FemHab: The effects of bed rest and hypoxia on oxidative stress in healthy women.

Independently, both inactivity and hypoxia augment oxidative stress. This study, part of the FemHab project, investigated the combined effects of bed rest-induced unloading and hypoxic exposure on oxidative stress and antioxidant status. Healthy, eumenorrheic women were randomly assigned to the following three 10-day experimental interventions: normoxic bed rest (NBR;n= 11; PiO2 = 133 mmHg), normobaric hypoxic bed rest (HBR;n= 12; PiO2 = 90 mmHg), and ambulatory hypoxic confinement (HAMB;n= 8: PiO2 = 90 mmHg). Plasma samples, obtained before (Pre), during (D2, D6), immediately after (Post) and 24 h after (Post+1) each intervention, were analyzed for oxidative stress markers [advanced oxidation protein products (AOPP), malondialdehyde (MDA), and nitrotyrosine], antioxidant status [superoxide dismutase (SOD), catalase, ferric-reducing antioxidant power (FRAP), glutathione peroxidase (GPX), and uric acid (UA)], NO metabolism end-products (NOx), and nitrites. Compared with baseline, AOPP increased in NBR and HBR on D2 (+14%; +12%;P< 0.05), D6 (+19%; +15%;P< 0.05), and Post (+22%; +21%;P< 0.05), respectively. MDA increased at Post+1 in NBR (+116%;P< 0.01) and D2 in HBR (+114%;P< 0.01) and HAMB (+95%;P< 0.05). Nitrotyrosine decreased (-45%;P< 0.05) and nitrites increased (+46%;P< 0.05) at Post+1 in HAMB only. Whereas SOD was higher at D6 (+82%) and Post+1 (+67%) in HAMB only, the catalase activity increased on D6 (128%) and Post (146%) in HBR and HAMB, respectively (P< 0.05). GPX was only reduced on D6 (-20%;P< 0.01) and Post (-18%;P< 0.05) in HBR. No differences were observed in FRAP and NOx. UA was higher at Post in HBR compared with HAMB (P< 0.05). These data indicate that exposure to combined inactivity and hypoxia impairs prooxidant/antioxidant balance in healthy women. Moreover, habitual activity levels, as opposed to inactivity, seem to blunt hypoxia-related oxidative stress via antioxidant system upregulation.

Size Effect and Notch Size Effect in Metal Fatigue

It is a well known phenomenon that the constant amplitude fatigue limit of a large component is lower than the fatigue limit of a small specimen made of the same material. In notched components the opposite occurs: the fatigue limit defined as the maximum stress at the notch is higher than that achieved with smooth specimens. These two effects have been taken into account in most design handbooks with the help of experimental formulas or design curves. The basic idea of this study is that the size effect can mainly be explained by the statistical size effect. A component subjected to an alternating load can be assumed to form a sample of initiated cracks at the end of the crack initiation phase. The size of the sample depends on the size of the specimen in question. The main objective of this study is to develop a statistical model for the estimation of this kind of size effect. It was shown that the size of a sample of initiated cracks shall be based on the stressed surface area of the specimen. In case of varying stress distribution, an effective stress area must be calculated. It is based on the decreasing probability of equally sized initiated cracks at lower stress level. If the distribution function of the parent population of cracks is known, the distribution of the maximum crack size in a sample can be defined. This makes it possible to calculate an estimate of the largest expected crack in any sample size. The estimate of the fatigue limit can now be calculated with the help of the linear elastic fracture mechanics. In notched components another source of size effect has to be taken into account. If we think about two specimens which have similar shape, but the size is different, it can be seen that the stress gradient in the smaller specimen is steeper. If there is an initiated crack in both of them, the stress intensity factor at the crack in the larger specimen is higher. The second goal of this thesis is to create a calculation method for this factor which is called the geometric size effect. The proposed method for the calculation of the geometric size effect is also based on the use of the linear elastic fracture mechanics. It is possible to calculate an accurate value of the stress intensity factor in a non linear stress field using weight functions. The calculated stress intensity factor values at the initiated crack can be compared to the corresponding stress intensity factor due to constant stress. The notch size effect is calculated as the ratio of these stress intensity factors. The presented methods were tested against experimental results taken from three German doctoral works. Two candidates for the parent population of initiated cracks were found: the Weibull distribution and the log normal distribution. Both of them can be used successfully for the prediction of the statistical size effect for smooth specimens. In case of notched components the geometric size effect due to the stress gradient shall be combined with the statistical size effect. The proposed method gives good results as long as the notch in question is blunt enough. For very sharp notches, stress concentration factor about 5 or higher, the method does not give sufficient results. It was shown that the plastic portion of the strain becomes quite high at the root of this kind of notches. The use of the linear elastic fracture mechanics becomes therefore questionable.

