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Origem do plexo braquial e seus nervos em quatis (Nasua nasua Linnaeus, 1766) / Brachial plexus origin and their nerves in quati (Nasua Nasua, Linnaeus, 1766)Felipe, Rodrigo Lopes de 23 January 2014 (has links)
The coati is a procionidae foun in American cerrado. It is as animal with little
morphological features, characterized by the neural system. The objective of this
work was to study the origin and distribution of the brachial plexus of this taxon. Five
adult specimens were dissected, however, without a definitr age, donated by IBAMA
or collected dead on the banks of higways. The specimes were fixed in aqueous
formaldehyde solution, 10% and kept immersed the same solution before and
dissection. The formationof the brachial plexus occurred between the ventral branch
of the fifth cervical spinal nerve (C5), to the first thoracic (T1), origined the nerves
supraescapular, subescapulares (cranial e caudal), toracodorsal, axilar, radial,
musculocutâneo, mediano, ulnar e peitorais (cranial e caudal) and distributed in the
neck, chest and forelimb. / O quati é um procionídeo encontrado no cerrado americano. Consiste em um
animal silvestre com aspectos morfológicos do sistema nervoso pouco caracterizado.
O objetivo deste trabalho é estudar a origem e distribuição do plexo braquial deste
táxon. Foram dissecados cinco espécimes adultos, porém, sem idade definida,
doados pelo IBAMA ou coletados mortos às margens de rodovias. Os espécimes
foram fixados em solução aquosa de formol, a 10% e conservados imersos em igual
solução, antes a após a dissecação. A formação do plexo braquial ocorreu entre o
ramo ventral do quinto nervo cervical espinhal (C₅), até o primeiro torácico (T₁),
dando origem aos nervos supraescapular, subescapulares (cranial e caudal),
toracodorsal, axilar, radial, musculocutâneo, mediano, ulnar e peitorais (cranial e
caudal) distribuindo-se no pescoço, tórax e membro torácico. / Mestre em Ciências Veterinárias
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Avaliação da sensibilidade no trajeto do nervo intercostobraquial, em mulheres com linfadenectomia axilar, pós-cirurgia por câncer de mama / Evaluation of the sensibility in the region of the intercostobrachial nerve, in women with linfadenectomia axillary after surgery for breast cancerBreast Cancer. Innervation. Evaluation.Marina Scarulis Mamede dos Santos 04 July 2008 (has links)
A cirurgia da remoção da mama, associada à linfadenectomia axilar, tem sido o tratamento tradicional do câncer de mama. Apesar dos seus benefícios, a cirurgia está associada a algumas seqüelas e complicações, entre elas, as alterações de sensibilidade no trajeto do nervo intercostobraquial. Objetivos: Analisar, através do estesiômetro de Semmes-Weinstein, as alterações de sensibilidade no trajeto do nervo intercostobraquial, em mulheres que realizaram linfadenectomia axilar, por câncer de mama; identificar os descritores de alteração de sensibilidade, segundo a percepção dessas mulheres; comparar a sensibilidade entre mulheres com e sem linfadenectomia axilar; comparar a percepção da sensibilidade de mulheres com linfadenectomia com a resposta obtida com a utilização do estesiômetro. Métodos: Foi aplicado o estesiômetro de Semmes-Weinstein para a avaliação da sensibilidade no trajeto do nervo intercostobraquial e um questionário com dados pessoais e sociodemográficos, acerca do tratamento e sobre a percepção da sensibilidade no membro superior. Participaram desse estudo, 94 mulheres, divididas em dois grupos: um grupo composto por 47 mulheres que realizaram linfadenectomia axilar por câncer de mama e um grupo composto por 47 mulheres não diagnosticadas por câncer de mama e sem qualquer tipo de cirurgia nas axilas. Em cada participante foi realizado o teste com o estesiômetro, por duas vezes consecutivas, e no grupo com cirurgia, também foi aplicado o questionário. Resultados: A prevalência de alteração de sensibilidade, avaliada por meio do estesiômetro de Semmes-Weinstein foi alta, mostrando que 85,1% das mulheres do grupo com linfadenectomia axilar tiveram respostas abaixo dos valores considerados de normalidade, baseado nas respostas do grupo sem linfadenectomia axilar. Foi confirmada a repetibilidade na aplicação do estesiômetro, no grupo com linfadenectomia, através do teste de Kappa (p = 0,8696). O sintoma mais relatado foi adormecimento (70,2%). Conclusões: Na população desse estudo, a queixa de alterações de sensibilidade teve alta prevalência e consideramos o estesiômetro um aparelho de fácil aplicação