For many years, it has been known that Rheumatoid arthritis (RA) is a negative risk factor for the development of Alzheimer’s disease (AD). It has been commonly assumed that RA patients’ usage of non-steroidal anti-inflammatory drugs (NSAIDs) have helped prevent the onset and progression of AD pathogenesis. Furthermore, experiments in animal models of Alzheimer’s disease have looked to inhibit inflammation, and have demonstrated some efficacy against AD-like pathology in these models. Thus many NSAID clinical trials have been performed over the years, but all have proven unsuccessful in AD patients. This suggests that intrinsic factors within RA pathogenesis itself may underlie RA’s protective effect. My dissertation research goal was to investigate this inverse relationship between RA and AD, in order to more precisely pinpoint critical events in AD pathogenesis toward developing therapeutic strategies against AD. It seemed improbable that any secreted factors, produced in RA pathogenesis, could maintain high enough concentrations in the circulatory system to cross the blood brain barrier and inhibit AD pathogenesis, without affecting all other organ systems. It did seem possible that the leukocyte populations induced in RA, could traverse the circulatory system, extravasate into the brain parenchyma, and impede or reverse AD pathogenesis. We thus investigated the colony-stimulating factors, which are up-regulated in RA and which induce most of RA’s leukocytosis, on the pathology and behavior of transgenic AD mice. We found that G-CSF and more significantly, GM-CSF, reduced amyloidosis throughout the treated brain hemisphere one week following bolus intrahippocampal administration into AD mice. We then found that 20 days of subcutaneous injections of GM-CSF (the most amyloid-reducing CSF in the bolus experiment) significantly reduced brain amyloidosis and completely reversed cognitive impairment in aged cognitively-impaired AD mice, while increasing hippocampal synaptic area and microglial density. These findings, along with two decades of accrued safety data using Leukine, the recombinant human GM-CSF analogue, in elderly leukopenic patients, suggested that Leukine should be tested as a treatment to reverse cerebral amyloid pathology and cognitive impairment in AD patients. It was also implied that age-related depressed hematopoiesis may contribute to AD pathogenesis.

Diss. (sammanfattning) Umeå : Umeå universitet, 2006. / Härtill 4 uppsatser.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2016-07-29T18:01:25Z No. of bitstreams: 2 Dissertação - Sarah Buzaim Lima - 2014.pdf: 1725548 bytes, checksum: 3cc0f75bc25a3e6588ba134aa819f252 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2016-07-29T18:02:58Z (GMT) No. of bitstreams: 2 Dissertação - Sarah Buzaim Lima - 2014.pdf: 1725548 bytes, checksum: 3cc0f75bc25a3e6588ba134aa819f252 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-07-29T18:02:58Z (GMT). No. of bitstreams: 2 Dissertação - Sarah Buzaim Lima - 2014.pdf: 1725548 bytes, checksum: 3cc0f75bc25a3e6588ba134aa819f252 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2014-08-06 / The parasitary diseases which are considered endemic in developing countries are a relevant public health problem. Around 50 million people in the world are infected by the teniasis-cysticercosis complex. Therefore, biological factors involved in the host susceptibility to parasitary diseases should be investigated due to the relevance of these infections in public health both in Brazil and in the world. As demonstrated by the literature, Interleukin-4, the main Th2 cytokine, has an important role in the immune response against parasites. The aim of this study was to evaluate the role of this cytokine in the subcutaneous cysticercosis pathogenesis through the comparison of the inflammatory responses in conventional BALB/C mice infection and in Interleukin-4 deficient BALB/C mice (IL-4 KO). An experimental model of subcutaneous infection with Taenia crassiceps cysticerci was used and macroscopic and microscopic parameters