Master of Science / Department of Kinesiology / Timothy I. Musch / Aged rats exhibit a decreased muscle microvascular O[subscript]2 partial pressure (PO[subcript]2mv) at rest as well as during contractions compared to young rats and this may contribute to their reduced exercise tolerance. Age-related reductions in nitric oxide (NO) bioavailability due, in part, to elevated reactive O[subscript]2 species (ROS) constrain muscle blood flow (Qm). Therefore, antioxidants may restore NO bioavailability, Qm and ameliorate the reduction in PO[subscript]2mv and hence the decrease in exercise tolerance seen in aged rats. PURPOSE: To test the hypothesis that antioxidants would elevate Qm at rest and during contractions and therefore PO[subscript]2mv in aged muscle. METHODS: PO[subscript]2mv and Qm were measured in the spinotrapezius while muscle oxygen consumption (VO[subscript]2m) was estimated in 20 anesthetized male Fisher 344 x Brown Norway hybrid (F344xBN) rats at rest and during 1 Hz contractions before and after antioxidant intravenous infusion (76mg/kg vitamin C and 52mg/kg tempol). Moreover, muscle force production was measured in a subset of animals. RESULTS: Before infusion, contractions invoked a biphasic PO[subscript]2mv that fell from 30.6 [plus or minus] 0.9 mmHg to a nadir of 16.8 [plus or minus] 1.2 mmHg with an 'undershoot' of 2.8 [plus or minus] 0.7 mmHg below the subsequent steady-state (19.7 [plus or minus] 1.2 mmHg). Antioxidants elevated baseline PO[subscript]2mv to 35.7 [plus or minus] 0.8 mmHg (P<0.05) and reduced or abolished the 'undershoot' (P<0.05) without changing the steady-state contracting PO[plus or minus]2mv. Antioxidants did not change Qm at rest but during contractions Qm was reduced from 157 [plus or minus] 28 to 91 [plus or minus] 15 ml min[superscript]-1 100g[superscript]-1 (P<0.05). Antioxidants produced no significant effect on VO[subscript]2m. However, antioxidant supplementation produced a 16.5% decrease (P<0.05) in muscle force production that occurred within the first contraction and remained throughout the duration of stimulation. In addition, the ratio of muscle force production to VO[subscript]2m (F/VO[subscript]2m) actually increased from 0.92 [plus or minus] 0.03 to 1.06 [plus or minus] 0.6 (P<0.05) following infusion of antioxidants. CONCLUSION: Antioxidant supplementation significantly alters the balance between muscle O[subscript]2 delivery and VO[subscript]2 at rest and during contractions, which modifies the microvascular PO[subscript]2mv profile. Specifically, antioxidants elevate PO[subscript]2mv, which improves the potential for diffusive blood-myocyte flux. This effect arises, in part, from the unanticipated fall in muscle force production consequent to antioxidant supplementation.

