Orientador: Agrício Nubiato Crespo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-17T15:39:14Z (GMT). No. of bitstreams: 1 Carvalho_EduardoGeorgeBaptistade_D.pdf: 1487097 bytes, checksum: 8b21a6026c0fd35ff39cc175609d11d7 (MD5) Previous issue date: 2011 / Resumo: A correção de sulcos e cicatrizes de pregas vocais permanece como grande desafio à fonocirurgia. Substâncias que promovam a reestruturação da lâmina própria parecem ser a melhor opção. Esta pesquisa avaliou a influência do fator de crescimento de fibroblastos na integração tecidual de enxerto de fragmento de fáscia superficial na lâmina própria de prega vocal de coelhos associado à injeção de FGF, quanto às alterações histológicas induzidas como reação inflamatória aguda e crônica, fibrose desencadeada pelo procedimento e presença de neovascularização. Doze coelhos adultos foram submetidos ao enxerto de fragmento de 0,1 X 0,1 cm de fáscia cervical superficial na lâmina própria de ambas as pregas vocais. Na prega vocal direita foi injetado fator de crescimento de fibroblastos. Após um e doze meses, os animais foram sacrificados e suas pregas vocais submetidas a estudo histológico. O fator de crescimento de fibroblastos induziu resposta inflamatória em todos os animais após um mês do experimento inicial. Desencadeou fibrose além da causada pelo procedimento cirúrgico na prega vocal direita em todos os animais após 12 meses do experimento inicial. Fato que demonstra que o fator de crescimento de fibroblastos não representa uma boa opção terapêutica na correção das alterações da lâmina própria de pregas vocais quando associado ao enxerto de fáscia. / Abstract: The correction of sulcus and scars of vocal cords remains as a major challenge to fonosurgery. Substances which promote the restructuring the lamina propria seem to be the best option. This study evaluated the influence of fibroblasts growth factor in integration fragment of fascia grafted in the vocal fold lamina propria of rabbits associated with the injection FGF, regarding the histological alterations , acute and chronic inflammatory reaction, fibrosis, presence of neovascularization and the density of collagen. Twelve adult rabbits were submitted to grafting of fragment of 0.1 X 0.1 cm cervical fascia in the vocal fold lamina propria. Fibroblasts growth factor was injected in the right vocal fold. After a month and 12 months, the animals were sacrificed and their vocal folds submitted to histological study. The fibroblasts growth factor induced acute inflammatory response in all animals after one month of initial experiment. It induced fibrosis in addition to the caused by surgical procedure on the right vocal fold in all animals after 12 months of initial experiment. Fact which demonstrate that the fibroblasts growth factor with fascia grafting is not a good therapeutic option in correction of alterations of the vocal fold lamina propria. / Doutorado / Otorrinolaringologia / Doutor em Ciências Médicas

