RESUMEN
Introdução: Diferentes técnicas e abordagens para a introdução de implantes mamários já foram descritas. Entretanto, estes mesmos estudos não levam em conta a natureza das propriedades cutâneas e suas consequências. A presença de ptose e alterações nas fibras elásticas cutâneas pode interferir na contratilidade, elasticidade, resiliência da pele e, consequentemente, no resultado da cirurgia de implantes para aumento mamário. Métodos: Por meio de um estudo transversal retrospectivo, foram avaliados os registros em prontuário médico de pacientes submetidas ao procedimento de implante de aumento mamário no período entre abril de 2011 a abril de 2013. Dados sobre o grau de falência das fibras elásticas e ptose mamária foram coletados e para todas as análises estatísticas foi considerado um valor de p de 0,05. Resultados: Das 70 pacientes elegíveis, a média de idade foi 33,2 ± 9,3 anos. A ausência de falência das fibras elásticas cutâneas estava presente em 44,2% da amostra. Para os níveis 1 (discreta), 2 (moderada) e 3 (acentuada), constatou-se as prevalências 12,8%, 24,4% e 18,5%, respectivamente. A ptose e a falência das fibras elásticas apresentaram correlação de r = 0,67 e p < 0,001. Conclusões: O estudo dos elementos de ptose mamária e fibras elásticas cutâneas permitiu avaliar os seus variados graus de apresentação. Sugere-se a proposta de estudos prospectivos para o melhor entendimento da relação causal entre falência das fibras elásticas e ptose mamária.
Introduction: Different techniques and approaches have already been described for the introduction of breast implants. However, these same studies do not take into account the nature of the cutaneous properties and its consequences. The presence of ptosis and degeneration of the elastic fibers can interfere in the contractility, elasticity, resilience of the skin and, consequently, the outcome of implant surgery for breast augmentation. Methods: A cross-sectional retrospective study was performed, with evaluation of the medical records of patients undergoing breast augmentation implant procedure from April 2011 to April 2013. Data on the degree of degeneration of the elastic fibers and breast ptosis were collected and a p value of 0.05 was considered for all statistical analyses. Results: Of the 70 eligible patients, the mean age was 33.2 ± 9.3 years. An absence of degeneration of the elastic fibers was present in 44.2% of the sample. A prevalence of 12.8%, 24.4% and 18.5% was found for level 1 (mild), 2 (moderate) and 3 (severe) ptosis, respectively. The correlation between ptosis and the degeneration of the elastic fibers was r = 0.67, p < 0.001. Conclusions: The study of the elements of breast ptosis and cutaneous elastic fibers enabled the evaluation of their varying degrees of presentation. Prospective studies are suggested for a better understanding of the causal relationship between the degeneration of the elastic fibers and breast ptosis.
Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Historia del Siglo XXI , Mama , Estudios Transversales , Estudios Retrospectivos , Implantes de Mama , Implantación de Mama , Procedimientos de Cirugía Plástica , Tejido Elástico , Mama/cirugía , Registros Médicos , Registros Médicos/estadística & datos numéricos , Estudios Transversales/métodos , Estudios Transversales/estadística & datos numéricos , Implantes de Mama/efectos adversos , Implantación de Mama/métodos , Procedimientos de Cirugía Plástica/métodos , Tejido Elástico/cirugía , Tejido Elástico/trasplanteRESUMEN
Synthetic polymers, including polytetrafluoroethylene and Dacron, and biomatrix proteins, including collagen and fibrin, have been used for the construction of vascular substitutes. However, these materials induce inflammatory reactions, contributing to thrombosis, smooth muscle cell (SMC) proliferation, and neointima formation, processes leading to the failure of vascular substitutes. Thus, a pressing issue in vascular reconstruction is to construct vascular substitutes with surface materials that are inflammation-resistant. Here, we demonstrate that the vascular elastic laminae exhibit such a property. Aortic specimens from donor rats were treated with 0.1M NaOH for various times, resulting in elastic lamina-collagen matrix scaffolds with and without the basal lamina. Matrix scaffolds were implanted into the host aorta with three different surface materials, including the elastic lamina, basal lamina, and adventitial collagen, and observed for leukocyte adhesion, endothelial migration, cell proliferation, and neointimal formation on these surfaces. It was found that the elastic lamina was associated with significantly lower leukocyte adhesion, BrdU incorporation, and neointima formation than the basal lamina and adventitial collagen, while the migration of endothelial cells was comparable on all three surfaces. The adventitial collagen matrix was associated with leukocyte infiltration from blood and subsequent SMC migration from the host aorta, whereas the elastic laminae were resistant to such processes. The morphology of the implanted elastic laminae appeared normal at all times. These observations suggest that the vascular elastic laminae exhibit inflammation-resistant properties and inhibit SMC mitogenic activities compared with collagen-containing matrices and may be considered a potential surface material for vascular reconstruction.