Three studies were performed to examine biophysical sources of individual variability in the thermoregulatory responses to exercise, and the influence of skin blood flow on heat loss potential during severe heat stress. Study 1 investigated whether unbiased comparisons of changes in rectal temperature (ΔTre) should be compared at a fixed absolute rate of heat production (Hprod; W) or a fixed Hprod per unit mass (W/kg), and whether local sweat rates (LSR) should be compared at a fixed evaporative requirement for heat balance (Ereq; W) or a fixed Ereq per unit of surface area (W/m2), between independent groups of unequal body mass and body surface area (BSA). Study 2 examined whether individual variation in ΔTre, whole-body sweat loss (WBSL), and steady-state LSR is best explained by biophysical factors related to Hprod, Ereq, and body size, and if factors related to aerobic fitness (VO2max) and body fatness correlate with the residual variance in these responses. Study 3 tested whether alterations in skin blood flow shift the critical vapour pressure (Pcrit) above which core temperature could no longer be regulated in hot/humid conditions, indicating altered heat loss potential from the skin. In study 1, exercise at fixed absolute Hprod and Ereq resulted in greater ΔTre and LSR in smaller individuals (smaller mass and BSA), but exercise at set Hprod in W/kg and Ereq in W/m2 resulted in no differences in ΔTre and LSR, respectively, regardless of body size and %VO2max. In study 2, 50-71% of the individual variation in ΔTre, whole-body sweat loss (WBSL), and steady-state LSR was explained by Hprod (W/kg), absolute Ereq (W) and Ereq (W/m2) respectively, while body fat percentage and %VO2max contributed merely 1-4% to the total variability. In study 3, despite a ~20% lower skin blood flow, Pcrit was unaffected by a large reduction in skin blood flow following iso-smotic dehydration, with no differences in core and skin temperatures and sweating observed. Collectively, these findings suggest that between-group comparisons and modelling of thermoregulatory responses must first consider biophysical factors related to metabolic heat production and body size, rather than factors related to VO2max and body fatness. Furthermore, lower levels of skin blood flow may not impair maximum heat dissipation from the skin to the external environment during severe passive heat stress as previously thought.

The etiology of renal dysfunction in sepsis is currently attributed to altered perfusion, microcirculatory abnormalities and cellular alterations. To clarify these mechanisms, we characterized the changes in renal perfusion and cortex metabolism in a large animal model of sepsis. In this model, sepsis was associated with metabolic alterations that may reflect early induction of cortical glycolysis. Septic shock was associated with reduced renal perfusion and decreased cortical and medullary blood flow, followed by signs of anaerobic metabolism in the cortex when flow reductions became critical. Attempts to correct renal hypoperfusion and alleviate the associated perfusion/metabolism mismatch with fenoldopam or renal denervation were unsuccessful. In the final study we focussed on the role of renal autoregulation in experimental sepsis and septic shock. Evidence suggests that higher blood pressure targets are needed in patients with impaired renal autoregulation and septic shock, but the effects of vasopressors should also be considered. We therefore investigated the effects of arginine vasopressin and norepinephrine on renal autoregulation in ovine septic shock. In experimental septic shock, arginine vasopressin was associated with a lower autoregulatory threshold than norepinephrine. As vasopressors may have different effects on renal autoregulation, individualized therapy of blood pressure management in patients with septic shock should take into account drug-specific effects. / Doctorat en Sciences médicales (Médecine) / info:eu-repo/semantics/nonPublished

