Made available in DSpace on 2014-10-09T12:33:14Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:06:16Z (GMT). No. of bitstreams: 0 / Dissertacao (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Orientador: Luiz Eduardo Naresse / Banca: Celso Vieira de Souza Leite / Banca: Paulo Antonio Rodrigues / Banca: Pedro César Garcia de Oliveira / Banca: José Carlos Yamashita / Resumo: O presente estudo foi desenvolvido com o objetivo de avaliar as características pós-operatórias de superfícies radiculares expostas tratadas com enxerto de tecido conjuntivo, com duas técnicas de fixação do enxerto. O estudo envolveu 42 pacientes, que de maneira randomizada constituíram dois grupos iguais de estudo, denominados teste e controle, com 21 pacientes em cada um deles. No grupo teste o enxerto foi fixado ao leito receptor com adesivo de fibrina derivado de veneno de serpente e no grupo controle a fixação dos tecidos foi realizada com fio de sutura poligalactina 910. A idade dos pacientes variou entre 19 e 49 anos e estes apresentavam defeitos de recessão gengival incluídos nas classes I e II de Miller. Os controles foram realizados avaliando-se parâmetros clínicos tais como: tempo cirúrgico, tempo de hemostasia, presença de eritema, alteração de hálito e sabor, grau de recobrimento radicular, altura da recessão, profundidade de sondagem vestibular, nível de inserção clínica, índice de placa, índice gengival, quantidade de gengiva inserida, mucosa ceratinizada e a estética, com registros no momento pré-operatório, trans-operatório e aos 7, 14, 21, 30, 60 e 90 dias de pós-operatório. A análise comparativa entre o momento inicial e o final em cada um dos grupos mostrou resultados estatisticamente significantes, com melhores resultados ao término do estudo para todas as variáveis estudadas. Ao final do estudo, observamos entre os grupos, resultados estatisticamente significantes para as variáveis; tempo cirúrgico, quantidade de gengiva inserida e profundidade de sondagem vestibular, com melhores resultados nos pacientes do grupo teste. Com as demais variáveis não foram observadas diferenças significantes, inclusive para a estética alcançada. / Abstract: The present study aimed to evaluate the postoperative characteristics of exposed root surfaces treated with connective tissue graft, with two different techniques to fix it. The study involved 42 patients, randomly of two equal groups named test and control, each one with 21 patients. In the test group, the graft was fixed to exposed root surfaces with fibrin adhesive derived from serpent venom and in the control group this graft was accomplished with a conventional suture. The age of the patients ranged between 19 and 49 years old and they presented this defect named Millerþs class I and II. Controls were carried out by assessing clinical parameters such as: surgical time, hemostasis time, presence of erythema, breath and taste alteration, root coverage degree, recession height, vestibular probing depth, clinical insertion level, plaque index, gingival index, amount of attached gum, keratinized mucosa and aesthetics, with records at preoperative and trans-operative moments and at 7, 14, 21, 30, 60 and 90 days, postoperatively. The comparative analysis between the initial and final moments in each group showed statistically significant results, with the best results at the end of the study for all variables studied. Statistically significant results were observed at the end of the study between the groups only for the following variables; surgical time, amount of attached gum and vestibular probing depth, with the best results for patients in the test group. Significant differences were not observed in the remaining variables, including aesthetics. This study concluded that the fibrin adhesive derived from serpent venom presented favorable characteristics when applied in periodontal surgery for root coverage in recessions of marginal tissue, Millerþs Class I and II, as a suture substitute. / Doutor

