Thesis (Ph. D.)--University of Wisconsin--Madison, 1976. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M.S.)--University of Wisconsin--Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 79-80).

Orientador: Anamarli Nucci / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-03T19:33:58Z (GMT). No. of bitstreams: 1 Carandina-Maffeis_Rosana_M.pdf: 2259720 bytes, checksum: 14e27a6d30270e69678079e6624e4f16 (MD5) Previous issue date: 2003 / Resumo: A miastenia grave (MG) é a doença autoimune melhor compreendida. Assume grande importância por suas manifestações clínicas de morbi-mortalidade, as quais declinaram com o maior conhecimento fisiopatológico da doença nas últimas décadas . Analisou-se retrospectivamente os prontuários dos pacientes adultos com MG autoimune do Hospital de Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas ( HC - FCM - UNICAMP ), acompanhados no período de 1982 a 2001. Enfocou-se dados de apresentação clínica, exames complementares, tratamento e evolução. Medidas de significância estatística foram realizadas por teste do Qui-Quadrado ou teste exato de Fisher quando indicado, com significância quando p < = 0,05; e por análise de regressão logística multivariada para resposta dicotômica. Foram estudados 127 casos, 71% mulheres e 29% homens, com média de idade de início da MG de 36,95 e mediana de 32 anos. Doenças autoimunes associadas estavam presentes em 19,68%. Na classificação de Osserman e Genkins ( O e G ) 17,3% foram grau I, 42,5% IIa, 29,9% IIb, 7,1% III e 3,1% IV . Um primeiro teste de estimulação nervosa repetitiva ( TER ) evidenciou decremento > 10% em 69,57%, e em 25% dos casos grau I. Anticorpos anti receptor de acetilcolina (AcARACo ), fração ligador, foram positivos em 67,24% dos casos submetidos ao exame. A tomografia computadorizada ( TC ) de mediastino mostrou uma sensibilidade de no máximo 75% para detecção de timoma e especificidade de 67,92%. O exame anátomo patológico evidenciou 16% de timoma. A timectomia como parte da terapêutica foi realizada em 59% dos casos. Anti-colinesterásico foi utilizado em 96,9%, prednisona em 86%, outros imunossupressores em 35%, plasmaférese aguda em 20% e a imunoglobulina (IgIV) aguda em 3,93%. Na evolução 29,13% apresentaram remissão completa, 7,09% remissão farmacológica, 53,54% melhora, 4,72% ficaram inalterados, 0,79% (um caso) piora, 2,36% exacerbação e 2,36% óbito relacionado a MG. Entre os fatores associados com remissão completa mostrou-se significante a realização de timectomia (p=0,0002) e com evolução não favorável o sexo masculino (p=0,0469). Óbitos pela MG foram associados a uma pior classificação de O e G ( graus III e IV ) / Abstract: Introduction: Myasthenia gravis (MG) is the best known autoimmune diseased. There is very importance due to its morbidity and mortality, with improvement in the treatment in the last years. Objectives: to analyze retrospectively the experience of UNICAMP University Hospital about MGAA. Casuistics and Methods: to review retrospectively the charts of adults myasthenic patients attended in Unicamp University Hospital and that were followed in a regular bases during the period 1982-2001. It was analysed the clinical classification, laboratory examinations (repetitive nerve stimulation; acetylcholine receptor antibodies; CT or MRI images of mediastinum and histopathological exams of surgical removed material), treatment and outcome. Variables were analyzed by Chi ¿ square or Fisher' s exact test ( probability ¿ p < = 0,05 was considered significant ), and by multivariance regression analysis. Results: 127 patients fulfilled criteria for MGAA , 71% were females and 29% males; 87,4% white and 11,81% black. The mean age at the beginning of MG was 36,95 years, median 32 years, extremes 19 and 71 years. Another autoimmune disease was present in 19,68%. Osserman-Genkins scale classified 17,3% as grade I, 42,5% as IIa, 29,9% as IIb, 7,1% as III and 3,1% as grade IV. Repetitive nerve stimulation was positive in 69,57%, and only in 25% grade I. Acetylcholine receptor antibodies was positive in 67,24% from