Fisiología respiratoria: circulación pulmonar / Respiratory physiology: pulmonary circulation

El pulmón recibe sangre desde la circulación bronquial y pulmonar. La circulación pulmonar presenta importantes diferencias con la sistémica, sus vasos sanguíneos poseen características únicas que le permiten cumplir sus diferentes funciones, siendo la más importante el intercambio gaseoso. Existen múltiples factores, activos y pasivos, que están involucrados en la regulación de la resistencia vascular y flujo sanguíneo pulmonar.

The lung receives blood from the bronchial and the pulmonary circulation. The pulmonary circulation presents important differences with the systemic circulation, its blood vessels have unique characteristics that allow them to fulfill their different functions, the most important being gas exchange. There are multiple factors, active and passive, that are involved in the regulation of vascular resistance and pulmonary blood flow.

Morphological assessment of vascular anastomoses performed using high frequency electric welding / Evaluación morfológica de anastomosis vasculares realizada mediante soldadura eléctrica de alta frecuencia

SUMMARY: The studies of the properties of vascular structures and tissues during electric welding, in particular direct morphological changes in the blood vessel walls in the areas of welding processes, are of interest. Perforating veins, femoral veins, abdominal aorta, vena cava and porcine perforating veins of the limbs were used in this study. We performed end-to-end electric welding of the aorta, venous end-to-side electric welding, vein end-to-artery side arterial and venous welding, venous end-to-end electric welding, as well as arterial and venous lumen sealing.The results of histological studies showed the formation of a coagulated acellular protein matrix, represented by unorganized denatured protein fibrous structures. In the area of vascular tissue coagulation, lacunes were formed as a result of water evaporation from the biological tissue. In the perifocal area of the welded junction, cell reduction occurred without necrosis or charring. The data obtained confirm the safety of high frequency electric welding of the main vessels and the prospectfor clinical use of the studied techniques.

RESUMEN: Los estudios de las propiedades de las estructuras y tejidos vasculares durante la soldadura eléctrica son relevantes, en particular los cambios morfológicos directos en las paredes de los vasos sanguíneos en las áreas de los procesos de soldadura. En este estudio se utilizaron venas perforantes, venas femorales, parte abdominal de la aorta, vena cava y venas perforantes porcinas de los miembros. Realizamos soldadura eléctrica de extremo a extremo de la parte abdominal de la aorta, soldadura eléctrica de extremo a lado venosa, soldadura arterial y venosa de extremo a arteria del lado venoso, soldadura eléctrica de extremo a extremo venoso, así como lumen arterial y venoso. Los resultados de los estudios histológicos mostraron la formación de una matriz de proteína acelular coagulada, representada por estructuras fibrosas de proteínas desnaturalizadas no organizadas. Se formaron lagunas como resultado de la evaporación del agua del tejido biológico en el área de la coagulación del tejido vascular, En el área perifocal de la unión soldada, la reducción celular ocurrió sin necrosis ni carbonización. Los datos obtenidos confirman la seguridad de la soldadura eléctrica de alta frecuencia de los vasos principales y la perspectiva de uso clínico de estas técnicas.

Morphometric analysis of accessory vessel grooves (AVG) in the skulls of the ancient spradon population: an anthropological approach / Análisis morfométrico de los surcos de vasos sanguíneos accesorios (SVA) en los cráneos de la antigua población de spradon: un enfoque antropológico

SUMMARY: Accessory vessel grooves (AVG), or accessory vessel sulcus, is the name given to grooves seen in the frontal region of the skull. In studies conducted by anthropologists on antiquity skeletons, it is seen that some variations are confused with traumas due to the unknown skeletal morphology. This situation leads to an incorrect evaluation of the socio-economic or health structure of the population. In this study, an accessory vessel grooves research was carried out on the skeletons of the late Roman-early Byzantine population. Studies were conducted on 69 adult human skeletons of known age and sex, and 3 human skeletal skulls whose sex could not be determined. Accessory vessel grooves rate was calculated as 10.54 % in the Spradon ancient population. While there is 10.52 % AVG in female individuals in the population, lower AVG levels have been detected in males compared to females with 9.67 %. There is no significant difference between male and female individuals in terms of AVG. Although the lengths of AVG differ in the right and left frontal, it can be said that there is no difference in direction. Although the relation of AVG variation with high blood pressure is included in the literature, the intense appearance of this structure in the Spradon Population, especially in young individuals, weakens this hypothesis. The literature on the existence of AVG will expand further with the studies to be carried out on ancient Anatolian populations in the following years.

RESUMEN: Surcos de los vasos accesorios (SVA), o canales de vasos accesorios, es el nombre que se les da a los surcos que se ven en la región frontal del cráneo. En los estudios realizados por antropólogos sobre esqueletos de la antigüedad, algunas variaciones se pueden confundir con traumas debido a la morfología esquelética desconocida. Esta situación conduce a una valoración incorrecta de la estructura socioeconómica o sanitaria de la población. En este estudio, se llevó a cabo una investigación de surcos de vasos sanguíneos accesorios en los esqueletos de la población romana tardía y bizantina temprana. Se realizaron estudios en 69 esqueletos humanos adultos de edad y sexo conocidos, y 3 cráneos esqueléticos humanos cuyo sexo no se pudo determinar. La tasa de surcos de vasos accesorios se calculó como 10,54 % en la población antigua de Spradon. Si bien hay un 10,52 % de SVA en las mujeres de la población, se han detectado niveles más bajos de SVA en los hombres en comparación con las mujeres en un 9,67 %. No existe una diferencia significativa entre hombres y mujeres en términos de SVA. Aunque la relación de la variación de SVA con la hipertensión arterial está incluida en la literatura, la importante advertencia de esta estructura en la población de Spradon, particularmente en sujetos jóvenes, debilita esta hipótesis. La literatura sobre la existencia de SVA se ampliará aún más con los estudios que se llevarán a cabo en las antiguas poblaciones de Anatolia en el futuro.

