Weeks Of Postoperative Period Research Articles

The Perioperative Profile of Community Outreach Camp Patients with Pseudoexfoliation Who Underwent Cataract Surgery in a Tertiary Care Centre

Purpose: To study the perioperative profile of pseudoexfoliation (PXF) among the camp patients who underwent cataract surgery. Methods: This retrospective study was conducted among camp patients with PXF, who underwent cataract surgery in a tertiary care centre. Anterior segment examination including distribution of PXF material over anterior segment structures, pupillary dilatation, gonioscopy, applanation tonometry, intraoperative and postoperative complications, and subsequent management were all documented from the records. Results: A total of 1985 patients underwent cataract surgery between November 2016 and October 2019 of which PXF was recorded in 140 (7%) patients. 49 patients had bilateral PXF, while 83 patients had unilateral PXF. 50% (91/181) of eyes had PXF on anterior lens capsule and pupillary border and 67% (113/167) of eyes had both cortical and nuclear cataracts simultaneously. Intraocular pressure (IOP) was significantly elevated in PXF eye of unilateral PXF patients. The prevalence of PXF glaucoma in our study population was 2.8%. 16.7% (22/132) of patients had intraoperative complications of which posterior capsule rent (PCR) occurred more in bilateral PXF patients and zonular dehiscence (ZD) was seen more in unilateral PXF patients. Postoperatively, surge in anterior segment inflammation was noted from 8% on the first day to 11% at the end of the first week. Conclusions: PXF eyes require meticulous preoperative examinations and intraoperative handling to prevent complications like ZD and PCR. Following cataract surgery, these patients require frequent follow-up visits in the initial two weeks of postoperative period to address the surge in anterior chamber reactions.

ЭКСПЕРИМЕНТАЛЬНАЯ ОЦЕНКА МЕХАНИЧЕСКИХ ПРОЧНОСТНЫХ СВОЙСТВ ПРЕЦИЗИОННЫХ ОДНОРЯДНЫХ МЕЖКИШЕЧНЫХ АНАСТОМОЗОВ

Objective of the research is to study strength properties of author’s enteroenteroanastomosis single-layer suture by the method of pneumompression. Matherial and Methods. Experiment was carried out on 45 rabbits of «butterfly» breed. There were three groups of animals. Author’s single-layer precise suture was fulfiled in the first group. Author’s single-layer precise interrupted suture was made in second group rabbit. In third (control) group Albert-Schmieden suture was used. Animals were taken off the experiment on 1, 3, 5, 14 and 30 days after a surgery. Strength properties were studied at the same terms by pneumopression. Results. Anastomoses pneumopression displayed progressive decreasement of strength properties in both precise suture groups to third day up to 111.2±1.7 and up to 98,3±6,0 mm.Hg. in a control group. Strength decreasement for both precise suture groups came to 16.2%, whereas for control group - 36%. Rupture pressure was rising from fifth day in precise suture groups up to 120.7±2.4 mm.Hg., and to 114.3±7.0 mm.Hg. in the control group to 198,8±3,8 and 172,0±8,5 mm. Hg correspondently in the second week of postoperative period. Futher data not significantly changed. Conclusions. Single-layered precise suture techniques of anastomoses formation with microsurgery showed to be beneficial as for Albert-Shmiden’s suture rupture pressure was much more variable in all stages of repair. It demonstrates authentically better outcomes in author’s single-layer precise intestinal suture methods.

ANALYSIS OF THE FUNCTIONAL AND RADIOLOGICAL OUTCOME OF TIBIAL PLATEAU FRACTURES TREATED BY OPEN REDUCTION INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE BASED ON 3D CT THREE COLUMN FOUR SEGMENT SPECIFIC FIXATION - A PROSPECTIVE STUDY