the cases that performed the exam. CT images of mediastinum showed 75% sensibility for diagnosis of thymoma and 67,92% specificity. Thymic histopathology revealed thymoma in 16%. Seventy five patients (59%) were submitted to thymectomy. The treatment with anticholinesterasic agents was prescribed for 96,9%, prednisone for 86%, and another immunossupressor for 35%. Plasmapheresis was indicated in 20% and intravenous immunoglobulin in 3,93%. Evolution: 29,13% was in complete remission, 7,09% in pharmacologic remission, 53,54% were considered improved, 4,72% had unchanged status, 0,79% (one case) worse, 2,36% exacerbation and 2,36% died of MG. Thymectomy associated to complete remission was considered significant (p=0,0002), and males were associated to unfavorable evolution (p=0,0469). Death of MG was associated to a worse clinical classification on Osserman-Genkins scale. Conclusions: One hundred and Twenty seven pacients with MGAA were followed; and clinical presentation range from ocular MG to severe MG, but mild generalized MG predominated. The treatment considered drugs and thymectomy. A favorable evolution was observed in 90% of cases / Mestrado / Neurologia / Mestre em Ciências Médicas

Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references. Available also from UMI/Dissertation Abstracts International.

Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references (leaves 200-211). Available also in a digital version from Dissertation Abstracts.

Not available / text

In the field of spinal-cord neurophysiology, the nature of and the rules which govern the strength of functional connections between muscle afferents and motoneurons supplying the same muscle are important to delineate. This study addressed a facet of this issue by testing the possibility that the strength of the spindle Ia-motoneuronal connections is stronger (as demonstrated by the differing amplitudes of the mean maximum composite Ia EPSPs) if both neurons supply the same sub-volume of the muscle, providing the various sub-volumes of the muscle are capable of independent action. Intracellular recordings were made of the Ia EPSP responses of semimembranosus (SM) and lateral gastrocnemius (LG) motoneurons in anesthetized low-spinal cats to electrical stimulation (Group I range) of nerve branches supplying different parts of the homonymous muscle, as well as different heteronymous muscles. For study of SM motoneurons, stimulated nerve branches included those supplying the anterior (SMa) and posterior (SMp) heads of the SM muscle and three providing heteronymous input from the anterior (BFa) and posterior (BFp) parts of biceps femoris and the distal part of the semitendinosus (STd) muscle. Ia EPSPs were partitioned such that stimulation of the SMa nerve branch produced significantly larger EPSPs in SMa motoneurons than in SMp cells; likewise, stimulation of the SMp nerve branch produced larger EPSPs in SMp motoneurons than in SMa cells. Study of the differences in the strength of heteronymous Ia input (i.e., from BFa, BFp and STd) between the SMa and SMp cell groups correlates with the different actions reported previously for the two heads of the SM muscle. For study of LG motoneurons, the stimulated nerve branches were those supplying the four neuromuscular compartments of the LG muscle (LG1, LG2, LG3 and LGm) and the nerve to a heteronymous muscle, soleus (SOL). In all five instances, partitioned Ia effects were evident. An association is suggested between the present results and previous electromyographic studies. The previous studies have shown that the muscle heads (SM) or neuromuscular compartments (LG) under consideration in this study are capable of somewhat separate actions. The present study also included assessment of the relative extent to which the partitioned Ia effects could be attributed, in part, to one or two developmental factors, topographic specificity and species specificity. The analysis suggested that both factors were potentially implicated, with species specificity somewhat predominant over topographic specificity.