Estudo de anatomia comparada suína por angiotomografia: contribuições para modelos de pesquisa e treinamento em cirurgia vascular e endovascular / Comparative angiotomographic study of swine vascular anatomy: contributions to research and training models in vascular and endovascular surgery

Resumo Contexto Modelos com animais de médio e grande porte permitem que pesquisadores avaliem a eficácia e a segurança de procedimentos cardiovasculares em sistemas que se assemelham à anatomia humana e podem ser usados para simular cenários para fins de treinamento. Embora modelos suínos tenham sido extensivamente utilizados, muitos fatores fisiológicos e anatômicos permanecem desconhecidos ou apenas superficialmente descritos. Objetivos Descrever a anatomia vascular do suíno por tomografia computadorizada, compará-la à anatomia humana e discutir a aplicação dos modelos porcinos em procedimentos abertos e endovasculares. Métodos Três porcos machos da raça Landrace foram submetidos a tomografia computadorizada. A anatomia vascular de pescoço, tórax, abdome e membros foi analisada e descrita; foram destacadas similaridades e divergências relevantes entre a anatomia vascular de suínos e de humanos e as implicações em procedimentos vasculares nos suínos. Resultados O território carotídeo, o arco aórtico e os ramos terminais da aorta em suínos apresentaram diferenças marcantes quando comparados aos de humanos. Foram detectadas compressões de veias renal e ilíaca comum, ambas à esquerda, semelhantes às encontradas nas síndromes humanas de Nutcracker e May-Thurner. Medidas vasculares (diâmetro, comprimento e ângulos) de diferentes topografias de suínos foram fornecidas. Conclusões Os dados fornecidos podem ser úteis para o planejamento de ensaios pré-clínicos e pesquisa básica, bem como para o refinamento do treinamento cirúrgico usando modelos suínos no campo da cirurgia vascular.

Abstract Background Medium and large animal models allow researchers to evaluate the efficacy and safety of cardiovascular procedures in systems that resemble human anatomy and can be used to simulate scenarios for training purposes. Although porcine models have been used extensively, many physiological and anatomical features remain unknown or only superficially described. Objectives To describe the normal porcine vascular anatomy on computed tomography scans, compare it to human vascular anatomy, and discuss the application of porcine models for open and endovascular procedures. Methods Three male Landrace pigs underwent computed tomography. The vascular anatomy of the neck, thorax, abdomen, and limbs was analyzed and described; relevant similarities and differences between porcine and human vascular anatomies and the implications for vascular procedures in pigs are highlighted. Results The carotid territory, aortic arch, and terminal aorta branches all show marked differences in pigs compared to their human counterparts. Compressions of both left renal and common iliac veins were detected, analogous to those seen in human Nutcracker and May-Thurner syndromes. Vascular measurements (diameters, lengths, and angles) of several different porcine territories are presented. Conclusions The data presented should be useful for planning preclinical trials and basic research and for refining surgical training using porcine models in vascular fields.

Morfometría y vascularización de la glándula tiroides en conejo (Oryctolagus cuniculus) / Morphometry and vascularization of the thyroid glands in rabbits (Oryctolagus cuniculus)

Las glándulas tiroides consisten en dos partes denominadas lobos que se encuentran en ambos lados de la laringe. El objetivo de este estudio fue caracterizar las medidas, topografía y vascularización de la glándula tiroides de conejos Nueva Zelanda. Las disecciones anatómicas se realizaron en 36 cadáveres adultos, 17 machos y 19 hembras, con masa corporal media de 2,5 kg y longitud cara-sacral media de 40 cm. Los cadáveres fueron obtenidos del sector de necropsia de la Universidad. Los especímenes tuvieron la arteria aorta torácica canalada, por la cual se inyectó solución de formaldehído al 10 %, seguida de látex coloreado. En los machos, el lobo izquierdo de la glándula tiroidea midió 1,40 x 0,40 x 0,01 cm y el derecho 1,36 x 0,56 x 0,01 cm; en las hembras, el lobo izquierdo midió 1,50 x 0,49 x 0,01 cm y el derecho 1,37 x 0,48 x 0,01cm. No hubo diferencia significativa (p> 0,05) entre las medias de las medidas entre machos y hembras, pero la extensión del lóbulo izquierdo de las hembras y la anchura del lóbulo derecho de los machos fueran significativamente mayores (p <0,05). La extremidad craneal de los lobos tiroideos se encontraba al nivel del cartílago cricoide en casi todos los especímenes. El extremo caudal presentó topografía más variable, desde el tercer hasta el décimo anillo traqueal, habiendo predominado al nivel del quinto anillo. Invariablemente, la irrigación arterial fue determinada por las arterias tiroideas izquierda y derecha, originadas de la arteria carótida común. Las anastomosis entre las arterias tiroideas fueron comunes. La constancia en las dimensiones y irrigación de la glándula tiroidea puede ser ventajosa en la elección del Coelho como modelo experimental para el estudio de esta glándula.

