898 resultados para Neuromuscular manifestations


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The Rab3 small G protein family consists of four members, Rab3A, -3B, -3C, and -3D. Of these members, Rab3A regulates Ca2+-dependent neurotransmitter release. These small G proteins are activated by Rab3 GDP/GTP exchange protein (Rab3 GEP). To determine the function of Rab3 GEP during neurotransmitter release, we have knocked out Rab3 GEP in mice. Rab3 GEP−/− mice developed normally but died immediately after birth. Embryos at E18.5 showed no evoked action potentials of the diaphragm and gastrocnemius muscles in response to electrical stimulation of the phrenic and sciatic nerves, respectively. In contrast, axonal conduction of the spinal cord and the phrenic nerve was not impaired. Total numbers of synaptic vesicles, especially those docked at the presynaptic plasma membrane, were reduced at the neuromuscular junction ∼10-fold compared with controls, whereas postsynaptic structures and functions appeared normal. Thus, Rab3 GEP is essential for neurotransmitter release and probably for formation and trafficking of the synaptic vesicles.

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It is well established that long-term changes in synaptic structure and function are mediated by rapid activity-dependent gene transcription and new protein synthesis. A growing body of evidence supports the involvement of the microRNA (miRNA) pathway in these processes. We have used the Drosophila neuromuscular junction (NMJ) as a model synapse to characterize activity-regulated miRNAs and their important mRNA targets. Here, we have identified five neuronal miRNAs (miRs-1, -8, -289, -314, and -958) that are significantly downregulated in response to neuronal activity. Furthermore we have discovered that neuronal misexpression of three of these miRNAs (miR-8, -289, and -958) is capable of suppressing new synaptic growth in response to activity suggesting that these miRNAs control the translation of biologically relevant target mRNAs. Putative targets of the activity-regulated miRNAs-8 and -289 are significantly enriched in clusters mapping to functional processes including axon development, pathfinding, and axon growth. We demonstrate that activity-regulated miR-8 regulates the 3'UTR of wingless, a presynaptic regulatory protein involved in the process of activity-dependent axon terminal growth. Additionally, we show that the 3'UTR of the protein tyrosine phosophatase leukocyte antengen related (lar), a protein required for axon guidance and synaptic growth, is regulated by activity-regulated miRNAs-8, -289, and -958 in vitro. Both wg and lar were identified as relevant putative targets for co-regulation based through our functional cluster analysis. One putative target of miR-289 is the Ca2+/calmodulin-dependent protein kinase II (CamKII). While CamKII is not predicted as a target for co-regulation by multiple activity-regulated miRNAs we identified it as an especially pertinent target for analysis in our system for two reasons. First, CamKII has an extremely well characterized role in postsynaptic plasticity, but its presynaptic role is less well characterized and bears further analysis. Second, local translation of CamKII mRNA is regulated in part by the miRNA pathway in an activity-dependent manner in dendrites. We find that the CamKII 3'UTR is regulated by miR-289 in-vitro and this regulation is alleviated by mutating the `seed region' of the miR-289 binding site within the CamKII 3'UTR. Furthermore, we demonstrate a requirement for local translation of CamKII in motoneurons in the process of activity-regulated axon terminal growth.

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A estimulação elétrica neuromuscular (EENM) é uma recente técnica terapêutica no tratamento das disfagias orofaríngeas. Poucos estudos utilizaram a EENM em casos oncológicos, havendo muitas dúvidas sobre o método de aplicação e os resultados de diferentes condições de estimulação nessa população. Este trabalho teve por objetivo verificar o efeito imediato da EENM sensorial e motora, nas fases oral e faríngea da deglutição, em pacientes após tratamento do câncer de cabeça e pescoço. Para isso foi realizado um estudo transversal intervencional que incluiu 11 pacientes adultos e idosos (mediana de 59 anos) acometidos por câncer de cabeça e pescoço. Todos os indivíduos foram submetidos ao exame de videofluoroscopia da deglutição, no qual, de modo randomizado, foram solicitadas deglutições de 5 ml de alimentos nas consistências líquida, mel e pudim em três condições distintas: sem estimulação, com EENM sensorial, com EENM motora. Foi classificado o grau da disfunção da deglutição por meio da escala DOSS (Dysphagia Outcome and Severity Scale), a presença de estase de alimentos (escala de Eisenhuber), de penetração laríngea, aspiração laringotraqueal (Penetration and Aspiration Scale - PAS), além da medida do tempo de trânsito oral e faríngeo (em segundos). Para a comparação dos resultados, considerando os três estímulos aplicados, na escala de resíduos, na escala de penetração aspiração, na escala DOSS e no tempo de trânsito oral e faríngeo foi aplicado o teste de Friedman ou a análise de variância para medidas repetidas (de acordo com a distribuição dos dados). Para todos os testes foi adotado nível de significância de 5%. Os resultados demonstraram que houve melhora com a estimulação sensorial e motora na escala DOSS e na escala PAS para um paciente tratado de câncer de boca e outro de laringe e piora, em ambas as escalas, para dois pacientes (câncer de boca), sendo um para a estimulação motora e outro na sensorial. A aplicação da escala de Eisenhuber permitiu verificar que a EENM, tanto em nível sensorial como motor, modificou de forma variável a presença de resíduos para os casos de câncer de boca, enquanto para o paciente com câncer de laringe houve redução de resíduos em valécula/raiz da língua para a estimulação sensorial e motora, além de aumento de resíduos em parede posterior da faringe com o estímulo motor. Além disso, não foi encontrada diferença estatisticamente significante para o tempo de trânsito oral e faríngeo nas diferentes estimulações para todas as consistências testadas (p>0,05). Diante desses achados, concluiu-se que a EENM, em nível sensorial e motor, apresentou variável impacto imediato nas fases oral e faríngea da deglutição, podendo melhorar a função de deglutição de pacientes com significante disfagia após o tratamento para o câncer de cabeça e pescoço, no que se diz respeito ao grau da disfagia e à presença de penetração e aspiração.

