Sistemas ultrassônicos tiveram uma evolução tecnológica nos últimos anos e isso permitiu que seus recursos de hardware e software pudessem ser explorados para extrair informações, auxiliando em diagnósticos e tratamentos mais eficazes. Através da análise do comportamento mecânico de tecidos moles, técnicas como elastografia estática, vibroacustografia, elastografia transiente e elastografia remota tiveram seu papel reconhecido na complementação do diagnóstico clínico. Contudo, a propagação destas técnicas na medicina tem sido restringida pela acessibilidade às tecnologias utilizadas, ausências de parâmetros quantitativos, dificuldade da excitação em estruturas profundas e acesso a informações em níveis moleculares. Este estudo aborda o desenvolvimento de um protocolo para efetuar medidas quantitativas de viscoelasticidade em tecidos moles marcados com nanopartículas de óxido de ferro usando excitação magnética e medição ultrassônica. Ao aplicar uma força magnética pulsada em um meio fluido marcado com nanopartículas magnéticas, um movimento é induzido, gerando uma onda de cisalhamento que se propaga pelo tecido. A propagação dessa onda é mapeada usando a técnica de ultrassom pulso-eco e processamento de dados usando métricas de similaridades entre ecos (mapa de rf) consecutivos. Nos estudos realizados em mimetizadores de tecidos moles (phantom) com características mecânicas equivalentes ao tecido biológico, a amplitude de deslocamento dessas ondas é da ordem de micrometro. Através da medida da velocidade deslocamento dessa onda avaliou-se o melhor modelo reológico para quantificar os parâmetros mecânicos de viscosidade e elasticidade. Os resultados mostraram a eficiência desta técnica ao quantificar os valores viscoelásticos condizentes com a literatura e a comprovação da análise de tecidos moles marcado com nanopartículas excitadas com campo magnético de baixa intensidade, possibilitando uma avaliação em âmbito molecular em tecidos moles. / Ultrasonic systems had a technological development in recent years and allowed their hardware and software resources could be exploited to extract information, assisting in more effective diagnosis and treatment. Through the mechanical behavior analysis of soft tissue techniques such as static elastography, vibroacoustography, transient elastography and remote elastography had recognized role in complementing clinical diagnosis. However, the spread of these techniques in medicine has been restricted by accessibility to the technologies used, quantitative parameters absences, difficulty of deep structures access and information on molecular levels. This study addresses the development of a protocol to make quantitative measurements of viscoelastic soft tissue labeled with iron oxide nanoparticles using magnetic excitation and ultrasonic measurement. By applying a pulsed magnetic force in a fluid medium labeled with magnetic nanoparticles, a motion is induced, generating a shear wave that propagates through the tissue. The propagation of this wave is mapped using the pulse-echo ultrasound technique and data processing using similarities measurements between echoes (rf map) consecutive. In studies of soft tissue-mimicking phantom with mechanical properties equivalent to the biological tissue, the displacement amplitude of these waves is of micrometer order. By measuring the shear wave velocity, it was evaluated the best rheological model for quantifying mechanical parameters of viscosity and elasticity. The results showed the efficiency of this technique to quantify the viscoelastic values consistent with the literature and the evidence of soft tissue analysis labeled excited nanoparticles with low intensity magnetic field, providing an assessment on the molecular level in soft tissues.