The thyroid glands consist of two parts called lobes located on both sides of the larynx. The aim of this study was to characterize the measures, topography and arterial irrigation of New Zealand´s rabbits thyroid glands. The anatomical dissections were performed in 36 adult cadavers, 17 males and 19 females, with a mean body mass of 2.5 kg and a mean cranium-sacral length of 40 cm. The specimens were obtained from the necropsy unit of the University. The cadavers had the thoracic aorta artery cannulated, through which 10 % formaldehyde solution was injected, followed by injection colored latex. In males, the left lobe of the thyroid gland measured 1.40x0.40x0.01cm and the right 1.36x0.56x0.01cm; in females, the left lobe measured 1.50x0.49x0.01cm and the right one was 1.37x0.48x0.01cm. There was no significant difference (p> 0.05) between the means of the measurements between males and females, but the left lobe length of the females and the right lobe width of the males were significantly higher (p <0.05). The cranial extremity of the thyroid lobes was at the level of the cricoid cartilage in almost all specimens. The caudal end showed more variable topography, from the third to the tenth tracheal ring in few specimens, but predominated at the level of the fifth ring. Invariably, arterial irrigation was determined by the left and right thyroid arteries, originating from the common carotid artery. Anastomoses between the thyroid arteries were common. The constancy in dimensions and irrigation of the thyroid gland may be advantageous in choosing the rabbit as an experimental model for the study of this gland.

Morphometry and Vascularization of the Rabbit Kidneys (Oryctolagus cuniculus) / Morfometría y Vascularización del Riñón de Conejo (Oryctolagus cuniculus)

Rabbits have been used as urologic models in many studies. The aim of this study was to characterize the renal morphology and anatomical variations of the renal pedicle in rabbit. The research ethics committee of Rio de Janeiro Federal Rural University approved this study. The animals were obtained from the university's necropsy unit. Dissections were performed in 50 adult rabbits, male and females, without macroscopic renal pathology. Kidney measurements were made with a digital caliper: length, width, and thickness. The length and origin of the renal arteries and main branches and length of the renal veins were also determined. The terminology of Nomina Anatomica Veterinaria was followed. The mean and standard deviation of the length of the right kidney was 3.150±0.2588 cm in males and 3.127±0.3769 cm in females and in the left kidney was 3.083±0.0818 cm in males and 3.162±0.0848 cm in females. The width of the right kidney was 1.933±0.0848 cm in males and 1.996±0.0680 cm in females and in the left kidney was 1.850±0.0659 cm in males and 2.004±0.0940 cm in females. There was no significant difference in the measurements between the two sexes and antimeres and in the measures of renal vessels in relation to sex, but the left artery and renal vein were always larger than the right in both sexes. The results of the present study are expected to contribute to the body of knowledge in the field of comparative and applied anatomy.

Los conejos se han utilizado como modelos urológicos en muchas investigaciones. El objetivo de este estudio fue caracterizar la morfología renal y variaciones anatómicas del pedículo renal en el conejo. El comité de ética de la investigación de Río de Janeiro Universidad Federal Rural aprobó este estudio. Los animales se obtuvieron de unidad de necropsia de la universidad. Las disecciones se realizaron en 50 conejos adultos, machos y hembras, sin patología renal macroscópica. Se realizaron con un calibrador digital las siguientes mediciones en el riñón : longitud, ancho y grosor. También se determinaron la longitud y el origen de las arterias renales y ramas principales y longitud de las venas renales. Se siguió la terminología de Nomina Anatomica Veterinaria. La Media y DE de la longitud del riñón derecho fue 3,150±0,2588 cm en machos y 3,127±0,3769 cm en hembras y en el riñón izquierdo fue 3,083±0,0818 cm en machos y 3,162±0,0848 cm en hembras. El ancho del riñón derecho fue 1,933±0,0848 cm en machos y 1,996±0,0680 cm en las hembras y en el riñón izquierdo fue 1,850±0,0659 cm en machos y 2,004±0,0940 cm en hembras. No hubo diferencias significativas en las mediciones entre los dos sexos y los antímeros, así como en las medidas de los vasos renales en relación con el sexo; pero la arteria y vena renal izquierda fueron siempre mayores que las del lado derecho en ambos sexos. Se espera con los resultados del presente estudio contribuir al conocimientos en el campo de la anatomía comparada y aplicada.

Topography of arterial and venous blood vessels in the kidneys of English Thoroughbred Horses / Topografia dos vasos sanguíneos arteriais e venosos nos rins de Cavalos Puro Sangue Inglês

In equines, kidney diseases are typically associated with respiratory and digestive problems, but surgical intervention is not common. The study of kidney blood vessels of domestic and wild animals are of fundamental importance for understanding many aspects of their physiology and nutrition. The current study used 30 pairs of kidneys from English Thoroughbred horses being 15 males and 15 females of different ages. The organs were donated by the Jockey Club of Sao Paulo. During the animal necropsies, the kidneys and their arteries and veins were removed together. The organs were fixed in formalin 10% for about 48 hours, for dissection and individualization of the components of the renal pedicle. After dissecting the material, the components of the renal pedicle were individualised. To analyse the results, the cranioventral, craniodorsal, caudoventral and caudodorsal quadrants were defined using two lines: craniocaudal and dorsoventral. Overall, the following results were obtained: in the hilar region, two arterial branches occurred in the right kidney in 50% of cases and two in the left kidney (33.3%); in the juxtahilar region, the number of arterial branches ranged from four to five in the right kidney in 20% of cases, whereas six occurred in the left kidney (16.7%); and regarding the extrahilar region, three branches occurred in the right kidney (26.7%) and three in the left kidney (20.0%).

