Variveis:

Diabetes mellitus descompensada, tabagismo, uso de esteroides, desnutrio, obesidade, infeces, hipo /hipertenso,

BP , !lu"o de sangue, espessura tissular, spot do laser, fototipo# Peso/ $ %

%riteria of e"clusion &ere previous operation: burn, tumor, radiotherap' in the anatomical region, pregnanc' or lactation, ma(or disease )cancer, *$V/ +$D,, diabetes, h'pertension, d'slipidemia, organ failures-, rheumatologic or autoimmune conditions )lupus, rheumatoid arthritis, dermatom'ositis, scleroderma-, use of nonsteroidal anti.inflammator' drugs, corticosteroids, or immune modulators, and refusal to participate in the stud'

!atores como hiperglicemia, fumo e e"cesso de peso devem ser corrigidos no pr/.operat0rio#

!ichamento:
1$,234, 2#5 64$7*2, P# +#5 %*+PP311, P# *# 8ptical properties of human s9in . Journal of Biomedical Optics, v# :;, n# <, sept#, p# =<=<=:.:> ?=:? @ ore recentl', the introduction of s9in color measurements has e"tended this to include the potential for ob(ective determination of s9in features, : including melanin and hemoglobin concentrations, ?AB the depth and diameter of blood vessels, ;A< the depth of pigmented s9in lesions, :=,:: the maturit' and depth of bruises, :?,:C and 9eratin fiber arrangements#:DE @+bsorption describes a reduction in light energ'# 6ithin the visible region, there are t&o substances generall' considered to dominate the absorption of light in s9in: hemoglobin and melaninE @*emoglobin is the dominant absorber of light in the dermis# Formal adult hemoglobin )*b +- is a protein consisting four pol'peptide chains, each of &hich is bound to a heme# ?? 2he heme in *b + is named iron. photoporph'rin $G ?C,?D and is responsible for the ma(orit' of light absorption in bloodE @2he volume fraction of melanosomes in the epidermis varies t'picall' from :H in pale s9in to >H in dar9er s9in, >C although one group has suggested greater values# >D,>> *o&ever, despite their lo& numbers relative to 9eratins, melanosomes are appro"imatel' := times the diameter of the largest 9eratin structures in the epidermis >B and possess a greater refractive inde"# elanin has been sho&n to contribute significantl' to the degree of scatter &ithin the epidermis# >I,>< +s &ell as the volume fraction, the distribution and siJe of melanin structures in the epidermis also var' &ith s9in t'pe# 2hus, the total amount of scatter that occurs as a result of melanin in the epidermis can var' substantiall' bet&een individuals, B=,B: although this is not al&a's ta9en into account &hen simulating the effects of var'ing melanin concentration on s9in color, D?,B? or &hen simulating laser treatments, :>,BC for e"ampleE @Blood normall' occupies around =#?Hto =#BHof the ph'sical volume of the dermis ?,B,>D,BD.BB depending upon its anatomical location# 2he vessel &alls surrounding this blood, in addition to the &alls of vessels that remain vacant, ma' occup' a similar volume# Dermal vessels var' in thic9ness and structure from capillaries of around := to :? Km diameter at the epidermal (unction to terminal arterioles and post.capillar' venules )appro"imatel' ?> Km in diameter- in the papillar' dermis and venules )appro"imatel' C= Km- in themid.dermis# B; !urthermore, blood vessels occur in higher densities at particular depths, giving rise to so.called blood vessel ple"i# B; 2he contribution to light scatter b' these structures, inclusive of refraction effects, ma' be significant BIA;= and varies &ith location and depth, as &ell as bet&een individualsE $ndirect measurements do not suffer from such changes in the properties of the interrogated s9in volume, although care must be ta9en to consider variations in blood perfusion, for e"ample, &hich ma' result from sudden changes in ambient temperature, the use of some drugs and even contact bet&een the s9in and the measurement device#

$, G# L#5 %*3F, M# N#5 %3F, N#5 1$+F7, O# M#5 O*8P, 1# 6# + comparative stud' of BC?#I and >C? nm laser irradiation on some rheological factors in human blood in vitro. Journal of Photochemistry and Photobiology B: Biology, v# ;D, p# ;A:? ?==D#

@During the past t&o decades, a lot of e"perimental data have sho&n that lo& po&er laser irradiation has positive eects of bio.stimulation on living bodies Q:ADR, and a large number of clinical studies &ith lo& po&er laser irradiation have been used to treat various pathologic processes such as &ound healing, tissue repair and post endovascular restenosis Q>AIR# $n %hina, intravenous lo& po&er laser irradiation has been applied clinicall' in aid of treatment for acute cerebral infarction, and the results have been encouraging Q<,:=R# $t is deduced that the blood microcirculation in brain ma' be improved b' laser irradiation, &hich promotes the recover' of patients#E @4ecentl', the eect of laser irradiation on blood microcirculation &as conSrmed b' in vivo measurement &ith time. dependent 2:.&eighted contrast enhanced magnetic resonance imaging ) 4$- Q:CR# *o&ever, it is not 'et clear &h' laser irradiation can improve the microcirculation, though the interaction of blood and laser irradiation has been studied in a fe& instances Q:DR#E @%oncluding the results of laser irradiation on blood viscosit', er'throc'te electrophoresis and er'throc'te deformabilit', the positive eect of laser irradiation is evident# %omparing the results of laser irradiation &ith >C? and BC?#I nm, the &avelength eect is obvious, i#e# that the laser of >C? nm functioned better than the laser of BC?#I nm did in these circumstancesE

@+s the evidenced in 2able B, it is demonstrated that laser irradiation reall' improved er'throc'te deformabilit' for %a?T.treated er'throc'te samples# 2hese results support the suggestion that the *bm is the initial site of action in laser irradiation on blood# +s considered from the beginning of this report5 &h' does laser irradiation improve microcirculationU 2he results of this &or9 ma' give a preliminar' ans&er in as much as that laser irradiation can modulate the rheological properties of blood# 2he improvement of rheological properties is therefore the possible cause of the improvement of the microcirculation#E

