Chan Hoi Yun. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 131-144). / Abstracts in English and Chinese. / DECLARATION --- p.i / ACKNOWLEDGMENTS --- p.ii / ABBREVIATIONS --- p.iii / ABSTRACT IN ENGLISH --- p.v / ABSTRACT IN CHINESE --- p.viii / CONTENTS --- p.xi / Chapter Chapter 1 --- Introduction / Chapter 1.1. --- Steroid Hormones --- p.1 / Chapter 1.1.1. --- Synthesis of estrogens and progesterone --- p.1 / Chapter 1.2. --- Cellular Mechanisms of Female Steroid Hormones --- p.5 / Chapter 1.2.1. --- Genomic actions of female steroid hormones --- p.5 / Chapter 1.2.2. --- Non-genomic actions of female steroid hormones --- p.7 / Chapter 1.2.3. --- Estrogen antagonists --- p.7 / Chapter 1.2.3.1. --- Classification of estrogen antagonists --- p.7 / Chapter 1.2.3.2. --- Mechanisms of estrogen antagonists --- p.9 / Chapter 1.3. --- Chronic (genomic) Effects of 17β-Estradiol and Progesterone --- p.10 / Chapter 1.3.1. --- Effects of lipid metabolism --- p.10 / Chapter 1.3.2. --- Effects on cell proliferation --- p.11 / Chapter 1.3.3. --- Effects on endothelial cells --- p.12 / Chapter 1.4. --- Acute Effects of 17β-Estradiol and Progesterone --- p.13 / Chapter 1.4.1. --- Role of endothelium in 17β-estradiol or progesterone Relaxation --- p.13 / Chapter 1.4.2. --- Involvement of plasma membrane estrogen receptors --- p.14 / Chapter 1.4.3. --- Role of Ca2+ and K+ channel in estrogen relaxation --- p.14 / Chapter 1.4.4. --- Interaction with vasoconstrictors --- p.15 / Chapter 1.4.5. --- Interaction with endothelium-dependent dilators --- p.16 / Chapter 1.4.6. --- Interaction with adrenergic response --- p.17 / Chapter 1.5. --- Clinical Studies --- p.19 / Chapter 1.6. --- Therapeutic Values of Estrogen and Progesterone --- p.20 / Chapter 1.7. --- Objectives of the Present Study --- p.22 / Chapter Chapter 2 --- Method and Materials / Chapter 2.1. --- Tissue Preparation --- p.25 / Chapter 2.1.1. --- "Preparation of the rat aorta, mesenteric artery and carotid Artery" --- p.25 / Chapter 2.1.2. --- Removal of the functional endothelium --- p.26 / Chapter 2.2. --- Organ Bath Set-up --- p.26 / Chapter 2.3. --- Force Measurement --- p.28 / Chapter 2.3.1. --- Vascular action of 17β-estradiol and progesterone --- p.29 / Chapter 2.3.1.1. --- Role of endothelium/nitric oxide in 17β-estradiol- or progesterone-induced relaxation --- p.29 / Chapter 2.3.1.2. --- Role of inducible nitric oxide in progesterone-induced relaxation --- p.30 / Chapter 2.3.1.3. --- Effect of estrogen receptor inhibitor on 17β-estradiol- induced relaxation --- p.30 / Chapter 2.3.1.4. --- Interaction between progesterone and 17β-estradiol --- p.31 / Chapter 2.3.1.5. --- Effect of 17β-estradiol on protein kinase C-mediated contraction --- p.31 / Chapter 2.3.1.6. --- Synergistic interaction between β-adrenoceptor agonists and 17β-estradiol --- p.32 / Chapter 2.4. --- Porcine Coronary Artery Experiments --- p.33 / Chapter 2.4.1. --- Vessel preparation --- p.33 / Chapter 2.4.2. --- Force measurement --- p.33 / Chapter 2.4.3. --- Experimental protocol --- p.34 / Chapter 2.4.3.1. --- Effect of physiological level of 17β-estradiol on β- adrenoceptor agonist-induced relaxation --- p.34 / Chapter 2.4.3.2. --- Effect of physiological level of 17β-estradiol on phosphodiesterase inhibitor-induced relaxation --- p.34 / Chapter 2.5. --- Ovariectomy --- p.35 / Chapter 2.5.1. --- Method of ovariectomy --- p.35 / Chapter 2.5.2. --- Preparation of blood vessels --- p.36 / Chapter 2.5.3. --- Experimental protocols --- p.38 / Chapter 2.5.3.1. --- Effect of ovariectomy on contractility of rat carotid arteries --- p.38 / Chapter 2.5.3.2. --- Effect of ovariectomy on relaxation of rat carotid arteries --- p.38 / Chapter 2.6. --- Chemicals and Solutions --- p.39 / Chapter 2.7. --- Statistical Analysis --- p.42 / Chapter Chapter 3 --- Results / Chapter 3.1. --- Role of Endothelium/Nitric Oxide in 17β-Estradiol- and Progesterone-induced Relaxations --- p.43 / Chapter 3.1.1. --- Relaxant response of 17β-estradiol --- p.43 / Chapter 3.1.2. --- Effects of inhibitors of nitric oxide activity on 17β- estradiol-induced relaxation --- p.46 / Chapter 3.1.3. --- Relaxant response of progesterone --- p.46 / Chapter 3.1.4. --- Effects of inhibitors of nitric oxide activity on progesterone-induced relaxation --- p.50 / Chapter 3.2. --- Effect of Estrogen Receptor Inhibitor on 17β-Estradiol- induced Relaxation --- p.56 / Chapter 3.3. --- Interaction between Progesterone and 17β-Estradiol --- p.56 / Chapter 3.4. --- Effect of Female Sex Steroid Hormones on Protein Kinase C-mediated Contraction --- p.59 / Chapter 3.4.1. --- Effect of 17β-estradiol on phorbol ester-induced contraction --- p.59 / Chapter 3.4.2. --- Effect of progesterone on phorbol ester-induced contraction --- p.59 / Chapter 3.5. --- Effects of β-adrenoceptor Agonists on 17β-Estradiol- induced Relaxations --- p.62 / Chapter 3.5.1. --- Effect of isoproterenol on 17β-estradiol-induced relaxation --- p.62 / Chapter 3.5.2. --- Role of endothelium/nitric oxide on the isoproterenol potentiation of 17β-estradiol-induced relaxation --- p.63 / Chapter 3.5.3. --- Role of cyclic AMP on isoproterenol-enhancement of 17β- estradiol-induced relaxation --- p.69 / Chapter 3.5.4. --- Effects of β-adrenoceptor antagonists --- p.69 / Chapter 3.6. --- Effects of Physiological Concentration of 17β-EstradioI onβ-adrenoceptor Agonists-induced Relaxationsin Porcine Coronary Artery --- p.77 / Chapter 3.6.1. --- Effect of 17β-estradiol on isoproterenol-induced relaxations --- p.77 / Chapter 3.6.2. --- Effect of 17β-estradiol on fenoterol-induced relaxations --- p.11 / Chapter 3.6.3. --- Effect of 17β-estradiol on dobutamine-induced relaxations --- p.81 / Chapter 3.6.4. --- Effect of 17β-estradiol on IBMX-induced relaxation --- p.86 / Chapter 3.7. --- Effect of Ovariectomy on the Vascualr Reactivity --- p.88 / Chapter 3.7.1. --- Effect of ovariectomy on the contractile activity of rat carotid artery --- p.88 / Chapter 3.7.1.1. --- Effect of ovariectomy on phenylephrine-induced contraction --- p.88 / Chapter 3.7.1.2. --- Effect of ovariectomy on U46619-induced contraction --- p.96 / Chapter 3.7.1.3. --- Effect of ovariectomy on high K+- induced contraction --- p.102 / Chapter 3.7.1.4. --- Effect of ovariectomy on acetylcholine-induced relaxation --- p.106 / Chapter Chapter 4 --- Discussions / Chapter 4.1. --- Role of Endothelium/Nitric oxide in 17β-Estradiol- and Progesterone-induced Relaxations --- p.110 / Chapter 4.2. --- Effect of Estrogen Receptor Inhibitor on 17β-Estradiol- induced Relaxation --- p.113 / Chapter 4.3. --- Interaction between Progesterone and 17β-Estradiol --- p.114 / Chapter 4.4. --- Effects of Female Sex Steroid Hormones on Protein Kinase C-mediated Contraction --- p.115 / Chapter 4.5. --- Effects of β-Adrenoceptor Agonists on 17β-Estradiol- induced Relaxations --- p.116 / Chapter 4.6. --- Effects of 17β-Estradiol on β-Adrenoceptor Agonists- induced Relaxations in Porcine Coronary Artery --- p.121 / Chapter 4.7. --- Effect of Ovariectomy on the Vascular Reactivity --- p.125 / Chapter 4.8. --- Conclusions --- p.129 / References --- p.131 / Publications --- p.145

