Thesis (M.S.)--University of Michigan, 1987.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2009.

Thesis (Ph. D.)--Case Western Reserve University, 2006. / Frances Payne Bolton School of Nursing. Includes bibliographical references. Available online via OhioLINK's ETD Center.

Thesis (M.A.)--Georgia State University, 2006. / Title from title screen. Lesley Reid, committee chair; Wendy Simonds, Dawn Baunach, committee members. Electronic text (80 p.) : digital, PDF file. Description based on contents viewed June 18, 2007. Includes bibliographical references (p. 66-74).

Persistent postsurgical pain (PPSP) is reported as recurrent and frequently disabling complication of many surgical procedures. The consequences for PPSP not only reduce the quality of life for patients but also financially tax the health care system, considering the volume of surgical procedures performed annually. Development of chronic pain has been proposed to involve a complex pathophysiology combined with pre-, intra-, and post-operative risk factors. There is no definite recommendation on which factor to assess (in which surgery) and what tools to utilize for conducting a study on PPSP, since many recognized risk factors for PPSP are contradictory. For a comprehensive overview of major PPSP risk factors for identification and possible prevention, we conducted a systematic review and meta-analysis of the published literature on the risk factors across six major surgical groups: breast surgery, chest/thoracic surgery, total hip arthroplasty/total knee arthroplasty (THA/TKA), gynecologic surgery, iliac crest bone harvest (ICBH), and groin hernia repair. Furthermore, to assess the generalizability of the meta-analysis results, we sought to conduct a retrospective, cross-sectional study examining the prevalence and major risk factors of PPSP after cystectomy for bladder cancer. The meta-analysis found that no single risk factor was associated with PPSP across all surgical groups. Age and previous surgery were found to be risk factors for PPSP in gynecologic surgery. For thoracic surgery, male sex and BMI were found as risk factors for PPSP. Surgical duration, presurgical chronic pain, and BMI were risk factors for groin hernia repair. The prevalence of PPSP in our cystectomy study was 22.1%. Female sex and presurgical chronic pain were risk factors significantly associated with PPSP after cystectomy. No risk factors were universally associated with PPSP. Persistent pain after each type of surgical procedure appear to have separate set risk factors among age, BMI, sex, previous surgery, and presurgical pain.

PURPOSE: To investigate relationships between preoperative and intraoperative characteristics with outcome variables in patients suffering from primary rhegmatogenous retinal detachment (RRD) or traction retinal detachment (TRD) complicated by serous choroidal detachment (CD). Choroidal detachment is a rare complication of retinal detachment and the current literature cites generally poor visual outcome variables. By investigating a retrospective case series, we hope to elucidate new relationships and embolden existing ones so that future physicians can make more educated decisions regarding the care for these complicated patients. METHODS: A retrospective case series analyzed 18 patient’s medical records (18 eyes) who had been diagnosed and surgically treated for RRD or TRD associated with a CD at the Longwood Medical Eye Center at Beth Israel Deaconess Medical Center. Patients with RDCD who had undergone 23-gauge pars plana vitrectomy with silicone oil tamponade were selected. Exclusionary criteria included ocular complications such as phthisis bulbi and open globe trauma. Patients experienced a variety of surgical procedures including by not limited to relaxing retinotomy (n=12 eyes), choroidal drainage (n=10 eyes), endoscopy-assisted PPV (n=10 eyes), and ERM peeling (n=8 eyes). Primary outcome variables tabulated were primary and final anatomic success, defined as successful reattachment of the retina to the underlying choroid, and final visual acuity. RESULTS: The mean age of the sample group was 69 with 8 patients (44%) diagnosed with preoperative hypotony (IOP <= 6 mmHg). A total of 12 patients were pseudophakic (67%). With a mean follow-up of 21.6 months, patients exhibited expected visual outcomes with 6 patients (33%) improving visual acuity and 7 patients (39%) decreasing visual acuity. Final anatomic success was seen in 17 cases (94%). A significant correlation was found between decreased number of previous surgeries and better visual outcomes (change in BCVA). Another significant relationship correlates choroidal drainage with worse visual outcomes (change in BCVA). Finally, patients who received ERM peeling had better rates of primary anatomic success. CONCLUSION: The advanced age of the sample lends itself to increased risk for cataracts and thus pseudophakia. In addition, high rates of diabetes and macular degeneration follow. The pathophysiology of RDCD in relation to the risk factors of hypotony and macular holes is possibly based on the Starling forces and favorable fluid transudation into the suprachoroidal space. Although the outcomes of this study were similar to previous literature, the visual outcomes are still poor at best. Reducing the number of previous, invasive, ocular surgeries was seen to be correlated with better visual outcomes. In addition, performing ERM peels is seen to be correlated with improved rates of primary anatomic success. More research is required on the etiology of the disease process and a case-controlled longitudinal study may be helpful in determining more relationships with outcome variables.