of the injury, cytokines profiles in splenocytes cultures from the infected animals from both types of BALB/c mice were evaluated to compare the local and systemic inflammatory response to the infection. During the experimental days the development of the chronic granulomatous inflammatory response was observed in the conventional animals with presence of macrophagic and lymphoplasmocytic inflammatory infiltrate and in the IL-4-KO animals with macrophages and polymorphonuclear cells in the inflammatory infiltrate. Conventional animals presented a mixed immune response pattern with an initial increase of IFNγ, which a Th1 cytokine, and evolved to chronicity with predominance of Th2 response and presence of IL-10 which modulates the immune response and favors the parasite infection. In the IL-4-KO animals it was possible to observe a partial destruction of the parasites in the first days of infection with increase in the Interferon gamma (IFNγ) production which is part of a Th1 accentuated response also the co-expression of IL-10 in these animals inhibited the accentuated Th1 response and contributed to the persistence of the infection. Fibrosis and tissue repair were not compromised in these animals. Furthermore, infected IL-4-KO animals presented a spontaneous production of IL-13 in higher concentrations than the conventional animals at 30 days of infection which contributed to the role of the Th2 immune response against the infection. The IL-4 deficiency directed the inflammation towards a greater microbicidal potential, partial destruction of the parasites in the first days of infection and significant reduction of eosinophils. / As parasitoses, consideradas endêmicas em países em desenvolvimento, são um problema relevante de saúde pública. Cerca de 50 milhões de indivíduos no mundo estão infectados pelo complexo teníase-cisticercose. Portanto, fatores biológicos envolvidos na suscetibilidade do hospedeiro frente às parasitoses devem ser investigados, dada a relevância dessas infecções para a saúde pública no Brasil e no mundo. Como demonstrado na literatura, a Interleucina-4, principal citocina da resposta Th2, tem um importante papel na resposta imune contra parasitos. O objetivo deste estudo foi avaliar a participação desta citocina na patogênese da cisticercose subcutânea comparando-se a resposta inflamatória resultante da infecção em camundongos BALB/c convencionais e BALB/c deficientes para o gene da Interleucina-4 (IL-4-KO). Utilizando um modelo experimental de infecção no subcutâneo com cisticercos de Taenia crassiceps, foram avaliados parâmetros macroscópicos e microscópicos da lesão e perfil de citocinas em cultura de esplenócitos dos animais, visando caracterizar e comparar a resposta inflamatória local e sistêmica na infecção. Observou-se durante os dias experimentais o desenvolvimento de resposta inflamatória crônica granulomatosa nos animais convencionais com presença de infiltrado inflamatório macrofágico e linfoplasmocitário, e nos IL-4-KO, macrofágico e polimorfonuclear. Animais convencionais apresentaram um padrão de resposta misto, com produção inicial aumentada de Interferon gama (IFNγ) - resposta Th1, que evoluiu para a cronicidade com uma resposta Th2 predominante e presença de IL-10, modulando a resposta inflamatória e favorecendo a instalação do parasito. Nos animais IL-4-KO observou-se destruição parcial dos parasitos já nos primeiros dias de infecção, com aumento da produção de IFNγ, resposta Th1 mais acentuada; a co-expressão de IL-10 nesses animais inibiu a resposta Th1 acentuada e contribuiu para persistência da infecção. Fibrose e reparação tecidual não estiveram comprometidas durante os dias experimentais. Além disso, animais IL-4-KO infectados apresentaram produção espontânea de IL-13 maior que os convencionais aos 30 dias de infecção, contribuindo para participação da resposta Th2 na infecção. A deficiência de IL-4 direcionou a inflamação para um maior potencial microbicida, destruição parcial dos parasitos já nos primeiros dias de infecção, e redução significativa de eosinófilos.