Objectives This thesis aimed to explore psychological factors associated with walking behaviour in patients with Peripheral Arterial Disease, within the framework of Leventhal et al’s (1998) Common-sense Model of Self-regulation of Health and Illness. The objective was to identify psychological factors which could be modified to increase walking behaviour in these patients. Method A series of three studies were conducted to achieve these aims. The first study was an exploratory qualitative study, to explore the illness and treatment beliefs and walking behaviour of patients with intermittent claudication. The second study was a cross-sectional postal questionnaire to a cohort of patients with intermittent claudication, which tested the influence of the psychological factors identified in the qualitative study, in a larger sample. The final study was a randomised controlled trial of a brief psychological intervention designed to modify the illness and walking beliefs of patients with intermittent claudication, in order to increase walking behaviour. Results Beliefs about intermittent claudication, and beliefs about walking were both found to be associated with walking behaviour in the qualitative study. The results from the cross-sectional postal questionnaire confirmed this relationship – taken as a set, illness and walking beliefs accurately predicted adherence to minimum walking levels for 93.4% of the sample. The brief psychological intervention successfully modified illness and treatment beliefs and increased walking behaviour in patients newly diagnosed with intermittent claudication. Conclusion This thesis highlights the importance of illness and walking beliefs to the walking behaviour of patients with intermittent claudication. The thesis has added to the body of knowledge about intermittent claudication, and the findings of this thesis have implications for the treatment of patients with intermittent claudication within the health service. Theoretical and clinical implications of this research are discussed.

