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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
121

The research of risk factors for local progression of malignant hepatic tumours treated with radiofrequency ablation / Piktybinių navikų, esančių kepenyse, vietinio progresavimo rizikos veiksnių tyrimas taikant radijo dažnio abliaciją

Trakymas, Mantas 26 May 2009 (has links)
Local tumour progression remains the main problem after radiofrequency ablation of liver tumours and it is usually the only measure of treatment efficacy. The aim of our study was to investigate and evaluate the prognostic value of computed tomography and ultrasonography as well as the histological result of core biopsy material from ablated tumour on assessment of radiofrequency ablation effectiveness. Materials and methods: We have studied 68 malignant primary and metastatic hepatic tumours treated by radiofrequency ablation. Ablation was performed using perfusion electrodes. Evaluation of tumours before ablation and follow up was performed by means of contrast enhanced computed tomography and ultrasonography. Ablation zone was biopsied for histological examination. Results and conclusions: 58 successfully treated hepatic tumours were suitable for the final analysis. The local progression of nine (15.5 %) tumours was detected on follow up. Mean follow up time for analysed tumours was 16.3 months with a range from 1.7 to 38.7 months. It was showed, that: 1. The result of histological examination of ablation zone biopsy material taken one month after radiofrequency ablation of malignant liver tumour does not predict local tumour progression. 2. Tumour size 30 mm and larger and tumour proximity closer than 5 mm to hepatic vessels larger than 3 mm are significant risk factors for local tumour progression after radiofrequency ablation of malignant liver tumours 3. Tumour type... [to full text] / Nors vietinis naviko progresavimas yra esminė problema, atliekant piktybinių navikų kepenyse radijo dažnio abliaciją, dažniausiai tai yra vienintelis rodiklis, apibrėžiantis šio gydymo metodo veiksmingumą. Mūsų tyrimo tikslas buvo nustatyti kompiuterinės tomografijos ir ultragarso tyrimų bei histologinio stulpelinės biopsijos medžiagos, paimtos iš abliuoto naviko, histologinio tyrimo rezultato reikšmę anksti vertinant radijo dažnio abliacijos veiksmingumą. Tyrimo medžiaga ir metodai: Į tyrimą buvo įtraukti 68 pirminiai ir metastaziniai kepenyse esantys navikai. Radijo dažnio abliacija buvo atliekama naudojant perfuzijos elektrodus. Navikai prieš abliaciją ir po jos atliekant kontrolinius tyrimus buvo vertinami kompiuterinės tomografijos ir ultragarsinio tyrimo metodais. Po abliacijos praėjus vienam mėnesiui buvo atliekama abliacijos zonos punkcinė stulpelinė biopsija, audiniai tiriami histologiškai. Rezultatai ir išvados: Galutinei analizei buvo tinkami 58 sėkmingai gydyti navikai. Radiologinio stebėjimo metu buvo nustatyti devyni (15,5 %) vietinio naviko progresavimo atvejai. Vidutinis analizuotų navikų stebėjimo laikas buvo 16,3 mėnesiai (nuo 1,7 iki 38,7 mėnesių). Nustatyta, kad: 1. Biopsijos medžiagos, paimtos iš abliacijos zonos praėjus vienam mėnesiui po naviko, esančio kepenyse, radijo dažnio abliacijos, histologinio tyrimo rezultatas neleidžia prognozuoti vietinio naviko progresavimo 2. Naviko dydis 30 mm ir naviko lokalizacija arčiau kaip per 5 mm nuo didesnio nei 3... [toliau žr. visą tekstą]
122

