Size-dependent sex allocation in Solanum lycocarpum St. Hil. (Solanaceae) / Alocação de sexo dependente de tamanho em Solanum lycocarpum St. Hil. (Solanaceae)

Resource allocation to reproduction can change depending on size, as predicted by the size-dependent sex allocation. This theory is based on the fact that small individuals will invest in the allocation of sex with lower cost of production, usually male gender. In plants, there are some andromonoecy species, presence of hermaphrodite and male flowers in the same individual. Andromonoecy provides a strategy to optimally allocate resources to male and female function, evolving a reproductive energy-saving strategy. Thus, our objective was to investigate the size-dependent sex allocation in Solanum lycocarpum St. Hil. We tested the hypothesis that plants with larger size will invest in the production of hermaphrodite flowers, because higher individuals have greater availability of resources to invest in more complex structures involving greater energy expenditure. The studied species was S. lycocarpum, an andromonoecious species. From June 2016 to March 2017 the data were collected in 38 individuals, divided in two groups: the larger plant group (n=18; height=3-5 m) and the smaller plant group (n=20; height=1-2 m).Our data show that there was effect of plant size on the flower production and the sexual gender allocation. The larger plants showed more flowers and higher production of hermaphrodite flowers. Furthermore, in the flower scale, we observed allometric relationship among the flower's traits with proportional investments in biomass, anther size and gynoecium size. Our results are in agreement with size-dependent sex allocation theory and andromonoecy hypothesis related to mechanisms for optimal resource allocation to male and female function.

A alocação de recursos para reprodução pode mudar dependendo do tamanho, conforme previsto pela alocação sexual dependente do tamanho. Essa teoria é baseada no fato de que indivíduos pequenos investirão na alocação sexual com menor custo de produção, geralmente do sexo masculino. Nas plantas, existem algumas espécies andromonoicas, presença de hermafrodita e flores masculinas no mesmo indivíduo. A andromonoicia fornece uma estratégia para alocar recursos de maneira ideal às funções masculina e feminina, desenvolvendo uma estratégia reprodutiva de economia de energia. Assim, nosso objetivo foi investigar a alocação sexual dependente do tamanho em Solanum lycocarpum St. Hil. Testamos a hipótese de que plantas de maior tamanho investirão na produção de flores hermafroditas, pois indivíduos mais altos economizam mais disponibilidade de recursos para investir em estruturas mais complexas que envolvem maior gasto de energia. A espécie estudada foi S. lycocarpum, uma espécie andromonoica. De junho de 2016 a março de 2017, os dados foram coletados em 38 indivíduos, divididos em dois grupos: o maior grupo de plantas (n = 18; altura = 3-5 m) e o menor grupo de plantas (n = 20; altura = 1-2 m). Nossos dados mostram que houve efeito do tamanho da planta na produção de flores e na alocação sexual. As plantas maiores apresentaram mais flores e maior produção de flores hermafroditas. Além disso, observamos uma relação alométrica entre as características da flor, com investimentos proporcionais em biomassa, tamanho da antera e tamanho do gineceu. Nossos resultados estão de acordo com a teoria de alocação de sexo dependente de tamanho e a hipótese de andromonoicia relacionada a mecanismos para a alocação ótima de recursos para a função masculina e feminina.

Size-dependent sex allocation in Solanum lycocarpum St. Hil. (Solanaceae)