This study investigates the clinical and major risk factor profiles in Whites, Indians and Blacks with atherosclerotic peripheral vascular disease at the Vascular Service in Durban; and compares them to that for coronary artery disease in the same race groups. The clinical profile for chronic peripheral vascular disease was established in a retrospective study of 2175 patients seen at the Vascular Service during 1981-1986. Atherosclerosis was confirmed in 1974 patients (92,3%) on the basis of clinical, doppler, angiographic and histological evidence. The disease predominantly affected the aorta and distal peripheral vessels. Extracranial cerebrovascular disease occurred less commonly in Blacks than in Whites and Indians. Occlusive disease was the most common pathological type in all race groups. Aneurysmal disease occurred mainly in the aorta with peripheral aneurysms being most common in Blacks. The disease manifested in Blacks at an . earlier age and more aggressively than in Whites and Indians. The risk factor profile for atherosclerotic peripheral vascular disease was established in a prospective study of 302 male patients consisting of 100 Whites, 97 Indians and 105 Blacks on the basis of historical, clinical and haematological data. The sample was randomly selected, and not strictly representative of the clinical pattern in the retrospective study. All patients were confirmed to have atherosclerosis on the basis of the previously mentioned criteria. Smoking was the single most common risk factor in all race groups. Hypertension occurred more commonly in Whites and Indians than in Blacks, while diabetes was commonest in Indians. Insulin resistance did not occur in Blacks, but was possibly present in Whites and Indians. Total cholesterol, LDL cholesterol and triglycerides were raised in Whites and Indians, but not in Blacks. HDL cholesterol was reduced in all 3 race groups. These findings suggest that contrary to the established view, atherosclerotic peripheral vascular disease is an established entity in Blacks seen at the Vascular Service in Durban without a concomitant increase in coronary and extracranial cerebrovascular disease. In Whites and Indians atherosclerosis occurred in all of the vascular beds. This could support the contention that in a socially developing society atherosclerosis affects the aorta and distal peripheral vessels before the coronary vascular bed. Since this occurs in the presence of normal levels of total cholesterol, LDL cholesterol and triglycerides, it does not support the contention that hypercholesterolaemic states are essential for atherosclerotic lesions to develop. On this basis it is postulated that with social transition there is a differential atherosclerotic involvement of the vascular beds due to a differential vascular susceptibility. Smoking is an important socio-environmental risk factor, while at the biochemical level a reduced HDL cholesterol and not a raised total cholesterol, LDL cholesterol or triglyceride could trigger the 'lipid pathway' in atherogenesis. It is further postulated that the differential vascular susceptibility does not exist in a fully developed society once lipid aberrations include a raised total cholesterol, LDL cholesterol and triglycerides. Insulin resistance/hyperinsulinaemia may play a role in the evolution of the disease within the coronary vascular bed. / Thesis (M.D.)-University of Natal, Durban, 1996.

