Nerve grafts prevent paraplegic pressure ulcers

We present an optimistic neural solution to the depressing challenge of decubitus pressure ulcers in the paraplegic patient. This is a limited study of two paraplegic men followed for several years. Sural nerve grafts, performed end-to-side, successfully bridged the sciatic nerve to intercostal nerves with surprising benefits for both men.

Transplante pancreato-duodenal em ratos com microcirurgia. A téchnica e os resultados após 12 anos de experimentação

In this study we present the technical details, adaptations and modifications of the original procedure of pancreaticoduodenal transplantation in rats described by Lee et al. in 1972. We also present the results and technical failures observed in a follow-up of 12 years. From March, 1982 to December, 1994, we performed in the Laboratory of Surgical Technique and Experimental Surgery of Faculty of Medicine, Botucatu - UNESP, Brazil, 665 duodenopancreatectomies in donor rats and 592 surgeries for revascularization of the pancreatic graft in recipient animals. The observed percentage of technical failures in donor rats was 11% due to bleeding and/or vascular complications, irregular flushing of the graft with saline and respiratory insufficiency. In recipients of grafts, we observed a percentage of technical failures of 22,5% due to porto-caval thrombosis, vascular bleeding, pancreatitis and graft ischemia. In both surgeries, the successful results are directly related to the technical performance of the surgeon and the cares in the postoperative period.

Treatment of mucus retention phenomena in children by the micro-marsupialization technique: case reports

The purpose of the present study was to emphasize the technique of micro-marsupialization as an alternative for the treatment of mucus retention phenomena. Out of 41 patients, 14 were selected for treatment by the micro-marsupialization technique on the basis of clinical criteria. Patient age ranged from 5-9 years. The technique was performed as follows: the area was disinfected with 0.1% iodine; a topical anesthetic was applied to cover the entire lesion for approximately 3 min; a 4.0 silk suture was passed through the internal part of the lesion along its widest diameter; and a surgical knot was made. Of the original 14 patients treated by the micro-marsupialization technique, 12 presented full regression one week after treatment. Recurrence occurred in two cases. It was possible to conclude that the micro-marsupialization technique is an alternative to be considered, especially in pediatric dentistry.

Fator de crescimento nervoso em cola de fibrina no reparo término-lateral de nervos em ratos

Purpose: To determine the effects of end-to-side nerve repair performed only with fibrin glue containing nerve growth in rats. Methods: Seventy two Wistar rats were divided into six equal groups: group A was not submitted to nerve section; group B was submitted to nerve fibular section only. The others groups had the nerve fibular sectioned and then repaired in the lateral surface of an intact tibial nerve, with different procedures: group C: ETS with sutures; group D: ETS with sutures and NGF; group E: ETS with FG only; group F: ETS with FG containing NGF. The motor function was accompanied and the tibial muscle mass, the number and diameter of muscular fibers and regenerated axons were measured. Results: All the analyzed variables did not show any differences among the four operated groups (p>0.05), which were statistically superior to group B (p<0.05), but inferior to group A (p>0.05). Conclusion: The end-to-side nerve repair presented the same recovery pattern, independent from the repair used, showing that the addition of nerve growth factor in fibrin glue was not enough for the results potentiating.

Clinical and microbiological changes after minimally invasive therapeutic approaches in intrabony defects: a 12-month follow-up

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ultrasonic waves: Bioeffects on yeast cells

Applications of ultrasound were starting from 1912 with the primary objective the detection of icebergs on prevention of maritime accidents. Algae, fish deaths and destruction were observed in the vicinity of sonar that equipped ships and submarines during the First World War.The evolutions of research and studies with ultrasound have big advances following the discovery of piezoelectric transducers in science and technology. As an example we can mention its application in microsurgery, fatigue detection in aerospace mechanics, catalysis sonochemical, biotechnology and others.The work presented here aims to demonstrate the application of ultrasonic in pulsed mode beams in biotechnology with the aim of improving the fermentation of a culture broth containing biological agents. In these experiments we used as ultrasound equipment and oscilator Sonics VCX-600 (20KHz), probe type wave guide. The experiments were conducted in a glass reactor of 200 mL of biomaterial containing cane juice and Saccharomyces cerevisiae in suspension. The parameters analyzed were related to the content Alcohlic (FID gas chromatography), and cell viability (Neubauer chamber), TRS (refractometry). Analysis of results showed that the total production exceeded in irradiated samples compared to normal fermentation (without ultrasound), suggesting additional advantage of ultrasound activation. Lastin Trials 1400 min, showed ethanol production systems 12% more than non-enabled systems. In this context alternatives for ethanol production, bio fuel and many other byproducts of the alcohol industries and chemicals could benefit from the use of ultrasound beams in this range of frequencies.

Efeitos do FK-506 na regeneração de nervos após neurorrafia láteo-terminal: estudo em ratos

Pós-graduação em Bases Gerais da Cirurgia - FMB

Nanodisplacement measurements of piezoelectric flextensional actuators using a new interferometry homodyne method

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Nano-displacement measurements of a new piezoelectric flextensional actuator by using a high dynamic range interferometry homodyne method

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Surgical-allogeneic facial reconstruction: facial transplants

Several factors including cancer, malformations and traumas may cause large facial mutilation. These functional and aesthetic deformities negatively affect the psychological perspectives and quality of life of the mutilated patient. Conventional treatments are prone to fail aesthetically and functionally. The recent introduction of the composite tissue allotransplantation (CTA), which uses transplanted facial tissues of healthy donors to recover the damaged or non-existent facial tissue of mutilated patients, resulted in greater clinical results. Therefore, the present study aims to conduct a literature review on the relevance and effectiveness of facial transplants in mutilated subjects. It was observed that the facial transplants recovered both the aesthetics and function of these patients and consequently improved their quality of life.