Orientador: Rickson Coelho Mesquita / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Física Gleb Wataghin / Made available in DSpace on 2018-08-27T04:25:10Z (GMT). No. of bitstreams: 1 Forti_RodrigoMenezes_M.pdf: 12387880 bytes, checksum: 7008f6dbed4a5d63effefff5a6582b33 (MD5) Previous issue date: 2015 / Resumo: Técnicas de espectroscopia baseadas em óptica de difusão são essenciais para a obtenção das propriedades ópticas e dinâmicas em meios turvos, caracterizados pela predominância dos efeitos de espalhamento sobre a absorção. Nestas condições, a luz se propaga esfericamente no meio, num regime aproximadamente difusivo. A luz espalhada pode então ser detectada no mesmo plano de incidência, e sua detecção fornece informação das propriedades ópticas e dinâmicas das moléculas que compõem o meio. Em particular, a técnica encontra uma vasta aplicação no estudo das propriedades do tecido biológico, uma vez que este se comporta como um meio turvo na região do infravermelho próximo. Por se tratar de uma técnica experimental relativamente recente, pouco é conhecido em relação à propagação da luz em meios com diferentes geometrias, principalmente em relação às propriedades dinâmicas do meio. Este projeto propôs um estudo teórico-experimental detalhado da propagação da luz em meios turvos semi-infinitos e de duas camadas, com foco na obtenção das propriedades dinâmicas do meio, através de uma técnica óptica de difusão conhecida como espectroscopia de correlação de difusão (DCS). Mais especificamente, esse projeto testou as geometrias de um meio semi-infinito e de duas camadas, com o uso de simulações de Monte Carlo e experimentos em ambientes controlados. Foi mostrado que o uso da geometria de duas camadas, ao invés da de um meio semi-infinito, como é usualmente feito na literatura, traz melhoras significativas para a recuperação das propriedades de fluxo do meio. As geometrias usadas neste trabalho representam aproximações mais precisas das estruturas muscular e cerebral, por exemplo, e retratam diferentes situações encontradas em Biologia e Medicina. Por fim, o sistema também foi testado em voluntários sadios. Os resultados obtidos neste projeto tem aplicação direta nas áreas citadas, e podem contribuir significativamente para o desenvolvimento de técnicas físicas para o monitoramento cerebral e muscular na clínica médica / Abstract: Spectroscopic techniques based on diffuse optics are essential for determination of the optical and dynamical properties of turbid media, in which scattering predominates over absorption. Under these conditions, light propagates spherically in the medium, in an approximate diffusive regimen. Scattered light can thus be detected at the same plane of incidence, and its detection can provide information both on the optical and dynamical properties of the medium. Diffuse optical techniques are particularly useful to study the properties of biological tissue, since it behaves like a turbid medium in the near infrared region. Because diffuse optics is a relatively novel experimental technique, not much is known regarding the propagation of light in media with different geometries, particularly with relation to the dynamical properties of the medium. This project proposes a combined theoretical and experimental study of light propagation in semi-infinite and two-layered turbid media, focusing on the dynamical properties of the medium with a diffuse optical technique called diffuse correlation spectroscopy (DCS). More specifically, this project employed the semi-infinite and the two-layer geometries, testing them using Monte Carlo simulations and controlled enviroments. It was shown that by using a two-layer geometry, instead of the semi-infinite geometry, as routinely done in the literature, it is possible to significantly improve the accuracy of the recovered dynamical properties. The geometries tested in this work represent more accurate approximations for muscle and brain structures, for example, and therefore could depict different situations encountered in problems in the fields of Biology and Medicine. Last, the system was also tested in healthy subjects. The results obtained in this project have direct application in the above-cited fields, and may significantly contribute to the development of experimental techniques for diagnosis and/or monitoring of the brain and muscle in the clinic / Mestrado / Física / Mestre em Física