As doenças renais em equinos, geralmente estão associadas a problemas respiratórios e digestórios, entretanto não são frequentes as intervenções cirúrgicas neste órgão para estes animais. O estudo dos vasos sanguíneos relativos aos rins nos animais domésticos e selvagens é de fundamental importância para o entendimento de diversos aspectos de sua fisiologia e nutrição. Neste trabalho, foram utilizados 30 pares de rins de equinos Puro Sangue Inglês, dos quais 15 machos e 15 fêmeas, de diferentes faixas etárias, provenientes de doação do Jockey Club de São Paulo. Durante a necropsia dos animais, os rins unidos por meio de suas artérias e veias renais foram retirados em bloco. Em seguida, foram fixados em solução de formol a 10%, por aproximadamente 48h, para a dissecação e individualização dos componentes dos pedículos renais. Para a análise dos resultados foram demarcados os quadrantes cranioventral, craniodorsal, caudoventral e caudodorsal, com duas linhas uma craniocaudal e a outra dorsoventral. Os resultados obtidos revelaram que: os ramos arteriais da região hilar são observados no rim direito em número de dois em 50%, no esquerdo em número de dois (33,3%), os ramos arteriais na região justahilar são computados no rim direito em número de quatro a cinco em 20% e no rim esquerdo em número de seis (16,7%), e nos ramos dispostos na região extrahilar são registrados no rim direito em número de três (26,7%) e no esquerdo em número de três (20%).

Grading angiogenesis in oral squamous cell carcinoma: A histomorphometric study.

Context: Like normal tissues, tumors require an adequate supply of oxygen, metabolites and an effective way to remove waste products. This is achieved by angiogenesis, which is defined as the process by which new blood vessels are produced by sprouting from preexisting vasculature. There is a large spectrum of physiological and pathological processes in which angiogenesis occur, ranging from tissue hypertrophy, wound healing, and inflammation to tumors. Aims: The present study was designed to morphometrically evaluate the angiogenesis in different grades of oral squamous cell carcinomas (OSCCs) under light microscope by the use of H and E stained sections and to assess that whether the parameters of vascularity like mean vascular density (MVD), mean vascular area (MVA), and total vascular area (TVA) can be used to histologically grade the tumors. Subjects and Methods: A total of 10 cases each of well‑, moderately‑ and poorly‑differentiated SCC cases were retrieved from the archives of the Department of Oral Pathology and Microbiology and were morphometrically analyzed for mean vascular density (MVD), MVA, and TVA. Ten cases of normal oral mucosa were taken as Control. Statistical analysis was done using SPSS 19.0 version (IBM, Armonk, NY, USA) software for windows. Group mean for MVD, TVA and MVA were calculated for 10 cases of each group. “Student’s t‑test” was applied to assess the intergroup variation of mean values of MVD, TVA, and MVA. Results: Our results showed significant differences between all the three parameters, that is, MVD, MVA and TVA when poorly differentiated OSCC was compared with the normal mucosa, well‑ and moderately‑differentiated OSCC. However, when comparison was made between the well‑ and moderately‑differentiated OSCC, the differences in the three parameters were present but not statistically significant. Conclusion: There was an increased MVD, MVA and TVA in poorly differentiated OSCC, which could be used as an additional criterion to histologically grade the tumor.

Ovarian blood vessel occlusion as a surgical sterilization method in rats

To evaluate the female sterilization by occlusion of the ovarian blood flow, using the rat as experimental model. Fifty-five females rats were divided into four groups: I (n=10), bilateral ovariectomy, euthanized at 60 or 90 days; II (n=5), opening the abdominal cavity, euthanized at 90 days; III (n=20), bilateral occlusion of the ovarian blood supply using titanium clips, euthanized at 60 or 90 days; and IV (n=20), bilateral occlusion of the ovarian blood supply using nylon thread, euthanized at 60 or 90 days. The estrous cycle was monitored by vaginal cytology. After euthanasia, the reproductive tissues were evaluated histologically. RESULTS: Ovarian atresia was identified macroscopically at 60 days after surgery in the rats in groups III and IV; however, most of the rats in group III maintained cyclicity. Histology of the tissues from group IV revealed that the ovarian tissue was replaced by dense fibrous connective tissue that was slightly vascularized and that intact follicles were absent by 90 days. OOvarian blood vessels occluded caused ischemia, leading to progressive tissue necrosis, and bilateral occlusion using a nylon ligature is a viable method for surgical sterilization.

Vascular pattern of chorionic blood vessels of placenta and its correlation with the birth weight of neonate / Patrón vascular de los vasos sanguíneos coriónicos de la placenta y su correlación con el peso al nacer del recién nacido

Two hundred fresh full term placentae of normal pregnancies were collected from the department of Obstetrics and Gynaecology, RIMS, Ranchi, Jharkhand, India to observe the incidence of vascular pattern of chorionic blood vessels of placenta and to note the relationship between vascular pattern of placenta and the birth weight of neonate. Dye was injected into umbilical vessels under normal physiological pressure and diameter of chorionic blood vessels were taken at the centre and periphery. Two types of vascular pattern of chorionic blood vessels of placentae were observed- Dispersal and Magistral. Dispersal pattern was found in 63 percent cases and magistral pattern was observed in 37 percent cases. An interesting observation was noted that the birth weight of neonate was higher in magistral pattern in comparison to dispersal pattern in both sexes...