BP4DP1$, F# #5 7P2F8V+, ,# V# 3ffect of $ntravenous 1aser $rradiation of the Blood on Plasma %ontent of %eruloplasmin in Patients &ith %hronic Pancreatitis# Bulletin of Experimental Biology and Medicine, v# :D<, n# B, (une, p# BC>.B ?=:=#
@%hronic pancreatitis is one of the most urgent problems of gastroenterolog'# 2his disease constitutes up to :=H in total morbidit' structure QD,IR# Disturbances in the o"idant.antio"idant s'stem are undoubtedl' an important component in the pathogenesis of chronic pancreatitis Q:R# %eruloplasmin )%P- is considered to be the ma(or plasma antio"idantE @6e e"amined <= patients &ith chronic pancreatitis )B< &omen and :B men- aging CB.;; 'ears )mean >C#:W>#? 'ears-5 histor' of chronic pancreatitis varied from :.?I 'ears# 2he control group comprised D> patients receiving drug therap' including analgesics, spasmol'tics, protease inhibitors, antisecretor' drugs, infusion therap', and enJ'mes# Patients of the main group )nXD>- apart from the same drug therap' additionall' received $1$B performed using a atri9s V18V apparatus for laser therap' )YXBC= nm, radiation po&er at the tip of the lightguide :#>.?#= m6-5 duration of the procedure &as ?= min# 2he course consisted of ; dail' irradiation sessions# +dditionall', C= health' individuals &ere e"amined#E @%P is a vitall' important multifunctional protein# Due to some its properties it &as classiSed as an acute phase protein# $t &as found that blood level of %P increases in acute and chronic inZammator' processes# During inZammation, %P inactivates free radicals formed b' phagoc'tiJing leu9oc'tes and released into the e"tracellular Zuid lac9ing defense enJ'mes catalase and ,8D Q;R#E @+fter drug therap', a tendenc' to normaliJation of %P level &as observed )2able :-# +fter addition of $1$B to comple" therap' of e"acerbation of chronic pancreatitis, the initiall' elevated concentration of %P in blood plasma signiScantl' decreased and returned to normal# 2he significant decrease and normaliJation of %P content in the main group probabl' reZect more rapid suppression of the inZammator' process in the pancreas against the bac9ground of comple" therap' &ith $1$B, because it is 9no&n that lo&.intensit' laser irradiation e"hibit pronounced anti. inZammator' and antio"idant effects#E

O+13,,V+N+, 7# +#5 ,+ B84, 3# 7#5 VP%*$F,V$$, +# V# 3ffect of intravenous laser irradiation on the molecular structure of blood and blood components# Journal of Applied Spectroscopy, v# ;C, n# :, p# ::>.?? ?==B#

@2he greatest interest is in photoreactions initiated b' intravenous laser irradiation of blood, &hich is ac9no&ledged to be the most effective laser biostimulation method# + &ide variet' of positive effects have been observed &hen using this method, such as stimulation of the antio"idant s'stem, enhancement of the immune response, improvement of the rheological characteristics of blood and microcirculation blood flo&, etc# Q:ACR#E @Based on stud' of the absorption spectra in the PV.visible and $4 ranges of the spectrum, it has been sho&n QBR that the primar' photoacceptor for emission from a *eAFe laser in blood is hemoglobin )*b-E

,%*$FD1, +#5 *3$FO3, 7#5 ,%*$FD1, #5 P34F34,284!34.,%*[F, *#5 ,%*$FD1, 1# ,'stemic 3ffects of 1o&.$ntensit' 1aser $rradiation on ,9in icrocirculation in Patients &ith Diabetic icroangiopath'# Micro ascular !esearch, v# BD, p# ?D= A?DB, ?==?#

Patients &ith diabetic ulcers or gangrene &ere sub(ected to an initial $4 thermograph' in order to evaluate s9in circulation# 2hirt' patients sho&ing a reduced temperature profile over their forefoot region )mean temperature belo& ?<\%- and levels of gl'cos'lated hemoglobin higher than BH &ere included in the stud'# %linical or blood chemical signs of infection, medication &ith drugs that might influence platelet aggregation, vasodilatation, or a combination of these &ere e"clusion criteria# +fter obtaining informed con.sent from the patients, the forefeet of the sub(ects &ere randomiJed into t&o groups )n :>-:7roup : re.ceived a single session of topical lo&.intensit' laser irradiation over one randoml' chosen forefoot Qlaser.treated side )1/2-R, the second side being left un.treated Qlaser.untreated side )1/=-R# $n group ?, the laser &as positioned over one forefoot &ithout being turned on Qplacebo.@treatedEside )P/2-R, the second side being left @untreatedE Qplacebo.untreated side )P/=-R Briefl', a noncontact $4 thermograph' camera )2hermo 2racer 2*$:==, nbn 3lectronics, 7raJ, +ustriacoupled to a micro.computer &as used for the temperature recordings# 2his instrument measures the $4 radiation emitted from the patient]s s9in &ith a sensitivit' of =#:\%# +nal'sis of the thermograms &as performed &ith Pic.6in $ris, Version ?#??, soft&are, &hich allo&s measurements over a defined region of interest# $n our stud', the area distal of a line dra&n bet&een the medial and lateral malleolus &as defined as the@ fore.foot region#E2hermograms &ere ta9en at = min and ?= and >= min after the start and at :> min, after the end of the irradiation and placebo.irradiation procedure, respectivel'# + continuous.&ave heliumAneon )*eFe- laser )&avelength, BC?#I nm5 po&er output, C= m6- &as utiliJed for the light irradiation# 2he beam )original spot diameter, > mm- &as diverged b' the instrument]s scanner, and the irradiation time &as ad(usted to receive an energ' densit' of C= M/cm? at the s9in surface 2he laser effect &as evaluated b' comparing the s9in temperature :> min after the end of the irradiation procedure of the laser.treated forefeet to that of the placebo.treated forefeet b' anal'sis of covariance )+F%8V+- using the respective baseline measurements as covariates# 2he s'stemic effect &as evaluated similarl' b' comparing data from the laser.untreated forefeet to those of the placebo.untreated forefeet# P values=#=> &ere considered as indicating statistical significance and are results from t&o.sided tests# 2he soft&are used for statistical anal'sis &as the ,+, ,'stem for 6indo&s ),+, $nstitute $nc#, %ar', F%-# 2he base.line.ad(usted s9in temperature :> min after the cessation of laser irradiation &as significantl' higher in the laser.treated forefeet compared to that in the placebo.treated forefeet )P=#===:-5 the baseline. ad(usted difference in the temperature &as :#<D =#C>\%# ,imultaneousl', the baseline.ad(usted s9in temperature &as significantl' higher in the laser.un treated forefeet compared to that in the placebo. untreated forefeet )P=#===:-5 the baseline.ad(usted difference &as :#;==#CC\%# +s can be seen in !ig# :, the rise in s9in temperature commenced earlier in the laser.treated feet than in the laser.untreated feet#

