Rogerio Fraga

Modelo pélvico sintético como uma ferramenta didática efetiva comparada à pelve cadavérica

Anatomy is considered a fundamental subject of medical education. Practical classes which involve the use of manipulable anatomic components are essential to teaching and learning. The aim of this study was to evaluate the synthetic pelvic model (SPM) as a didactic tool, compared to the traditionally- -used cadaveric pelvis (CP), as well as student satisfaction in relation to both methods. Sixty-seven students were given a theory class following the preliminary theoretical test (PTT). The study sample was randomized in three groups: G1 had a traditional practical class (TPC); G2 had a practical class with SPM (PCS); and G3 had no practical class. A final test (FTT) was applied to all the groups. G1 and G2 were subjected to method evaluation (ME). Statistical analysis was conducted using analysis of variance (ANOVA) and the Mann-Whitney U test. In the FTT, G3 presented scores lower than G1 (p = 0.041) and G2 (p = 0.000). No statistically significant difference was found between G1 and G2 (p >0.05). G2 presented greater satisfaction with the method (p = 0.001). In conclusion, both CP and SPM proved to be effective didactic tools and student satisfaction was greater with G2.

Numeric and volumetric changes in Leydig cells during aging of rats

PURPOSE To analyze the effects of aging in rats on the nuclear volume, cytoplasmic volume, and total volume of Leydig cells, as well as their number. METHODS Seventy-two Wistar rats were divided into six subgroups of 12 rats, which underwent right orchiectomy at 3, 6, 9, 12, 18, and 24 months of age. The weight and volume of the resected testicles were assessed. A stereological study of Leydig cells was conducted, which included measurements of cell number and nuclear, cytoplasmic, and total cell volumes. RESULTS The weight and volume of the resected testicles showed reductions with age. Only the subgroup composed of 24-month old rats showed a decrease in the nuclear volume of Leydig cells. Significant reductions in the cytoplasmic volume and total volume of Leydig cells were observed in 18- and 24-month old rats. The number of Leydig cells did not vary significantly with age. CONCLUSIONS Aging in rats resulted in reduction of the nuclear, cytoplasmic, and total cell volumes of Leydig cells. There was no change in the total number of these cells during aging.

Objective assessment of surgical technique in rotation and nasal projection variation

INTRODUCTION In rhinoplasty, facial esthetic analysis is critical for proper surgical planning. Parameters such as rotation and nasal projection should be routinely evaluated. Few studies have objectively assessed changes in facial angles postoperatively. OBJECTIVE To evaluate the effectiveness of medial intercrural sutures and of rotation of the nasal tip on the increase of rotation and nasal projection in Caucasian patients undergoing primary rhinoplasty. METHODS A prospective study carried out between 2011 and 2013, with 27 patients treated with primary rhinoplasty with a basic technique by the same surgeon, with medial intercrural sutures and rotation of the nasal tip. Rotation and nasal projection were measured from photographs obtained preoperatively and after 12 months. RESULTS All 27 patients completed the study. The mean age was 27.1 years. There was a mean increase of 8.4° in the rotation - a statistically significant value. There was no significant change in the projection. CONCLUSION The medial intercrural and nasal tip rotation sutures are effective in increasing nasal rotation in Caucasian patients undergoing rhinoplasty.

Effects of immunosuppression with tacrolimus and mycophenolate mofetil on renal histology and function in single kidney rats submitted to ischemia and reperfusion

PURPOSE To evaluate renal histological changes and renal function in single kidney rats submitted to renal ischemia-reperfusion and to immunosuppression with tacrolimus and mycophenolate-mofetil. METHODS Experimental study with 80 Wistar rats distributed into control, Sham and six other groups treated with immunosuppressive drugs. Animals undergoing surgery, right nephrectomy and left renal clamping, killed on the 14th day and analyzed for renal histology, urea and creatinine. RESULTS The group receiving tacrolimus at higher doses (T3) showed renal histological lesions indicative of early nephrotoxicity, and significant increase in urea and creatinine. The group M (mycophenolate-mofetil alone) and the group M2 (mycophenolate-mofetil combined with half the usual dose of tacrolimus) presented a slight rise in serum urea. The groups using mycophenolate-mofetil alone or combined with tacrolimus showed creatinine levels similar to that of the group T3. CONCLUSIONS Histologically, the association of injury by ischemia-reperfusion with the use of tacrolimus or mycophenolate-mofetil alone demonstrated a higher rate of renal changes typical of early nephrotoxicity. In laboratory, the combination of injury by ischemia-reperfusion with tacrolimus at higher doses proved to be nephrotoxic.

