Acta Cirúrgica Brasileira, Volume: 28, Issue: 9, Published: 2013
  • A modified microsurgical model for end-to-side selective portacaval shunt in the rat: intraoperative microcirculatory investigations Original Articles

    Klarik, Zoltan; Toth, Eniko; Kiss, Ferenc; Miko, Iren; Furka, Istvan; Nemeth, Norbert

    Abstract in English:

    PURPOSE: To investigate the intraoperative microcirculatory changes of the affected organs (small bowel, liver and kidney) during the making of a modified selective portacaval (PC) shunt. METHODS: On ten anaesthetized Sprague-Dawley rats the selective end-to-side mesocaval anastomosis was performed, where only the rostral mesenteric vein is utilized and the portal vein with the splenic vein are left intact. Morphometric and microcirculatory investigations using a LDF device determining flux units (BFU) were carried out. RESULTS: After completing the shunts the microcirculatory flux values did not recover in the same manner on the surface of the small intestine, the liver or the kidney. BFU values showed deterioration in the small intestine and in the liver (p<0.001). During the reperfusion the BFU values improved, but not in the same manner. The small intestine values left behind the kidney and liver data. CONCLUSIONS: Technically, the advantages of the models include the selective characteristic, the mesocaval localization and the relatively easy access to those vessels. However, its major disadvantage is the time needed for positioning the vessels without coiling or definitive stretching. Intraoperative LDF may provide useful data on the microcirculatory affection of the organs suffering from hypoperfusion or ischemia during creating the shunts.
  • Biocompatibility of Ferrara intracorneal ring segment with and without chondroitin sulfate coating: clinical and histopathological evaluation in rabbits Original Articles

    Andreghetti, Eduardo; Hashimoto, Mitsuo; Domingues, Maria Aparecida Custódio; Antunes, Vitor Andrigheti Coronado; Segundo, Paulo de Souza; Silva, Maria Rosa Bet de Moraes

    Abstract in English:

    PURPOSE: To investigate and compare the biocompatibility of two types of Ferrara intracorneal ring segment: with and without chondroitin sulfate coating by clinical and histopathological evaluation. METHODS: A randomized experimental study was carried out on thirty right-eye corneas from 30 Norfolk albino rabbits allocated into two experimental groups: Group G1 - implanted with Ferrara intracorneal ring segment without coating (FICRS) and Group G2 - implanted with Ferrara intracorneal ring segment with chondroitin sulfate coating (FICRS-CS). Left eyes formed the control group. Clinical parameters analyzed were: presence of edema, vascularization, infection and ring extrusion one, 30, and 60 days after surgery. Histopathological parameters analyzed were: number of corneal epithelial layers over and adjacent to the ring, presence of spongiosis, hydropic degeneration, basement membrane thinning, inflammatory cells, neovascularization and pseudocapsule formation. RESULTS: At clinical examination 60 days after implant, edema, vascularization and extrusion were observed respectively in 20%, 26.7%, 6.7% of FICRS corneas and in 6.7%, 6.7%, and 0% of FICRS-CS corneas. Histopathological evaluation showed epithelial-layer reduction from 5 (5;6) to 3 (3;3) with FICRS and from 5 (5;5) to 4 (3;5) with FICRS-CS in the region over the ring. Epithelial spongiosis, hydropic degeneration, and basement membrane thinning were present in 69.2%, 53.8%, and 69.2% of FICRS and in 73.3%, 73.3%, and 46.7% with FICRS-CS, respectively. Vascularization was present in 38.5% of FICRS and 13.3% with FICRS-CS, inflammatory cells in 75% of FICRS and 33.3% with FICRS-CS, and pseudocapsule in 66.7% of FICRS and 93.3% with FICRS-CS. Giant cells occurred only in the FICRS-CS group (20%). CONCLUSION: Ferrara intracorneal rings coated with chondroitin sulfate (FICRS-CS) caused lower frequency of clinical and histopathological alterations than Ferrara intracorneal rings without the coating (FICRS), demonstrating higher biocompatibility of the FICRS-CS.
  • Clorhexidine as a factor that promotes peritoneal adhesions in rats with induced peritonitis Original Articles