na prática clínica, baixo custo e confiável. Porém, enfatizamos a importância do treinamento do profissional que irá aplicá-lo e a padronização do teste, de acordo com as orientações do fabricante. / The surgery of the removal of the breast associated to the axillary lymph node dissection has been the traditional treatment for breast cancer. In spite of their benefits, the surgery is associated some sequels and complications, among them the sensibility alterations in the region of the intercostobrachial nerve. Objective: To analyze the sensibility alterations around intercostobrachial nerve in women who were operated by axillary lymph node dissection, for breast cancer through the Semmes- Weinstein monofilament testing; to identify the subject headings of sensibility alteration according to those women\'s perception; to compare the sensibility among women with and without axillary lymph node dissection; and to compare the perception of the women\'s sensibility with axillary lymph node dissection with the answer obtained by the Semmes-Weinstein monofilament testing. Methods: The Semmes-Weinstein monofilament testing was applied for the evaluation of the sensibility in the region of the intercostobrachial nerve and a questionnaire with personal data and sociologically demographic aspects, concerning the treatment and about the perception of the sensibility in the superior member. In that study, 94 women took part in, divided in two groups. A group composed by 47 women that were operated by axillary lymph node dissection for breast cancer and a group composed by 47 women no diagnosed by breast cancer and without any axillary surgery. In each participant the test was accomplished with the monofilament for twice consecutive and in the group with surgery the questionnaire was applied also. Results: The prevalence of sensibility alteration, appraised through the Semmes-Weinstein monofilament testing it was high, 85,1% of the group with axillary lymph node dissection had answers below the considered values of normality, based on the answers of the group without axillary surgery. The repeatability was confirmed in the application of the monofilament in the group with axillary lymph node dissection through the test of Kappa (p=0,8696). The symptom more told was numbness (70,2%). Conclusions: In the population of that study, the complaint of sensibility alterations had high prevalence and we considered the Semmes-Weinstein monofilament testing appliance of easy application in practice clinic, low cost and reliable. However we emphatize the importance of the professional\'s training that will apply it and the standardization of the test in agreement with the manufacturer\'s orientations.
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Extraocular Muscles in Amyotrophic Lateral SclerosisTjust, Anton January 2017 (has links)
Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disease of motor neurons characterized by muscle paralysis and death within 3-5 years of onset. However, due to unknown mechanisms, the extraocular muscles (EOMs) remain remarkably unaffected. The EOMs are highly specialized muscles that differ from other muscles in many respects, including innervation and satellite cells (SCs). Understanding whether these factors play a role in the relative sparing of EOMs in ALS could provide useful clues on how to slow down the progression of ALS in other muscles. The EOMs and limb muscles from terminal ALS patients and age-matched controls as well as the commonly used SOD1G93A ALS mouse model were studied with immunofluorescence. Antibodies against neurofilament and synaptophysin were used to identify nerves and neuromuscular junctions (NMJs); against Pax7, NCAM, MyoD, myogenin, Ki-67, dystrophin and laminin, to identify SCs and their progeny in EOMs and limb muscles. The proportion and fiber size of myofibers containing myosin heavy chain (MyHC) slow tonic and MyHC slow twitch were also determined in human EOMs. The abundance of SCs differed extensively along the length of control human EOMs, being twice as abundant in the anterior portion. Pax7-positive cells were also detected in non-traditional SC positions. EOMs from terminal ALS patients showed similar numbers of resting and activated SCs as the controls. In limb muscles of ALS patients, the number of resting and activated SCs ranged from low (similar to normal aged, sedentary individuals) to high numbers, especially in muscles with long duration of disease and varied between the upper and lower limbs. The EOMs maintained a high degree of innervation