Afecções ortopédicas são freqüentes em pequenos animais e dentre essas afecções destaca-se a luxação coxofemoral – a mais freqüente dentre as luxações. Devido a tal incidência, a luxação coxofemoral tornou-se objeto de inúmeras pesquisas em medicina veterinária, sendo o tratamento cirúrgico o mais efetivo para sua correção. Ainda não foi, no entanto, desenvolvida uma técnica cirúrgica preferencial, amplamente difundida nas rotinas hospitalares. O presente trabalho avalia comparativamente o implante de fáscia lata bubalina e de pino de Steinmann transarticular para a estabilização de articulações coxofemorais luxadas. Foram utilizados 26 cães, separados em dois grupos que foram também, por sua vez, subdivididos. O primeiro grupo foi denominado “grupo Experimental” e reuniu 16 animais: oito pertencentes ao subgrupo “pino” e oito ao subgrupo “fáscia”. O segundo grupo foi denominado “grupo Rotina” e constituído por dez animais provenientes da rotina de atendimentos do Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul (UFRGS), sendo igualmente subdividido nos subgrupos “pino” e “fáscia”, com cinco animais cada um. Os cães foram submetidos às respectivas técnicas de estabilização e acompanhados clínica e radiograficamente durante 60 dias, findos os quais os animais do grupo Experimental passaram por avaliação macroscópica direta das articulações, além da histopatologia e teste de tensiometria. A principal vantagem da fáscia respeita à deambulação dos animais, que apresentaram evolução pós-operatória significativamente precoce em relação ao grupo submetido ao implante do pino de Steinmann transarticular, além de menor grau de atrofia muscular. Os testes de tensiometria, avaliações radiográficas e exames histopatológicos não apresentaram diferenças estatisticamente significativas entre os grupos, evidenciando também que ambas as técnicas não geraram alterações deletérias à articulação operada. Destarte, conclui-se que a técnica de estabilização da articulação coxofemoral com implante de fáscia lata é eficaz e vantajosa quando comparada à técnica do pino transarticular. / The orthopedics disorders are very frequent in small animals and among them we can find the coxofemoral luxation as the most frequent disease. Because of a high incidence it became an important subject for veterinary researches. Surgery is the most effective treatment in cases of coxofomoral luxation, although the techniques that already exist are not so used in the clinics routine because of some difficulties these techniques present. In this paper the bubaline fascia lata implant and Steinmann transarticular pin were compared in surgeries for coxofemoral luxation. Twenty-six animals were used, divided into two groups that were subdivided. The first group was called “Grupo Experimental” and was formed by 16 animals, 8 animals in the subgroup called “pino” and the other 8 animals in the subgroup “fáscia”. The second group was called “Rotina” because these animals came from the routine of the clinic sector of Universidade Federal do Rio Grande do Sul Veterinary Hospital, and these groups were also subdivided in the subgroups “pino” and “fáscia”, with 5 animal each. These groups were submitted to the mentioned above stabilization techniques and after that, they were observed clinically and radiografically during 60 days. After that, it was realized a macroscopic study in the articulations of “Grupo Experimental”, besides an histopatological exam and a tensiometry test. The results showed that the technique with the bubaline fascia lata implant proved to be really efficient and it has some advantages comparing to the transarticular pin technique. The most important advantage is related to the deambulation, where the animals in this group showed a better evolution after the surgery. The level of muscular atrophy in this group was less marked. The tensiometry tests, the radiographic and histopatological exams did not present important differences between the two groups, but they were useful to show that the two techniques did not cause bad alterations in the worked articulation. In this sense it can be concluded that the stabilization of the coxofemoral articulation using bubaline fascia lata implant is a better technique comparing to the transarticular pin technique due to its advantages, mainly related to the deambulation and the muscular atrophy.

