O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .

Polímeros biorreabsorvíveis como substrato para cultura de células e engenharia tecidual

Biomateriais poliméricos são desenvolvidos para uso como substitutos de tecidos danificados e/ou estimular sua regeneração. Uma classe de biomateriais poliméricos são os biorreabsorvíveis, compostos que se decompõem tanto in vitro quanto in vivo. São empregados em tecidos que necessitam de um suporte temporário para sua recomposição tecidual. Dentre os vários polímeros biorreabsorvíveis, destacam-se os alfa-hidróxi ácidos, entre eles, diferentes composições do poli(ácido lático) (PLA), como o poli(L-ácido lático) (PLLA), poli(D-ácido lático) (PDLA), poli(DL-ácido lático) (PDLLA), além do poli(ácido glicólico) (PGA) e da policaprolactona (PCL). Estes polímeros são considerados biorreabsorvíveis por apresentarem boa biocompatibilidade e os produtos de sua decomposição serem eliminados do corpo por vias metabólicas. Diversas linhas de pesquisa mostram que os diferentes substratos à base de PLA estudados não apresentam toxicidade, uma vez que as células são capazes de crescer e proliferar sobre eles. Além disso, diversos tipos de células cultivadas sobre diferentes formas de PLA são capazes de se diferenciarem sobre os diferentes polímeros e passar a produzir componentes de matriz extracelular. Neste trabalho, é revisada a utilização de substratos à base de alfa-hidróxi ácidos, com destaque para diferentes formas de PLA, utilizados como substratos para cultura de células, bem como suas aplicações.

Characterization of PVDF/HAP composites for medical applications

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Biocompatibility studies of anionic collagen membranes with different degree of glutaraldehyde cross-linking

The work describes the biocompatibility and biodegradation studies of anionic collagen membranes casted form collagen gels collagen, that were selective hydrolyzed at the carboxyamide groups, as a function of the degree of cross-links induced by glutaraldehyde. Independently from the degree of cross-links, all membranes studied were characterized by a similar inflammatory response, inversely dependent on glutaraldehyde reaction time, that decreased from the time of the implant. Cell alterations, mineralization or contact necrosis were not observed in any of the membranes studied. Rates for membrane tissue biodegradation were directly related to glutaraldehyde reaction time, and ranged from 30 to periods longer than 60 days, associated with good biocompatibility. Although other properties must be considered, their use in the treatment of periodontal diseases, the biological behavior observed with the 8 h GA cross-linked membrane suggests that, anionic collagen membrane described in this work may be of potential use, not only in association with guided tissue regeneration technique for periodontal tissue reconstruction, but also in other collagen biomaterial applications where controlled biodegradability is required. (C) 1998 Published by Elsevier B.V. Ltd. All rights reserved.

Relief grating induced by photo-expansion in Ga-Ge-S and Ga-Ge-As-S glasses

We report the fabrication of relief diffraction gratings recorded on a surface of photosensitive Ga10Ge25S65 and Ga5Ge25As5S65 glasses by means of interference of two UV laser beams at 351 nm. The diffraction efficiency (eta) of first diffraction order was measured. Atomic-force-microscope (AFM) was used to perform a 3D imaging analysis of the sample surface topography that shows the superposition of an imprinted grating over the topography of the glass. The change in the absorption edge and the refractive index has been evaluated and a structural approach of the relief grating on the glass surface has been discussed.

Tibial segmental bone defect treated with bone plate and cage filled with either xenogeneic composite or autologous cortical bone graft

Tibia segmental defect healing in sheep were clinically, radiographically and histologically evaluated. Twelve young sheep aged four to five months were divided into two groups, G1 and G2. A 3.5 cm long segmental defect was created in the right tibial diaphysis with maintenance of the periosteum. The bone defects in both groups were stabilized with a bone plate combined with a titanium cage. In G1 the cage was filled with pieces of autologous cortical bone graft. In G2 it was filled with a composite biomaterial which consisted of inorganic bovine bone, demineralized bovine bone, a pool of bovine bone morphogenetic proteins bound to absorbable ultra-thin powdered hydroxyapatiteand bone-derived denaturized collagen. Except for one G1 animal, all of them showed normal limb function 60 days after surgery. Radiographic examination showed initial formation of periosteal callus in both groups at osteo-tomy sites, over the plate or cage 15 days postoperatively. At 60 and 90 days callus remodeling occurred. Histological and morphometric analysis at 90 days after surgery showed that the quantity of implanted materials in G1 and G2 were similar, and the quantity of new bone formation was less (p = 0.0048) and more immature in G1 than G2, occupying 51 +/- 3.46% and 62 +/- 6.26% of the cage space, respectively. These results suggest that the composite biomaterial tested was a good alternative to autologous cartical bone graft in this experimental ovine tibial defect. However, additional evaluation is warranted prior to its clinical usage.