Analysis of the histology of the scar bladder and biochemical parameters of rats with a solitary kidney undergoing immunosuppression with tacrolimus.

PURPOSE To evaluate bladder histology in healing and biochemical analysis of rats with single kidney in ischemia/reperfusion, treated with tacrolimus. METHODS Fifty rats randomized into five groups. Three rats died in surgery, 47 rats divided in groups: Control (non-operated, n=10), Sham (operated without drugs, n=8), T1 (operated + tacrolimus 1mg/kg, n=10), T2 (operated + tacrolimus 0.1 mg/kg, n=10), T3 (operated + tacrolimus 10mg/kg, n=9). The surgery was: laparotomy, right nephrectomy, left kidney ischemia/reperfusion, cystotomy followed by bladder suture. After that, rats were submited to gavage daily (Control and Sham with saline solution. T1, T2, T3 with tacrolimus in doses already mentioned). On the 14th day, after death induction, cystectomy was performed and bladder was histologicaly analysed. The serum urea, creatinine and tacrolimus were analysed too. RESULTS There was difference in serum tacrolimus in T3 compared to the other groups (p<0.05). There was higher doses of creatinine in T3 group and higher urea in groups with tacrolimus. There were significant differences among all histologic variables comparing groups with and without tacrolimus (p<0.05). CONCLUSION Tacrolimus associated with ischemia/reperfusion is nephrotoxic, suppresses inflammation and seems to delay the healing bladder.

Quantitative analysis of the renal aging in rats. Stereological study

PURPOSE To evaluate the renal function and the renal histological alterations through the stereology and morphometrics in rats submitted to the natural process of aging. METHODS Seventy two Wistar rats, divided in six groups. Each group was sacrificed in a different age: 3, 6, 9, 12, 18 and 24 months. It was performed right nephrectomy, stereological and morphometric analysis of the renal tissue (renal volume and weight, density of volume (Vv[glom]) and numerical density (Nv[glom]) of the renal glomeruli and average glomerular volume (Vol[glom])) and also it was evaluated the renal function for the dosage of serum creatinine and urea. RESULTS There was significant decrease of the renal function in the oldest rats. The renal volume presented gradual increase during the development of the rats with the biggest values registered in the group of animals at 12 months of age and significant progressive decrease in older animals. Vv[glom] presented statistically significant gradual reduction between the groups and the Nv[glom] also decreased significantly. CONCLUSIONS The renal function proved to be inferior in senile rats when compared to the young rats. The morphometric and stereological analysis evidenced renal atrophy, gradual reduction of the volume density and numerical density of the renal glomeruli associated to the aging process.

Gastroplastia vertical restritiva com derivação gastrointestinal em Y de Roux em suínos: aspectos histopatológicos do segmento gástrico isolado

OBJECTIVE: Establish an animal model for the Roux en Y gastric bypass and to evaluate its weight loss and amount of food intake, as well as verify macroscopic, morphometric and histopathologic aspects of the bypassed segment. METHODS: Sixteen male pigs were studied in two groups. The Group Surgery was composed of 8 animals submitted to a Roux en Y gastric bypass. The Group Control comprised 8 pigs receiving identical care, except for the surgical procedure. Group Surgery was followed for 90 days, when the bypassed gastric segment was resected. Group Control was followed for 84 days, when the stomach was resected. RESULTS: Weight loss and the amount of food intake were evaluated in both groups. Macroscopic findings, histopathologic changes of the gastric wall, gastric gland morphometry and the amount of collagen type I and III of the gastric mucosa in the bypassed gastric segment were evaluated. Group Control exhibited a significant larger weight gain and food intake compared to surgery. The gastric glands were smaller and type I collagen was predominant in Surgery compared to Control. No changes were noted in the type III collagen. Fat tissue was identified among the muscle fibers in the isolated segment of Group Surgery. CONCLUSION: This model of Roux en Y gastric bypass in pigs offers consistent weight and food intake reduction. Secondly, Roux en Y gastric bypass in pigs does not induce macroscopic changes in mucosa. Finally, the histopathological findings are consistent with initial atrophy of the isolated gastric segment.