Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A hanseníase é uma doença infecciosa com características únicas, dentre elas o fato de atingir intensamente a inervação da pele e seus anexos. Entremeando estes anexos, está a microcirculação cutânea, que a principio também tem sua inervação comprometida. Vários artigos apontam para alterações de disautonomia microcirculatória, citando como exemplo as alterações no reflexo vasomotor. O presente estudo se propõe a avaliar a microcirculação cutânea na hanseníase virchowiana, tanto em sua morfologia quanto em sua reatividade vascular. Para isto, utilizamos a tecnologia de luz ortogonal polarizada através do equipamento Cytoscan, a analise de Fourier do sinal do laser Doppler para estudo da vasomotricidade e o laser Doppler fluxometria associado à iontoforese de substâncias vasoativas (acetilcolina, nitroprussiato de sódio e noradrenalina) para avaliação da reatividade vascular. Dez pacientes portadores de hanseníase virchowiana sem outras comorbidades que pudessem alterar os parâmetros microcirculatórios, foram avaliados pelos métodos descritos e seus resultados foram comparados aos de dez controles sem hanseníase ou qualquer outra comorbidade. Em relação à vasomotricidade não foram observadas alterações estatisticamente significativas entre os grupos, o que fala a favor da teoria de origem miogênica para a vasomotricidade. Em relação à iontoforese de substâncias vasoativas constatou-se uma diminuição da resposta vasodilatadora à acetilcolina e ao nitroprussiato nos pacientes com hanseníase. Os exames com o Cytoscan mostraram aumento no tamanho dos capilares, bem como alterações em sua morfologia. Os resultados apresentados sugerem que, provavelmente devido ao longo período de alteração inervatória decorrente da hanseníase virchowiana, estes pacientes apresentam uma alteração significativa tanto morfológica quanto na reatividade vascular da microcirculação cutânea. / Leprosy is an infectious disease with unique characteristics. One of them is the fact that it compromises not only the cutaneous and adnexial innervation, but also the innervation of the cutaneous microcirculation. Several articles indicate the impact of disautonomy on the microcirculatory level, citing the example of changes in vasomotor level. The present study proposes to evaluate morphology and microvascular reactivity of the cutaneous microcirculation of the virchowian leprosy. Methods employed in the study were: the Cytoscan, which uses the orthogonal polarized light, the Fourier analysis of the laser Doppler signal to study vasomotion, and the laser Doppler flowmetry associated with iontophoresis of vasoactive substances (acetylcholine, sodium nitroprusside and norepinephrin). Ten patients with virchowian leprosy, without any other comorbidity that could modify the microvascular parameters were evaluated and their results were compared to ten controls without leprosy or any other comorbidity. Regarding the vasomotion, no statistical significant differences were noticed between the groups. Our data are in agreement with the vasomotions miogenic origin theory. According to iontophoresis of vasoactive substances, it was found that there is a reduced endothelial-dependent and endothelial-independent vasodilation in patients with leprosy while tests by direct visualization we observed an increase in the size of capillaries, as well as changes in their morphology. The results suggest that the significant changes in morphology and vascular reactivity of skin microcirculation are probably due to the long period of innervatory changes arising from leprosy.

Thesis deals with the design and realization of revisions devices for the treatment of hyperhidrosis. One of the methods how to treat hyperhidrosis is iontophoresis. This prevents sweating using an electric current. The work is divided on the parts. First part is a theory, which deals with basic principles of treatment. Next part is the analysis of original solutions and hardware design of new solutions. In conclusion I revive device by microcontroller programming and checking its functionality. I was able to create a prototype board, programmable firmware and successfully tested a prototype.

Le cross-linking du collagène cornéen (CXL) est une cornéoplastie mini-invasive reposant surun concept biomécanique difficile à objectiver physiquement et dont les preuves del’efficacité thérapeutique sont d’interprétation complexe. Les principes, les nuances et lesrésultats du CXL sont colligés dans cette thèse afin de valider l’intérêt du modèleexpérimental choisi pour tester la pertinence de notre travail de recherche sur l’élastographiecornéenne par ondes de cisaillement.Notre cheminement expérimental a abouti au choix du modèle de CXL trans-épithélial (TCXL)assisté par iontophorèse (I-CXL), réalisé in vivo, sur oeil de lapin. Les mesuresélastographiques obtenues après euthanasie ont ainsi pu démontrer une modificationsignificative du profil d’élasticité de la cornée après CXL, testé successivement de manièredynamique et statique.Nos résultats confirment donc l’efficacité biomécanique instantanée du I-CXL et donnent uneidée plus précise de la valeur de la photo-polymérisation du tissu cornéen isolée desphénomènes liés à la cicatrisation. Les enjeux technologiques de l’élastographe cornéen paranalyse des ondes de cisaillement ont pu être définis afin de développer une stratégie de miseen oeuvre d’un système pertinent pour la pratique clinique. / Corneal collagen cross-linking (CXL) is a kind of minimaly invasive corneoplasty mainlybased on a biomechanical concept, which is very difficult to measure physically, and whichthe therapeutic efficacy understanding is complex.Principles, different protocols and resultsare summarized in this thesis in order to illustrate the usefulness of the experimental modelchosen in our experimentations about elastographic corneal shear wave imaging.The pathway of our experimental work have led to the choice of trans-epithelial CXL (TCXL)assisted by iontophoresis (I-CXL), performed in vivo, on rabbits eyes. Elastographicmeasurements we obtained after animals euthanasia have shown a significant change of thecorneal elasticity profile after CXL, successively tested in a dynamic and in a static fashion.Our results do confirm the biomechanical efficacy of the I-CXL procedure and give a moreprecise idea of the sole photo-polymerization effect by avoiding any confounding healingconcern. Technological issues for corneal elastography with shear wave imaging have beenraised in this thesis to develop a realistic strategy for the launch of a clinically useful device.