The development of a radio frequency plasma within a graphite furnace

Bir, David J. January 1992 (has links)
Graphite Furnace Atomic Absorption Spectroscopy (GFAA) and Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES) are two primary means of analyzing metals at the elemental level. Both techniques are widely accepted as tools for basic research. Each technique is performed differently and has its own distinct advantages as well as disadvantages. The choice of which technique to employ is determined by the needs of the analysis and the limitations of the instrumental technique.The idea to merge the two techniques was originallydeveloped by the research group of Dr. Michael W. Blades of the University of British Columbia, Vancouver, in 1989, who successfully demonstrated a "mini" plasma within a graphite furnace. The goal of the research was to design a device that would combine the advantages of both techniques and hopefully eliminate or minimize the unfavorable characteristics of each technique.The sustaining of a "mini" plasma has been demonstrated by this group. Although the end result was similar to that of Blades' group, the method of achieving the plasma was such that the "new" instrument could easily be mounted onto the furnace via a small Interface/Power Coupling device. The advantages of this system are: existing GFAA instruments can be used; modification of the furnace and RF supply is minimal; RF electronics can be remotely located; removal of the interface device is quickly achieved; and sample introduction, through the use of an autosampler, can be facilitated with small modification.Background spectra were acquired using helium, argon, and a mixture of argon/helium. It was found that all the plasmas have highly structured backgrounds and demonstrate the potential for many analysis regions. Two methods of sample introduction were used in acquiring the line emission of magnesium: injection through the sample inlet port to the furnace and end window injection. Inlet port injection suffers from a loss of sensitivity, when compared to end cap injection, but is more easily performed. / Department of Chemistry
123

Procesų, įtakojančių radiodažninės abliacijos kepenų audinyje rezultatus, tyrimas / The investigation of the processes influencing the results of radiofrequency ablation in the liver tissue

Vanagas, Tomas 01 June 2011 (has links)
Vienas iš būdų padėti pacientams, sergantiems kepenų navikais, yra lokalus naviko sunaikinimas radiodažnine abliacija. Pagrindine šio metodo problema išlieka aukštas naviko atkryčio dažnis. Disertacijos tikslas yra ištirti procesus, vykstančius radiodažnine abliacija paveiktame kepenų audinyje, išsiaiškinti šių procesų mechanizmus bei hipertermijos sąlygojamus pakitimus audinio, ląstelės ir subląsteliniame lygmenyje. Retrospektyviu tyrimu įvertintas pacientų, kuriems KMUK Chirurgijos klinikoje buvo atlikta kepenų navikų radiodažninė abliacija, navikų atkryčio dažnis, jo atsiradimo laikas ir veiksniai, galintys sąlygoti atkrytį. Eksperimentiškai įvertinti fizikiniai veiksniai, sąlygojantys šilumos plitimą kepenų audinyje, jų įtaka kepenų audinio pažeidimo mąstui ir tolygumui. Nustatyti morfologiniai ir biocheminiai pakitimai, vykstantys pereinamojoje kepenų audinio pažeidimo zonoje, bei šių pakitimų atsiradimo laikas. Ištirti pereinamosios kepenų audinio pažeidimo zonos hepatocitų mitochondrijų funkcijų pokyčiai ir apoptozės proceso vyksmui reikalingų energetinių resursų susidarymas, eksperimentiškai modeliuojant šios zonos temperatūrinius kitimus. Tyrimo naujumą lemia tai, kad darbe nustatyta jog apoptozės procesas pereinamoje radiodažninio pažeidimo zonoje gali būti nustatomas praėjus valandai po terminio pažeidimo. Eksperimentuose su hepatocitų mitochondrijomis nustatėme iki šiol neaprašytą neigiamą hipertermijos poveikį kepenų ląstelių mitochondrijų funkciniams rodikliams. / Radiofrequency ablation is one of the most widely accepted method for the local ablation of liver tumors. One of the negative aspects of this method is a high local recurrence rate, which is associated with the worse survival. The aim of the dissertation was to explore the processes in radiofrequency ablation affected liver tissue, ascertain the mechanisms of these processes and hyperthermia induced changes in the liver tissue, cells and subcellular level. The liver tumor recurrence rate, time and factors that could determine the recurrence were estimated using retrospective analysis of data. The physical parameters determining the spreading of the heat in liver tissue in experimental model and the influence of these parameters on extent and homogeneity of the damage were determined. The morphological and biochemical changes in the remote from the heat source zone were determined and the time of these changes was detected. The changes of liver cells mitochondria functions and the intracellular formation of energy resources necessary for these processes in subcellular level (apoptosis) were investigated simulating temperature changes in experimental model. The scientific novelty was governed by the data those support the activation of apoptotic pathway in the early period after exposure to hyperthermia. Our experimental study revealed yet unpublished data of the adverse effects of hyperthermia on the key functional parameters of the mitochondria.
124

Patients’ Preferences and Trade Offs for the Treatment of Small Hepatocellular Carcinomas

