RESUMEN
Objetivo: analisar a topografia e biometria do forame mandibular e da lingula mandibular em crânios secos para verificar sua variabilidade e determinar suas posições topográficas. Material e Método: Para analisar as distâncias, foram realizadas medições utilizando um paquímetro digital Mitutoyo® devidamente calibrado para coletar a distância em milímetros, do centro do forame até as quatro margens (anterior, posterior, superior e inferior) do ramo mandibular (N = 176). Realizamos as medidas do forame mandibular em milímetros para determinar sua geometria externa. A lingula mandibular (N = 76) foi estudada quanto à sua localização topográfica e forma quando sua estrutura é preservada. Todos os dados foram documentados em um protocolo de coleta de dados com o objetivo de desenhar diagramas esquemáticos e arquivar as fotografias dos casos e a análise dos resultados. Resultados: em relação à frequência, o forame estava presente em todos os casos (100%), em ambos os lados da superfície medial do nervo mandibular. O número de forames de cada lado é único: foram observados 175 casos (99,5%). Apenas um forame (0,5%) era o dobro do lado direito. Em relação à sua posição em relação às margens da mandíbula, na maioria delas, está localizada próxima à margem inferior, variando entre 9,6 mm e 39,1 mm, com média de 26,0 mm. A margem posterior da mandíbula variou entre 6,8 mm e 24,0 mm, com média de 12,30 mm. A lingula mandibular dos maxilares foi analisada em 32 maxilares (64 casos), com formato triangular (55%), presente na maioria dos casos (86%) e posição ântero-superior em 43% deles. Conclusões: o forame mandibular é um elemento anatômico importante para o sucesso da técnica de bloqueio do nervo alveolar inferior. Sua estrutura acessória, a lingula mandibular, é uma posição de referência em cirurgia ortognática; devido à sua localização e aspecto, serve como um escudo protetor para o feixe neurovascular alveolar inferior
Objective: to analyze the topography and biometrics of the mandibular foramen and mandibular lingula in dry skulls to verify their variability and to determine their topographic positions. Material and method: to analyze the distances, measurements were made using a properly calibrated Mitutoyo® digital caliper to collect the distance in millimeters, from the center of the foramen to the four margins (anterior, posterior, superior and inferior) of the mandibular ramus (N=176). We performed the measurements of the mandibular foramen in millimeters to determine its external geometry. The mandibular lingula (N=76) was studied regarding its topographical location and shape when its structure was preserved. All data were documented in a data collection protocol aimed at drawing schematic diagrams and archiving the photographs of the cases and the analysis of the results. Results: in relation to the frequency, the foramen was present in all cases (100%), on both sides on the medial surface of the mandibular ramus. The number of foramen on each side is unique: 175 cases (99.5%) were observed. Only one foramen (0.5%) was double on the right side. Regarding its position in relation to the margins of the jaw, in most of them, it is located near the inferior margin, having varied between 9.6mm and 39.1mm, with an average of 26.0mm. The posterior margin of the jaw varied between 6.8mm and 24.0mm, with an average of 12.30mm. The mandibular lingula of the jaws were analyzed in 32 jaws (64 cases), having triangular shape (55%), present in most cases (86%) and in anterosuperior position in 43% of them. Conclusions: the mandibular foramen is an important anatomical element for the success of the inferior alveolar nerve block technique. Its accessory structure, the mandibular lingula, is a reference position in orthognathic surgery; due to its location and aspect, it serves as a protective shield for the inferior alveolar neurovascular bundle
Asunto(s)
Cirugía Ortognática , Anestesiología , MandíbulaRESUMEN
Autogenous bone grafts are the gold standard for reconstruction of atrophic jaws, pseudoarthroses, alveolar clefts, orthognathic surgery, mandibular discontinuity, and augmentation of sinus maxillary. Bone graft can be harvested from iliac bone, calvarium, tibial bone, rib, and intraoral bone. Proximal tibia is a common donor site with few reported problems compared with other sites. The aim of this study was to evaluate the use of proximal tibia as a donor area for maxillofacial reconstructions, focusing on quantifying the volume of cancellous graft harvested by a lateral approach and to assess the complications of this technique. In a retrospective study, we collected data from 31 patients, 18 women and 13 men (mean age: 36 years, range: 19-64), who were referred to the Department of Oral and Maxillofacial Surgery at the Servidores do Estado Federal Hospital. Patients were treated for sequelae of orthognathic surgery, jaw fracture, nonunion, malunion, pathology, and augmentation of bone volume to oral implant. The technique of choice was lateral access of proximal tibia metaphysis for graft removal from Gerdy tubercle under general anesthesia. The mean volume of bone harvested was 13.0 ± 3.7 mL (ranged: 8-23 mL). Only five patients (16%) had minor complications, which included superficial infection, pain, suture dehiscence, and unwanted scar. However, none of these complications decreases the result and resolved completely. We conclude that proximal tibia metaphysis for harvesting cancellous bone graft provides sufficient volume for procedures in oral and maxillofacial surgery with minimal postoperative morbidity.