Nesta pesquisa foi comparada a diferença das medidas obtidas utilizando-se a análise cefalométrica do perfil tegumentar tendo como base a análise facial de Arnett relacionada à Horizontal Verdadeira com a análise cefalométrica do perfil tegumentar feita a partir do Plano de Frankfurt. Utilizamos 140 radiografias cefalométricas requisitadas como parte de documentação ortodôntica, obtidas de pacientes com idade variando de 06 a 49 anos, sendo 64 do sexo masculino e 76 do sexo feminino, pertencentes ao arquivo do IOM - (Instituto de Odontologia Multidisciplinar) ? RJ. As radiografias cefalométricas em norma lateral foram obtidas pelo mesmo operador, obedecendo ao protocolo adotado pelo IOM. Todos os pacientes foram orientados a assumir a Posição Natural da Cabeça, tendo como referência um espelho posicionado a frente e a Linha Vertical Verdadeira foi obtida por meio da utilização de um fio metálico unido à um prumo de chumbo, posicionado próximo à margem anterior do chassi porta-filme, de forma que apareça à frente do perfil tegumentar do paciente. A partir das medidas lineares obtidas nas Análises Cefalométricas dos Tecidos Moles, foram realizadas análises estatísticas visando dois objetivos: comparar as medidas de A à I obtidas nos traçados (um utilizando como referência uma perpendicular ao Plano Horizontal de Frankfurt e o outro à Linha Vertical Verdadeira) e analisar os resultados comparativamente. Após a análise estatística (Kolmogorov-Smirnov, para distribuição normal de dados; t-Student para amostras emparelhadas e teste não paramétrico de Wilcoxon) e a interpretação dos resultados obtidos, concluímos que houve diferenças significantes entre as formas de medidas das variáveis A, B, C, D, F, G e I, pois o valor do nível descritivo (p-valor) se apresentou abaixo de 0,05. Entretanto para as medidas E e H o valor do nível descritivo (p-valor) se apresentou maior que 0,05, demonstrando não haver diferenças significantes entre as formas dessas medidas. As correlações entre as medidas apresentadas estabelecidas pela análise facial de Arnett, de acordo com este estudo, não deverão ser utilizadas em pacientes que se submeteram à radiografias cefalométricas realizadas a partir do Plano Horizontal de Frankfurt, salvo no caso da distância interlabial, representada pela medida H, que além de não apresentar diferenças significantes neste estudo, não tem, segundo a análise de Arnett, correlação com nenhuma outra medida. / In this research a comparison was made between the differences in measurements obtained using the soft tissue profile?s cephalometric analysis based on Arnett?s facial analysis related to the true vertical with the cephalometric analysis of soft tissue profile based on the Frankfurt Plan. A total of 140 lateral cephalometric radiographs were used as part of the orthodontic documentation, taken from patients whose ages ranged from 06 to 49 years of age, of these 64 males and 76 females, being part of the files of the IOM (Instituto de Odontologia Multidisciplinar do Rio de Janeiro). The lateral cephalometric radiographs were obtained from the same operator obeying the protocols adapted by the IOM. All patients were oriented to place themselves in the Natural Head Posture using, as a reference, a mirror in front of then and the true vertical line was obtained using a metal wire and a plumb-line, placed close to the frontal chassis of the film chamber, in such a way that it appears in front of the soft tissue profile of the patient. Parting from the lineal measurements obtained from the Cephalometric Analyses of the Soft Tissues statistical analyses were made relating to two objectives: to compare the measurements from A to I obtained from the drafts/ sketches (one using as it reference a perpendicular to the Frankfurt Horizontal Plane and the other the True Vertical Line), comparatively analyse these results. After the statistical analysis (Kolgomorov Smirnov) for a normal data distribution: t-student for matched pairs and the no-parametric Wilcanox test) and the analysis of the results obtained, it was concluded that there were significant differences between the forms of the measurements of the variables A, B, C, D, F, G and I since the descriptive value (p-value) was below 0,05. The measurements for E and H, however, being over 0,05, showing than there were no significant differences between these forms of measurement. The correlation between the demonstrated measurements established by Arnett?s facial analysis, in accordance with this study, should not be used in patients who have undergone lateral cephalometric radiograph initiated on the basis of the Frankfurt Horizontal Plane except in the case of interlabial distance represented by the measurement H, which even differences in this study, does not have, according to Arnett?s studies, correlations with any other measurements.