Vários materiais têm sido introduzidos nas pregas vocais na tentativa de solucionar a incompetência glótica, porém poucos são os estudos que avaliam o processo cicatricial decorrente da enxertia destes materiais. O objetivo desta pesquisa foi quantificar o processo inflamatório celular na prega vocal de coelhos submetidos a enxerto unilateral de gordura ou fáscia muscular. Estudamos 24 coelhos, divididos em 2 grupos, nos quais gordura ou fáscia foi enxertada. O grupo controle foi formado pela prega vocal contralateral, a qual foi submetida ao mesmo procedimento, excetuando-se a colocação do enxerto. Metade dos coelhos de cada grupo foi sacrificada após 90 dias, enquanto a outra metade foi sacrificada após 180 dias da cirurgia. A densidade celular inflamatória peri-enxerto foi avaliada em todas as pregas vocais. Houve um aumento do infiltrado inflamatório no grupo submetido à enxertia de gordura, quando comparado ao submetido à enxertia de fáscia. Bem como ao grupo controle, após 90 dias. Quanto aos coelhos sacrificados após 180 dias, não houve diferença entre os grupos entre si e em relação ao grupo controle. Esse estudo sugere que o enxerto de fáscia parece ser mais aceitável que o enxerto de gordura para a prega vocal, uma vez que origina menor reação inflamatória tecidual / Several material have been introduced into the vocal folds in attempt to solve glottic incompetence, however just a few studies are related with the consequent inflammatory process. The aim of this article was to quantify the cellular inflammatory process in rabbit vocal fold, which have undergone unilateral fat or muscular fascia introduction. Twenty-four rabbits were allocated into two groups, in which muscular fascia or fat were implanted. The control group, formed by the contra-lateral vocal fold, underwent the same surgical procedure, except for the grafting. Half the rabbits from each group were sacrificed after 90 days from the surgery, while the other half was sacrificed after 180 days. The inflammatory cellular density around the graft was measured in all vocal folds. There was a higher cellular inflammatory reaction in the group submitted to fat grafting when compared to the group submitted to muscular fascia grafting, and to the control group, after 90 days. As for the rabbits sacrificed after 180 days, there was no significant difference between the implanted groups with each other, and with the control group. This study suggests that muscular fascia graft seems to be more acceptable than fat grafts for the vocal fold, as it produces a lower local inflammatory reaction

OBJETIVO: Comparar a viscosidade dinâmica da camada superficial da fáscia temporal com a de outros tecidos biológicos tradicionalmente utilizados em implantes de pregas vocais para o tratamento de rigidez de pregas vocais. DESENHO DO ESTUDO: Experimental. MÉTODO: Amostras de camada superficial da fáscia temporal, camada profunda da fáscia temporal e gordura abdominal de 12 cadáveres são submetidas a medição de viscosidade dinâmica. RESUTADOS: A viscosidade dinâmica das diferentes amostras apresenta-se na seguinte ordem crescente: camada superficial da fáscia temporal, camada profunda da fáscia temporal e gordura abdominal. Observa-se diferença estatística na comparação entre todas as amostras. DISCUSSÃO: Quanto maior for a viscosidade da mucosa da prega vocal, maior é a pressão subglótica necessária para se iniciar a fonação. Dessa maneira, um bom material implantável em lâmina própria de prega vocal deve ter baixa viscosidade. Por esse parâmetro, a camada superficial da fáscia temporal é um material promissor para implantação em pregas vocais. CONCLUSÃO: A viscosidade dinâmica da camada superficial da fáscia temporal é menor que a da camada profunda da fáscia temporal e que a da gordura abdominal. / OBJECTIVE: To compare the dynamic viscosity of superficial layer of temporalis fascia with that of other biological tissues traditionally used for vocal fold implants to treat vocal fold rigidity. STUDY DESIGN: Experimental. METHOD: Measurement of dynamic viscosity of samples of superficial layer of temporalis fascia, deep layer of temporalis fascia and abdominal fat of 12 cadavers are performed. RESULTS: Dynamic viscosity values of the different samples are presented in the following increasing order: superficial layer of temporalis fascia, deep layer of temporalis fascia and abdominal fat. There is statistical difference among all the samples. CONCLUSION: Dynamic viscosity of superficial layer of temporalis fascia is lower than the ones of deep layer of temporalis fascia and abdominal fat.