Doscientas placentas de término de gravidez normales frescas fueron recogidas del departamento de Obstetricia y Ginecología, RIMS, Ranchi, Jharkhand, India. Se observó la incidencia del patrón vascular de los vasos sanguíneos coriónicos de la placenta y la relación entre el patrón vascular de ésta y el peso al nacer del recién nacido. Se inyectó tinta dentro de los vasos umbilicales bajo presión fisiológica normal, y se tomaron los diámetros de los vasos sanguíneos coriónicos en el centro y la periferia. Dos tipos de patrón vascular coriónicos se observaron en la placenta, disperso y magistral. El patrón disperso se encontró en el 63 por ciento de los casos y el patrón magistral se observó en 37 por ciento de los casos. Una observación interesante mostró que el peso al nacer de los recién nacidos fue mayor en el patrón magistral en comparación con el patrón disperso en ambos sexos...

Vasculites dos médios e grandes vasos: [revisão] / Medium and large vessel vasculitis: [revision]

As vasculites são constituídas por um grande grupo de síndromes caracterizadas por inflamação e necrose da parede dos vasos sangüíneos, resultando em estreitamento ou oclusão do lúmen. A distribuição dos vasos envolvidos varia consideravelmente e serve de base para a classificação das síndromes vasculíticas: grandes vasos (arterite de Takayasu, arterite temporal); pequenos e médios vasos (poliarterite nodosa, síndrome de Churg-Strauss, granulomatose de Wegener, vasculites nas doenças reumáticas); e pequenos vasos (vasculite de hipersensibilidade, púrpura de Henoch-Schonlein, poliangeíte microscópica, crioglobulinemia). Este artigo revisa as vasculites dos médios e grandes vasos e opções terapêuticas atuais; além de oferecer orientação sobre abordagem diagnóstica e tratamento dos pacientes com suspeita de vasculite cutânea.

Vasculitis comprises a broad group of syndromes characterized by inflammation and necrosis on thewalls of blood vessels, resulting in narrowing or occlusion of the lumen. The distribution of involved blood vesselvaries considerably and serves as the basis for one classification of vasculitic syndromes: large vessels (Takayasu arteritis, giant cell arteritis); medium and small muscular arteries (polyarteritis nodosa, Churg-Strausssyndrome, Wegener's granulomatosis, vasculitis in rheumatic diseases); and small vessels ("hypersensitivity" vasculitis, Henoch-Schonlein purpura, microscopic polyangiitis, cryoglobulinemia). This article reviews medium and large vessel vasculitis and current treatment options; it also presents a comprehensive approach to diagnosing and treating patients with suspected cutaneous vasculitis.

Morphometric evaluation of endometrial blood vessels.

Five hundred endometrial specimens were studied to document the changes in blood vessels in various phases of menstrual cycle, menstrual disturbances and in unexplained infertility. Sixty-three cases were taken as control and 437 cases as study group which included cases of dysfunctional uterine bleeding (DUB), endometrial polyps, fibroids, adenomyosis, infertility and atrophic endometrium. Using light microscopy, the vascular morphology was studied. The blood vessels were concentrated more in basal layer in the proliferative phase and in functional layer in the secretory phase. Cases of complex hyperplasia and pill endometrium had significantly higher vessel concentration. Congestion and dilatation of blood vessels were significantly higher in cases of DUB. The present study showed a positive correlation between endometrial angiogenesis and menstrual disorders. The alteration in blood vessel morphology has significant role in prognosis and in various anti-angiogenic therapies.

Superficial peripheral vein type classification of adolescents, adults and elderly according to the Delphi technique / Classificação de veias superficiais periféricas de adolescentes, adultos e idosos pela técnica Delphi / Clasificación de las venas periféricas superficiales en adolescentes, adultos y ancianos mediante la técnica Delphi

This descriptive research attempts to cooperate with the standardization of communication about vein types in Nursing. Authors utilized the "Delphi" technique and aimed at elaborating and validating a peripheral vein type classification of adolescents/adults/elderly according to their vein characteristics. Initially, authors identified different vein types in literature. This was a preliminary classification that contained the titles and definitions, which were complemented during the expert (nurses, angiologists, anesthetists and biochemists) validation process. Twelve criteria and 27 vein types were validated (agreement level > 90 percent). In addition, authors organized a set of pictures representing the different vein types. From these, 144 were used; 35 experts chose one picture to exemplify each classification title. The pictures representing 21 vein types were identified. This classification contributes to the clinical assessment of blood vessels and can be used in teaching, research and patient care management.

Esta investigación descriptiva tiene por objetivo colaborar en la estandarización de los tipos de venas para la práctica de enfermería. Se utilizó la técnica "Delphi", para elaborar y validar una clasificación sobre los tipos de venas periféricas superficiales en adolescentes/adultos/ancianos, para ello se tuvo en consideración las características de los vasos. Inicialmente se identificó a través de la bibliografía los diferentes tipos de venas, los cuales conformaron la clasificación, usando títulos y definiciones que fueron complementados durante el proceso de validación por expertos (enfermeros, angiólogos, anestesiólogos y bioquímicos). Se validaron 12 criterios y 27 tipos de venas (nivel de concordancia > 90 por ciento). Además, se elaboró un conjunto de fotos representativas para la población sobre los diferentes tipos de venas, de las cuales fueron usadas 144. De esta forma, 35 peritos escogieron una foto como ejemplo de cada título de clasificación, siendo identificadas las fotos representativas de 21 tipos de venas. Esta clasificación contribuyó en la evaluación clínica de los vasos sanguíneos, pudiendo ser utilizada para la enseñanza, investigación y gestión en el cuidado del paciente.