compared to hindlimb muscles of symptomatic SOD1G93A mice. MyHC slow tonic fibers were less abundant in ALS patients than in controls. The change seemed more pronounced in bulbar onset patients, and in this group of subjects only, there was a strong association between decline in MyHC slow tonic fibers and age of death. Notably, the decline in MyHC slow tonic fibers was unrelated to disease duration. Our data suggested that SCs play a minor role in the progression of ALS in general and in the sparing of the EOMs in particular. The generally preserved innervation in the EOMs of G93A mice may reflect distinct intrinsic properties relevant for sparing of the oculomotor system. Even though the EOMs are relatively spared in ALS, MyHC slow tonic myofibers were selectively affected and this may reflect differences in innervation, as these fibers are multiply innervated. / Amyotrofisk lateralskleros (ALS) är en obotlig neurodegenerativ sjukdom som främst påverkar kroppens viljestyrda motoriska nervceller. ALS leder till förlamning, muskelförtvining och slutligen döden genom andningssvikt, vanligen inom tre till fem år efter sjukdomsdebuten. Av okända anledningar så bibehålls ögonmusklernas funktion mycket bättre vid ALS i jämförelse med andra muskler och är hos merparten av patienter i stort sett opåverkade. Ögonmusklerna är mycket specialiserade muskler som skiljer sig från andra muskler i kroppen på flera sätt, bland annat genom deras unika nervförsörjning och genom de satellitceller – muskelspecifika stamceller, som finns i dem. En ökad förståelse för hur dessa faktorer inverkar på ögonmusklernas motståndskraft vid ALS skulle kunna ge värdefulla ledtrådar till hur man skulle kunna sakta ned sjukdomens fortskridande i andra muskler vid ALS. Ögonmuskler och extremitetsmuskler från avlidna ALS-patienter och åldersmatchade friska kontroller, tillsammans med transgena möss med den sjukdomsalstrande mutationen SOD1G93A, studerades genom immunfluorescens och efterföljande mikroskopering. Antikroppar mot molekylerna Pax7, NCAM, MyoD, myogenin, Ki-67, laminin och dystrofin användes för att identifiera satellitceller och deras dotterceller i ögonmuskler och extremitetsmuskler. Antikroppar mot neurofilament och synaptofysin användes för att identifiera nerver och neuromuskulära synapser hos transgena SOD1-möss. Antikroppar mot toniska (tonic) och ryckande (twitch) muskelmyosinkedjor användes för att bestämma proportionen av och storleken på dessa typer av muskelfibrer i ögonmuskler från avlidna ALS-patienter och friska kontroller. Mängden satellitceller varierade mellan de främre och de mer bakre delarna i friska, humana ögonmuskler och var dubbelt så många i den främre delen av muskeln jämfört med den mellersta och bakre delen av muskeln. Celler som uttryckte satellitcellsmarkören Pax7 hittades även i icke-traditionella satellitcellspositioner i ögonmusklerna. Mängden satellitceller i ögonmusklerna från ALS-patienter var samma som hos friska kontroller. I extremitetsmusklerna hos ALS-patienter varierade mängden satellitceller mellan låga nivåer (liknande de hos friska åldrade, inaktiva individer) till höga nivåer, särskilt i muskler där sjukdomen fortskridit under lång tid. Dessutom varierade mängden satellitceller mellan övre och nedre extremiteter. Hos symptomatiska SOD1G93A-möss hade ögonmusklerna en mycket välbevarad innervation jämfört med bakbensmusklerna, där många neuromuskulära synapser saknade kontakt mellan nerven och motorändplattan. Proportionen muskelfibrer med toniska muskelmyosinkedjor var lägre hos ALS-patienter jämfört med friska kontroller. Denna minskning var tydligare hos patienter där sjukdomssymtomen hade debuterat i tugg- och ansiktsmuskulaturen – så kallad bulbär ALS. Dessutom fanns det i den här gruppen, men ingen annan studerad grupp, en stark korrelation mellan nedgången i toniska fibrer och patientens ålder. Värt att notera är att minskningen av toniska muskelfibrer saknade korrelation med hur länge patienten hade varit sjuk i ALS. Den generellt välbevarade innervationen i ögonmusklerna hos SOD1G93A-möss kan spegla distinkta inneboende egenskaper hos ögonmusklerna som är av vikt för bevarandet av ögonrörligheten vid ALS. Gällande satellitceller så antyder våra data att satellitceller och deras regenerativa kapacitet spelar en försumbar roll vid ALS i allmänhet och vid ögonmusklernas bevarande i synnerhet. Slutligen, även om ögonmuskler generellt är välbevarade vid ALS så är toniska muskelfibrer märkbart påverkade och detta kan spegla skillnader mellan olika nervcellsgruppers känslighet vid ALS.
