Existem poucos ensaios clínicos aleatórios controlados mencionando o impacto da qualidade de vida (QV) e morbidade no tratamento de retrações gengivais múltiplas. O objetivo deste estudo foi comparar a QV e morbidade em dois grupos de pacientes: A. intervenção cirúrgica com enxerto de tecido conjuntivo subepitelial (ETCS) removido do palato; B. intervenção cirúrgica utilizando matriz de colágeno (MC - sem enxerto do palato) no tratamento de retrações gengivais múltiplas. Foi conduzido um ensaio clínico aleatório de boca dividida. Foram selecionados quinze pacientes com retrações gengivais múltiplas envolvendo caninos e pré-molares na maxila. Qualidade de vida foi avaliada através do questionário \"Oral Health Impact Profile\" (OHIP-14) através de regressão multinível. A morbidade incluiu dor, quantidade de medicamentos, capacidade de escovação e mastigação. Os parâmetros foram avaliados no Baseline, 7, 15, 30, e 180 dias após a intervenção. Resultados: OHIP-14 em 7 e 15 dias apresentou melhor QV no grupo MC comparado ao ETCS (p=0,002 e p=0,001 respectivamente). Correlações foram estabelecidas nos diferentes domínios do OHIP-14 após o tratamento com CM: dor física, desconforto psicológico, incapacidade física, incapacidade psicológica e desvantagem social (p<0,05). Houveram diferenças estatísticas significantes para dor pós-operatória e quantidade de medicamentos, favoráveis ao grupo MC (p<0,05). Conclusão: este estudo mostrou que o tratamento cirúrgico com a MC para retrações gengivais múltiplas Classe I de Miller foi positivamente associado ao impacto físico e psicológico na qualidade de vida dos pacientes, quando comparado ao ETCS removido do palato. / There are few randomized controlled clinical trials mentioning the oral health-related quality of life (OHRQoL) effect and morbidity in treatments of multiple gingival recession coverage. This study aims to compare the OHRQoL and morbidity in two groups of patients: A. surgical intervention with connective tissue graft (CTG) removed from the palate; B. surgical intervention using a collagen matrix (CM - no graft from the palate) in the treatment of multiple gingival recessions. Methods: A split-mouth randomized clinical trials was conducted. Fifteen patients with bilateral multiple recessions in maxillary canines and pre-molars were selected. Quality-of-life was assessed by the Oral Health Impact Profile-14 (OHIP-14) questionnaire through multinível regression. The morbidity included pain, quantify of medication, healing and inflammation/edema. Parameters were evaluated at baseline, 7, 15, 30, and 180 days. Results: OHIP-14 in 7 and 15 days showed better OHRQoL in CM group when compared with CTG (p=0,002 and p=0,001 respectively). Correlation was stablished in OHIP-14 subscales after treatment with CM: physical pain, psychological discomfort, physical disability, psychological disability, and handicap (p<0,05). There were statistically significant differences for pain and amount of medication, favoring CM group (p<0,05). Conclusion: This study shows that surgical treatment with CM for multiple gingival recessions Miller Class I was positively associated with psychological and physical impacts on patient\'s quality of life, when compared with CTG removed from the palate.