Evaluation of anionic collagen membranes in the treatment of class II furcation lesions: an histometric analysis in dogs

This study aims to evaluate the effect of using anionic collagen membranes in guided tissue regeneration treatment of Class II furcation lesions in dogs. The defects were created in the buccal furcation of 16 mandibular premolars of four dogs. After 56 days without plaque control, the sites were scaled and divided into two groups according to the treatment applied: control sites, open flap debridement; and test sites, guided tissue regeneration treatment. The animals were killed after 3 months. Histological and histometrical analyses showed that the collagen membrane was better than open flap debridement in terms of newly formed cementum and epithelial migration prevention. It provided effective blockade of epithelial tissue and promoted regeneration of lost periodontal tissues, suggesting that the membrane warrants further study. (C) 1997 Elsevier B.V. Limited. All rights reserved.

Loss of imprinting and loss of heterozygosity on 11p15.5 in head and neck squamous cell carcinomas

Background. IGF2 and H19 are reciprocal imprinted genes with paternal and maternal monoallelic expression, respectively. This is interesting, because IGF2 is known as a growth factor, and H19 encodes a RNA with putative tumor suppressor action. Furthermore, IGF2 and H19 are linked genes located on chromosome 11p15.5, a common site of loss of heterozygosity in human cancers.Methods. We performed an allelic-typing assay using a PCR-RFLP-based method for identification of heterozygous Informative cases in head and neck squamous cell carcinomas. Tumoral total RNA was extracted from each of the heterozygotes and further studied by RT-PCR analysis.Results. We detected the expression of the IGF2 gene in 10 of 10 informative cases. Two cases exhibited LOI of the IGF2 gene as evidenced by biallelic expression, and in another case, LOH was coupled with monoallelic expression of this growth factor. LOI for the H19 gene was observed in 1 of 14 informative samples analyzed. In this case, we also detected parallel mono-allelic expression of the IGF2 gene. Down-regulation of the H19 gene was observed in 10 of 14 cases.Conclusion. These findings support the hypothesis that H19 may be a tumor suppressor gene involved In head and neck carcinogenesis. Furthermore, our data showed that genetic and epigenetic chances at 11p15.5 could lead to abnormal expression of imprinted genes in HNSCC. (C) 2001 John Wiley & Sons, Inc.

Adhesive performance of dentin bonding agents applied in vivo and in vitro. Effect of intrapulpal pressure and dentin depth

The purpose of this study was to evaluate the influence of intrapulpal pressure and dentin depth on bond strengths of an etch-and-rinse and a self-etching bonding agent to dentin in vitro and in vivo. Twenty-four pairs of premolars were randomly divided into four groups (n = 6) according to the dentin bonding agent, Single Bond and Clearfil SE Bond, and intrapulpal pressure, null or positive. Each tooth of the pair was further designated to be treated in vivo or in vitro. The intrapulpal pressure was controlled in vivo by the delivery of local anesthetics containing or not a vasoconstrictor, while in vitro, it was achieved by keeping the teeth under hydrostatic pressure. Class I cavities were prepared and the dentin bonding agents were applied followed by incremental resin restoration. For the teeth treated in vitro, the same restorative procedures were performed after a 6 month-storage period. Beams with I mm 2 cross-sectional area were prepared and, microtensile tested. Clearfil SE Bond was not influenced by any of the variables of the study, while bond strengths produced in vitro were significatly higher for Single Bond. Overall, lower bond strengths were produced in deep dentin, which reached statistical significance when Single Bond was applied under physiological or simulated intrapulpal pressure. In conclusion, in vitro bonding may overestimate the immediate adhesive performance of more technique-sensitive dentin bonding systems. The impact of intrapulpal pressure on bond strength seems to be more adhesive dependent than dentin morphological characteristics related to depth. (C) 2007 Wiley Periodicals, Inc.

Collagen-hydroxyapatite films: piezoelectric properties

In this paper we report a study of the physicochemical, dielectric and piezoelectric properties of anionic collagen and collagen-hydroxyapatite (HA) composites, considering the development of new biomaterials which have potential applications in support for cellular growth and in systems for bone regeneration. The piezoelectric strain tensor element d(14), the elastic constant s(55) and the dielectric permittivity 8(11), were measured for the anionic collagen and collagen-HA films. The thermal analysis shows that the denaturation endotherm is at 59.47 degreesC for the collagen sample. The collagen-HA composite film shows two transitions, at 48.9 and 80.65 degreesC. The X-ray diffraction pattern of the collagen film shows a broad band characteristic of an amorphous material. The main peaks associated to the crystalline HA is present in the sample of collagen-HA. In the collagen-HA composite, one can also notice the presence of other peaks with low intensities which is an indication of the formation of other crystalline phases of apatite. The scanning electron photomicrograph of anionic collagen membranes shows very thin bundles of collagen. The scanning electron photomicrography of collagen-HA film also show deposits of hydroxyapatite on the collagen fibers forming larger bundles and suggesting that a collagenous structure of reconstituted collagen fibers could act as nucleators for the formation of apatite crystal similar to those of bone. The piezoelectric strain tensor element d(14) was measured for the anionic collagen, with a value of 0.062 pC N-1, which is in good agreement compared with values reported in the literature obtained with other techniques. For the collagen-HA composite membranes, a slight decrease of the value of the piezoelectricity (0.041 pC N-1) was observed. The anionic collagen membranes present the highest density, dielectric permittivity and lowest frequency constant f.L. (C) 2001 Elsevier B.V. B.V. All rights reserved.

