Intra-articular pressure profiles of the cadaveric equine fetlock joint in motion

The study of the influence of motion and initial intra-articular pressure (IAP) on intra-articular pressure profiles in equine cadaver metatarsophalangeal (MTP) joints was undertaken as a prelude to in vivo studies, Eleven equine cadaver MTP joints were submitted to 2 motion frequencies of 5 and 10 cycles/min of flexion and extension, simulating the condition of lower and higher (double) rates of passive motion. These frequencies were applied and pressure profiles generated with initial normal intra-articular pressure (-5 mmHg) and subsequently 30 mmHg intra-articular pressure obtained by injection of previously harvested synovial fluid.The 4 trials performed were 1) normal IAP; 5 cyles/min; 2) normal IAP; 10 cycles/min; 3) IAP at 30 mmHg; 5 cycles/min and 4) IAP at 30 mmHg; 10 cycles/min. The range of joint motion applied (mean +/- s.e.) was 67.6 +/- 1.61 degrees with an excursion from 12.2 +/- 1.2 degrees in extension to 56.2 +/- 2.6 degrees in flexion, Mean pressure recorded in mmHg for the first and last min of each trial, respectively, were 1) -5.7 +/- 0.9 and -6.3 +/- 1.1; 2) -5.3 +/- 1.1 and -6.2 +/- 1.1; 3) 58.8 +/- 8.0 and 42.3 +/- 7.2; 4) 56.6 +/- 3.7 and 40.3 +/- 4.6. Statistical analyses showed a trend for difference between the values for the first and last minute in trial 3 (0.05>P<0.1) with P = 0.1 and significant difference (P = 0.02) between the mean IAP of the first and last min in trial 4. The loss of intra-articular pressure associated with time and motion was 10.5, 16.9, 28.1 and 28.9% for trials 1-4, respectively. As initial intraarticular pressure and motion increased, the percent loss of intra-articular pressure increased.The angle of lowest pressure was 12.2 +/- 1.2 (mean +/- s.e.) in extension in trials 1 and 2, In trials 3 and 4, the lowest pressures were obtained in flexion with the joints at 18.5 +/- 2.0 degrees (mean +/- s.e.). This demonstrated that the joint angle of least pressure changed as the initial intra-articular pressure changed and there would not be a single angle of least pressure for a given joint.The volume of synovial fluid recovered from the MTP joints in trial 3 compared to 4 (trials in which fluid was injected to attain IAP of 30 mmHg) was not significantly different, supporting a soft tissue compliance change as a cause for the significant loss of intra-articular pressure during the 15 min of trial 4.The pressure profiles generated correlate well with in vivo values and demonstrated consistent pressure profiles. Our conclusions are summarised as follows:1. Clinically normal equine MTP joints which were frozen and then later thawed were found to have mostly negative baseline intra-articular pressures, as would be expected in living subjects,2. Alternate pressure profiles of the dorsal and plantar pouch at baseline intra-articular pressure document the presence of pressure forces that would support 'back and forth' fluid movement between joint compartments. This should result in movement of joint fluid during motion, assisting in lubrication and nutrition of articular cartilage,3. If joint pressure was initially greater than normal (30 mmHg), as occurs in diseased equine MTP joints, joint motion further increased joint capsule relaxation (compliance) and, therefore, reduced intra-articular pressure.4. Peak intra-articular pressures reached extremely high values (often >100 mmHg) in flexion when initial pressure was 30 mmHg. Joint effusion pressures recorded for clinical MCP joints are frequently 30 mmHg. These IAP values are expected to produce intermittent synovial ischaemia in clinical cases during joint flexion.5, Additional in vivo studies are necessary to confirm our conclusions from this study and to identify the contributions of fluid absorption and the presence of ischaemia in a vascularised joint.

Contratos internacionais do comércio no direito brasileiro de lege lata de lege ferenda

Pós-graduação em Direito - FCHS

Queimando-lata - sem eira, nem beira

O artigo analisa a forma de exploração do trabalho dos queima-latas na agricultura paulista, discutindo a trajetória da sua migração e as condições de sua reprodução.