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Specifically, this paper will address the following topics : 1. The history of psychoanalytic thinking onnarcissism will be discussed, leading up to more recent ideas on the narcissistic personality disorder. 2. Drawing on historical and current ideas, an integrated definition of the narcissistic personality disorder will be presented and elaborated upon, including an examination of differing male/female narcissistic compensatory styles. 3. To foster an understanding of the development of narcissistic defenses and of differing gender styles of defense, various theories relating to gender differences in the narcissistic personality disorder will be explored: self/object relations theories, Kohut's theory on narcissism, psychosexual development theories, behavioral manifestation theories, and bodily development theories.4. The role of preoedipal development, as it relates to the formation of the male/female narcissistic personality disorder, will be examined. This section of the paper will propose that, in the narcissistic personality disorder, a pathological arrest occurred during the second or third year of life in response to trauma experienced at that time. The degree and timing of the trauma and the degree of structuralization preceding the trauma all contribute to the rigidity of the narcissistic disorder and the severity of the pathology. 5. The role of oedipal development in the male/female narcissistic personality disorder will be discussed. This discussion will address the intrapsychic configurations which arise during the oedipal period, after narcissistic defenses have solidified during the preoedipal years. While narcissism can be seen as a developmental line, with narcissistic defenses arising at any time during development, this paper will focus primarily on defenses which arise during the separation/individuation phases of development.

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Grady distinguishes two main types of metaphor in order to provide a solution in the controversies stemming from the conceptual theory of metaphor: correlation-based metaphors and resemblance metaphors. In “correlation-based metaphors”, the source domain is sensory-motor, while the target domain is not. On the contrary, “resemblance metaphors” are originated by a physical or conceptual perception which is common in both domains, by the association of concepts with common features. Primary metaphors are the minimal units of correlation-based metaphors; they are inherent in human nature and the result of the nature of our brain, our body and the world that we inhabit. We acquire them automatically and we cannot avoid them. Furthermore, as corporal experiences are universal, so are primary metaphors. In this paper, I will argue that primary metaphors manifest themselves visually through scene-setting techniques such as composition, framing, camera movement or lighting. Film-makers can use the different aspects of mise-en-scène metaphorically in order to express abstract notions like evil, importance, control, relationship or confusion. Such visual manifestations, as also occurs with their verbal equivalents, frequently go unnoticed or have been used so often that they have become clichés. But the important thing to bear in mind is that their origin lies in a primary metaphor and due to this origin these kinds of film-making strategies have been so expressively successful.

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A woman stung by the box jellyfish Carybdea marsupialis (Cnidaria, Cubozoa) at a Spanish Mediterranean beach, showed systemic manifestations over several months (pain far from the inoculation point, arthralgia, paresthesia, hyperesthesia, increase of eosinophils and IgE) in addition to the skin condition.

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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

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La nation s’est affirmée à partir de la fin du 18e siècle comme l’un des grands paramètres de la modernité. Sa remise en cause, tout spécialement dans les dernières décennies du siècle dernier, est à la fois partie prenante et symptomatique de l’actuel phénomène d’effritement des identités collectives. Le Québec n’échappe pas à ce courant de fond, comme en témoigne l’œuvre du vidéaste et cinéaste Robert Morin, qui propose une galerie de personnages en manque d’attaches et souvent réduits à leur propre subjectivité. Dans un contexte de questionnement généralisé des concepts de nation et de collectivité, ces individualités se sentent isolées et tentent désespérément de réactualiser les liens qui les unissent à leurs semblables, mais sans grand succès. La communauté revêt ainsi une dimension nostalgique, parcourant l’œuvre de Morin dans son entièreté et se manifestant de différentes manières, tant à l’écran qu’à travers son approche du médium qui reste grandement tributaire des pratiques filmiques et vidéographiques des années ’60 et ’70. Écartelé entre la prise de conscience de son isolement et son désir d’appartenir à une entité collective, qu’elle soit nationale ou autre, le sujet délié que l’on retrouve chez Morin, comme cette thèse tente de le démontrer, subit ce phénomène de déliaison et lutte simultanément pour l’enrayer.

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Essai présenté à la Faculté des arts et des sciences en vue de l’obtention du doctorat en psychologie (D.Psy.)

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La nation s’est affirmée à partir de la fin du 18e siècle comme l’un des grands paramètres de la modernité. Sa remise en cause, tout spécialement dans les dernières décennies du siècle dernier, est à la fois partie prenante et symptomatique de l’actuel phénomène d’effritement des identités collectives. Le Québec n’échappe pas à ce courant de fond, comme en témoigne l’œuvre du vidéaste et cinéaste Robert Morin, qui propose une galerie de personnages en manque d’attaches et souvent réduits à leur propre subjectivité. Dans un contexte de questionnement généralisé des concepts de nation et de collectivité, ces individualités se sentent isolées et tentent désespérément de réactualiser les liens qui les unissent à leurs semblables, mais sans grand succès. La communauté revêt ainsi une dimension nostalgique, parcourant l’œuvre de Morin dans son entièreté et se manifestant de différentes manières, tant à l’écran qu’à travers son approche du médium qui reste grandement tributaire des pratiques filmiques et vidéographiques des années ’60 et ’70. Écartelé entre la prise de conscience de son isolement et son désir d’appartenir à une entité collective, qu’elle soit nationale ou autre, le sujet délié que l’on retrouve chez Morin, comme cette thèse tente de le démontrer, subit ce phénomène de déliaison et lutte simultanément pour l’enrayer.