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IMMUNODEFICIENT R2G2 MOUSE STRAIN YIELDS SPLEENS WITH UNUSUAL CYTOARCHITECTURE AND SYMPATHETIC INNERVATIONBritt, Nicholas Mason, Miller, Madeleine Kate, Hoover, Donald B., Ph.D., Schweitzer, John B., M.D. 05 April 2018 (has links)
The nervous system and immune system contact one another through two-way communication in order to establish and preserve homeostasis. The sympathetic neurotransmitter norepinephrine has an impact on how the immune system responds by affecting regional blood flow and activation of adrenergic receptors on leukocytes. Former studies showed that immune cells are capable of releasing nerve growth factor allowing for the establishment and continuation of sympathetic nerves in targeted tissues. From this gathered information, it was hypothesized that sympathetic nerves would prove to be less frequent in spleens from the immunodeficient R2G2 mouse strain (Envigo) when compared to 129P3/J (129) and C57BL/6 (C57) strains. R2G2 mice are an immunodeficient strain that lacks functional T, B, and natural killer cells. Ten to eleven week aged-matched male mice were measured by body weight, spleen weight, and temperature. Spleens were cut and fixed for histological investigation. Sympathetic nerves were labeled by immunostaining tyrosine hydroxylase (TH). Hematoxylin & eosin (H&E) was used to stain spleen sections in order to evaluate cytoarchitecture. Von Willebrand factor (VWF) was used to immunostain for megakaryocytes. R2G2 mice showed slightly higher temperatures and body weights but yielded a significantly smaller spleen weight (R2G2, 38.20 ± 1.48; 129, 65.08 ± 11.71; C57, 81.33 ± 8.38; P< 0.0001, ANOVA). TH stain revealed sympathetic innervation in all strains but location and morphology differed in R2G2 mice compared to controls. Control spleens had nerves which entered white pulp regions of the spleen and were closely related to leukocytes. Fiber profiles in the controls were filamentous with small acute bends. R2G2 differed by having (TH+) nerve fibers more associated with arteries and less localized in the surrounding parenchyma. The fibers were abnormally swollen and held a more granular shape instead of a filamentous shape. The H&E stain showed clear red and white pulp zones in the control spleens with 129 showing more distinct germinal centers than C57. R2G2 H&E sections showed cytoarchitecture with indistinct pulp areas. VWF staining revealed R2G2 mice had an abundant amount of megakaryocytes versus control mice megakaryocyte counts (R2G2, 11.28 ± 3.87 per 20X field; 129, 1.73 ± 0.70; C57, 1.42 ± 0.13; P< 0.0001, ANOVA) and extramedullary hematopoiesis was highly prominent. This evidence supports that leukocytes secrete neurotrophic factors or are vital to establishing normal growth of TH+ nerves toward the white pulp. Leukocytes may not be required for sympathetic innervation of blood vessels in the spleen, however, lack of leukocytes shows TH+ nerve fibers with abnormal morphology in severely immune threatened mice.
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Studium morfologických a funkčních změn autonomní inervace srdce a cév a jejich příčin u chronických chorobných stavů / Study of morphological and functional alternations of autonomic cardiac and vessels innervation and its causes in chronic diseasesMistrová, Eliška January 2017 (has links)
Within the span of few decades, there has been a significant increase in diabetes mellitus and chronic stress in developed countries, such as the Czech Republic. These conditions have a significant negative effect on physical and mental health. Repeated and long-term exposure to raised levels of glucose, overactivity of the sympathetic nervous system and the increase in plasma levels of stress hormones affects most of the organs in the body, including the heart. The cardiovascular system is regulated by a broad number of neurotransmitters, hormones and neuropeptides. Alterations in the innervation of the cardiovascular system, as a result of both diseases, can affect its physiological functions. The present thesis focuses not only on the role of the classic, but primarily on the peptidergic innervation of the heart. The aim was to contribute to the explanation of the impact of neuropeptides and their shared receptor systems on the genesis and the development of heart damage due to diabetes mellitus and/or exposure to stressors. Knowledge of the physiological characteristics of neuropeptides and their involvement in the pathogenesis of both diseases and related complications could be helpful in determining the optimal treatment method or alternatively allow us to use the cardio protective effect of...
