Made available in DSpace on 2014-06-11T19:25:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-02-06Bitstream added on 2014-06-13T20:33:01Z : No. of bitstreams: 1 rossignoli_ps_me_botib.pdf: 490866 bytes, checksum: f176efec33b6a37dac4112f62d7e9225 (MD5) / A aromatização da testosterona a estradiol é essencial para a diferenciação sexual do cérebro, o qual está organizado intrinsecamente no tipo feminino, organizando-o então no tipo masculino. Trabalhos em nosso laboratório, no entanto, apontam para existência de vias metabólicas adicionais para os androgênios neste processo, sugerindo a atuação do hormônio masculino per se. Dessa forma, no presente estudo investigou-se o papel da testosterona, durante a fase crítica de diferenciação sexual hipotalâmica, em ratos machos. Para isso, ratas Wistar prenhes receberam 15mg/kg/dia do anti-androgênico flutamida (grupo Flutamida) ou óleo de amendoim (grupo Controle), s.c., no 19º e no 22º dias de gestação, bem como durante os cinco primeiros dias após o parto. Foram avaliados efeitos imediatos e, principalmente, tardios do bloqueio androgênico sobre parâmetros reprodutivos, sexuais e de desenvolvimento físico da prole masculina. Assim, a exposição perinatal a flutamida levou à redução do peso corporal ao desmame, aumento do peso corporal ao atingir a puberdade, redução da distância anogenital (DAG) ao nascimento, retardo para a instalação da puberdade, diminuição dos pesos úmidos dos testículos e da próstata ventral, aumento do peso úmido do epidídimo e menor índice gônado-somático na vida adulta. Fêmeas não tratadas acasaladas com os machos do grupo Flutamida apresentaram reduzidas taxas de implantação, maiores taxas de perdas pré-implantação e baixa taxa de fertilidade, resultando em reduzido número de descendentes. Frente a uma fêmea receptiva normal, os animais do grupo Flutamida apresentaram maior latência para o início da cópula, realizaram maior número de montas sem intromissão peniana, maior número de intromissões até a 1ª ejaculação, com maior latência para a 1ª ejaculação, além de não ejacularem ou ejacularem... / Studies in our laboratory indicate the existence of additional pathways for androgens in THE process of sexual differentiation, suggesting the importance of the male hormone per se. Thus, the present study investigated the role of testosterone during the critical phase of sexual differentiation of hypothalamus in male rats. Therefore, pregnant Wistar rats received 15mg/kg/day of flutamide (Flutamide group) or peanut oil (Control group), s.c. at day 19 of pregnancy and for the first five postnatal days. The perinatal exposure to flutamide led to a reduction in body weight at weaning, aN augmentation in body weight at puberty, reduction in anogenital distance at birth, delay in the puberty installation, decrease in wet weight of testes and ventral prostate, increase in wet weight of epididymis and decrease in gonadosomatic index. Normal females mated with treated males presented more pre-implantation losses, reduced implantation rates, and consequently reduced offspring size. Flutamide group showed increases in latency to copulatory behavior, number of mounts without penis intromission, number of intromissions until ejaculation, latency to ejaculation, and reduced number of ejaculations. after Castration followed by estrogenization, 45.5% of the animals took lying down the mounts of a non-experimental male. Flutamide treated rats presented reductions in percentage of normal spermatozoa, spermatozoa concentration, and daily testicular sperm production. The height of the epithelium of the ventral prostate was not altered by treatment, although there was a 10% reduction in cell nuclei prostatic epithelial marked positively for androgen receptor (AR) and a 60% reduction in plasma testosterone during the adulthood. Thus, the present results indicated that perinatal androgen blockage damaged differentiation process of the brain and peripheral reproductive structures.Thus, the binding of ... (Complete abstract click electronic access below)