O objetivo deste estudo foi avaliar a resposta do tecido conjuntivo subcutâneo de camundongos isogênicos após o uso da Terapia Fotodinâmica antimicrobiana (aPDT), utilizando dois fotossensibilizadores, Derivado fenotiazínico (Helbo Blue) e Curcumina, em diferentes tempos de aplicação de lasers (30 segundos, 1 minuto ou 2 minutos). Foram utilizados 141 camundongos isogênicos da linhagem BALB/c cujo tecido conjuntivo subcutâneo foi exposto aos dois fotossensibilizadores, e em seguida irradiado com laser diodo no grupo do Derivado Fenotiazínico e ao LED no grupo da Curcumina. Para cada fotossensibilizador foram utilizados três tempos de irradiação: 30 segundos, 1 minuto e 2 minutos. Ao final de cada um dos períodos experimentais (7, 21 e 63 dias), uma porção do tecido conjuntivo subcutâneo da área do centro da área em que foi aplicada a aPDT foi removida e submetida ao processamento histotécnico de rotina. Foi realizada a descrição do processo inflamatório de forma qualitativa e semi-quantitativa (por meio de escores). Adicionalmente, foi realizada a marcação imunohistoquímica para neutrófilos e macrófagos. Os dados numéricos foram analisados por meio do programa estatístico Sigma Plot 12.0®, utilizando o teste não paramétrico de Kruskal-Wallis, seguido pelo Pós-teste de Dunn, quando houve diferença significativa entre os grupos. O nível de significância adotado foi de 5%. Foi possível observar que, com relação aos parâmetros fibrosamento, espessura e infiltrado inflamatório, no período inicial de 7 dias, as alterações teciduais foram pequena magnitude. No período de 21 dias, apenas o parâmetro infiltrado inflamatório apresentou pequenas variações entre os grupos. No período final de 63 dias, a compatibilidade tecidual foi observada para os dois fotossensibilizadores (Derivado Fenotiazínico e Curcumina) que não apresentaram diferenças significativas nos parâmetros avaliados, independentemente do tempo de aplicação do laser. / The aim of this study was to evaluate the response of subcutaneous connective tissue of isogenic mice after Antimicrobial Therapy (aPDT), using two photosensitizers, Phenothiazine Derivative (Helbo Blue) and Curcumin, at different laser application times (30 seconds, 1 minute or 2 minutes). One hundred and forty one (141) BALB/c isogenic mice were used, which had the subcutaneous connective tissue exposed to the two photosensitizers, followed by irradiation with laser diode to the Phenothiazine derivatives group, and LED to the Curcumin group. Three irradiation times were used to each photosensitizer: 30 seconds, 1 minute and 2 minutes. At the end of each experimental period (7, 21 and 63 days), a sample of the subcutaneous connective tissue, was collected and histotechnical processing was performed. Inflammatory process was described by qualitative and semi-quantitative analysis, using scores. Additionally, immunohistochemical technique was performed to identify neutrophils and macrophages. Data obtained was analyzed by the statistical program Sigma Plot 12.0®, using the non-parametric Kruskal-Wallis test, followed by the Dunn\'s post-test, when significant difference was found between groups. The significance level adopted was 5%. It was also possible to observe that, in relation with the parameters: fiber collagen formation, tissue thickness and inflammatory infiltrate, at the initial period of 7 days, the tissue alteration were of small significance (p<0.05). At 21-days period, only the inflammatory infiltrate parameter presented variation between groups (p<0.05). In the later time point of 63 days, it was observed tissue compatibility regarding the two photosensitizers (Phenothiazine Derivative and Curcumin) with no differences in the evaluated parameters or the laser application times.

Recentes estudos vêm demonstrando os efeitos benéficos da infiltração percutânea de dióxido de carbono em diferentes campos da Medicina, inclusive como alternativa para tratamento de depósitos localizados de gordura formados após lipoaspiração da parede abdominal. É possível que os efeitos dessa terapia encontrem-se relacionados à capacidade do método em aumentar a circulação sangüínea local, bem como aos efeitos lipolíticos do CO2 sobre adipócitos do tecido envolvido. Entretanto, até a presente data, poucos estudos avaliaram os efeitos histológicos e citométricos sobre adipócitos, presentes no tecido subcutâneo da parede abdominal. O objetivo do presente estudo foi avaliar os efeitos da infusão de gás carbônico sobre a população e morfologia de adipócitos da parede abdominal. Quinze voluntárias, com média de idade de 34 anos, foram submetidas a sessões de infusão de CO2 durante três semanas consecutivas (duas sessões por semana com intervalos de dois a três dias entre cada sessão). O volume de gás carbônico infundido por sessão, em pontos previamente demarcados, foi sempre calculado com base na superfície da área a ser tratada, com volume de gás de 250 mL/100 cm de