Molinari, Michele 23 July 2012 (has links)
Objective: The primary aim of this study was to assess patients’ preferences between radiofrequency ablation (RFA) versus hepatic resection (HR) for the treatment of small hepatocellular carcinomas (HCC). Methods: Decision analysis was performed by using probability trade-off (PTO) technique to elicit patients’ preferences and the strength of their decisions. Results: The vast majority of the study population preferred RFA over HR (70% vs. 30%, p=0.001). Their initial choice changed if 5-year survival benefit after surgery was at least 14% superior to RFA and if the 3-year disease-free survival advantage was at least 13% better than ablation. Conclusions: The results of this study suggest that fully informed cirrhotic patients would prefer RFA if diagnosed with early stage HCC even if able to undergo surgery.
125

Comparação de eficácia e segurança no tratamento da insuficiência venosa crônica grave (CEAP 6) ablação endovenosa por radiofrequência versus ablação endovenosa por laser versus escleroterapia por espuma versus elastocompressão. /

Pimenta, Rafael Elias Farres January 2018 (has links)
Orientador: Marcone Lima Sobreira / Resumo: Introdução: A doença venosa em sua apresentação mais grave, úlcera venosa em atividade ou cicatrizada, afeta de 2 – 6 milhões de pessoas, se considerarmos a população acima de 70 anos. A terapia de compressão (EC) é considerada o tratamento clínico mais eficaz para úlcera venosa(UV), mas a recorrência deve ser prevenida com o tratamento da hipertensão venosa. Evidências sugerem que a recorrência da úlcera é diminuída com a cirurgia venosa superficial, com superioridade de intervenções endovenosas minimamente invasivas, como laser (EVLA) ou ablação por radiofrequência (RF), sobre o tratamento cirúrgico clássico. A escleroterapia com espuma (EE) tem demonstrado também eficácia na correção da hipertensão venosa, sendo seu uso cada vez mais difundido. Entretanto, ainda faltam evidências comparando as técnicas entre si com a terapia compressiva clássica. Objetivo: Comparar as técnicas endovenosas, como radiofrequência (RF) e endolaser (ELVA), com escleroterapia por espuma (EE) e o tratamento clínico por meio de elastocompressão em pacientes com insuficiência venosa crônica (IVC) avançada (CEAP 6). Casuística e Métodos: Estudo prospectivo, controlado e randomizado. Foram incluídos 126 (cento e vinte e seis) pacientes, num total de 139 (cento e trinta e nove) pernas com úlceras venosas ativas, randomizados de maneira independente em 4 grupos: Radiofrequência ou Laser ou Espuma ou Elastocompressão. A área da ferida foi determinada em cm2, com controle fotográfico das úlceras venosas ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: ABSTRACT: Introduction: Venous disease in its more serious presentation, healed or open venous ulcers, affects 2 – 6 million people worldwide. Compression therapy (EC) is considered the most effective clinical treatment for venous ulcers (VU) ; however, recurrence is prevented by treating underlying venous hypertension. Current evidence suggests that ulcer recurrence is reduced by superficial venous surgery. Minimally invasive endovenous treatment modalities, such as laser (EVLA) or radiofrequency ablation (RF) have shown superiority over the classic open surgical treatment. Foam sclerotherapy (EE) has also been shown to be effective in treating venous hypertension, Nonetheless, there isn’t enough evidence comparing all these techniques against classic compression therapy. Objective: To compare catheter-based endovenous techniques, such as radiofrequency (RF) and endolaser (ELVA) with foam sclerotherapy (EE) and clinical treatment using elastic compression in patients with advanced chronic venous disease (IVC) (CEAP 6). Methods: Randomized, open label, controlled trialy. One hundred twenty-six (N=126) patients in a total of 139 (one hundred thirty-nine) legs with active venous ulcers, were randomized and enrolled in an independent manner into 4 groups: RF, EVLA, EE or EC.. The wound area was measured in cm2. Photographic assessment of venous ulcer healing along with ultrasonography control. Major adverse events, such as deep vein thrombosis, pulmonary embolism, and death were... (Complete abstract click electronic access below) / Doutor
126