Orientador: Agricio Nubiato Crespo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T13:38:08Z (GMT). No. of bitstreams: 1 Carvalho_EduardoGeorgeBaptistade_M.pdf: 6583260 bytes, checksum: c2467f978ca8069f79000308c237d538 (MD5) Previous issue date: 2006 / Resumo: A correção de alterações da lâmina própria nas pregas vocais, como sulcos, cicatrizes e degenerações senis, ainda é um desafio à fonocirurgia. Materiais implantáveis e métodos de implantação são continuamente investigados. Este trabalho avaliou a utilização de enxerto de fragmento da faseia lata na lâmina própria da prega vocal de cães, estudando as alterações histológicas conseqüentes, quanto à reação inflamatória aguda e crônica, à fibrose e ã neovascularização. Doze cães adultos foram submetidos à enxertia de um fragmento de 0,3 X 0,3 cm da faseia lata na lâmina própria da prega vocal direita. Na prega vocal esquerda, o mesmo acesso cirúrgico foi reproduzido, sem colocação do enxerto. Após dois e seis meses, os animais foram sacrificados e suas pregas vocais estudadas histologicamente. A faseia não induziu resposta inflamatória, aguda ou crônica, em qualquer animal, nem desencadeou fibrose além da conseqüente ao procedimento cirúrgico, como observado no lado controle. Em todos os casos, identificou-se o tecido enxertado sem evidências de reabsorção e com aumento da neovascularização, demontrando que a faseia lata apresenta integração tecidual boa na camada superficial da lâmina própria de prega vocal de cão / Abstract: Satisfactory corrective treatment for sulcus, scar and senile alterations in the lamina propria of vocal folds is still under development. This study assessed the utilization of a fascia lata graft in the vocal fold lamina propria of dogs by analyzing the histological alterations induced by acute and chronic inflammatory reactions as well as the fibrosis triggered by graft procedure and persistence. A fragment measuring 0.3 X 0.3 cm of the fascia lata was grafted in the right vocal old lamina propria of 12 adult dogs. Identical surgical access in the left vocal fold was reproduced without introducing the graft. After periods of two and six months, the animals were sacrificed and a histological study of their vocal cords was performed. Besides the reactions resulting from the surgical procedure in the control side, the fascia did not induce an acute or chronic inflammatory reaction or trigger fibrosis in any of the animals. In all the cases, the grafted tissue did not show evidence of resorption, demonstrating that the superficial layer of the lamina propria in dogs presents good tolerance to fascia lata grafting / Mestrado / Otorrinolaringologia / Mestre em Ciências Médicas

INTRODUCTION: Transverse rectus abdominus muscle flaps (TRAM) can result in significant abdominal wall donor-site morbidity. We present our experience with bilateral pedicle TRAM breast reconstruction using a double-layered polypropylene mesh fold over technique to repair the rectus fascia. METHODS: A retrospective study was performed that included patients with bilateral pedicle TRAM breast reconstruction and abdominal reconstruction using a double-layered polypropylene mesh fold over technique. RESULTS: Thirty-five patients met the study criteria with a mean age of 49 years old and mean follow-up of 7.4 years. There were no instances of abdominal hernia and only 2 cases (5.7%) of abdominal bulge. Other abdominal complications included partial umbilical necrosis (14.3%), seroma (11.4%), partial wound dehiscence (8.6%), abdominal weakness (5.7%), abdominal laxity (2.9%), and hematoma (2.9%). CONCLUSIONS: The TRAM flap is a reliable option for bilateral autologous breast reconstruction. Using the double mesh repair of the abdominal wall can reduce instances of an abdominal bulge and hernia.