O objetivo deste estudo foi comparar em 6 meses os resultados do recobrimento radicular, hipersensibilidade dentinária, dor pós-operatória e estética utilizando o retalho avançado coronalmente modificado (RACm) associado ao enxerto de tecido conjuntivo subepitelial (ETCS) ou a matriz de colágeno suíno (MC) no tratamento de retrações gengivais (RG). Neste ensaio clínico aleatório cego de não-inferioridade, desenho de boca dividida, quinze pacientes com RG superiores múltiplas adjacentes, classe I de Miller, localizadas em caninos e pré-molares, com pelo menos uma RG >= 3 mm foram selecionados e distribuídos aleatoriamente em grupo controle (RACm+ETCS) e grupo de teste (RACm+MC). A altura da RG residual (desfecho primário) foi menor para o grupo controle (0,3 ± 0,6 mm) comparado ao grupo teste (0,6 ± 1,0 mm) (p = 0,008). A porcentagem de recobrimento radicular foi de 89,3% para o grupo controle e 77,7% para o grupo teste. Ambos os grupos demonstraram ganho em largura do TQ em 6 meses (p < 0,05) com diferença entre os grupos (p = 0,031). A profundidade de sondagem e o ganho de nível clínico de inserção foram similares entre os grupos e em todos os períodos avaliados. Ambos os grupos foram eficazes na redução da hipersensibilidade dentinária. A dor pósoperatória foi maior no grupo controle comparada ao grupo teste. A satisfação estética do paciente e do periodontista foi alta independente do grupo sem diferença estatística e a formação de cicatriz nas papilas e as diferenças visuais nas áreas enxertadas foram maiores no RACm+ETCS. Quando equilibrados os resultados clínicos de cobertura radicular, os resultados centrados no paciente e a satisfação estética, a associação RACm+MC é uma alternativa viável ao RACm+ETCS para o tratamento das RG múltiplas. / The aim of this study was to compare the 6 months outcome of root coverage, dentin hypersensitive, pain after surgery and aesthetics using the modified coronal advanced flap (mCAF) associate with connective tissue graft (CTG) or collagen matrix (CM) in the treatment of gingival recession (GR). Fifteen patients with superior multiple recessions in canines and pre-molars were selected for this non-inferority randomized clinical trial, which was divided in control group (mCAF+CTG) and test group (mCAF+CM). The residual GR (primary outcome) was lower for control group (0,3 ± 0,6 mm) comparing with test group (0,6 ± 1,0 mm) (p = 0,008). The root coverage percentage was 89,3% for control group and 77,7% for test group. Both groups demonstrated gain of keratinized tissue in 6 months (p < 0,05) statically different between groups (p = 0,031). The probing depth and gain of clinical attachment level were similar between the groups in all evaluated periods. Dentin hypersensitive was reduced in all groups. The pain after surgery was higher in control group comparing with test group. Aesthetic satisfaction evaluated by patient and periodontist was high independently of group with no statistical difference, however, the scar formation at papillae base and visual differences were visually higher using mCAF+CTG. Considering the clinical outcomes balanced with patient related outcomes and aesthetic satisfaction, the use of mCAF+CM is a alternative to mCAF+CTG in the treatment of multiple gingival recession.

Existem poucos ensaios clínicos aleatórios controlados mencionando o impacto da qualidade de vida (QV) e morbidade no tratamento de retrações gengivais múltiplas. O objetivo deste estudo foi comparar a QV e morbidade em dois grupos de pacientes: A. intervenção cirúrgica com enxerto de tecido conjuntivo subepitelial (ETCS) removido do palato; B. intervenção cirúrgica utilizando matriz de colágeno (MC - sem enxerto do palato) no tratamento de retrações gengivais múltiplas. Foi conduzido um ensaio clínico aleatório de boca dividida. Foram selecionados quinze pacientes com retrações gengivais múltiplas envolvendo caninos e pré-molares na maxila. Qualidade de vida foi avaliada através do questionário \"Oral Health Impact Profile\" (OHIP-14) através de regressão multinível. A morbidade incluiu dor, quantidade de medicamentos, capacidade de escovação e mastigação. Os parâmetros foram avaliados no Baseline, 7, 15, 30, e 180 dias após a intervenção. Resultados: OHIP-14 em 7 e 15 dias apresentou melhor QV no grupo MC comparado ao ETCS (p=0,002 e p=0,001 respectivamente). Correlações foram estabelecidas nos diferentes domínios do OHIP-14 após o tratamento com CM: dor física, desconforto psicológico, incapacidade física, incapacidade psicológica e desvantagem social (p<0,05). Houveram diferenças estatísticas significantes para dor pós-operatória e quantidade de medicamentos, favoráveis ao grupo MC (p<0,05). Conclusão: este estudo mostrou que o tratamento cirúrgico com a MC para retrações gengivais múltiplas Classe I de Miller foi positivamente associado ao impacto físico e psicológico na qualidade de vida dos pacientes, quando comparado ao ETCS removido do palato. / There are few randomized controlled clinical trials mentioning the oral health-related quality of life (OHRQoL) effect and morbidity in treatments of multiple gingival recession coverage. This study aims to compare the OHRQoL and morbidity in two groups of patients: A. surgical intervention with connective tissue graft (CTG) removed from the palate; B. surgical intervention using a collagen matrix (CM - no graft from the palate) in the treatment of multiple gingival recessions. Methods: A split-mouth randomized clinical trials was conducted. Fifteen patients with bilateral multiple recessions in maxillary canines and pre-molars were selected. Quality-of-life was assessed by the Oral Health Impact Profile-14 (OHIP-14) questionnaire through multinível regression. The morbidity included pain, quantify of medication, healing and inflammation/edema. Parameters were evaluated at baseline, 7, 15, 30, and 180 days. Results: OHIP-14 in 7 and 15 days showed better OHRQoL in CM group when compared with CTG (p=0,002 and p=0,001 respectively). Correlation was stablished in OHIP-14 subscales after treatment with CM: physical pain, psychological discomfort, physical disability, psychological disability, and handicap (p<0,05). There were statistically significant differences for pain and amount of medication, favoring CM group (p<0,05). Conclusion: This study shows that surgical treatment with CM for multiple gingival recessions Miller Class I was positively associated with psychological and physical impacts on patient\'s quality of life, when compared with CTG removed from the palate.

