AgradecimientosLlegando al final del camino, uno se pregunta si ha valido la pena el tiempo y esfuerzo invertido y la respuesta es sí. Desde aquel primer día que empecé esta aventura, hasta el último de ellos, ésta ha sido, sin duda, la experiencia más enriquecedora de mi vida. Todo lo aprendido y todo vivido, son cosas que formarán parte de mí y que siempre recordaré con especial alegría.El trabajo que hay en estas páginas no es algo individual, pues debo dar las gracias a todas las personas que han influido en él en mayor o menor medida. Ha sido mucha la gente que he tenido el placer de conocer durante estos años y que no han dejado de sorprenderme día a día, empezando por mis dos directores de tesis, Carlos y María José, que han sido mis maestros durante estos años y con los que siempre estaré en deuda por todos los consejos y ayuda que me han aportado, no sólo en el ámbito académico. Pero, sobre todo, por la paciencia que han demostrado en muchas de las discusiones que hemos tenido.Muchísimas gracias a mis compañeros de trabajo con los que he compartido tantos momentos y anécdotas: Rober, Fer, Sandra, Eliseo, Juanjo, Pablo, Álex y, especialmente, a mi segundo de a bordo y amigo Fran, por la ayuda y consejos que han sido cruciales para que esta tesis saliera adelante.I would also like to thank Andrew Maidment and, specially, Predrag Bakic for his enthusiastic support this last year and during my stay at the University of Pennsylvania. I could have never thought in a better place to stay.Finalmente, gracias a mis padres Marina y Jesús y a mi hermano Óscar, además de todos los amigos, viejos y nuevos, que han visto como aquella decisión que hizo que me dedicara a la investigación ha dado por fin sus frutos. Una carrera investigadora que no sé a dónde me llevará a partir de ahora. Es un emocionante misterio, el no saber qué me deparará el futuro, que me intriga y estoy deseando descubrir.That quite definitely is the answer. I think the problem, to be quite honest with you, is that you've never actually known what the question is.Deep Thought, The Hitchhiker's Guide to the Galaxy Douglas Adams AbstractThe characterization of the mechanical behavior of soft living tissues is a big challenge in Biomechanics. The difficulty arises from both the access to the tissues and the needed manipulation in order to know their physical properties. Currently, the biomechanical characterization of organs is mainly performed by testing ex-vivo tissue samples or by means of indentation tests. In the first case, the obtained behavior does not represent the real response of the organ. In the second case, it is only a representation of the mechanical response of the indented areas. The purpose of the research reported in this thesis is the development of a methodology for the in-vivo characterization of the biomechanical behavior of two different organs: the breast and the cornea. The proposed methodology allows the in-vivo characterization of their biomechanical behavior using medical images.The research reported in this thesis desc...

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Introduction: Redo retroperitoneal lymph node dissection (Redo surgery) for the treatment of germ cell tumors (GCTs) is an uncommonly performed procedure. We describe clinical characteristics and outcome of patients disease requiring redo surgery for recurrence or residual retroperitoneal disease. Materials and methods: INCan (Instituto Nacional de Cancerologia) germ cell tumor surgical database was reviewed from January 2007 to December 2012 and clinical features of patients subjecting to re-operative retroperitoneal surgery (Redo surgery) for GCTs were individualized. Preoperative evaluation, histopathology, morbidity, and technical aspects of this procedure, which is a critical part of the management of GCT, are described. Disease-specific survival was estimated using the Kaplan-Meier method. Results: A total of 20 patients were identified who underwent 27 Redo surgery, after post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND). The most common sites of disease in the Redo surgery were para-aortic region. The most frequent histologic finding at time of Redo surgery was teratoma. The median interval to Redo surgery was 12months (P25 8.5-P75 14.75). The overall Intraoperative complication rate was 18% and median length of hospital stay was 3days. The 5-year diseasespecific survival rate was >55%. Disease-specific mortality for patients underwent to Redo surgery was 40% (n=8). Conclusion: Redo surgery is integral component of management of GCTs in cases of retro peritoneum recurrences of failures; it is the last opportunity for cure. Clinical outcomes after repeating retroperitoneal surgery depend on re operative histology.

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