INTRODUCTION: Transverse rectus abdominus muscle flaps (TRAM) can result in significant abdominal wall donor-site morbidity. We present our experience with bilateral pedicle TRAM breast reconstruction using a double-layered polypropylene mesh fold over technique to repair the rectus fascia. METHODS: A retrospective study was performed that included patients with bilateral pedicle TRAM breast reconstruction and abdominal reconstruction using a double-layered polypropylene mesh fold over technique. RESULTS: Thirty-five patients met the study criteria with a mean age of 49 years old and mean follow-up of 7.4 years. There were no instances of abdominal hernia and only 2 cases (5.7%) of abdominal bulge. Other abdominal complications included partial umbilical necrosis (14.3%), seroma (11.4%), partial wound dehiscence (8.6%), abdominal weakness (5.7%), abdominal laxity (2.9%), and hematoma (2.9%). CONCLUSIONS: The TRAM flap is a reliable option for bilateral autologous breast reconstruction. Using the double mesh repair of the abdominal wall can reduce instances of an abdominal bulge and hernia.

No description available.

Skeletal muscle fascia is a connective tissue which provides structure and aidswith force transfer in a muscle. Currently there are no good ways of detectingand analyzing micrometer thick structures of this tissue in-vivo. In this thesis,we created a model to detect skeletal muscle fascia, and tested its performanceusing simulated data. Utilizing the ultrasound simulation software Vantage,which operates through MATLAB, we created a simulation model which repli-cates the properties and behaviour of skeletal muscle fascia. To detect thetissue, we changed and adapted a previously implemented model of ultrasoundlocalization microscopy (ULM), previously only used to create super resolutionimages of blood vessels. Finally we evaluated the models ability to locate anddetermine the thickness of the simulated fascia. Additionally we tested themodels ability to separate adjacent objects.We found that our model was successful at detecting and localizing thesimulated fascia, with a sub wavelength accuracy. The precision of the locatedfascia appears more accurate for horizontally aligned objects compared to thevertically aligned ones. The results from determining the thickness of the fasciaproved relatively successful as well. However the results showed a high variance.This could be improved through an inclusion of stocasticity in the simulationmodel we developed. Finally the ability to distinguish two objects close to eachother showed successful results as well. The method was able to clearly detecta fascia circle with a 0.5mm diameter. It was unable to detect the sides a fasciacircle with a 0.25mm diameter.The main limitation with the model we have developed lies in the simulationsperformed. The simulation model we used was very basic, meaning that it didnot perfectly represent the skeletal muscle fascia we sought to examine. Furtherdevelopment of the simulation model is required to provide a result which ismore representative of real skeletal muscle fascia.The analysis of this first model shows promise in detecting the simplifiedfascia provided by our simulation model. At this stage, the method will requiremore extensive testing, together with a more thorough statistical analysis, beforewe can state the usefulness of the method.

IntroductionL’anatomie nerveuse pelvienne est imprécise dans la littérature. ObjectifsReprésenter en 3D l’innervation autonome du pelvis. Démontrer la capacité de l’IRM voir cette innervation.Matériels et méthodesDes coupes ont été faites sur le bassin de fœtus et d’adultes, puis traitées par des colorations et immunomarquages. Les lames ont été numérisées et reconstruites en 3D.Nous avons effectué une confrontation anatomo-radiologique entre des images d’IRM et de dissection.RésultatsNous avons pu décrire l’innervation autonome du pelvis et faire une cartographie des neuromédiateurs. Nous avons également pu suggérer des plans d’épargne nerveuse lors de la chirurgie. Les acquisitions IRM ont permis une visualisation de l’innervation de façon précise avec une bonne concordance.ConclusionCe travail permet une meilleure description de l’innervation pelvienne et des plans chirurgicaux à emprunter en chirurgie pelvienne. L’IRM permet bien de visualiser l’innervation pelvienne. / Introduction :Pelvis nervous anatomy is imprecise in literature. Objectives:1-To describe and represent in 3D pelvic autonomic innervation. 2-To demonstrate the capacity of MRI to visualize pelvic autonomous innervation.Materiel/patients and methods:Serial histological sections were made from foetuses and adults. Sections were treated with conventional and immunostainings. Sections were digitalized and reconstructed in 3D. An anatomo-radiological comparison was made between MRI images and dissection. Results:Our study enabled to localize the pelvic autonomous innervation and to realize a complete neuro-mediators cartography.MRI acquisition allowed an good visualization of the autonomous innervation, with a good correlation with dissection.Conclusion and perspectives:This study enabled a better understanding of pelvic nervous anatomy and physiology. It also demonstrated that this anatomy is visible on MRI.