Introduction: Tibial plateau fractures are caused by high-energy trauma. Historically, the Schatzker and AO/OTA classication systems are widely used, In 2010 Luo et al in china has developed Three-Column Four segment specific fixation for complex Tibial plateau fractures. Aim & Objective: To analyse the functional outcome and radiological outcome of Tibial plateau fractures treated by Open Reduction Internal Fixation (ORIF) with Locking Compression Plate (LCP) based on Three-Column Four segment specic xation. Materials and Methods: This is a prospective study of 33 patients with Tibial plateau fractures with column specic involvement based on preoperative CT were selected for the study after getting ethical clearance in duration from Dec 2019 to June 2021. Outcome of surgery was evaluated using knee society scoring system and Modied Rasmussen Radiological Assessment criteria. Results: In our study we had all 100% study population (33 patients) had RTA as mode of injury with male predominance of 81% with age range of 20–60. In this, 73% had more than one column fracture. 2 patients temporarily stabilized with external xation while others with above knee slab, then denitive management by column specic xation by ORIF with LCP. We achieved union in all cases within range of 10-15 weeks of post operative period with few complications. We allowed full weight bearing after clinical and radiological signs of union at an average of 12-14 weeks. About 85% had good functional range of movements and able to perform their daily activities. Conclusion: Column based concept makes the surgeon to prepare better for the choice in approach, implant selection and column specic xation which gives better biomechanical strength and rigid construct than unilateral plating. Early joint mobilization and weight bearing was started around 2-3 months and contributes to better nal knee range of motion.

Result of single stage early surgical treatment of high-grade multiligamentous knee injuries (Schenck Type III, IV and V)

Introduction:The Multiligament Knee Injury is a complex knee problem and mostly associated with subluxation or dislocation of knee joint. Failure to diagnose and treat them appropriately can leads to devastating outcome particularly high-grade injury (Schenck Type 3,4 and 5). We favor single stage early surgical treatment of high grade Multiligament knee injury which leads to good functional outcome and return to work.Hypotheses:Single stage early surgical treatment of high grade Multiligament knee injury will leads to good functional outcome with higher IKDC and Lysholm score and helps the patients to in return early to work with higher satisfaction rate.Methods:From June 2013 to January 2020, 42 patients with age from 18 years to 56 years with acute (< 6 weeks) Multiligament knee injury included in surgical treatment. Patients with neurovascular injury were not included in study. From 42 patients, 28 patients was type 3,8 patients was type 4 and 6 patients was type 5 in this study. In all 42 patients, single stage treatment first Intraarticular ligament (anterior cruciate ligament ACL, posterior cruciate ligament PCL or both) reconstruction done by arthroscopic method then Extraarticular ligament (medial collateral ligament MCL, lateral collateral ligament LCL, Posterolateral corner PLC) treated with repair/augmentation/reconstruction depending upon status of ligaments by open method. We used only autograft (hamstring and peroneal longus tendon) of same limb or contralateral limb. Patient evaluation done with IKDC and Lyshlom score both in preoperative and postoperative period. Patient limb was kept in full extention in brace and started with aggressive physiotherapy with passive ROM at 2 weeks in post operative period . Follow up done at 2 weeks then every 6 weeks interval till 6 months then every 3 months interval. Partial weight bearing started at 6 weeks and full weight bearing usually between 10 weeks to 12 weeks.Results:Road traffic accident was the most common cause of Multiligament knee injury. Average follow up was 4 years (range 2 to 6.5 years) .40 % has excellent ,40% has good and 20% has average result. There was a significant improvement in both outcome scores as compared with the preoperative scores. Postoperatively average IKDC was 78 and Lyshlom was 86. Terminal restriction of knee movement was in 19% patients particularly those associated with medial side injury was the major complication in our study. Manipulation under anaesthesia was done in 4 cases and implant removal in 1 case and arthroscopic synovectomy and long term antibiotic in 1 case who develop early infection. Gade 1 posterior laxity and grade 1 varus stress was observed in 10 patints.Recovery after surgery takes 9 to 12 months of rehabilitation prior to returning to full activities.Conclusion:Proper evaluation and full diagnosis is key in Multiligament injury of knee. Failure to treat all injured structure can lead to change in knee kinematics and poorer outcome and increased risk for graft failure.Operative treatment with proper rehabilitation yields good functional and clinical outcome with early return to work and sports activity.

Does Immobilization Period Affects The Functional Outcomes After Bankart Repair?