Minimum invasive surgery is based on bilateral teleoperation in which surgeon interacts with the master side to the slave side that is located at a distance. The synchronization in between the two ends is through a communication channel. The primary objective in the telesurgery is the position and force tracking providing the surgeon with high fidelity. The presence of time delays in the communication channels makes the realization more difficult, and sometimes it may even destabilize the system. The work focuses on a design of the force control system by using Model Predictive Control to compensate for the effects of the time delay related to the use of surgical arms. Another vital issue of minimum impact velocity during contact with the environment has been tried to achieve by using the prediction from the Model Predictive Control to prevent accidental tissue damage. This work also addresses a problem of the developing a simple delayed free predictive kinematic imaging to understand the type of behavior of the system during contact with the environment when no perception is available.

Made available in DSpace on 2015-07-22T20:50:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-03-25 / O retalho cutâneo é um procedimento cirúrgico freqüente na cirurgia plástica, essencialmente nas perdas de substâncias, sendo fundamental na reconstrução funcional e estética de deformidades traumáticas, congênitas ou de origem neoplásica. A insuficiência arterial do retalho é a principal complicação que, se duradoura, pode levar à necrose. O laser de baixa intensidade tem merecido destaque por promover aumento da microcirculação, aceleração do processo cicatricial de feridas e neoformação vascular. Objetivo: Investigar a Potência do laser de baixa intensidade na viabilidade do retalho cutâneo randômico, em ratos. Métodos: Trinta e seis animais foram distribuídos aleatoriamente em grupo controle; grupo tratado com potência de 30mW e grupo tratado com potência de 60mW. Em ambos os grupos tratados foram utilizados a fluência de 3J/cm2. O retalho cutâneo foi realizado nos animais com uma barreira plástica interposta entre o retalho e o leito doador. A irradiação laser foi aplicada imediatamente após a operação e nos dias 1, 2, 3 e 4 após a operação. As porcentagens das áreas de necroses dos retalhos foram calculadas no 7º dia pós-operatório. Adicionalmente, 4 fragmentos de cada retalho foram coletados para calcular a densidade vascular segundo método bidimensional. Resultados: Os animais tratados mostraram a área de necrose estatisticamente menor do que o grupo controle (53 por cento). A necrose nos grupos tratados foi 24 por cento (grupo 30mW) e 25 por cento (grupo 60mW). Quanto à densidade vascular, os animais tratados demonstraram aumento estatisticamente significante em relação ao grupo controle (37 por cento), O grupo 30mW apresentou 57 por cento de densidade vascular e o grupo 60mW apresentou 59 por cento. Conclusão: O laser de baixa intensidade foi eficaz no aumento da viabilidade do retalho cutâneo randômico, não havendo diferenças entre as potências utilizadas / Background and Objectives: Potency values in low level laser therapy (LLLT) are not well defined. This present study was designed to assess the effects of LLLT with output power of 30 and 60mW, in the viability of a random skin flap in rats. Methods: Thirty six wistar rats were randomically divided in three groups: control (CG), was not irradiated; 30 mW potency (30mW) and 60 mW potency (60mW). In both treated groups a fluency of 3J/cm2 was used. Two minutes after elevation of a random pattern, cranially based, dorsal flap (4 x 10 cm), laser irradiation was applied and repeated on the first, second, third and fourth postoperative days. Percentages of flap necrosis were calculated on the seventh postoperative day. Also, four fragments of each flap were collected in order to allow determination of the percentages of vascular density, according to bidimensional method the blood vessels morphometric analysis. Statistical analysis included Wilcoxon’s test and Kruskal Wallis’ variance analysis. A significance level of 5 % was elected (p ≤ 0.005). Results: Laser treated animals presented significantly less necrosis than control rats (CG = 53 % x 30G = 24 %; p <0.05) (CG x 60G = 25 %; p < 0.05). No difference was found between laser treated animals. Also, laser treated animals presented