Background: Pulmonary embolism (PE) accounts for almost 40% of perioperative deaths after bariatric surgery. Placement of prophylactic inferior vena cava (IVC) filter before bariatric surgery to improve outcomes has shown varied results. We performed a meta-analysis to evaluate postoperative outcomes associated with the preoperative placement of IVC filters in these patients. Methods: A systematic review was conducted by three investigators independently in PubMed, EMBASE, the Web of Science and Scopus until February 28, 2013. Our search was restricted to studies in adult patients undergoing bariatric surgery with and without IVC filters. Primary outcomes were postoperative deep vein thrombosis (DVT), pulmonary embolism (PE), and postoperative mortality. Meta-analysis used random effects models to account for heterogeneity, and Sidik-Jonkman method to account for scarcity of outcomes and studies. Associations are shown as Relative Risks (RR) and 95% Confidence Intervals (CI). Results: Seven observational studies were identified (n=102,767), with weighted average incidences of DVT (0.9%), PE (1.6%), and mortality (1.0%) for a follow-up ranging from 3 weeks to 3 months. Use of IVC filters was associated with an approximately 3-fold higher risk of DVT and death that was nominally significant for the former outcome, but not the latter (RR 2.81, 95%CI 1.33-5.97, p=0.007; and RR 3.27, 95% CI 0.78-13.64, p=0.1, respectively); there was no difference in the risk of PE (RR 1.02, 95%CI 0.31-3.77, p=0.9). Moderate to high heterogeneity of effects was noted across studies. Conclusions: Placement of IVC filter before bariatric surgery is associated with higher risk of postoperative DVT and mortality. A similar risk of PE in patients with and without IVC filter placement cannot exclude a benefit, given the potential large imbalance in risk at baseline. Randomized trials are needed before IVC placement can be recommended. / Revisión por pares

Resumo: A aromatização da testosterona a estradiol é essencial para a diferenciação sexual do cérebro, o qual está organizado intrinsecamente no tipo feminino, organizando-o então no tipo masculino. Trabalhos em nosso laboratório, no entanto, apontam para existência de vias metabólicas adicionais para os androgênios neste processo, sugerindo a atuação do hormônio masculino per se. Dessa forma, no presente estudo investigou-se o papel da testosterona, durante a fase crítica de diferenciação sexual hipotalâmica, em ratos machos. Para isso, ratas Wistar prenhes receberam 15mg/kg/dia do anti-androgênico flutamida (grupo Flutamida) ou óleo de amendoim (grupo Controle), s.c., no 19º e no 22º dias de gestação, bem como durante os cinco primeiros dias após o parto. Foram avaliados efeitos imediatos e, principalmente, tardios do bloqueio androgênico sobre parâmetros reprodutivos, sexuais e de desenvolvimento físico da prole masculina. Assim, a exposição perinatal a flutamida levou à redução do peso corporal ao desmame, aumento do peso corporal ao atingir a puberdade, redução da distância anogenital (DAG) ao nascimento, retardo para a instalação da puberdade, diminuição dos pesos úmidos dos testículos e da próstata ventral, aumento do peso úmido do epidídimo e menor índice gônado-somático na vida adulta. Fêmeas não tratadas acasaladas com os machos do grupo Flutamida apresentaram reduzidas taxas de implantação, maiores taxas de perdas pré-implantação e baixa taxa de fertilidade, resultando em reduzido número de descendentes. Frente a uma fêmea receptiva normal, os animais do grupo Flutamida apresentaram maior latência para o início da cópula, realizaram maior número de montas sem intromissão peniana, maior número de intromissões até a 1ª ejaculação, com maior latência para a 1ª ejaculação, além de não ejacularem ou ejacularem ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Studies in our laboratory indicate the existence of additional pathways for androgens in THE process of sexual differentiation, suggesting the importance of the male hormone per se. Thus, the present study investigated the role of testosterone during the critical phase of sexual differentiation of hypothalamus in male rats. Therefore, pregnant Wistar rats received 15mg/kg/day of flutamide (Flutamide group) or peanut oil (Control group), s.c. at day 19 of pregnancy and for the first five postnatal days. The perinatal exposure to flutamide led to a reduction in body weight at weaning, aN augmentation in body weight at puberty, reduction in anogenital