Som e vida após a lata: construção de instrumentos musicais com material alternativo

Pós-graduação em Música - IA

Overproduction and properties of lipase by wild strain of Burkholderia lata LBBIO-BL02 using chicken fat

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Bone defect repair on the alveolar wall of the maxillary sinus using collagen membranes and temporal fascia: an experimental study in monkeys

Few studies has been done using guided bone regeneration in maxillary sinus defects. AIM: To assess the bone repair process in surgical defects on the alveolar wall of the monkey maxillary sinus, which communicates with the sinus cavity, by using collagen membranes: Gen-derm - Genius Baumer, Pro-tape - Proline and autologous temporal fascia. MATERIALS AND METHODS: In this prospective and experimental study, orosinusal communications were performed in four tufted capuchin monkeys (Cebus apella) and histologic analysis was carried out 180 days after. RESULTS: In the defects without a cover (control), bone proliferation predominated in two animals and fibrous connective tissue predominated in the other two. In defects repaired with a temporal fascia flap, fibrous connective tissue predominated in three animals and bone proliferation predominated in one. In the defects repaired with Gen-derm or Pro-tape collagen membranes there was complete bone proliferation in three animals and fibrous connective tissue in one. CONCLUSIONS: Surgical defect can be repaired with both bone tissue and fibrous connective tissue in all study groups; collagen membranes was more beneficial in the bone repair process than temporal fascia or absence of a barrier.

Transmission of clear cell tumor in a graft liver from cadaveric donor: Case report

Neoplasms in children after organ transplantation are related to the type and intensity of immunosuppression and the donorrecipient serostatus, especially in relation to the EpsteinBarr virus. The patient was a two-yr-old female child with biliary atresia who underwent a liver transplantation from a female cadaver donor. Two adults received kidney transplants from the same donor. Nine months after transplantation, one of the adult recipients developed an urothelial tumor in the kidney graft. Imaging tests were repeated monthly in the liver-transplanted child and revealed no abnormalities. However, one yr and two months after the transplantation, the patient developed episodes of fever. At that time, imaging and liver biopsy showed a clear cell tumor of urothelial origin in the graft and the disease was limited to the liver. The patient underwent liver retransplantation, and she is currently free of tumor recurrence. Although rare, the occurrence of tumors in the post-transplant period from cadaver donors, without previously diagnosed tumors, is one of the many problems encountered in the complex world of organ transplantation.

La rinascita del Lido Iride. Progetto di riqualificazione della fascia costiera di Platamona