INTRODUÇÃO: O infarto agudo do miocárdio está associado à hiperativação simpática e diminuição do fluxo sanguíneo muscular (FSM). Por outro lado, tem sido documentado que o treinamento físico promove importantes adaptações autonômicas e vasculares no indivíduo. O objetivo deste estudo foi testar a hipótese de que o treinamento físico diminuiria a atividade nervosa simpática muscular (ANSM) e aumentaria o FSM em repouso e durante o exercício físico em pacientes com Síndrome Isquêmica Miocárdica Instável (SIMI). MÉTODOS: Foram incluídos no estudo, 63 pacientes internados na Unidade Clínica de Coronariopatia Aguda diagnosticados com SIMI. Um mês após o evento isquêmico, 51 pacientes continuaram o seguimento e foram alocados, consecutivamente, em 2 grupos: treinamento físico (SIMI-TF, n=25, 54±1 anos), e sedentário (SIMI-Sed, n=26, 52±2 anos). Ao final do estudo, 14 pacientes do grupo SIMI-TF e 20 pacientes do grupo SIMI-Sed finalizaram o protocolo experimental. Esses pacientes foram comparados a um grupo controle saudável (n=13, 49±1anos). A ANSM foi medida pela técnica de microneurografia. O FSM foi avaliado por pletismografia de oclusão venosa, a pressão arterial (PA) foi medida pelo método oscilométrico indireto e a frequência cardíaca pelo eletrocardiograma. Todas as avaliações foram realizadas no basal, durante a fase de internação hospitalar e, no basal e durante 3 minutos de exercício físico de preensão de mãos (30% da contração voluntária máxima) no período de seguimento do estudo (1º., 3º.e 7º. mês após o evento isquêmico). O treinamento físico foi realizado em cicloergômetro, 3 vezes por semana, durante 6 meses. RESULTADOS: Durante a fase de internação hospitalar, a ANSM basal foi significativamente maior (65±2 vs. 32±2 disparos/100batimentos, p<0,001) e a condutância vascular no antebraço (CVA= FSM/PAmédia) foi significativamente menor (1,91±0,1 vs. 2,99±0,38 unidades, p<0,001) no grupo SIMI em relação ao grupo Controle. Comportamento semelhante foi observado 1 mês após o evento isquêmico, a ANSM continuou aumentada (64±3 vs. 62±4 vs. 32±2 disparos/100batimentos, p<0,001, respectivamente) e a CVA diminuída (1,73±0,1 vs. 1,72±0,1 vs. 2,99±0,4 unidades, p<0,001, respectivamente) nos grupos SIMI-Sed e SIMI-TF em relação ao grupo Controle. Durante o exercício de preensão de mãos, os níveis de ANSM foram maiores (71±4 e 69±4 vs. 43±3 disparos/100batimentos, p<0,001, respectivamente) e a CVA foi menor (1,60±0,1 e 1,59±0,2 vs. 3,53±0,47 unidades, p<0,001, respectivamente), nos grupos SIMI-Sed e SIMI-TF em relação ao grupo Controle. Após o treinamento físico, a ANSM basal diminuiu no grupo SIMITF (62±4 vs. 40±3 disparos/100batimentos, p=0,02), atingindo níveis semelhantes ao grupo Controle (40±3 vs. 32±2 disparos/100batimentos, p=0,24, respectivamente). Durante o exercício físico, a ANSM diminuiu no grupo SIMI-TF (72±5 vs. 60±5 disparos/100batimentos, p<0,001). Porém, a CVA não foi significativamente modificada tanto no basal como durante o exercício no grupo SIMI-TF. Nenhuma alteração significativa foi observada na ANSM e CVA do grupo SIMI-Sed, tanto em repouso como durante o exercício. CONCLUSÕES: Em pacientes com SIMI, o treinamento físico normalizou a ANSM basal e diminuiu seus níveis durante o exercício, porém, não modificou o FSM. Como a ativação simpática está relacionada com pior prognóstico, nossos resultados ressaltam a importância clínica do treinamento físico em pacientes após SIMI / Introduction: The myocardial infarction is associated with sympathetic hiperactivation and reduced forearm blood flow (FBF). On the other hand, the exercise training leads to important autonomic and vascular adaptations. The purpose of this study was to test the hypothesis that exercise training would decrease the muscle sympathetic nerve activity (MSNA) and would increase the FBF at rest and during exercise in patients with acute coronary syndrome (ACS). Methods: Sixty-three patients admitted to the coronary intensive care unit with ACS were studied. One month after ischemic event, 51 patients continued the follow-up study and were allocated consecutively in two groups: exercise training (ACS-ET, n=25, 54±1 years) and sedentary (ACSSed, n=26, 52±2 years). At the end of the study, 14 patients in the group ACS-ET and 20 patients in the group ACS-Sed concluded the experimental protocol. These patients were compared to a control group of healthy