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Energiapuun haketuksen ja murskauksen kustannukset

Energiapuun tuotannossa puu on hienonnettava kuljettimille ja kattilaan sopivaan kokoon. Tämä tehdään Suomessa yleensä joko metsätien varressa välivarastolla, keskitetyssä terminaalissa tai voimalaitoksella. Puu hienonnetaan joko terävillä terillä hakettamalla tai tylpemmillä työkaluilla murskaamalla. Hakkeessa on vähemmän käsittelyä haittaavia pitkiä tikkuja ja sen valmistamiseen tarvittava energia on hiukan pienempi kuin murskaimilla. Viimeksi mainitulla on merkitystä lähinnä karsittua puuta haketettaessa. Murskain puolestaan sallii enemmän epäpuhtauksia raaka-aineessa, joten esimerkiksi kantoja käsitellään vain murskaimilla. Tässä tarkastellaan erityisesti pienpuun haketuksen ja murskauksen kustannuksia. Pienpuuta saadaan nuoren metsän kunnostuksista ja ensiharvennuksista. Se voi olla joko karsimatonta kokopuuta tai karsittua rankaa. Kokonaiskustannukset pienpuun haketukselle tai murskaukselle ovat tämän tutkimuksen mukaan välivarastolla noin 3,4 euroa/MWh ja terminaalilla tai voimalaitoksella noin 2 euroa/MWh. Pääomakustannukset ovat pienpuulla tavallisesti 1-1,2 euroa/MWh, keskitetyllä terminaalilla toimittaessa noin kolmanneksen vähemmän, jos pääomalle asetetaan 10% tuottovaatimus. Työvoimakustannukset ovat 30-80 snt/MWh varaston ja laitteen koosta riippuen, käyttöenergia dieselmoottoria käytettäessä noin 50 snt/MWh, sähkömoottorilla noin 30 snt/MWh. Muut kulut, mm. huolto, ovat yhteensä 40-80 snt/MWh. Energiapuun hankinnan kokonaiskustannuksista raaka-aineen hienontamisen osuus on 10-30% puutavaran lajista ja käytetystä työmenetelmästä riippuen. Terminaaleilla ja voimalaitoksilla toimittaessa on usein kiinnitettävä huomiota melun- ja pölyntorjuntaan. Muun muassa näistä syistä saattaa kiinteä, sähkökäyttöinen murska olla sopiva sellaisiin kohteisiin, joissa käsiteltävät määrät ovat suuria ja toiminta pysyvää. Melun ja pölyn kunnollinen torjunta vaatii suuria rakenteita, joita on vaikea yhdistää liikuteltaviin laitteisiin.