Thesis (Ph.D.) - University of Glasgow, 2008. / Ph.D. thesis submitted to the Division of Molecular Genetics, Institute of Biomedical and Life Sciences, University of Glasgow, 2008. Includes bibliographical references. Print version also available.

Orientador: Lea Rodrigues Simioni, Yoko Oshima Franco / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-12T10:25:13Z (GMT). No. of bitstreams: 1 RochaJunior_DimasdosSantos_M.pdf: 1074208 bytes, checksum: 78f54f332c4a0788a9a1522ffdfffefa (MD5) Previous issue date: 2008 / Resumo: O dimetilaminoetanol (DMAE) é comercializado em vários países como suplemento da dieta, amplificador da cognição e também como matéria-prima de produtos cosméticos. No Brasil, a Agência Nacional de Vigilância Sanitária aprovou o uso cosmético em 2002, visando a uma ação antienvelhecimento, após a observação do efeito colateral decorrente da administração oral do medicamento Deanol-®: contração involuntária da musculatura do rosto e do pescoço. Pesquisou-se, neste trabalho, a ação do DMAE em preparação isolada do nervo frênico-diafragma de camundongos, utilizando-se técnicas miográfica e eletrofisiológica. DMAE, sob o parâmetro miográfico, mostrou dois efeitos neuromusculares principais, dependentes da concentração: o facilitador da neurotransmissão (1 mg/mL, n = 6 e 4 mg/mL, n = 11) e o bloqueador neuromuscular completo aos 40 minutos (20 mg/mL, n = 4). Em preparações previamente curarizadas (d-Tubocurarina, 10 µg/mL) e sob estímulo direto, o DMAE (8 mg/mL, n = 3) aumentou a amplitude da contração muscular (30%), mostrando uma ação direta sobre a fibra muscular; enquanto sob estímulo indireto, demonstrou não possuir ação anticolinesterásica. O DMAE, sob o parâmetro eletrofisiológico, agiu pré-sinapticamente sobre a terminação nervosa, constatado pelo aumento gradativo dos valores de conteúdo quântico (1 mg/mL, n = 4). As implicações desses resultados são discutidas neste trabalho. / Abstract: The dimethylaminoethanol (DMAE) is commercialized in several countries as diet supplement, amplifier of the cognition and also as substance in the constitution of cosmetic products. In Brazil, the cosmetic use was approved by the Agência Nacional de Vigilância Sanitária, in 2002, aiming at an antiaging action, after the collateral effect from oral Deanol® administration: the involuntary contraction of the face and the neck muscles. The objective of this work was to study the DMAE action in isolated mouse phrenic nerve-diaphragm preparation, using myographical and electrophysiological techniques. DMAE, under myographical parameter, showed two main neuromuscular and concentration-dependents effects: the facilitatory (1 mg/mL, n = 6 and 4 mg/mL, n = 11) and the neuromuscular blocker at 40 min (20 mg/mL, n = 4). In pre-curarized preparations (d-Tubocurarine, 10 µg/mL) and under direct stimuli, DMAE (8 mg/mL, n = 3) increased the amplitude of muscular contraction (30%), showing a direct action on the muscular fiber; whereas under indirect stimuli, showed to have no anticholinesterasic action. DMAE, under electrophysiological parameter did act presynaptically on the nervous terminal by a gradual increase of quantum content values (1 mg/mL, n = 4). The implications of these results are argued in this work. / Mestrado / Mestre em Farmacologia