There is no consensus about the absolute immobilization time period and whether the rehabilitation should start in the first or in the third week after Bankart Repair. PURPOSE: The aim of this study was to compare the clinical outcomes of 1 and 3 weeks of absolute immobilization time after the surgery and evaluate their effects on recurrent instability. METHOD: Forty-two patients with arthroscopic Bankart surgery were included to the study. Patients were randomly allocated into two groups. One week of absolute immobilization was performed to the patients in group-1 (n=21, age:24.7±7.1, BMI: 25.3±3 kg/cm2) and 3 weeks of absolute immobilization was performed to the patients in group-2 (n=21, age: 22.1±6.7 years, BMI: 24.8±2.8 kg/cm2). All of the patients come to the clinic once in a week and performed supervised exercise program and the rehabilitation program was progressed. They were also prescribed home exercise program. Shoulder ROM, pain level and shoulder function were assessed, according their groups at the first or third weeks, 4, 8 and 12 weeks of post-operative period. The pain level during resting, activity and at night was assessed with VAS. Shoulder ROM was assessed with standard goniometer and shoulder function was assessed using ASES questionnaire. At the average of 30. weeks after the surgery, it was questioned whether there was a re-dislocation. The demographics of the patients on both groups were analyzed with student t test. Two-way repeated measures ANOVA was used for the statistical analyses. RESULTS: There were no significant the “Group*time” interactions for pain at rest and activity and flexion, abduction, external rotation, internal rotation angles (p>0.05). The main effect of time was significant at rest and activity pain and all ROM measurements (p<0.05). There was a significant “Group*Time” interaction for pain at night (p<0.05). Pain at night was higher in the group-1 at post-operative 1 and 4. weeks compared to group-2. There were no statistically significant differences between the two groups in shoulder function at post-operative 12 weeks (p>0.05) and 30 weeks (p>0.05). One patient had re-dislocation in the group-2. CONCLUSION: One or three weeks of absolute post-operative immobilization period does not differ in terms of functional outcomes on patients with Bankart repair.

Surgical management of Tympanomastoid Paraganglioma: Experience in BSMMU, Dhaka

Objective: To characterize the clinical presentation, surgical management, and outcomes of a consecutive cases of patients with tympanomastoid paraganglioma (TMP) tumors managed at a single tertiary referral center with 5 years’ experience.&#x0D; Study Design: Retrospective review.&#x0D; Setting: Bangabandhu Sheikh Mujib Medical University, a tertiary referral center in Bangaldesh.&#x0D; Methods: Between November 2014 and May 2019, 10 patients with histologically confirmed TMP tumor underwent surgical treatment. Tumor stage was described using the Sanna modified Fisch and Mattox’s classification system.&#x0D; Results: Distribution of tumors according to modified Fisch and Mattox classification was as follows: type A2 1 case (10%); B1 2 cases (20%), B2 6 cases (60%) and B3 1 case (10%). Class A2 tumour was safely removed via postauricular-transcanal approach. Two patients with Class B1 tumors were operated on through canal wall up mastoidectomy approach. Six patients including five Class B2 and one Class B3 tumors were managed by canal wall down mastoidectomy approach. One Class B2 underwent a subtotal petrosectomy with blind sac closure of the external auditory canal and middle ear obliteration. Gross total tumor removal was achieved in 9 cases (90%). One patient developed facial weakness (HB grade III) after one week of postoperative period which recovered completely by conservative treatment. No recurrence was noted in follow-up period.&#x0D; Conclusion: Early diagnosis of tympanomastoid paragangliomas are very rare because of its benign and slow-growing nature. Clinical differentiation between tympanojugular and tympanomastoid paragangliomas are difficult. Surgery is the recommended primary modality of treatment for tympanomastoid paragangliomas with minimum morbidity and recurrence rate.&#x0D; Bangladesh J Otorhinolaryngol; October 2019; 25(2): 66-75

Comparative evaluation of conventional with endoscopy assisted nasal septal correction surgery in a tertiary care teaching hospital Trichy

