motor conduction studies between 10 and 60 days of age yielded an earlier and more specific prognostic estimation than the clinical criterion, and could be used for indication of surgery in these patients.
15

Evaluation of the effect of tooth movement on the development of diabetes-induced neuropathy in rats = Avaliação do efeito da movimentação ortodôntica no desenvolvimento de neuropatia decorrente do diabetes induzido em ratos / Avaliação do efeito da movimentação ortodôntica no desenvolvimento de neuropatia decorrente do diabetes induzido em ratos

Freitas, Fabiana Furtado, 1988- 24 August 2018 (has links)
Orientador: Juliana Trindade Clemente Napimoga / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T14:35:21Z (GMT). No. of bitstreams: 1 Freitas_FabianaFurtado_M.pdf: 645432 bytes, checksum: e82ee77ed413f662feeacfa6a76c4c23 (MD5) Previous issue date: 2014 / Resumo: O diabetes induz resposta inflamatória acentuada resultando em maior movimentação dental por dispositivos ortodônticos. Sendo assim, este estudo teve como objetivo avaliar se o aumento da resposta inflamatória, decorrente do tracionamento dental por um dispositivo ortodôntico, induzido pelo diabetes altera a excitabilidade neuronal no gânglio trigeminal. Para este estudo foram utilizados ratos Wistar (±150 g, n= 4-6/grupo) tratados com injeção intraperitoneal de tampão citrato (veículo; Normoglicêmicos ¿ NG), estreptozotocina 75 mg/kg (Diabético ¿ DG), ou estreptozotocina 75 mg/kg + injeção subcutânea de insulina (Diabético tratado com insulina ¿ IG). Vinte e oito dias após o tratamento foi instalado um dispositivo ortodôntico e a movimentação dentária foi avaliada nos dias 0, 1, 3, 6 ou 12. Após o tempo correspondente, os animais foram anestesiados e a maxila, gânglio trigeminal e tecido gengival removidos e submetidos à análise para quantificação da movimentação dentária e análise bioquímica (ELISA) para avaliação da liberação de glutamato, Fator de Necrose Tumoral-alfa (TNF-?), Interleucina 1-beta (IL-1?), Substância P (SP) e Peptídeo Relacionado ao Gene da Calcitonina (CGRP). Os resultados demonstraram que o diabetes aumentou significativamente o movimento dental induzido pelo tracionamento ortodôntico nos dias 1, 3 e 6 quando comparado aos animais NG e IG (p<0.05: Two-way ANOVA, Teste de Bonferroni). Corroborando com esses resultados, os animais DG demonstraram maior liberação de TNF-? e IL-1? no tecido gengival em relação aos animais NG e IG (p<0.05). No entanto, apesar do acentuado processo inflamatório nos animais DG, a liberação de glutamato (gânglio trigeminal), SP e CGRP (tecido gengival) foi significativamente reduzida (p<0.05). Os resultados sugerem que a ativação neuronal no gânglio trigeminal é reduzida no diabetes / Abstract: Diabetes is known to result in a greater inflammatory response that in turn accentuated orthodontic tooth movement. Thus, this study aimed to evaluate if the higher inflammatory response induced by the orthodontic tooth movement in diabetic animals changes the neuronal excitability in the trigeminal ganglia. For that, Wistar rats (± 150 g, n=4-6/group) were treated with an intraperitoneal injection of citrate buffer (vehicle; Normoglycemic ¿ NG), streptozotocin 75 mg/kg (Diabetic ¿ DG) or streptozotocin 75 mg/kg + subcutaneous injection of insulin (Diabetic treated with insulin ¿ IG). Twenty-eight days after the treatment, an orthodontic appliance was placed and the tooth movement was evaluated at days 0, 1, 3, 6 and 12. After the corresponding time, the animals were terminally anesthetized and their maxillae, trigeminal ganglia and gingival tissue were removed and submitted to analyze the amount of tooth movement and biochemical analysis (ELISA) to measure the release of glutamate, Tumor Necrose Factor-alpha (TNF-?), Interleukin 1-beta (IL-1?), Substance P (SP) and Calcitonin Gene-Related Peptide (CGRP). The results demonstrated that diabetes accentuated orthodontic tooth movement at days 1, 3 and 6 when compared with NG and IG (p<0.05: Two-way ANOVA, Bonferroni¿s test). Corroborating these results, DG rats demonstrated higher release of TNF-? and IL-1? than that observed for the NG and IG rats (p<0.05). Although the greater inflammatory response induced in DG rats, the release of glutamate, SP and CGRP were significantly reduced (p<0.05). The results suggest that neuronal activation in trigeminal ganglia is reduced in diabetes / Mestrado / Odontopediatria / Mestra em Odontologia
16

