Vanessa Dello Monaco Martins

Poland’s Syndrome: Different Clinical Presentations and Surgical Reconstructions in 18 Cases

BackgroundThe literature reports many variations of Poland’s syndrome. This article describes 18 cases of Poland’s syndrome in different stages of treatment, with variable clinical presentations and reconstructive techniques.MethodsThis study evaluated 15 females and 3 males, ages 2 to 43 years, for breast deformity, nipple–areolar complex position, pectoralis muscle malformation, thoracic deformities, and the presence of brachysyndactyly. Surgical treatment was performed for 14 patients, individualized for each case.ResultsFor the women, the hypoplastic breast was treated with a latissimus dorsi muscular flap associated with silicone gel implant in five cases. Two other patients still are receiving tissue expansion for a future muscular and prosthetic reconstruction. Prosthetic implants alone were used on the affected side in four cases. The nipple–areolar complex was reconstructed for two patients. Seven women underwent contralateral breast surgery: reduction mammoplasty in three cases, mastopexy in two cases, and prosthetic implants in two cases. The only man who underwent surgery was treated with endoscopic rotation of the latissimus dorsi muscle flap.ConclusionsThis study demonstrated several breast reconstruction options for patients with Poland’s syndrome, reinforcing the importance of an individualized treatment to achieve complete and adequate rehabilitation.

Malformações do sistema nervoso central: análise de 157 necrópsias pediátricas

The malformations of the central nervous system affect about 5 to 10 children per 1000 births. We studied the central nervous system malformations in 5837 pediatric autopsies performed in the Sector of Anatomic Pathology, Hospital de Clinicas-UFPR, between 1960 and 1995. There were 157 central nervous system malformations (2.69%), the commonest were neural tube defects (61%): 47 cases of anencephaly and 45 cases classified in the group of myeloencephaloceles. The anomalies of the prosencephalic evagination corresponded to 8% of all central nervous system malformations, with seven cases of holoprosencephaly. Posterior fossa malformations occurred in 3%, with three cases of Arnold-Chiari. In the present study, the mortality rate due to central nervous system malformations was higher in the neonatal period.

A neuropatologia no período neonatal: análise de 1616 casos de necropsia

The lesions of the central nervous system represent an important cause of morbid-mortality in the neonatal period. This is due to the vulnerability of the brain to several adverse conditions during gestation and after birth. This study analyses the prevalence and pattern of central nervous system lesions in neonates autopsied at Hospital de Clínicas - Curitiba. There were 5743 pediatric autopsies performed in the Sector of Anatomic Pathology from 1960 to 1995 with 2049 cases corresponding to death during neonatal period. These later autopsies were reviewed and all cases with central nervous system lesions were selected and classified according to sex, age and pattern of central nervous system lesion. The central nervous system was affected in 1616 (78,87%) of neonatal autopsies and there was predominance of intracerebral hemorrhages (73,39%), congenital malformations (4,27%) and infections (3,59%). The hypoxic hemorrhages are the most prevalent central nervous system lesions in the neonatal period, affecting mainly premature babies. There was predominance of central nervous system malformations in the female neonates.

Os ácidos graxos de cadeia curta na cicatrização de anastomoses colônicas: estudo experimental em ratos

ABSTRACTBackground: The aim of the present study was to evaluate the intraluminal effects of short chain fatty acids(SCFA) on the healing of defunctioned colon and in the presence of faecal loading in rats. Methods: Fiftyadult Wistar rats were divided in four groups. Two of them, twenty six rats, were submitted to Hartmann’sprocedure (HC - Har tmann Contr ol - and HSCF A - Hartmann SCF A) and colonic anastomosis wer e performedin the other two groups (AC - Anastomosis Control - and ASCFA - Anastomosis SCFA). The control groups(HC and AC) received rectal infusions of saline, while the experimental groups (HSCFA and ASCFA)received the same kind of infusion but with an isosmolar solution of sodium butyrate at 80mmol/l (SCFA).The animals were sacrificed at the 7 th and 14 th postoperative day. Histologic preparations with sirius redstaining were performed to analyse the collagen densitometry by optic microscopy with a polarized light.Collagen I, collagen III and total collagen were quantified by a computer software. Results: In the groupssubmitted to Hartman’s operation – with bowel rest - the animals submitted to rectal infusions of SCFAshowed an increase in the quantity of total and collagen I. Evaluating the groups submitted to colonicanastomosis – with interference of intraluminal bulk – there was an increase in collagen I in the experi-mental group. The interference of the diet bowel content in the healing process, with or without SCFArectal infusions, was analyzed crossing the groups of different surgical procedures. Conclusion: The maineffect of rectal infusions of SCFA was related to the collagen I, either with or without interference of theintestinal bulk. The presence of diet bowel content also increased the collagen production.Key Words: Fatty acids, volatile; Wound healing; Colon; Collagen; Anastomosis, surgical.