V$131+, 4# 7#5 7M34D3, V#5 !4$78, 1#5 MPF$84, 3# %# P# 1#5 18P3,. +42$F,, 4# +# B#5 V13$F3, B# #5 P48V8P86$2,%*, $# "istomorphometric analysis of inflammatory response and necrosis in re#implanted central incisor of rats treated $ith lo$#le el laser therapy # 1asers ed ,ci, v# ?;, p# >>:A ; ?=:?#

2he main feature of the inflammator' process is the intense osteoclastic activit' QDR# 2herefore, the modulation of inflammator' process is important to attenuate e"ternal root resorption# 6ith these aspects in mind, lo&.level laser therap' )1112- could be an important non.pharmacological tool due its modulator' properties in biological tissues# +nti.inflammator' properties of 1112 are based on its effects in the reduction of prostaglandin 3?, tumor necrosis factor.^,interleu9in.:_, cicloo"igenase.? m4F+, and plasminogen activator levels +t the cellular level, biomodulation occurs through the increase of the +2P production due to a change in the redo" properties of the carriers in the respirator' chain follo&ing photoe"citation of their electronic states and acceleration of electron transfer )primar' reactions-# ,econdar' reactions occur b' increasing cell membrane transporters )Fa`/*` antiporter, Fa`/V` +2Pase-, concentration of second messengers )%a?`, c+ P- and s'nthesis of DF+ and 4F+ ?; Q:BR# Providing a rise in mitotic velocit' and protein s'nthesis thus leads to auic9 tissue regeneration Q:;A:<R# 1aser therap' also has other effects on tissues, such as increasing blood flo& and l'mphatic drainage, and the activation of the immune and microcirculation s'stems Q:;A?:R# Due the reduction in the inflammator' process, 1112 has, as a secondar' effect, an analgesic action Q:>R#

$n this perspective, the aim of our stud' &as to evaluate the histological conditions of the dental and periodontal ligaments in the central upper.left incisor teeth in rats re.implanted &ith )and &ithout- lo&.level laser irradiation )at :>, C=, and B= da's after re.implantation-# ,event'.t&o male adult 6istar rats ):I=A?== g- &ere housed under standard conditions of temperature )??.?>\%-, relative humidit' )D=.B=H-, and light/dar9 c'cle ):?/:? h- &ith access to food and &ater ad libitum# + continuous.&ave diode laser )$n7a+lP- )Luasar edical, Dentofle", BraJil- &ith an output po&er of >= m6 and a &avelength of BI> nm &as used# 2he spot siJe &as =#=? cm? and the optical po&er densit' &as ?#> 6/cm?# 2he optical po&er &as calibrated using a Fe&port ultifunction 8ptical eter model :IC>%# 1aser irradiation dose &as fi"ed at >= M/cm? in four different points a total of ?== M/cm? in onl' one session# 2he tip &as 9ept : mm from the irradiated tissue and total energ' deliver' &as : M per point )D M of total dose-# 2he protocol of irradiation &as the same for all e"perimental sub.groups

6hen 7: and 7? are compared in each e"perimental period, it is possible to observe significant differences in all comparisons )pb=#=:- )2able?-# !igure? sho&s areas used to ma9e !igs#Cand D +fter :> da's of re.implantation, the 1112 and control group presented degenerating changes probabl' in conseauence of the loss of the blood flo& due to the dental avulsion# 2he periodontal ligament collagen fibers &ere bro9en, but inflammator' cells and blood clot &ere present# 2he highest difference bet&een the control group and the 1112 group &as observed in the root pulp# $rradiated tooth odontoblasts presented slight degenerative morphological changes, so the cell la'er &as organiJed and c'toplasms &ere normall' stained &ith their nucleuses present and &ere &ell preserved# 8n the other hand, intense degenerations &ere observed in the control group# 4oot pulp odontoblasts &ere disorganiJed, c'toplasms &ere pale, and nucleuses &ere not present or discolored, sho&ing morphological evidence of degeneration )!ig#C-#

+fter C= da's of replantation, both groups developed pulpal and periodontal necrosis &ith the presence of dentinal resorption# $n some areas, total loss of dentin allo&ed the pulp to become in close contact &ith the periodontal ligament# *o&ever, differences bet&een the control and the 1112 group &ere observed# 2he most evident difference &as the number of pulpal inflammator' cells, scored a sintense in control group as &ell as amounts of necrotic areas &ere scored as moderate# 8n the other hand, the 1112 group &as scored slight for both parameters mentioned above )!ig# Da, b+fter B= da's of re.implantation, both groups developed pulpal and periodontal necrosis &ith the presence of dentinal resorption and allo&ing the pulp to become in close contact &ith the periodontal ligament# *o&ever, differences bet&een the control and 1112 groups &ere observed# Fecrosis and inflammator' cells &ere scored as moderate in 1112 group# Fecrosis presented &ell.defined characteristics of liauef'ing necrosis &ith regional collection of eosinophilic material surrounded b' inflammator' cells# 8n the other hand, the control group &as scored as intense for necrosis and inflammator' cells# 2he pulp presented necrosis in all e"tension &ith the follo&ing characteristics: greater number of inflammator' cells even in the pulp than in the periodontal ligament# Fecrosis areas &ere also larger and presented basophilic material collection )!ig#Dc, d-#