Neuron-glial interactions in dendrite growth

Le Roux, Peter David January 1995 (has links)
Interactions between neurons and glia occupy a central role in many aspects of development, maintenance, and function of the central nervous system (CNS). A fundamental event in CNS development is the elaboration of two distinct neuronal processes, axons and dendrites. The overall aim of this research was to characterize the interactions between central nervous system neurons and astroglial cells that regulate dendrite growth from cerebral cortical neurons. Embryonic (E18) mouse cerebral cortical neurons were cocultured with early postnatal (P4) rat astroglia derived from cerebral cortex, retina, olfactory bulb, mesencephalon, striatum and spinal cord. Axon and dendrite outgrowth from isolated neurons was quantified using morphological and double-labeling immunohistochemical techniques at 18 hours and 1, 3 and 5 days in vitro. Neurons initially extended the same number of neurites, regardless of the source of glial monolayer; however, astroglial cells differed in their ability to maintain primary dendrites. Homotypic cortical astroglia maintained the greatest number of primary dendrites. Astroglia derived from the olfactory bulb and retina maintained intermediate numbers of dendrites, whereas only a small number of primary dendrites were maintained by astroglia derived from striatum, spinal cord or mesencephalon. Initially longer axons were observed from neurons grown on astroglia that did not maintain dendrite number. After 5 days in vitro, axon growth was similar on the various monolayers, total primary dendrite outgrowth, however, was nearly threefold greater on astroglia derived from the cortex, retina and olfactory bulb than on astroglia derived from mesencephalon, striatum or spinal cord. This effect was principally on the number of primary dendrites rather than the elongation of individual dendrites and was independent of neuron survival. Similar morphological differences were observed after 5 days in vitro when cortical neurons were grown on polylysine in either a noncontact coculture system where astroglia continuously conditioned the culture medium or in astroglial conditioned medium. Preliminary biochemical analysis of the medium conditioned by cortical astroglia using heat and trypsin degradation, ultracentrifugation, dialysis, and heparin affinity chromatography suggested that a heparin binding protein with a molecular weight between 10 and 100kDa may be responsible for astroglial mediated dendrite growth. Neurons that were grown in medium conditioned by either mesencephalic or cortical astroglia for the first 24 hours followed by culture medium from astroglia of the alternate source for 4 days in vitro, confirmed that astroglia maintained, rather than initiated, the outgrowth of the primary dendritic arbor. In the next series of experiments, E18 mouse cortical neurons were cocultured with neonatal (P4) or mature (P12) rat astroglia derived from cortex and mesencephalon or astroglia derived from P4 and P12 lesioned cortex. After 5 days in vitro, the maturational age of astroglia did not appear to alter the extent of primary dendrite growth; instead dendrite growth reflected the region of the CNS from which the astroglia were derived. By contrast, a reduced ability to support axon growth from mouse cortical neurons in culture was observed on astroglia derived from mature rat cortex or mesencephalon. Reactive astroglia demonstrated similar neurite supporting characteristics to mature astroglia and were able to maintain dendrite growth, principally primary dendrite number. Axon elongation, however, was reduced on both neonatal and mature reactive astroglia. Neuron survival did not correlate with the ability of the various astroglia to support process outgrowth. Collectively these results indicate: 1) neuron-glial interactions are critical for the regulation of process outgrowth from embryonic cortical neurons in vitro, 2) axon and dendrite growth appear to be differently controlled by astroglia, 3) CNS astroglia demonstrate regional differences in maintaining, but not initiating growth of the primary dendritic arbor, 4) this effect may be due, in part, to release of a diffusible heparin binding protein factor, and 5) mature and reactive astroglia support primary dendrite, but limited axon growth. We propose therefore that the local astroglial environment maintains primary dendrite growth from neurons until synaptic contacts can be established. A mechanism that maintains the primary dendritic arbor and allows separate regulation of axon and dendrite growth, prior to the arrival of afferents, may be critical for establishing appropriate and specific synaptic connections. These findings have important implications in understanding development and function of the mammalian central nervous system and may lead to novel strategies for intervention in acute and chronic neurological disorders.
17