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Cartographie des effets électrophysiologiques auriculaires de la stimulation nerveuse cardiaqueDandan, Nazih Y. January 1994 (has links)
Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Étude de certains paramètres pouvant contribuer aux mécanismes de défense de la surface oculaire chez les oiseaux de proieDupont, Chantal January 1994 (has links)
Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Linterface neuro-immune et lexpression de la protéine prion cellulaire dans le cadre des maladies à prions. Une étude comparative des espèces bovine et humaineDefaweux, Valérie 01 June 2007 (has links)
Le tropisme cellulaire des prions infectieux diffère selon lespèce animale, celui-ci est corrélé à la souche infectieuse et à des facteurs spécifiques de lhôte. Par exemple, certains prions infectieux sont lymphotropiques, notamment en cas de scrapie chez les moutons et de variant de la maladie de Creutzfeldt-Jakob (vMCJ) chez lhomme. Par opposition, certains prions se caractérisent par un neurotropisme comme observé chez des patients Creutzfeldt-Jakob atteints de la forme sporadique ou chez des bovins atteints dencéphalopathies spongiformes bovines (ESB).
Lhypothèse de notre travail repose sur les observations suivantes : dans le cas du variant de la maladie de Creutzfeldt-Jakob et des encéphalopathies spongiformes bovines, lagent responsable est identique, la voie dinoculation et les lésions neurologiques le sont également, seul le tropisme de cette souche pour les organes lymphoïdes diffère.
En effet, les amygdales, la rate et lappendice sont infectieux chez lhomme. Par contre, linfectiosité est surtout confinée au niveau du système nerveux chez le bovin. Lors dune inoculation expérimentale par voie orale de lagent responsable de lESB chez les bovins, les plaques de Peyer iléales sont les seuls tissus lymphoïdes infectieux.
Notre hypothèse de travail est que des propriétés de lhôte interviennent dans le tropisme de lagent infectieux.
Deux axes de recherche ont été envisagés afin de vérifier cette hypothèse :
Lanalyse de la distribution des fibres nerveuses au sein des tissus lymphoïdes associés aux muqueuses (MALT) des espèces bovine et humaine
Létude de lexpression de PrPc et de ses isoformes au sein des tissus lymphoïdes et nerveux des espèces bovine et humaine.
Pour atteindre au mieux nos objectifs, il nous manquait un outil essentiel permettant la caractérisation spécifique des FDC bovines. En effet, aucun marqueur spécifique de ces cellules nétait commercialisé. Nous avons donc produit, en collaboration avec le Centre dEconomie Rural de Marloie, un anticorps monoclonal spécifiquement dirigé contre les cellules folliculaires dendritiques (FDC) bovines. Cet anticorps nous a permis détudier la distribution des FDC au sein des organes lymphoïdes bovins. Une attention particulière a été portée aux FDC isolées à partir des plaques de Peyer jéjunales (PPJ) et iléales (PPI). Lapparente différence dinfectivité de ces tissus lymphoïdes chez des bovins atteints expérimentalement dESB nous a conduit à comparer les capacités fonctionnelles des FDC isolées à partir de PPJ et de PPI. Ces observations sont décrites et discutées dans le chapitre 1.
Dans le chapitre 2, nous avons établi une cartographie des fibres nerveuses au sein des amygdales, des plaques de Peyer iléales et jéjunales bovines de plusieurs catégories dâge et ensuite comparé ce pattern dinnervation à celui des amygdales humaines; ceci permettra de pister les voies potentielles de neuro-invasion. Une attention particulière a été portée à linterface cellules folliculaires dendritiques fibres nerveuses. En effet, les FDC matures jouent un rôle prépondérant dans la pathogenèse des maladies à prion puisquen leur absence, une infection périphérique na pas lieu. De plus, la proximité entre fibres nerveuses et FDC est un paramètre intervenant dans la neuro-invasion; nous avons dès lors aussi analysé les contacts entre les FDC et les éléments nerveux.