O objetivo deste estudo foi comparar em 6 meses os resultados do recobrimento radicular, hipersensibilidade dentinária, dor pós-operatória e estética utilizando o retalho avançado coronalmente modificado (RACm) associado ao enxerto de tecido conjuntivo subepitelial (ETCS) ou a matriz de colágeno suíno (MC) no tratamento de retrações gengivais (RG). Neste ensaio clínico aleatório cego de não-inferioridade, desenho de boca dividida, quinze pacientes com RG superiores múltiplas adjacentes, classe I de Miller, localizadas em caninos e pré-molares, com pelo menos uma RG >= 3 mm foram selecionados e distribuídos aleatoriamente em grupo controle (RACm+ETCS) e grupo de teste (RACm+MC). A altura da RG residual (desfecho primário) foi menor para o grupo controle (0,3 ± 0,6 mm) comparado ao grupo teste (0,6 ± 1,0 mm) (p = 0,008). A porcentagem de recobrimento radicular foi de 89,3% para o grupo controle e 77,7% para o grupo teste. Ambos os grupos demonstraram ganho em largura do TQ em 6 meses (p < 0,05) com diferença entre os grupos (p = 0,031). A profundidade de sondagem e o ganho de nível clínico de inserção foram similares entre os grupos e em todos os períodos avaliados. Ambos os grupos foram eficazes na redução da hipersensibilidade dentinária. A dor pósoperatória foi maior no grupo controle comparada ao grupo teste. A satisfação estética do paciente e do periodontista foi alta independente do grupo sem diferença estatística e a formação de cicatriz nas papilas e as diferenças visuais nas áreas enxertadas foram maiores no RACm+ETCS. Quando equilibrados os resultados clínicos de cobertura radicular, os resultados centrados no paciente e a satisfação estética, a associação RACm+MC é uma alternativa viável ao RACm+ETCS para o tratamento das RG múltiplas. / The aim of this study was to compare the 6 months outcome of root coverage, dentin hypersensitive, pain after surgery and aesthetics using the modified coronal advanced flap (mCAF) associate with connective tissue graft (CTG) or collagen matrix (CM) in the treatment of gingival recession (GR). Fifteen patients with superior multiple recessions in canines and pre-molars were selected for this non-inferority randomized clinical trial, which was divided in control group (mCAF+CTG) and test group (mCAF+CM). The residual GR (primary outcome) was lower for control group (0,3 ± 0,6 mm) comparing with test group (0,6 ± 1,0 mm) (p = 0,008). The root coverage percentage was 89,3% for control group and 77,7% for test group. Both groups demonstrated gain of keratinized tissue in 6 months (p < 0,05) statically different between groups (p = 0,031). The probing depth and gain of clinical attachment level were similar between the groups in all evaluated periods. Dentin hypersensitive was reduced in all groups. The pain after surgery was higher in control group comparing with test group. Aesthetic satisfaction evaluated by patient and periodontist was high independently of group with no statistical difference, however, the scar formation at papillae base and visual differences were visually higher using mCAF+CTG. Considering the clinical outcomes balanced with patient related outcomes and aesthetic satisfaction, the use of mCAF+CM is a alternative to mCAF+CTG in the treatment of multiple gingival recession.

