[pt] O implante de prótese mamária de silicone a que meninas adolescentes se submetem na atualidade se tornou um fenômeno cultural sem precedentes. Baseado em tal fenômeno, este trabalho pretende investigar o que move meninas adolescentes a se submeterem ao referido procedimento cirúrgico, a partir da noção de corpo representado para a psicanálise em articulação com o campo da cultura. O campo de pesquisa foi estabelecido a partir de declarações de meninas adolescentes que se submeteram ou iriam se submeter ao implante de prótese mamária de silicone, coletadas na mídia, através da internet com seus blogs, redes sociais e artigos jornalísticos. As considerações finais deste trabalho ressaltam que, diante da chamada crise da adolescência, o implante de prótese mamária de silicone a que meninas adolescentes se submetem remete ao projeto de alcançar um padrão de beleza imaginário que funcionaria como suporte subjetivo para tal crise. / [en] The silicone breast implants that adolescent girls undergo nowadays have become an unprecedented cultural phenomenon. Based on this phenomenon, it is intended to investigate what makes adolescent girls undergo such procedure from the idea of body representation for psychoanalysis interrelated with the idea of body for medicine and the field of culture. The research field was based on statements of adolescent girls who had or would have the silicone breast implants surgery, as well as media search, through the internet, with its blogs, social networks and journalistic articles. Results highlight that, facing with the so called adolescent crisis, the silicone breast implants which adolescent girls undergo take them to the project of reaching an imaginary standard of beauty that would work as a subjective support for such crisis.