Questo progetto, maturato in seguito a profonde riflessioni basate sull’analisi e la valutazione della situazione territoriale, è scaturito dalla volontà di fornire una risposta alle carenze funzionali e strutturali di un’area dalle molteplici potenzialità. La fascia costiera di Platamona è stata al centro di progetti di lottizzazione che, invece di tutelare l’aspetto naturalistico e unificare un sistema costiero che si estende per circa otto chilometri, hanno inserito strutture prevalentemente ricettive e turistiche in maniera piuttosto arbitraria e senza tener conto della possibilità di organizzare il progetto d’intervento tramite un apposito strumento urbanistico. Il risultato, un tessuto edilizio disomogeneo e disorganizzato, non contribuisce certo alla volontà di attribuire un carattere e un’identità al luogo; anzi, la frequenza di aree in stato di abbandono, che rischiano di diventare discariche a cielo aperto fa quasi pensare ad una situazione di stallo e di incuria sia da parte delle amministrazioni che dei privati. L’idea del progetto deriva da un approccio che ha come obiettivo il massimo sfruttamento delle risorse locali e il minor impatto possibile sul paesaggio e sul sistema attuale. La volontà è quella di riorganizzare e riqualificare gli spazi più significativi, inserendoli all’interno di un sistema di percorsi e connessioni che vogliono unificare e rendere fruibile l’intero sistema costiero fra Platamona e Marina di Sorso. Inoltre è da rivalutare l’aspetto naturalistico del SIC dello Stagno e Ginepreto di Platamona, un’oasi naturalistica che ha tutte le potenzialità per essere posta al centro di un’attività di ricerca e diventare la meta di un turismo mirato. Nel Piano di gestione dello stagno sono già stati previsti e realizzati percorsi su passerelle in legno che si snodano fra i canneti e la pineta limitrofa, con alcune torrette di avvistamento, attualmente posizionate nella zona a sud. Uno degli obiettivi è dunque quello di completare questi percorsi per gran parte del perimetro dello stagno e di stabilire un percorso ciclo-pedonale ad anello che circondi e renda fruibile l’intera area del SIC. A livello di percorsi e connessioni, oltre alla nuova pista ciclabile che correrà parallelamente alla SP 81, si cercherà di fornire nuovi collegamenti anche all’ambito della spiaggia. L’idea è di costruire una passeggiata sul fronte mare che si articoli con leggere passerelle in legno fra le dune irregolari. Si snoderebbe dalla rotonda di Platamona fino alla piazza di Marina di Sorso, per una lunghezza di circa otto chilometri. Il suo scopo è di rendere fruibile l’intera fascia di spiaggia in modo da evitare un eccessivo calpestio del sistema dunario, che purtroppo risente della forte presenza antropica dei mesi estivi. Nel ripensare questi collegamenti e percorsi, si rende necessaria la creazione di aree di sosta attrezzate che si presentano con una certa periodicità, dettata dai pettini e dalle discese a mare. Vi saranno punti di sosta ombreggiati con alberature, aiuole, sedute, fontane e giochi per bambini. Diventa dunque prioritario il fatto di rendere evidente il concetto di unitarietà del sistema costiero in questione, rendendolo riconoscibile tramite l’organizzazione di spazi, episodi e percorsi. Infine il tentativo che riguarda nello specifico il Lido Iride, è quello relativo al suo recupero. L’intento è di restaurarlo e destinarlo a nuove funzioni ricreative-culturali. La struttura principale è mantenuta invariata, soprattutto le stecche che costituivano le cabine sulla spiaggia (elementi alquanto evocativi e radicati nella memoria del luogo). Il complesso sarà riorganizzato in previsione di ospitare workshop e corsi formativi riguardanti la cultura del mare e della salvaguardia dell’ambiente. Molto attuale e sempre più emergente anche in Sardegna risulta l’archeologia subacquea, a cui sono già state dedicate apposite strutture nelle zone di Cagliari e di Orosei. Dunque si riadatteranno le cabine con lo scopo di farle divenire alloggi temporanei per coloro che seguiranno tali corsi, mentre gli altri edifici del complesso fungeranno da supporto per delle lezioni all’aperto (l’arena e la piscina) e per il ristoro o l’allestimento di spazi espositivi (l’edificio centrale del lido). A causa della posizione del complesso balneare (a ridosso della spiaggia) si presuppone che il suo utilizzo sarà prevalentemente stagionale; perciò si è pensato di fornire una struttura di supporto e d’ausilio, la cui fruizione sia auspicabile anche nei mesi invernali: il Nuovo Centro Studi di Platamona. Questo nuovo complesso consiste in una struttura dotata di laboratori, aule conferenze, alloggi e ristorante. Si attesterà sul fronte mare, seguendo la direttrice del nuovo camminamento e innalzandosi su piattaforme e palafitte per non essere eccessivamente invasivo sul sistema dunario. Consisterà in due edifici di testata alti rispettivamente tre e quattro piani, ed entrambi avranno la peculiarità di avere il basamento aperto, attraversato dall’asse della passeggiata sul mare. L’edificio a tre piani ospiterà i laboratori, l’altro il ristorante. Dietro l’edificio dei laboratori si svilupperà una corte porticata che permetterà di giungere alla sala conferenza. Nella parte retrostante i due edifici di testata saranno distribuiti delle stecche di alloggi su palafitte immerse nel verde, caratterizzate da coperture con volte a botte. Lo stile architettonico del nuovo complesso si rifà all’architettura mediterranea, che s’identifica tramite l’utilizzo di basamenti e piccole aperture in facciata, l’uso di pietre e materiali da costruzioni locali, le bianche superfici che riflettono la luce e il forte segno architettonico dei muri che marcano il terreno seguendone l’orografia fino a diventare un tutt’uno.