significantly more vascular density than control rats (CG = 37 % x 30G = 57 %; p <0.05) (CG x 60G = 59 %; p < 0.05). No difference was found between laser treated animals. Conclusion: Low level laser with potency of 30 and 60mW, increased the viability of a random skin flap in rats. / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2014-06-11T19:25:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-12-21Bitstream added on 2014-06-13T20:13:37Z : No. of bitstreams: 1 bernabe_dg_me_araca.pdf: 7019228 bytes, checksum: e0f61885765ce32b3656f184e94c9a2b (MD5) / Universidade Estadual Paulista (UNESP) / Propósito: Investigar a efetividade da descompressão no tratamento inicial de ameloblastomas e os efeitos desse tipo de tratamento conservador nas características histopatológicas e de proliferação celular do tumor. Materiais e Métodos: Foram estudados retrospectivamente 8 pacientes portadores de ameloblastoma de mandíbula procedentes da Faculdade de Odontologia de Araçatuba-UNESP e do Hospital das Clínicas da FMUSP, sendo 4 ameloblastomas unicísticos e 4 multicísticos que tiveram como tratamento inicial pré-cirúrgico a descompressão. Foram avaliados o dados clínicos e imaginológicos antes e depois da descompressão. Foram definidos critérios para a indicação da descompressão. Fez-se também o estudo comparativo histopatológico antes e depois da descompressão. Os efeitos da descompressão sobre a proliferação celular do tumor foram investigados por meio da contagem de AgNORs e avaliação da expressão de PCNA e Ki-67. Resultados: Em todos os casos a descompressão foi efetiva promovendo considerável redução do tumor. O caráter cístico do tumor foi comprovado por punção aspirativa prévia em todos os pacientes. Aspecto radiográfico unilocular foi visto em 5 casos e multilocular com grande loja radiolúcida em 2. O período de descompressão foi de 5 a 12 meses e a técnica mostrou ser bem aceita pelo paciente, de baixo custo e de fácil execução. A avaliação comparativa histopatológica revelou que em alguns casos a descompresssão pode modificar o clássico padrão do epitélio odontogênico do ameloblastoma para um epitélio do tipo ameloblastomatoso com abrandamento dos critérios de Vickers & Gorlin. Não observamos significativa diferença na contagem do AgNOR e na expressão do PCNA e do Ki-67 do epitélio tumoral antes e depois da descompressão. Conclusão: Nossos resultados indicam que a descompressão é um valioso método no tratamento inicial de... / Purpose: To investigate the effectiveness of decompression in ameloblastoma initial treatment and its action on histopathologic characteristics and cellular proliferation of the tumor. Materials e Methods: A retrospective study of 4 unicystic and 4 multicystic mandible ameloblastoma submitted to decompression was realized with. Clinical and radiologic informations before and after decompression were obtained from the records of the Faculty of Dentistry of Araçatuba, UNESP and of the Hospital das Clínicas of the School of Medicine, USP. Criterions for decompression indication were determined and a histopathologic comparative study before and after decompression was realized. The effect of decompression on cellular proliferation was investigated by AgNOR count and expression of PCNA and Ki-67 evaluation. Results: Decompression was effective in all the studied cases presenting a considerable decrease of the tumor. The cystic aspect was confirmed by previous aspirate punction. Unilocular radiologic aspect was observed in 5 cases and multilocular with great radiolucent region in 2 cases. The decompression period lasted from 5 to 12 months and the technique was well accepted by the patients, with low cost and easy accomplishment. In some cases the histopathological comparative evaluation showed an alteration of the classical odontogenic epithelium pattern of the ameloblastoma to an ameloblastomatous epithelium with lightening of Vickers & Gorlin criterions. Significative difference in the cellular proliferation to the tumoral epithelium was not observed between before and after the decompression. Conclusion: Our results consider decompression as a valuable method for initial treatment of unicystic and multicystic ameloblastoma with great cystic degeneration. It decreases the tumor size and increases the bone support reducing the necessity of mandibulectomy... (Complete abstract, click electronic address below)