Peripheral arterial disease (PAD) is a common manifestation of stenoses and occlusions of the arteries of the lower extremities. Clinically, PAD is an important effect on functional ability, and quality of life because symptomatic patients are typically able to walk less than one to three blocks before rest is required.The double product break point (DPBP), also defined as the oxygen consumption at which the first portion of nonlinear increase in rate pressure product (systolic blood pressure X heart rate) begins has been identified to determine the anaerobic threshold during exercise test. The purpose of this study was to determine whether the DPBP could be detected in patients with PAD during a symptom-limited GXT on the motor-driven treadmill. Six male subjects (68.2 ± 6.5 yrs) with history of diagnosis of PAD participated in this study. Double product (DP) was assessed every 15 seconds during the test via the Kyokko Bussan CM-4001 automated blood pressure unit. The DPBP and VT were determined visually by three blinded observers. The mean values of Peak V02 and maximal heart rate were 19.4 ± 5.8 (ml/kg/min) and 130 ± 13 (bpm), respectively. In 4 of the six exercise tests in the present study, the DPBP and the VT were determined. The mean V02 at the DPBP and the VT were 15.7 ± 2.6 ml/kg/min and 14.2 ± 0.6 ml/kg/min, corresponding to 73 ± 7.2 and 74.5 ± 5.4 % respectively. In 3 of the six exercise tests both of the DPBP and VT were determined. The Mean V02 at the DPBP and VT were 14.6 ± 1.8 and 14.3 ± 0.7, respectively. The difference of the mean VO2 at the VT and DPBP was -.0.33 ml/kg/min.In conclusion, the results of the present study suggest that the DPBP can be identified and used as a useful marker to determine the functional performance in PAD patients. Walking time or distance measurement depends on the patient's perception of the pain. Thus, this study provides an objective way to appraise the functional performance and therapeutic results obtained from the exercise training in PAD patients, and provides a reference for exercise prescription for this population. / School of Physical Education

Thesis (M.S.)--University of Michigan, 1983.

Thesis (M.S.)--University of Michigan, 1983.

Thesis--University of Oklahoma. / Bibliography: leaves 94-96.

Made available in DSpace on 2014-06-11T19:26:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-02-28Bitstream added on 2014-06-13T20:34:47Z : No. of bitstreams: 1 morbio_ap_me_botfm_prot.pdf: 609878 bytes, checksum: 5a21cb119882b76086085ae467bd5e8c (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A doença venosa crônica (OVC) pode ser causada pela presença de insuficiência valvular em veias superficiais, principalmente na veia safena magna (VSM), perfurantes ou profundas, obstrução do sistema venoso profundo e a falha da bomba muscular da panturrilha. O refluxo é uma das principais causas da OVC e na avaliação da gravidade da doença sua presença deve ser pesquisada, seu efeito hemodinâmico necessita ser quantificado, como também a melhor definição de sua distribuição anatômica. Somente o diagnóstico clínico não é suficiente para a programação do tratamento. O mapeamento dúplex (MO) é o teste ideal, pois avalia a presença ou não de refluxo, precisa a exata localização dos segmentos incompetentes ou com obstrução e pode ainda quantificar o efeito hemodinâmico. Na insuficiência do sistema venoso superficial, as alterações da VSM são freqüentes e assim sua avaliação pelo MO é importante, e este artigo faz uma revisão sobre este assunto. / Chronic venous disease (CVO) may be the result of valvular incompetence in superficial veins, mainly in the great saphenous vein (GSV), perforating or deep veins, deep venous system obstruction and calf mucle pump defficiency. The reflux is one of the CVO main causes, its presence need a evaluation of the severity of the disease, quantification of its hemodynamic effects and the best definition of its anatomic distribuition. Only clinic diagnostic is not enough to treatment programming. The duplex scanning (OS) is the ideal test for CVO diagnostic, because evaluate the reflux, detect a exact local of incompetents segments or obstruction and can to quantify the hemodynamic effects. In superficial venous system insufficiency, the GSV alterations are common and therefore its evaluation by OS is very important, and this article is a review about this subject.

Orientador: Hamilton Almeida Rollo / Banca: Mariângela Giannini / Banca: Newton de Barros Júnior / Resumo: A doença venosa crônica (OVC) pode ser causada pela presença de insuficiência valvular em veias superficiais, principalmente na veia safena magna (VSM), perfurantes ou profundas, obstrução do sistema venoso profundo e a falha da bomba muscular da panturrilha. O refluxo é uma das principais causas da OVC e na avaliação da gravidade da doença sua presença deve ser pesquisada, seu efeito hemodinâmico necessita ser quantificado, como também a melhor definição de sua distribuição anatômica. Somente o diagnóstico clínico não é suficiente para a programação do tratamento. O mapeamento dúplex (MO) é o teste ideal, pois avalia a presença ou não de refluxo, precisa a exata localização dos segmentos incompetentes ou com obstrução e pode ainda quantificar o efeito hemodinâmico. Na insuficiência do sistema venoso superficial, as alterações da VSM são freqüentes e assim sua avaliação pelo MO é importante, e este artigo faz uma revisão sobre este assunto. / Abstract: Chronic venous disease (CVO) may be the result of valvular incompetence in superficial veins, mainly in the great saphenous vein (GSV), perforating or deep veins, deep venous system obstruction and calf mucle pump defficiency. The reflux is one of the CVO main causes, its presence need a evaluation of the severity of the disease, quantification of its hemodynamic effects and the best definition of its anatomic distribuition. Only clinic diagnostic is not enough to treatment programming. The duplex scanning (OS) is the ideal test for CVO diagnostic, because evaluate the reflux, detect a exact local of incompetents segments or obstruction and can to quantify the hemodynamic effects. In superficial venous system insufficiency, the GSV alterations are common and therefore its evaluation by OS is very important, and this article is a review about this subject. / Mestre