Made available in DSpace on 2014-06-11T19:30:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-12-22Bitstream added on 2014-06-13T20:40:19Z : No. of bitstreams: 1 chiquito_gcm_dr_botfm.pdf: 519392 bytes, checksum: d24af1dc24abca95f3a571e391642cf3 (MD5) / O presente estudo foi desenvolvido com o objetivo de avaliar as características pós-operatórias de superfícies radiculares expostas tratadas com enxerto de tecido conjuntivo, com duas técnicas de fixação do enxerto. O estudo envolveu 42 pacientes, que de maneira randomizada constituíram dois grupos iguais de estudo, denominados teste e controle, com 21 pacientes em cada um deles. No grupo teste o enxerto foi fixado ao leito receptor com adesivo de fibrina derivado de veneno de serpente e no grupo controle a fixação dos tecidos foi realizada com fio de sutura poligalactina 910. A idade dos pacientes variou entre 19 e 49 anos e estes apresentavam defeitos de recessão gengival incluídos nas classes I e II de Miller. Os controles foram realizados avaliando-se parâmetros clínicos tais como: tempo cirúrgico, tempo de hemostasia, presença de eritema, alteração de hálito e sabor, grau de recobrimento radicular, altura da recessão, profundidade de sondagem vestibular, nível de inserção clínica, índice de placa, índice gengival, quantidade de gengiva inserida, mucosa ceratinizada e a estética, com registros no momento pré-operatório, trans-operatório e aos 7, 14, 21, 30, 60 e 90 dias de pós-operatório. A análise comparativa entre o momento inicial e o final em cada um dos grupos mostrou resultados estatisticamente significantes, com melhores resultados ao término do estudo para todas as variáveis estudadas. Ao final do estudo, observamos entre os grupos, resultados estatisticamente significantes para as variáveis; tempo cirúrgico, quantidade de gengiva inserida e profundidade de sondagem vestibular, com melhores resultados nos pacientes do grupo teste. Com as demais variáveis não foram observadas diferenças significantes, inclusive para a estética alcançada. / The present study aimed to evaluate the postoperative characteristics of exposed root surfaces treated with connective tissue graft, with two different techniques to fix it. The study involved 42 patients, randomly of two equal groups named test and control, each one with 21 patients. In the test group, the graft was fixed to exposed root surfaces with fibrin adhesive derived from serpent venom and in the control group this graft was accomplished with a conventional suture. The age of the patients ranged between 19 and 49 years old and they presented this defect named Millerþs class I and II. Controls were carried out by assessing clinical parameters such as: surgical time, hemostasis time, presence of erythema, breath and taste alteration, root coverage degree, recession height, vestibular probing depth, clinical insertion level, plaque index, gingival index, amount of attached gum, keratinized mucosa and aesthetics, with records at preoperative and trans-operative moments and at 7, 14, 21, 30, 60 and 90 days, postoperatively. The comparative analysis between the initial and final moments in each group showed statistically significant results, with the best results at the end of the study for all variables studied. Statistically significant results were observed at the end of the study between the groups only for the following variables; surgical time, amount of attached gum and vestibular probing depth, with the best results for patients in the test group. Significant differences were not observed in the remaining variables, including aesthetics. This study concluded that the fibrin adhesive derived from serpent venom presented favorable characteristics when applied in periodontal surgery for root coverage in recessions of marginal tissue, Millerþs Class I and II, as a suture substitute.