Le but de cette thèse était d’étudier la céramique d’entités géographiques antiques définies, afin d’en cerner les faciès et de les confronter à l’analyse des fonctions et des approvisionnements. Le territoire d’investigation se situe sur les pagi antiques du Laonnois, du Soissonnais, du Tardenois, du Noyonnais et du Vermandois (en latin dans le titre), compris dans le territoire de trois cités de Gaule Belgique (cité des Rèmes, des Suessions et des Viromanduens).L’étude s’appuie sur un catalogue de 36 sites d’habitats (ruraux et urbains) et 8 sites funéraires, réunis à partir d’études personnelles et du dépouillement des rapports de fouilles réalisés par les différents acteurs de l’archéologie préventive. Quatre vingt cinq horizons-sites ont ainsi pu servir de base à la constitution d’une chronologie composée de treize horizons de synthèse. Ceux-ci sont détaillés au sein du chapitre II, tandis que le chapitre III caractérise les catégories principales de la céramique et leur évolution au travers du temps. Enfin, le chapitre IV débute par une analyse du faciès fonctionnel de la céramique des cinq pagi, en axant son propos sur une comparaison entre ville et campagne. Il se poursuit avec une analyse des faciès, notamment à travers la céramique commune sombre et se conclut par une analyse globale des approvisionnements et de l’économie avec un point détaillé sur la terre sigillée, la terra nigra et la céramique commune sombre. / The purpose of this thesis is to study the ceramic who has a definite antique geographic entity, in order to uncertain the fascia and to confront it to the function analysis and approvisionements. The investigation territory is situated on the antique pagi of the Laonnois, of Soissonnais, of Tardenois, of Noyonnais and of Vermandois (in Latin in the title), comprised in the territory of the three cities of Belgian Gaul (City of Remes, of Suessions and of Viromanduens)The study is relying on a catalogue of 36 sites of habitats (rural and cities) and 8 funeral sites, reunited with personal studies and counting of excavation reports done by various actors of preventive archaeology. Eighty five site-horizons have then served as a base to the constitution for a chronology composed of thirteen synthesis horizons. These have been detailed within Chapter II, whereas chapter III characterises the principle categories of the ceramics and their evolution through time. Finally, chapter IV starts with an analysis of the conventional fascia of the 5 pagi, focusing its remarks between town and county. It continues with a comparison between fascia, notably through the dark ceramic commons and concludes with a global analysis of approvisionements and the economy with a detail point of the simian ware, the terra nigra and the dark common ceramic.

This thesis presents work on investigations into the mechanical properties of connective tissue. A model system of hydrogels was used to investigate how volume change through water flow is coupled to relaxation. This was done using digital image correlation (DIC) and a custom built setup. It was found, in hydrogels, that water loss is directly coupled to an increase in tension and water intake is directly coupled to tension relaxation. The experimental setup was tested by investigating the mechanical properties of the well known material polydimethylsiloxane (PDMS) and the novel materials of carbon nanotube (CNT) elastomers, cholesteric liquid crystal elastomers (CLCEs), and 3D polydomain liquid crystal elastomers (3DLCEs). The setup accurately demonstrated the incompressibility of PDMS, even at short time scales, and demonstrated how DIC can map the inhomogeneity of material by locating clusters of CNTs in CNT elastomers by how they deform. Novel results for 3DLCEs were also found, where it was discovered that there is a softening of the bulk modulus at small time scales resulting in a volume increase following deformation, the bulk modulus then recovers and there is over all no volume change. This is in stark contrast to the typical case, where it is the shear modulus that becomes comparable to the bulk modulus, resulting in increased volume. A theoretical investigation was carried out into critical damping in viscoelastic oscillators, where the aim was to apply to the findings to connective tissue. The fractional Maxwell model and zener model where both solved for, where it was found that damping decreases as the material becomes more solid and the peak of critical damping becomes broader. Finally, investigations into how strain relates to the viscoelastic properties of connective tissue were carried out on horse tendon and rat fascia. How relaxation changes was determined through the relaxation constant, where a large constant means it takes the sample longer to relax and it is more solid like. It was found, that in general, the relaxation constant increases quickly with an imposed strain and then either stabilises or increases more slowly. This growth of relaxation constant also occurs during the initial stages of tissue injury, where irreversible deformation occurs.

No description available.