distance at birth, delay in the puberty installation, decrease in wet weight of testes and ventral prostate, increase in wet weight of epididymis and decrease in gonadosomatic index. Normal females mated with treated males presented more pre-implantation losses, reduced implantation rates, and consequently reduced offspring size. Flutamide group showed increases in latency to copulatory behavior, number of mounts without penis intromission, number of intromissions until ejaculation, latency to ejaculation, and reduced number of ejaculations. after Castration followed by estrogenization, 45.5% of the animals took lying down the mounts of a non-experimental male. Flutamide treated rats presented reductions in percentage of normal spermatozoa, spermatozoa concentration, and daily testicular sperm production. The height of the epithelium of the ventral prostate was not altered by treatment, although there was a 10% reduction in cell nuclei prostatic epithelial marked positively for androgen receptor (AR) and a 60% reduction in plasma testosterone during the adulthood. Thus, the present results indicated that perinatal androgen blockage damaged differentiation process of the brain and peripheral reproductive structures.Thus, the binding of ... (Complete abstract click electronic access below) / Orientador: Oduvaldo Câmara Marques Pereira / Coorientador: Agnaldo Bruno Chies / Banca: André Sampaio Pupo / Banca: Lusiane Maria Bendhack / Mestre

Context: Inferior vena cava (IVC) anomalies have a 0.5% incidence rate and could be associated with other congenital abnormalities. In later stage of the disease, trophic ulcers with or without deep vein thrombosis (DVT) is consistent finding.Case Report: A 29-year-old male patient presented with recurrent lower extremity ulcers. Further workup revealed an absent infrahepatic inferior vena cava, prominently dilated azygos and hemiazygos veins with enlarged retroperitoneal collaterals without DVT.Conclusion: IVC anomaly should be suspected in a young patient presenting with unexplained venous thrombosis and recurrent ulcers of a lower extremity. IVC anomaly would inherently lead to blood flow stasis and endothelial injury. Thus per Virchow's triad, other risk factors for hypercoagulability such as physical inactivity, smoking tobacco, oral contraceptive pills should be avoided and when hereditary thrombophilias or other irreversible risk factors are present, lifelong anticoagulation should be considered.

Die interventionelle Radiologie hat sich in den letzten Jahrzehnten zunehmend auf palliativmedizinische sowie onkologische Bereiche ausgeweitet und kann durch minimal-invasive Therapieoptionen gerade in vulnerablen Patientenkollektiven attraktive Behandlungsmöglichkeiten zur Verfügung stellen. Die tumorbedingte untere Einflussstauung ist ein seltenes Krankheitsbild und stellt eine schwere symptomatische Komplikation einer malignen Grunderkrankung dar. Dabei kommt es im Rahmen dieser Grunderkrankung durch die Primärtumormasse oder Metastasen zu extrinsischer Kompression der Vena cava inferior (VCI), Gefäßinvasion oder Thrombusbildung. Ziel der Dissertationsarbeit ist es, den technischen und klinischen Erfolg der Sinus-XL ® Stentimplantation in die Vena cava inferior bei einer tumorbedingten unteren Einflussstauung zu untersuchen. Als technischer Erfolg wurde dabei die problemlose Stentimplantation mit anschließender Aufhebung der VCI-Stenose/Okklusion und Revaskularisation der VCI definiert. Bezüglich des klinischen Erfolges wurde der Frage nachgegangen, inwieweit die Stentimplantation die typischen Symptome einer unteren Einflussstauung (Ödeme der unteren Extremität, Aszites und Anasarka) lindern und bestenfalls eliminieren kann. In der vorliegenden Arbeit sind dazu retrospektiv die Daten von insgesamt 21 Patienten (11 Frauen, 10 Männer) mit einem medianen Alter von 61 Jahren (19-92 Jahre), die zwischen Oktober 2010 und Januar 2021 aufgrund einer tumorbedingten unteren Einflussstauung mit einem Sinus-XL ® Stent endovaskulär versorgt wurden, ausgewertet worden. Zur Quantifizierung der klinischen Symptomatik wurde für das jeweilige Symptom ein Scoring-System entwickelt bzw. modifiziert. Der technische Erfolg belief sich auf 100% (21/21). Postinterventionell konnte zudem eine signifikante