L’oreille interne est l’organe responsable pour la perception auditive et le maintien de l’équilibre. L’OMS estime que 360 millions personnes dans le monde (plus que 5 % de la population) souffrent d’une perte auditive handicapante, soit 40 dB dans l’oreille qui entend le mieux. Une des principales stratégies de traitement est l’administration systémique de stéroïdes, ex : la dexaméthasone. Ces stéroïdes sont utilisés pour prévenir les inflammations ou œdèmes pouvant endommager les très sensibles cellules ciliées de l’oreille interne.La libération contrôlée de principes actifs (PA) est un vrai challenge car l’oreille interne est protégée par la barrière hémato-cochléaire qui ressemble à la barrière hémato-encéphalique et protège l’oreille de substances toxiques. Par conséquent, il est nécessaire d’utiliser de fortes doses pour obtenir des concentrations thérapeutiques dans l’oreille interne. Ainsi, une libération locale et contrôlée semble une approche prometteuse pour limiter la survenue d’effets secondaires.D’un point de vue clinique, un deuxième obstacle doit être surmonté: la taille minuscule de la cochlée et sa difficulté anatomique d’accès. Les deux membranes semi-perméables (la fenêtre ronde et ovale) qui relient l’oreille moyenne avec l’oreille interne sont une voie possible –mais challenging -pour libérer le PA dans l’oreille interne. L’injection de solutions ou de gels chargés en PA dans l’oreille moyenne à travers la membrane tympanique semble être une méthode fiable et économique pour un traitement à court ou moyen terme. Malheureusement, ces formulations risquent d’être éliminées ou dégradées rapidement et par conséquent requièrent des applications répétées. Un autre désavantage est que l’anatomie varie énormément d’un patient à l’autre menant à des concentrations très diverses dans l’oreille interne.Pour un traitement à long terme une libération à partir d’implants cochléaires semble prometteuse : l’implant étant inséré directement dans l’oreille interne, il permet de libérer le PA de manière contrôlée pendant des mois ou des années. Néanmoins, cette intervention est très invasive et le bénéfice pour chaque patient doit être évalué en détail.L’objectif de cette étude est de développer un implant miniaturisé pour la libération contrôlée de dexaméthasone dans l’oreille interne.Dans un premier temps, de fins films de silicone chargés en PA ont été préparés et caractérisé in vitro. La libération à partir de ces films peut être ajustée en modifiant le type de silicone (ex : le type des chaînes latérales, degré de réticulation) ou en ajoutant différents quantités de PEG 400 ou 1000. Une solution analytique de la seconde loi de Fick a pu être utilisée pour décrire les cinétiques de la libération à partir des films et prédire théoriquement la libération du PA à partir de matrices de taille et de forme diverses.Ensuite, deux types d’implants ont été préparés en se basant sur les systèmes les plus prometteurs. Le premier est l’implant « Ear Cube » ayant une forme prédéfinie avec un cube lié à un cylindre. Ce cylindre est en contact avec la périlymphe de l’oreille interne. Le second est un implant se formant in situ qui s’adapte parfaitement à l’anatomie de l’oreille moyenne en réticulant directement dans l’oreille moyenne. Cet implant est en contact avec l’oreille interne par un orifice. Les deux types d’implants ont été caractérisés in vitro.In vivo, la libération de dexaméthasone à partir d’implant se formant in situ a été évaluée avec des gerbilles. Le PA peut être détecté déjà 20 min après l’implantation et ce jusqu’à au moins 30 jours.Ainsi, les deux implants semblent prometteurs pour contrôler à long terme la libération de dexaméthasone directement dans l’oreille interne. A l’avenir, des études pour évaluer les effets des implants « Ear Cube » seront menées. De plus, ces systèmes pourraient être adaptés pour délivrer d’autres PA, ex : la gentamicine, pour traiter d’autres maladies. / The ear is the organ responsible for the perception of sound and the sense of balance. The WHO estimated that worldwide 360 million people (over 5 % of the population) are suffering from disabling hearing loss, meaning a loss of 40 dB in the better hearing ear in adults. One of the major strategies to treat hearing loss is to administer steroids, e.g. dexamethasone, systemically. Steroids are used to prevent inflammation and oedema damaging the highly sensitive inner ear hair cells.Unfortunately, drug delivery to the inner ear is very challenging due to the blood-cochlea barrier which is similar to the blood-brain barrier and protects the inner ear from drugs or toxic substances from the blood stream. High doses are often required to reach therapeutic drug concentrations in the inner ear. Thus, local drug delivery seems to be a more promising approach to limit adverse effects due to high systemic blood levels.Nevertheless, a second major hurdle has to be overcome in clinical practice: the small dimensions of the cochlea and its difficult anatomical access. The two semipermeable membranes connecting the middle with the inner ear (the round and oval window) are one possible - but challenging - route to deliver drugs locally to the inner ear. Drug loaded solutions or gels administered with an intra-tympanic injection into the middle ear seem to be a relatively safe and economical therapy for a short or mid-term treatment. Unfortunately, they might be washed away or degraded rapidly and, though, often require repeated applications. Additionally, the anatomy of the ear varies from patient to patient leading to different drug concentrations in the inner ear.For long term treatment, intra-cochlear implants seem to be promising: Since the device is inserted directly into the inner ear, the drug concentration is better controlled and – depending on the formulation – the drug can be released over prolonged periods of time. Nevertheless, this approach is rather invasive so that the benefit for the patient has to be discussed in detail.The purpose of this study was to develop a miniaturized implant being able to deliver dexamethasone directly to the inner ear.To facilitate the development of silicone-based implants loaded with dexamethasone, thin drug loaded films have been prepared and thoroughly characterized in vitro as a model system. Drug release can easily be adjusted by varying the type of silicone used (e.g. type of side chain, degree of crosslinking), or by adding various amounts of PEG 400 or 1000. An analytical solution of Fick’s second law could be used to describe the drug release kinetics from the films and to theoretically predict drug release from dosage forms of arbitrary size and shape.Subsequently, two types of implants have been prepared using the most promising silicone systems. The first system, the Ear Cube implant with a predefined shape consists of a cube on top of a cylinder which stays in contact with the perilymph of the inner ear. The second system, the in situ forming implant adapts perfectly to middle ear anatomy because it cures directly in vivo. It also stays in contact with the inner ear fluids via a hole. Both systems have been characterized in vitro.In vivo, the dexamethasone loaded in situ forming silicone-based implants have been evaluated in mongolian gerbils. Interestingly, dexamethasone was detected within the explanted gerbil cochleae already 20 min after implant formation until at least 30 days.Thus, both implants seem to be a good tool to administer dexamethasone locally to the inner ear in a prolonged and time controlled manner. Further studies should be performed to characterize the Ear Cube implants in vivo. Additionally, both systems could be tested with different types of drug, e.g. gentamicin, to treat also other diseases with this new promising inner ear implants.

An overview of the development of the Investment Casting market and Rapid Prototyping equipment is given in the introductory part of this diploma thesis. Basic methods of rapid prototyping and the FDM method are futher described in detail. The FDM method is consequently used in the practical part of this work for the preparation of the silicon mould. The largest part deals with the issue of the simulation of pouring process of wax into the silicon mould. A characteristics of the casting wax is made; the parametres, which are inserted into the simulation software ProCAST and the possibilities of their measurement are described. The process of the simulation of the mould filling and its validation with the real filling process are described in detail.