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Nasal septal deviation is of both congenital and traumatic etiology, found among children and adults and many of whom require corrective surgery. Recently endoscopy assisted nasal septal correction surgery is being performed in many centers as a preferred one. Hence it was decided to find out the postoperative outcomes among those who underwent both the types of surgical procedures.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 50&lt;strong&gt; &lt;/strong&gt;patients with septal deviation underwent conventional surgery and another 50 operated with endoscopy assisted method were considered for this study. Both groups were followed up for postoperative outcomes and relief of symptoms after 48 hours, 8 weeks and 24 weeks for statistical analysis. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Head ache, watering of eyes and nasal obstruction were found significantly less in endoscopy assisted nasal septal correction during the first 48 hours and 8 weeks when compared with conventional surgery and it became negligible after 24 weeks of postoperative period.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Endoscopy assisted surgery is convenient in targeting the surgical site with less trauma and less requirement of time to perform the surgery. However, the initial cost would be higher for installation of endoscopy and maintenance.&lt;/p&gt;

Clinical evaluation of healing of mandibular parasymphysis fractures with teeth in the fracture line

Introduction: The aim of this study was to evaluate the postoperative results of mandibular parasymphysis fracture containing tooth in the fracture line.Materials and methods: The study was conducted at department of Oral &amp; Maxillofacial Surgery, Dhaka Dental College and hospital. A total of 20 Patients included as study population, who were divided into two groups. Group I (retained group) consisted of 10 patients (50%) in which the teeth were retained in the fracture line. Group II (Extracted group) consisted of 10 patients (50%) in which teeth were extracted following specific criteria. All Patients were treated by open reduction and fixation with stainless steel miniplate and monocortical screw. Patients were followed up at 1st week, 8th week,12th week and 24th week of postoperative period and evaluated for healing related complications of fracture like infection, delayed union, malunion, and nonunion.Results: Out of 20 cases 3 patients (15%) had developed complications. In the retained group only one complication developed which was malunion. Where as in the extracted group two complications developed, one was delayed union and another one was infection. Postoperative complications rate in retained group was 10% and in extracted group it was 20%. In the early postoperative period the frequency of infection was more in both group and was decreased gradually with passage of time. In the 1st week of postoperative period the infection rate in extracted group was 20%. On the other hand in retained group it was 10%. No case of infection was found at following 8th and 12th week. After 24th week, 10% infection rate was found in extracted group and it was 0% in retained group. 10% delayed union was found in extracted group but absent in retained group. No case of malunion was found in extracted group but it was 10% in retained group. The complications rates were lesser in retained group than extracted group.Conclusion: Teeth associated with mandibular parasymphysis fracture should not be removed on a prophylactic basis to reduce the risk of complications of fractures site without an absolute indication for removal.Update Dent. Coll. j: 2016; 6 (2): 06-12

An Unusual Case of Postoperative Late Onset Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss, is a clinical entity of ambiguously defined etiology manifested by hearing loss of more than 30 dB on three contiguous frequencies occurring within 72 hours. Sudden sensorineural hearing loss has been called an otologic emergency and patient evaluation should proceed promptly. Early presentation to a physician and early institution of treatment improves the prognosis for hearing recovery. Although it is not an infrequent condition in otolaryngology practice, sudden sensorineural hearing loss following non-otologic surgery is an extremely rare complication. In literature, there are some case reports presenting, postoperative sudden sensorineural hearing loss after spinal and cardiac surgery. In all of the reported cases hearing loss existing during the first week of post operative period. In the present case of a 67 years old female patient who underwent coronary artery bypass surgery under general anesthesia and developed hearing loss of the left ear on postoperative fifteenth day. Because the patient were under anticoagulant, antihypertensive, and antidiabetic therapy, we only gave 1 mg/kg corticosteroid treatment for two weeks. Pure tone audiograms were repeated at daily intervals but no improvement seen in hearing. A high index of suspicion and close follow up are required to early diagnosis of this complication. It is crucial that individuals with sudden hearing loss are identified as soon as possible as the recovery rate had been shown to be higher in those who presented early.