Abstract Resource allocation to reproduction can change depending on size, as predicted by the size-dependent sex allocation. This theory is based on the fact that small individuals will invest in the allocation of sex with lower cost of production, usually male gender. In plants, there are some andromonoecy species, presence of hermaphrodite and male flowers in the same individual. Andromonoecy provides a strategy to optimally allocate resources to male and female function, evolving a reproductive energy-saving strategy. Thus, our objective was to investigate the size-dependent sex allocation in Solanum lycocarpum St. Hil. We tested the hypothesis that plants with larger size will invest in the production of hermaphrodite flowers, because higher individuals have greater availability of resources to invest in more complex structures involving greater energy expenditure. The studied species was S. lycocarpum, an andromonoecious species. From June 2016 to March 2017 the data were collected in 38 individuals, divided in two groups: the larger plant group (n=18; height=3-5 m) and the smaller plant group (n=20; height=1-2 m).Our data show that there was effect of plant size on the flower production and the sexual gender allocation. The larger plants showed more flowers and higher production of hermaphrodite flowers. Furthermore, in the flower scale, we observed allometric relationship among the flowers traits with proportional investments in biomass, anther size and gynoecium size. Our results are in agreement with size-dependent sex allocation theory and andromonoecy hypothesis related to mechanisms for optimal resource allocation to male and female function.

Resumo A alocação de recursos para reprodução pode mudar dependendo do tamanho, conforme previsto pela alocação sexual dependente do tamanho. Essa teoria é baseada no fato de que indivíduos pequenos investirão na alocação sexual com menor custo de produção, geralmente do sexo masculino. Nas plantas, existem algumas espécies andromonoicas, presença de hermafrodita e flores masculinas no mesmo indivíduo. A andromonoicia fornece uma estratégia para alocar recursos de maneira ideal às funções masculina e feminina, desenvolvendo uma estratégia reprodutiva de economia de energia. Assim, nosso objetivo foi investigar a alocação sexual dependente do tamanho em Solanum lycocarpum St. Hil. Testamos a hipótese de que plantas de maior tamanho investirão na produção de flores hermafroditas, pois indivíduos mais altos economizam mais disponibilidade de recursos para investir em estruturas mais complexas que envolvem maior gasto de energia. A espécie estudada foi S. lycocarpum, uma espécie andromonoica. De junho de 2016 a março de 2017, os dados foram coletados em 38 indivíduos, divididos em dois grupos: o maior grupo de plantas (n = 18; altura = 3-5 m) e o menor grupo de plantas (n = 20; altura = 1-2 m). Nossos dados mostram que houve efeito do tamanho da planta na produção de flores e na alocação sexual. As plantas maiores apresentaram mais flores e maior produção de flores hermafroditas. Além disso, observamos uma relação alométrica entre as características da flor, com investimentos proporcionais em biomassa, tamanho da antera e tamanho do gineceu. Nossos resultados estão de acordo com a teoria de alocação de sexo dependente de tamanho e a hipótese de andromonoicia relacionada a mecanismos para a alocação ótima de recursos para a função masculina e feminina.

Size-dependent sex allocation in Solanum lycocarpum St. Hil. (Solanaceae) / Alocação de sexo dependente de tamanho em Solanum lycocarpum St. Hil. (Solanaceae)

Resource allocation to reproduction can change depending on size, as predicted by the size-dependent sex allocation. This theory is based on the fact that small individuals will invest in the allocation of sex with lower cost of production, usually male gender. In plants, there are some andromonoecy species, presence of hermaphrodite and male flowers in the same individual. Andromonoecy provides a strategy to optimally allocate resources to male and female function, evolving a reproductive energy-saving strategy. Thus, our objective was to investigate the size-dependent sex allocation in Solanum lycocarpum St. Hil. We tested the hypothesis that plants with larger size will invest in the production of hermaphrodite flowers, because higher individuals have greater availability of resources to invest in more complex structures involving greater energy expenditure. The studied species was S. lycocarpum, an andromonoecious species. From June 2016 to March 2017 the data were collected in 38 individuals, divided in two groups: the larger plant group (n=18; height=3-5 m) and the smaller plant group (n=20; height=1-2 m).Our data show that there was effect of plant size on the flower production and the sexual gender allocation. The larger plants showed more flowers and higher production of hermaphrodite flowers. Furthermore, in the flower scale, we observed allometric relationship among the flower's traits with proportional investments in biomass, anther size and gynoecium size. Our results are in agreement with size-dependent sex allocation theory and andromonoecy hypothesis related to mechanisms for optimal resource allocation to male and female function.