superfície tratada. Utilizou-se As áreas foram demarcados respeitando-se o limite eqüidistante 2 cm entre elas. Em cada ponto de punção se injetou 10 mL, por sessão, mantendo-se fluxo de gás de 80 mL por minuto. Foram colhidos, por biópsia cirúrgica, fragmentos de tecido celular subcutâneo da região anterior da parede abdominal para estudo histológico antes e após tratamento. Os números e as alterações histomorfológicas nos adipócitos, tais como área, diâmetro médio, perímetro, comprimento, largura e número de adipócitos por campos de observação foram mensurados por processamento de imagem assistida por computador, utilizando-se o programa Image-Pró-plus. Os resultados encontrados antes e após a infusão de gás carbônico foram analisados por meio de teste t pareado, adotando-se nível de significância de 5% (p<0,05). Encontrou-se redução significativa nos valores das variáveis histomorfológicas mensuradas após o uso da hipercapnia tais como redução de sua área (p= 0,00001), diâmetro (p= 0,00001), perímetro (p= 0,00001), comprimento (p= 0,00001), largura (p= 0,00001), maior espaçamento entre as mesmas (p<0,0001) e menor número de adipócitos por campo (p= 0,00001). Conclui-se que existe efeito na morfologia e população dos adipócitos do tecido adiposo subcutâneo após utilização terapêutica de hipercapnia. / Recent researches have demonstrated the beneficial effects of percutaneous infiltration of carbon dioxide in different fields of medicine. Currently, this therapy proves to be an alternative for treatment of localized fat deposits formed after lipectomy of the abdominal wall. The effects appear to be related to the ability of therapy to increase local blood circulation and lipolitic effects of CO2 on tissue involved. However few studies have evaluated histological and cytometric effects on subcutaneous adipocytes tissue subjected to this new therapeutic modality. The purpose of this study was to evaluate the effects of infusion of carbon dioxide on the population and morphology of adipocytes in the abdominal wall. Fifteen volunteers were subjected to sessions of CO2 infusion for three consecutive weeks with two sessions per week at intervals of two to three days between each session. The volume of carbon dioxide infused per session, at points previously marked, was always based on the surface of the area to be treated with gas volume of 250 mL/100 cm2 of surface treated. Areas were demarcated with the limit up to 2 cm equidistant between them. At each point of puncture was injected 10mL of CO2, per session, keeping the gas flow of 80 mL/minute. Fragments of subcutaneous tissue of the anterior abdominal wall were collected by surgical biopsy for histological study before and after treatment. The numbers and histomorphological changes in adipocytes, such as area, diameter, perimeter, length, width and number of adipocytes per field of view were measured by image processing computer assisted using the program Image-Pro Plus. The results before and after the infusion of carbon dioxide were analyzed by paired t test. Significance level of 5% (p<0.05) was adopted. A significant difference was found in the values of variables measured after the use of hypercapnia as reduction of its area (p = 0,00001), diameter (p = 0.00001), perimeter (p = 0,00001), length (p = 0,00001), width (p = 0,00001), greater spacing between them and lower number of adipocytes per field (p = 0,00001). It is concluded that there is effect of adipocyte morphology and population of the subcutaneous adipose tissue after therapeutic use of hypercapnia

Les ressources marines constituent un réservoir considérable de substances actives, en particulier, de peptides bioactifs appelés cryptides. Les cryptides, qui sont initialement dissimulés au cœur des protéines, sont libérés lors de la digestion ou lors de procédés protéolytiques industriels. Ces cryptides pourraient procurer des bienfaits physiologiques ou assurer une protection contre des pathologies telles que celles du syndrome métabolique. Dans ce contexte, nous nous sommes intéressés à l’action de certains cryptides marins sur des cibles impliquées dans l’hypertension, le diabète et l’obésité. Nous avons pu mettre en évidence que certains cryptides pouvaient cibler in vitro plusieurs facteurs de risques associés au développement des anomalies du syndrome métabolique. / Marine products represent an important source of active substances, in particular bioactive peptides called cryptides. Cryptides are hidden within the sequence of a parent protein and are released during digestion or industrial proteolytic processes. These cryptides could provide physiological benefit or protection against diseases such as those of metabolic syndrome. In this context, we investigated the action of some marine cryptides on hypertension, diabetes and obesity. We demonstrated that some cryptides can target in vitro several factors associated with the development of metabolic syndrome.

