Acta Cirúrgica Brasileira, Volume: 31, Issue: 4, Published: 2016
  • Ultrasound and gross anatomy of the brachial plexus and major nerves of the forelimb. An anesthetic approach using the domestic rabbit (Oyctolagus cuniculus) as an experimental model1 Original Article

    Mencalha, Rodrigo; Sousa, Carlos Augusto dos Santos; Costa, Orlando; Abidu-Figueiredo, Marcelo

    Abstract in English:

    PURPOSE: To update the gross and sonographic anatomy and propose landmarks to perform ultrasound-guided (US-guided) axillary brachial plexus block (BPB) in rabbits. METHODS: Forty New Zeeland's rabbit (NZR) cadavers were dissected and the nerves were trimmed, identified, measured, and photographed. Additionally, in twenty NZRs, sonographic images of brachial plexus (BP) were performed through a simple-resolution ultrasound device. The US-guided block was achieved through a minimum volume of lidocaine necessary to surround the BP roots. The effectiveness of the brachial plexus block was assessed on sensitivity and motor functions. RESULTS: The BP resulted from connections between the ventral branches of the last four cervical spinal nerves and the first thoracic spinal nerve. In the axillary sonoanatomy, the BP appeared as an agglomerate of small, round hypoechoic structures surrounded by a thin hyperechoic ring. The amount of time and the minimum volume required to perform was 4.3 ± 2.3 min and 0.8 ± 0.3ml, respectively. CONCLUSIONS: The gross and sonographic anatomy of the BP showed uncommon morphological variations. Moreover, from sonographic landmarks, we showed complete reproducibility of the axillary US-guided brachial plexus block with simple resolution equipment and small volume of anesthetics required.
  • Evaluation of peritoneal endometriosis treatment using intralesional acetylsalicylic acid injection in rabbits Original Article

    Saad-Hossne, Rogério; Barretto, Adriana Beatriz; Siqueira, Juliana Menezes; Denadai, Rafael

    Abstract in English:

    PURPOSE: To investigate the efficacy of intralesional 20% aspirin injection for treatment of experimental peritoneal endometriosis. Methods: Peritoneal endometriosis was experimentally induced in forty adult nulligravid female rabbits. On day 30 post-endometriosis induction, rabbits were randomly divided to assess early (10 days) and late (20 days) effects of intralesional injection of physiological saline solution (control groups) in comparison to intralesional injection of 20% bicarbonate aspirin solution (experimental groups) as follows: control group 1 (10 days, n=10); control group 2 (20 days, n=10); experimental group 3 (10 days, n=10); experimental group 4 (20 days, n=10). Resected tissues, including endometriosis foci, were qualitatively (general morphology and signs of inflammatory cells infiltrate, necrosis and apoptosis) and quantitatively (remaining endometriosis area) assessed by histopathological analysis. Results: Extensive necrosis, hemorrhage, apoptosis, and fibrosis were observed in the experimental groups 3 and 4. Groups 1 and 2 presented typical endometrial tissue cysts, respectively. Groups 3 and 4 showed sparse endometrial tissue foci and no endometrial tissue, respectively. Quantitative analysis revealed that aspirin-treated groups 3 and 4 had significantly (p<0.05) smaller remaining endometriosis area, compared to control groups 1 and 2. Conclusion: Intralesional 20% aspirin injection caused total destruction of peritoneal endometriosis foci in rabbits.
  • Evaluation of diaphragmatic mobility following intra-abdominal sub-diaphragmatic fixation of a double-layered mesh in rats Original Articles

    Ioannis, Tzanoglou; George, Sakorafas; Nikolaos, Kostomitsopoulos; George, Mantziaras; Charalampos, Patraleksis; Nikolaos, Danias; Spyridon, Stergiopoulos; Michael, Safioleas

    Abstract in English:

    PURPOSE: To evaluate the tissue integration of a double-sided mesh after fixation in diaphragm and to study the diaphragmatic mobility by ultrasound. METHODS: Twenty male Wistar rats were used. The animals were assigned into two equal groups according to the day of euthanasia. The animals were anesthetized and a 1.5 x 1.5 cm of double-layer mesh was inserted between the diaphragm and the liver. For the evaluation of the diaphragm mobility a sonographic method was used. Measurements on specific breathing parameters were taking place. Pathological evaluation took place after the animal's euthanasia. RESULTS: Extra-hepatic granuloma was not differentiated overtime, (χ2=0.04, p>0.05). Neither fibrosis was significantly differentiated, (χ2=0.04, p>0.05). Intra-hepatic granuloma was significantly differentiated overtime, (χ2=10.21, p<0.05). Concerning Te parameter, means were significantly differentiated over time, F (3, 30) = 5.12, (p<0.01). Ttot parameter, it was differentiated over time, F (3, 8)=4.79, (p<0.05). IR parameter was also longitudinally differentiated, F (3, 30)=3.73, (p<0.05). CONCLUSION: The measurements suggest a transient malfunction of diaphragmatic mobility despite the fact that inflammatory reaction, fibrosis and extra-hepatic granuloma were not significantly differentiated with the passage of time.
  • The effects of aqueous extract of babassu (Orbignya phalerata) on the pleura and lung parenchyma in rats Original Articles

    Amorim, Elias; Saad Junior, Roberto; Salgado Filho, Natalino; Melo, George Castro Figueira de; Silva, Gyl Eanes Barros; Santos, Rennan Abud Pinheiro; Marchi, Danilo Dallago de; Carli, Ricardo Comunello de; Malafaia, Osvaldo; Ribas-Filho, Jurandir

    Abstract in English:

    PURPOSE: To evaluate macro and microscopically, changes following the use of the aqueous extract of babassu (Orbignya phalerata) in the lung parenchyma and pleura of rats. METHODS: Sixty adult male rats with average weight of 350 g, were randomized into two groups of 30 animals (experimental and control) further divided into sub-groups of 10 to be sacrificed at 48 h, 72 h and 21 days. The substance was injected into the right pleura of the animals. RESULTS: There was intense pleuropulmonary macroscopic reaction with statistically significant differences between groups respectively (p<0.05, p<0.02, p<0.03). Microscopically, no statistically significant difference was evident (p>0.05). CONCLUSION: The aqueous extract of babassu (Orbignya phalerata) was found to be highly irritating to the pleura and lung of rats, evidenced macroscopically by numerous adhesions and inflammation while no major changes were evident microscopically.
  • The effects of low level laser therapy on Staphylococcus aureus infected third-degree burns in diabetic rats Original Articles

    Ranjbar, Reza; Takhtfooladi, Mohammad Ashrafzadeh

    Abstract in English:

    PURPOSE: To characterize the effects of low-level laser (LLL) on third-degree burn wounds which were infected with Staphylococcus aureus (S. aureus) in diabetic rats. METHODS: Thirty streptozotocin-induced diabetic rats were divided into two groups: the control and the LLL groups. Third-degree burns were induced using a heated metal rod, and then, were contaminated with S. aureus. The wounds in the LLL group were irradiated with a LLL (685nm) daily for five consecutive days, starting three days after the induction. The wound area was measured at 3, 5, 8, 14 and 21 days after burning. At the end of trial, the skin samples were harvested. RESULTS: Reduction in wound areas in the LLL and control groups were significantly different only on the 21st day (p<0.05). The mean bacterial numbers in the LLL group were significantly lower (p<0.05) than those in the control group. The number of macrophages, new blood vessels, fibroblast, and elevated collagen deposition in the LLL group significantly increased compared to the control group (p<0.05). The mean breaking strength of scars in the control group was significantly lower (p<0.05) than that of the LLL group. CONCLUSION: The low-level laser improved the healing of S. aureus third-degree burn infections in diabetic rats.
  • Medical ozone treatment ameliorates the acute distal colitis in rat Original Articles