Nav1.1 and Nav1.6: electrophysiological properties, epilepsy-associated mutations and therapeutic targets

Patel, Reesha Rajni 25 May 2016 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / Voltage-‐gated sodium channels (VGSCs) are critical for the initiation and propagation of electrical signals in neurons; consequently they are significant regulators of neuronal excitability. They are exquisitely tuned and aberrations in their activity can lead to pathophysiological conditions. This dissertation highlights the roles of two prominent brain isoforms of VGSCs, Nav1.1 and Nav1.6. These isoforms have distinct localization in the brain. Specifically, Nav1.1 is predominantly expressed in the soma and proximal axon initial segment (AIS) of GABAergic neurons, while Nav1.6 is found at the distal AIS and nodes of Ranvier of both GABAergic and excitatory neurons. Several mutations have been identified in Nav1.1 and recently mutations in Nav1.6 have been discovered in patients with distinct epileptic phenotypes that respond poorly to current anti-epileptics. There is a need to better understand mechanistically how mutations in these channel isoforms lead to epilepsy in order to identify more efficacious treatment strategies. Therefore, the aims of this dissertation were to 1) examine the differential biophysical properties of Nav1.1 and Nav1.6, 2) determine the biophysical consequences of epilepsy-­associated mutations in Nav1.1 and Nav1.6 and examine the effects of cannabinoids on wildtype and mutant channel activity and 3) test the effects of selective inhibition of Nav1.1 versus Nav1.6 on epileptiform activity. To address these aims, whole­‐cell electrophysiology and mutlielectrode array recordings were used. The results demonstrate that 1) Nav1.1 and Nav1.6 have important differences in their biophysical properties that may be important in the fine­‐tuning of neuronal excitability, 2) epilepsy-­‐associated mutations in Nav1.1 and Nav1.6 alter several biophysical properties of the channels but have differential effects on resurgent current generation suggesting a divergence in the mechanism by which they induce epileptogenesis and cannabidiol can inhibit aberrant channel activity and reduce neuronal excitability and 3) pharmacological inhibition of Nav1.6, but not Nav1.1, abolishes epileptiform activity. Overall, this dissertation provides insight into the distinct contributions of Nav1.1 and Nav1.6 to physiological and pathophysiological firing activity and their ability to be targeted for therapeutic purposes. This knowledge is critical for understanding the potential role of VGSCs in epilepsy syndromes and identifying possible drug targets for more efficacious treatment strategies.
18

The Role of Heterogeneity in Rhythmic Networks of Neurons

Reid, Michael Steven 02 January 2007 (has links)
Engineers often view variability as undesirable and seek to minimize it, such as when they employ transistor-matching techniques to improve circuit and system performance. Biology, however, makes no discernible attempt to avoid this variability, which is particularly evident in biological nervous systems whose neurons exhibit marked variability in their cellular properties. In previous studies, this heterogeneity has been shown to have mixed consequences on network rhythmicity, which is essential to locomotion and other oscillatory neural behaviors. The systems that produce and control these stereotyped movements have been optimized to be energy efficient and dependable, and one particularly well-studied rhythmic network is the central pattern generator (CPG), which is capable of generating a coordinated, rhythmic pattern of motor activity in the absence of phasic sensory input. Because they are ubiquitous in biological preparations and reveal a variety of physiological behaviors, these networks provide a platform for studying a critical set of biological control paradigms and inspire research into engineered systems that exploit these underlying principles. We are directing our efforts toward the implementation of applicable technologies and modeling to better understand the combination of these two concepts---the role of heterogeneity in rhythmic networks of neurons. The central engineering theme of our work is to use digital and analog platforms to design and build Hodgkin--Huxley conductance-based neuron models that will be used to implement a half-center oscillator (HCO) model of a CPG. The primary scientific question that we will address is to what extent this heterogeneity affects the rhythmicity of a network of neurons. To do so, we will first analyze the locations, continuities, and sizes of bursting regions using single-neuron models and will then use an FPGA model neuron to study parametric and topological heterogeneity in a fully-connected 36-neuron HCO. We found that heterogeneity can lead to more robust rhythmic networks of neurons, but the type and quantity of heterogeneity and the population-level metric that is used to analyze bursting are critical in determining when this occurs.
19