Asunto(s)
Aorta Abdominal/patología , Aorta Abdominal/cirugía , Prótesis Vascular , Movimiento Celular , Colágeno Tipo VI/metabolismo , Túnica Íntima/crecimiento & desarrollo , Túnica Íntima/patología , Animales , División Celular , Tejido Elástico/patología , Tejido Elástico/trasplante , Células Endoteliales/patología , Matriz Extracelular/metabolismo , Leucocitos/patología , Masculino , Ratas , Ratas Sprague-Dawley , Trasplantes , Túnica Íntima/cirugíaRESUMEN
OBJECTIVE: To study the value of an acellular matrix graft of the tunica albuginea for reconstruction of the penis in cases of severe Peyronie's disease. MATERIAL AND METHODS: In nine mongrel dogs, an acellular matrix graft of the tunica albuginea was used to cover a 30 x 10 mm2 tunical defect. Equal numbers of animals were sacrificed at 1, 3 and 6 months after surgery. Before death, an erection was induced by means of papaverine injection and cavernosography was performed. After death the penis was prepared for histopathological study. RESULTS: All animals survived the surgery and none developed haematoma, wound infections or dehiscence. All dogs developed a straight, rigid erection. Cavernosography showed patent corpora cavernosa in all animals. The papaverine injection and cavernosographic results did not change over time. Inspection of the graft site and measurement of its length and width showed healing with no contracture. Histologically, the regenerated matrix appeared thicker than the neighbouring tunica albuginea in the 1-month group; otherwise the appearance was normal. Gradual orientation of the fibrocytes, capillaries and collagen fibres was demonstrated at 1 month and was complete at 3 and 6 months. Comparison between an implanted tunica at 6 months and a control tunica from a normal dog showed no significant histological difference. CONCLUSION: A homologous acellular matrix graft of the tunica albuginea may be an alternative treatment for severe cases of Peyronie's disease.
Asunto(s)
Tejido Elástico/trasplante , Induración Peniana/cirugía , Pene/cirugía , Procedimientos de Cirugía Plástica/métodos , Procedimientos Quirúrgicos Urológicos Masculinos/métodos , Animales , Modelos Animales de Enfermedad , Perros , Tejido Elástico/citología , Estudios de Seguimiento , Masculino , Induración Peniana/diagnóstico por imagen , Induración Peniana/patología , Pene/diagnóstico por imagen , Pene/patología , Radiografía , Resultado del TratamientoRESUMEN
Bioprosthetic heart valves fabricated from glutaraldehyde crosslinked porcine aortic valves often fail because of calcific degeneration. Calcification occurs in both cusp and aortic wall portions of bioprosthetic heart valves. The purpose of this study was to discern the role of different aortic wall components in the calcification process. Thus, we selectively extracted cells and other extracellular matrix proteins from porcine aorta using trypsin/DNase/RNase, cyanogen bromide (CNBr), and sodium hydroxide (NaOH) treatments and subdermally implanted these pretreated aortas in young rats. Total DNA and phospholipid data showed complete removal of cells by CNBr and NaOH treatments, whereas trypsin/DNase/RNase treatment was effective in removing DNA but not phospholipids. As shown by amino acid data and Masson's trichrome staining, collagen was removed in CNBr and NaOH treatments. Control fresh porcine aorta calcified significantly after 21 days of implantation (Ca 26.4 +/- 2.4 microg/mg). Removal of cells and collagen from the aorta by CNBr treatment did not lead to a statistically significant reduction in aortic calcification (Ca 20.8 +/- 3.0 microg/mg). Moreover, partial degradation of elastin fibers caused by NaOH (during extraction) and trypsin treatment (after implantation) of the aorta significantly increased elastin-oriented calcification (Ca 94.4 +/- 9.3 and 58.4 +/- 4.6 microg/mg, respectively). Our results indicate that the elastin component of the aorta may undergo independent calcification irrespective of devitalized cell-mediated calcification observed in glutaraldehyde crosslinked aortas. Our results also demonstrate the importance of studying elastin-oriented calcification in decellularized elastin-rich aortic matrices currently used in tissue-engineering applications.