Quality of Life in Patient,s After Laparoscopic and Open Cholecystectomy

The aim of this study was to establish Gastrointestinal Life Quality Index scores of patients before and after laparoscopic and open cholecystectomy comparing scores after both operations. The 120 patients were involved in this prospective study, 51 male and 69 female, 59 of patients were underwent by laparoscopic method and rest of them, 61, by open method on Surgery Clinic on Clinical university center in Tuzla in period from February 2006 to October 2006, chosen by consecutive method. This study evaluates patients life quality according to score of Gastrointestinal Life Quality Index. Patients have been tested two weeks before the operation and in two, five and ten weeks of post-operative period. Except from Gastrointestinal Life Quality Index total score, established scores,a parts of life quality are: symptoms, physical function, emotional and mental status and also social activities. For analysis of achieved results, SPSS (Statistical Package for Social Sciences, V 10.01) program with statistical parameters was used: average values and standard deviation. Out of statistical tests, we used Chi-square test and Student t-test. Values p < 0,05 have been accepted as statisticaly significant. The results of the study confirm a working hypothesis that patients life quality after two and five weeks of postoperative period is significantly better (p < 0.05) in laparoscopic method group versus open method group. Also, in domains Gastrointestinal Life Quality Index symptoms, physical function, emotional and menthal status and social activities results are significantly better (p < 0.05) in the laparoscopic cholecystectomy group than in open method cholecystectomy group. Ten weeks of post-operative period, results showed that these two groups have no difference in life quality in total score, also in domain score. This comparative study between laparoscopic and open cholecystectomy according to patients life quality aspects confirms advantages of laparoscopic technique in comparison to open cholecystectomy method.

KALP CERRAHİSİNDE DEMİNERALİZE KEMİK MATRİKSİ’NİN MEDİAN STERNOTOMİ İYİLEŞMESİ ÜZERİNE ETKİSİ

OZET Yaslanmaya bagli sternumdaki incelme, kemik iyilesmesini zorlastirmakta ve sternumun tespitlendigi yerden kaymasina neden olabilmektedir. Calismamizda demineralize kemik matriksinin sternum iyilesmesi uzerindeki etkisini arastirdik. Bu amacla Ondokuz Mayis Universitesi Tip Fakultesi Kalp ve Damar Cerrahisi Kliniginde, Kasim 2009 – Ekim 2010 tarihleri arasinda median sternotomi yapilan, yaslari 65 ve uzerinde 24 hasta calismaya alindi. Hastalar randomize olarak Grup I (n=12) calisma grubu ve Grup II (n=12) kontrol grubu olarak ikiye ayrildi. Calisma grubundaki hastalara sternumun her iki tarafinin me-dullasina 1 cc’lik demineralize kemik matriksinin macun formu suruldu. Kontrol grubuna herhangi bir madde tatbik edilmedi. Operasyon bitiminde her iki gruptaki hastalarin ster¬numlari standart olarak celik tellerle birlestirildi. Tum hastalara preoperatif donemde ve postoperatif 8. haftada bilgisayarli tomografi cekildi. Bu tomografilerde Hounsfield uni¬tesi olarak olculen sternumdaki kemik yogunluklari birbirleriyle karsilastirildi. Calisma¬ya alinan hastalarin 11’i erkek ve 13’u kadindi. Hastalarin preoperatif ve postoperatif or¬talama sternum dansitesi degerleri karsilastirildiginda, calisma grubu icin p=0,001<0,05 ve kontrol grubu icin p=0,000<0,05 oldugu saptandi. Calisma ve kontrol grubundaki has¬talarin postoperatif 8. haftada olculen sternum yogunluklari birbiriyle karsilastirildiginda ise her iki grup arasinda istatistiksel farklilik olmadigi goruldu. Sternotomi iyilesmesinde bircok faktor rol oynamaktadir. Bu calismanin sonucunda yasli hastalarda demineralize kemik matriksi uygulamasinin sternum iyilesmesini hizlandirici bir etkisinin olmadigini, ancak bu maddenin sternumdaki tellerin zamanla kemigi kesmesine bagli kemikte mey¬dana gelebilecek ayrilma ve kirilmalari uzun donemde onleyebilecegini dusunmekteyiz. Effect of demineralized bone matrix on recovery of median sternotomy in heart surgery ABSTRACT Stenosis of secondary sternum, causes to ageing, and this ageing makes difficult the re¬covery of bones, and can cause to sliding of sternum from the area that was determined. In our research, we searched that the effect of demineralized bone matrix on recover of sternum that contains noncollagen proteins like osteocalcin, osteonectin and osteopontin that has feature of osteoconductive and osteoinductive. With this purpose, in the clinic of Ondokuz Mayis University department of cardiovascular surgery between November 2009 and October 2010, 24 patients whose ages 65 and 65+ were included into the survey. These patients were randomly divided into two groups, Group I was study group (n=12) and Group II was control group (n=12). To the first group (study group), at the end of the operation, the putty form of demineralized bone matrix (1 cc) was applied to both sides of medulla of sternum. Any substances weren’t applied to the second group (control group). At the end of the operation, sternums of the patients in a standard way was com¬bined with steel wires. All patients had axial reconstruction tomography in preoperative period and 8th week in postoperative period. In these tomographies, density of bones in sternum which was measured as Hounsfield Unit (HU), was compared with each others. 24 patients, 11 of them were male and 13 of them were female. In this measurements, the density of sternum of patients which was measured in preoperative and postoperative pe¬riod, were compared with each other; It was diagnosed that for study group p=0.001<0.05 and for control group p=0.000<0.05. While the density of sternum of patients in studygroup and control group which was measured in 8th week of postoperative period was compared, any statistical differences were not found between both groups. In the end of this research, we think that demineralized bone matrix which is applied to aged patients who have got osteoporotic fragile medulla defection, has not got any accelerate effect on healing of sternum; but in the long term, this substances can prevent breaks seen on bones because of the wires on sternum that cut bones in time. J. Exp. Clin. Med., 2011; 28:141-144