Amplitudskillnader vid antidrom och ortodrom nervimpulsmätning / Differences of amplitude in antidrome and orthodrome nerve conduction studies

Nilsson, Magdalena January 2021 (has links)
Bakgrund: Det perifera nervsystemets axon utgår från cellkroppar i ryggmärg eller hjärna och går ut till kroppens perifera delar. Det perifera nervsystemet undersöks med hjälp av elektroneurografi. Elektroneurografi kan utföras antingen antidromt, där mätningen sker i motsatt riktning till nervimpulsens naturliga, eller ortodromt, där nervimpulsmätningen sker i nervens naturliga riktning. Vid elektroneurografi används den nervledningshastighet, amplitud och kurvformation som undersökningen resulterar i för att sätta en diagnos. Studien syftade till att undersöka om det förelåg signifikant sensorisk amplitudskillnad beroende på om antidrom eller ortodrom elektroneurografi användes genom att undersöka nervus medianus och nervus ulnaris, detta för att bedöma om den metod som använts vid framtagandet av referensvärdena har betydelse.  Material &amp; Metod: 33 neurologiskt friska testindivider i åldrarna 18–80 år deltog i studien. Nerverna stimulerades i handledsnivå och registrering gjordes i fingrarna vid ortodrom elektroneurografi, det omvända gjordes vid antidrom elektroneurografi. Parat t- test användes. Signifikansnivån (α) sattes till 0,05 och normalfördelning ansågs föreligga då median och medelvärde hade en differens på ≤5. Resultat: Det fanns en signifikant amplitudskillnad mellan de båda metoderna vid samtliga mätningar.  Diskussion: Referensvärdena bör baseras på samma metod som kliniken använder för att undvika felaktiga positiva eller negativa diagnoser. / Background: The peripheral nervous system (PNS) goes from the soma in the spinal cord or brain out to the peripheral body parts. The PNS is studied using electroneurography. Electroneurography can be performed either by an antidrome method, which measures against the nerve impulses natural direction, or with an ortodromic method, in which the nerve impulses are measured in its natural direction. In electroneurography the nerve conduction velocity, amplitude and formation are used to make a diagnosis. The aim of the study was to examine if there was a significant difference in sensory amplitude when using an antidrome method compared to an ortodrome method by examining the median nerve and the ulnar nerve, this to be able to determine if the method used to achieve the reference values matters. Materials &amp; Method: 33 neurologically healthy test subjects in the ages 18–80 participated in the study. The nerves were stimulated at the wrist and the registrating electrode was positioned on the fingers by the orthodromic method and the other way around by the antidromic method. Paired t- test was used. The level of significance (α) was placed at 0,05. The data was considered to be normally distributed when the median and mean had a difference of ≤5. Results: There were a significant difference in amplitudes in all of the measurements.  Discussion: The reference values should be produced using the same method that is used in the clinic to avoid misdiagnosis.
20

Regeneração do ramo mandibular do nervo facial de ratos após a implantação de células multipotentes do estroma mesenquimal indiferenciadas e diferenciadas in vitro que  apresentam fenótipo de células de Schwann / Regenereation of the mandibular branch of rats\' facial nerve regenereation after implanting undifferenciated mesenchymal stromal multipotent cells and differenciated Schwann-like cells in vitro