Analysis of the topography of a Bragg grating in chalcogenide glass

Relief Bragg gratings were recorded on the surface of Ga-Ge-S glass samples by interference of two UV laser beams at 351 nm, Scanning force microscopy was used to perform a 3D image analysis of the resulting surface topography, which shows the superposition of an imprinted grating over the base topography of the glass. An important question regarding the efficiency of the grating is to determine to what extent the base topography reduces the intended coherent scattering of the grating because of its stochastic character. To answer this question we separated both base and grating structures by Fourier filtering, examined both spatial frequency and roughness, and determined the correlation. (C) 2001 Elsevier B.V. B.V. All rights reserved.

Fibrin adhesive implant in wound healing repair of dental sockets with topical application of epsilon aminocaproic acid: Histological analysis

The aim of the study was to evaluate wound healing repair of dental sockets after topical application of 5% epsilon-aminocaproic acid (EACA) and the use of fibrin adhesive implant in rats under anticoagulant therapy with warfarin. Sixty Albinus wistar rats were used, divided into three groups of 20. In Group I, the animals were given 0.1 mL/100 mg of 0.9% saline solution per day, beginning 6 days before dental extraction and continuing throughout the experimental period. In Group II, the animals received 0.03 mL of sodium warfarin daily, beginning 6 days before the surgery and continuing until the day of sacrifice; after tooth extractions, the sockets were filled with fibrin adhesive material. In Group III the animals were treated as in Group II, and after extractions, the sockets were irrigated with 5 mL of 5% EACA and filled with the same fibrin adhesive material. All groups presented biological phases of wound healing repair, the differences being evident only in the chronology. The results obtained in Group III were very similar to those of Group I in the last period of wound repair, whereas Group II presented a late chronology compared to the other groups. © 2005 Wiley Periodicals, Inc.

Structural characterization of blends containing both PVDF and natural rubber latex

Films containing different volumes of latex of natural rubber (NR) in a fixed mass of poly (vinylidene fluoride) (PVDF) powder were fabricated by compressing under annealing a mixture of both materials without using any solvent. This is an important issue keeping in mind that these films have to be used in the future as biomaterials in different applications once the solvents that are used to dissolve the PVDF become toxic to human. The films with different percentage of latex in PVDF were characterized using microRaman scattering and Fourier transform infrared absorption (FTIR) spectroscopies, thermomechanical techniques using thermogravimetry (TG), differential scanning calorimetry (DSC), dynamical-mechanical analysis (DMA) and scanning electron microscopy (SEM). The results showed that the latex of NR and PVDF do not interact chemically, leading to the formation of a polymeric blend with high thermal stability and mechanical properties suitable for applications involving bone (prostheses, for instance). Besides, the results recorded using the micro-Raman technique revealed that for a fixed amount of PVDF the higher the amount of latex in the blend, the better the miscibility between both materials. Copyright (c) 2005 John Wiley & Sons, Ltd.

Alumina/zirconia composite coated by biomimetic method

In this study, a bioactive zirconia-toughened alumina (ZTA) composite was developed for orthopedic applications. This composite was obtained by slip casting of suspension powder mixtures.Biomimetic processes were used to grow a bone-like apatite layer on composite substrates using sodium silicate solution as a nucleating agent and simulated body fluids. The composites, with or without coating, were characterized by diffuse reflectance infrared Fourier transform (DRIFT) spectroscopy and scanning electron microscopy (SEM) with energy dispersion spectroscopy (EDS), and their apparent density was determined by the Archimedes method. The composites obtained by this process possessed the expected stiffness and dimensions and their density values were similar to those of the composite's theoretical density (98.8%TD). The morphology of the hydroxyapatite formed on the composite surface was homogeneous and composed of small globules, characterizing a carbonated hydroxyapatite. The results of the tests indicated that the method employed to produce the composite and its coating was efficient under the conditions of this study. (c) 2006 Elsevier B.V. All rights reserved.

A comparative study of the corrosion of high copper dental amalgams

Metallographic studies carried out for Tytin-Plus and Dispersalloy amalgams show a porous multiphase material, whose surface phases are: gamma-(Ag3Sn), gamma(1)-(Ag2Hg3), eta'-(Cu6Sn5) and epsilon-(Cu3Sn). Additionally, Dispersalloy is present in the Ag-Cu eutectic. The application of surface analysis by SEM reveal a heterogeneous distribution of the above mentioned phases. Microstructures consisting of colonies or clusters were not observed. The corrosion testing of these materials was done in 0.9% NaCl aerated solution at 25 degrees C using potentiodynamic polarization curves and ac impedance measurements. The corrosion process in these multiphase systems can be interpreted as the sum of more than one electrodissolution process and the posterior formation of corrosion films. on each electrode, the corrosion film is formed by different mechanisms. (C) 1998 Elsevier B.V. B.V. All rights reserved.