Physiological and clinical effects of radiofrequency-based therapy

Radha Kumaran, Binoy January 2017 (has links)
Electrophysical agents (EPA) are a fundamental element of therapy practice and are vital for the treatment of a variety of conditions. Many of these agents employ some form of electromagnetic fields (EMF), in which radiofrequency (RF) is a major component. The therapeutic effects of RF are mainly linked to their effects on pain relief and potential effects on tissue repair. Although RF across various frequency ranges has been in use, reviews have shown that the frequency ranges currently used in therapy practice have narrowed to within 30 kHz-30,000 kHz (30 MHz). The most commonly used and hence the most commonly researched are shortwave therapies (SWT) that operate at 27.12 MHz, which is presently used predominantly in its pulsed form (PSWT). In addition to SWT, devices employing significantly lower RF ranges have also been used widely despite their lack of evidence. Capacitive Resistive Monopolar Radiofrequency (CRMRF) that operates at 448 kHz is one such RF. This programme of research was designed to investigate the physiological and clinical efficacy of CRMRF delivered using the 'Indiba Activ 902' device. The project also evaluated the scope and evidence for RF-based EPAs in therapy, through a comprehensive review of literature. A total of 120 relevant clinical studies on either acute (30 studies) or chronic (90 studies) conditions were reviewed. Notable evidence was identified for chronic OA knee and acute postoperative pain and wound healing. Some evidence also exists for chronic low back pain and healing of chronic wounds. Only eight studies reported devices that employed RF outside the shortwave frequency band. In a randomised crossover laboratory study on asymptomatic adults, the effects of contrasting doses of CRMRF on skin temperature (SKT), skin blood flow (SBF), nerve conduction velocity (NCV), deep blood flow and the extensibility of tissues were examined against a placebo dose and a control condition with no treatment. The study further compared CRMRF results with that of PSWT. The results showed that high (moderately thermal) and low (sub/minimally thermal) doses of CRMRF significantly enhanced and sustained SKT (p < 0.001), while only the high dose meaningfully increased SBF (p < 0.001). High dose PSWT increased SKT marginally (p < 0.001) but did not sustain it. Further, the high and low dose CRMRF significantly enhanced blood flow volume at depth (p=0.003), while PSWT failed to show any significant impact. None of the treatments significantly affected deep blood flow velocity, tissue extensibility or NCV. These results were reproduced on a cohort of patients affected by OA knee in a randomised controlled trial (RCT), and the effects appeared more pronounced in the patients than in the asymptomatic people. More importantly, the RCT showed that a four-week high dose CRMRF treatment (eight sessions) produced statistically and clinically significant gains in pain and function associated with OA knee in the short to medium term (p < 0.001), which was also significantly more pronounced than the gains produced by a placebo, or standard care (p=0.001for pain; p=0.031 for function). The findings of this study were considered promising. It is therefore suggested that CRMRF-based treatment can potentially be used as an adjunct to current therapeutic methods to enhance the clinical outcomes. However, further studies are needed to substantiate this, and the current results will provide credible baseline data for future research.
127

Miringotomia pelo método de microeletrocautério por radiofreqüência associado à mitomicina C em modelo animal

Faccini, Vanessa Chisté Guimarães January 2007 (has links)
Introdução: Este presente estudo tem como objetivo descrever uma técnica cirúrgica alternativa à inserção do tubo de ventilação na membrana timpânica: a miringotomia por radiofreqüência isolada e associada à mitomicina C. Ressaltando-se, então, a importância de um método cirúrgico que proporcione uma execução mais simples, sem necessidade de anestesia geral, e não sujeito às complicações vinculadas ao tubo de ventilação. Método: Estudo experimental randomizado e comparado, em ratos da linhagem Wistar. Foram comparadas as técnicas de miringotomia por microlanceta e por microeletrocautério por radiofreqüência (ponteira 0,3 mm e 0,7 mm) isolada e associada à mitomicina C, considerando o tempo de fechamento timpânico. Resultados: Houve uma diferença estatisticamente significante entre a miringotomia por radiofreqüência e por microlanceta. Ao analisar a técnica por radiofreqüência com ponteira 0,7 mm associada à mitomicina C (teste de Wilcoxon), o P encontrado foi menor que 0,001, demonstrando uma significância estatística. O tempo máximo de fechamento foi de 44 dias e a mediana encontrada foi de 14 dias. Conclusão: A miringotomia por radiofreqüência apresenta uma patência mais prologada que a microlanceta. Ao associar a técnica de radiofreqüência com ponteira de maior diâmetro (0,7 mm) à mitomicina C há uma otimização no tempo de cicatrização da miringotomia. / Introduction. The present study describes the myringotomy by radiofrequency, isolated or associated to mitomycin C, an alternative surgical technique to the insertion of a ventilation tube through the tympanic membrane, and emphasizes the value of this easier surgical procedure requiring no general anesthesia and avoiding the complications that can occur with the ventilation tube. Method. Randomized and compared study in Wistar rats. The time elapsed for tympanic membrane recovery was compared between the myringotomy with microlancet and the myringotomy by radiofrequency (0.3mm and 0.7mm tip) isolated or associated to mitomycin C. Results. There was a statistically significant difference between the procedures. Analysis (Wilcoxon Test) of the myringotomy with 0.7mm tip radiofrequency associated to mitomycin C revealed P <0,001. The longest time for membrane recovery was 44 days with a mean of 14 days. Conclusion. Myringotomy by radiofrequency lasts longer than myringotomy with microlancet. The association of the radiofrequency with 0.7mm tip to mitomycin C enhances the patency of the myringotomy.
128