Hérnia perineal após disjunçao da sínfise púbica: apresentação de caso e técnica para correção

Traunatic perineal hernia remains a rare clinical entity despite an overall increase in blunt trauma. Because of the incidence of other associated injuries, the mortality is high. Most of the perineal defects are repaired during the orthopaedics surgery to reconstitute the pelvis and few patients develop a true perineal hernia without pelvic instability. A 80-year-old woman was involved in a running over accident with disjunction of pubic symphysis, dislocation of sacrum-iliac junction and fracture of pubis and ischium. The patient was submitted to an orthopaedic surgery and latter development an perineal hernia through the genitalia. The diagnosis could be established with physical examination alone. Conventional radiology, computadorized tomography, and ultrasound should also be done to progran the surgery. The repair approach was performed using a marlex mesh, fixed in the pelvic bones, Cooper ligament, and the abdominal wall. The mesh was stood in a retro- peritoneal position, rebuilding the pelvic floor without reconstruction the pelvic bones. We conclude that this is an efficient approach to repair of traumatic postoperative perineal hernia, mainly in patients with high operative risk, when the osseous repair is not necessary.

Correção laparoscópica de hérnia diafragmática traumática crônica

Diaphragmatic hernia secondary to blunt or penetrating trauma is rarely by itself a fatal event. However, if unpercieved, it may lead to severe complications caused by herniation of abdominal contents to the ethorax. Blunt trauma related to car accidents is the most frequent cause of diaphragmatic hernias. Associated injuries are frequently observed, provoked by severe traumas of great impact. These blunt trauma hernias occur mainly on the left side due to abdominal anatomy, since the liver is usually located on the right side. When injuries are observed on the right they tend to be more severe, generally related to major trauma of solid organs. Less frequently diaphragmatic hernias may be bilateral. The management of diaphragmatic injury would appear to be a simple matter of suturing the defect. However, peroperative diagnosis can be difficult and even at the time of surgery some diaphragmatic injuries can be overlooked if carefull exploration is not done. Associated injuries tend to divert attention from the diaphragmatic injury. Laparoscopic diagnosis and repair have been described with successfull. Laparotomy or thoracotomy can be employed for surgical repair of traumatic diaphragmatic hernias. Standard (laboratory/imaging) examinations may fail to make the diagnosis. Recently, the laparoscopic approach has proved useful for more precise evaluation of such injuries, very often allowing immediate repair of these lesions.

Hérnia traumática da parede abdominal

A rare case of blunt traumatic abdominal hernia is presented in which jejunal loops herniated through the abdominal wall. The patient had a serious motor vehicle accident seven years ago, while wearing the seat belt. He developed a traumatic hernia in the anterior lateral abdominal wall, which was operated, and relapsed after some months. The patient was reoperated and we observed the unattachment of the anterior lateral abdominal musculature from the ilium crest. After the hernial sac treatment, the defect was solved with the use of a polypropylene mesh. The postoperative evolution was good and four months later there were no signs of recurrence. Traumatic abdominal hernia remains a rare clinical entity, despite the increase in blunt abdominal trauma. Traumatic abdominal wall hernia falls into two general categories: small lower quadrant abdominal defects, typically the result of blunt trauma with bicycle handlebars, and larger abdominal wall defects related to motor vehicle accidents. The diagnosis may be often established by the physical examination alone. Conventional radiology and computerized tomography usefulness have been proved. In the vast majority of cases, early repair is recommended. The appropriate treatment is the reduction of the herniated bowel into the abdomen, the debridment of nonviable tissues, and a primary tension free closure of the detect.

Incidentaloma gigante de adrenal em paciente jovem

Incidental adrenal tumors are lesions occasionally observed during abdominal US or CT scans. These tumors have been observed in patients without clinical or laboratorial signs of adrenal disease. The authors report a case of a 18 - years - old young man who was admitted to the Franco da Rocha Hospital, São Paulo, with abdominal pain and a palpated mass in the epigastrium which began one month ago. These findings were preceeded by a blunt trauma at the epigastrium three months earlier. First clinical hypothesis was of a traumatic pancreatic pseudocyst. However, investigation and laparotomy showed a large left adrenal solid mass, weighting 700 g. The mass was removed and histology was performed. There was no evidence of malignant neoplasm, then the diagnostic of incidental adenoma of adrenal was confirmed. The authors hope to stimulate surgeons for early detection of these lesions in order to prevent the complications and improve the prognosis.