Morphological aspects of tympanic bulla after ventral osteotomy in cats

PURPOSE: To evaluate tympanic bulla healing after experimental ventral osteotomy in cats. METHODS: Twenty adult cats were submitted to unilateral ventral bulla osteotomy and divided into two groups: cats of A1 group (n=10) were euthanized at 8 weeks and cats of A2 group (n=10), at 16 weeks postoperative. RESULTS: Signs of Horner's syndrome or damage to the inner ear were not found. Open-mouth radiographs taken in the immediate postoperative showed interruption in the contour of the larger compartment of the operated bulla. The result of Mcnemar'test was significant in A2 group (*p=0.0156). Macroscopic exams revealed that the operated bullae were similar to the normal ones, with preservation of the tympanic cavity. Connective tissue at the osteotomy site of the larger compartment was significantly found in the operated bullae in both groups (McNemar test: A1 p=0.0020*; A2 p=0.0078*). Histomorphometric analyses showed that the connective tissue length at the osteotomy site was shorter in A2 group than in the A1 group (Mann-Whitney test: p=0.0021*). CONCLUSIONS: Experimental ventral osteotomy did not alter significantly the tympanic bulla conformation and complete regeneration of tympanic bulla frequently did not occur before 16 weeks of postoperative period.

Morphological aspects of tympanic bulla after lateral osteotomy in cats

To evaluate tympanic bulla healing after experimental lateral osteotomy in cats. Twenty adult cats were submitted to unilateral lateral bulla osteotomy and divided into two groups: cats of B1 group (n=10) were euthanized at 8 weeks and cats of B2 group (n=10), at 16 weeks postoperative. Oblique lateral radiographs taken immediately postoperative showed interruption in the contour of the external acoustic meatus of the operated bullae in all cats of both groups (McNemar test: p=0.0010*). This feature was still observed in the radiographs taken after 8 and 16 weeks postoperative (McNemar test: B1 p=0.0020*; B2 p=0.0312*). Macroscopic examination showed that the operated bullae were similar to the normal ones, with preservation of the tympanic cavity. Connective tissue at the osteotomy site was significantly found in the operated bullae in both groups (McNemar test: B1 p=0.0020*; B2 p=0.0010*). The length of connective tissue at the osteotomy site was measured by histomorphometry. There was no statistically significant difference between the values of B1 group and B2 group (Mann-Whitney test: p=0.0524). Experimental lateral osteotomy did not alter significantly the tympanic bulla conformation and complete regeneration of the tympanic bulla frequently did not occur before 16 weeks of postoperative period.