Esta pesquisa descritiva visa colaborar com a padronização da comunicação sobre os tipos de veias na prática de enfermagem. Utilizou a técnica "Delphi" e teve como objetivo elaborar e validar uma classificação sobre os tipos de veias superficiais periféricas de adolescentes/adultos/idosos, segundo características dos vasos. Inicialmente foram identificados pelos autores na literatura os diferentes tipos de veias, que constituíram a classificação, contendo títulos e definições que foram complementadas durante o processo de validação por peritos (enfermeiros, angiologistas, anestesistas e bioquímicos). Foram validados 12 critérios e 27 tipos de veias (ind. concordância > 90 por cento). Complementarmente foi constituído um conjunto de fotos, representacional na população, dos diferentes tipos de veias. Destas, 144 foram usadas; 35 peritos escolheram uma foto para exemplificar cada título da classificação. Foram identificadas fotos representativas de 21 tipos de veia. Esta classificação contribui para a avaliação clínica do vaso sanguíneo, podendo ser empregada no ensino, na pesquisa e na gestão do cuidado ao paciente.

Distribuição da artéria gástrica esquerda e artérias gástricas curtas na superfície do estômago de eqüinos e relação com a área superficial do órgão / Distribution of left gastric artery and breve gastric arteries on the surfaceof equine stomach and the relation to the organ´s superficial area

Vasos responsáveis pelo suprimento sangüíneo do estômago originam-se da artéria celíaca, primeiro ramo da aorta abdominal, localizada na região do hiato aórtico. Assim, dirigem-se à superfície do estômago as artérias gástricas esquerda e direita, as artérias gastroepilóicas esquerda e direita e as artérias gástricas curtas. Apesar de bem conhecidas as origens destes vasos, informações a respeito do comportamento dos mesmos ao atingirem a superfície do estômago ainda são escassas. O fluxo sangüíneo na parede do estômago exerce importante papel nos mecanismos de defesa da mucosa gástrica. Eqüinos em treinamento intensivo apresentam alta freqüência de ocorrência de lesões ulcerativas na mucosa do estômago, tornando as pesquisas sobre vascularização sangüínea deste órgão com grande significado prático na compreensão dos mecanismos relacionados à proteção da mucosa gástrica. O objetivo deste trabalho foi avaliar alguns aspectos relacionados à distribuição arterial na superfície do estômago de eqüinos adultos, sem raça definida e destinados a abate. Utilizaram-se estômagos oriundos de 15 machos e 15 fêmeas. A área superficial do estômago foi mensurada com software de análise de imagens e os dados correlacionados ao número de ramos avaliados. Observou-se reduzida participação da artéria gástrica esquerda na irrigação da curvatura menor do estômago. Estes achados justificam estudos relacionados à particularidades anatômicas da região da curvatura menor do estômago de eqüinos, em trabalhos futuros.

Vessels responsible for stomach blood supply have their origin in the celyac artery, abdominal aorta first branch, in the aortic hiatus region. Thus, the stomach surface receives the left and right gastric arteries, the left and right gastroepiploic arteries and the breves gastric arteries. Origins of these vessels are well-known, but information about stomach surface arterial distribution are still unknown. Stomach surface blood supply has an important role on gastric mucosa defense mechanisms. Equines submitted to intensive training show high frequency of the ulcerative lesions in the gastric mucosa, with is a promising of applicability for researches on vascularization. The aim of this study was to analyze some aspects of the stomach surface arterial distribution, of the mixed breed adults equines destined to slaughter. Equine stomachs of 15 male and 15 female were analyzed. The stomach surface area was measured with images analysis software and the data correlation with number of vessels branch accounted. A low contribution of the left gastric artery to the stomach minor curvature irrigation was observed. These results justify studies related to anatomic particularities of the region of equine stomach minor curvature, in future researches.

Efeito do grau de bipartição escrotal sobre a vascularização arterial do escroto de caprinos nativos do Estado do Piauí / Effect of the scrotal division degrees on the arterial supply distribution of native goats from the Piaui State

Avaliou-se a vascularização arterial do escroto em caprinos com vários graus de divisão escrotal. Foram utilizados 30 animais, distribuídos em três grupos: I - animais que apresentavam escroto único e aqueles com divisão até extremidade caudada dos testículos; II - animais com divisão escrotal até 50% do comprimento dos testículos; III - caprinos com divisão escrotal acima de 50% do comprimento testicular. Os caprinos foram sacrificados e, no Laboratório de Anatomia Animal da Universidade Federal do Piauí, realizadas as técnicas de repleção, corrosão ou dissecação, para estudo das artérias escrotais. A artéria escrotal origina-se freqüentemente (95%) da artéria pudenda externa, eventualmente (3,3%) da epigástrica caudal superficial, ou ainda origina-se como um ramo cranial da artéria epigástrica caudal superficial e um ramo caudal da artéria pudenda externa (1,7%). Na região dorsal do septo do escroto emite dois a três ramos primários, que fornecem os ramos secundários e terminais, os quais distribuem-se, indistintamente, nas faces cranial e caudal do escroto e, ocasionalmente, no septo do órgão. O número de ramos terminais não apresenta diferença em relação à configuração escrotal, porém a região correspondente à divisão escroto, conta com maior quantidade desses ramos nos animais que apresentam essa característica mais acentuada.