Made available in DSpace on 2014-10-09T12:33:14Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:06:16Z (GMT). No. of bitstreams: 0 / Por mais de 30 anos, a utilização do meio de cultura, enriquecido com soro bovino, e de fibroblastos murinos, com a taxa de proliferação controlada por irradiação ou por ação de drogas anti-cancerígenas, vem desempenhando com sucesso o seu papel de auxiliar no desenvolvimento dos queratinócitos em cultura, para fins clínicos. Porém, atualmente há uma preocupação crescente acerca da possibilidade de transmissão de príons e virose animais, aos pacientes transplantados. Levando em conta esta preocupação, o presente trabalho tem como objetivo cultivar fibroblastos humanos em meio enriquecido com lisado de plaquetas humanas e determinar a dose de irradiação dessas células, para obtenção da camada de sustentação na cultura de células da epiderme. Para realização do objetivo proposto, padronizamos a lise das plaquetas, utilizamos este lisado para cultivar os fibroblastos humanos e verificamos a dose de irradiação suficiente para inibir sua duplicação. Queratinócitos humanos foram cultivados nestas camadas de sustentação, em meio de cultura suplementado com o lisado. Com os resultados obtidos concluímos que o lisado de plaquetas a 10% promoveu uma melhor adesão e proliferação dos fibroblastos humanos e em todas as doses testadas (60 a 300 Gy), estes tiveram as suas atividades mitóticas inativadas pela radiação ionizante, sendo que as camadas de sustentação obtidas com doses de 70 a 150 Gy foram as que proporcionaram o melhor desenvolvimento dos queratinócitos em meio contendo 2,5% de lisado de plaquetas humanas. Portanto, foi possível padronizar, tanto o cultivo dos fibroblastos humanos, quanto sua inativação para utilização como camada de sustentação na cultura de queratinócitos, de maneira a eliminar os componentes xenobióticos. / Dissertacao (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Orientador: Antonio Fernando Martorelli de Lima / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-03T08:16:11Z (GMT). No. of bitstreams: 1 Silva_RobertCarvalhoda_M.pdf: 2259841 bytes, checksum: 868f2b22f3c2bf119cbb342511bda348 (MD5) Previous issue date: 2002 / Resumo: Este estudo avaliou o resultado do tratamento de recessões gengivais usando o retalho colocado coronal associado ou não ao enxerto subepitelial de tecido conjuntivo, grupos teste e controle, respectivamente. Os índices dicotômicos de Placa (IPI) e Gengival (IG), e os parâmetros lineares Profundidade de Sondagem (PS), Nível da Margem Gengival (NMG), Nível Clínico de Inserção (NCI), Faixa de Tecido Queratinizado (TQ) e espessura gengival (Esp 1 e 2) foram obtidos imediatamente antes do procedimento cirúrgico e 6 meses após. Os índices de Placa (IPI) e de Sangramento (IS) foram mantidos abaixo de 20% durante todo o período experimental. Os dados referentes aos parâmetros lineares foram avaliados pelo teste t pareado de Student para comparação entre os tempos e entre os grupos experimentais. Não houve diferença estatística significativa entre os grupos para nenhuma das variáveis no exame inicial (p > 0,05). No grupo teste, houve diferença estatística significativa (p < 0,05) para todos os parâmetros entre os tempos experimentais, enquanto que, no grupo controle, a diferença estatística significativa foi encontrada apenas nos parâmetros PS, NMG e NCI (p < 0,05). A comparação entre os grupos 6 meses após os procedimentos de recobrimento radicular mostrou diferença estatística entre os parâmetros TQ, Esp 1 e Esp 2 (p <0,05), entretanto não houve diferença (p > 0,05) nos parâmetros PS, NMG e NCI. Ambas técnicas cirúrgicas foram eficientes para produzir recobrimento radicular. A aplicação clínica do retalho colocado coronal associado ao enxerto subepitelial de tecido conjuntivo foi mostrada em três situações clínicas diferentes associadas a problemas estéticos e funcionais. Foram utilizadas diferentes formas de avanço coronário do retalho sobre o enxerto de tecido conjuntivo subepitelial que proporcionaram recobrimento completo da superfície radicular exposta com aumento significativo da faixa de gengiva queratinizada e espessura gengiva!. Esses resultados confirmaram que a associação do retalho colocado coronal e o enxerto de tecido conjuntivo subepitelial foi eficiente na resolução de problemas estéticos e funcionais / Abstract: This study evaluated the results of the treatment of gingival recessions using the coronally positioned flap associated or not with the subepithelial connective tissue graft, test group and control group, respectively. The dichotomic Plaque Index (PU) and Gingival Index (GI), as well as the linear parameters Probing Depth (PD), Gingival Margin Levei (GML), Clinical Attachment Level (CAL), width of keratinized Tissue (KT) and Gingival/mucosal Thickness (GT1 and GT2) were assessed at baseline and 6 months latter. 80th Plaque Index (PU)and Gingivallndex (GI) were maintained below 20% through all the experimental period. Data corresponding to the linear parameters were analyzed using Student t test for paired observations to assess changes obtained within and between groups. The results did not show significant statistical differences between groups for any of the parameters at baseline evaluation (p > 0.05). In the test group, there was significant statistical difference for all parameters between the evaluation periods (p < 0.05), however, in the control group, significant difference was found for PD, GML and CAL only (p<0,05). The between-groups comparison 6 months postsurgery showed significant difference for KT, GT1 and GT2 (p < 0,05), however no significant difference was found for PD, GML and CAL (p > 0,05). 80th approaches were effective to produce root coverage. The clinical application of the coronally positioned flap associated with the subepithelial connective tissue graft was shown in three different clinical situations associated with aesthetic and functional problems. Different forms of coronally advancing the flap over the subepithelial connective tissue graft were used which provided complete root coverage and significant increase of keratinized tissue width as well as gingival thickness. These results confirmed that the coronally positioned flap was effective in the resolution of aesthetic and functional problems / Mestrado / Periodontia / Mestre em Clínica Odontológica

Abstract Lysyl oxidases (EC 1.4.3.13, protein-lysine 6-oxidases) are extracellular copper enzymes that initiate the cross-linking of collagens and elastin by catalyzing oxidative deamination of the ε-amino group in certain lysine and hydroxylysine residues. The cross-links formed are responsible for the tensile strength of collagen fibers and the unique elastic properties of elastin. Three human lysyl oxidase isoenzymes, lysyl oxidase (LOX), lysyl oxidase-like protein (LOXL), and lysyl oxidase-like 2 protein (LOXL2), have been identified and characterized so far. Two additional human lysyl oxidase isoenzymes, lysyl oxidase-like 3 (LOXL3) and lysyl oxidase-like 4 (LOXL4), proteins were identified, cloned, and partially characterized in this study. Both polypeptides showed a high degree of overall similarity to each other and to the LOXL2 polypeptide, whereas the two polypeptides showed a significant similarity to LOX and LOXL only in the C-terminal region, which contains all amino acid residues thought to be needed for the catalytic activity of the LOX enzyme. The LOXL3 gene is expressed in several tissues, the highest expression levels being in the placenta, heart, ovary, testis, small intestine, and spleen. The LOXL4 gene is likewise expressed in most human tissues studied, the highest levels being seen in the skeletal muscle, testis, and pancreas. Both polypeptides were shown to be secreted extracellular proteins. The role of the first described LOX isoenzyme was studied by inactivating its gene in mice. Most Lox-/- embryos died at the end of gestation, and the few live-born pups were cyanotic and died within a few hours, autopsy revealing large aortic aneurysms. Light microscopy demonstrated structural abnormalities in the aortic walls of Lox-/- embryos, and further analysis by electron microscopy showed highly fragmented elastic fibers, discontinuity in the smooth muscle cell layers, and endothelial cell damage. Doppler ultrasonography of Lox-/- embryos in utero revealed multiple signs of cardiovascular dysfunction, which contributed to the early death of the Lox-/- mice. The results indicate that Lox has an essential role in the development and function of the cardiovascular system and that this role cannot be replaced to any significant extent by other lysyl oxidase isoenzymes.