A alocação de recursos para reprodução pode mudar dependendo do tamanho, conforme previsto pela alocação sexual dependente do tamanho. Essa teoria é baseada no fato de que indivíduos pequenos investirão na alocação sexual com menor custo de produção, geralmente do sexo masculino. Nas plantas, existem algumas espécies andromonoicas, presença de hermafrodita e flores masculinas no mesmo indivíduo. A andromonoicia fornece uma estratégia para alocar recursos de maneira ideal às funções masculina e feminina, desenvolvendo uma estratégia reprodutiva de economia de energia. Assim, nosso objetivo foi investigar a alocação sexual dependente do tamanho em Solanum lycocarpum St. Hil. Testamos a hipótese de que plantas de maior tamanho investirão na produção de flores hermafroditas, pois indivíduos mais altos economizam mais disponibilidade de recursos para investir em estruturas mais complexas que envolvem maior gasto de energia. A espécie estudada foi S. lycocarpum, uma espécie andromonoica. De junho de 2016 a março de 2017, os dados foram coletados em 38 indivíduos, divididos em dois grupos: o maior grupo de plantas (n = 18; altura = 3-5 m) e o menor grupo de plantas (n = 20; altura =1-2 m). Nossos dados mostram que houve efeito do tamanho da planta na produção de flores e na alocação sexual. As plantas maiores apresentaram mais flores e maior produção de flores hermafroditas. Além disso, observamos uma relação alométrica entre as características da flor, com investimentos proporcionais em biomassa, tamanho da antera e tamanho do gineceu. Nossos resultados estão de acordo com a teoria de alocação de sexo dependente de tamanho e a hipótese de andromonoicia relacionada a mecanismos para a alocação ótima de recursos para a função masculina e feminina.

Size-dependent sex allocation in Solanum lycocarpum St. Hil. (Solanaceae).

Resource allocation to reproduction can change depending on size, as predicted by the size-dependent sex allocation. This theory is based on the fact that small individuals will invest in the allocation of sex with lower cost of production, usually male gender. In plants, there are some andromonoecy species, presence of hermaphrodite and male flowers in the same individual. Andromonoecy provides a strategy to optimally allocate resources to male and female function, evolving a reproductive energy-saving strategy. Thus, our objective was to investigate the size-dependent sex allocation in Solanum lycocarpum St. Hil. We tested the hypothesis that plants with larger size will invest in the production of hermaphrodite flowers, because higher individuals have greater availability of resources to invest in more complex structures involving greater energy expenditure. The studied species was S. lycocarpum, an andromonoecious species. From June 2016 to March 2017 the data were collected in 38 individuals, divided in two groups: the larger plant group (n=18; height=3-5 m) and the smaller plant group (n=20; height=1-2 m).Our data show that there was effect of plant size on the flower production and the sexual gender allocation. The larger plants showed more flowers and higher production of hermaphrodite flowers. Furthermore, in the flower scale, we observed allometric relationship among the flower's traits with proportional investments in biomass, anther size and gynoecium size. Our results are in agreement with size-dependent sex allocation theory and andromonoecy hypothesis related to mechanisms for optimal resource allocation to male and female function.

Favorable Long-term Outcome in Patients Submitted to Liver Transplantation After Downstaging of Hepatocellular Carcinoma According to a Brazilian Selection Protocol.