The present study was design to investigate the arterial distribution of goat's scrotum with several degrees of scrotum division. We used 30 animals divided in 3 groups of 10 animals each as follow: group I: animals with simple scrotum; II - animals with 50% of scrotum division; III - animals with more than 50% of scrotum division. The goats were sacrificed under deep anaesthesia and the techniques for evaluate the arterial distribution were performed at the Laboratory of animal anatomy of the Federal University of Piaui. The origin of the scrotum artery was mainly from the pudenda artery (95%), follows by the superficial caudal ephigastric artery (3,3%), or had your origin as one cranial branch of the superficial caudal ephigastric artery and one caudal branches of the extern pudenda artery (1,7%). The dorsal region of scrotal septum seed two or three primary branches that provide the secondary and terminals branches, which had indiscriminate distribution into the cranial and caudal faces of the scrotum, and occasionally at the septum. The number of the terminal branches doesn't have show any difference with the scrotum configuration, however the region that corresponds to the scrotum division had more number of these branches at the animals with the greatest scrotal division.

Vascular anatomy of the proximal fibula from embalmed cadaveric dissection.

OBJECTIVES: To study the vascular pattern of proximal fibula with use of embalmed cadaveric specimens. MATERIAL AND METHOD: The present study was done on 33 lower extremities from 19 embalmed human, adult cadavers. The average ages of the cadavers were 68.6 years (range from 36 to 98 years), 11 females and 8 males. The size and site of vessels around the proximal fibula were recorded. RESULTS: There were three main blood supplies of proximal fibular the epiphyseal artery, the lateral genicular artery, and the periosteal blood supply. They are anterior tibial recurrent artery and posterior tibial artery or artery of the neck of fibula posteriorly. Inferior lateral genicular artery was seen in all specimens (33/33). Among them, 42.4% (14/33) had a single artery with double accompanied veins. The average diameter of artery and veins were 1.71 mm (0.75-2.25), and 1.69 mm (1.30-2.10), respectively. The others were single artery and single vein. The average diameter ofartery and veins were 1.66 mm (0.65-2.14), and 2. 1 mm (0. 95-2.30) respectively. Anterior tibial recurrent artery was seen in 31 of 33 specimens (94%). The average size of artery and accompanying vein were 1.24 mm (0.8-2.1), and 1.86 mm (0.8-2.6), respectively. Posterior tibial recurrent artery was an inconsistent branch that appeared in only 11 of 33 specimens (33%). Artery of the neck of fibula appeared in 24 of 33 specimens (72.7%). The others were replaced by the predominant posterior tibial recurrent artery (7/33) and neither of them was found in two specimens. CONCLUSION: Based on the present results, the authors recommend preserving the epiphyseal blood supply, the inferior lateral genicular artery, and the periosteal blood supply for free epiphyseal transfer In addition, surgeons should pay attention to the variation of posterior periosteal blood supply because its variations will affect the viability percentage of proximal fibular epiphyseal transfer.

Formação do sistema venoso portal em Chinchilla lanígera / Formation of the portal venous system in Chinchilla lanigera

O estudo referente à formação do sistema venoso portal (VP) em chinchila (Chincilla lanigera) foi obtido através da análise de 10 animais dos quais o sis tema porta extra-hepático sofreu injeção de látex corado, seguidos de dissecação em estereolupa. Logo após foram confeccionados esquemas a partir dos resultados observados, onde se averiguou que a VP é originada sempre através da confluência de duas raízes. A primeira destas raízes é o tronco mesentérico comum (TM), formado a partir da união das veias mesentérica cranial e mesentérica caudal. O TM recebe ainda como tributárias as veias pancreaticoduodenal cranial e gastroepiplóica direita. A segunda raiz, que apresenta menor calibre, é a veia lienal. Esta descrição foi observada em 100% dos espécimes mantendo-se constante, sugestionando que os resultados obtidos possam ser considerados como modelo padrão.

The study regarding the formation of the system portal vein (VP) in chinchilla (Chinchilla lanigera) was obtained through the analysis of 10 specimens in which the extra-hepatic portal system suffered injection of red-faced latex, following by dissection in estereolupa. Thereafter outlines were made starting from the observed results, where it was discovered that VP is always originated from the confluence of two roots. The first of these roots is the trumcus mesentenricus communis (TM), formed from the union of the vena mesentericas cranialis and mesenterica caudalis. TM still receives as tax the vena pancreaticoduodenalis cranialis and gastroepiploica sinistra. The second root, with smaller caliber, is the vena lienalis. This description was observed in 100% of the specimens staying constant, suggesting that the obtained results can be considered as standard model.