Orientadores: Angelica de F. Assunção Braga, Gloria M. Braga Poterio / Tese (doutorado) - Universidade Estadual de Campínas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-03T16:20:50Z (GMT). No. of bitstreams: 1 Munhoz_DerliConceicao_D.pdf: 15032169 bytes, checksum: 2cf164e00717816740722f20f7f288c8 (MD5) Previous issue date: 2003 / Resumo: Além dos fatores relacionados ao paciente, ao bloqueador neuromuscular, fatores técnicos relacionados com a monitorização da função neuromuscular podem influenciara instalação do bloqueio neuromuscular. O objetivo do presente estudo foi avaliar a influência de duas diferentes freqüências de estúnulos sobre o tempo de instalação do bloqueio neuromuscular produzido pelo Pancurônio e pelo Rocurônio. Este estudo foi desenvolvidoem duas etapas: uma etapa clínica e uma experimental. No estudo clínico foram incluídos 120 pacientes, estado ASA I e lI, submetidos a cirurgias eletivas sob anestesia geral, distn"buídos aleatoriamente em dois grupos de acordo com a freqüência de estúnulos empregada: Grupo I - O,lHz (n=60) e Grupo II - 1Hz (n=60). Em cada grupo formaram-se dois subgrupos (n=30) de acordo com o bloqueador neuromuscular empregado: Subgrupo P (pancurônio - O,lmg.kg-l) e Subgrupo R (rocurônio - 0,6mg.kgO1). Após indução anestésica e injeção do bloqueador neuromuscular, os pacientes foram ventilados sob máscara com oxigênio a 100% até a obtenção de redução de 75% ou mais na amplitude da resposta do músculo adutor do polegar, quando foram realizadas as manobras de laringoscopia e intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Avaliaram-se: parâmetros neuromusculares (tempo de início de ação do bloqueador neuromuscular e tempo para bloqueio neuromuscular total) através da análise dos registros das respostas do músculo adutor do polegar obtidas por estimulação do nervo ulnar, com auxílio de estimulador de nervo periférico (TOF-GUARD); condições de intubação traqueal; pressão arterial média e fteqüência cardíaca. No grupo 1,subgrupos P e R, os tempos para início de ação foram, respectivamente, 159,33 :t 35,22 e 83,0 :t 17,25 segundos. No grupo lI, subgrupos P e R, foram 77,83 :t 9,52 e 48,96 :t 10,16 segundos, respectivamente. Os tempos para obtenção de bloqueio neuromuscular total foram 222,0 :t 46,56 e 125,33 :t 20,12, no Grupo 1,subgrupos P e R, respectivamente.No grupo lI, foram de 105,96:t 18,58 e 59,83 :t 10,36 segundos nos subgrupos P e R respectivamente. Nos dois subgrupos, os tempos de início de ação e para bloqueio neuromuscular total foram significativamente menores no Grupo II em relação ao Grupo I. As condições de intubação traqueal foram satisfatórias em 117 pacientes (97,5%) e insatisfatórias em 3 (2,5%). No estudo experimental foram utilizados ratos machos da linhagem Wistar, com peso entre 250 e 300g. As preparações foram montadas de acordo com a técnica descrita por BULBRING (1946). O diafTagma foi submetido à estimulação indireta de 0,1 e 1Hz de :freqüência (Grupos I e II, respectivamente) e as variações de tensão produzidas pelas contrações do diaftagma foram registradas em fisiógrafo Gould RS 3400. Formaram-se subgrupos (n=5) PE e RE de acordo com o bloqueador neuromuscular empregado (pancurônio-2J.1g/rnle rocurônio-4J.1g/rnl,respectivamente). O grau de bloqueio das respostas do músculo diaftagma foi avaliado em 5, 15 e 30 minutos após a adição do bloqueador neuromuscular. Nos dois grupos (Grupo I - O,lHz e Grupo II - 1Hz) e subgrupos PE (pancurônio) e RE (rocurônio), observou-se um aumento cumulativo nos graus de bloqueio das respostas musculares com diferença significativa entre os diferentes tempos estudados em relação à resposta muscular controle. Nos dois subgrupos, a comparação dos valores médios dos graus de bloqueio nos diferentes tempos estudados entre os dois grupos também mostrou diferença estatisticamente significante. Para as duas drogas, os graus de bloqueio neuromuscular para o Grupo II foram maiores do que para o Grupo I, em todos os instantes (p < 0,01). Concluímos que, tanto no estudo clínico como no experimenta~ a freqüência de estímulo empregada interfere no tempo de instalação do bloqueio neuromuscular: tempo de início de ação e de bloqueio neuromuscular