BACKGROUND: In October 2008, the Brazilian Ministry of Health authorized listing of downstaged hepatocellular carcinoma (HCC) for liver transplantation, according to a standardized protocol. The aim of this study was to compare the outcome of patients submitted to liver transplantation after downstaging of HCC with the results other standard indications in Brazil. METHODS: We conducted a retrospective analysis of 2,667 adult 1st elective deceased-donor liver transplantations registered at the database of the Transplant Notification Center of the São Paulo State Health Secretariat. These cases are classified into 3 groups: "cirrhosis," including 1,709 patients transplanted because of end-stage liver disease; "Milan-HCC," including 873 HCC patients initially meeting the Milan criteria; and "downstaging" group, including 85 HCC patients submitted to tumor downstaging to the Milan criteria before liver transplantation. RESULTS: One-, 3-, 5-, and 6-year patients survivals were, respectively, 82.7%, 72.0%, 66.1%, and 66.1%, in the "downstaging" group and 76.7%, 68.4%, 63.9%, and 63.5% in the "Milan-HCC" group (P = .483). At the same time intervals, patient survivals were 67.8%, 62.9%, 60.9%, and 60.2% in the "cirrhosis" group. These probabilities were significantly lower than those of both "downstaging" (P = .047) and "Milan-HCC" (P = .001) groups. CONCLUSIONS: Patients submitted to liver transplantation after downstaging of HCC, according to a Brazilian selection protocol, present long-term outcomes similar to HCC patients initially within the Milan criteria and better survival than recipients with end-stage liver disease.

Detection of aneuploidies in spontaneous abortions by quantitative fluorescent PCR with short tandem repeat markers: a retrospective study.

Approximately 10-15% of all pregnancies end in spontaneous abortions. Many factors can lead to embryonic loss; however, it has been well established that over 50% of all miscarriages result from chromosomal abnormalities, primarily aneuploidies (>96%). Identifying the cause of miscarriage can significantly reduce the psychological stress in women, and enable better genetic counseling for a future pregnancy. Quantitative fluorescent polymerase chain reaction (QF-PCR) has been previously used in the study of chromosomal abnormalities. In this retrospective study, the frequency of aneuploidy in samples of 130 miscarriages undergone by patients (age average: 34.1 ± 4.6 years) at our institution was determined by QF-PCR using short tandem repeat markers. The gender of the miscarriage cases was determined by amplifying the amelogenin locus (70 males and 60 females). Seventy-one of these cases (54.6%) presented aneuploidies such as trisomy, monosomy, triploidy, and double trisomy. Trisomy 22 was the most common aneuploidy (present in 14 cases), followed by trisomy 15, trisomy 16, and monosomy X. We also observed monosomy at chromosomes X and 21 and a case with multiple aneuploidies at chromosomes 16 and 22. The most common aneuploidies associated with miscarriages were detected by QF-PCR; therefore, we concluded that QF-PCR is a rapid and reliable method for the detection of aneuploidy, and can be used as an accessory to the widely used karyotype analysis.

Biomass allocation and nutrients balance related to the concentration of Nitrogen and Phosphorus in Salvinia auriculata (Salviniaceae) / Alocação de biomassa e o Balanço de nutrientes relacionados à concentração de Nitrogênio e Fósforo em Salvinia auriculata (Salviniaceae)

Abstract Aquatic plants can use differential allocation (trade-off) of carbon among their structures depending on the nutrition concentration. Given that N and P are limiting in the growth of plants, our questions were: Are the N and P concentrations in S. auriculata related to the biomass allocation to its structures? Is a differential allocation of N and P between floating and submerged leaves? We evaluated the relation between the nutrients and the biomass allocation, and the trade-off among the leaves using the Spearman correlation. Our results showed that N and P concentrations in S. auriculata are related to the biomass allocation to its structures, and that there is no trade-off of these nutrients between “shoot and root”. Thus, we can see the importance of N and P concentration in the biomass of S. auriculata, and why this plant is capable to development in different environments as a weedy.

Resumo Plantas aquáticas podem realizar alocação diferencial (trade-off) de carbono entre as suas estruturas dependo da disponibilidade de nutrientes. Considerando que N e P são limitantes para o crescimento de plantas, nossas perguntas foram: As concentrações de N e P em S. auriculata estão relacionadas com a alocação de biomassa para suas estruturas? Existe alocação diferencial de N e P entre os folíolos aéreos e a “raiz”? Avaliamos a relação entre os nutrientes e a biomassa, e o trade-off entre as folhas utilizando correlação de Spearman. Os resultados encontrados mostram que as concentrações de N e P em S. auriculata estão relacionadas com a alocação de biomassa para as suas estruturas, e que não há um trade-off de N e P entre os folíolos aéreos e a “raiz”. Dessa maneira, é possível observar a importância de N e P no ganho de biomassa de S. auriculata, e porque a espécie é capaz de se desenvolver em diferentes ambientes como uma planta daninha.