Análise do exercício físico e eletroestimulção do músculo tibial cranial após neurorrafia término-lateral do nervo fibular em ratos

Pós-graduação em Bases Gerais da Cirurgia - FMB

Comparison Between Micro- and Macrosurgical Techniques for the Treatment of Localized Gingival Recessions Using Coronally Positioned Flaps and Enamel Matrix Derivative

Background: The aim of this study is to compare the macro- and microsurgery techniques for root coverage using a coronally positioned flap (CPF) associated with enamel matrix derivative (EMD). Methods: Thirty patients were selected for the treatment of localized gingival recessions (GRs) using CPF associated to EMD. Fifteen patients were randomly assigned to the test group (TG), and 15 patients were randomly assigned to the control group (CG). The microsurgical approach was performed in the TG, and the conventional macrosurgical technique was performed in the CG. The clinical parameters evaluated before surgery and after 6 months were GR, probing depth, relative clinical attachment level, width of keratinized tissue (WKT), and thickness of keratinized tissue (TKT). The discomfort evaluation was performed 1 week postoperative. Results: There were no statistically significant differences between groups for all parameters at baseline. At 6 months, there was no statistically significant difference between the techniques in achieving root coverage. The percentage of root coverage was 92% and 83% for TG and CG, respectively. After 6 months, there was a statistically significant increase of WKT and TKT in TG only. Both procedures were well tolerated by all patients. Conclusions: The macro- and microsurgery techniques provided a statistically significant reduction in GR height. After 6 months, there was no statistically significant difference between the techniques regarding root coverage, and the microsurgical technique demonstrated a statistically significant increase in WKT and TKT. J Periodontol 2010;81:1572-1579.

The pterional craniotomy: tips and tricks

This review intended to describe in a didactic and practical manner the frontotemporosphenoidal craniotomy, which is usually known as pterional craniotomy and constitute the cranial approach mostly utilized in the modern neurosurgery. This is, then, basically a descriptive text, divided according to the main stages involved in this procedure, and describes with details how the authors currently perform this craniotomy.

Detecção de trombose venosa em retalhos livres por medidas de glicemia capilar

INTRODUÇÃO: A monitorização do retalho livre após a cirurgia é de vital importância, especialmente nas primeiras horas de pós-operatório, pois o momento de reabordagem pode ser o definidor entre o salvamento ou a perda do retalho. Até o momento, não existe trabalho na literatura estudando a decisão de abordagem do retalho baseada em medidas objetivas ou a comparação da glicemia entre retalhos que evoluíram bem com os que sofreram sofrimento vascular. O objetivo deste estudo é avaliar a validade da medida da glicemia capilar do retalho como método de monitorização de retalhos microcirúrgicos comparando com a avaliação clínica. MÉTODO: Foram estudados prospectivamente 16 pacientes portadores de retalhos livres, realizados de maio de 2012 a julho de 2012. A glicemia capilar foi avaliada por equipe formada por profissionais não envolvidos com a cirurgia realizada. A avaliação clínica do retalho foi realizada no pós-operatório imediato, na chegada à UTI, a cada 3 horas e sempre que necessário. RESULTADOS: Dos 16 pacientes, 5 (31,3%) apresentaram complicações nas primeiras 24 horas. Todas as complicações observadas foram trombose venosa. Foi observada diferença estatisticamente significante na glicemia capilar de portadores de retalhos que apresentaram trombose venosa em comparação àqueles que não tiveram a complicação, nas medidas realizadas 6 horas, 9 horas e 12 horas após a operação (P < 0,05). CONCLUSÕES: A medida da glicemia capilar não foi superior à avaliação clínica por profissional experiente na detecção de trombose venosa de retalhos livres.

Costruzione di uno scaffold vascolarizzato per la chirurgia ortopedica

Specific aims The aim is to improve the treatment of the bone losses at the metacarpal bones level (both diaphysis and epiphysis) combining microsurgery, tissue engineering and biomaterials, so to minimize the donor side morbidity and optimize healing and outcomes. Methods Pre-operative controlateral X-ray or 3-D CT to allow custom-made HA scaffolds. Cement as temporary spacer in acute lesion and monitoring of infective risks. Treatment of the bone loss recurring to pre-fabricated or custom-made HA scaffolds, adding platelet gel or growth factor OP1. Stable synthesis. Control group with auto/omografts. Outcome indices: % of bone-union; finger TAM, Kapandji, DASH score; NMR and Scintigraphy at 180 days for revascularisation and bio-substitution of the scaffold. Preliminary results The authors just treated 6 patients, 4 males and 2 females, with an average age of 38.5 yrs, affected by segmental bone losses at the hand and wrist, recurring to pre-fabricated not vascularised scaffolds. In all cases the synthesis was performed with angular stability plates and a stable synthesis achieved. All patients have been controlled at a mean follow-up of 10.5 months (from 2 to 16 ). In all case but one the bone-scaffold osteo-integration was achieved at an average of 38 days at the hand, and 46 days at the wrist. The outcome studies, according to the DASH score, finger TAM, and Kapandji, were good and excellent in 5 cases, poor in one.