2he comparative histological anal'sis bet&een the :>.da' control and 1112 sub.group sho&ed that in both groups, degenerative changes &ere present due to insufficient blood suppl'# *o&ever, the most important difference bet&een the groups &as observed in the pulpal tissue, &here odontoblasts of the irradiated tooth did not sho& an' degenerative morphological change, different than &as observed in the control group# 2he comparative histological anal'sis bet&een C=.da' control and 1112 sub.groups sho&ed that in both groups pulpal and periodontal ligament necrosis &as observed# *o&ever, the most important difference bet&een the groups &as seen b' the auantit' of the pulpal inflammator' cells and necrosis areas that &ere more evident in the control group than in the irradiated group# %omparative histological anal'sis bet&een B=.da' control and 1112 sub.groups sho& that in both groups it &as seen that not onl' pulp &as affected b' necrosis but also the periodontal ligament# *o&ever, the most important difference bet&een the groups &as that the pulpal necrosis of the 1112 sub.group presented &ell.defined characteristics of a liauef'ing necrosis that &as not observed in the control sub.group# +ccording to the light microscop' aualitative anal'sis, the :>.da' 1112 sub.group sho&ed an organiJed histological tissue &ith nuclei cells &hen compared to the respective control sub.group# 2he C=. and B=.da' 1112 sub.groups also sho&ed mature histological characteristics &ith more collagen fibers and small number of necrosis areas &hen compared to the respective control sub.groups#

V+13,%8, $# 2#5 !3443$4+, 1# ,#5 +4$7+, ,# V# V#5 B+4B3$48, D# !#5 3F37POO8, D# 2#5 +B+23P+P18, !#5 +4LP3,, # # 3ffect of phototherap' &ith lo& intensit' laser on local and s'stemic immunomodulation follo&ing focal brain damage in rat# Journal of Photochemistry and Photobiology B: Biology, v# <;, n# C, p# :D>. >:, Dec# ?==<#

$n(ur' to the central nervous s'stem )%F,- leads to a &ell.regulated inZammator' response, &hich is important for tissue regeneration Q:ACR# 2his inZammator' response involves activation of microglia, brain macrophages, and astroc'tes5 processes li9el' mediated b' the release of inZammator' c'to9ines# Fumerous c'to9ines, including tumor necrosis factor.a )2F!.a-, interleu9in.:b )$1.:b-, interleu9in.B )$1.B- and interleu9in.:= )$1.:=- are induced rapidl' after acute %F, insults QD,>R#

$1.:b and 2F!.a are 9no&n pro.inZammator' c'to9ines &hich have been detected in brain tissue of e"perimentall' brain.in(ured rats QB,;R and in the cerebrospinal Zuid of patients &ith severe brain in(uries QI,<R# $1.:=, on the other hand, has been found to inhibit e"pression of $1.:b and 2F!.a and therefore has anti.inZammator' effect Q:=,::R# $1.B and 2F!.a can either enhance or inhibit neuronal in(ur', probabl' depending on the time course and e"tent of e"pression# 2hese mediators pla' a vital role not onl' propagating the neuroinZammator' response, but also serving as useful indicators of its presence Q:?R

2he laser phototherap' &as applied on t&o points at the in(ured site immediatel' after lesion according to the e"perimental groups# 2he laser irradiation &as done in contact# !or controlling the aseptic conditions prior to the irradiations the laser handpiece &as cleaned &ith ;=H alcohol solution and &as coated &ith a ph'sical barrier )thin translucent plastic Slm- )!ig# :3-# Fon.irradiation &ere coated &ith bon' &a" )!ig# :!-# Fon.irradiated lesions &ere used as controls# +fter irradiation, the in(ured sites )irradiated and non.irradiated- and the s9in incisions &ere sutured# 2he animals &ere 9ept at ?= % and then returned to their cages# 2hree hours later, under gentle restriction, &ithout anesthesia, the animals received a second irradiation# 2his irradiation &as done in contact to the rat s9in immediatel' over the lesion site# 2he rationale to perform t&o irradiations resides on the efScac' improvement of the phototherap' &ith lo& intensit' laser &hen applied in a fractioned approach Q?IR# %ontrol animals &ere submitted to the same environmental conditions of irradiated animals5 ho&ever, the laser eauipment &as 9ept off# 2he rats &ere sacriSced at t&o time points: B and ?D h post lesion# $mmediatel' after sacriSce samples of blood &ere collected from the heart of the animals b' using a s'ringe# 2he rat in(ured brain tissue &as assa'ed t&ice using a auantitative sand&ich enJ'me immunoassa' techniaue# 2he *uman $1:.b)DN>=:-, 2F!.a )DN>:=-, $1.B )DN>=B- and $1.:= )DN>??- 31$,+ 9its )Duo,et from 4cD ,'stem, inneapolis, P,+- &ere used follo&ing the manufacturer]s instructions# 2he absorbance &as read in a micro plate reader )7enious 4eader, 23%+F ,alJburg A +ustria- using a D>= nm Slter +fter brain cr'ogenic trauma the animals &ere randoml' divided into five groups )nX:= animals per group-: %ontrol: no laser irradiation# 41C: BB= nm laser irradiation, C M/cm?per point# 4 41>: BB= nm laser irradiation, > M/cm?per point# $41C: ;I= nm laser irradiation, C M/cm?per point# $41>: ;I= nm laser irradiation, > M/cm?per point