Résumé: Comparées aux classiques insulines humaines régulières (IHR), les insulines analogues ultrarapides (IAUR) ont été conçues pour mieux synchroniser le pic insulinémique avec l’absorption du repas. Le progrès a été démontré chez les patients diabétiques de type 1, mais le contrôle glycémique s’est peu ou pas amélioré chez les patients diabétiques de type 2 (DT2), qu’ils soient sous IAUR ou IHR. Or ces patients constituent 75 % des utilisateurs d’insuline. L’utilité des IAUR est donc toujours débattue. La dose (donc le volume) injectée et le flot sanguin dans le tissu adipeux sous-cutané (FSTA) sont les facteurs majeurs de l’absorption de l’insuline. Les patients DT2, résistants à l’insuline, s’injectent des doses importantes et leur FSTA est de 50 à 70 % plus faible que celui des sujets sains de poids normal (PN). Nous avons montré que l’absorption sous-cutanée des IAUR est diminuée chez les sujets obèses et DT2 (ODT2) par rapport aux sujets PN, que le volume injecté avait un effet délétère additionnel et que le FSTA peut être augmenté de façon pharmacologique avec un agent vasoactif (AV) chez des sujets résistants à l’insuline. Nous suggérons que l’ajout d’un AV à une IAUR va augmenter le FSTA au site d’injection et donc améliorer sa pharmacocinétique (PK) et sa pharmacodynamie (PD). Pour vérifier cette hypothèse, nous avons 1) évalué la réponse du FSTA à 4 AV chez des sujets PN, obèses non-diabétiques et ODT2; 2) évalué la PK/PD et la biodisponibilité de l’IAUR lispro ± AV chez des sujets ODT2; et 3) caractérisé l’expression des cibles des AV dans le tissu adipeux sous-cutané chez les sujets énumérés en 1). Les 4 AV ont augmenté le FSTA des sujets ODT2, mais moins que celui des autres sujets. L’occurrence de la raréfaction et/ou dysfonction microvasculaire chez les sujets ODT2 pourrait expliquer l’hyporéactivité vasculaire aux AV testés. Le plus actif des AV chez les sujets ODT2 a été ajouté à l’IAUR lispro pour améliorer sont absorption sc. Les PK/PD ont été améliorées seulement chez les sujets ODT2 avec une hémoglobine glycosylée A1c ≥ 8 %; c’est-à-dire 4 sujets sur 8. Chez ces derniers, l’absorption de 30 U + AV a été plus rapide de 14 et 71 min à 20 et 80 % de l’aire sous la courbe totale de la lispro plasmatique, respectivement. Chez les 4 autres sujets ODT2, l’absorption de la lispro semble s’être détériorée avec l’AV. Une interaction chimique a peut-être eu lieu entre l’AV et la lispro, ce qui aurait perturbé son absorption. Selon nos résultats, le niveau de contrôle du diabète, le volume d’injection et les caractéristiques chimiques de l’AV seraient des modulateurs de l’efficacité du concept IAUR + AV. Il nous faut maintenant déterminer l’impact de ces facteurs sur la capacité d’un AV à améliorer l’absorption sc de l’IAUR chez les sujets ODT2. / Abstract: Compared to classic regular human insulin (RHI), short-acting insulin analogues were designed to better synchronize plasma insulin increase to food absorption. Although improvements were noted in subjects with type 1 diabetes, slight to no improvement in glycemic control were observed in subjects with type 2 diabetes (T2D) using SAIA instead of RHI. Nevertheless, they represent 75 % of all insulin users. Consequently, the relative useful-ness of SAIA in T2D patients is currently hotly debated. Injected volume and subcutaneous (sc) adipose tissue blood flow (ATBF) are two main factors involved in insulin absorption. In fact, T2D patients use large doses of insulin because of their resistance to insulin and have an ATBF 50 to 70 % lower than lean healthy subjects. We already showed that SAIA absorption is decreased in obese T2D (OT2D) subjects compared to normal weight healthy subjects and that volume has additional detrimental effects. We also showed that ATBF can be increased pharmacologically with vasoactive agents (VA) in healthy and insulin-resistant subjects. Then we suggest that in OT2D subjects, addition of VA to SAIA preparations will locally increase ATBF, improve insulin sc absorption (Pharmacokinetic - PK) and bioavailability, thus insulin hypoglycemic effect (Pharmacodynamic - PD). To test this hypothesis, we 1) assessed ATBF response of 4 selected VA within