    Bicalho, Paulo Roberto Rodrigues; Mayrink, Claudio Alvarenga Campos; Fernandes, Fernando; Alvarenga, Daniel Gomes de; Nunes, Tarcizo Afonso; Reis, Fabíola Alves dos; Duval Araújo, Ivana

    Abstract in English:

    PURPOSE: To investigate the effects of chlorhexidine on the formation of adhesions and dilation of the colon at the oral end of anastomosis in the presence of peritonitis. METHODS: Peritonitis was induced in male Wistar rats by cecal ligation and puncture (CLP). Abdominal cavities were irrigated with tepid solutions containing 0.9% saline (SAL group; n=8) or 0.05% chlorhexidine (CHD group; n=8), after which colon anastomoses were performed. Control rats (n=8) were submitted to colon anastomoses but not to CLP. Animals were euthanised seven days after surgery and the incidence of adhesions, the degree of dilation of colon loops and an index were calculated to determine variables correlation. RESULTS: No animals exhibited macroscopic signs of residual peritonitis or abdominal abscesses. Adhesions were observed in 75% of control and 100% of SAL and CHD animals. Dilation of intestinal loops at the oral end of anastomosis was observed in control (50%), SAL (57.2%) and CHD (66.7%) animals. The calculated index was 1.25 in group A; 1.86 in group B; and 2.0 group C. CONCLUSION: Chlorhexidine promoted stronger adhesions and a greater dilatation of colonic loops than control group.
  • Superoxid dismutase activity in portal vein endothelium after partial liver resection Original Articles

    Sayão Filho, Rogério Heggendorn; Perini, Marcos Vinicius; Cruz, José Arnaldo; Requena, Juliana; Barbeiro, Hermes Vieira; Molan, Nilza Trindade; Lopasso, Fabio Pinatel; D'Albuquerque, Luiz Augusto Carneiro; Cecconello, Ivan

    Abstract in English:

    PURPOSE: To investigate superoxide dismutase (SOD) activity in the portal vein endothelium and malondialdehyde acid (MDA) production in liver tissue of rats submitted to 70% hepatectomy. METHODS:Twelve rats were distributed in two groups (hepatectomy and sham). Animals were sacrificed on post operative day 1 and portal vein, liver tissue and blood samples were collected. Portal vein SOD production was measured using lucigenin-amplified chemiluminescence assays. MDA measurement was used as an index of oxidative stress through the formation of TBARS (Thiobarbituric Acid Reactive Species). RESULTS: There was no difference in post operative bilirrubin, AST, ALT levels between groups. DHL level was higher in the hepatectomy group (p=0.01). MDA production in the remnant liver tissue and endothelial portal vein SOD activity were also significantly (p<0.05) elevated in the hepatectomy group when compared to control group. There was no correlation between MDA and SOD activity. SOD activity, on the other hand, showed a positive correlation with LDH level (p=0.038) and MDA levels showed a positive correlation with AST and ALT levels (p<0.001). CONCLUSION: There is an increased production of malondialdehyde acid in liver tissue after partial hepatectomy and increased activity of superoxide dismutase in portal vein endothelium as well.
  • Effect of chronic stress in newborn rats on the progression of ligature-induced-periodontitis in adulthood Original Articles

    Semenoff, Tereza Aparecida Delle Vedove; Rosa Júnior, Aurélio; Borges, Álvaro Henrique; Porto, Alessandra Nogueira; Caporossi, Cervantes; Semenoff Segundo, Alex

    Abstract in English:

    PURPOSE: To investigate the effect chronic stress in newborn rats on the progression of ligature-induced-periodontitis in adulthood. METHODS: Ten couples of adult Wistar rats were selected for mating. After birth, the female and their respective offsprings were allocated into two groups. Ligature Group (LG): offsprings were only watched during breast-feeding; Stress-ligature Group (SLG): after 24h of live birth, the offsprings were moved away from their mothers every day for four hours during breast-feeding for 20 days; in both approaches, after reaching ± 250g, ten rats were included in the groups. Periodontal disease was induced by a silk suture placed around the maxillary right second molar. The left side was used as control. After 15 days, the animals were subjected to euthanasia, maxillary bones were removed and stored in 10% formaldehyde. After 48h, radiographs were taken and revealed and were used for bone destruction analysis. Examiner was blind and calibrated for measurements. RESULTS: Stress-ligature group presented higher bone loss values in relation to ligature group (p<0.05). CONCLUSION: Exposure to chronic stress imposed on offsprings produced a greater progression of bone loss induced during adulthood.
  • Study of hepatocellular function in the murine model following hepatic artery selective clamping Original Articles

    Tralhão, José Guilherme; Abrantes, Ana Margarida; Gonçalves, Ana Cristina; Hoti, Emir; Laranjo, Mafalda; Martins, Ricardo; Oliveiros, Bárbara; Cardoso, Dulce; Sarmento-Ribeiro, Ana Bela; Botelho, Maria Filomena; Castro-Sousa, Francisco

    Abstract in English:

    PURPOSE: To investigate the impact of selective hepatic artery clamping (SHAC) in hepatocellular function. METHODS: Three groups of Wistar male rats were subjected to SHAC ischemia period of 60min: Group A continuous SHAC were subjected to SHAC ischemia period of 60min, Group B intermittent SHAC of 30min with 5min of reperfusion and Group C intermittent SHAC of 15min with 5min of reperfusion. Animals without SHAC were included-Group D. To evaluate hepatocellular function blood markers and hepatic extraction function (HEF) using 99mTc-mebrofenin were performed before and after surgery. Flow cytometry was used to analyze oxidative stress and cell viability. RESULTS: A mortality rate of 7.6% in Group A was observed. HEF maintained normal values between the groups. Flow cytometry demonstrated no significant differences between the groups in viability, type of cell death as well as in the production of reactive oxygen species. CONCLUSIONS: The selective hepatic artery clamping compared to other clamping techniques results on increased cell viability and decreased hepatocyte death. The SHAC is a potential alternative to decrease per-operative bleeding while maintaining hepatocellular function.
  • Effect of Brassica oleracea in rats skin wound healing Original Articles

    Rebolla, Aline; Arisawa, Emilia Angela Lo Schiavo; Barja, Paulo Roxo; Posso, Maria Belén Salazar; Carvalho, Carolina da Silva

    Abstract in English:

    PURPOSE: To investigate the effect of Brassica oleracea herbal balsam on the healing of skin wounds in rats. METHODS: Twenty four rats (Wistar, 60 days, 250 g) were divided into four groups: untreated animals (C) and treated with the ointment (T), subdivided into two experimental times (seven and 16 days). A 3cm² skin wound was made in the back of all animals. 100 ml of the Brassica oleracea was applied twice a day in T group. Biometric analysis was made with images captured at one, four, seven, ten, 13, and 16 days. At seven and 16 days, animals of each group were euthanized. The wound area removed was processed for histological and histomorphometric analysis to quantify birefringent collagen fibers. Statistical analysis was made considering p < 0.05 as significant. RESULTS: Biometric analysis revealed no significant differences between groups in both experimental times studied. However, histomorphometric analysis showed that the number of type I collagen fibers was significantly higher in the specimens of the group T16 compared to the other groups. CONCLUSION: Brassica oleracea accelerated the wound healing process increasing the number of type I collagen fibers and the maturity of the newly formed tissue.
  • The effect of carbon dioxide pneumoperitoneum on the healing colonic anastomosis in rats Original Articles

    Durães, Leonardo de Castro; Farias, Igor Eduardo Caetano de; Morais, Pedro Henrique Alves de; Oliveira, Paulo Gonçalves de; Cavalcanti Neto, Florêncio Figueiredo; Lino Junior, Ruy Souza; Feres, Omar; Sousa, João Batista de

    Abstract in English:

    PURPOSE: To investigate the effects of pneumoperitoneum on colonic anastomosis healing. METHODS: Colonic anastomosis was performed in 120 rats divided into four groups: Group I - pneumoperitoneum before laparotomy, Group II - pneumoperitoneum after laparorrhaphy, Group III - pneumoperitoneum before laparotomy and after laparorrhaphy, Group IV - no pneumoperitoneum (control group). Pneumoperitoneum pressure was 5 mmHg. Animals were killed on the 3rd, 7th and 14th postoperative day. Hhistopathological features, anastomosis breaking strength, collagen histomorphometry and hydroxyproline concentration were assessed. RESULTS: Breaking strength between groups: (day 3, p=0.165; day 7, p=0.219; day 14, p=0.539). Histopathology revealed that group II had, on day 7, less infiltration of mononuclear cells (p=0.006), greater infiltration of polymorphonuclear cells (p=0.001) and greater necrosis (p=0.001); and on day 14, less fibrosis. Histomorphometry revealed a decrease in collagen in groups I and III (p<0.001) on day 7 and an increase in groups I and II on day 14 (p<0.001). Hydroxyproline concentration was similar for groups on days 3 (p=0.152), 7 (p=0.913) or 14 (p=0.981). CONCLUSION: Carbon dioxide does not impair the healing of colonic anastomosis in rats.
  • Immediate graft histological assay, post pig's liver transplantation Original Articles

    Brito, Marcus Vinicius Henriques; Araújo, Marialva Tereza Ferreira de; Cunha, Luane Cristine Batista; Oliveira, Antônio Jorge Barbosa de; Rodrigues, Jacqueline Barreto; Brito, Nathalya Botelho

    Abstract in English:

    PURPOSE: To describe the vascular and tissue histopathological changes in seven sequential experimental liver transplantations in pigs. METHODS: Fourteen female pigs, Sus domesticus species, with body mass between 5 and 8 kg were utilized. After the end of all anastomoses of the graft implantation in the receptor, the animal was monitored for 30 minutes, and at its end one of the biopsies was collected for histological analysis. The histological criteria utilized were: lytic hepatocyte necrosis, density of septal and portal inflammatory infiltrated, sinusoidal congestion and hemorrhage. The analysis was performed separately for the portal region in zone 1, 2 and 3. RESULTS: Among the structural changes undergone by the graft, those with greater frequency and intensity were vascular congestion and steatosis, which stood out in transplantations 5, 6 and 7. CONCLUSIONS: The technique demonstrated vascular alterations represented by vasocongestion, edema and minimum inflammatory reaction. In relation to the parenchyma, was observed macrovacuolar pan-acinar steatosis, focal lytic and occasional hemorrhages, beyond the accumulation of hemosiderin in Kuppfer's cells.
  • Virtual planning and construction of prototyped surgical guide in implant surgery with maxillary sinus bone graft Original Articles

    Martins, Renato Jahjah Cunha; Lederman, Henrique Manoel

    Abstract in English:

    PURPOSE: To evaluate the efficacy of associating techniques of bone grafting in the maxillary sinus with the use of a prototyped surgical guide for planning and positioning dental implants in total edentulous maxillae, rehabilitated after six months. METHODS: Eight patients consecutives with totally edentulous maxilla presenting few remaining bone in the posterior alveolar ridge, associated with pneumatization of the maxillary sinus were selected. Twenty eight Brånemark RP 10mm implants were installed in 14 maxillary sinuses. The surgical planning for the implant installation was performed with the DentalSlice software by means of a computerized tomography. The obtained images were used for building a surgical guide that, placed over the maxilla, showed the exact position for the implants installation (prototyped surgical guide). The portion of the implants that went into the maxillary sinus was covered by an autogenous bone graft. RESULTS: The patients were re-evaluated six months after the surgery and a 100% success rate was achieved. All of the implants presented no mobility or symptoms, permitting an oral rehabilitation with total fixed screw-retained prosthesis over the implants. CONCLUSION: The technique of associating implants and bone graft in the maxillary sinus aided by a prototyped guide planned on DentalSlice has showed itself efficient for positioning implants and for quantifying and locating the bone graft.
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