<p>In this study, metastasizing serotonin-producing ileocaecal carcinoid tumours (MSPCs) were examined for biological characteristics that could be used to define clinically relevant subgroups within this patient population. Possible targets for new treatment options were also explored.</p><p>It was found that MSPCs share several biological characteristics such as expression of serotonin, tachykinins (TKs), chromogranin A, islet autoantigen-2 and connective tissue growth factor (CTGF). TKs and serotonin were demonstrated in the same endocrine tumours in the gut and lung. IA-2 expression was shown to be up-regulated in MSPCs, possibly in connection with active hormone secretion. CTGF expression was high in tumour areas adjacent to extensive stroma expressing alpha-smooth muscle actin. This indicated myofibroblast differentiation, which may be associated with fibrosis-related complications prevalent in patients with MSPCs. When compared with other endocrine tumours, MSPCs behaved as a relatively homogeneous group, though within the MSPC population several subgroups could be defined. Patients with tumours displaying either a solid growth pattern and/or a Ki67 index ≥1% had a less favourable prognosis than those who did not. Another group of patients, who had increased plasma TK concentrations, were more likely to suffer from severe diarrhea. This information should be considered when discussing clinical treatment and when undertaking tumour biological studies. New treatment possibilities, such as drugs that specifically target TK receptors and antibodies to CTGF, are also discussed.</p><p>In conclusion, MSPCs comprise a clinically relevant tumour group with similar biological features that are distinct from other endocrine tumours. Subgroups of patients within this patient category can be defined which may be relevant when establishing prognosis and when selecting future treatment modalities.</p>

Connective ties in discourse: Three ERP studies on causal, temporal and concessive connective ties and their influence on language processing. <br><br> Questions<br><br> In four experiments the influence of lexical connectives such as " darum", therefore, " danach", afterwards, and " trotzdem", nevertheless, on the processing of short two-sentence discourses was examined and compared to the processing of deictical sentential adverbs such as " gestern", yesterday, and " lieber", rather. These latter words do not have the property of signaling a certain discourse relation between two sentences, as connective ties do. Three questions were central to the work: <br><br> * Do the processing contrasts found between connective and non-connective elements extend to connective ties and deictical sentential adverbs (experiments 2 and 3)? <br><br> * Does the semantic content of the connective ties play the primary role, i.e is the major distinction to be made indeed between connective and non-connective or instead between causal, temporal and concessive? <br><br> * When precisely is the information provided by connective ties used? There is some evidence that connective ties can have an immediate influence on the integration of subsequent elements, but the end of the second sentences appears to play an important role as well: experiments 2, 3, and 4. <br><br> Conclusions<br><br> First of all, the theoretical distinction between connective and non-connective elements does indeed have " cognitive reality" . This has already been shown in previous studies. The present studies do however show, that there is also a difference between one-place discourse elements (deictical sentential adverbs) and two-place discourse elements, namely connective ties, since all experiments examining this contrast found evidence for qualitatively and quantitatively different processing (experiments 1, 2, and 3).<br><br> Secondly, the semantic type of the connective ties also plays a role. This was not shown for the LAN, found for all connective ties when compared to non-connective elements, and consequently interpreted as a more abstract reflection of the integration of connective ties. There was also no difference between causal and temporal connective ties before the end of the discourses in experiment 3. <br><br> However, the N400 found for incoherent discourses in experiment 2, larger for connective incoherent than non-connective incoherent discourses, as well as the P3b found for concessive connective ties in the comparison between causal and concessive connective ties gave reason to assume that the semantic content of connective ties is made use of in incremental processing, and that the relation signaled by the connective tie is the one that readers attempt to construct.<br><br> Concerning when the information provided by connective ties is used, it appears as if connectivity is generally and obligatorily taken at face value. As long as the meaning of a connective tie did not conflict with a preferred canonical discourse relation, there were no differences found for varying connective discourses (experiment 3). However, the fact that concessive connective ties announce the need for a more complex text representation was recognized and made use of immediately (experiment 4). Additionally, a violation of the discourse relation resulted in more difficult semantic integration if a connective tie was present (experiment 2). It is therefore concluded here that connective ties influence processing immediately.