RESUMEN
O objetivo deste trabalho foi estudar a ação do fenofibrato, um agonista do receptor ativador da proliferação peroxissomal alfa, no remodelamento cardíaco e na expressão de componentes do sistema renina-angiotensina (SRA) em um modelo de obesidade induzida por dieta. Camundongos machos C57B1/6 com três meses de idade foram alimentados durante 11 semanas com dieta controle (grupo C, 3,57 kcal/g de dieta) ou dieta hiperlipídica (grupo HL, 5,40 kcal/g de dieta), em seguida foram separados em quatro grupos e estudados durante cinco semanas: C; HO; C-L (C mais fenofibrato) e HL-F (HL mais fenofibrato). Os animais HL foram mais pesados e apresentaram maior pressão arterial (PA) comparados aos animais C, mas HL-F foram mais leves e tiveram PA menor que HL. A resistência insulínica vista nos camundongos HL foi melhorada com fenofibrato nos camundongos HL-F. Fenofibrato reduziu colesterol total, triglicerídeos e aumentou HDL-c. Os animais HL apresentou um ventrículo esquerdo (VE) mais pesado e com espessura da parede maior, como também cardiomiócitos maiores e uma menor razão cardiomiócito/capilares que os animais C. Fenofibrato foi eficiente em melhorar estas alterações. As expressões cardíacas de Angiotensina II (ANG II) e de seu receptor tipo 1 (AT1R) foram maiores, enquanto que a expressão de seu receptor tipo 2 (AT2R) foi menor nos animais HL que nos animais C, e fenofibrato foi eficiente em atenuar estas diferenças. Como conclusão, a dieta HL lidera para a obesidade, elevação da PA, hipertrofia cardíaca, alterações metabólicas e expressão proteica alterada do SRA em camundongos, sugerindo a participação do SRA nestas alterações. Fenofibrato é eficiente em diminuir a PA e controlar a expressão proteica do SRA, assim como no tratamento da resistência insulínica e do remodelamento cardíaco adverso, diminuindo a hipertrofia dos cardiomiócitos e melhorando a vascularização do miocárdio, desta maneira, diminuindo importantes fatores de risco para doenças ...
The aim was to study the action of fenofibrate, a peroxisome proliferator-activated receptor alpha agonist, in cardiac remodeling and protein expressions of RAS components in a model of obesity induced by diet. 3-mo-old C57B1/6 male were fed for 11 weeks with standard chow (SC group, 3.57 kcal/g of chow) or high-fat chow (HF group, 5.40 kcal/g of chow), then they were separated into four groups and studied for five weeks: SC; HF; SC-F (SC plus fenofibrate) and HF-F (HF plus fenofibrate). HF was heavier and had higher blood pressure (BP) than SC, but HF-F was lighter and had lower BP than HF. The insulin resistance seen in HF mice was corrected by fenofibrate in HF-F mice. Fenofibrate reduced total cholesterol, triglycerides and raised the HDL-c. HF had thicker and heavier left ventricle (LV) with bigger LV cardiomyocyte and smaller cardiomyocyte-to-capillaries ratio than SC, and fenofibrate was efficient in treating these alterations. Cardiac expressions of angiotensin II (ANG II) and ANG II receptor 1 were higher, and ANG II receptor 2 was lower in HF than in SC, and fenofibrate was efficient in attenuating these differences. In conclusion , HF diet leads to obesity, BP elevation, cardiac hypertrophy, metabolic changes and altered RAS protein expression in mice, suggesting that RAS is involved. Fenofibrate is efficient in decreasing BP and in controlling RAS protein expressions, and treats the insulin resistance and the adverse cardiac remodeling decreasing the cardiomyocyte hypertrophy and improving the myocardial vascularization, therefore, decreasing important cardiovascular risk factors
Asunto(s)