2he onl' difference in c'to9ines amounts bet&een control and irradiated groups &as observed in the blood# 2he concentrations of $1.B in the 41C group &ere significantl' smaller than those of control samples at both e"perimental times )pb =#=>-#

8ther interesting observation of the %B$ )%r'ogenic Brain $n(ur'- &as the signiScant increase of the circulating levels of $1.B in ?D h# $t is 9no&n that $1.: is a 9e' driver of %F, inZammation in humans, and increased circulating levels of $1.B and acute.phase proteins, are do&nstream effectors of $1.: QC=R# 2hus, if the $1.: is highl' e"pressed in the in(ured brain as observed, the increase in $1.B in the blood &ill occur# ,urprisingl', in ?D h &hen the $1.:b in the brain &as diminished, the $1.B in the blood increased# a'be this Snding &ould be resultant of a cascade of events, &here once initiated &ill be acting for longer time# 2his could be true, once even in the samples &here the levels of $1.:b &ere maintained stable in the brain )41C and $41>groups- the levels of $1.B in the blood also increased in ?Dh# %hanges in the $1.:= levels &ere neither detectable in the brain nor in the blood in all e"perimental groups# Psing laser phototherap', it &as possible to observe local and s'stemic immunomodulation follo&ing focal brain damage in rat# din the blood, &here significant increases in the 2F!.a concentration &ere observed in the control group, this increase &as not observed in the group treated &ith infrared laser irradiation and C M/cm? )$41C groupdthe $1.:b levels significantl' decreased in time in the control samples, &here the cr'ogenic lesion has received no further treatment# $n spite of &avelength and energ' densit', laser phototherap' modulated the $1.:blevel# ,table $1. :blevels &ere observed in the brain of 41C and $41> groups during the &hole e"perimental time# 2he effect of laser phototherap' on the e"pression of c'to9ines in the nervous s'stem, particularl' for neuroprotective purposes, is far from elucidated# +lthough phototherap' accelerates &ound healing and has an anti. inZammator' action, in the %F, its beneScial effect is still to be proved# $n fact, in a previous stud' using the %B$ model, &e sho&ed a signiScant increase in vascular permeabilit' indirectl' measured b' the edema formation Q?>R, &hich &ould be deleterious to the brain, especiall' in closed head trauma# $n the other hand, it &as possible to observe changes in the distribution of the inZammator' cells depending on the brain area anal'Jed, &ith a particular decrease in the inZammator' cell amount at the subcortical area irradiated &ith infrared laser and C#? M/cm? &hich &ould be beneScial to&ard the brain regeneration Q?>R# 2hus, although some alterations of the local and s'stemic levels of the studied c'to9ines in the cr'olesioned rats &ere observed, at this point it is difScult to conclude if these changes &ould be beneScial or deleterious to the %F, healing#

!un9, M# 8#, Vruse, +#, and Virchner, *# %'to9ine production after heliumAneon laser irradiation in cultures of human peripheral blood mononuclear cells# J. Photochem. Photobiol. B. v# :B, n# C.D, p# CD;AC>>, Dec# :<<?#

Abstract
2he effects of laser light on the immune s'stem have not been e"tensivel' characteriJed# 1o&.po&er laser sources, such as the helium neon )*eFe- laser &ith a &avelength of BC?#I nm, have been found to produce photobiological effects &ith evidence of interference &ith immunological functions# 6e have investigated the effects of *eFe laser irradiation on !icoll.*'paaue.isolated human peripheral blood mononuclear cells )PB %-# %ultured cells &ere irradiated for various times at t&o selected intensities and then stimulated &ith different mitogens# 2he rate of incorporation of C*.th'midine into the DF+ of stimulated cells decreased &ith increasing energ' densit'# 2he levels of interleu9in.:^ )$1.:^-, interleu9in. ? )$1.?-, tumour necrosis factor.^ )2F!.^- and interferon.e )$!F.e- in supernatants of the cultures &ere determined )irradiated either before or after stimulation-# 6hen stimulating cells after irradiation, significantl' increased levels of all c'to9ines &ere detected after C= min of irradiation ):I#< M cm f?-, &hereas after B= min of irradiation )C;#I M cmf?- c'to9ine levels &ere found to be significantl' decreased#

3F+, 3# +#5 V8,,,8V,VN, F#5 %*P, %5 *P, %# $nflammator' intermediates produced b' tissues encasing silicone breast prostheses# J %n est Surg. v# I, n : p# C:.D?, Man.!eb :<<>#

Abstract
,ilicone prostheses, &hen implanted &ithin the soft tissues of the breast, evo9e an inflammator' reaction# $n response to silicone e"posure, inflammator' mediator production b' individual cells has been observed in various e"perimental studies# $n this stud', inflammator' mediator production b' periprosthetic tissues )&hole organ- &as measured# 2he mediator levels &ere correlated &ith both the tissue histopatholog' of the periprosthetic capsules and the clinical s'mptoms noted b' each patient# 2issue surrounding breast implants removed at surger' from ten &omen )average age and implant duration D= and ; 'ears respectivel'- &as cultured in vitro for ?D hours# %ontrol tissues consisting of )a- augmentation mammaplast' s9in scars from eight additional patients and )b- 9nee s'novium from seven orthopedic surger' patients &ith arthritis undergoing primar' (oint arthroplast' &ere similarl' cultured# 2he mediators Qinterleu9in.? )$1.?-, tumor necrosis factor.alpha )2F!.alpha-, interleu9in.B )$1.B-, and prostaglandin 3? )P73?-R liberated into the culture media &ere measured b' an enJ'me lin9ed immunosorbent assa'# 6hen compared to controls, the mediator levels of $1.B and 2F!.alpha &ere substantiall' greater, although $1.? and P73? &ere lo&er# 1evels varied greatl' from patient to patient: in pg/ml per := g tissue, $1.? ranged from := to over :,===5 2F!.alpha from :== to :,===5 $1.B from :== to :,===,===5 and P73? from :== to :=,===# 2he correlation bet&een 2F!.alpha and P73? levels &as #> bet&een $1.B and P73? &as #B, and bet&een $1.B and 2F!.alpha &as #;;# 2he correlation bet&een 2F!.alpha and $1.B &as statisticall' significant at a p.value less than #=:# 3levated levels of 2F!.alpha production &ere associated &ith an increased number of macrophages and overall tissue cellularit' )p b #=>-# Fo significant relationship &as observed bet&een mediator production and clinical s'mptoms# 6e conclude that overall cellularit', specificall' macrophages, in the periprosthetic capsule ma' lead to 2F!.alpha production but that c'to9ine production b' periprosthetic tissues alone is not a predictor of clinical s'mptomatolog' in patients &ith silicone breast prostheses#

