ABSTRACT
Há tempo sabe-se que o omento humano pode promover atividade angiogênica em estruturas adjacentes nas quais ele é aplicado. Na medicina veterinária, são poucas as pesquisas com retalho pediculado de omento maior como indutor angiogênico e imunogênico, porém suas propriedades de adesão e drenagem são bem conhecidas. Os objetivos deste estudo foram criar um retalho pediculado de omento maior, mensurar seu comprimento durante as etapas de criação e avaliar a possibilidade de alcance para ossos longos (fêmur, tíbia, úmero, rádio e ulna) através de túnel subcutâneo, visando a utilizá-lo futuramente como indutor angiogênico em focos de fratura, para aceleração da osteogênese e controle de infecções ósseas. Foram utilizados 30 cadáveres frescos de cães de todas as raças, com exceção dos condrodistróficos. Os resultados foram conclusivos e confirmaram a possibilidade de alcance do retalho de omento para ossos longos de cadáveres de cães em que todos os retalhos alcançaram a metáfise distal dos ossos avaliados. A média de comprimento do omento, em camada dupla, dos 30 animais avaliados foi de 30,87cm; da camada simples foi de 54,37cm e do retalho em L foi de 92,7cm. Com a extensão máxima do omento, foi possível alcançar as metáfises distais de todos os ossos propostos, com comprimento médio excedente de 29,87cm para fêmur, 20,73cm para tíbia/fíbula, 25,13cm para úmero e 16,27cm para rádio/ulna. As variáveis peso e retalho em L avaliadas estatisticamente de cada indivíduo apresentaram correlação positiva moderada. Concluiu-se que, em cadáveres de cães, é possível levar o retalho pediculado de omento maior através de túnel subcutâneo para metáfise distal de ossos longos e que, quanto maior o peso do animal, maior o comprimento do retalho em L.
It's known for long time hat the human omento can promote angiogenic activity in adjacent structures in which it is applied. In veterinary medicine, there is little research with greater omentum flap as angiogenic and immunogenic inductor, however, their adhesion properties and drainage are well known. This study wondered whether if the greater omentum can be used as angiogenic inductor in bone fractures, and therefore increase osteogenenic rates and decreasing bone infection. Initially it was designed an experimental study which aimed to obtain a greater omentum pedicle flap and conduct it so long as possible through a subcutaneous defect in order to reach long bones (femur, tibia, humerus, radius/ulna). For the experiment it was used 30 dogs cadavers of all breeds, except condrosdistrophics breeds. The results were conclusive and confirmed the possibility of reaching the omentum flap for long bones. All the animals had reached the distal half of the evaluated bones. Results were satisfactorily accomplished and in 100 percent of the cases the flap reached the distal half of the evaluated bones. The averages of the different flap length were: 30.87cm when double layer was used; 54.37cm in simple layer; and 92.7cm when the flap was built in L. The maximum length of the omentum has secured the possibility of reaching the distal metaphases of all the bones studied. The average length exceeded 29.87cm to femur, 20.73cm to tibia/fibula, 25.13cm to humerus, and 16.27cm to radius/ulna. The flap length variety statistically evaluated showed moderate positive correlation on the presented individuals. It was concluded that the omentum pedicle flap can be taken through the subcutaneous defect until the distal metaphase of the long bones of dogs cadavers without tension. Animals with high corporal weight have the biggest L flap length.
ABSTRACT
OBJECTIVES: Anterior tunnelling technique consist of anterior cervical fractional interspace decompression without fusion. This method provides sufficient space for adequate neuroforaminal decompression but avoids the need for fusion or fixation. We report early clinical results of 32 cases that underwent anterior tunnelling operation for treatment of cervical radiculopathy. METHODS: This method is identical to conventional approach until the exposure of anterior cervical body and bilateral retraction of longus colli is made. A vertical window is then made at the vertebral bodies and disc space lateral to the insertion site of the longus colli. The window is deepened with drilling that follows a tunnelling fashion down to the compressive lesion. We analyzed clinical results from 32 patients who treated between December 1998 and August 2000. RESULTS: Satisfactory results were obtained in 87% of the patients. Two patients required revision surgery. None revealed surgical spinal instability on last follow-up. CONCLUSION: Anterior tunnelling operation is an acceptable surgical option for the treatment of cervical radiculopathy. Its advantages are short hospitalization, minimal postoperative discomfort, and technical feasibility.
Subject(s)
Humans , Decompression , Follow-Up Studies , Hospitalization , RadiculopathyABSTRACT
Continuous epidural analgesia with morphine via portable infusor(Baxter Infusor, BI) is a good technique for the management of intractable cancer pain. The method of subcutaneous tunnelling with portable infusor has been widely used for the cancer pain management. We examined the doses of morphine, duration of subcutaneous tunnelling, side effects, age distribution and causes of pain. The mean initial dose of morphine was 6.09 and the last 24.02 mg. Mean duration of subcutaneous tunnelling was 53.71 days and voiding difficulty, pruritus, respiratory depression were observed. Most of the patients were at the ages of 6th decade and the most common cause of pain was stomach cancer. It is suggested that the management of intractable cancer pain with epidural morphine through subcutaneous tunnelling via portable infusor is satisfactory and reliable.