Belastungsharninkontinenz (BHI) geht mit einem großen Verlust an Lebensqualität einher. Während bei der Frau durch Einführung der suburethralen Schlingen auf der Grundlage der Integraltheorie (Petros und Ulmsten) seit Jahren eine wirksame Therapieoption der BHI existiert, gibt es für den Mann bisher kein derart gereiftes theoretisches Konzept zur Erklärung der Inkontinenzmechanismen. Ein bestehendes Problem ist hier die noch immer kontrovers diskutierte Mikroanatomie, vor allem aber die Verankerung und das funktionelles Zusammenspiel der Kontinenz erzeugenden Einzelstrukturen. Anliegen dieser Arbeit ist es, eine Analyse der anatomischen Schnittstellen zwischen Beckenwand und Organen im Spatium retropubicum (ventraler vesikourethraler Suspensionsapparat, VVUS) beim Mann durchzuführen, um eine Ableitung von Aufgaben bei der Miktion und Erzeugung von Kontinenz herzustellen. Fernziele sind dabei, klinisch brauchbare Therapieformen der männlichen BHI voranzutreiben und einen Nutzen für die anatomische Lehre abzuleiten. Methodisch basiert die Arbeit auf makroskopisch-anatomischen Präparationen der sogenannten „puboprostatischen Bänder“ (PPL), des Arcus tendineus fasciae pelvis (ATFP) und der Beckenfaszien, ferner des M. pubococcygeus an Alkohol- und Thiel-fixierten männlichen Becken (n=11) mit kontinuierlicher Fotodokumentation. Die histologische Analyse ausgewählter Gewebeblöcke dient der Festlegung von Kontaktstellen der einzelnen Gewebe. Ein Pool aus 650 Dünnschnittpräparaten in HE- und Crossmon-Färbung wurde durch immunhistochemisch mit α-SMCA-AK markierten Schnitten zur exakten Differenzierung der muskulären Grundstruktur komplettiert. Die Schnittstelle zur Klinik bildet eine Pilotserie von MRT-Untersuchungen des VVUS bei 3 gesunden männlichen Probanden, die mit dem Präparationssitus verglichen wurde und Potenzial für zukünftige Studien aufzeigt. Wesentliche Erkenntnisse sind: 1. „Puboprostatische Bänder“ existieren nicht. Ein Komplex aus Einzelstrukturen, die vor allem Assoziation zur Harnblase haben, bildet das makroskopische Korrelat. 2. Die Mm. pubovesicales zeigen einen fächerförmigen Verlauf, daher sollte eine Neubezeichnung als M. collaris vesicae erfolgen. 3. Der ATFP dient als Aponeurose für die Mm. pubovesicales neben der Stabilisierung des vesikourethralen Überganges. 4. Die Endopelvine Faszie existiert, sie trägt zum Erhalt einer bestimmten Höhenlage des vesikourethralen Überganges bei und stabilisiert die Urethra durch ihren langstreckigen lateralen Verlauf. Die Evaluation der Abbildungsweise des VVUS in anatomischen Lehrmedien ist der studentischen Ausbildung geschuldet. Dabei wird auf seine ungleiche Darstellung hingewiesen und eine Revision angeregt. Die Voraussetzung für die Optimierung der männlichen Harnkontinenz bleibt in jedem Fall die enge Zusammenarbeit zwischen Anatomie und Klinik bei der Aus- und Fortbildung.