8M8.+ +$O3, 3# +#5 1+613,,, 8# M#5 P32234, M# B# 3levated %oncentrations of $nterleu9in.:band $nterleu9in. :4eceptor +ntagonist in Plasma of 6omen &ith ,ilicone Breast $mplants# &linical and diagnostic laboratory immunology, v# C, n# C, p# ?>;A?><, a' :<<B#

gg,ilicone]] refers to a group of compounds including fluids, gels, rubbers, sponges, foams, and resins )C-# ,ilicones are never found in nature but are derived from auartJ, also 9no&n as silica )<-# 2he fluid and gel are used as a pol'mer )dimeth'lpol'silo"ane- in breast implants )?-# 2he inflammator' effects of silicon )silicone- e"posure are &ell documented in animals ):C, :B-# $n humans, rheumatic autoimmune s'ndromes are reported in some &omen &ith silicone breast implants ),B$s- )>, :<-# 2o this end, plasma from ?; &omen &ith ,B$s and >= &omen &ithout ,B$s &ere assa'ed for the proinflammator' c'to9ine# !eagents# %ommercial solid.phase enJ'me immunoassa' )3$+- 9its for $1.:b and $1.:ra &ere purchased from 4cD ,'stems, inneapolis, inn# Plasma donors# Plasma &as obtained from peripheral blood in hepariniJed tubes b' venipuncture from >= health' control &omen )ages, ?? to D> 'ears- &ithout ,B$s and ?; age.matched &omen &ith ,B$s# 2he samples from &omen &ith ,B$s &ere remnant samples from samples sent to ,pecialt' 1aboratories, $nc#, for routine clinical testing# Plasma samples from both &omen &ith ,B$s and control &omen &ere 9ept froJen at .?=h% until the time of assa'# 'etermination of %(#)ra and %(#)b by E%A. )i- $1.:ra#2he 4cD ,'stems Luanti9ine 3$+ 9it &as used tomeasure $1.:ra levels in plasma# 2his 9it uses the auantitative sand&ich 3$+ techniaue# Briefl', a monoclonal antibod' specific for $1.:ra &as coated onto microtiter plates# + seriall' diluted recombinant human $1.:ra standard provided b' the manufacturer )C,=== to <C#I pg/ml- and undi.luted samples in ?== ml &ere added to the &ells# +fter &ashing a&a' unbound proteins, an enJ'me.lin9ed pol'clonal antibod' specific for $1.:ra &as added to the &ells# 2he mean concentration of $1.:ra in ?; &omen &ith ,B$s &as ?,=;=BC>> pg/ml, compared &ith a mean concentration of CD=BD= pg/ml )P,=#===:- in the plasma of >= &omen &ithout ,B$s )!ig# :+-# 8f the ?; &omen &ith ,B$s tested, ?= );DH- had $1.:ra concentrations greater than <== pg/ml, &hereas onl' : of >= )?H- &omen &ithout ,B$s had a similarl' elevated concentration# 2he mean concentration of $1.:bin plasma &as >? B?> pg/ml in ?; &omen &ith ,B$s, &hereas the mean concentration &as =#>=B=#?= pg/ml in the plasma of >= &omen &ithout ,B$s )P,=#=>- )!ig# :B-# $t is our thesis that in &omen &ith ,B$s, there is a slo& and persistent release of silicone compounds )silicone, silica, or silicates- from the implant site into the l'mphatics, l'mph nodes, and the immune s'stem, &ith the resultant production of interleu9ins and other c'to9ines both locall' and s'stemicall'#

,$1V+, # #5 8D81$F, #5 !+$F2P%*, M#5 N+ +7P%*$, %# #5 O+FD8F+, %# B#5 MPF$84, 6# %#5 !PM$6+4+, *# %P4$, 4#5 73 P341$, 4#5 !3443$4+ # %# ,'stemic $nflammator' 4eaction +fter ,ilicone Breast $mplant# Aesth Plast Surg#, v# C>, p#;I<A<D, ?=::#