Avaliar as alterações profilométricas dos tecidos moles vestibulares entre o exame inicial e os 5 anos de acompanhamento, utilizando sistemas de implantes dentários de um e dois estágios. Sessenta pacientes receberam aleatoriamente implantes dentários de dois estágios (BRA) ou de estágio único (STM). Os modelos foram obtidos no início do estudo (após a inserção da coroa), no primeiro ano e no quinto ano de acompanhamento. Os arquivos de estereolitografia foram obtidos dos modelos para superposição digital. Um implante e o dente natural contralateral foram selecionados para a análise. Trinta e três pacientes (BRA = 16; STM = 17) foram incluídos. As medidas incluíram mudanças para altura da coroa (CH) e espessura estimada do tecido mole, bem como a mudança profilométrica no implante e no local do dente. Métodos não paramétricos foram aplicados para as análises estatísticas, medianas e quartis foram apresentados. O grupo BRA perdeu -0,39 mm e o grupo STM perdeu -0,40 mm de volume entre o início e o acompanhamento de 5 anos no local do implante (p> 0,05). O local do dente perdeu -0,18 mm (BRA) e -0,12 mm (STM) (p> 0,05). As diferenças de volume entre implantes e dentes foram de -0,05 mm (inicial a 1 ano) e -0,25 mm (inicial a 5 anos) para BRA, enquanto para STM, os valores foram de 0,03 mm (inicial a 1 ano) e -0,16 mm (inicial a 5 anos). As mudanças para CH em 1 e 5 anos de acompanhamento foram de 0,10 e 0,09 mm (BRA) e 0,03 e 0,22 mm para STM. As mudanças na espessura do tecido em 1 e 5 anos no grupo BRA foram de -0,28 e -0,66 mm a 1 mm, -0,21 e -0,46 mm a 3 mm e -0,32 e -0,45 mm a 5 mm, respectivamente. As mudanças no grupo STM foram de -0,15 e -0,54 mm a 1 mm, -0,24 e -0,48 mm a 3 mm e -0,32 e -0,57 mm a 5 mm, respectivamente. Nenhuma mediana significativamente diferente foi observada. Alterações mínimas, lineares e profilométricas, ocorreram nos locais dos implantes entre o exame inicial e os 5 anos, entre os locais do implante e do dente e entre os dois sistemas de implantes. / To assess the profilometric changes of the buccal soft tissues between baseline and 5 years of loading using a one- and two-piece dental implant system. Sixty patients randomly received dental implants of either a two-piece type (BRA) or a one-piece type (STM). Casts were obtained at baseline (after crown insertion), at the 1-year and at the 5-year followup. Stereolithography files were obtained from the casts for digital superimposition. One implant and the contralateral natural tooth were selected for the analysis. Thirty-three patients (BRA = 16; STM = 17) were included. Measurements included changes for crown height (CH) and estimated soft tissue thickness, as well as the profilometric change at the implant and the tooth site. Nonparametric methods were applied for the statistical analyses and medians and quartiles presented. The BRA group lost -0.39 mm and the STM group lost -0.40 mm of volume between baseline and the 5-year follow-up at the implant site (p > 0.05). The tooth site lost -0.18 mm (BRA) and -0.12 mm (STM) (p > 0.05). Volume differences between implants and teeth amounted to -0.05 mm (baseline to 1 year) and -0.25 mm (baseline to 5 years) for BRA, while for STM, the values were 0.03 mm (baseline to 1 year) and -0.16 mm (baseline to 5 years). The changes for implant CH at 1 and 5 years of follow-up amounted 0.10 and 0.09 mm (BRA) and to 0.03 and 0.22 mm (STM). The changes in tissue thickness at 1 and 5 years in the BRA group amounted to -0.28 and -0.66 mm at 1 mm, -0.21 and -0.46 mm at 3 mm, and -0.32 and -0.45 mm at 5 mm, respectively. The changes in the STM group amounted to -0.15 and -0.54 mm at 1 mm, -0.24 and -0.48 mm at 3 mm, and -0.32 and -0.57 mm at 5 mm, respectively. No significantly different medians were observed. Minimal profilometric and linear changes occurred at implant sites between baseline and 5 years, between implant and tooth sites and between the two implant systems.