<br><br> This claim has to be modified somewhat, since the sentence-final elements suggested that connective ties trigger different integration processes than non-connective elements. It seems as if the answer to the question of when connective ties are processed is neither exclusively immediately nor exclusively afterwards, but that both viewpoints are correct. It is suggested here that before the end of a discourse economy plays a central role in that a canonical relation is assumed unless there is evidence to the contrary. A connective tie could have the function of reducing the dimensions evaluated in a discourse to the one signaled by the connective tie. At the end of the discourse the representation is evaluated and verified, and an integrated situation model constructed. Here, the complexity of the different discourse relations that connective ties can signal, is expressed. / Konnektiva im Diskurs: Drei EKP-Studien zu kausalen, temporalen und konzessiven Konnektoren und ihrem Einfluss auf die Sprachverarbeitung. <br><br> Einführung und Fragestellung<br><br> In vier Experimenten wurde der Einfluss von lexikalischen Konnektiva wie " darum", " danach" und " trotzdem" auf die Verarbeitung von kurzen zweisätzigen Diskursen untersucht und mit der Verarbeitung von deiktischen Satzaderbien wie " gestern" und " lieber" verglichen, die nicht wie die Konnektiva die Eigenschaft haben, die Diskursrelation zwischen zwei Sätzen explizit auszudrücken.<br><br> Drei Fragen standen im Mittelpunkt der Arbeit: <br><br> * Findet sich der Kontrast zwischen konnektiven und nicht-konnektiven Elementen auch zwischen Konnektiva und deiktischen Satzadverbien wieder (Experimente 2 und 3)? <br><br> * Spielt der semantische Inhalt der Konnektiva die primäre Rolle: ist die Hauptunterscheidung zwischen konnektiven und nicht-konnektiven Elementen zu machen, oder zwischen kausalen (darum, deshalb), temporalen (danach, hinterher) und konzessiven (trotzdem, dennoch) Elementen (Experimente 3 / 4)? <br><br> * Wann genau wird die Information, die Konnektiva bieten, genutzt? Es gibt Evidenz dafür, dass Konnektiva einen sofortigen Einfluss haben, aber auch dafür, dass das Ende der Texte eine gewichtige Rolle spielt: Experimente 2, 3, und 4. <br><br> Konklusionen<br><br> Zunächst einmal hat die theoretische Unterscheidung zwischen konnektiven und nicht-konnektiven Worten tatsächlich " kognitive Realität" . Dies wurde bereits in früheren Studien gezeigt. Die aktuellen Experimente zeigten jedoch, dass es auch einen Unterschied zwischen einstelligen (deiktische Satzadverbien) und zweistelligen (Konnektiva) Diskursrelationen gibt, da alle Experimente, die diesen Kontrast untersuchten, qualitativ und quantitativ andere Verarbeitung für Konnektiva zeigten (Experimente 1, 2 und 3).<br><br> Zweitens spielt der semantische Typus der Konnektiva ebenfalls eine Rolle. Dieser Einfluss zeigte sich nicht für die LAN, die für alle Konnektiva im Vergleich mit nicht-konnektiven Elementen gefunden wurde, und die dementsprechend auch als Korrelat abstrakterer Integration von Konnektiva vorgeschlagen wird. Es zeigte sich ebenfalls kein Unterschied zwischen kausalen und temporalen Konnektiva vor dem Ende des Diskurses in Experiment 3. Die N400, gefunden für inkohärente Satzpaare in Experiment 2, größer für inkohärent konnektive als inkohärent nicht-konnektive Diskurse, wie auch die P3b, gefunden im Vergleich zwischen kausalen und konzessiven Konnektiva in Experiment 4, lieferten jedoch Grund zu der Annahme, dass die Bedeutung von Konnektiva in der inkrementellen Verarbeitung genutzt wird, und dass die Relation, die Konnektiva signalisieren, diejenige ist, die Leser versuchen zu erstellen.<br><br> Im Hinblick auf wann die Information, die Konnektiva liefern, genutzt wird, scheint es, also ob Konnektivität generell und obligatorisch für bare Münze genommen wird. So lange die Bedeutung der Konnektiva nicht mit einer präferierten kanonischen Diskursrelation konfligierte, zeigten sich keine Differenzen innerhalb verschiedener konnektiver Diskurse (Experiment 3), aber die Tatsache, dass konzessive Konnektiva die Notwendigkeit einer komplexeren Textrepräsentation voraussagen, wurde sofort erkannt und genutzt (Experiment 4). Zusätzlich resultierte eine Verletzung der Diskursrelation in Experiment 2 in erschwerterer semantischer Integration, wenn ein Konnektivum vorhanden war. Es wird daher gefolgert, dass Konnektiva die Verarbeitung sofort beeinflussen. <br><br> Diese Schlussfolgerung muss jedoch etwas abgeschwächt werden, da die satzfinalen Elemente darauf hinwiesen, dass Konnektiva andere Integrationsprozesse am Ende der Diskurse auslösten als nicht-konnektive Elemente. Es scheint, dass die Antwort auf die Frage, wann Konnektiva verarbeitet werden, weder sofort noch hinterher ist, sondern dass beide Sichtweisen korrekt sind. Es wird hier vorgeschlagen, dass vor dem Ende eines Diskurses Ökonomie insofern eine entscheidende Rolle spielt, als eine kanonische Relation angenommen wird so lange es keine gegenteilige Evidenz gibt. Ein Konnektivum könnte die evaluierten Dimensionen in einem Diskurs auf die signalisierten reduzieren. Am Ende des Diskurses wird die erstellte Textrepräsentation evaluiert und verifiziert, und ein integriertes Situationsmodell erstellt. Hier drückt sich dann die Komplexität der verschiedenen Diskursrelationen, die Konnktiva signalisieren können, aus.