BACKGROUND AND PURPOSE: Pharmacokinetic assessment of drug tissue permeation following iontophoresis is limited. The depth of ketoprofen tissue permeation following cathodic iontophoresis (4 mA, 40 minutes) and the stereoselectivity of drug delivery were examined in this study. SUBJECTS: Ketoprofen (750 mg) was iontophoresed onto one porcine medial thigh, with passive drug permeation conducted on the other thigh. METHODS: Skin, subcutaneous fascia, and muscle biopsies from the drug delivery sites were harvested and stored separately, and the "R" and "S" ketoprofen enantiomers were determined. Results. Iontophoretic and passive applications yielded equivalent total ketoprofen concentrations in the skin and fascia. In contrast, multivariate analysis demonstrated that the ketoprofen concentration in the first centimeter of muscle following iontophoresis was greater than the drug concentration in the deeper underlying muscle layers and greater than that delivered to any muscle layer following passive delivery. No transcutaneous stereoselective delivery) of ketoprofen was detected. CONCLUSION AND DISCUSSION: Compared with passive delivery, iontophoresis enhances nonstereoselective ketoprofen permeation into the fascia-muscle interface. With delivery to deeper tissue sites, however, there is no apparent enhancement over passive application.

Siekiant pagreitinti 5-aminolevulino rūgšties (5-ALA) skvarbą į (pro) odą ir sudaryti terapines fotodinaminiam gydymui tinkamas jos koncentracijas, įvertinta 5-ALA ir naujo provaisto skvarba į (pro) odą iš įvairių vietinio poveikio vaisto formų. Atlikta naujo provaisto 2-(dimetilamino)-etil-5-amino-4-oksopentanoato (DMAE-ALA) sintezė, ištirtos jo charakteristikos. Nustatytas susintetinto provaisto stabilumas įvairių pH verčių buferiniuose vandeniniuose tirpaluose ir odos esterazių poveikyje, įrodytas provaisto tinkamumas pernašai į (pro) odą. Atlikti 5-ALA ir du teigiamus krūvius vaisto formoje įgaunančio provaisto jontoforetinės ir pasyvios pernašos iš buferinių tirpalų ir celiuliozinės bei polivinilkarboksilinės kilmės polimerinių gelių į (pro) odą tyrimai in vitro. Patvirtintas reikšmingas skatinamas jontoforezės poveikis krūvinių molekulių pernašai į (pro) odą ir krūvio dydžio reikšmė elektros srovės skatinamos pernašos greičiui. Ištirta vaisto formų, pagamintų iš polivilinkarboksilinės kilmės ir celiuliozės polimerų, kokybė ir jų pasyvioji bei jontoforetinė pernaša. Įrodyta, kad provaisto įterpimui naudojant celiuliozės polimerų pagrindu pagamintus gelius, pasiekiama didžiausia 5-ALA pernaša. Nustatyta, kad du krūvius turintis 5-ALA provaistas į (pro) odą skverbėsi geriau negu vieną krūvį įgaunantys arba elektriškai neutralūs 5-ALA dariniai. Sudarytos rekomendacijos, skirtos pasiekti didžiausiai 5-ALA pernašai į (pro) odą. / Passive and iontophoretic delivery of 5-aminolevulinic acid and newly synthesized prodrug into (through) skin from various topical formulations was evaluated, while trying to accelerate the penetration of 5-ALA and its derivative into (through) skin and to generate the therapeutic concentration suitable for photodynamic therapy. A new prodrug 2-(dimethylamino)-ethyl-5-amino-4-oxopentanoate (DMAE-ALA) was synthesized, its characteristics have been evaluated. Stability of the prodrug in aqueous solutions of various pH values and at exposure with skin esterases (dermal and epidermal stability) has been evaluated. Suitability of the prodrug for topical delivery was confirmed. Studies for the evaluation of 5-ALA and DMAE-ALA passive and active delivery from cutaneous solutions, cellulose and polyvinyl carboxy polymer gels into (through) skin in vitro have been performed. Significant effect of iontophoresis on delivery of charged molecules into (through) skin as well as the significance of the charge of the molecule on the delivery rate has been confirmed. It has been shown that the insertion of the prodrug into cellulose-based polymer gels produces the highest amount of 5-ALA delivered into (through) skin. It was determined that the two-charged prodrug DMAE-ALA penetrated into (through) the skin more efficiently than single-charged or electrically neutral 5-ALA derivatives. Recommendations for achieving most efficient 5-ALA delivery into (through) the skin have been composed.