+ugmentation mammoplast' &ith silicone implants has been conducted regularl' since :<B?, though not &ithout controvers'# Bet&een :<<? and ?==B a moratorium &as established in the P,+ for aesthetic devices due to suspicion of immune reactions and rheumatologic complications, besides implant rupture, silicone lea9age, and local complications Q:ADR# 2he ma(orit' of studies, including e"tensive anal'sis b' the $nstitute of edicine, eventuall' dispelled such fears Q:, C, >R# ,'stemic inflammator' reactions in this conte"t ma' be divided into perioperative, earl' postoperative, and those in the late follo&.up period# During a fe& da's immediatel' after the operation inflammation is e"pected and can be e"plained b' surgical tissue damage itself, amplified or not b' hematoma, seroma, or bacterial contamination QIR# $n a prospective controlled protocol &ith 'oung and health' &omen, %.reactive protein and other mar9ers &ere documented up to the si"th postoperative month# 2he h'pothesis &as that even though modern products are reputedl' safe, reliable, and &ell.tolerated, s'stemic inflammation might be elicited b' these foreign bodies# Methods 2his &as a prospective, controlled observational clinical trial# Patients &ere seen on four occasions: ):- preoperative assessment &hich included patient selection, informed consent, clinical and biochemical assessment5 )?perioperative period &hich included the surgical procedure, complications, and conditions of discharge5 )C- ?.month follo&.up &hich included evaluation of the operation and biochemical tests5 and )D- B.month follo&.up &hich included evaluation of the same variables as the B=.da' follo&.up, including autoantibodies +dult females &ho &ere candidates for breast augmentation )inde" group- or for abdominal liposuction )controls&ere consecutivel' recruited# %riteria of inclusion &ere age bet&een :I and C= 'ears old, B $X:I#>.C= 9g/m? , and informed consent# %riteria of e"clusion &ere previous operation, burn, tumor, or radiotherap' in the anatomical region, pregnanc' or lactation, ma(or disease )cancer, *$V/ +$D,, diabetes, h'pertension, d'slipidemia, organ fail. ures-, rheumatologic or autoimmune conditions )lupus, rheumatoid arthritis, dermatom'ositis, scleroderma-, use of nonsteroidal anti.inflammator' drugs, corticosteroids, or immune modulators, and refusal to participate in the stud' 2he incision &as made in the inframammar' fold and, conventionall', a subglandular poc9et &as created# $n four cases insufficient glandular tissue &as reported, so the submuscular )three patients- or subfascial techniaue )one case- &as emplo'ed# !ollo&.up 4outine Demographic, nutritional, and clinical information &as collected, emphasiJing criteria of inclusion and e"clusion# Diagnosis &as based on current therap', and the hospital chart &as scrutiniJed for confirmation# 2he surgical out.come concerning aesthetic and general results )s'mmetr', hematoma, fluid collection, hardness, pain, infection- and rheumatologic complaints )fever, (oint s&elling, tender.ness- &ere registered# !esults 2he final numbers &ere ?= in 7roup $ and ?D controls# +ll patients &ere successfull' operated on, &ithout mortalit'# 2he mean volume of the breast prostheses &as ?>IW?: ml )rangeX??=.?I=- and the mean aspirated volume in the course of liposuction &as :<;?WD<< ml )range X:?==AC===Fo infectious or rheumatologic abnormalit' &as observed# 6hen last e"amined, all mammar' implants &ere soft, painless, and cosmeticall' adeauate# %.reactive protein strongl' increased after ? months in patients &ho under&ent breast enlargement )pX=#==:-

4+ 8,, 1# Efeito do laser de baixa pot*ncia no processo inflamat+rio indu,ido por estiramento muscular em ratos. 2ese apresentada ao Programa de P0s.7raduao em !armacologia do $nstituto de %iincias Biom/dicas da Pniversidade de ,o Paulo, para obteno do 2jtulo de Doutor em %iincias Biom/dicas# ,o Paulo, ?==<# +p0s a leso, ocorrem alteraes nas populaes de c/lulas inflamat0rias circulantes# $nicialmente neutr0filos e posteriormente mon0citos e linf0citos so recrutados para o sjtio inflamat0rio onde produJem enJimas proteoljticas para a limpeJa e reparo do tecido lesionado# !atores auimiotticos estimulam a infiltrao de neutr0filos, incluindo prostaglandinas, 2F!.^e as interleucinas $1.:B e $1.B 8s neutr0filos fagocitam a fibra muscular lesionada por meio de ativao do sistema enJimtico nicotinamida adenina dinucleotjdio fosfato.o"idase )F+DP*.o"idase- e da liberao de enJimas proteoljticas a partir dos seus grknulos intracelulares# 3ssa resposta no / especjfica, podendo acarretar leso de c/lulas normais ad(acentes ao local lesionado )F$3 +F et al#, ?==>5 *8F7 et al#-# De forma inicial ocorre a sjntese das citocinas pr0.inflamat0rias, 2F!.^e $1.:_, as auais estimulam a sjntese de $1.B# + $1.B tem um papel de mediador primrio da reao de fase aguda, estimulando a produo heptica de protejnas de fase aguda, como a protejna % reativa )P%4- e inibidores de proteases )como o inibidor de protease ^.:-# + resposta de fase aguda restaura protejnas depletadas ou lesadas e ainda reverte os efeitos pre(udiciais da resposta inflamat0ria inicial, assim, vista desse kngulo, a $1.B desempenha um papel mais restaurativo do aue pr0.inflamat0rio e ainda estimula a glkndula hip0fise a liberar o hormlnio adrenocorticotr0fico )+%2*-, aumentando a liberao do hormlnio cortisol a partir do c0rte" adrenal )F$3 +F et al#, ?==C5 F$3 +F et al#, ?==>5 1$4+ et al#, ?==<-

A alia-.o dos n/ eis de citocinas em m0sculo es1uel2tico +s dosagens das citocinas 2F!.^, $1.:_, $1.B e $1.:= nas amostras de tibial anterior foram realiJadas pelo teste imunoenJimtico )31$,+-, seguindo instrues do 9it comercial )4cD ,'stem, 3P+-# Para isto, placas de <B poos foram sensibiliJadas com :==ml de anticorpo monoclonal para cada citocina: anti.$1:_e $1.B foram dilujdos em tampo fosfato de s0dio )=,? , p* B,>-# $ndependentemente do estjmulo desencadeante do processo inflamat0rio, as c/lulas lesionadas ativam o sistema fagocjtico mononuclear )mon0citos circulantes e macr0fagos teciduais- iniciando assim a cascata de eventos pela secreo das citocinas $1.: )interleucina- e 2F! )fator de necrose tumoral-# Dentre suas aes pr0.inflamat0rias, o 2F!.^ e"erce vrias atividade biol0gicas aue inclui a proliferao, a diferenciao e a morte celular )apoptose- )P+P,8V+ et al#, ?===5 B8P%*34, ?==>- estimula a produo de colagenases, aumenta a e"presso de mol/culas de adeso necessria para e"travasamento leucocitrio, inflamao etc# 3m relao a $1:._ foi observado aue a 2erapia 1aser de Bai"a Potincia conseguiu inibir a produo dessa citocina# 3ste fato assume relevkncia para o curso da leso, pois sugere uma diminuio de dor e desconforto muscular, uma veJ aue essa citocina esta relacionada diretamente com o grau de leso e desta forma# Pma veJ aue a $1.B / liberada, ir levar ao hepat0cito a informao da necessidade de sjntese de protejnas de fase aguda como a protejna % reativa )P%4- )487348 et al#, ?==>5 F$3 +F et al#, ?==>5 , $2 et al#, ?==I-# + determinao da concentrao plasmtica dessa protejna a(uda, clinicamente, a avaliar a presena, a e"tenso e a atividade do processo inflamat0rio e a monitorar a evoluo e a resposta terapiutica# + P%4 representa um indicador e"tremamente sensjvel de inflamao aguda, corroborando com o presente estudo# Pm aumento significativo foi observado no grupo lesionado no protocolo de B horas e :? h %omo demonstrado nos nossos resultados do processo inflamat0rio, podemos observar uma reduo do e"travasamento plasmtico, dos njveis de 2F!.^, $1 :, $1 B, $1 :=, da P%4