In this study, metastasizing serotonin-producing ileocaecal carcinoid tumours (MSPCs) were examined for biological characteristics that could be used to define clinically relevant subgroups within this patient population. Possible targets for new treatment options were also explored. It was found that MSPCs share several biological characteristics such as expression of serotonin, tachykinins (TKs), chromogranin A, islet autoantigen-2 and connective tissue growth factor (CTGF). TKs and serotonin were demonstrated in the same endocrine tumours in the gut and lung. IA-2 expression was shown to be up-regulated in MSPCs, possibly in connection with active hormone secretion. CTGF expression was high in tumour areas adjacent to extensive stroma expressing alpha-smooth muscle actin. This indicated myofibroblast differentiation, which may be associated with fibrosis-related complications prevalent in patients with MSPCs. When compared with other endocrine tumours, MSPCs behaved as a relatively homogeneous group, though within the MSPC population several subgroups could be defined. Patients with tumours displaying either a solid growth pattern and/or a Ki67 index ≥1% had a less favourable prognosis than those who did not. Another group of patients, who had increased plasma TK concentrations, were more likely to suffer from severe diarrhea. This information should be considered when discussing clinical treatment and when undertaking tumour biological studies. New treatment possibilities, such as drugs that specifically target TK receptors and antibodies to CTGF, are also discussed. In conclusion, MSPCs comprise a clinically relevant tumour group with similar biological features that are distinct from other endocrine tumours. Subgroups of patients within this patient category can be defined which may be relevant when establishing prognosis and when selecting future treatment modalities.

[Truncated abstract] An important field of research in orthopaedic biomechanics is the elucidation and mathematical modelling of the mechanical response of cartilaginous tissues. Such research has applications in the understanding of joint function and degenerative processes, as well as in surgical planning and simulation, and engineering of tissue replacements. In the case of surgical and tissue engineering applications especially, patient-specific mechanical properties are highly desirable. Unfortunately, obtaining such information would generally involve destructive mechanical testing of patient tissue, thus rendering the tissue functionally unusable. Development of a laser scanning confocal arthroscope (LSCA) within our School will soon allow non-invasive extraction of 3D microstructural images of cartilaginous tissues in vivo. It is also envisaged that, linked to a suitably formulated constitutive formulation, such information could allow estimation of tissue mechanical response without physical biopsy. This thesis describes the development of techniques to potentially allow non-invasive patient-specific estimation of tissue mechanical response based on confocal arthroscopy data. A microstructural constitutive model is developed which is capable of directly incorporating LSCA-derived patient-specific structural information. A fibre composite type homogenisation approach is used as the basis for the model. ... The result is a series of orientation tensors describing the 3D orientation of linear features in the image stack. The developed analysis techniques are used to estimate fibre volume fraction and orientation distribution for each of the meniscal specimens. The developed constitutive model and image-derived structural parameters are finally used to estimate the reaction force history of two meniscal cartilage specimens subjected to partially confined compression. The predictions are made on the basis of the specimens? individual structural condition as assessed by confocal microscopy and involve no tuning of material parameters. Although the model does not reproduce all features of the experimental curves, as an unfitted estimate of mechanical response the prediction is quite accurate. In light of the obtained results it is judged that more general non-invasive estimation of tissue mechanical properties is possible using the developed framework. The likely limitations and potential areas of improvement are discussed.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 6 uppsatser.