The present work details the creation and analysis of a finite element model of the foot, wherein the plantar fascia was modeled as a viscohyperelastic solid. The objective of this work was to develop a fully functional CAD and Finite Element Model of the foot and plantar fascia for analysis by examining the transient stresses on the plantar fascia through the use of a viscohyperelastic material model. The model’s geometry was developed through the use of image processing techniques with anatomical images provided by the National Institutes of Health. The finite element method was used to analyze the transient response of the plantar fascia during loading. As a first step towards modeling the transient response of the mechanical behavior of the plantar fascia under dynamic loadings, standing conditions were used to analyze the relaxation of the plantar fascia over a time period of 120 seconds (which is the steady-state relaxation time of the plantar fascia). This study resulted in a fully functional model with transient stress data on the behavior of the plantar fascia during loading, along with stress and deformation data for the bones and soft tissue of the foot. The results obtained were similar to that recorded in literature. This model is the first step towards fully characterizing the mechanics of the plantar fascia so as to develop novel treatment methods for plantar fasciitis, and can be applied to future studies to develop novel orthotic devices and surgical techniques for the treatment of and prevention of plantar fasciitis.

Title: Manual techniques based on the theory of fascial chains Objectives: The aim of this thesis is to summerize academic findings and information about anatomy, histology, neurophysiology and biomechanical properties of fascial tissue from the latest research and studies in the theoretical part. Analytical and descriptive part is firstly focused on principles of tissue remodeling, mechanism of myofascial therapy effects and on diagnostic methods which are available for evaluation of structure, properties and function of fascia. The main goal is to describe and compare different diagnostic and therapeutic approaches of most known authors based on various theories of fascial chains. Another important purpose of this work is to demonstrate the objective effect of particular fascial techniques and manual therapies. Methods: This thesis is theoretical work with the purpose of summerizing, organizing and analyzing relevant studies related to the topic through the literary research in available academic databases. Results: The key information concerning structure and properties of fascial tissue have been collected and analyzed according to the latest fascial researches. This thesis describes three best known and widely used approaches which concern the theory of fascial chains and practical outfall...

A incompetência glótica ainda representa um desafio para a laringologia. Implantes de biomateriais no espaço de Reinke ou no espaço paraglótico estão entre as opções de tratamento, e suturas e confecção de bolsões subepiteliais são normalmente utilizados para fixação desses implantes. Alternativamente, a cola biológica pode ser usada como adesivo nesses casos. A cola de fibrina (CF) é produto da reação de dois componentes do sistema de coagulação: o fibrinogênio e a trombina, que formam uma rede de fibrina, responsável, entre outros, pela adesão dos tecidos. Entretanto, além do efeito adesivo, a CF e seus componentes podem interferir no processo cicatricial, atuando sobre citocinas como o fator de crescimento transformador-beta (TGF-beta). O objetivo deste estudo é avaliar o efeito da cola de fibrina na deposição de colágeno após enxertia de fáscia em pregas vocais de coelhos. Dezoito coelhos foram submetidos a enxerto de fáscia em ambas as pregas vocais, sendo o lado esquerdo fixado com CF. Os coelhos foram sacrificados após 7, 30 e 90 dias. As laringes foram removidas e as pregas vocais preparadas para estudo histomorfométrico através da coloração picrossirius, a fim de avaliar a deposição de colágeno total em torno do enxerto. Foi observado um aumento estatisticamente significativo na densidade de colágeno em torno dos enxertos de fáscia nas pregas vocais que receberam a CF (p=0,0102) após 90 dias, em comparação com as pregas vocais controles. A aplicação da CF interferiu na deposição de colágeno em torno dos enxertos de fáscia, resultando em um aumento significativo na densidade de colágeno após 90 dias, possivelmente em decorrência da interação de seus componentes com citocinas e células envolvidas no processo de cicatrização / The glottal incompetence is still a challenge in Laryngology. Implants of biomaterials in Reinkes space or paraglottic space are among the treatment options, and sutures and pockets dissections are usually used to set these implants. Alternatively, biological glue can be used as adhesive in these cases. Fibrin glue (FG) is the product reaction of two components of the coagulation system: the fibrinogen and thrombin that form a fibrin net, responsible for the tissues adhesion, among other functions. However, the FG and its components may interfere in wound healing, interacting with cytokines as the transforming growth factor-beta (TGF-beta). The objective is to study the effect of fibrin glue on collagen deposition after fascia grafting on the rabbits vocal folds. Eighteen rabbits were submitted to the fascia graft on both vocal folds, being the left side fixed with FG. The rabbits were sacrificed after 7, 30 and 90 days. The larynx were removed and vocal folds prepared for histomorphometric study through Picrosirius Red stain, in order to evaluate the collagen deposition around the graft. There was a significant increase in collagen density around the grafts on the vocal folds that received FG (p=0.0102) after 90 days, compared with the control. FG application interfered in collagen deposition around fascia grafts, resulting in a significantly increase of collagen density after 90 days, which possibly resulted from the interaction of FG and its components with the cytokines and cells involved in the wound healing