Reduktion des transstenotischen Druckgradienten (p = 0,008) und eine signifikante Aufweitung des Stenosendiameters (p < 0,001) erreicht werden. Die primäre und primär-assistierte Stentoffenheit betrug 92,9 % (13/14) und 100% (14/14), die anatomische Stentoffenheit (< 50% Restenose) belief sich auf 53,3 % (8/15). Die Reinterventionsrate lag bei 4,8 % (1/21). Schwerwiegende Komplikationen traten nicht auf. Der klinische Erfolg bezüglich der Ödeme der unteren Extremität belief sich auf 82,4 % (14/17), 93,8 % (15/16) sowie auf 85,7 % (18/21) und zeigte in allen betrachteten Zeitintervallen eine signifikante Scorewertreduktion (p < 0,001). Das klinische Outcome bezüglich der Ödeme war bei kürzeren Stenosen/Obstruktionen signifikant besser (p = 0,025). Bezüglich einer intrahepatischen Segmentbeteiligung, der transstenotischen Druckgradienten, der absoluten Gradientenreduktion sowie der Überlebenszeit nach der Intervention zeigten sich hingegen keine als klinisch relevant einzustufende Ergebnisse. Ein eindeutiger Effekt der Intervention auf die Symptome Anasarka und Aszites konnte nicht nachgewiesen werden. Diesbezüglich zeigten sich klinische Erfolgsraten von 42,9 % (6/14) und 5,3 % (1/19). Im postinterventionellen Verlauf konnten außerdem signifikante Reduktionen der präinterventionellen Harnstoffwerte sowie des Körpergewichtes der Patienten verzeichnet werden. Zusammenfassend zeigt die vorliegende Arbeit, dass die Sinus-XL ® Stentimplantation geeignet ist, eine tumorbedingte Vena cava inferior-Stenose/Obstruktion aufzuheben und eine Revaskularisation der VCI zu erreichen. Die klinischen Symptome einer unteren Einflussstauung – insbesondere bezogen auf die Ödeme der unteren Extremität und mit Einschränkungen bezogen auf die Symptome Aszites und Anasarka – können ebenfalls durch die Stentimplantation gelindert und teilweise sogar langanhaltend eliminiert werden. Die Sinus-XL ® Stentimplantation sollte daher stets als Therapieoption bei tumorbedingten unteren Einflussstauungen in Erwägung gezogen werden. Nicht zuletzt stellt die Stentimplantation auch eine sichere und komplikationsarme Intervention dar. Weitere Studien, bestenfalls multizentrische Studien, sind jedoch notwendig, um die dargestellten Ergebnisse weiter zu untermauern. / In recent decades interventional radiology has increasingly expanded into palliative as well as oncologic settings and can provide attractive treatment options through minimal-invasive therapies, especially in vulnerable patient populations. Malignant obstruction of the inferior vena cava (IVC) is a rare clinical condition and represents a severe symptomatic complication of an underlying malignant disease. Extrinsic compression of the inferior vena cava, vascular invasion or thrombus formation occur as part of the underlying disease. The aim of this work is to investigate the technical and clinical success of Sinus-XL ® stent implantation into the inferior vena cava in case of malignant obstruction of the inferior vena cava. Technical success was defined as the successful stent implantation with subsequent resolution of the stenosis/occlusion and revascularization of the IVC. Regarding clinical success, the question was addressed to what extent stent implantation can alleviate and, at best, eliminate the typical symptoms of malignant IVC obstruction (lower extremity edema, ascites and anasarca). Therefore data from a total of 21 patients (11 women, 10 men) with a median age of 61 years (19-92 years) who underwent endovascular treatment with a Sinus-XL ® stent for malignant IVC obstruction between October 2010 and January 2021 was retrospectively analyzed. In order to quantify the extent of the clinical symptoms a scoring system was developed or modified for each symptom. The technical success was 100% (21/21). After the intervention a significant reduction of the transstenotic pressure gradient (p = 0.008) and a significant widening of the stenotic diameter (p < 0.001) were achieved. Primary and primary-assisted stent patency were 92.9% (13/14) and 100% (14/14), anatomic stent patency (< 50% restenosis) was 53.3% (8/15). The reintervention rate was 4.8% (1/21). No major complications occurred. The clinical outcome regarding lower extremity edema was 82.4% (14/17), 93.8% (15/16), and 85.7% (18/21), showing