Carpal tunnel syndrome (CTS) is a peripheral median neuropathy that is commonly characterized by thickening and fibrosis of the subsynovial connective tissue (SSCT) surrounding finger flexor tendons. The degenerative process affecting SSCT can be initiated with excessive relative motion between the tendon and SSCT that ruptures interconnecting collagen. We used colour Doppler ultrasound to evaluate flexor digitorum superficialis tendon motion at two movement speeds with palmar compression, forearm compression, and partial ischemia (via brachial blood pressure cuff). Partial ischemia decreased SSCT displacement (22.9 ± 3.3 mm vs. 22.0 ± 3.3 mm; p = 0.015) while tendon displacement did not change. There was also a trend for increased relative tendon-SSCT displacement and shear strain index (SSI – relative displacement normalized to tendon displacement), which suggested partial ischemia might increase the strain in collagen that connects tendon and SSCT. Forearm compression decreased tendon displacement (28.5 ± 4.1 mm vs. 27.0 ± 4.6 mm; p = 0.043) while SSCT displacement also trended to decrease (24.0 ± mm vs. 22.5 mm; p = 0.059). With a lack of change in relative tendon-SSCT displacement and SSI, maintaining flexion-extension range of motion may have meant that forearm compression strained the musculotendinous unit at a location where SSCT was uncompromised. Palmar compression did not significantly affect any dependent motion variables, which suggested palmar compressive forces likely do not affect tendon-SSCT shear injury risk. The fast movement speed increased relative tendon-SSCT displacement and SSI while decreasing mean velocity ratio (MVR), which suggested greater tendon-SSCT shear strain in all baseline and compression conditions. Previously, increased relative tendon-SSCT displacement with fast movement speed was only shown in cadaveric investigations, but we confirmed this effect is transferable in an in vivo model. We induced ischemia proximally and found a reduction in SSCT displacement at the distal carpal tunnel. This finding suggests that the vascular network integrated within SSCT may play a role in altering tendon-SSCT excursion, independent of other external mechanical factors previously shown to increase relative motion and potential shear injury risk. Overall, this thesis showed that external mechanical compression at the palm or forearm likely do not negatively affect relative tendon-SSCT motion and that local ischemia and carpal tunnel blood flow should be considered when evaluating tendon and SSCT motion in relation to CTS development and progression. / Thesis / Master of Science (MSc)

Background Pulmonary arterial hypertension (PAH) is a rare progressive disease with no known cure. Of various aetiologies, PAH in association with connective tissue disease (PAH-CTD) is the most rapidly progressive and difficult to treat. Management of PAH has evolved significantly in the past ten years since the introduction of oral therapies. Evidence for the efficacy of these agents outside randomised controlled trials is limited, but guidelines exist. Aim To measure the impact of first-line monotherapy with bosentan or sildenafil and the introduction of prescribing guidelines on outcomes in PAH-CTD. Methods Following a retrospective analysis of consecutive, incident, treatment-naive PAH-CTD cases identified by the ASPIRE registry, influences on outcome measures have been compared. First-line monotherapy episodes for 247 patients was analysed against four distinct endpoints: change in exercise capacity, WHO functional class, time on monotherapy and all-cause mortality. Results Treatment with bosentan or sildenafil resulted in clinical stability at 2 years for nearly 1/4 patients. No difference was identified between the groups in terms of either exercise capacity or WHO functional class. Sildenafil patients were found to remain on monotherapy longer than those prescribed bosentan. Patients prescribed sildenafil have improved survival over those treated with bosentan. Unexpected baseline differences in between groups may confound the results as the haemodynamics of the bosentan patients were more severe. Conclusions A significant number of patients with PAH-CTD remain clinically stable on monotherapy at 2 years. Both agents seem equally effective in this aggressive form of PAH. A novel endpoint “TOM” may be of value in future research assessing response to treatment.

No description available.

No description available.