Lexpression de la PrPc est une condition sine qua non pour la formation de PrPres. Cette protéine cellulaire sert probablement de récepteur pour son homologue infectieux mais sert surtout de substrat pour lamplification de PrPres ; toute modification au niveau de sa synthèse pourrait entraîner un changement de la cinétique dinfection et pourrait expliquer lapparente absence dinfectivité constatée au niveau du système immunitaire chez les bovins. Lexpression tissulaire et cellulaire spécifique disoformes de la PrPc représente un facteur de lhôte potentiellement capable dinfluencer le tropisme cellulaire de lagent infectieux chez lhumain et le bovin. Cette expression a été étudiée dans les systèmes MALT bovins et humains. Pour affiner notre étude, nous avons analysé, par des techniques de western-blotting, le glycopattern de la PrPc ainsi que lexpression de ses formes tronquées dans les tissus lymphoïdes humains et bovins mais également dans des populations cellulaires spécifiques, les lymphocytes et les FDC. Afin de vérifier si les isoformes de PrPc sont spécifiques aux tissus lymphoïdes, nous avons effectué une étude comparative du pattern de glycosylation et du ratio des formes clivées de PrPc, exprimés au sein de différentes régions du système nerveux central bovin et humain. Les résultats de ces travaux sont repris dans le chapitre 3.
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L'innervation en ingénierie dentaire / The innervation in tooth engineeringKökten, Tunay 06 October 2014 (has links)
Notre approche biomimétique permet de régénérer une dent entière. Un protocole en deux étapes à partir de réassociations de cellules dentaires embryonnaires permet le développement de la couronne in vitro et, après implantation, la différenciation fonctionnelle des cellules, l’initiation du développement radiculaire et la vascularisation dentaire. Cependant, l’absence d’innervation a nécessité des expériences complémentaires :- La co-implantation de réassociations cellulaires avec un ganglion trigéminal permet la croissance d’axones autour de la dent formée, mais pas dans le mésenchyme dentaire.- Pour tenter de résoudre ce problème, la régénération axonale a été testée dans un contexte immunodéprimé en utilisant la cyclosporine A (CsA). Dans ces conditions, des fibres nerveuses entrent dans la pulpe dentaire, jusqu’aux odontoblastes. Cependant, la CsA a aussi un effet direct sur la croissance axonale.- Des co-implantations chez des souris immunodéprimées (Nude) montrent que l’immunomodulation seule suffit pour l’innervation de la dent.- Dans la dent, les axones assurent différentes fonctions en interagissant avec les cellules voisines. Les relations entre axones et autres cellules (odontoblastes, cellules endothéliales, péricytes et cellules gliales) ont été analysées dans les mésenchymes dentaire et péri-dentaire de réassociations implantées et comparées à ce que l’on observe pour une molaire physiologique à un stade similaire.Ce travail décrit les conditions permettant l’innervation des dents régénérées. Des expériences préliminaires encourageantes ont été réalisées avec des cellules souches pour remplacer la CsA. / Our biomimetic approach allowed the regeneration of a whole tooth. Using embryonic dental cells, a two-steps protocol allowed crown formation in vitro and, after implantation, functional cells differentiation, initiation of root formation and tooth vascularization. However, the teeth were not innervated, which led to complementary experiments:- The co-implantation of cell re-associations with a trigeminal ganglion allowed axonal growth around the forming teeth, but not in the dental mesenchyme. - To try to solve this point, axonal regeneration was tested in immunodepressed conditions, using cyclosporin A (CsA). In these conditions, nerve fibers entered the dental pulp and reached odontoblasts. However, CsA shows multiple effects, including direct ones on nerve growth. - Co-implantations were performed in immunocompromised Nude mice allowed axons to reach the odontoblast layer, thus showing that immunomodulation is sufficient.- Axons in the dental mesenchyme interfere with several functions by interacting with neighbor cells. Relationships between axons and other cells (odontoblasts, endothelial cells, pericytes and glial cells) were analyzed in the peridental and dental mesenchymes of implanted reassociations and compared to the physiological situation in developing molars at similar stage. This work describes conditions allowing the innervation of engineered teeth. Preliminary encouraging attempts have been made to replace CsA by using stem cells.