Intégration monolithique de composants bipolaires et de circuits radiofréquences sur substrats mixtes silicium/silicium poreux / Monolithic integration of bipolar devices and radiofrequency circuits on porous silicon/silicon hybrid substrates

Capelle, Marie 17 December 2013 (has links)
Le récent essor des systèmes de communication sans fil implique le développement de circuits RF performants, à fort taux d’intégration, bas coût, et adaptés à la production de masse. L’intégration monolithique de systèmes RF sur silicium permet de répondre en partie à ces critères. Cependant, le silicium est responsable de pertes dans le substrat dégradant les performances des composants passifs. Pour adresser cette limite, des caissons isolants de silicium poreux peuvent être réalisés au sein du silicium (substrat mixte). Les objectifs de cette thèse sont de montrer la faisabilité de l’intégration monolithique sur substrat mixte et d’étudier son impact sur les performances de circuits RF. Ce manuscrit décrit l’élaboration des substrats mixtes et donne une comparaison des performances de composants passifs intégrés sur silicium poreux et sur substrats standards. Enfin, l’intégration monolithique de circuits RF est menée sur substrat mixte 6’’. La caractérisation de ces démonstrateurs montre une amélioration des performances par rapport au silicium. De plus, la compatibilité du substrat mixte avec un procédé industriel de microélectronique est validée. / The rapid growth of wireless systems involves the development of highly efficient, large-scale, low-cost and radio frequency (RF) systems. Monolithic integration of RF circuits on silicon can enhance the appeal of this technology further. However, in order to fully realize the next generation of system-on-chip on silicon, the losses which results in to degradation in the performances of passive components need to be addressed. This work investigates locally insulating porous silicon regions on silicon substrates, targeting highly efficient passive components. This thesis begins with a detailed description of porous silicon/silicon hybrid substrate fabrication using a novel mask. The influence of the hybrid substrate on fabricated passive device performances was studied and the results were compared to similar devices on conventional silicon substrates. Finally, monolithic integration of passive and active devices was demonstrated on 6” hybrid substrates, with performance improvements when compared with standard silicon. This work has also shown that hybrid substrates can be fully integrated into industrial scale microelectronic processes.
129

Investigação experimental da relação entre temperatura e impedância elétrica de biomaterial - fígado bovino e modelagem de ablação por radiofrequência para tratar tumor hepático

