Acta Cirúrgica Brasileira, Volume: 36, Issue: 6, Published: 2021
  • Locking compression plate fixation of critical-sized bone defects in sheep. Development of a model for veterinary bone tissue engineering ORIGINAL ARTICLE

    Marcondes, Geissiane de Moraes; Paretsis, Nicole Fidalgo; Souza, Anderson Fernando de; Ruivo, Maria Raquel Bellomo Agrello; Rego, Mário Antônio Ferraro; Nóbrega, Fernanda Silveira; Cortopassi, Silvia Renata Gaido; De Zoppa, André Luis do Valle

    Abstract in English:

    ABSTRACT Purpose To develop a segmental tibial bone defect model for tissue engineering studies in veterinary orthopedics using single locking compression plate (LCP) fixation and cast immobilization. Methods A 3-cm bone defect was created in the right tibia of 18 adult Suffolk sheep. A 10-hole, 4.5-mm LCP was applied to the dorsomedial aspect of the bone. Four locking screws were inserted into the proximal and three into the distal bone fragment. Operated limbs were immobilized with casts. Animals were submitted to stall rest, but were allowed to bear weight on the operated limb. During the recovery period, animals were checked daily for physiological parameters, behavior and lameness. Follow-up radiographs were taken monthly. Results Surgical procedures and postoperative recovery were uneventful. Animals adapted quickly to casts and were able to bear weight on the operated limb with no signs of discomfort or distress. No clinical or radiographic complications were detected over a 90-day follow-up period. Conclusions Surgical creation of tibial segmental bone defects followed by fixation with single LCP and cast immobilization was deemed a feasible and appropriate model for veterinary orthopedic research in tissue engineering.
  • Thoracic aortic aneurysm. An experimental model in pigs ORIGINAL ARTICLE

    Argenta, Rodrigo; Perini, Sílvio César; Pereira, Adamastor Humberto

    Abstract in English:

    ABSTRACT Purpose To describe an unpublished experimental model of descending thoracic aortic aneurysm in pigs. Methods Ten Landrace female pigs aged 10 to 12 weeks old and with initial weights from 17 to 25 kg were anesthetized and their descending thoracic aortas exposed by fifth intercostal space left thoracotomy. The thoracic aorta was isolated. A 2-cm wide × 2-cm long patch of ready-made bovine pericardium was sewn onto the left anterolateral side of the aorta. After three weeks’ follow-up, a control aortography was taken, and the animals were euthanized. The segment of thoracic aorta containing the aneurysm and the adherent tissues were explanted en bloc. The specimens were stained for histological examination. Results One hundred percent of the animals survived the procedure, and after sacrifice a patent aneurysm was observed in all of them. There were no defects on the suture lines. Weight gain during follow-up was normal. All specimens exhibited intense adventitial reaction with myofibroblasts. There were no complications related to the thoracotomy. Conclusions The descending thoracic aortic aneurysms induced experimentally appear to be stable, were of easy execution, with null mortality and no influence on the animals’ normal development. Furthermore, they have similar characteristics to those observed in human degenerative aneurysms.
  • Effect of S53P4 bioactive glass and low-level laser therapy on calvarial bone repair in rats submitted to zoledronic acid therapy ORIGINAL ARTICLE

    Bellato, Caio Peres; Oliveira, Danilo Louzada de; Kasaya, Marcus Vinicius Satoru; Moreira, David; Cini, Marcelo Augusto; Saraiva, Patricia Pinto; Gulinelli, Jéssica Lemos; Santos, Pâmela Leticia

    Abstract in English:

    ABSTRACT Purpose To evaluate the influence of bioactive glass and photobiomodulation therapy (PBMT) in calvarial bone repair process in rats submitted to zoledronic acid therapy. Methods Twenty-four rats were selected and treated with the dose of 0.035 mg/kg of zoledronic acid every two weeks, totalizing eight weeks, to induce osteonecrosis. After the drug therapy, surgical procedure was performed to create 5-mm diameter parietal bone defects in the calvarial region. The rats were then randomly assigned to groups according to the following treatments: AZC: control group, treated with blood clot; AZBIO: bone defect filled with bioactive glass; AZL: treated with blood clot and submitted to PBMT; and AZBIOL: treated with bioactive glass S53P4 and submitted to PBMT. Tissue samples were collected and submitted to histomorphometric analysis after 14 and 28 days. Results At 14 days, bone neoformation in the AZBIO (52.15 ± 9.77) and AZBIOL (49.77 ± 13.58) groups presented higher values (p ≤ 0.001) compared to the AZC (23.35 ± 10.15) and AZL groups (23.32 ± 8.75). At 28 days, AZBIO (80.24 ± 5.41)still presented significant higher bone recovery values when compared to AZC (59.59 ± 16.92)and AZL (45.25 ± 5.41) groups (p = 0.048). In the 28-day period, the AZBIOL group didn’t show statistically significant difference with the other groups (71.79 ± 29.38). Conclusions The bioactive glass is an effective protocol to stimulate bone neoformation in critical defects surgically created in rats with drug induced osteonecrosis, in the studied periods of 14 and 28 days.
  • Cervical ventral slot in rabbits (Oryctolagus cuniculus). Piezosurgery versus conventional technique ORIGINAL ARTICLE