subjects (n=13, 49±1 years). The MSNA was measured by microneurography technique. The FBF was measured by venous occlusion plethysmography, the blood pressure (BP) was measured by indirect oscillometric method and the heart rate was measured by electrocardiogram. All measurements were done at rest condition during inpatient phase and at rest condition and during 3 minutes of handgrip exercise (30% of maximum voluntary contraction) during outpatient follow-up (1st, 3rd and 7th months after the ischemic event). The exercise training was performed on a cycle ergometer 3 times per week for 6 months. RESULTS: During inpatient phase, the MSNA at rest was significantly higher (65±2 vs. 32±2 bursts/100heart beats, p<0.001) and forearm vascular conductance (FVC=FBF/mean BP) was significantly lower (1.91±0.1 vs. 2.99±0.38 units, p<0.001) in ACS group when compared to control group. One month after the ischemic event, the MSNA remained significantly higher (64±3 vs. 62±4 vs. 32±2 bursts/100 heart beats, p<0,001) and the FVC continue significantly lower (1.73±0.1 vs. 1.72±0.1 vs. 2.99±0.4 units, p<0,001) in the ACS-Sed and ACS-ET groups when compared to the control group. During handgrip exercise, the MSNA levels were significantly higher (71±4 and 69±4 vs. 43±3 bursts/100heart beats, p <0.001, respectively) and FVC levels were significantly lower (1.60±0.1 and 1.59± 0.2 vs. 3.53 ± 0.47 units, p <0.001, respectively) in the ACS-Sed and ACS-ET groups when compared to the control group, respectively. After exercise training, the MSNA at rest decreased significantly in the group ACS-ET (62±4 vs. 40±3 bursts/100 heart beats, p=0.02), reaching similar levels to those found in the control group (40±3. vs. 32±2 burts/100 heart beats, p= 0.24, respectively). During handgrip exercise the MSNA decreased significantly in ACS-ET group (72±5 vs. 60±5 bursts/100 heart beats, p <0.001). However, the FVC was not significantly changed at rest and during exercise in ACS-ET group. No significant change was observed in MSNA and FVC in ACS-Sed group at rest and during exercise. CONCLUSIONS: In patients with ACS, the exercise training normalized the MSNA at rest and decreased their levels during exercise, but no change was observed in the FVC. Since sympathetic activation is related to poor prognosis, our results highlight the clinical importance of ET in patients with ACS

With old age, blood flow to the high-oxidative red skeletal muscle is reduced and blood flow to the low-oxidative white muscle is elevated during exercise. Changes in the number of feed arteries perforating the muscle are thought to contribute to this altered hyperemic response during exercise. We tested the hypothesis that exercise training would ameliorate age-related differences in blood flow during exercise and feed artery structure in skeletal muscle. Young (6–7 mo old, n = 36) and old (24 mo old, n = 25) male Fischer 344 rats were divided into young sedentary (Sed), old Sed, young exercise-trained (ET), and old ET groups, where training consisted of 10–12 wk of treadmill exercise. In Sed and ET rats, blood flow to the red and white portions of the gastrocnemius muscle (GastRed and GastWhite) and the number and luminal cross-sectional area (CSA) of all feed arteries perforating the muscle were measured at rest and during exercise. In the old ET group, blood flow was greater to GastRed (264 ± 13 and 195 ± 9 ml·min−1·100 g−1 in old ET and old Sed, respectively) and lower to GastWhite (78 ± 5 and 120 ± 6 ml·min−1·100 g−1 in old ET and old Sed, respectively) than in the old Sed group. There was no difference in the number of feed arteries between the old ET and old Sed group, although the CSA of feed arteries from old ET rats was larger. In young ET rats, there was an increase in the number of feed arteries perforating the muscle. Exercise training mitigated old age-associated differences in blood flow during exercise within gastrocnemius muscle. However, training-induced adaptations in resistance artery morphology differed between young (increase in feed artery number) and old (increase in artery CSA) animals. The altered blood flow pattern induced by exercise training with old age would improve the local matching of O2 delivery to consumption within the skeletal muscle.

