Abdominal Complications After Lung Transplantation in a Brazilian Single Center.

Surgical and nonsurgical abdominal complications have been described after lung transplantation. However, there is limited data on this event in this population. The objective of this study was to analyze the incidence of abdominal complications in patients undergoing lung transplantation at the Heart Institute of the Faculty of Medicine, University of São Paulo (InCor-HCFMUSP) between the years 2003 and 2016. The main causes of abdominal complications were inflammatory acute abdomen (7 patients; 14%), obstructive acute abdomen (9 patients; 18%), gastroparesis (4 patients; 8%), distal intestinal obstruction syndrome (4 patients; 8%), perforated acute abdomen (7 patients; 14%), cytomegalovirus (CMV; 6 patients; 12%), and other reasons (12 patients; 26%). Separating these patients according to Clavien-Dindo classification, we had 21 patients (43%) with complications grade II, 4 patients (8%) with complications grade IIIa, 7 patients (14%) with grade IIIb complications, 7 patients (14%) with grade IV complications, and 10 patients (21%) with grade complications V. In conclusion, abdominal disorders are seriously increased after lung transplantation and correlate with a high mortality. Early abdominal surgical complication has worse prognosis.

Comparative ultrastructural analysis of different regions of two digital flexor tendons of pigs.

Tendons are parallel arrays of collagenous fibers which are specialized in resisting and transmitting tensile forces. In this work we examined the structure of the superficial digital flexor tendon (SDFT) and the deep digital flexor tendon (DDFT) of pigs, which are considered "wrap around" tendons and so receive compression and tension forces. In both tendons, fibrocartilaginous areas were observed in the regions subjected to compression plus frictional loading. Histological and ultrastructural analyses of the tensional region showed an extracellular matrix (ECM) rich in collagen bundles, that were all arranged in the same direction. Fibroblasts were seen closely associated with the collagen bundles. Chondrocyte-like cells and high levels of glycosaminoglycans (GAGs) were observed in the compressional regions. The collagen bundles in the compressional region were arranged in several directions and were associated with proteoglycans (PGs). The crimp pattern detected in the tensional region showed that the collagen fibrils were ordered aggregates which formed helical superstructures.

Investigation of a fatigue failure in a stainless steel femoral plate.

Surgical implants are exposed to severe working conditions and therefore a wide range of failure mechanisms may occur, including fatigue, corrosion, wear, fretting and combinations of them. The mechanical failures of metallic implants may also be influenced by several other factors, including the design, material, manufacturing, installation, postoperative complications and misuse. An 83-year-old patient suffered an oblique femoral shaft fracture due to a fall at home. A stainless steel locking compression plate (LCP) employed in the fracture reduction failed after four months and was sent back to the producer. A second LCP of the same type was implanted and also failed after six months. A failure analysis of the second femoral LCP is performed in this paper. The results demonstrate that poor material quality was decisive to the failure. The chemical analysis revealed a high P content in the steel, which is not in accordance to the standards. A combination of factors lead to LCP fracture and these include: brittle crack initiation due to phosphorus, segregation at grain boundaries, crack propagation due to cyclic loading and final fast fracture favored by the loss of ductility due to cold work.

Anatomical study of the gastrocnemius venous network and proposal for a classification of the veins.

OBJECTIVES: To present a detailed description of the gastrocnemius venous network. DESIGN: Anatomical study in cadavers. MATERIAL AND METHODS: Forty lower limbs from 20 adult male cadavers were studied. All gastrocnemius veins were dissected from the gastrocnemius muscle heads proximally toward their drainage site. RESULTS: Eighty heads of 40 gastrocnemius muscles showed 438 gastrocnemius veins. The number of veins per muscle head varied between 2 and 12. There were 221 gastrocnemius trunks distributed as 95 main gastrocnemius trunks, 81 axial and 45 collateral ones. From the 95 main gastrocnemius trunks, 83 (87%) drained into the popliteal vein. Direct observation of the gastrocnemius venous network allowed us to classify the anatomical distribution as four distinct types. CONCLUSIONS: The majority of main gastrocnemius venous trunks drain into the popliteal vein. There is wide variability in the number of gastrocnemius veins. We propose a classification of four distinct types of anatomical pattern.

Cytoarchitecture of the oculomotor nuclear complex and of the trochlear nucleus in the marmoset (Callithrix jacchus).

The cytoarchitecture of the oculomotor nuclear complex (ONC) and of the trochlear nucleus (TN) was studied in the encephalon of 10 adult marmosets (Callithrix jacchus). All the encephala were fixed with Bouin, embedded in paraffin and submitted to 20-mum serial sections in the transversal, frontal and horizontal directions. The following staining methods were employed: Nissl, Kluver-Barrera, and Pal-Weigert, modified by Erhart [1951]. Morphologically we delimited four cell columns in the ONC of the marmoset, namely lateral, dorsal, anterior, and dorsal central. The lateral and dorsal central columns comparatively correspond, in man, to the somatic portion. The others to the visceral portion. The trochlear nucleus of the marmoset is compact, round in shape and can be divided in to central cellular, dorsoventral and ventrolateral groups. The neurons of both the nuclei, of the multipolar type, predominantly have a round shape but it is also possible to observe oval or triangular neurons. They have a central nucleus, the Nissl substance is not dense and is irregularly disposed. Some differences in the size of neurons can be observed among the columns of the ONC.

The architecture of the splenic artery in the adult man.