Animales , Masculino , Ratas , Fenofibrato/farmacología , PPAR alfa/agonistas , Remodelación Ventricular , Remodelación Ventricular/fisiología , Sistema Renina-Angiotensina , Sistema Renina-Angiotensina/fisiología , Enfermedades Cardiovasculares/prevención & control , Grasas de la Dieta/administración & dosificación , Resistencia a la Insulina , Presión Arterial , Sobrepeso/inducido químicamenteRESUMEN
Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonists have been shown controlling blood pressure (BP) in spontaneously hypertensive rats and salt-sensitive hypertensive rats. The present study aims to test the hypothesis that PPAR-gamma agonist rosiglitazone has beneficial effects on cardiac and vascular adverse remodeling in a model of renovascular hypertension (two-kidneys-one-clip, 2K1C model). Wistar rats were divided into four groups (n=6): SHAM group, 2K1C, 2K1C+HYD (treated with hydralazine for 5 weeks) and 2K1C+ROSI (treated with rosiglitazone for 5 weeks). The left ventricle (LV), thoracic aorta (Ao) and common carotid artery (CCA) were analyzed. The BP did not show significant difference at the end of the experiment in groups 2K1C+ROSI, 2K1C+HYD and SHAM. The LV mass was smaller in 2K1C+ROSI compared with the other groups. The intima-media thickness was smaller in 2K1C+ROSI compared with untreated 2K1C ones, but not in 2K1C+HYD; 2K1C and 2K1C+HYD showed smaller Ao and CCA density of smooth muscle cell nuclei, and smaller surface density of the elastic lamellae than SHAM. The Ao and CCA circumferential wall tension and tensile stress were greater in 2K1C than in SHAM. Hypertrophied cardiomyocytes were seen in 2K1C, but not in 2K1C+ROSI and SHAM; 2K1C+ROSI had enhanced volume and length densities of intramyocardial arteries than 2K1C. The volume density of cardiac interstitium was greater in 2K1C and 2K1C+HYD than in SHAM. In conclusion, PPAR-gamma agonist rosiglitazone has beneficial effects controlling BP, reducing vascular adverse remodeling, and preserving intramyocardial vascularization in renovascular hypertensive rats (2K1C model).
Asunto(s)
Aorta/efectos de los fármacos , Arteria Carótida Común/efectos de los fármacos , Hipertensión Renovascular/tratamiento farmacológico , Miocardio/patología , PPAR gamma/agonistas , Tiazolidinedionas/uso terapéutico , Animales , Aorta/patología , Arteria Carótida Común/patología , Hipertensión Renovascular/patología , Hipertensión Renovascular/fisiopatología , Inmunohistoquímica , Insulina/sangre , Leptina/sangre , Masculino , Ratas , Ratas Endogámicas SHR , Ratas Wistar , Rosiglitazona , Tiazolidinedionas/farmacología , Túnica Íntima/patologíaRESUMEN
PURPOSE: To investigate changes in cardiac functional parameters and the cardiac expression of angiotensin-converting enzyme (ACE), angiotensin II type 1 receptor (AT1), procollagen type I (proc-I) and transforming growth factor-ß1 (TGF-ß1) in rats irradiated at heart. MATERIAL AND METHODS: Male Wistar rats were irradiated with a single dose of radiation (0, 5, 10 and 15 Gray [Gy]) delivered directly to the heart and the molecular evaluations were performed at various times post-irradiation (two days, 15 days and four months). The expression of ACE, AT1, proc-I and TGF-ß1 were analysed using Real Time-Polymerase Chain Reaction (RT-PCR) and/or Western blotting. Cardiac structural and functional alterations were investigated at the four-month time point by echocardiography and by quantitative methods (stereology). RESULTS: Rats irradiated with 15 Gy showed a modest reduction in the ejection fraction. Cardiac proc-I, TGF-ß1, ACE and AT1 were also measurably increased. CONCLUSIONS: Irradiated rat hearts show simultaneous elevations in renin-angiotensin system components AT1 and ACE and cardiac remodeling markers proc-I and TGF-ß1.