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Innervation pelvi-périnéale : étude anatomique et immuno-histochimique avec reconstruction tridimensionnelle chez le foetus et l’adulte féminin. Applications chirurgicales lors des protectomies pour cancer / Innervation of the pelvis and perineum : anatomical and immunohistochemical study and three-dimensional reconstruction in the fœtus and female adult. Surgical applications during protectcomy for cancerPeschaud, Frédérique 28 June 2011 (has links)
Introduction : Le système nerveux autonome (SNA) est en situation supralévatorienne, le système somatique en situation infra lévatorienne. Le sympathique assurerait les fonctions de sécrétion et le parasympahtique, les fonctions dʼérection. Le rectum est en rapport étroit avec ces éléments nerveux. La protectomie avec exérèse totale du mésorectum pour cancer est associée à des séquelles sexuelles par lésion iatrogène des nerfs pelviens.Objectifs : Étudier la physiologie et lʼanatomie topographique et structurelle de l'innervation pelvipérinéale Matériels et méthodes : Cinq pelvis de foetus et dix pelvis dʼadultes féminins ont été prélevés pour études macroscopiques, microscopiques etimmunohistochimiques des nerfs pelviens. Les coupes ont été colorées puis immunomarquées pour détecter les fibres nerveuses (PS-100), somatiques(PMP22), autonomes adrénergiques (TH), cholinergiques (VAChT), sensitives(CGRP) et les fibres pro-érectiles (nNOS). Les lames ont été numérisées et reconstruites en 3D.Résultats : Les fibres nerveuses du SNA, richement interconnectées,véhiculent de façon mixte lʼinflux sympathique et parasympathique.Celles issues du plexus hypogastrique inférieur contrôlant les fonctions sexuelles sont regroupées avec le pédicule vaginal long et forment la bandelette neuro-vasculaire (BNV) sur la face antérolatérale du rectum à « 2et 10h ». Cette BNV est en avant de lʼexpansion postérolatérale du septum recto vaginal (SRV) qui la protège et qui est lʼéquivalent chez lʼhomme du fascia de Denonvilliers. Cette BNV concentre lʼensemble des fibres nerveusespro-érectiles destinées au périnée. Une lésion tronculaire de cette bandelette pourrait conduire à un trouble de lʼérection clitoridienne et de la lubrification vulvaire car, à ce niveau, les efférences sympathiques et parasympathiques coexistent.Conclusion: Un modèle anatomo-physiologique et pédagogiquedʼinnervation pelvipérinéale féminine a été développé. Ces travaux offrent des perspectives dʼétudes cliniques afin de mieux évaluer les dysfonctions sexuelles postopératoires. / Introduction: The nerve supply of the autonomic nervous system (ANS) to the pelvis is located above the levator ani muscle, and the somatic nerve supply to the pelvis is situated below levator ani. Sympathetic innervation assures secretory functions and parasympathetic innervation allows erection. The rectum is anatomically closely associated with these nerves. Protectomy with total excision of the mesorectum for cancer is associated with sexual sequellae due to iatrogenic damage to the pelvic nerves.Objectives: To study the physiology and topographic and structural anatomy of the innervation of the pelvis.Materials and methods: Five fœtal pelvises and ten adult female pelvises were collected for macroscopic, microscopic, and immunohistochemical studies of pelvic nerves. Sections were stained and then immunostained to reveal nerve fibres (PS-100), somatic nerves (PMP22), adrenergic autonomic nerves (TH), cholinergic autonomic nerves (VAChT), sensory nerves (CGRP) and pro-erectile nerves (nNOS). Sections were numbered and reconstructed in 3D.Results: ANS nerve fibres, densely interconnected, carry a combination of sympathetic and parasympathetic fibres.Nerve fibres controlling sexual function from the inferior hypogastric plexus are clustered along the vaginal pedicle and form the neurovascular bundle (NVB) on the anterolateral face of the rectum between “2 and 10 o’clock”. This NVB is in front of the expansion of the rectovaginal septum (RVS) which protects it. In males, the equivalent structure is the rectoprostratic fascia. This NVB contains all of the pro-erectile nerves supplying the perineum. A truncal lesion to this bundle could result in erectile dysfunction of the clitoris as well as difficulties in vulvar lubrication because sympathetic and parasympathetic efferent fibres are both present at this site.Conclusion: An educational anatomical and physiological model of the innervation of the female pelvis and perineum has been developed. This work offers perspectives for clinical studies to facilitate better evaluation of cases of post-operative sexual dysfunction.
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