Made available in DSpace on 2016-08-10T10:39:18Z (GMT). No. of bitstreams: 1 PRISCILLA SILVA ROSA DE ALMEIDA.pdf: 3720637 bytes, checksum: b39a9c071d90058d47a3a8c7aec2c7f3 (MD5) Previous issue date: 2008-07-21 / Soft tissue sarcomas (STS) are tumors with mesodermical origin, comprising about 1% of all adult neoplasms. Because of its effect on the p53 protein coding sequence, and its association with an increased risk for some cancer types, TP53 codon 72 polymorphism has been investigated in several studies. TP53 codon 72 codes for either Arginine (p53Arg), or Proline (p53Pro) at the p53 protein primary sequence. It was demonstrated that such amino acid change affects p53 biochemical and biological properties, and several studies have been developed in order to associate TP53 codon 72 polymorphisms as a risk, and as a prognostic factor for different cancer types. Any published study on the TP53 codon 72 polymorphism in adult soft tissue sarcomas was found in the literature. The present study aimed to investigate TP53Arg/Pro polymorphism as a potential prognostic factor in 100 adult subjects with STS. Patients were assisted at the Hospital Araújo Jorge of the Associação de Combate ao Câncer em Goiás in Goiânia, Brazil. DNA from patients was obtained from formaldehyde-fixed and paraffin-embedded tissue samples stored at the Pathology Department of the institution. Control group included 85 healthy donors randomly selected from Goiânia s population and, for this group, DNA extraction was performed from peripheral blood. Polymorphism genotyping was achieved by using polymerase chain reaction (PCR) with specific primer sets for each polymorphic variant. Statistical analysis was performed by using GenePop Ò web version 3.4 software. In this study, TP53 allelic and genotypic frequencies were investigated for subjects and controls, however, any statistical difference between the two groups was found. Our study supports the evidence that p53Arg is the most frequent allele in Latin American population, but worldwide genic and genetic frequency data are conflicting because of ethnical differences among the studied populations. According to the results, no significant association was demonstrated between TP53 codon 72 polymorphism and clinocopathological characteristics such as gender, age, tumor localization, histology, tumor size, stage, grade, node status, and distant metastasis. The five-year overall survival for the study group was 48.1%. Tumors with p53Pro/Pro genotype demonstrated a reduced survival rate (30%) when compared to p53Arg/Arg (45%), and p53Arg/Pro group (54.9%), but this association was not statistically significant (p = 0.444). In the present study, the p53Arg variant was not statistically associated with a more favorable prognosis in adult STS patients. / Os sarcomas de partes moles (SPM) são tumores de origem mesodérmica, representando cerca de 1% do total das neoplasias em adultos. O polimorfismo do códon 72 do gene TP53 é extensivamente estudado por causar impacto na seqüência codificadora do gene, além de estar associado ao maior risco para o desenvolvimento de alguns tipos de câncer. Este polimorfismo resulta na expressão de arginina (p53Arg) e/ou prolina (p53Pro) na posição 72 da proteína p53. As formas polimórficas de TP53, em relação ao polimorfismo do códon 72, apresentam propriedades bioquímicas e biológicas diferentes, e por esta razão, vários estudos foram conduzidos na tentativa de associar tais formas polimórficas como fator de risco e prognóstico para inúmeras neoplasias. Entretanto, a literatura não relata nenhum estudo que associe este polimorfismo aos sarcomas de partes moles do adulto. Neste contexto, o objetivo do presente estudo foi avaliar o polimorfismo p53Arg/Pro como potencial fator de risco e/ou prognóstico em 100 casos de SPMs em adultos atendidos no Hospital Araújo Jorge da Associação de Combate ao Câncer em Goiás. O grupo controle incluiu 85 indivíduos saudáveis selecionados aleatoriamente da população da cidade de Goiânia. As amostras dos casos constituíram de tecidos fixados em formol e incluídos em parafina e, para a extração de DNA, os tecidos foram previamente desparafinizados. A extração de DNA do grupo controle foi realizada a partir de sangue periférico. Para a genotipagem do polimorfismo, a reação em cadeia da polimerase (PCR) foi realizada utilizando conjuntos de primers específicos para cada variante polimórfica. Após a análise dos dados obtidos, verificou-se que as freqüências alélicas e genotípicas não apresentaram diferenças estatisticamente significativas entre os casos e os controles. Nosso estudo corrobora com as evidências de que o alelo p53Arg é o mais comum em populações latinoamericanas. Entretanto, os dados sobre as freqüências gênicas e genotípicas da literatura mundial são conflitantes, fato que pode ser atribuído às diferenças étnicas descritas entre as populações estudadas. Nenhuma relação estatisticamente significativa foi encontrada entre o polimorfismo do códon 72 de TP53 e as características clínico-patológicas estudadas, como sexo, idade agrupada, localização, histologia, tamanho e grau histológico tumoral, estadiamento e presença de mestástases. A sobrevida global em cinco anos para o grupo estudado foi de 48,1%. As análises de sobrevida em relação ao polimorfismo de TP53 revelaram que os pacientes cujos tumores apresentaram o genótipo p53Pro/Pro tiveram sobrevida inferior (30%), quando comparados ao grupo de pacientes com os genótipos p53Arg/Arg (45%) e p53Arg/Pro (54,9%). Entretanto, essa diferença não foi estatisticamente significativa (p = 0,444). Sabese que a isoforma p53Arg apresenta função apoptótica mais marcante. Esta característica pode conferir ao paciente um melhor prognóstico da doença. No presente trabalho, contudo, não pudemos verificar que esta variante esteve associada a um prognóstico mais favorável em pacientes adultos com SPMs.