Possebon, Ricardo Billig 31 May 2016 (has links)
Submitted by Cátia Araújo (catia.araujo@unipampa.edu.br) on 2017-01-26T11:42:00Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Investigação experimental da relação entre temperatura e impedância elétrica de biomaterial.pdf: 3519740 bytes, checksum: 10be4a8a93b923ea3f3e7c97738e2769 (MD5) / Approved for entry into archive by Cátia Araújo (catia.araujo@unipampa.edu.br) on 2017-01-26T11:42:22Z (GMT) No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Investigação experimental da relação entre temperatura e impedância elétrica de biomaterial.pdf: 3519740 bytes, checksum: 10be4a8a93b923ea3f3e7c97738e2769 (MD5) / Made available in DSpace on 2017-01-26T11:42:22Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Investigação experimental da relação entre temperatura e impedância elétrica de biomaterial.pdf: 3519740 bytes, checksum: 10be4a8a93b923ea3f3e7c97738e2769 (MD5) Previous issue date: 2016-05-31 / O câncer é uma das principais causas de morte no mundo, matando mais de 8 milhões de pessoas por ano, isto faz com que essa doença se torne uma das piores de nossa geração e afetando milhares de famílias mundo afora. Nos países em desenvolvimento esses números se agravam, devido à detecção tardia da doença e a utilização de tratamentos convencionais, que muitas vezes são ineficazes e causam diversos efeitos colaterais. A ablação por radiofrequência (RFA) é um tratamento de combate ao câncer que utiliza energia térmica, gerada pela passagem de uma corrente elétrica a partir de um eletrodo inserido sobre o tumor, para matar as células cancerígenas. Este processo é minimamente invasivo e não apresenta efeitos colaterais significativos, fazendo com que o paciente possa ir para casa um dia após o procedimento. Visando ampliar e facilitar a utilização do RFA foi desenvolvido um software de modelagem matemática que utiliza elementos finitos para simular os resultados da ablação tumoral (RAFEM). Com o auxílio deste software os médicos serão capazes de otimizar os parâmetros do processo, tais como: voltagem, potência e o tempo de aplicação. Experimentos de RFA foram realizados para descobrir parâmetros que influenciam o processo, como a máxima temperatura atingida pelo eletrodo durante o processo. Descobriu-se que a temperatura na ponta do eletrodo ultrapassa os 100°C, causando a necrose do tecido nesta região. A relação entre a temperatura da superfície do eletrodo e tempo de aplicação obtido foi posteriormente utilizado como parâmetro de entrada no software para realizar as simulações. Os resultados obtidos foram validados através da comparação com os dados experimentais obtidos por Mulier et al. (2012). O software RAFEM mostrou-se eficaz na simulação dos efeitos causados pelo processo de RFA, tornando-se uma potencial ferramenta para auxiliar médicos e pacientes no tratamento de combate ao câncer. / Cancer is a leading cause of death worldwide, killing more than 8 million of people a year, making the cancer one of the worst of our generation and affecting thousands of families around the world. In developing countries these numbers become worse, since disease detection is later and only conventional treatments are used, which are often ineffective and cause many collateral effects. Radiofrequency ablation (RFA) is a treatment against cancer that applies thermal energy generated by passing electric current from an electrode inserted in the tumor to kill cancer cells. This procedure is minimally invasive and not presents significant collateral effects, so that the patient can go home one day after the treatment. Aiming to expand and facilitate the use of RFA, mathematical modeling software (RAFEM) that uses finite element method to simulate tumor ablation was developed. With the aid of this software doctors will be able to optimize the process parameters, such as voltage, power and application time. RFA experiments were performed to find out which parameters influence the process, such as the maximum temperature reached by the electrode during the process. It was found that the temperature at the electrode tip exceeds 100°C, causing tissue necrosis in the tip region. The relationship of the electrode surface temperature vs time was used as an input parameter of the software to perform the simulations. The results were validated by comparison with experimental data obtained by Mulier et al. (2015). The RAFEM software was proved to be effective in the simulation of the effects caused by the RFA process. This makes it to be a potential tool to assist doctors and patients in the treatment against cancer.
130

Ablação por radiofreqüência do ventrículo esquerdo no rato: um novo modelo de insuficiência cardíaca com tamanhos de infarto do miocárdio semelhantes e baixa mortalidade / Left ventricle radio-frequency ablation in the rat: a new model of heart failure due to myocardial infarction homogeneous in size and low in mortality