Biomass allocation and nutrients balance related to the concentration of Nitrogen and Phosphorus in Salvinia auriculata (Salviniaceae).

Aquatic plants can use differential allocation (trade-off) of carbon among their structures depending on the nutrition concentration. Given that N and P are limiting in the growth of plants, our questions were: Are the N and P concentrations in S. auriculata related to the biomass allocation to its structures? Is a differential allocation of N and P between floating and submerged leaves? We evaluated the relation between the nutrients and the biomass allocation, and the trade-off among the leaves using the Spearman correlation. Our results showed that N and P concentrations in S. auriculata are related to the biomass allocation to its structures, and that there is no trade-off of these nutrients between "shoot and root". Thus, we can see the importance of N and P concentration in the biomass of S. auriculata, and why this plant is capable to development in different environments as a weedy.

Body size and clonality consequences for sexual reproduction in a perennial herb of Brazilian rupestrian grasslands.

Body size is one of the most important factors regarding herbaceous perennial plants life-histories, and several fitness components of these organisms are related to size. Clonal plants show distinct kinds of reproduction and can develop offspring by sexual or asexual ways. We aimed to understand how body size affects Comanthera nivea (Eriocaulaceae) sexual reproduction and to verify how clonal growth is related to flower head production in this species. We sampled 600 rosettes in rupestrian grasslands and performed linear regression analysis between body size and number of produced flower heads. We also compared the flower head production between isolated rosettes and rosettes within clones. Our results showed that body size was significantly related, but explained only a small part of flower head production. The flower head production was higher in rosettes within clones than in isolated ones. The clones presented a rosette or a small group of rosettes that concentrated the sexual reproduction. Clonality was positively associated with sexual reproduction. Clonality can represent an important way of allowing the persistence of plants by sexual reproduction in markedly seasonal stressful environments. The cases of clonality enhancing the sexual reproduction must be considered and put in focus on reproductive biology research.

Water level-dependent morphological plasticity in Sagittaria montevidensis Cham. and Schl. (Alismataceae).

Aquatic plants are able to alter their morphology in response to environmental condition variation, such as water level fluctuations. The aim of this study was to evaluate the effect of water level on Sagittaria montevidensis morphology through measures of vegetative structures formed in drought and flood periods. We hypothesised that the plant height and the biomass of S. montevidensis leaves will increase during flood periods, while the biomass and diameter of petioles, and the basal plant area will increase during dry periods. We sampled a total amount of 270 individuals in nine sediment banks per visit, totalling 1080 plants. In order to compare plant morphology between dry and flood periods, we measured the water level in each bank and took the following variables for each plant: diameter, height and diameter of the biggest petiole. In order to compare biomass allocation between dry and flood periods, we sampled a total amount of 90 individuals in nine sediment banks per visit, totalling 360 plants. Plants were dried and weighed in the laboratory. All measured morphologic traits, as well as the biomass of leaf blades and petioles, were higher during flood periods, indicating that water level highly influences the morphology of S. montevidensis individuals. Our results suggest that these morphological responses allow survival and maintenance of S. montevidensis populations under environmental stress. These results can be linked to the invasive potential of S. montevidensis and sheds light on basic management practices that may be applied in the future.

Soil factors effects on life history attributes of Leiothrix spiralis and Leiothrix vivipara (Eriocaulaceae) on rupestrian grasslands in Southeastern Brazil.

