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- ItemSomente MetadadadosEarly and late postoperative inflammatory and collagen deposition responses in three different meshes: an experimental study in rats(Springer, 2014-08-01) Pereira-lucena, C. G. [UNIFESP]; Artigiani Neto, R. [UNIFESP]; Rezende, D. T. de [UNIFESP]; Lopes-Filho, G. de J. [UNIFESP]; Matos, D. [UNIFESP]; Linhares, M. M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Although meshes reduce abdominal hernia recurrence, they increase the risk of inflammatory complications. This study aimed to compare the early and late postoperative inflammation and collagen deposition responses induced by three meshes.Rats were allocated into three groups. in group I, a polypropylene (PP) mesh was implanted in the abdominal wall. in groups II and III, PP + polyglactin (PP + PG) and PP + titanium (PP + TI) meshes were employed, respectively. On the seventh (7th) postoperative day, collagen deposition and inflammation were evaluated, and immunohistochemistry was performed on abdominal wall biopsies. These data were compared with those obtained on the fortieth (40th) postoperative day in a previous study.The early inflammatory responses were the same in all groups. With time, it decreased in group I (p = 0.047) and increased in group II (p = 0.003). Group I exhibited early elevated VEGF (p < 0.001), COX2 (p < 0.001), and collagen (p = 0.023) levels, and group II exhibited the most severe inflammatory tissue response. On the 40th postoperative day, the VEGF (p < 0.001) and collagen (p < 0.005) were reduced as compared with the 7th postoperative day in all groups.Belatedly, the inflammatory reaction decreased in PP mesh group and increased in PP + PG mesh group. the PP mesh induced early great elevations in VEGF, COX2 and collagen levels, whereas the PP + PG mesh caused severe tissue inflammation with small elevation in these levels. PP + TI mesh induced inflammatory response levels between the others. in conclusion, the inflammatory response depends on the mesh density and also the mesh material with clinical implications.
- ItemAcesso aberto (Open Access)Effects of the polypropylene mesh implanted through inguinotomy in the spermatic funiculus, epididium and testis of dogs(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2005-12-01) Goldenberg, Alberto [UNIFESP]; Paula, Joaquim Ferreira De; Universidade Federal de São Paulo (UNIFESP); FM; FAAPURPOSE: To investigate the effects of polypropylene mesh, implanted by inguinotomy, in the spermatic funiculus, epididium and testis of dogs. METHODS: Eighteen dogs were considered (12-23 Kg), separated in three groups. Group A (n=7): left side (with mesh) versus right side (without mesh); Group B (n=7): left side (without mesh) versus right side (with mesh) and Group C (n=4): without any surgical manipulation (control group). After being observed for 60 days, the animals were subjected to bilateral removal of the spermatic funiculus, epididium and testis that were submitted to histological analysis. During the re-operation, a macroscopic evaluation was performed. RESULTS: On the mesh side, we noted 100% of mesh adherence to the posterior wall of the inguinal canal, as well as the adherence of the spermatic funiculus to the mesh. A congestion of the pampiniform plexus was noted in three animals. Chronic inflammation reaction and foreign body reaction in the spermatic funiculus was observed in 100% of the animals. On the side that did not carry a mesh, chronic inflammatory reaction was observed in 71% of the animals. All the animals presented chronic inflammatory reaction in the deferent duct in the mesh side and in eleven animals in the side without the mesh. These alterations were not found in Group C. There was a considerable statistical reduction in the average difference of the diameter of the lumen of the deferent duct in the mesh side. In the epididium and testis, macro and microscopic alterations were not significant, although one animal presented a marked reduction of spermatogenesis on the mesh side. CONCLUSION: The polypropylene mesh, when in contact with the spermatic funiculus of dogs, causes a more intense chronic inflammatory reaction and a significant reduction in the diameter of the lumen of the deferent duct.