Antonio, Ednei Luiz [UNIFESP] 25 August 2010 (has links) (PDF)
Made available in DSpace on 2015-07-22T20:49:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-08-25. Added 1 bitstream(s) on 2015-08-11T03:26:11Z : No. of bitstreams: 1 Publico-12813.pdf: 1387975 bytes, checksum: 1d75cdf7d28bb4222766829baf96a412 (MD5) / O Infarto do Miocárdio (IM) em roedores é o modelo animal mais freqüentemente utilizado para reproduzir experimentalmente a Insuficiência Cardíaca Congestiva (ICC) de humanos. A oclusão cirúrgica da artéria coronária descendente anterior (ACDA) é o método mais tradicionalmente usado para obter o IM experimental há décadas. Este modelo é bem validado para simular ICC, como é evidenciado pelo grande número de publicações que disponibilizam informações significativamente relevantes. A ligadura da coronária em ratos é inerentemente associada a infartos de tamanho variável, e em alguns casos, ausência de necrose miocárdica. Outro fator desfavorável é a alta taxa de mortalidade pós-oclusão coronária (OC). A proposta deste trabalho foi de padronizar um novo modelo de ICC secundário ao IM por aplicação de corrente elétrica de radiofreqüência no ventrículo esquerdo (VE), e analisar as características do modelo. Para tanto, foram utilizados 210 ratos Wistar-EPM, machos e fêmeas, distribuídos em grupos, operados pelo método tradicional de oclusão coronária, ablação por radiofreqüência e sem intervenção cirúrgica, como grupo controle. Após a promoção do IM, os animais foram separados em grupos de uma e quatro semanas para avaliação, do qual eram anestesiados e seqüencialmente avaliados por ecocardiograma (ECO), estudo hemodinâmico, mecânica miocárdica e anátomo-patológico. Os infartos transmurais ocorreram em todos os casos operados por ablação com mortalidade imediata de 7,5%. Animais de OC foram incluídos somente os IM > 40% do VE. A variabilidade no tamanho dos IMs foi menor nos ratos de Ab (x ± DP: 45 ± 8%:) quando comparado com OC (40 ± 19%). O ECO e estudo hemodinâmico mostraram aumentos comparáveis quanto à dimensão do VE, pressão diastólica final e teor de água pulmonar uma e quatro semanas pós-IM. Mecânica miocárdica seis semanas pós-IM foram compatíveis na disfunção inotrópica e lusitrópica. Avaliações histopatológicas foram identificadas lesões semelhantes às que ocorreram após OC, com fase de cicatrização completa em quatro semanas. Ab VE originou IM com tamanhos semelhantes e baixa mortalidade imediata. Resultou em evolução histopatológica, dilatação e disfunção ventricular, disfunção na mecânica miocárdica e congestiva. Resultados que reproduziu o IM por OC. Palavras chave: ablação por radiofreqüência, infarto do miocárdio, insuficiência cardíaca, ratos. / The Myocardial Infarction (MI) in rodents is the most frequently used animal model to reproduce experimentally the Congestive Heart Failure (CHF) in humans. Surgical closure of the anterior descending coronary artery (ADCA) is the method traditionally used to obtain the experimental MI decades. This model is well validated to simulate CHF, as evidenced by the large number of publications that provide relevant information significantly. The coronary artery ligation in rats is inherently associated with infarcts of variable size, and in some cases, absence of myocardial necrosis. Another unfavorable factor is the high rate of mortality after coronary occlusion (CO). The purpose of this study was to standardize a new model of CHF secondary to MI by applying radio frequency electric current in the left ventricle (LV), and analyze the characteristics of the model. To this end, we used 210 Wistar-EPM, male and female, in groups, operated by the traditional method of coronary occlusion, and radiofrequency ablation without surgical intervention or control group. After the promotion of MI, animals were separated into groups of one and four weeks for evaluation, which were anesthetized and sequentially assessed by echocardiography (ECHO), hemodynamic, myocardial mechanics, and pathological. The transmural infarction occurred in all cases operated ablation with immediate mortality of 7.5%. CO animals were included only MI> 40% LV. The variability in the size of the MI were lower in rats Ab (x ± SD: 45 ± 8%) when compared with coronary occlusion (CO, 40 ± 19% SD). The echocardiography and hemodynamic study showed comparable increases in the sizes of the LV end-diastolic pressure and pulmonary water content in one and four weeks post-MI. Myocardial mechanics six weeks post-MI were compatible in the inotropic and lusitropic dysfunction. Histopathological evaluations were identified lesions similar to those that occurred after CO, with complete healing phase in four weeks. Ab IM VE originated with similar size and low mortality. Resulted in histopathological changes, and ventricular dilation, mechanical dysfunction and myocardial failure. Results reproducing the IM by CO. / TEDE / BV UNIFESP: Teses e dissertações

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