In this study, we hypothesized that the life history traits of Leiothrix spiralis and L. vivipara would be linked to soil factors of the rupestrian grasslands and that rosette size would be influenced by soil moisture. Soil analyses were performed from five populations of L. spiralis and four populations of L. vivipara. In each area, three replicates were employed in 19 areas of occurrence of Leiothrix species, and we quantified the life history attributes. The microhabitats of these species show low favorability regarding to soil factors. During the dry season, their rosettes decreased in diameter due the loss of its most outlying leaves. The absence of seedlings indicated the low fecundity of both species. However, both species showed rapid population growth by pseudovivipary. Both L. spiralis and L. vivipara exhibit a kind of parental care that was quantified by the presence of connections between parental-rosettes and ramets. The findings of the present study show that the life history traits are linked to soil factors.

The use of Salvinia auriculata as a bioindicator in aquatic ecosystems: biomass and structure dependent on the cadmium concentration.

This study shows, in a multiple-level approach, the responses of Salvinia auriculata to Cd pollution in aquatic ecosystems. S. auriculata ramets were cultivated in nutrient solution and subjected to five treatments with Cd for ten days. At the end of the experiment, the number of new ramets and the dry biomass were determined. For ultrastructural observations, the leaves of S. auriculata were analyzed using a scanning electron microscope and transmission electron microscope. At the end of the experiment, the plants exposed to Cd showed damage in the leaves including necrosis and chlorosis, stomate deformations and damaged trichomes. We observed a decrease in the number of new ramets and dry biomass of S. auriculata following the increase in Cd concentration in the solution. At the ultrastructural level, leaves exposed to Cd presented chloroplast deformations and deterioration in the cell wall. All the symptoms of toxicity were directly proportionate to the concentration of Cd in the solution. The results suggests that S. auriculata shows good potential for use as a bioindicator and it can be used in the biomonitoring of aquatic ecosystems contaminated by Cd.

Apolipoprotein A5-1131T>C polymorphism, but not APOE genotypes, increases susceptibility for dyslipidemia in children and adolescents.

Apolipoprotein A5 (APOA5) and apolipoprotein E (APOE) play important roles in the metabolism of cholesterol and triglycerides. The aim of this study was to determine the allelic and genotypic distributions of the APOA5-1131T>C (rs 662799) and the APOE HhaI polymorphisms and to identify the association of both individual and combined APOA5-APOE genetic variants and the risk for dyslipidemia in children and adolescents. We genotyped 53 dyslipidemic and 77 normolipidemic individuals. The total cholesterol, triglycerides and HDL cholesterol were determined enzymatically. For APOA5 polymorphism, the presence of the allele C confers an individual risk for dyslipidemia (OR = 2.38, 95% CI = 1.15-4.89; P = 0.018). No significant differences were observed for lipid parameters among the APOA5 groups, except for a higher value of HDLc (P = 0.024) in C-carriers. The allelic and genotypic frequencies of APOE polymorphism were similar between groups and did not increase the susceptibility for dyslipidemia. None of the combined APOA5-APOE polymorphisms increased risk for dyslipidemia. We demonstrated an association between APOA5-1131T>C polymorphism and dyslipidemia in children and adolescents. This finding may be useful to guide new studies with genetic markers down a path toward a better characterization of the genetic risk factors for dyslipidemia and atherosclerotic diseases.

Lack of association of C282Y and H63D mutations in the hemochromatosis (HFE) gene with diabetes mellitus type 2 in a case-control study of women in Brazil.

Hereditary hemochromatosis is one of the most common autosomal recessive diseases; it is characterized by excess absorption of iron. Clinically, the major challenge is to diagnose increased iron deposition before irreversible tissue damage has occurred. C282Y and H63D are the main mutations related to hereditary hemochromatosis; these mutations have been reported to be associated with increased risk of developing diabetes mellitus type 2 (DM2). We investigated whether these mutations are associated with increased risk for the development of DM2 in women in Brazil. Seventy-two women with clinical diagnosis of DM2 under treatment with hypoglycemic agents and a control group composed of 72 women with no clinical history of diabetes were studied. The C282Y and H63D mutations were determined by PCR-RFLP. Significant differences were not observed for C282Y and H63D, when we compared diabetic and non-diabetic women. We suggest that mutations C282Y and H63D in the HFE gene are not significant risk factors for the development of DM2 in Brazilian women.