Vários materiais têm sido introduzidos nas pregas vocais na tentativa de solucionar a incompetência glótica, porém poucos são os estudos que avaliam o processo cicatricial decorrente da enxertia destes materiais. O objetivo desta pesquisa foi quantificar o processo inflamatório celular na prega vocal de coelhos submetidos a enxerto unilateral de gordura ou fáscia muscular. Estudamos 24 coelhos, divididos em 2 grupos, nos quais gordura ou fáscia foi enxertada. O grupo controle foi formado pela prega vocal contralateral, a qual foi submetida ao mesmo procedimento, excetuando-se a colocação do enxerto. Metade dos coelhos de cada grupo foi sacrificada após 90 dias, enquanto a outra metade foi sacrificada após 180 dias da cirurgia. A densidade celular inflamatória peri-enxerto foi avaliada em todas as pregas vocais. Houve um aumento do infiltrado inflamatório no grupo submetido à enxertia de gordura, quando comparado ao submetido à enxertia de fáscia. Bem como ao grupo controle, após 90 dias. Quanto aos coelhos sacrificados após 180 dias, não houve diferença entre os grupos entre si e em relação ao grupo controle. Esse estudo sugere que o enxerto de fáscia parece ser mais aceitável que o enxerto de gordura para a prega vocal, uma vez que origina menor reação inflamatória tecidual / Several material have been introduced into the vocal folds in attempt to solve glottic incompetence, however just a few studies are related with the consequent inflammatory process. The aim of this article was to quantify the cellular inflammatory process in rabbit vocal fold, which have undergone unilateral fat or muscular fascia introduction. Twenty-four rabbits were allocated into two groups, in which muscular fascia or fat were implanted. The control group, formed by the contra-lateral vocal fold, underwent the same surgical procedure, except for the grafting. Half the rabbits from each group were sacrificed after 90 days from the surgery, while the other half was sacrificed after 180 days. The inflammatory cellular density around the graft was measured in all vocal folds. There was a higher cellular inflammatory reaction in the group submitted to fat grafting when compared to the group submitted to muscular fascia grafting, and to the control group, after 90 days. As for the rabbits sacrificed after 180 days, there was no significant difference between the implanted groups with each other, and with the control group. This study suggests that muscular fascia graft seems to be more acceptable than fat grafts for the vocal fold, as it produces a lower local inflammatory reaction

OBJETIVO: Comparar a viscosidade dinâmica da camada superficial da fáscia temporal com a de outros tecidos biológicos tradicionalmente utilizados em implantes de pregas vocais para o tratamento de rigidez de pregas vocais. DESENHO DO ESTUDO: Experimental. MÉTODO: Amostras de camada superficial da fáscia temporal, camada profunda da fáscia temporal e gordura abdominal de 12 cadáveres são submetidas a medição de viscosidade dinâmica. RESUTADOS: A viscosidade dinâmica das diferentes amostras apresenta-se na seguinte ordem crescente: camada superficial da fáscia temporal, camada profunda da fáscia temporal e gordura abdominal. Observa-se diferença estatística na comparação entre todas as amostras. DISCUSSÃO: Quanto maior for a viscosidade da mucosa da prega vocal, maior é a pressão subglótica necessária para se iniciar a fonação. Dessa maneira, um bom material implantável em lâmina própria de prega vocal deve ter baixa viscosidade. Por esse parâmetro, a camada superficial da fáscia temporal é um material promissor para implantação em pregas vocais. CONCLUSÃO: A viscosidade dinâmica da camada superficial da fáscia temporal é menor que a da camada profunda da fáscia temporal e que a da gordura abdominal. / OBJECTIVE: To compare the dynamic viscosity of superficial layer of temporalis fascia with that of other biological tissues traditionally used for vocal fold implants to treat vocal fold rigidity. STUDY DESIGN: Experimental. METHOD: Measurement of dynamic viscosity of samples of superficial layer of temporalis fascia, deep layer of temporalis fascia and abdominal fat of 12 cadavers are performed. RESULTS: Dynamic viscosity values of the different samples are presented in the following increasing order: superficial layer of temporalis fascia, deep layer of temporalis fascia and abdominal fat. There is statistical difference among all the samples. CONCLUSION: Dynamic viscosity of superficial layer of temporalis fascia is lower than the ones of deep layer of temporalis fascia and abdominal fat.