Plastic surgery in chest wall reconstruction: relevant aspects - case series

Objective: to discuss the participation of Plastic Surgery in the reconstruction of the chest wall, highlighting relevant aspects of interdisciplinaryness. Methods: we analyzed charts from 20 patients who underwent extensive resection of the thoracic integument, between 2000 and 2014, recording the indication of resection, the extent and depth of the raw areas, types of reconstructions performed and complications. Results: among the 20 patients, averaging 55 years old, five were males and 15 females. They resections were: one squamous cell carcinoma, two basal cell carcinomas, five chondrosarcomas and 12 breast tumors. The extent of the bloody areas ranged from 4x9 cm to 25x40 cm. In 12 patients the resection included the muscular plane. In the remaining eight, the tumor removal achieved a total wall thickness. For reconstruction we used: one muscular flap associated with skin grafting, nine flaps and ten regional fasciocutaneous flaps. Two patients undergoing reconstruction with fasciocutaneous flaps had partially suffering of the flap, solved with employment of a myocutaneous flap. The other patients displayed no complications with the techniques used, requiring only one surgery. Conclusion: the proper assessment of local tissues and flaps available for reconstruction, in addition to the successful integration of Plastic Surgery with the specialties involved in the treatment, enable extensive resections of the chest wall and reconstructions that provide patient recovery.

The Shadow Moiré method using the phase shifting technique and digital image processing: computational implementation and application to the 3D-reconstruction of a buckled plate

The Shadow Moiré fringe patterns are level lines of equal depth generated by interference between a master grid and its shadow projected on the surface. In simplistic approach, the minimum error is about the order of the master grid pitch, that is, always larger than 0,1 mm, resulting in an experimental technique of low precision. The use of a phase shift increases the accuracy of the Shadow Moiré technique. The current work uses the phase shifting method to determine the surfaces three-dimensional shape using isothamic fringe patterns and digital image processing. The current study presents the method and applies it to images obtained by simulation for error evaluation, as well as to a buckled plate, obtaining excellent results. The method hands itself particularly useful to decrease the errors in the interpretation of the Moiré fringes that can adversely affect the calculations of displacements in pieces containing many concave and convex regions in relatively small areas.

Dose-response curve to soil applied herbicides and susceptibility evaluation of different amaranthus species using model identity

Greenhouse studies were conducted in 2008-2009 with the objective of adjusting dose-response curves of the main soil-applied herbicides currently used in cotton for the control of Amaranthus viridis, A. hybridus, A. spinosus, A. lividus, as well as comparing susceptibility among different species, using the identity test models. Thirty six individual experiments were simultaneously carried out in greenhouse, in a sandy clay loam soil (21% clay, 2.36% OM) combining increasing doses of the herbicides alachlor, clomazone, diuron, oxyfluorfen, pendimethalin, prometryn, S-metolachlor, and trifluralin applied to each species. Dose-response curves were adjusted for visual weed control at 28 days after herbicide application and doses required for 80% (C80) and 95% (C95) control were calculated. All herbicides, except clomazone and trifluralin, provided efficient control of most Amaranthus species, but substantial differences in susceptibility to herbicides were found. In general, A. lividus was the least sensitive species, whereas A. spinosus demonstrated the highest sensitivity to herbicides. Alachlor, diuron, oxyfluorfen, pendimethalin, S-metolachlor, and prometryn are efficient alternatives to control Amaranthus spp. in a range of doses that are currently lower than those recommended to cotton.

A simple RT-PCR-based strategy for screening connexin identity

Vertebrate gap junctions are aggregates of transmembrane channels which are composed of connexin (Cx) proteins encoded by at least fourteen distinct genes in mammals. Since the same Cx type can be expressed in different tissues and more than one Cx type can be expressed by the same cell, the thorough identification of which connexin is in which cell type and how connexin expression changes after experimental manipulation has become quite laborious. Here we describe an efficient, rapid and simple method by which connexin type(s) can be identified in mammalian tissue and cultured cells using endonuclease cleavage of RT-PCR products generated from "multi primers" (sense primer, degenerate oligonucleotide corresponding to a region of the first extracellular domain; antisense primer, degenerate oligonucleotide complementary to the second extracellular domain) that amplify the cytoplasmic loop regions of all known connexins except Cx36. In addition, we provide sequence information on RT-PCR primers used in our laboratory to screen individual connexins and predictions of extension of the "multi primer" method to several human connexins.

Lyophilized allografts without pre-treatment with glutaraldehyde are more suitable than cryopreserved allografts for pulmonary artery reconstruction

Various methods are available for preservation of vascular grafts for pulmonary artery (PA) replacement. Lyophilization and cryopreservation reduce antigenicity and prevent thrombosis and calcification in vascular grafts, so both methods can be used to obtain vascular bioprostheses. We evaluated the hemodynamic, gasometric, imaging, and macroscopic and microscopic findings produced by PA reconstruction with lyophilized (LyoPA) grafts and cryopreserved (CryoPA) grafts in dogs. Eighteen healthy crossbred adult dogs of both sexes weighing between 18 and 20 kg were used and divided into three groups of six: group I, PA section and reanastomosis; group II, PA resection and reconstruction with LyoPA allograft; group III, PA resection and reconstruction with CryoPA allograft. Dogs were evaluated 4 weeks after surgery, and the status of the graft and vascular anastomosis were examined macroscopically and microscopically. No clinical, radiologic, or blood-gas abnormalities were observed during the study. The mean pulmonary artery pressure (MPAP) in group III increased significantly at the end of the study compared with baseline (P=0.02) and final [P=0.007, two-way repeat-measures analysis of variance (RM ANOVA)] values. Pulmonary vascular resistance of groups II and III increased immediately after reperfusion and also at the end of the study compared to baseline. The increase shown by group III vs group I was significant only if compared with after surgery and study end (P=0.016 and P=0.005, respectively, two-way RM ANOVA). Microscopically, permeability was reduced by ≤75% in group III. In conclusion, substitution of PAs with LyoPA grafts is technically feasible and clinically promising.

Encapsulated specialty oils commercialized in São Paulo state, Brazil: evaluation of identity (fatty acid profile) and compliance of fatty acids and Vitamin E contents with nutrition labeling

Encapsulated specialty oils commercialized in São Paulo state, Brazil, were evaluated for their identity (fatty acids profile) and compliance with nutrition labeling (fatty acids and Vitamin E (alpha tocopherol) contents). Twenty one samples [flaxseed oil (6), evening primrose (5), safflower (8), borage (1), and black currant (1)] purchased from local markets or collected by the health surveillance agency were analyzed. The fatty acids and vitamin E contents were analyzed by gas chromatography with flame ionization detector and liquid chromatography with UV detector, respectively. Nine samples were adulterated (5 samples of safflower oil, 3 of flaxseed oil, and one of evening primrose). Among them, 3 flaxseed and 2 safflower oil samples were probably adulterated by the addition of soybean oil. Conjugated linoleic acid (CLA) was found in two safflower oils samples although the sale of oils with conjugated linoleic acid (CLA) is not permitted by the National Health Surveillance Agency in Brazil (ANVISA). Only two samples presented all values in compliance with nutrition labeling (one safflower oil sample and one borage oil sample). The results show that a continuous monitoring of encapsulated specialty oils commercialized in Brazil is necessary including a greater number of samples and sanitary surveillance.