Made available in DSpace on 2014-06-11T19:25:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-26Bitstream added on 2014-06-13T19:53:33Z : No. of bitstreams: 1 kanamura_ms_me_botfm.pdf: 2849170 bytes, checksum: 08cc2f979c93a13d548fc6f0228e430f (MD5) / Universidade Estadual Paulista (UNESP) / Apesar da existência de inúmeros tipos de implantes para reposição de volume em cavidades anoftálmicas, até o momento, nenhum deles pode ser considerado ideal, o que faz com que seja necessário continuar buscando novas soluções. Avaliar a biocompatibilidade de esferas de silicone gelatinosas e rígidas, quando colocadas em cavidades evisceradas de coelhos, comparando-as. Estudo prospectivo e experimental, no qual foram utilizados 30 coelhos albinos, espécie Orictolagus cuniculus, submetidos à cirurgia de evisceração do olho direito, sendo feita a colocação de esferas de silicone gelatinosas ou rígidas na cavidade escleral. Os animais foram sacrificados sete, 30 e 90 dias após a colocação das esferas. Os parâmetros avaliados foram: avaliação clínica diária, ultrassonografia da cavidade eviscerada 15 dias após o procedimento, análise histológica do conteúdo orbitário sete, 30 e 90 dias após a cirurgia, com análise morfométrica da pseudocápsula que se formou ao redor das esferas. Os resultados obtidos foram submetidos à avaliação estatística para comparação dos resultados entre e dentro dos grupos experimentais. Durante o seguimento, ocorreram três extrusões de esferas, duas das quais pertencentes ao grupo das esferas rígidas e uma, do grupo das esferas gelatinosas. O exame ultrassonográfico mostrou ausência de coleções ou processo inflamatório ao redor das esferas e boa integração das mesmas com os tecidos orbitários. Ao exame histológico observou-se semelhança de resposta tecidual com ambas as esferas. O exame morfométrico apontou para superioridade das esferas gelatinosas no tocante a espessura da pseudocápsula, que foi menos espessa, principalmente na avaliação feita no setor posterior da cavidade escleral. Todos os parâmetros estudados mostraram que as esferas de silicone... / Despite the existence of many types of implants for volume replacement in anophthalmic sockets, so far, none can be considered ideal implant, which makes it necessary to continue searching for new solutions. To evaluate the biocompatibility of soft and rigid silicone spheres placed in scleral cavities of eviscerated rabbits, comparing them. Prospctive and experimental study using 30 rabbits, specie Orictolagus cuniculus, underwent evisceration surgery of the right eye and replacement of orbital volume with spheres composed by gelatinous (soft) or rigid silicone. The animals were sacrificed seven, 30 and 90 days after surgery. The studies parameters were: daily clinical assessment, ultrasound of the orbit 15 days after the procedure, histological analysis of the orbital contents seven, 30 and 90 days after surgery and morphometric evaluation in the pseudocapsule in all the animals. Statistical analysis for comparison between and within groups was done. During follow-up occurred three spheres extrusions, two of which belonging to the group of rigid spheres and one from gelatinous sphere group. Ultrasound examination showed no inflammation or collections around spheres and good integration with the orbital tissues. The histological evaluation proved both materials had similar response and the morphometric evaluation showed thinner pseudocapsule formation around the gelatinous sphere, mainly in the posterior scleral region. All the parameters evaluated showed both spheres had good tecidual integration to the orbital tissue in rabbit eviscerated eyes. Therefore, gelatinous silicone sphere induced thinner psedudocapsule formation. The authors agree the gelatinous silicone spheres might be helpful to be used... (Complete abstract click electronic access below)