Trombose carotídea após traumatismo contuso

The authors report a case of thrombosis of common and internal carotid arteries caused by blunt trauma. They emphasize the rarity of this lesion and the variability of clinical presentation. Different forms of treatment are analysed, such as the use of anticoagulation and surgery. Treatment needs to be individualized for each patient.

Ascite quilosa traumática

Chylous ascites is a rare clinical entity. In infancy it is less commom still. The etiology of most of them is usually congenital or idiopathic; trauma is a less frequent cause. It has been implicated in about 10% of all cases 1-5. There have been less than one hundred cases published in the English literature, including 12 in children. We report a pediatric case of chylous ascites as a result of blunt abdominal trauma managed by ligation of the lymphatic leak.

Lesão complexa da via biliar principal: a ligadura como opção associada a colecistojejunostomia

The authors present a case of distal common bile duct injury. Ligation of the bile duct and a bypass cholecystojejunostomy were chosen as treatment. Diagnosis of blunt traumatic injury to the extrahepatic biliary ducts may be difficult due to the benign nature of initial bile peritonitis. Surgical treatment for associated abdominal injuries usually makes the diagnosis possible. One of the challenges in the treatment of these injuries relates to the small diameter of the, usually, normal common bile duct. Primary repair and T tube drainage is the best option for non-complex injuries. End-to-end anastomosis and, preferentially, biliary-enteric anastomosis are the best surgical options for more complex injuries. Severe injuries have high complication rates, especially when the distal portion of the common bile duct is affected. Early leaks and late strictures are likely to develop in these situations. Cholecistojejunostomy and ligation of the injuried common bile duct are good surgical options for complex injuries. They carry a low complication rate and consequently low morbidity.

Pseudoaneurisma gigante de artéria esplênica

Splenic artery pseudoaneurysm larger than 10 cm is a rare condition. The risk of rupture is probably high and surgical treatment is necessary. The objective of this article is to report a case of a patient with giant pseudoaneurysm of the splenic artery submitted to surgical resection. A 26-year-old man complaining of gastrointestinal hemorrhage and abdominal pain The patient’s medical history revealed that one year before he had an abdominal blunt trauma. The angiography showed a giant pseudoaneurysm of the splenic artery with compression of the stomach. The patient was operated on by abdominal access and the spleen and pseudoaneurysm were resected. The postoperative course was uneventful and the patient was discharged 13 days after surgery without problems.

Inversão circulatória vértebro-subclávia - "steal syndrome" - secundária a trauma torácico fechado

The authors report a case of thrombosis of the right subclavian artery in its pre-vertebral segment causing subclavian steal syndrome as a result of a blunt thoracic trauma in a 43-year-old woman. Aspects of the diagnosis and surgical treatment of this rare injury are reported and discussed.

Ruptura isolada da pelve renal secundária ao trauma abdominal contuso

Blunt rupture of the renal pelvis is a exceedingly rare injury. Hematuria is absent in one-third of cases. Such injuries are usually caused by desacceleration forces. Despite improved imaging techniques, diagnosis of this injuries is frequently delayed. Diagnosis is suggested by the presence of massive medial extravasation of contrast material at excretory urography or computed tomography. Surgical treatment consists in pyeloplasty or pyeloraphy with stent placement (double J) or nephrostomy.

Colecistite aguda decorrente de hemorragia intraluminar da vesícula biliar após trauma abdominal fechado

Isolated gallbladder injury following abdominal blunt trauma is rare and early diagnosis is difficult to make, particularly when no other organ is injured. However, ultrasonography is valuable for investigating gallbladder injuries. We report a case of isolated gallbladder blunt trauma presented as acute cholecystitis with hemobilia. In isolated blunt traumatic injury to the gallbladder, treatment options vary depending on the specific injury. The characteristics of blunt trauma injuries to the gallbladder and their appropriate management are discussed.