a significant score reduction in all time intervals considered (p < 0.001). Clinical outcome regarding edema was significantly better with shorter stenosis/obstruction (p = 0.025). In contrast, with regard to intrahepatic segment involvement, transstenotic pressure gradients, absolute gradient reduction, and survival time after the intervention, there were no results that could be classified as clinically relevant. A clear effect of the intervention on the symptoms of anasarca and ascites could not be demonstrated. In this regard, clinical success rates of 42.9% (6/14) and 5.3% (1/19) were shown. In the post-interventional course, significant reductions of the pre-interventional urea levels as well as of the patients´ body weight could also be recorded. In conclusion, the present work shows that Sinus-XL ® stent implantation is suitable to resolve malignant IVC obstruction and to achieve revascularization of the IVC. The clinical symptoms - especially related to lower extremity edema and with limitations related to the symptoms of ascites and anasarca - can be alleviated by stent implantation and in some cases even eliminated. Sinus-XL ® stent implantation should therefore always be considered as a therapeutic option for malignant IVC obstruction. Last but not least, stent implantation also represents a safe and low-complication intervention. However, further studies, at best multicenter studies, are necessary to further substantiate the presented results.

Although ACC exerted a strong effect on the haemodynamic changes after SA, SA per se did not have much influence on ACC. The incidence and severity of ACC remained unchanged compared with the pre-spinal state. As long as maternal blood pressure were well controlled, the uterine blood flow indices were not affected by ACC. / Although there are many publications on ACC, most publications have considered ACC as a single entity, or reported its effects in terms of just a few end-point measures. The information published so far on ACC remains fragmented. This will be readdressed by taking a multidisciplinary approach with input from the fields of anaesthesia, obstetrics and radiology to non-invasively assess the haemodynamic changes associated with ACC. / Aortocaval compression occurs when parturients lie in the supine position with the gravid uterus compressing the aorta and the inferior vena cava. This interferes with venous return to the heart to reduce cardiac output, resulting in hypotension, uterine hypo-perfusion and fetal acidosis. Under neuraxial anaesthesia when the compensatory mechanisms via the sympathetic nervous outflow are blocked, the effects from ACC are exaggerated and results in maternal and fetal morbidity. / Intermittent IVC compression was responsible for most of the haemodynamic effects, presenting mainly as a reduction in cardiac output. Blood pressure or heart rate changes are poor indicators for IVC compression, and most patients were asymptomatic. Patients who have moderate to severe ACC have a higher incidence of hypotension after SA and consume a higher amount of phenylephrine for maintaining BP. / The research was conducted on non-labouring term parturients presenting for elective Caesarean section under spinal anaesthesia. Measurements were performed to assess the patency of blood vessels and haemodynamic responses to lateral tilts, using ultrasound and non-invasive haemodynamic monitors. / This research has achieved the following: (1) Qualitative measurements of compression of the aorta and IVC with US imaging and Doppler US; (2) Development of a new simple bedside method for detecting ACC using US; (3) Quantitative measurements of physiological responses in the maternal and fetal circulation associated with ACC; (4) Investigation of the effects of spinal anaesthesia per se on ACC. / Lee, Wee Yee Shara. / Adviser: Khaw Kim Sun. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3446. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 234-254). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

No description available.

Thesis (B.S.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 1980. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ENGINEERING. / Includes bibliographical references. / by Martin Raymond Prince. / B.S.