Eine totale Mittelohr-Prothese (TORP) mit einem mit Silikon ummantelten Kugelgelenk ist in der Lage Druckveränderungen zu kompensieren und somit eine bessere Schallübertragung, im Vergleich zu starren Prothesen, zu erzielen. Die Ergebnisse können als vorläufig betrachtet werden, da diese experimentelle Studie sich auf eine von vielen verschiedenen möglichen Situationen der Tympanoplastik und eine damit verbundene kleine Stichprobengröße beschränkte. Dennoch sind die Ergebnisse mit der flexiblen TORP vielversprechend für die weitere Entwicklung. / A total ossicular replacement prosthesis (TORP) with a silicone coated ball and socket joint (BSJ) is able to compensate pressure changes and therefore provide better sound transmission compared with rigid prostheses. The findings may be considered preliminary as this experimental study was limited to just one of the many different possible situations of tympanoplasty and it involved a small sample size. Nevertheless, the results with the flexible TORP were promising and could encourage further investigations on such prostheses.

Silicone release liners are silicone coatings on top of papers or films that are used in the adhesives industry to prevent adhesion before the final use of the adhesive e.g. labels. The process of production of release liners involves the casting of molten polysiloxanes on top of the substrates that crosslink by hydrosilylation reaction forming silicone networks. The quality of the release liner can be assessed by diverse methods usually performed when the coating process has been finished. Rarely an online control of the reaction is possible. Fluorescence spectroscopy was found to be a non-invasive useful method to control the reaction during the whole process by introducing very small concentration of fluorescent molecules in the polymer formulations; those fluorophores are sensitive to environmental changes as the silicone polymer molecules crosslink. In response to that stimulus, the fluorescence intensity varies along the time upon reaction allowing the identification of the gel point and further modifications or molecules rearrangements in a post-curing stage within weeks that are non-observable with conventional quality control methods. It was found that the fluorescent molecules do not require to be attached covalently to the polysiloxanes, thus fluorescence spectroscopy is a simple method to implement for controlling the production of silicone coatings. Moreover, the characterization of several silicone formulations was performed to find the optimal conditions for the production of release liners and to understand the effect of every component in the formulation on the performance of the silicones. The kinetics of the reaction was also studied and even a mechanism for the hydrosilylation reaction was proposed.

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Pharmaceutical Technology Author: Alena Podzimková Title of Thesis: Characterization of silicone scar treatment gels Supervisor: PharmDr. Eva Šnejdrová, Ph.D. This diploma thesis deals with characterization of silicone gels by various methods, specifically measurement of rheological properties, overall characterization of the composition by infrared spectroscopy, identification of volatile compounds by gas chromatography and determination of molecular weight distribution of polymers by gel permeation chromatography. The theoretical part provides information about scars and their treatment options and describes the principles and the evaluation of tests performed in the experimental part. Five commercial gels and three newly formulated scar healing gels were evaluated. Analysis of viscosity curves confirmed newtonian type of flow in commercial gels Scar Gel Dr. Max and Stratamed and in the newly formulated gels. Strataderm, RejuvaSil and ScarEsthetique show a decrease in viscosity under stress. Oscillation tests have shown a gel structure only with the commercial ScarEsthetique and RejuvaSil. Scar Gel Dr. Max, Strataderm, the newly formulated gels and Stratamed contain polymeric polydimethylsiloxane. In case of Scar...

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Modifications, alterations, and enhancements to the body have been a practice forvarious ethnic, religious, and cultural groups across the globe for centuries. Over recent years, augmentations to the buttocks have become increasingly popular amongst women in Black and Brown communities. It is necessary to examine the health concerns, medical neglect, and societal influences that have contributed to the alarming increase of health complications and fatalities within these communities as a result of the procedures. Specifically, the administration of illegal injectable substances to the buttocks and the “Brazilian Butt Lift” procedure are in need of serious ethical focus and concern. In addition to the harmful health effects that result from these procedures, it is also important to recognize relevant societal and structural factors that intersect this rising issue. To fully comprehend the magnitude of the ongoing concerns, the history of buttock augmenting will be thoroughly discussed, other serious contributing factors, accessibility to adequate healthcare, and health knowledge. Cosmetic enhancements should come from a place of both empowerment and wellbeing, however the current conditions in the industry as it pertains to marginalized communities reflect otherwise. There are several contextual aspects as to why the ramifications of these procedures are so detrimental and it is my intention to highlight these issues, discuss the ethical implications, implore further research efforts, and then provide possible solutions to help address this growing issue. / Urban Bioethics

<p>Bilder borttagna av upphovsrättsliga skäl.</p>