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Peptidil-Dipeptidasa A/genética , Peptidil-Dipeptidasa A/metabolismo , Receptor de Angiotensina Tipo 1/genética , Receptor de Angiotensina Tipo 1/metabolismo , Regulación hacia Arriba/efectos de la radiación , Animales , Colágeno Tipo I/genética , Colágeno Tipo I/metabolismo , Relación Dosis-Respuesta en la Radiación , Corazón/fisiología , Corazón/efectos de la radiación , Masculino , Miocitos Cardíacos/citología , Miocitos Cardíacos/efectos de la radiación , Ratas , Ratas Wistar , Sistema Renina-Angiotensina/efectos de la radiación , Factor de Crecimiento Transformador beta1/genética , Factor de Crecimiento Transformador beta1/metabolismoRESUMEN
Rosiglitazone, a PPAR gamma agonist, is an antidiabetic drug that shows secondary beneficial actions on cardiovascular system. Our study is centered on myocardial remodeling in maternal protein restriction offspring, focusing on fibrosis and vascularization. Wistar rat dams received one of the two diets: normal (19% protein; NP) or low protein (5% protein; LP) during gestation and lactation. Three-month-old male offspring were divided into four groups: NP treated with rosiglitazone (NPR, 5 mg/kg/day); untreated NP (NP); LP treated (LPR); untreated LP (LP) until six months. Blood pressure (BP) was higher in LP, but rosiglitazone reduced BP at the first week of treatment in LPR. Rosiglitazone had beneficial effects on fibrosis (less than 23%, P<0.05) and vascularization (plus 57% of capillary/cardiomyocyte ratio, P<0.01) compared with LP offspring, independently of blood glucose. Multivariate analysis classified 95% of groups, and LPR offspring showed values close to those of NP offspring. Rosiglitazone showed beneficial effects on rat offspring programmed by low protein diet during gestation decreasing cardiac fibrosis and enhancing myocardial vascularization. These results are significant in translational medicine for patients with chronic diseases in adult life and increased cardiovascular risk.
Asunto(s)
Enfermedades Cardiovasculares/tratamiento farmacológico , Dieta con Restricción de Proteínas/efectos adversos , Corazón/efectos de los fármacos , Hipoglucemiantes/farmacología , Tiazolidinedionas/farmacología , Remodelación Ventricular/efectos de los fármacos , Animales , Presión Sanguínea/efectos de los fármacos , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/patología , Fibrosis , Masculino , PPAR gamma/agonistas , Ratas , Ratas Wistar , RosiglitazonaRESUMEN
This study investigated the effects of rosiglitazone on nutritionally programmed chronic disease, with a focus on blood pressure (BP) and aortic wall structural remodeling. Wistar pregnant rats were fed one of two diets: a normal protein diet (19% protein; NP rats) or low-protein diet (5% protein; LP rats). Male offspring at 3 months of age were randomly divided into four groups: NP offspring treated with rosiglitazone (NPR); untreated NP offspring (NP); LP offspring treated with rosiglitazone (LPR); untreated LP offspring (LP). Rosiglitazone was administered at a dose of 5 mg/kg/d until 6 months of age. BP was elevated in LP offspring. Rosiglitazone reduced BP beginning in the first week of treatment in the LPR offspring. The insulin sensitivity was increased in LP offspring, and was not altered by rosiglitazone. LP offspring exhibited a 40% reduction in the amount of elastic fibers in the aorta wall compared with NP offspring (p < 0.01), and the quantity of elastic fibers was not altered by rosiglitazone. The smooth muscle cells, elastic lamellae, circumferential wall tension (CWT) and tensile stress (TS) were increased in LP offspring, indicating increased blood flow in the aorta. Rosiglitazone reduced both CWT and TS by 30% compared to the levels in untreated LP offspring (p < 0.01 for both). Rosiglitazone restored the expressions of angiotensin II type 1 receptor and endothelial nitric oxide synthase nearly to the levels in the NP offspring. ANOVA disclosed a significant two-factor interaction between protein content in the diet and rosiglitazone treatment (p < 0.001 for CWT and p < 0.00001 for TS, two-way ANOVA). We conclude that rosiglitazone has beneficial effects in reducing the BP and the aortic tunica media hypertrophy with consequent balance of the wall stress in metabolically programmed offspring.