three experimental groups (normal weight, obese non-diabetic and OT2D subjects); 2) evaluated insulin PK/PD and bioavailability improvement in OT2D subjects after the addition of the best VA to SAIA lispro and 3) characterized expression of selected VA targets in sc adipose tissue biopsies, within equivalent experimental groups, and compared results with ATBF responses. All 4 VA were able to increase ATBF of OT2D subjects but in a less extend than other subjects. The occurrence of microvascular rarefaction and/or dysfunction in OT2D subjects can explain the hyporeactivity to tested VA. Nevertheless, one VA among others was shown more effective to increase ATBF in OT2D subjects and was then tested (mixed) with SAIA lispro. With the AV, PK/PD were improved only in OT2D subjects with A1c glycated hemoglobin ≥ 8 %; 4 subjects on 8. The sc absorption of 30 U + VA was faster by 14 and 71 min for respectively 20 and 80 % of the total area under the lispro plasmatic curve. But the sc absorption with VA appeared blunted with the other subjects. Maybe detrimental chemical interactions occurred between the VA and lispro, which could impede absorption. Our results suggest that diabetes control state, injection volume, and VA chemical characteristics influence the efficacy of our SAIA + VA concept. Further tests are needed to seize the impact of these factors on VA effectiveness in sc absorption improvement of SAIA in OT2D subjects.

Las técnicas ablativas basadas en energía por radiofrecuencia (RF) se emplean con el fin de lograr un calentamiento seguro y localizado en el tejido biológico. En los últimos años ha habido un rápido crecimiento en el número de nuevos procedimientos médicos que hacen uso de dichas técnicas, lo cual ha ido acompañado de la aparición de nuevos diseños de electrodos y protocolos de aplicación de energía. Sin embargo, existen todavía muchas incógnitas sobre el verdadero comportamiento electro-térmico de los aplicadores de energía, así como de la interacción energía-tejido en aplicaciones concretas. El principal propósito de esta Tesis Doctoral es adquirir un mejor conocimiento de los fenómenos eléctricos y térmicos involucrados en los procesos de calentamiento de tejidos biológicos mediante corrientes de RF. Esto permitirá, por un lado, mejorar la eficacia y seguridad de las técnicas actualmente empleadas en la clínica en campos tan diferentes como la cirugía cardiaca, oncológica o dermatológica; y por otro, sugerir mejoras tecnológicas para el diseño de nuevos aplicadores. La Tesis Doctoral combina dos metodologías ampliamente utilizadas en el campo de la Ingeniería Biomédica, como son el modelado computacional (matemático) y la experimentación (ex vivo e in vivo). En cuanto al área cardiaca, la investigación se ha centrado, por una parte, en mejorar la ablación intraoperatoria de la fibrilación auricular por aproximación epicárdica, es decir, susceptible de ser realizada de forma mínimamente invasiva. Para ello, se ha estudiado mediante modelos matemáticos un sistema de medida de la impedancia epicárdica como método de valoración de la cantidad de grasa previo a la ablación. Por otra parte, se ha estudiado cómo mejorar la ablación de la pared ventricular por aproximación endocárdica-endocárdica (septo interventricular) y endocárdica-epicárdica (pared libre del ventrículo). Con este objetivo, se han comparado mediante modelado por computador la eficacia de los modos de ablación bipolar y unipolar en términos de la transmuralidad de la lesión en la pared ventricular. En lo que respecta al área de cirugía oncológica, la investigación se ha centrado en la resección hepática asistida por RF. Las técnicas de calentamiento por RF deberían ser capaces de minimizar el sangrado intraoperatorio y sellar vasos y ductos mediante la creación de una necrosis coagulativa por calentamiento. Si este calentamiento se produce en las cercanías de grandes vasos, existe un problema potencial de daño a la pared de dicho vaso. En este sentido, se ha evaluado con modelos matemáticos y experimentación in vivo si el efecto del flujo de sangre dentro de un gran vaso es capaz de proteger térmicamente su pared cuando se realiza una resección asistida