- ItemSomente MetadadadosExperimental study comparing meshes made of polypropylene, polypropylene plus polyglactin and polypropylene plus titanium: inflammatory cytokines, histological changes and morphometric analysis of collagen(Springer, 2010-06-01) Pereira-Lucena, C. G. [UNIFESP]; Artigiani-Neto, R. [UNIFESP]; Lopes-Filho, G. J. [UNIFESP]; Frazao, C. V. G. [UNIFESP]; Goldenberg, A. [UNIFESP]; Matos, D. [UNIFESP]; Linhares, M. M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Incisional hernia occurs in approximately 11% of all laparotomies. Changes in collagen have been closely implicated in its pathogenesis. the high recurrence rate (45-54%) after primary suture has stimulated the development of meshes. Currently, meshes are the biomaterials implant group most used in medicine. This study aims to compare the serum and tissue inflammatory responses and collagen deposition caused by meshes made of polypropylene, polypropylene + polyglactin and polypropylene + titanium.Thirty Wistar rats were divided into three groups. in group I, a high-density polypropylene mesh was positioned on the abdominal wall. in groups II and III, low-density meshes were used in associations with polyglactin and titanium, respectively. Immediately before the operation and on the first, third and fortieth postoperative days, pro-inflammatory cytokines were assayed. On the 40th postoperative day, the region of the inserted prosthesis was biopsied. the tissue inflammatory reaction was evaluated using a scale for objective scoring. for collagen, picrosirius was used with data reading using the Image Tool computer software.Cytokines: there were no statistically significant differences between the groups. Histology: on the 40th postoperative day in group I, there were fewer inflammatory tissue response and greater collagen deposition (P < 0.01). in group II, there were greater inflammatory tissue response and less collagen deposition (P < 0.01). Group III presented intermediate values between groups I and II.There were no significant differences in cytokine levels between the groups in the present study. in the animals with the polypropylene + polyglactin mesh implant there was the most intense inflammatory process with lower tissue maturation and collagen deposition on the 40th postoperative day. the polypropylene mesh presented a less severe late inflammatory process, with greater tissue maturation and collagen deposition. the polypropylene + titanium mesh presented intermediate values between the others.
- ItemAcesso aberto (Open Access)Hérnia de Littré(Colégio Brasileiro de Cirurgiões, 2004-02-01) Lima Neto, Edgar Valente De [UNIFESP]; Goldenberg, Alberto [UNIFESP]; Matos, Delcio [UNIFESP]; Universidade Federal de Alagoas; Universidade Federal de São Paulo (UNIFESP)Littré's hernia is an extremely rare surgical event. It is characterized by the presence of Meckel's diverticulum in the hernial sack. The authors report one case of Littré's hernia in a 42 year-old male who had the diagnosis accomplished in the intraoperative. The diverticulum presented no signs of complications and was treated conservatively , without exeresis.
- ItemSomente MetadadadosProlapsed orbital fat: 15 consecutive cases(Taylor & Francis As, 2009-01-01) Pires Viana, Giovanni Andre [UNIFESP]; Osaki, Midori Hentona [UNIFESP]; Orlando Filho, Vagner Tadeu [UNIFESP]; Sant'Anna, Ana Estela [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Prolapsed orbital fat has rarely been described and is often confused with other conjunctival tumours, such as dermolipoma. We describe the clinical features and treatment of 15 patients with prolapsed orbital fat. We report here our experience in 15 consecutive patients who presented to the Vision Institute of Federal University of São Paulo, Brazil, between July 2004 and December 2007. Age, sex, presenting complaint, physical findings, associated local and systemic diseases, type of treatment, and complications were recorded. Ten patients were men, and ages ranged from 44-86 (mean 68). Eleven patients presented with unilateral disease. Thirteen had superotemporal prolapse, and two atypical superonasal prolapse. Two gave a history of trauma. All patients had the prolapsed fat excised for cosmetic reasons. There were no complications. Orbital fat prolapse is usually superotemporal, mainly in men, and is easily differentiated from other lesions, such as prolapsed lacrimal gland. Excision is always indicated, usually for cosmetic reasons.