Introdução: Considerando-se a crescente tendência da utilização de próteses sobre implantes tanto em nossa população quanto em âmbito mundial, ganha importância o estudo das diversas condições envolvidas na longevidade e funcionalidade dessas peças para os indivíduos em geral. Objetivo: Determinar a ocorrência de alterações patológicas associadas a próteses totais implantadas e correlacioná-las a variáveis individuais, das peças protéticas e à participação de leveduras do gênero Candida nesses indivíduos. Metodologia: Pacientes portadores de próteses sobre implantes foram avaliados no momento da remoção das peças para controle e manutenção, após anuência com os termos do consentimento livre e esclarecido. Os participantes tiveram seus fluxos salivares totais avaliados inicialmente. Após a remoção das próteses, as peças foram avaliadas tecnicamente (próteses, implantes, parafusos e abutments), a boca examinada clinicamente, as condições da mucosa subjacente às próteses foram anotadas, e eventuais lesões associadas às próteses foram avaliadas e tratadas. Paralelamente foi realizada coleta de material para exame micológico de dois sítios - mucosa sob a prótese e base da prótese. O material foi coletado com auxílio de swabs e transferido a placas com meio de cultura diferencial (Chromagar®) para observação de crescimento e identificação de leveduras. Resultados: Foram coletados dados referentes a 91 participantes e 102 próteses sobre implantes. Trinta e quadro homens e 57 mulheres com idade média de 66,6 anos. Quatro overdentures, 72 protocolos inferiores e 26 superiores. Nenhum participante apresentou hipossalivação. Candida spp foram identificadas em 70,3% das arcadas inferiores e 85,7% das arcadas superiores. O tempo de uso das próteses interferiu na porcentagem de identificação das leveduras. Candida albicans foi a principal espécie identificada (93% dos casos positivos). Outras espécies identificadas foram: Candida glabrata, C. kruzei e C. tropicalis. Técnicas de higienização adicionais à escovação convencional reduziram a contaminação pelos fungos, enquanto hábitos de fumar ou consumir bebidas alcoólicas a aumentaram. Inflamação em mucosa relacionou-se positivamente à presença de Candida em mucosa e próteses. Oito participantes foram submetidos a intervenções cirúrgicas para remoção de processos proliferativos inflamatórios (8,8%). Foram avaliados 532 implantes, registrando-se perda de 1,13% deles e necessidade de reaperto em 271 parafusos (50,1%). Os dados foram analisados de forma descritiva e submetidos a testes estatísticos adequados ao tipo de dados obtidos. Conclusões: Os resultados obtidos nesta investigação sugerem que os cirurgiões dentistas que trabalham na área da Implantodontia devem rever seus protocolos de orientação aos pacientes e regimes de manutenção das próteses totais sobre implantes, a fim de manter a saúde dos indivíduos, prevenir lesões inflamatórias nos tecidos orais e proporcionar longevidade à reabilitação. / Introduction: Considering the increasing tendency of the use of prostheses on implants in both our population and worldwide, it is important to study the several conditions involved in the longevity and functionality of these parts for individuals in general. Aim: To determine the occurrence of pathological changes associated with full-arch implant-supported fixed prostheses and to correlate them with individual variables, prosthetic specimens and the participation of Candida yeasts in these individuals. Methodology: Patients with full-arch implant-supported fixed prostheses and overdentures were evaluated at the time of removal of the parts for control and maintenance, after consent with the terms of free and informed consent. The participants had their total salivary flows initially evaluated. After the removal of the prosthesis, the pieces were evaluated technically (prostheses, implants, screws and abutments), the mouth examined clinically, the conditions of the mucosa underlying the prostheses were noted, and any lesions associated with the prostheses were evaluated and treated. In parallel, material was collected for mycological examination of two sites - mucosa under the prosthesis and base of the prosthesis. The material was collected with the help of swabs and transferred to plates with differential culture medium (Chromagar®) for observation of growth and identification of yeasts. Results: Data were collected on 91 participants and 102 implants. Thirty-one men and 57 women with mean age of 66.6 years. Four overdentures, 72 in the lower arch and 26 in the upper arch. No participant presented hyposalivation. Candida spp. were identified in 70.3% of the lower arches and 85.7% of the upper arches. The time of use of the prostheses interfered in the percentage of identification of the yeasts. Candida albicans was the main species identified (93% of the positive cases). Other species identified were: Candida glabrata, C. kruzei and C. tropicalis. Hygiene techniques in addition to conventional brushing reduced fungal contamination, while smoking or drinking increased. Inflammation in mucosa was positively related to the presence of Candida in mucosa and prostheses. Eight participants underwent surgical interventions to remove proliferative inflammatory processes (8.8%). A total of 532 implants were evaluated, with a loss of 1,13% of them and the need to re-tighten 271 screws (50.1%). Data were analyzed descriptively and submitted to statistical tests appropriate to the type of data obtained. Conclusions: The results obtained in this research suggest that dental surgeons working in the implantology area should review their patient orientation protocols and maintenance of full-arch implant-supported fixed prostheses in order to maintain the health of individuals, prevent inflammatory lesions in tissues oral and provide longevity to rehabilitation.