Lymphadenectomy in colorectal cancer liver metastases resection: incidence of hilar lymph nodes micrometastasis.

BACKGROUND: Liver resection is considered the best treatment for metastatic colorectal cancer. Several prognostic factors have been investigated, and many studies have shown that hepatic hilum lymph nodes involvement has a negative impact on prognosis. The present study evaluated the frequency of microscopic involvement of hilar lymph nodes, through systematic lymphadenectomy and analysis of micrometastases in patients undergoing hepatectomy due to colorectal metastasis. METHODS: A total of 28 patients underwent hepatic resection with hilar lymphadenectomy. Lymph nodes considered negative by conventional hematoxylin and eosin (H&E) staining were analyzed by serial sectioning with 100-microm intervals and immunohistochemistry (IHC) with anti-human pancytokeratin antibody AE1/AE3. RESULTS: In average, 6.18 lymph nodes were dissected per patient. No morbidity or mortality was associated to lymphadenectomy. In two patients, conventional H&E analysis showed presence of microscopic lymph node metastasis. IHC analysis allowed the identification of three other patients with lymph node micrometastases. The overall frequency of microscopic metastases, including micrometastasis, was 18%. CONCLUSIONS: Systematic lymphadenectomy allowed the detection of microscopic lymph node metastases, resulting in more accurate staging of extrahepatic disease. The inclusion of IHC increased the detection of lymph node micrometastasis.

Influence of ischemic preconditioning in myocardial protection in patients undergoing myocardial revascularization with intermittent crossclamping of the aorta. Analysis of ions and blood gases.

OBJECTIVE: To test the hypothesis that short periods of ischemia may increase the myocardial protection obtained with intermittent crossclamping of the aorta. METHODS: In the control group (18 patients), surgery was performed with systemic hypothermia at 32 degrees C and intermittent crossclamping of the aorta. Extracorporeal circulation was used. In the preconditioning group (17 patients), 2 crossclampings of the aorta lasting 3min each were added prior to the intermittent crossclamping of the conventional technique with an interval of 2min of reperfusion between them. Blood samples for analyses of pH, pCO2, pO2, sodium, potassium, calcium, and magnesium were obtained from the coronary sinus at the beginning of extracorporeal circulation (time 1), at the end of the first anastomosis (time 2), and at the end of extracorporeal circulation (time 3). RESULTS: No difference was observed in the results of the 2 groups, except for a variation in the ionic values in the different times of blood withdrawal; sodium values, however, remained stable. All patients had a good clinical outcome. CONCLUSION: The results of intermittent crossclamping of the aorta with moderate hypothermia were not altered by the use of ischemic preconditioning.

The use of bone bridges in transtibial amputations.

UNLABELLED: We sought to describe the bone bridge technique in adults, and present a variation for use in children, as well as to present its applicability as an option in elective transtibial amputations. This paper presents a prospective study of 15 transtibial amputations performed between 1992 and 1995 in which the bone bridge technique was employed. The patients' ages ranged from 8 to 48 years, with an average of 22.5 years. This technique consisted of the preparation of a cylinder of periosteum extracted from the tibia and with cortical bone fragments attached to it to promote a tibiofibular synostosis on the distal extremity of the amputation stump. We noted that the cortical bone fragments were dispensable when the technique was employed in children, due to the increased osteogenic capacity of the periosteum. This led to a variation of the original technique, a bone bridge without the use of the cortical bone fragments. RESULTS: The average time spent with this procedure, without any significant variation between adults and children, was 171 minutes. The adaptation to the definitive prosthesis was accomplished between 20 and 576 days, with an average of 180 days. Revision of the procedure was necessary in 3 amputations. CONCLUSIONS: This technique may be employed in transtibial amputations in which the final length of the stump lies next to the musculotendinous transition of the gastrocnemius muscle, as well as in the revision of amputation stumps in children, where the procedure has been shown to be effective in the prevention of lesions due to excessive bone growth.