por RF en sus cercanías. Además, se ha realizado un estudio computacional y experimental ex vivo e in vivo del comportamiento electro-térmico de aplicadores de RF bipolares internamente refrigerados, puesto que representan una opción más segura frente a los monopolares en la medida en que las corrientes de RF fluyen casi exclusivamente por el tejido biológico situado entre ambos electrodos. Respecto al área dermatológica, la investigación se ha centrado en mejorar el tratamiento de enfermedades o desórdenes del tejido subcutáneo (tales como lipomatosis, lipedema, enfermedad de Madelung y celulitis) mediante el estudio teórico de la dosimetría correcta en cada caso. Para ello, se han evaluado los efectos eléctricos, térmicos y termo-elásticos de dos estructuras diferentes de tejido subcutáneo durante el calentamiento por RF, y se ha cuantificado el daño térmico producido en ambas estructuras tras dicho calentamiento / González Suárez, A. (2014). Computational Models and Experimentation for Radiofrequency-based Ablative Techniques [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/36502 / TESIS

In recent years, clinical studies have shown that the most effective method of treatment to reduce the incidence of sudden cardiac death in patients at increased risk of malignant arrhythmias is to provide the patient with an implantable cardioverter-defibrillator (ICD). Complications associated with the transvenous implanted system, especially lead disorders and systemic infections, and have led to the development of a so-called subcutaneous defibrillator, which is thought to minimize these complications. Despite the medical benefits of implantable defibrillator treatment, which is generally well accepted by patients, anxiety, depression, and deterioration in their quality of life have been reported in clinical trials examining patients' psychopathology and quality of life after defibrillator implantation. Methodology: The objective of the diploma thesis was to find out which group of patients better assesses the quality of life depending on the type of implanted defibrillation device (ICD and S-ICD). For the purposes of the survey, the method of quantitative research was chosen in the form of its own questionnaire survey. The questionnaire contained a total of seventeen questions in which patients evaluated quality of life in five areas. Patients who met the following criteria were included in...

Problemstellung: Die Tiergesundheit hat sich bei Milchkühen in den letzten Jahren weltweit negativ entwickelt. Wichtigster Ausdruck dafür ist die auf ca. 2,4 Jahre verkürzte Nutzungsdauer. Dabei spielt das Fettmobilisationssyndrom eine dominante Rolle. Das Fettgewebe ist nicht nur als reiner Energiespeicher, sondern als endokrines stoffwechselaktives Organ anzusehen. Untersuchungen an Menschen und Mäusen haben gezeigt, dass das Fettgewebe in Abhängigkeit von seiner Lokalisation im Körper unterschiedlich auf metabolische und hormonelle Stimuli reagiert. Es gibt Hinweise, dass auch für das Rind ähnliche Differenzen angenommen werden können. Zielstellung: Um die Eigenschaften des bovinen Fettgewebes und seine Rolle im Energiestoffwechsel besser charakterisieren zu können, war das Ziel der vorliegenden Untersuchung, die mRNA-Expressionen ausgewählter für den Fettstoffwechsel relevante Gene im bovinen Fettgewebe an verschiedenen Lokalisationen grundlegend in gesunden Rindern zu untersuchen. Material und Methoden: Die Probenentnahme erfolgte an 12 gesunden Schlachtkühen direkt nach der Tötung, die aufgrund Schwermelkbarkeit oder Unfruchtbarkeit geschlachtet wurden. Das Fettgewebe wurde aus dem Omentum majus, dem Depotfett der Niere, im kaudalen Beckendrittel (retroperitoneales Fett), dem Hüftbereich (subkutanes Fett) und dem Fett an der Herzbasis entnommen. Die Proben wurden in Flüssigstickstoff tiefgefroren, auf Trockeneis transportiert und bis zur Untersuchung bei -70°C gelagert. Die mRNA-Expression für die verschiedenen Gene (Hormonsensitive Lipase (HSL), Lipoproteinlipase (LPL), Fettsäuresynthase (FASN), Leptin, Adiponektin, Retinolbindungsprotein 4 (RBP4), Tumornekrosefaktor  (TNF) und Interleukin 6 (IL-6), Fettsäurebindungsproteine (FABP3, 4 und 