A incompetência glótica ainda representa um desafio para a laringologia. Implantes de biomateriais no espaço de Reinke ou no espaço paraglótico estão entre as opções de tratamento, e suturas e confecção de bolsões subepiteliais são normalmente utilizados para fixação desses implantes. Alternativamente, a cola biológica pode ser usada como adesivo nesses casos. A cola de fibrina (CF) é produto da reação de dois componentes do sistema de coagulação: o fibrinogênio e a trombina, que formam uma rede de fibrina, responsável, entre outros, pela adesão dos tecidos. Entretanto, além do efeito adesivo, a CF e seus componentes podem interferir no processo cicatricial, atuando sobre citocinas como o fator de crescimento transformador-beta (TGF-beta). O objetivo deste estudo é avaliar o efeito da cola de fibrina na deposição de colágeno após enxertia de fáscia em pregas vocais de coelhos. Dezoito coelhos foram submetidos a enxerto de fáscia em ambas as pregas vocais, sendo o lado esquerdo fixado com CF. Os coelhos foram sacrificados após 7, 30 e 90 dias. As laringes foram removidas e as pregas vocais preparadas para estudo histomorfométrico através da coloração picrossirius, a fim de avaliar a deposição de colágeno total em torno do enxerto. Foi observado um aumento estatisticamente significativo na densidade de colágeno em torno dos enxertos de fáscia nas pregas vocais que receberam a CF (p=0,0102) após 90 dias, em comparação com as pregas vocais controles. A aplicação da CF interferiu na deposição de colágeno em torno dos enxertos de fáscia, resultando em um aumento significativo na densidade de colágeno após 90 dias, possivelmente em decorrência da interação de seus componentes com citocinas e células envolvidas no processo de cicatrização / The glottal incompetence is still a challenge in Laryngology. Implants of biomaterials in Reinkes space or paraglottic space are among the treatment options, and sutures and pockets dissections are usually used to set these implants. Alternatively, biological glue can be used as adhesive in these cases. Fibrin glue (FG) is the product reaction of two components of the coagulation system: the fibrinogen and thrombin that form a fibrin net, responsible for the tissues adhesion, among other functions. However, the FG and its components may interfere in wound healing, interacting with cytokines as the transforming growth factor-beta (TGF-beta). The objective is to study the effect of fibrin glue on collagen deposition after fascia grafting on the rabbits vocal folds. Eighteen rabbits were submitted to the fascia graft on both vocal folds, being the left side fixed with FG. The rabbits were sacrificed after 7, 30 and 90 days. The larynx were removed and vocal folds prepared for histomorphometric study through Picrosirius Red stain, in order to evaluate the collagen deposition around the graft. There was a significant increase in collagen density around the grafts on the vocal folds that received FG (p=0.0102) after 90 days, compared with the control. FG application interfered in collagen deposition around fascia grafts, resulting in a significantly increase of collagen density after 90 days, which possibly resulted from the interaction of FG and its components with the cytokines and cells involved in the wound healing