Salomone, Raquel 09 October 2012 (has links)
INTRODUÇÃO: O nervo facial desempenha um papel importante em diversas funções fisiológicas no organismo, no entanto, distúrbios funcionais desse nervo podem também afetar a psique do indivíduo, provocando mudanças significativas na autoimagem, interferindo no rendimento profissional e piorando a qualidade de vida. Lesões graves do nervo facial (neurotmeses) mesmo quando tratadas precocemente apresentam resultados funcionais pobres. Com a recente descoberta das células-tronco, as células multipotentes do estroma mesenquimal indiferenciadas (CMEMi) ou diferenciadas em células com fenótipo de células de Schwann (CMEMd) podem ser uma alternativa melhor para o tratamento de lesões graves do nervo facial. OBJETIVOS: Avaliar a melhora funcional e histológica do ramo mandibular do nervo facial após neurotmese e implantação das CMEMi e CMEMd. MÉTODOS: Em 48 ratos Wistar realizou-se a neurotmese do ramo mandibular direito do nervo facial com a formação de um hiato de 3mm e a tubulização (conduíte de silicone) da região do nervo lesada. Foram criados quatro grupos de acordo com o método de reparo: conduíte de silicone vazio (grupo A, grupo controle); conduíte de silicone com gel acelular (grupo B); conduíte de silicone com gel acelular e CMEMi (grupo C), e conduíte de silicone com gel acelular e CMEMd (grupo D). Um quinto grupo, grupo N, foi criado a partir de segmentos do nervo normal para a avaliação histológica. Os resultados funcionais foram avaliados com o estudo de condução nervosa e os histológicos por avaliação qualitativa e quantitativa dos segmentos proximais e distais. RESULTADOS: Na avaliação funcional, após 6 semanas, os grupos C e D apresentaram amplitudes maiores que os grupos A e B (p<0,001). O grupo C apresentou duração menor que os grupos A, B e D (p<0,001). Na avaliação qualitativa dos segmentos proximais, houve pouca diferença entre os grupos, já nos segmentos distais, as diferenças dos grupos A e B em relação aos grupos C e D foram bem evidentes, no entanto, em ambos os segmentos, o grupo C foi o que mais se aproximou do nervo normal. Na avaliação histológica quantitativa do segmento proximal, não houve diferença no número total e na densidade axonal entre os grupos (p0,169), somente nos diâmetros axonais dos grupos A e B quando comparados ao nervo normal (p<0,001). No segmento distal, o número e a densidade axonal do grupo C foram maiores que os do grupo A e B (p=0,001) e iguais as do grupo D (p=0,711), porém, em todos os grupos, número e a densidade axonal foram menores que do grupo N (p0,003). Não houve diferença na média dos diâmetros entre os grupos operados (p0,007), somente quando comparados com o grupo N (p<0,001). CONCLUSÕES: As CMEMi assim como as CMEMd beneficiaram a regeneração do ramo mandibular do nervo facial de ratos Wistar, contudo, as CMEMi apresentaram resultados funcionais e histológicos melhores que as CMEMd / INTRODUCTION: Facial nerve performs an important function in different physiological activities in the organism, however, functional disturbances of such nerve may also attack a persons mind, causing expressive changes in their self-image, interfering in professional life and aggravating their quality of life. Severe lesions in the facial nerve (neurotmesis) present poor functional results even when early treated. With recent discovering of the stem cells, undifferentiated multipotent stem cell (uMSC) from mesenchymal stroma or differentiated to Schwann cell-like (dMSC) can be a better perspective to treat severe lesion of the facial nerve. OBJECTIVES: The objective of this study is to evaluate the functional and histological improvement of the mandibular branch after neurotmesis and implantation of the uMSC and dMSC. METHODS: The neurotmesis of the right mandibular branch of the facial nerve with a 3mm gap formation and tubulization (silicone tubing) of the wounded nerve area was performed in 48 Wistar rats. Four groups were divided according to the restoration method: empty silicone tubing (group A, control group); silicone tubing with non-cell gel (group B); silicone tubing with non-cell gel and uMSC (group C) and silicone tubing with non-cell gel and dMSC (group D). A fifth group (N) was created from the normal nerve segments to perform histological evaluation. The nerve conduction study evaluated the functional results; quantity and quality evaluation of the distal and proximal segment evaluated the histological results. RESULTS: After six weeks, regarding functional evaluation, groups C and D presented larger amplitude than groups A and B (p<0.001). Group C presented lesser duration than groups A, B and D (p<0.001). There was little difference among the groups in the quality evaluation of the proximal segments; on the other hand, the differences in groups A and B in relation to groups C and D were quite expressive in the distal segments. However, group C, in both segments, was the one that came closer to the normal nerve. Regarding quantity histological evaluation of the proximal segment, there was no difference in the total number and in the axonal density among the groups (p0.169); there was difference only in the axonal diameters in groups A and B when compared to normal nerve (p<0,001). Regarding distal segment, axonal density and number, in group C, were higher than in group A and B (p=0.001) and the same as in group D (p=0,711), but number and axonal density were lesser than in group N (p0,003). There was no difference in the diameter average among the operated groups (p0.007), when only compared to group N (p<0.001). CONCLUSION: Both uMSC and dMSC benefited regeneration of the mandibular branch of the facial nerve in Wistar rats, although uMSC presented better functional and histological results

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