One hundred fascia-sparing myocutaneous rectus abdominis flaps: An update

Major efforts have been undertaken to reduce donor-site morbidity after abdominal flaps, which eventually culminated in the introduction of the deep inferior epigastric perforator (DIEP) flap. However, due to anatomical variations (absence of dominant perforators) and the risk of ischaemic complications, the selection of patients qualifying for a DIEP flap is limited. Furthermore, DIEP flaps can only be used as free flaps. We present our long-term experience with a dissection technique of rectus abdominis myocutaneous (RAM) flaps that was developed to circumvent these drawbacks. The dissection is characterised by preventing to sacrifice any perforators nourishing the flap and by fully preserving the anterior rectus sheath, but not the muscle. The study comprises a consecutive series of prospectively assessed patients, treated between February 2000 and April 2008. A total of 100 fascia-sparing RAM flaps were operated on 97 patients (age 22-84 years, median 64 years). Free flaps were mainly used for breast reconstruction (47 flaps/24 patients), and cranially (34) or caudally (19) pedicled flaps for soft-tissue coverage after sternectomy, urogenital tumour resection or rectum amputation. Eighty patients had a total of 213 risk factors, such as cardiovascular diseases, obesity, hyperlipidaemia, diabetes mellitus, smoking or steroid medication. Partial tissue loss (skin or fat necrosis) occurred in 13 flaps, out of which seven required surgical revision. The ischaemic complications were evenly distributed between the patient subsets. At a follow-up of 2-89 months (median 20 months), one patient showed a flap harvest-related abdominal bulge after bilateral-free transverse rectus abdominis myocutaneous (TRAM) flap. We conclude that the present dissection technique provides maximal perforator-related perfusion and minimal donor-site morbidity even in pedicled flaps and high-risk patients. In free flaps, it may, therefore, be recommended as an alternative to the DIEP flap.

Microfenestration using the CUSA Excel ultrasonic aspiration system in chondrodystrophic dogs with thoracolumbar disk extrusion: a descriptive cadaveric and clinical study

OBJECTIVE: To describe an ultrasonic surgical aspirator assisted disk fenestration technique in dogs. STUDY DESIGN: Descriptive cadaveric and prospective clinical study. ANIMALS: Fresh Beagle cadavers (n=5) and 10 chondrodystrophic dogs with thoracolumbar disk extrusion. METHODS: Cadaveric study: Intervertebral disks T12-L2 were fenestrated with the CUSA Excel in 5 Beagle cadavers, and fenestration efficacy assessed by morphologic examination of the completeness of fenestration and size of annulotomy. Clinical study: the affected intervertebral disk was fenestrated in 10 chondrodystrophic dogs treated by hemilaminectomy for thoracolumbar disk disease. Efficacy of fenestration was evaluated. RESULTS: Mean time necessary to perform CUSA assisted fenestration was 8 minutes (range, 5-10 minutes) for each disk in cadavers and patients. In cadaver spines, removal of the nucleus pulposus was complete in 11/15 disks. In 4 disks, remnants of nucleus pulposus material were observed on the contralateral side. Nuclear material was normal in 9/15 disks and showed evidence of chondroid degeneration on histopathologic examination in the 6 disks. Median annulotomy size was 3 mm. Clinically, no signs of early recurrence were observed and all dogs recovered uneventfully. CONCLUSIONS: CUSA assisted fenestration is a safe and efficient method of fenestration for removal of most of the nucleus pulposus through a limited annulotomy.