The spacial arrangement of the muscular, elastic and collagen fibers was examined in 27 splenic arteries (SA) of adults, 15 of these being males. There were realized, histologic and panorganographic sections, that received adequate staining according to their thickness, by one or most of the following methods: Azan, resorcin-fuchsin (Weigert), Verhoeff-Van Gieson, Sudan III or Masson trichome. Pellicle or total preparations were treated by alum carmine, Van Gieson, resorcin-fuchsin or nitric acid. Any sections and total preparations without staining were examined by polarized light. The finding shows a spiral disposition, without polarization, of the muscular and collagen bundles of the SA. The elastic fibers have different arrangements in the tunics of the SA. Support bundles are present in the proximal and distal extremities of the artery. The vessel dynamic is discussed in function of the spacial arrangement of the muscular, elastic and collagen elements, in relation to the support bundles and also the mechanic function of the spleen.

Anatomical study on the proximal attachments of the human popliteus muscle.

The anatomical study of the proximal attachments of the human popliteus muscle was performed in 25 knees obtained from the dissection room cadavers, of the Anatomy Department of the São Paulo University Medical School. Our findings suggest that the p.m. has four proximal attachments, the condylar, meniscal, capsular and fibular. The muscle can be divided into a lateral portion whose fibers are attached in the lateral condyle of the femur by means of the popliteal tendon. A medial portion whose deep fibers are attached in the posterior part of the lateral meniscus and the superficial ones in the knee capsule; and finally the fibular attachment that appears to have a philogenetic meaning.

Histological and ultrastructural study on the subcommissural organ of Bradypus tridactylus.

The subcommissural organ (SCO) of the Bradypus tridactylus was studied from the histological and ultrastructural point of view. The methods of GOMORI (alum-chromic-hematoxylin-phloxine), AZAN (M. Heidenhain), KLUVER and BARRERA (for nerve cells and myelinated fibers) and silver impregnation according to PALMGREN and CAJAL-DE CASTRO, were used. The material prepared for ultrastructural analize was submitted to the sequence of gluteraldehyde, osmium tetroxide, uranyl acetate and lead citrate. In function of the secretory phenomenon, a systematic study is made of different hystological and ultrastructural characteristics of the SCO and hypendymal rosettes, which were considered in the B. tridactylus as a morphofunctional unit. Fine vascular and nerve networks were observed, by the basal parts of the compact tubule alveolar system (hypendymal rosettes) which composes part of the SCO. Nerve fibers were seen between its cells reaching even up to the lumen, and they may end there in bulbar dilatations which seem to show secretory characteristics at the ultrastructural examination.

Electromyographic study of the subclavius muscle.

The electromyographic study of the subclavius muscle (SM) was performed in 31 different movements, in 12 subjects (10 male and 2 female) aged from 17 to 28 years. The action potentials were obtained with an electromyograph Teca TE 4. Our findings suggest that the SM acts mainly on the stability of the sternoclavicular joint; with more or less intensity according to the degree of the clavicular interaction with the movements of the peripheral parts of the superior limb. The SM seems to act as a substitute for the ligaments of the sternoclavicular joint.

Estudo sobre a reprodutividade das provas eletrodiagnósticas da reobase, cronaxia e curvas I/T em indivíduos sadios / Study about the reproductive of electrodiagnosis test of rheobase, cronaxie and curves I/T in individual healthy

Neste estudo foi realizada uma comparaçäo entre os dados obtidos por 2 examinadores para as provas da reobase, cronaxia e curva I-D aplicadas em 5 indivíduos, a fim de estudar as prováveis variaçöes que podem influenciar no critério de contraçäo mínima e suas possíveis causas. Apesar da ocorrência de variaçäo inter e intra-examinadores, existe uma margem de erro que deve ser levada em consideraçäo no exame eletrodiagnóstico clínico, uma vez que pequenas variaçöes podem näo refletir alteraçäo do estado patológico de um indivíduo, mas sim, uma faixa de erro possível no processo de investigaçäo

The motor nucleus of the trigeminal nerve in the marmoset (Callithrix jacchus)

A citoarquitetura do núcleo motor do nervo trigêmio no Sagui foi estudada em 10 encéfalos de Saguis adultos. Foram realizados cortes seriados de 20 micrômetros corados pelo método de: Niss'l, Kluver-Barrera e Pal-Weigert, modificado por Erhart. Com base em critérios citoarquiteturais foram reconhecidos, ao longo da coluna do núcleo, quatro subdivisöes: ventrolateral, ventromedial dorsal e intermediária. Os resultados foram correlacionados comparativamente com o conhecido em outros mamíferos, incluindo o homem

Correlative scanning and transmission electron microscopic study on the ependymal surface of Bradypus tridactylus.

Diferencas topograficas da superficie ependimal dos ventriculos encefalicos de Bradypus tridactylus foram estudadas a microscopia eletronica de varredura (com processamento por ponto critico de CO2 e recobrimento com carbono e ouro). Certas regioes selecionadas foram tambem analisadas a microscopia eletronica de transmissao de cilios, microvilos e estruturas supra-ependimais, por toda a superficie ventricular, e tambem saliencias vesiculares em pequeno numero. Lateralmente, entre o teto e o soalho do ventriculo lateral, sao descritas elevacoes estreladas interconectadas, medindo em media 98 x 190 microm, desprovidas de revestimento ependimal e constituidas por um complexo emaranhado de processos de astrocitos fibrosos e poucos corpos celulares. Na juncao entre essas formacoes e o tecido nervoso subjacente foram encontradas celulas gliais semelhantes as celulas ependimais, dotadas inclusive de cilios, delimitando complexos espacos labirinticos. Sao feitas consideracoes morfo-funcionais concernentes aos achados morfologicos