Asunto(s)
Aorta/trasplante , Enfermedades de la Aorta/etiología , Bioprótesis , Calcinosis/etiología , Tejido Elástico/trasplante , Elastina/química , Prótesis Valvulares Cardíacas , Complicaciones Posoperatorias/etiología , Aminoácidos/análisis , Animales , Aorta/química , Aorta/citología , Aorta/efectos de los fármacos , Enfermedades de la Aorta/metabolismo , Calcinosis/metabolismo , Reactivos de Enlaces Cruzados/farmacología , Bromuro de Cianógeno/farmacología , ADN/análisis , Dermis , Tejido Elástico/química , Tejido Elástico/efectos de los fármacos , Matriz Extracelular/química , Matriz Extracelular/efectos de los fármacos , Glutaral/farmacología , Masculino , Fosfolípidos/análisis , Complicaciones Posoperatorias/metabolismo , Ratas , Hidróxido de Sodio/farmacología , Porcinos , Trasplante Heterólogo , Trasplante Heterotópico , Tripsina/farmacologíaRESUMEN
O sistema interno de defesa dos moluscos é baseado sobretudo no encapsulamento, fagocitose e destruição das formas invasoras pelos hemócitos. Estudos realizados com o auxílio de técnicas de microscopia eletrônica permitiram elucidar as principais características ultraestruturais destas células e das cápsulas ou complexos encapsulantes por elas formados. Entretanto, as modificações que os hemócitos exibem em animais com diferentes gràus de susceptibilidade ao S. mansoni, o comportamento da matriz extracelular nos complexos encapsulantes e a formação de granulomas ainda não foram suficientemente explorados. [MATERIAIS E MÉTODOS]: Exemplares de B. glabrata provenientes de regiões geográficas distintas foram submetidos às análises histológicas (coloração pela hematoxilina/eosina, sírius-vermelho, orceína e Weigert), ultraestruturais e bioquímicas (técnica de hidroxiprolina). [RESULTADOS]: Os achados confirmam que somente um tipo celular (hemócito fagocitico) está presente nas reações celulares. Os elementos da matriz extracelular pesquisados não mostraram participação no interior ou na periferia das reações celulares hemocitárias. [CONCLUSÃO]: As reações teciduais de defesa em B. glabrata contra o S. mansoni são exclusivamente celulares não estando associadas á sintese e deposição de elementos da matriz extracelular.
Asunto(s)
Animales , Biomphalaria/parasitología , Colagenasas/metabolismo , Hemocitos/enzimología , Schistosoma mansoni/parasitología , Tejido Elástico/trasplanteRESUMEN
STUDY DESIGN: After autotransplanting the nucleus pulposus into the epidural space of rabbits, chondroitinase ABC was administered, and the effect of chondroitinase ABC was examined. OBJECTIVES: To examine whether chondroitinase ABC accelerates resolution of the nucleus pulposus transplanted into the epidural space. SUMMARY OF BACKGROUND DATA: No previous reports exist on the effect of chondroitinase ABC on the nucleus pulposus in the epidural space. METHODS: In Study 1, autotransplantation of the nucleus pulposus into the epidural space was performed in rabbits. Histologic change was observed. In Study 2, dry weight, deoxyribonucleic acid content, and the amount of glycosaminoglycans of autotransplanted nucleus pulposus were quantified and compared with the respective values in the control group, chondroitinase-ABC-injected group, and phosphate-buffered saline-injected group. In Study 3, granulocytes obtained from the blood of a rabbit treated with chondroitinase ABC or phosphate-buffered saline were added to the nucleus pulposus taken from the same rabbit. RESULTS: In chondroitinase ABC group, inflammatory cells tended to infiltrate earlier than those in the control group (Study 1). The dry weight of recollected nucleus pulposus in the chondroitinase ABC group was significantly less than in the other groups. Deoxyribonucleic acid content in the nucleus pulposus tended to be larger in the chondroitinase ABC group, although no significant difference in content compared with that in the other groups was found. Regarding the residual glycosaminoglycans in the transplanted nucleus pulposus, the amount of chondroitin sulfate markedly decreased in the chondroitinase ABC group (Study 2). The number of granulocytes infiltrating the nucleus pulposus was distinctly large in the chondroitinase ABC group (Study 3). CONCLUSION: Chondroitinase ABC can enhance resolution of the nucleus pulposus in the epidural space.