Ultrasound-guided retrobulbar nerve block in horses: a cadaveric study

Objective  To develop an ultrasound-guided technique for retrobulbar nerve block in horses, and to compare the distribution of three different volumes of injected contrast medium (CM) (4, 8 and 12 mL), with the hypothesis that successful placement of the needle within the retractor bulbi muscle cone would lead to the most effective dispersal of CM towards the nerves leaving the orbital fissure. Study design  Prospective experimental cadaver study. Animals  Twenty equine cadavers. Methods  Ultrasound-guided retrobulbar injections were performed in 40 cadaver orbits. Ultrasound visualization of needle placement within the retractor bulbi muscle cone and spread of injected CM towards the orbital fissure were scored. Needle position and destination of CM were then assessed using computerized tomography (CT), and comparisons performed between ultrasonographic visualization of orbital structures and success rate of injections (intraconal needle placement, CM reaching the orbital fissure). Results  Higher scores for ultrasound visualization resulted in a higher success rate for intraconal CM injection, as documented on the CT images. Successful intraconal placement of the needle (22/34 orbits) resulted in CM always reaching the orbital fissure. CM also reached the orbital fissure in six orbits where needle placement was extraconal. With 4, 8 and 12 mL CM, the orbital fissure was reached in 16/34, 23/34 and 28/34 injections, respectively. Conclusion and clinical relevance  The present study demonstrates the use of ultrasound for visualization of anatomical structures and needle placement during retrobulbar injections in equine orbits. However, this approach needs to be repeated in controlled clinical trials to assess practicability and effectiveness in clinical practice.

Influence of surgical approach on the efficacy of the intervertebral disk fenestration: a cadaveric study

OBJECTIVES: To investigate the influence of different approach angles on the amount of nucleus pulposus removed during intervertebral disc fenestration in dogs. METHODS: Twenty cadavers of beagle dogs were randomly divided into four groups: a control group and three treatment groups in which intervertebral fenestration was performed using either a dorsal, dorsolateral or lateral approach between the 12th thoracic and second lumbar spaces. The volume of nucleus pulposus, the weight of the residual nucleus pulposus and the angle of the working sector were measured. The ratio of the residual nucleus pulposus weight to the nucleus pulposus volume was used to evaluate the efficacy of the performed fenestration. Data were analysed with Kruskal-Wallis analysis of variance between groups on ranks with correction for ties and Bonferroni correction for multiple comparisons. Correlation between ratio and working angle was calculated using a Spearman's rank test (P<0.05). RESULTS: The calculated ratio of nuclear weight to volume was significantly less in the lateral approach group than that in the other groups. The working sector was widest in the dorsolateral approach group, but this did not correlate with efficient fenestration. CLINICAL SIGNIFICANCE: Using the lateral approach for intervertebral disc fenestration may increase the efficiency of the fenestration procedure.

How accurately can the acetabular rim be trimmed in hip arthroscopy for pincer-type femoral acetabular impingement: a cadaveric investigation

PURPOSE: The purpose of this study was to evaluate the precision of central hip arthroscopy in the assessment and treatment of pincer-type femoroacetabular impingement (FAI) avoiding the posterolateral portal, with its close proximity to the main arterial blood supply of the femoral head, the medial circumflex femoral artery. METHODS: Seven human cadaveric hips underwent arthroscopic trimming of the acetabular labrum and rim along a preoperatively defined 105 degrees arc of resection for treatment of a presumed pincer-type lesion. After the arthroscopic procedure, all specimens were dissected and measured for evaluation of the location, quantity, and quality of the area undergoing resection. RESULTS: The difference between the actual and planned arc of resection was 18.7 degrees +/- 4.7 degrees (range, 2 degrees to 34 degrees). This was mainly because of a lack of accuracy in the presumed posterior starting point (PSP), with a mean deviation of 19 degrees +/- 3.4 degrees (range, 10 degrees to 36 degrees). Correlation analysis showed that variance in the arc of resection was mainly dependent on the PSP (r = 0.739, P = .058). CONCLUSIONS: Central hip arthroscopy is a feasible option in treating anterosuperior pincer-type FAI by use of the anterior and anterolateral portals only. This cadaveric study showed that there is a significant risk of underestimating the actual arc of resection compared with the planned arc of resection for posterosuperior pincer-type lesions because of the modest accuracy in determining the PSP of the resection. CLINICAL RELEVANCE: Accurate preoperative planning and arthroscopic identification of anatomic landmarks at the acetabular side are crucial for the definition of the appropriate starting and ending points in the treatment of pincer-type FAI. Whereas anterosuperior pincer-type lesions can be addressed very precisely with our technique, the actual resection of posterosuperior lesions averaged 19 degrees less than the planned resection, which may have clinical implications.