La position assise peut être source d'inconfort, particulièrement en avion lors des vols longcourriers. Cet inconfort provient en partie de facteurs mécaniques liés à l'interaction entre le siège et le passager. Disposer de modèles biomécaniques pouvant simuler cette interaction et estimer ces facteurs permettrait d'optimiser le design du siège d'avion lors de sa phase de conception afin d'améliorer son ergonomie et réduire l'inconfort du passager. L'objectif de cette thèse est de développer un outil numérique permettant d'estimer les facteurs mécaniques menant à l'inconfort et la fatigue des passagers. Cet outil combine deux différents types de modèles. Un modèle éléments finis permettant de simuler la déformation des tissus sous-cutanés et un modèle corps rigides permettant d'estimer les efforts musculaires et articulaires. Une méthode de couplage des deux modèles a été développée permettant ainsi de simuler une position à partir de laquelle l'ensemble des facteurs d'inconfort sont estimés. Un modèle éléments finis a été développé après avoir fait une étude de sensibilité sur les différents paramètres de modélisation (maillage, géométrie, lois matériaux). Un modèle corps rigides développé par Anybody a été utilisé pour être couplé avec ce modèle éléments finis. Cette méthode de couplage itératif entre les deux modèles a permis de réaliser un ajustement de la posture initiale dans le siège. Afin de simuler l'ensemble de la population et sa grande diversité morphologique, un modèle surfacique paramétrique a été développé à partir de données 3d expérimentales, ce modèle surfacique permettant ainsi d'obtenir un modèle éléments finis représentant tout type d'anthropométrie. Différents processus de validation ont été effectués à l'aide de données et d'un modèle « sujetspécifique ». Les données de pression externe simulées ont été comparées à des données expérimentales. Une étude expérimentale sous IRM ouvert a permis de mesurer les déformations des différents tissus sous-cutanés afin de les comparer aux données simulées. Un outil numérique est donc aujourd'hui disponible pour simuler l'impact du siège sur les passagers, cependant de futures études devraient se concentrer d'une part sur les modèles en étudiant la variation morphologique interne inter individus, le positionnement dans le siège ainsi que l'influence du temps sur les tissus mous et d'autres part sur la définition de critères d'inconfort et de fatigue (inconfort considéré sur des temps longs représentatifs d'un vol long-courrier) / The sitting position could be a source of discomfort, in particular in a long haul flight. This discomfort comes partially from mechanical factors linked to the interaction between the passenger and the seat. Having biomechanical models which can simulate this interaction and estimate these factors would allow optimizing the seat design in its conception phase to improve it ergonomic quality and reduce the passenger discomfort. The objective of this thesis is to develop a digital tool allowing estimating the mechanical factors leading to discomfort and fatigue of the passenger. This tool assemble two kinds of models, a finite element model allowing to simulate the sub dermal tissue deformation and a multibody model allowing to estimate the muscular and joint forces. A coupling method of the two models have been developed allowing simulating a position from where the all discomfort factors are estimated. A finite element model has been developed after having done a sensitivity analysis on the different model parameters (mesh, geometry, material law). A multibody model developed by Anybody was used to be associated with this finite element model. This iterative coupling method between the two models allowed realizing an adjustment of the initial posture in the seat. To simulate the whole population and is large morphological diversity, a parametric shape model was developed from 3d experimental data, this shape model allowing to obtain a finite element model representing any kind of anthropometry. Different validation processes have been realized with experimental data and subject-specific model. The simulated extern pressures were compared to experimental data. An experimental study done in an open MRI allowed to measure the different subcutaneous tissue to compare it to the simulated data. A digital tool is consequently now available to simulate the impact of the seat on the passenger, however future studies should focus on the one hand on the models studying the internal morphological variations between people, the person positioning in the seat, the time influence on the soft tissue and on the other hand on the discomfort and fatigue criteria