    Aslaner, Arif; Çakır, Tuğrul; Tekeli, Seçkin Özgür; Avcı, Sema; Doğan, Uğur; Tekeli, Feyza; Soylu, Hakan; Akyüz, Cebrail; Koç, Süleyman; Üstünel, İsmail; Yılmaz, Necat

    Abstract in English:

    PURPOSE: To investigate the effect of medical ozone treatment on the experimental acute distal colitis in rats. METHODS: Eighteen rats were randomly distributed into three equal groups; control, acute distal colitis (ADC) without and with medical ozone treatment. Rats in the control group were taken saline. ADC was performed by rectal way with 4% acetic acid in groups 2 and 3, and the group 3 was treated with medical ozone for three weeks both rectally and intraperitoneally. At the twenty second day the distal colons samples were obtained for malondialdehyde and myeloperoxidase, blood samples were obtained to measure the levels of TNF-α and IL-1β levels. Histolopatological examination was evaluated with Ki-67, IL-1β and VEGF immunostaining densities. RESULTS: There was significant increase in tissue MDA, MPO activity, TNF-α and IL-1β after ozone administration. There was also a significant difference at immunostaining densities of histopathological examination. CONCLUSIONS: Medical ozone treatment ameliorated the experimental acute distal colitis induced by acetic acid in rats. Its possible effect is by means of decreasing inflammation, edema, and affecting the proliferation and the vascularization.
  • Antioxidant effect of Legalon(r) SIL in ischemia-reperfusion injury of rat skeletal muscle Original Articles

    Ergün, Yusuf; Üremiş, Muhammed; Kılınç, Metin; Alıcı, Tuğrul

    Abstract in English:

    PURPOSE: To evaluated the potential antioxidant agent Legalon (r) SIL (silibinin-C-2',3-bis(hydrogensuccinat)) in the skeletal muscle of rats. METHODS: IRI was achieved via tourniquet application in Wistar-albino rats. Experimental groups were chosen as (i) sham control, (ii) IRI (3+2 h), (iii) IRI and Legalon (r) SIL-50 (50 mg/kg/i.p.), (iv) IRI and Legalon (r) SIL-100 (100 mg/kg/i.p.), and (v) IRI and Legalon (r) SIL-200 (200 mg/kg/ i.p.). Muscle viability (evaluated by triphenyltetrazolium chloride dye method), malondialdehyde, superoxide dismutase, catalase, and glutathione peroxidase were assessed in muscle samples using a spectrophotometer. RESULTS: Although viability of the injured limb non-significantly declined in the IRI group, administration of Legalon (r) SIL did not prevent injury. However, dramatic increase observed in malondialdehyde levels in the IRI group was prohibited by Legalon (r) SIL in a statistically significant manner. In comparison with the sham-control group, IRI and Legalon (r) SIL administration did not cause any significant alterations in the levels of superoxide dismutase, catalase, and glutathione peroxidase. CONCLUSION: Although Legalon (r) SIL was not sufficient to prevent muscle injury in terms of viability, it is found to be an effective option to reduce reactive oxygen species-induced cell injury.
  • Effects of thymoquinone against cisplatin-induced cardiac injury in rats Original Articles

    Adalı, Fahri; Gonul, Yucel; Kocak, Ahmet; Yuksel, Yasemin; Ozkececi, Gulay; Ozdemir, Cigdem; Tunay, Kamil; Bozkurt, Mehmet Fatih; Sen, Ozlem Gulec

    Abstract in English:

    PURPOSE: T o investigate the possible protective effect of thymoquinone (TQ) in cisplatin (CP) induced myocardial injury. METHODS: A total of 28 adult male Wistar-Albino rats were randomly and equally divided into four groups as follows: Group 1 (control), Group 2 (CP at 15 mg/kg dose), Group 3 (TQ 40 mg/kg/day for two days prior to CP injection and on third day, CP at 15 mg/kg dose was intraperitoneally administered and TQ treatment continued until fifth day) and Group 4 (TQ at 40mg/kg/day dose for five days). RESULTS: There was a significant increment in CP group in terms of congestion, edema and pycnotic nuclei in myocardial fibers, comparing with other groups. TQ group exhibited significant increase in expression of antiapoptotic protein Bcl-2, comparing with CP group (p<0.05). In only CP administered group, expression of antiapoptotic protein Bcl-2 was lowest comparing with other groups. CONCLUSION: Established data indicate that cisplatin is cardiotoxic and thymoquinone may be useful in treating CP-induced cardiac injury.
  • Sex differences on solid organ histological characteristics after brain death1 Original Articles

    Simão, Raif Restivo; Ferreira, Sueli Gomes; Kudo, Guilherme Konishi; Armstrong Junior, Roberto; Silva, Luiz Fernando Ferraz da; Sannomiya, Paulina; Breithaupt-Faloppa, Ana Cristina; Moreira, Luiz Felipe Pinho

    Abstract in English:

    PURPOSE: To investigate gender differences in the evolution of the inflammatory process in rats subjected to brain death (BD). METHODS: Adult Wistar rats were divided into three groups: female; ovariectomized female; and male rats. BD was induced using intracranial balloon inflation and confirmed by maximal pupil dilatation, apnea, absence of reflex, and drop of mean arterial pressure. Six hours after BD, histological evaluation was performed in lungs, heart, liver and kidneys, and levels of inflammatory proteins, estrogen, progesterone, and corticosterone were determined in plasma. RESULTS: In the lungs, females presented more leukocyte infiltration compared to males (p<0.01). Ovariectomized female rat lungs were more hemorrhagic compared to other groups (p<0.001). In the heart, females had higher leukocyte infiltration and tissue edema compared to males (p<0.05). In the liver and kidneys, there were no differences among groups. In female group estradiol and progesterone were sharply reduced 6 hours after BD (p<0.001) to values observed in ovariectomized females and males. Corticosterone levels were similar. CONCLUSIONS: Sex hormones influence the development of inflammation and the status of organs. The increased inflammation in lungs and heart of female rats might be associated with the acute reduction in female hormones triggered by BD.
  • Effect of letrozole in carcinogen-plus-estrogen-induced endometrial hyperplasia in mice Original Articles

    Lara, Alessandra Cerávolo; Cândido, Eduardo Batista; Vidigal, Paula Vieira; Rocha, Ana Luiza Lunardi; Carvalho-Macedo, Alessandra Costa; Carneiro, Márcia Mendonça; Silva-Filho, Agnaldo Lopes

    Abstract in English:

    PURPOSE: To evaluate the effects of letrozole (Ltz) in carcinogen+estrogen-induced endometrial hyperplasia. METHODS: BALB/c female mice were divided into four groups of 12 animals each receiving an intrauterine dose of N-ethyl-N-nitrosourea (ENU) and weekly subcutaneous injections of estradiol hexaidrobenzoate (EHB), except for group I(control). The groups were divided in I (control), II (ENU+EHB), III (ENU+EHB+MPA) and IV (ENU+EHB+Ltz). Group III also received intramuscular injections of MPA (medroxy progesterone acetate) every four weeks, while group IV received oral doses of Ltz daily. At the end of 16 weeks, the animals were sacrificed, and blood samples were collected for the measurement of serum estradiol and progesterone levels. Uterine histological sections were made to evaluate the presence of endometrial proliferative lesions. Differences between groups were evaluated with student's t test, ANOVA and chi-square test. RESULTS: Groups ENU+EHB, ENU+EHB+MPA and ENU+EHB+Ltz showed varying degrees of endometrial hyperplasia. The incidence of hyperplasia in groups ENU+EHB and ENU+EHB+Ltz was higher and more severe than in group ENU+EHB+MPA. Control group showed lower levels of serum estradiol than the other groups. CONCLUSION: There was no evidence that letrozole could act as an antiestrogenic drug in the development of endometrial proliferative lesions.
  • Erratum Erratum

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