Orientador: Carlos Alberto Anaruma / Banca: Roberto Naves Domingos / Banca: Miriam Maria de Magalhães Oliveira / Resumo: Este trabalho apresenta uma série de resultados referentes à utilização da transmissão de fármacos tópicos através de ondas ultra-sônicas (fonoforese), em lesão cirúrgica produzida no músculo tibial anterior de ratos Wisttar. O fármaco utilizado foi a hidrocortisona gel manipulada a 10%. Foram utilizados 42 ratos Wisttar machos, com 60 dias de idade e peso médio de 300,0 g ( 50,0 g), que foram submetidos à lesão cirúrgica na pata direita no músculo tibial anterior. Após 24 horas a área da lesão foi tratada com ultra-som tendo como gel acoplante hidrocortisona a 10%. A freqüência utilizada foi de 1,0 MHz e intensidade de 0,4 W/cm2 por 1 minuto, durante 14 dias consecutivos. Depois da terapia aplicada os ratos foram sacrificados, o músculo criofixado e cortado em criostato. As lâminas obtidas foram coradas por H/E, Tricrômico de Masson e Tricrômico de Mallory para serem fotografadas em fotomicroscópio Zeiss. O tecido analisado proveniente dos animais lesados, tratados com ultra-som e hidrocortisona a 10% (fonoforese) apresentam: após 1 dia de tratamento, fibras musculares seccionadas pela incisão já fagocitada com predomínio de células mononucleadas. Nos animais sacrificados após 3 dias de tratamento notamos a presença de mioblastos, alguns miotubos e neovascularização. Quando analisamos os tecidos dos animais sacrificados após 7 dias de tratamento, observamos a presença de reorganização dos tecidos musculares. Nos animais sacrificados 14 dias após o tratamento, as fibras musculares mostram-se em avançado estado de regeneração. O aparecimento precoce de mioblastos e raras fibras necróticas, a partir do terceiro dia de aplicação, levam-nos a concluir que o fármaco tópico anti-inflamatório consegue atravessar a barreira de tecidos biológicos através da transmissão da energia ultra-sônica, e assim acelerar a reconstituição do tecido lesado. / Abstract: This work presents a series of referring results to the use of the transmission of topical pharmacs through ultrasonic waves (Phonophoresis) in a produced surgical injuries in previous in the tibialis anterior muscle of Wisttar rats. The used pharmac was hydrocortisone gel to 10%. We had been used, in these experiment 42 rats with 60 days years' old and 300,0 average weight of g ( 50,0 g). The animals had been submitted to the chirurgical injury in the right leg, in previous the tibiae muscle. After 24 hours the area of the injury was dealt with ultrasound with faceplate hydrocortisone gel to 10%. The used frequency was of 1,0 MHz and the intensity of 0,4 W/cm2, with a time of 1 minute of insomniac, during 14 days. After the therapeutically one applied the rats they had been sacrificed, the frost fixed and cut muscle in cryostat. The gotten blades had been stain by H/E, Gomori's Trichrome, Masson's Trichrome and Mallory's Trichrome to be photographed in Zeiss photomicroscope. The analyzed proceeding from the animals injured, treated with ultra-sound and hydrocortisone present: after 1 day of treatment, skeletal muscle staple fibers parted by the phagocyte incision already with predominance of mononuclear cells. After 3 days of treatment, in the sacrificed animals, it is noticed myoblasts, some multinucleated myofibers and new vessel. When one analyzes of the sacrificed animals after 7 days of treatment, observes it presence of reorganization of muscular. In the sacrificed animals 14 days after the treatment, visualizes muscular fibers in advanced state of regeneration. The precocious appearance of myoblasts and rare necrotic tissue as fibers to leaving of the third day of application of treatment lever to conclude that the topical pharmac obtained to cross the biological barrier through the transmission of the ultrasonic energy. Of this form the hydrocortisone is taken until the small farm of lesion. / Mestre