!31n%$8, N# 3studo %omparativo da 4esposta $nflamat0ria do 2rauma em %irurgias de 4eduo amaria, 2/cnica 2 $nvertido versus 2/cnica por Via +"ilar# !e . Soc. Bras. &ir. Pl3st. ,o Paulo v# :; n# ? mai#/ago#, p# >;.BI ?==?#

%om duJentas mamas operadas de reduo mamria por via a"ilar, com um seguimento de cinco anos, obteve.se um jndice de satisfao maior do aue auando foi utiliJada a t/cnica de 2 invertido ou t/cnica periareolar# !oram obtidas :B= das ?D= amostras de sangue de pacientes operadas de reduo mamria# 8ito pacientes foram operadas pela t/cnica do 2 invertido e oito pacientes operadas pela via a"ilar# 3m oitenta amostras de sangue de > ml de cada grupo de pacientes, foi realiJado um ensaio para deteno de citocinas pro.inflamat0rias no soro: !ator de Fecrose 2umoral )2F!.^- e $nterleucina.:_ )$1.:_-# M se encontra largamente descrito na literatura aue citocinas, principalmente $1. :_ e 2F!.^, constituem um elo de ligao entre a in(oria celular, o reconhecimento do no pr0prio e o desenvolvimento de sinais locais e sistimicos, assim como dos sintomas da inflamao, tais como migrao celular, edema, febre e hiperalgesia )Dinarello :<IB):<-, *op9ins :<<=)?=- e Dinarello :<<B)?:--#Fesse sentido, no presente estudo foram avaliados os njveis s/ricos de 2F!.^ e $1.:_ como possjveis marcadores de maior ou menor in(oria tecidual em dois tipos diferentes de t/cnica cirorgica de reduo mamria: por via a"ilar e pela via mamria )t/cnica do 2 invertido-#

P!O4O&O(O E5PE!%ME64A( !oram estudadas deJoito pacientes do se"o feminino, com idades variando de :I a >? anos, portadoras de hipertrofia mamria, com desconforto pelo peso das mamas e beneficiadas com sua reduo# 8 crit/rio de escolha das pacientes foi aleat0rio# 2odas as pacientes foram submetidas a avaliao pr/.operat0ria por um anestesista, tendo sido realiJados os seguintes e"ames laboratoriais, al/m dos convencionais: dosagem dos agentes inflamat0rios, citocinas, interleucina.:_ e 2F!.^ em todas as pacientes operadas, bem como a anestesia peridural# +s pacientes aceitas no protocolo permaneceram em regime de internamento hospitalar por ;? horas e se submeteram a cinco colheitas de sangue ):> ml de cada veJ, separadas em C amostras acondicionadas em fracos de >ml cada- nos seguintes perjodos: pr/.operat0rio, B horas ap0s a cirurgia, ?D, DI e ;? horas p0s.operat0rio, apro"imadamente, para dosagem de citocinas, interleucina.:_ e 2F!.^# +s dosagens de citocinas foram realiJadas utiliJando.se 9its especjficos para cada citocina# Dessa forma as concentraes de interleucina.:_ )$1.:_- e de !ator de Fecrose 2umoral )2F!.^-, foram determinadas atrav/s de ensaios de 31$,+ especjficos para cada citocina )human interleu9in.:_ . 3nJ'me $mmunoassa' Vit e 2F!.^ human 3nJ'me $mmunoassa' Vit, ambos obtidos da %+N +F %hemical %ompan', +nn +rbor, $ DI:=I P,+-#

!ES7(4A'OS Luanto p dosagem de citocinas: interleucina.:_ e 2F!.^, apenas :B pacientes foram estudadas, oito pela t/cnica a"ilar e oito pela t/cnica do 2 invertido, tendo sido danificadas as amostras de duas pacientes# 3m relao p dosagem de citocinas pro.inflamat0rias, observou.se diferena significante )pb =,=>- entre os njveis de $1.:_ nas pacientes submetidas p cirurgia por via a"ilar e naauelas aue sofreram interveno cirorgica pela t/cnica do 2 invertido, devendo.se registrar aue as primeiras tiveram maiores njveis de $1.: _ aue as segundas# Por outro lado, no foram observadas diferenas significantes entre os njveis de 2F!.^ nos dois grupos de pacientes estudados, muito embora se(a possjvel afirmar aue parece haver uma certa tendincia a elevao dos njveis de 2F!.^ nas pacientes submetidas p t/cnica do 2 invertido, na maioria dos tempos estudados )pr/.cirorgico, ?D, DI e ;? horas p0s.cirorgico-# 8 peaueno nomero de pacientes em cada grupo )n: I-, por certo, pode ter contribujdo para a no significkncia estatjstica#

B+$G+4: http://&&&#sciencedirect#com/science/article/pii/,:=:::CDD=<==:B;> http://&&&#sciencedirect#com/science/article/pii/:=:::CDD<?I==??F