5) und Glukosetransporter 4 (GLUT4)) , wurden mit einer quantitativen real time (RT)-PCR gemessen. Ergebnisse: Die mRNA-Expressionen der verschiedenen oben genannten Gene, ausgenommen IL-6 und FABP3, sind im bovinen Fettgewebe nachweisbar. Die mRNA-Expressionen unterschieden sich in den einzelnen Fettdepots nicht signifikant. Ausnahme hierbei bildete RBP4, dessen mRNA im pericardialen Fett signifikant höher exprimiert war als im subkutanen und omentalen Depot. Die mRNA-Expression des subkutanen, omentalen, perirenalen und pericardialen Fettdepots korrelierten signifikant positive untereinander. Schlussfolgerung: Die mRNA-Expressionen der in den Fettstoffwechsel involvierten und untersuchten Gene gesunder Rinder waren nachweisbar, unterschieden sich jedoch nicht signifikant von einander mit Ausnahme der RBP4 mRNA. Die positiven signifikanten Korrelationen zwischen dem subkutanen, omentalen, perirenalen und pericardialen Fettlokalisationen und gleichmäßigen Expressionen innerhalb der Gewebe deuten auf eine einheitliche Fettmetabolismus des gesamten Körpers. Verglichen mit Ergebnissen der Humanmedizin sind nur wenige Übereinstimmungen (HSL, LPL, GLUT4,TNF) zu eruieren. Weitere Studien mit gesunden Tieren im Vergleich zu erkrankten Rindern müssen klären, ob eine mögliche Verschiebung der mRNA-Konzentrationen auf das Fettmobilisationssyndrom hinweisen. / Purpose: Over the last years, the situation of animal health concerning dairy cows has developed worldwide in an adverse way. Most important indicator is the shortened useful life of approx. 2.4 years. The fat mobilization syndrome plays a dominant role in this process. Apparently, fatty tissue does not only serve as a mere energy reservoir, but also as an endocrin organ with metabolic activity. Researches on humans and mice have shown fatty tissue to react on metabolic and hormonal stimuli in different ways, depending on its body localization. There are dues to anticipate, similar differences in cattle. Objectives: In order to better characterize the attributes of bovine fatty tissue and its purpose in metabolism, the present study aims examine basically the expression of mRNA in selected genes which are important for lipid metabolism in bovine fatty tissue of different localizations in healthy cattle. Methods and material: Samples where taken from twelve carcasses of healthy dairy cows slaughtered for reason of difficult milking or infertility directly after killing. Fatty tissue was taken from omentum major, kidney capsula, caudal pelvis area (retroperiteonal fat), hip area (subcutaneous fat), and cardiac base. It was instantly quick-freezed in liquid nitrogen, put on dry ice while transporting, and stored at -70°C until analysis. The expression of mRNA of different genes (hormone-sensitive lipase (HSL), lipoproteine lipase (LPL), fatty acid synthase (FASN), fatty acid binding proteine (FABP3,4 and 5), retinol binding proteine 4 (RBP4), adiponectine, glucose transporter 4 (GLUT4), leptin, interleukin-6 (IL-6), and tumor necrosis factor a (TNFα) was measured by means of a quantitative real-time (RT)-PCR. Results: The mRNA-expressions of all these different genes except IL-6 and FABP3 were detected in bovine fatty tissue. The differences of mRNA-expression between sample localization were not statistically significant. RBP4 was excepted, which mRNA showed a significantly higher expression in pericardial fat than in subcutaneous and omental fat, respectively. The correlation between mRNA-expressions of subcutaneous, omental, pericardial and perirenal fat was significant. Conclusions: The mRNA-expression of examined genes being involved in fatty tissue metabolism, were detected in healthy cattle, but were not significantly different, except RBP4. Significantly positive correlations between subcutaneous, omental, perirenal and pericardial localization and consistent expression indicate an integrative metabolism of the whole body. Compared to results of the human medicine only few analogies (HSL, LPL, GLUT4, TNF) were found. Further studies comparing healthy and diseased cattle will have to prove, if possible displacements of the mRNA-level can indicate the fat mobilization syndrome being present.