total menores com a maior freqüência nos dois subgrupos / Abstract: In addition to factors related to patient and neuromuscular blocker, technical factors related to neuromuscular monitoring may also influencethe onset of neuromuscular blockade. The aim of the present study was to evaluate the influence of two different stimulation :&equencieson onset time of the neuromuscular blockade produced by Pancuronium and Rocuronium. This study was conducted in two stages: clinical and experimental. The clinical study included 120 patients, ASA I and II physical status, submitted to elective surgery under general anesthesia, random1y distributed into two groups according to the stimulation :&equencyused: GToup 1-0.1 Hz (n=60) and GToup lI-I Hz (n=60). In each group two subgroups were formed (n=30), according to the neuromuscular blocker used: Subgroup P (pancuronium-O.l mg.kg-l) and Subgroup R (rocuronium-0.6 mg.kg-l). Afier induction of anesthesia and injection of the neuromuscular blocker, the patients were ventilated by mask with 100% oxygen until achieving a 75% or more reduction in the amplitude of the abductor pollicis muscle response. That was the moment laryngoscopy and tracheal intubation were performed. Neuromuscular function was monitored by acceleromyography. Neuromuscular parameters were evaluated (the onset time of NMB action and time to maxima1 neuromuscular blockade) ana1yzingrecordings of adductorpollicis muscle response, obtained by stimulating the ulnar nerve with a neuromuscular transmission monitor (TOF-GUARD). Tracheal intubating conditions, mean arterialpressure and heart rate were also evaluated. In GToupI, onset times for subgroups P and R were 159.33 :i:35.22and 83.0 :i: 17.25 seconds, respectively. In GTouplI, onset times for subgroups P and R were 77.83 :i:9.52 and 48.96 :i: 10.16 seconds, respectively. Times to maxima1neuromuscularblockadein GToupI, subgroupsP and R were 222.0 :f: 46.56 and 125.33 :f: 20.12 seconds, respectively. In GTouplI, times to maxima1neuromuscular blockwere 105.96 :i: 15.58 and 59.83 :i: 10.36 for subgroups P and R, respectively. In both subgroups, onset times of action and times to maxima1 neuromuscular block were significant1yshorter in GToup II than in GToup I. Tracheal intubating conditions were suitable in 117 (97.5%) and unsuitable in 3 (2.5%) patients. In the experimental study, Wistar male rats, weighing between 250 and 300g were used. Microscope preparation was mounted according to the technique described by BULBRING (1946). An indirect stimulation of 0.1 to 1 Hz was applied to the diaphragm (GToupsI and lI, respectively) and tension variations produced by diaphragmatic contractions were recorded by a Gould RS 3400 physiographer. Subgroups PE and RA (n=5) were fonned, according to the neuromuscular blocker used (pancuronium-2 ~g/m1and rocuronium-4 ~g/m1,respective1y). The degree of diaphragmatic blockade was evaluated at 5, 15 and 30 minutes after adding the neuromuscular bIocker. In both groups (Group 1-0.1 Hz and Group 11-1 Hz) and subgroups RE (rocuronium) and PE (pancuronium), a cumulative increase in the degree of musc1eblockade was observed. There was a significant difrerence between difrerent times studied compared to controI musc1e response. In both subgroups, there was also a statistica11ysignificant difrerence when comparing the mean values of degrees of bIockade between both groups at difrerent times studied. For both drugs, the degree ofneuromuscular bIock for Group 11is greater than for Group I, at alI moments (p<0.01). We conc1ude that both in the clinical and experimental study the stimulation ftequency applied interfere with the onset time of neuromuscularbIockade / Doutorado / Medicina Interna / Doutor em Ciências Médicas