Magnetic Resonance Imaging (MRI) was used to determine changes in the size of the Inferior Vena Cava (IVC) as a result of blood pooling induced by lower body negative pressure (LBNP). Images of the IVC of supine human subjects (10 males, 10 females) were obtained under four conditions: 1) steady-state 0 mmHg LBNP, 2) steady-state –35 mmHg LBNP, 3) ramping from 0 to –35 mmHg LBNP, 4) ramping from –35 to 0 mmHg LBNP. Volumes for a given IVC segment were obtained under the first two conditions during both end inspiration and end expiration breath-holds. Inferior Vena Cava widths were measured under all four conditions at the levels of portal entry and portal exit. The IVC volume for men and women combined decreased 41% due to LBNP (p andlt; 1.02 x 10-9). The IVC was 64.4% wider at portal exit than at portal entry in men (p andlt; 0.0003). Lower Body Negative Pressure induced a decrease in men's vena cava width up to 46% at portal exit and up to 62% at portal entry. Supported by NASA EPSCoR WKU 522611 and NIH GCRC MO1 RR262.

Made available in DSpace on 2014-06-11T19:23:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-12-01Bitstream added on 2014-06-13T18:51:11Z : No. of bitstreams: 1 garciafilho_sp_me_jabo.pdf: 2459422 bytes, checksum: fe267c637159bc2324aed2f89e379fef (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Considerando-se que a paca (Cuniculus paca) é o segundo maior roedor da fauna brasileira, a pesquisa sobre estes animais vem tornando-se importante, pois além de haver grande interesse na sua criação comercial, já que apresentam carne de excelente qualidade, sendo roedores, podem vir a tornar-se animais alternativos para a experimentação, e ainda, como poucas são as informações detalhadas sobre sua morfologia, objetivou-se com este trabalho descrever a morfologia, morfometria e a ultraestrutura de segmentos das porções torácica e abdominal da aorta e segmentos das porções cranial e caudal da veia cava de quatro pacas (Cuniculus paca) machos e fêmeas. Parte dos segmentos foi analisada à microscopia de luz e parte, à microscopia eletrônica de varredura. Mensurou-se as espessuras do complexo formado pelas túnicas íntima+média e túnica adventícia da aorta e veia cava e analisou-se os resultados pela estatística descritiva, teste “T” pareado (p<0,05) e teste de Tukey (p<0,05). Em relação à espessura das túnicas estudadas, notou-se que, em todos os animais, os valores referentes à espessura do complexo formado pelas túnicas íntima+média da aorta torácica cranial foram significativamente maiores, quando comparados aos valores dos outros segmentos aórticos analisados; na veia cava comprovou-se que os valores da espessura das túnicas íntima, média e adventícia, para todos os animais, foram significativamente maiores no segmento cranial. As camadas das paredes dos vasos apresentaram variações entre si quanto à estrutura e espessura, supostamente devido a uma adaptação à exigência funcional / Considering that the paca (Cuniculus paca) is the second largest rodent of the Brazilian fauna, researches concerning these animals are becoming important because the wide interest on its commercial production since they have excellent meat quality and as rodents they could become alternatives to animal experimentation. As there is few detailed information on their morphology, the aim of this study is describe the morphology, morphometry and ultrastructure of segments of thoracic and abdominal aorta portions and segments of cranial and caudal vena cava portions in four males and females Cuniculus paca. Part of the segments were examined by light microscopy and part by scanning electron microscopy. Thickness measures of the tunica intima and media complex and tunica adventitia of the aorta and vena cava were taken and analyzed using T test (p <0.05) and Tukey test (p <0.05). In all animals the thickness values for the tunica intima and media complex of the cranial thoracic aorta were significantly higher when compared to the values of other aortic segments analyzed; in vena cava the thickness values of the intima, media and adventitia, for all animals, were significantly higher in the cranial segment. The layers of the vessel walls show variations in structure and thickness, presumably due to an adaptation to functional demand