Aspectos morfológicos da bulla tympanica de cães após osteotomia restrita ventral e lateral

O objetivo deste trabalho foi investigar os aspectos morfológicos da bulla tympanica após osteotomia ventral e lateral. Quarenta cães adultos foram distribuídos em dois grupos de 20 animais cada. No grupo A , os animais foram submetidos a osteotomia ventral da bulla tympanica e no grupo B, a osteotomia lateral da bulla tympanica. Cada grupo foi constituído de 2 subgrupos, de acordo com o período de observação: A1 e B1 (6 semanas), A2 e B2 (12 semanas). No exame macroscópico constatou-se que a concavidade de todas as bullae tympanicae operadas era semelhante às normais. Os estudos histológicos mostraram que a regeneração completa da bulla tympanica ocorreu em apenas alguns animais de cada subgrupo. A presença de tecido conjuntivo na área de osteotomia foi verificada na maioria das bullae tympanicae operadas, resultado estatisticamente significante. A análise histológica e a histomorfometria computadorizada não mostraram diferença significante quanto ao estágio de regeneração óssea em todos os subgrupos. Concluiu-se que uma área de ostetomia restrita não causou alterações significantes na conformação da bulla tympanica de cães submetida a osteotomia ventral ou lateral; e que a regeneração total da bulla tympanica geralmente não ocorreu antes de 12 semanas de pós-operatório.

POSSIBLE MODULATE ANTIDIURETIC HORMONE SECRETION IN RELATION TO CIRCULATING BLOOD VOLUME IN TOTAL ARTIFICIAL HEART IMPLANTED CALVES

Introduction: It has been reported that the circulating blood volume (CBV) increased significantly in total artificial heart (TAH) recipient. Participation of several hormonal factors including antidiuretic hormone (ADH) in this CBV increase has been supposed, yet its detailed mechanism is still unclear. We investigated possible modulation of ADH secretion in TAH recipient in chronic animal experiments. Method: Three calves were implanted with a pneumatic TAH, and the other four calves were implanted only with monitoring lines as controls. After two weeks of postoperative period, two groups were compared in: 1) transition of CBV, plasma ADH level (CADH), and plasma osmolality (Posm), 2) response of CADH to infusion of hyperosmolar saline solution (1M NaCl at 0.1ml/kg/min for 30 min) and to restriction of water intake (2L/day for 3days). Results: The postoperative CBV in a TAH calf significantly increased (130 ± 19 ml/kg), while in the other two TAH calves did not increase (92 ± 13 ml/kg), compared with in control calves (104 ± 19 ml/kg). The postoperative CADH and Posm were within the normal range in all calves (CADH: 1.5 ± 1.0 vs 0.8 ± 0.2 pg/ml, Posm: 273 ± 8 vs 273 ± 7, in TAHs vs controls, respectively). Sensitivity of ADH secretion to Posm elevation in the CBV-increased TAH calf was remarkably suppressed compared with the other, two TAH calves without CBV increase, and the control calves. (0.06 vs 0.55 vs 0.21 pg/ml/mOsm/kg±H2O at hyperosmolar saline infusion, and 0.11 vs. 0.43 vs. 0.55 pg/ml/mOsm/kg±H2O at water intake restriction, respectively). Conclusion: In TAH implanted calves, CBV increases occasionally and the ADH secretion in response to plasma osmolality elevation was modulated concomitantly, these phenomena do not occur consistently.

Time of remodelling of the patella tendon graft in anterior cruciate ligament surgery: an histological and immunohistochemical study in a rabbit model

We evaluated the remodelling process of the autogenous patellar tendon graft used for the anterior cruciate ligament reconstruction by light microscopy and immunohistochemistry features. Twenty New Zealand rabbits were operated on with a free patella graft and the results, from 2 to 24 weeks of post-operative time were compared with those of the normal contralateral anterior cruciate ligament and patellar tendon that were used as controls. The parameters evaluated were the presence of necrosis, inflammation, synovialization, cellularity, cell nuclear morphology, vascularization, fibrocartilaginous metaplasia and the orientation of the collagen bundles. Our study shows that the graft revascularizes during the early post-operative period (14 weeks) starting at the distal extremity. The collagen bundles has complete orientation after 16 weeks of post-operative period. There were no significant differences when comparing patella tendon grafts at 24 weeks with the controls regarding the synovialization, cellularity, cell nuclear morphology, vascularization, fibrocartilaginous metaplasia and orientation of the collagen bundles. Our study suggests that at 24 weeks of post-operative time the graft has enough biological potential to repair occasional microruptures caused by effort.