Viabilidade anátomo-clínica da utilização dos vasos perfurantes do músculo peitoral maior como pedículo receptor na reconstrução mamária imediata e tardia com microcirurgia / Viability of utilizing the pectoralis major perforator muscular vessels as a recipient pedicle in immediate and late breast reconstruction with microsurgery

Na reconstrução mamária com microcirurgia, a qualidade dos vasos, a proximidade com a região torácica e a anatomia constante são fatores relevantes na escolha do pedículo receptor. Apesar da grande aplicação clínica, os vasos toracodorsais e torácicos internos apresentam restrições como a imprevisibilidade da qualidade nas reconstruções tardias, as alterações do contorno do tórax e a inviabilidade de uma eventual revascularização futura do miocárdio. Com o desenvolvimento dos retalhos vascularizados por vasos perfurantes e o maior treinamento dos cirurgiões, novas alternativas de pedículos foram desenvolvidas. A preservação da cartilagem costal e dos vasos torácicos internos, bem como a maior exposição do campo operatório são mencionados como vantagens do emprego dos vasos perfurantes do músculo peitoral maior como receptor. Apesar da anatomia dos vasos perfurantes ter sido previamente estudada, são imprecisas as informações sobre sua origem e distribuição no tórax. Ademais, são escassos os dados relacionados à sua incidência e utilização nas reconstruções imediatas e tardias. Na presente investigação foram incluídos dois estudos: anatômico e clínico. No estudo anatômico avaliou-se a origem, distribuição e dimensões dos vasos perfurantes em 24 cadáveres frescos (48 regiões torácicas), por técnica de coloração e posterior dissecção. No estudo clínico analisou-se, 69 pacientes (77 reconstruções mamárias), sendo 46 imediatas e 31 tardias. Constatou-se no estudo anatômico 2,7 vasos perfurantes por região torácica, destes, 93% apresentaram pequeno e médio calibre e concentração preferencial no segundo espaço intercostal. Os vasos e o pedículo perfurante revelaram comprimento médio de 2,4 cm (1,0 a 3,2 cm) e 3,6 cm (2,1 a 4,5 cm), respectivamente. No estudo clínico, não foram observadas diferenças entre as pacientes submetidas à reconstrução imediata e tardia, quanto a idade (p=0,599), IMC (p=0,498), lateralidade da mama (p=0,671), hipertensão arterial...

In breast reconstruction with microsurgery, the proper selection of the recipient pedicle is a significant factor for success. The compatibility of caliber and the uniform anatomy are the chief relevant factors in the choice of recipient vessels. Regardless of their broad clinical application, the thoracodorsal and internal thoracic vessels demonstrate limitations such as the unpredictable quality of late reconstructions, the changes in thoracic contour and the impairment for future coronary bypass. The progress of microsurgical technique and the development of perforator flaps has led to new recipient pedicle alternatives. Thus, sparing of the costal cartilages and the internal thoracic vessels as well as the wide surgical exposure are the main advantages of using the pectoralis major perforator vessels as recipient pedicles. Although the anatomy of the perforator vessels has been previously studied, the data about their origin and distribution is inexact. In addition, the data concerning their incidence and quality of immediate and late reconstructions are not available. In the present investigation, an anatomical and clinical study were performed. In the anatomical study, the origin, distribution and size of perforator vessels were evaluated in 24 fresh cadavers (48 thoracic regions) by staining technique and posterior dissection. The clinical study analyzed 69 patients (77 reconstructions), 46 immediate and 31 late reconstructions. The anatomic study observed 2.7 perforator vessels per thoracic region, with 93% presenting small and medium caliber and major concentration in the second intercostal space. The vessels and the perforator pedicles demonstrated an average length of 2.4 cm (1.0 to 3.2 cm) and 3.6 cm (2.1 to 4.5 cm) respectively. In the clinical study, no differences were observed between the immediate and late reconstructions regarding age (p=0.599), BMI (p=0.498), breast side (p=0.671), hypertension (p=0.732), diabetes (p>0.999) and smoking...

Angioarquitetura venosa do órgão genital da fêmea bovina / Venous angioarchitecture of the bovine female genital organ

Investigou-se a angioarquitetura venosa da genitália de fêmeas bovinas não prenhes, para avaliar a presença de possíveis anastomoses dos vasos provenientes da região da vulva e da vagina com a veia útero-ovariana, usando-se cinco peças obtidas em abatedouros. No laboratório, um ramo da veia vaginal caudal, infundido com contraste radiográfico intravascular, foi submetido à radiografia; Observou-se que a veia vaginal forma intensa rede de anastomoses na superfície ventral do útero, entre os antímeros direito e esquerdo. As genitálias apresentaram anastomoses dos vasos vulvares e vaginais com vasos da cérvice, corpo e cornos uterinos, sugerindo que parte de um agente luteolítico administrado via intravulvosubmucosa pode ser transportado diretamente aos ovários por uma rota local, sem atingir a circulação sistêmica.

Estudo anatômico de pequenos vasos com corante radiopaco / Small vessels study using a radiopaque dye

A proposta do nosso trabalho consiste no estudo de um novo corante que, além de permitir o estudo macroscópico de pequenos vasos - seguindo a pesquisa pioneira de Salmon -, possibilita o estudo radiológico por ser uma solução radiopaca. Para tanto foram utilizados 10 ratos e cateterizadas suas aortas abdominais para a injeção do corante no sentido da periferia, acompanhando o seu fluxo pela artéria femoral esquerda (a da direita foi cauterizada). Os resultados de sua utilização na artéria femoral de rato mostraram tratar-se de uma solução com boa capacidade de penetração em vasos extremamente pequenos e que permite a dissecção sem que haja extravasamento do corante. Tendo em vista os resultados obtidos em ratos, acreditamos que o corante reúne os quesitos necessários para o estudo de detalhes da anatomia vascular.