    Roscamp, Marcelo; Hataka, Alessandre; Zambon, Frederico Carlini; Ferreira, Danyelle Rayssa Cintra; Minto, Bruno Watanabe; Dias, Luis Gustavo Gosuen Gonçalves

    Abstract in English:

    ABSTRACT Purpose To investigate the applicability of piezosurgery for cervical ventral slot (CVS), comparing it with the conventional technique of using high-speed burs for bone wear. Methods Thirty rabbits (Oryctolagus cuniculus) were divided into two treatment groups (T1 and T2) corresponding to CVS between C3-C4. In T1, the surgery was performed with piezoelectric apparatus, and in T2 with high-speed burs. The evaluated parameters were: duration of each stage of surgery, temperature variations during CVS, visibility of the surgical field, intra and postoperative complications, and anesthetic monitoring. At 14, 28, and 56 postoperative days, five animals from each treatment group were submitted for histopathological study of the surgical site. Results Compared with T2, T1 had more precise bone cut, and better visibility of the operative field, although it required longer total surgical time (p = 0.02) and triggered a greater number of intraoperative complications (p < 0.01), microscopic lesions in the spinal cord (p < 0.05), and transient neurological deficits in the postoperatively (p < 0.05). Conclusions It is necessary to perform surgical planning and have several tips of the piezoelectric instrument available for the safe use of the piezoelectric device in neurosurgery.
  • Platelet-concentrated and platelet poor-plasma promote different pattern on immunohistochemical expression of TGF-β1, however they impairs the osteoneogensis in calvarial defects treated with autograft due suppression of osteocalcin ORIGINAL ARTICLE

    Oliveira-Filho, Marco Antonio de; Souza, Marcelo; Tabushi, Fernando Issamu; Almeida, Luís Eduardo; Figueiredo, Fernanda Pirajá; Lourenço, Elora Sampaio; Giovanini, Allan Fernando; Malafaia, Osvaldo; Ribas Filho, Jurandir Marcondes

    Abstract in English:

    ABSTRACT Purpose Herein we evaluated the effects of platelet concentrate (PC) and platelet-poor plasma (PPP) on bone repair using noncritical defects in the calvaria of rabbits and compared them to the presence of TGF-β1 and osteocalcin on reparative sites. Methods Five noncritical defects of 8.7 mm in diameter were created on the calvaria of 15 animals. Each defect was treated differently, using autograft (ABG), ABG associated with PC (ABG + PC), ABG with PPP (ABG + PPP), isolated PPP, and blood clot (control). The animals were submitted to euthanasia on the second, fourth and sixth week post-surgery. Results The defects that received ABG+PC or PPP demonstrated lower bone formation when compared to specimens that received ABG in the same period. These results coincided to significant higher immunopositivity for TGF-β1 for specimens that received PC, and lower presence of cytokine in the group PPP. However, either higher or lower presence of TGF-β1 were also correlated to lower presence of osteocalcin. Likewise, these results were similar to findings in specimens treated only with PPP when compared to control. Conclusions PC and PPP were not effective when applied in association with ABG. Similarly, isolated use of PPP was not beneficial in optimizing the bone repair.
  • Comparison of two different biomaterials in the bone regeneration (15, 30 and 60 days) of critical defects in rats ORIGINAL ARTICLE

    Brassolatti, Patricia; Bossini, Paulo Sérgio; Andrade, Ana Laura Martins de; Luna, Genoveva Lourdes Flores; Silva, Juliana Virginio da; Almeida-Lopes, Luciana; Napolitano, Marcos Aurélio; Avó, Lucimar Retto da Silva de; Leal, Ângela Merice de Oliveira; Anibal, Fernanda de Freitas

    Abstract in English:

    ABSTRACT Purpose To evaluate and compare two types of different scaffolds in critical bone defects in rats. Methods Seventy male Wistar rats (280 ± 20 grams) divided into three groups: control group (CG), untreated animals; biomaterial group 1 (BG1), animals that received the scaffold implanted hydroxyapatite (HA)/poly(lactic-co-glycolic) acid (PLGA); and biomaterial group 2 (BG2), animals that received the scaffolds HA/PLGA/Bleed. The critical bone defect was induced in the medial region of the skull calotte with the aid of an 8-mm-diameter trephine drill. The biomaterial was implanted in the form of 1.5 mm thick scaffolds, and samples were collected after 15, 30 and 60 days. Non-parametric Mann-Whitney test was used, with the significance level of 5% (p ≤ 0.05). Results Histology revealed morphological and structural differences of the neoformed tissue between the experimental groups. Collagen-1 (Col-1) findings are consistent with the histological ones, in which BG2 presented the highest amount of fibers in its tissue matrix in all evaluated periods. In contrast, the results of receptor activator of nuclear factor kappa-Β ligand (Rank-L) immunoexpression were higher in BG2 in the periods of 30 and 60 days, indicating an increase of the degradation of the biomaterial and the remodeling activity of the bone. Conclusions The properties of the HA/PLGA/Bleed scaffold were superior when compared to the scaffold composed only by HA/PLGA.
  • Changes of renal histopathology and the role of Nrf2/HO-1 in asphyxial cardiac arrest model in rats ORIGINAL ARTICLE

    Jawad, Ali; Yoo, Yeo-Jin; Yoon, Jae Chol; Tian, Weishun; Islam, Md Sadikul; Lee, Eui-Yong; Shin, Ha-Young; Kim, So Eun; Ahn, Dongchoon; Park, Byung-Yong; Tae, Hyun-Jin; Kim, In-Shik

    Abstract in English:

    ABSTRACT Purpose To investigate the role of Nrf2/HO-1 in renal histopathological ailments time-dependently in asphyxial cardiac arrest (CA) rat model. Methods Eighty-eight Sprague Dawley male rats were divided into five groups of eight rats each. Asphyxial CA was induced in all the experimental rats except for the sham group. The rats were sacrificed at 6 hours, 12 hours, one day and two days post-CA. Serum blood urea nitrogen (BUN), creatinine (Crtn) and malondialdehyde from the renal tissues were evaluated. Hematoxylin and eosin and periodic acid-Schiff staining were done to evaluate the renal histopathological changes in the renal cortex. Furthermore, Nrf2/HO-1 immunohistochemistry (ihc) and western blot analysis were performed after CA. Results The survival rate of rats decreased in a time-dependent manner: 66.6% at 6 hours, 50% at 12 hours, 38.1% in one day, and 25.8% in two days. BUN and serum Crtn markedly increased in CA-operated groups. Histopathological ailments of the renal cortical tissues increased significantly from 6 hours until two days post-CA. Furthermore, Nrf2/HO-1 expression level significantly increased at 6 hours, 12 hours, and one day. Conclusions The survival rate decreased time-dependently, and Nrf/HO-1 expression increased from 6 hours with the peak times at 12 hours, and one day post-CA.
  • Sentinel lymph node biopsy using single-agent mapping tracer (blue dye) after neoadjuvant chemotherapy in a Brazilian cohort of breast cancer patients. Real world evidence CLINICAL INVESTIGATION

    Resende, Heloisa Magda; Lichtenfels, Martina; Soares, Igor Camargo; Renó, Angélica Araújo Cortines Laxe; Cunha, Ana Paula; Falcão, Pedro Gustavo; Pieroni, Carolina Soares Pimentel; Assis, Biazi Ricieri de; Cardoso, Paola; Marassi, Pedro Henrique Adário; Reis, Rafael dos Santos

    Abstract in English:

    ABSTRACT Purpose To reduce false-negative rates (FNR) in sentinel lymph node biopsy (SLNB) of clinically positive (cN+) axilla in patients undergoing neoadjuvant chemotherapy (NAC). The removal of three or more lymph nodes with dual-tracer mapping including a radioisotope was used. However, in the Brazilian Unified Health System, the radioisotope tracer is not feasible in some hospitals. We conducted a cross-sectional study to evaluate the detection rate of sentinel lymph node (SLN) in patients who converted from cN+ to ycN0 after NAC using blue dye as a single-agent mapping tracer. Methods During the period of March 2018 to September 2019, 34 patients who underwent NAC with cN+ who converted to ycN0 were enrolled in the study. The SLNB was performed using blue dye as a single-agent mapping followed by axillary lymph node dissection (ALND). Results The detection rate of sentinel lymph node was of 85.3%, being SLNB not possible for five patients (14.7%), due to fibrosis. The mean number of removed SLN was 2.5. Conclusions The use of blue dye as a single-agent mapping tracer demonstrated an acceptable detection rate of 85.3%. Although the FNR was possible to be determined, the small sample size might overestimate this rate. The removal of three or more lymph nodes with single-agent mapping tracer might be indicated for breast cancer patients who converted to ycN0 after NAC in the Brazilian health public services, in which radioisotope tracer is not suitable.
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