Adipose tissue (AT), which typically comprises an increased percentage of body mass with advancing age, receives a large proportion of resting cardiac output. During exercise, an old age-associated inability to increase vascular resistance within the intra-abdominal AT may compromise the ability of the cardiovascular system to redistribute blood flow to the active musculature, contributing to the decline in exercise capacity observed in this population. We tested the hypotheses that 1) there would be an elevated perfusion of AT during exercise with old age that was associated with diminished vasoconstrictor responses of adipose-resistance arteries, and 2) chronic exercise training would mitigate the age-associated alterations in AT blood flow and vascular function. Young (6 mo; n = 40) and old (24 mo; n = 28) male Fischer 344 rats were divided into young sedentary (YSed), old sedentary (OSed), young exercise trained (YET), or old exercise trained (OET) groups, where training consisted of 10-12 wk of treadmill exercise. In vivo blood flow at rest and during exercise and in vitro α-adrenergic and myogenic vasoconstrictor responses in resistance arteries from AT were measured in all groups. In response to exercise, there was a directionally opposite change in AT blood flow in the OSed group (∼150% increase) and YSed (∼55% decrease) vs. resting values. Both α-adrenergic and myogenic vasoconstriction were diminished in OSed vs. YSed AT-resistance arteries. Exercise training resulted in a similar AT hyperemic response between age groups during exercise (YET, 9.9 ± 0.5 ml·min−1·100−1 g; OET, 8.1 ± 0.9 ml·min−1·100−1 g) and was associated with enhanced myogenic and α-adrenergic vasoconstriction of AT-resistance arteries from the OET group relative to OSed. These results indicate that there is an inability to increase vascular resistance in AT during exercise with old age, due, in part, to a diminished vasoconstriction of AT arteries. Furthermore, the results indicate that exercise training can augment vasoconstriction of AT arteries and mitigate age-related alterations in the regulation of AT blood flow during exercise.

Purpose: This paper attempts to develop production functions (PF) between aerobic exercise inputs and long-run health outputs. Future studies could use such PF for estimating the benefits and costs (broadly defined) of different exercise programs to help develop optimal (utility maximizing) ones. Methods: To develop the PF, the paper reviewed the biomedical literature for the major dose-response relations between health, physical fitness, and exercise. Where relevant, the paper converted the dose-response relationships from relative risks to absolute probabilities and standardized terminology and units of measures. Results: The paper develops a clear set of biological PF that illustrate, quantitatively, how increases in peak cardiorespiratory (CR) fitness as measured by a short stress test reduce the probability of all-cause mortality; how increasing intensities of short (approximately 30 min, three to five times a week) exercise sessions increase peak CR fitness or retard its age-related decline; and how consistent exercise reduces the risk of myocardial infarctions (MI). Conclusions: The exercise-long-run health PF developed in this paper should provide a useful framework for other studies to estimate the broadly defined costs and benefits of different exercise programs and to help develop optimal ones.

The main objective of this thesis is to get know about introduce the principles of hemodialysis, blood flow measurement methods and the creation the system and peripheral design of blood flow meter. The thesis contains an introduction to hemodialysis, a description of the dialysis monitor, the distribution of ultrasonic flow meters and system design of blood flow meter with a brief description of each function block, circuit diagram of a flow meter and experimental verification of the circuit. There are also the list of components, printed circuit board drawing and technical drawing of the sensor included.

The aim of this work is to find a stable scheme which would solve the Stokes problem of the fluid flow, in which an elastic structure is immersed. Unlike most of the schemes solving fluid-structure interaction problems, in our scheme meshes of fluid and structure do not have to coincide. We have restricted ourselves to two-dimensional domain occupied by fluid with one-dimensional im- mersed structure. To describe a fluid-structure interaction, we have used an Immersed boundary method. At first we consider the strucure to be massless. We have modified an existing scheme and made it unconditionally stable, which was mathematically proven and numerically tested. Then we have proposed a modification where the structure is not massless and also proved the uncondi- tional stability in this case. The proposed schemes were implemented using the Freefem++ software and tested on aneurysm-like geometry. We have tested the behavior of our scheme in case when the qrowing aneurysm touches an obstacle, for example a bone (with no-slip condition on the bone boundary). Powered by TCPDF (www.tcpdf.org)