O cuidado com feridas crônicas faz parte do cotidiano do enfermeiro, o que torna relevante o conhecimento de sua experiência e expectativas em relação ao tratamento de pessoas com úlcera venosa crônica (UVC). Este estudo, com abordagem da Fenomenologia Social de Alfred Schutz, teve como objetivo compreender a experiência e as expectativas do enfermeiro em relação ao cuidado à mulher com úlcera venosa crônica na Atenção Primária à Saúde. Foi realizado com sete enfermeiras que atuam em Unidades de Atenção Primária à Saúde de Juiz de Fora, Minas Gerais. A obtenção dos depoimentos ocorreu em janeiro de 2012, e foi utilizada a entrevista fenomenológica, com as seguintes questões norteadoras: como é para você cuidar de mulheres com UVC? Fale-me das suas expectativas quando cuida de uma mulher com UVC. A análise compreensiva permitiu tipificar a enfermeira como aquela profissional que identifica as dificuldades da mulher para realizar seu autocuidado, considerando as questões inerentes a seu cotidiano, a baixa autoestima e a falta de suporte da família para o prosseguimento do tratamento. Ela percebe limitações na terapêutica, que é prejudicada por valores e crenças relacionadas à ferida, desmotivação da mulher e a própria frustração, principalmente em face da recidiva da lesão. Refere-se também à falta de insumos e tecnologia, de trabalho interdisciplinar e capacitação da equipe de enfermagem como fatores limitantes para o tratamento. Tem como expectativa a adesão da mulher ao tratamento da UVC e realça a necessidade do cuidado contínuo, as orientações para o autocuidado e a padronização de condutas no tratamento de feridas para evitar as recidivas da lesão, propiciando-se à mulher obter maior qualidade de vida. Evidenciou-se que os limites e as possibilidades que permeiam o cuidado se relacionam a diversos sujeitos, instituições e políticas de saúde nele envolvidos. Espera-se que esta pesquisa possibilite reflexões e ações no âmbito assistencial, do ensino e da pesquisa no que tange ao cuidado à mulher com UVC. Estas devem fundamentar a aplicação do conhecimento deste estudo nos referidos âmbitos, valorizando os diversos aspectos objetivos e subjetivos entremeados no cuidado a essa mulher. / The care of chronic wounds is part of daily nursing, being relevant to know your experience and expectations regarding the treatment of people with chronic venous ulcers (CVU). A study used the approach of Social Phenomenology by Alfred Schutz to understand the experiences and expectations of nurses who cared for women with Chronic Venous Leg Ulcers (CVLU) in primary health care. This study was conducted with seven nurses who were working in Primary Health Care units, Juiz de Fora, Minas Gerais. The taking of statements took place in January 2012, utilizing the phenomenological interview approach, asking the following questions: How do you take care of women with CVLU? What are your expectations when caring for a woman with CVLU? The comprehensive analysis resulted in classifying the professional nurse as one who identifies the difficulties of women to perform self-care, considering the issues inherent in their daily life, low self-esteem and lack of family support for the continuation of treatment. Perceived limitations in therapy are affected by values and beliefs related to the condition and the woman\'s and nurses frustration, mainly due to reoccurrence of the wounds. The study also refers to the lack of inputs and technology, interdisciplinary work and training of nursing staff as limiting factors for treatment. The expectation is that the treatment of CVLU, underlining the necessity of continuous care, self care guidelines and standardization of ducts to treat wounds and preventing recurrences of the injury, thereby allows women to achieve a better quality of life. It was evident that the limits and possibilities that permeate the care of this disease are due to various situations, including institutions and health policies related to it. It is hoped that this research allows will result in reflections and actions in health care, education and research regarding the care of women with CVLU. This research should support the application of knowledge in these areas of study, highlighting the various objective and subjective aspects woven into the care of woman.