Estudo das malformações congênitas do aparelho urinário: análise de 6.245 necropsias pediátricas

The presented study investigates epidemiologic aspects regarding congenital malformations of the urinary tract in a representative sample of stillborns, newborns, infants and children from Curitiba, analising autopsies from the Pediatric and Perinatal Pathology Unit (Service of the Clinical Hospital - Curitiba, Parana) in a 40-year period. Sex, age groups and death causes are correlated, dividing the cases in specific groups of study, revealing epidemiologic abnormalities, rare diseases and diseases related to the death process. Out of 6,245 autopsies, 182 cases (2.9%) presented urinary tract congenital malformations. There was no difference between sex, and the group of newborns was the most prevalent. The group of malformations of the kidney and upper urinary tract contributed with 150 abnormalities.

A ação dos ácidos graxos de cadeia curta na cicatrização de anastomoses colônicas: estudo experimental em ratos

Short-chain fatty acids (SCFA) derive from the fermentation of fibbers ingested in the diet and act as a cell substrate of the colonic mucosa. The object aim of the present study was to evaluate the action of SCFA in colonic wound healing .Sixteen female rats were used, divided into 2 groups of 8 animals each. In the control group (HC) the animals underwent Hartmann procedure and post-operative infusion of isotonic saline solution per rectum for 7 days. In the experimental group (HA) saline solution was replaced by isomolar solution with SCFA. In the animals of the control group, the average bursting pressure of the rectal stump was 128.37 mm Hg, and 137.25 mm Hg in the experimental group (p=0.5693). Histologic evaluation with hematoxicilin and eosin was similar in both groups studied. The collagen densitometry analysis showed a significantly greater concentration of the mature collagen (type I) in the experimental group when compared with the control group (p=0.0094). Greater concentration of total collagen was found in the experimental group when compared to the control group (p=0.0371). It was concluded that rats who underwent intraluminal infusion of SCFA have greater concentration of mature and total collagen in the suture line of the rectal stump, when compared with to the control group.

Estudo comparativo das extensões das lesões causadas por duas e quatro passadas de laser Erbium em ratos Wistar com 0% de sobreposição dos spots

CO2 lasers has been presented with the purpose of rejuvenating the face by means of resurfacing. Though each laser systems has the same base principle, there is a significant difference among lasers which could result in variations in the clinical and histological effects of the tissue. The Erbium:YAG laser has the characteristic of having the wavelength with 10 times more affinity for water than the CO2 laser. The purpose of this experimental study was to compare the morphometric alterations found in 2 and 4 Erbium:YAG laser passes with 0% overlap of spots. It was evaluated the homogeneity of ablation in length and was used the dorsal skin of 3 living mice. It was selected a control area in each mouse. Finally, in the maximum period of three hours, the skin was resected and sent to histopathology for evaluations proposed. As a result there was more homogeneity in the length of the ablation with 4 passes than with 2 passes. The conclusions of the experiment indicated that the length and homogeneity of the ablation were larger with 4 passes. The use of 0% overlap of spots does not guarantee homogeneity in ablation.

Injúria hipóxico-isquêmica de padrão hemorrágico em encéfalos de neomortos do Hospital de Clínicas de Curitiba: análise de 1028 casos de necrópsia entre 1960 e 1995

Hypoxic-ischaemic injury of the central nervous system (CNS) in newborns is a very prevalent entity affecting 1 to 6 children per 1000 births. This injury may induce severe neurological sequelae. We present the analysis of 1028 consecutive cases of hypoxic-ischaemic CNS injuries of haemorrhagic pattern detected in autopsies performed at the Division of Anatomic Pathology, Hospital de Clinicas, University of Parana, Brazil, from 1960 to 1995. The prevalence of these lesions was high (49.73%) amongst all autopsied newborns. The main types of haemorrhage were microscopical intra-parenchymal haemorrhages, intraventricular and periventricular haemorrhages and subarachnoid foci of bleeding. Our results emphasize that premature children constitute a high risk group for CNS haemorrhage needing special preventive therapeutic procedures to avoid neurological complications.

Linfoma T subcutâneo do tipo paniculite: relato de um caso acometendo paciente pediátrico

We report a case of lypotrophic lymphoma affecting a 3-year-old child with 1-month history of nontender subcutaneous nodules disseminated throughout the abdomen, chest and cervical region. Histological examination showed a T-cell lymphoma affecting the subcutaneous tissue. Subcutaneous panniculitis-like T-cell lymphoma is an unusual cutaneous T-cell lymphoma that rarely affects pediatric patients.