For small diameter (<6 mm) blood vessel replacements, lack of collaterals and vascular disease preclude homografts; while synthetic analogs, ePTFE, expanded polytetrafluoroethylene, and PET, polyethyleneterephathalate, are prone to acute thrombosis and restenosis. It is postulated that the hierarchical assembly of cell populated matrices fabricated from protein analogs provides a new design strategy for generating a structurally viable tissue engineered vascular graft. To this end, synthetic elastin and collagen fiber analogs offer a novel strategy for creating tissue engineered vascular grafts with mechanical and biological properties that match or exceed those of native vessels. This work details techniques developed for the fabrication of prosthetic vascular grafts from a series of extracellular matrix analogs composed of nanofibrous collagen matrices and elastin-mimetic proteins, with and without cells, and subsequent evaluation of their biocompatibility and mechanical properties. The work details the fabrication and mechanical analysis of vascular grafts made from aforementioned protein analogs. Subesequent studies detail seeding and proliferation of rodent mesenchymal stem cells on protein-based composites to recapitulate the media of native vasculature. Finally detailing in vivo biocompatibility and stability of tissue engineered vascular grafts.

The interface between tendon/ligament and bone tissue is a complex transition of biochemical, cellular, and mechanical properties. Investigating computational and tissue engineering models that imitate aspects of this interface may supply critical design parameters for designing future tissue replacements to promote increased biochemical and mechanical integration between tendon/ligament and bone. Strategies for modeling this tissue have typically focused on the development of heterogeneous structures to create gradients or multiphasic materials that mimic aspects of the transition. However, further work is required to elucidate the role of specific mechanical and material stimuli in recapitulating features of the tendon/ligament-bone insertion. In particular, in constructs that exhibit variation in both mechanical and biochemical properties, the interplay of mechanical, material, and chemical signals can complicate understanding of the particular factors at work in interface formation. Thus, the overall goal of this dissertation was to provide insight into the role of mechanical strain and scaffold degradability on cell behavior within heterogeneous biomaterials. Specifically, a method for determining cell vertical position within a degradable gel through a laminated interface was developed. A computational model was created to examine possible variation in local mechanical strain due to heterogeneity in mechanical properties and different interface geometries. Finally, the influence of biomaterial degradability on changes in encapsulated human mesenchymal stem cell morphology under response to cyclic mechanical strain was explored. Together, these studies provide insight into mechanical and material design considerations when devising tissue engineering strategies to regenerate the tendon/ligament-bone interface.

The purpose of this thesis was to quantify the prevalence, measure the severity, and describe treatment patterns in patients who present to medical clinics in Texas with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft-tissue infections (SSTI). Ten clinics participated in this prospective, community-based study. Clinicians consented patients and collected clinical information, pictures, and wound swabs; data were processed centrally. MRSASelect[trademark] was used for identification. Susceptibilities were determined via Etest[registered sign]. The results are as follows. Overall, 73/119 (61%) patients had CA-MRSA. Among these, 49% were male, 79% were Hispanic, and 30% had diabetes. Half (56%) of the lesions were [greater than or equal to] 5 cm in diameter. Most patients had abscesses (82%) and many reported pain scores of [greater than or equal to] 7/10 (67%). Many presented with erythema (85%) or drainage (56%). Most received incision and drainage (I&D) plus an antibiotic (64%). Antibiotic monotherapy was frequently prescribed: sulfamethoxazole/ trimethoprim (SMX/TMP) (78%), clindamycin (4%), doxycycline (2%), and mupirocin (2%). The rest frequently received SMX/TMP in combination with other antibiotics. SMX/TMP was commonly administered as one double-strength tablet twice daily. Isolates were 93% susceptible to clindamycin and 100% susceptible to vancomycin, doxycycline, SMX/TMP, and linezolid. We report a predominance of CA-MRSA SSTIs, favorable susceptibilites, and frequent prescribing of SMX/TMP in primary care clinics located in South Texas. / text