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Background The purpose of our study was to assess the biocompatibility of the porcine small bowel submucosa and its ability to increase the rectal diameter compared with a formal transverse coloplasty. Methods We assigned 36 New Zealand male rabbits to four experimental groups: groups C1 and C2 were treated with transverse coloplasty and groups S1 and S2 were treated with a patch of a porcine small intestine submucosa. We killed the animals in the C1 and S1 groups on the 7th postoperative day, and the animals in the C2 and S2 groups on the 30th postoperative day. We evaluated outcomes on the basis of animal survival, clinical course, anastomosis bursting pressures, morphometric examination, and histologic and immunohistochemical assessment. Results Morphometric examination showed a significant increase in colonic diameter in animals in the S2 group. We found no statistical difference regarding anastomosis bursting pressure between the C1 and S1 groups, and the C2 and S2 groups. On the 30th postoperative day, histologic examination showed total epithelium coverage of the grafts, and the immunohistochemical study showed an organized smooth muscular layer covering the graft. The higher concentration of collagen ticker fiber, type I, was seen in the S2 and C2 groups, but there was no statistical difference between them. Conclusions The implanted graft proved superior to transverse coloplasty regarding the increase in distal colon diameter. Remarkable regeneration, marked fibroplasia, and epithelium coverage occurred throughout the graft on the 30th postoperative day.

Background Myocardial infarction is a public health problem. Functional food is an alternative treatment for cardiovascular diseases. Objective The objective was to analyze the functional and anatomopathological post-myocardial-infarction effects of soybean extract (SE) and isoflavone (IF). Methods Myocardial infarction was induced in adult Wistar rats. After 5 days, an echocardiogram was performed to determine heart rate (HR), ejection fraction (EF), systolic volume (LVESV) and diastolic volume (LVEDV). Animals with ventricular dysfunction (EF n =14), SE ( n =15) and IF ( n =12). The IF group received 120 mg/kg/day isolated IF, and the SE group received 12.52 g/day. After 30 days, a new echocardiogram was performed. A histological exam was carried out to determine the collagen. Activity of biochemical markers [arginase, lactate dehydrogenase (LDH) and malate dehydrogenase] was measured. Results The animals of the control, IF and SE groups showed a reduction in EF after the infarction ( P =.432, P =.017 and P =.320, respectively). An increase of LVESV and LVEDV was observed in all groups ( P =.009, P =.001 and P =.140; and P =.003, P =.008 and P =.205, respectively). A reduction of HR was found in the SE group ( P =.020). There was a greater activity of LDH in the SE group. A smaller quantity of mature collagen was found in the region proximal to the myocardial infarction in the SE group. Conclusion A protective effect in the SE group was observed 30 days after the myocardial infarction.

PURPOSE: To evaluate the effects of venous supercharging in deep inferior epigastric artery perforator flap in rats. METHODS: 20 Wistar rats were randomized in 2 groups: control group (C), all had flaps raised based on the deep inferior epigastric perforator vessels (DIEP), and experimental group (E), which was identical to group C, except that the contralateral superficial inferior epigastric vein was also kept with the flap. Flow studies using laser Doppler flowmetry where performed daily in the four zones of the flap. On the 7th postoperative day rats were killed and flap survival was determined using digital planimetry. RESULTS: Flow values were presented as a percentage of the baseline flow after incision of the flap edges. The surviving flap area was demonstrated as a percentage of the total flap area. Evaluation by digital planimetry showed that flap survival in group E was higher than in group C (97,38%±1,32%vs.44,13%±4,83%, p=0,0006). CONCLUSION: This study shows that venous supercharging of the rat DIEP flap results in greater flap survival.

Two types of monofilament polypropylene mesh with different pore sizes, mass densities and burst strengths were used to repair two identical paired full-thickness abdominal wall defects in ten dogs, in order to compare their integration histology 90 days after implantation. On one side a standard mesh, Prolene® (Ethicon), was sutured to the borders of the defect, while on the other a new ultralightweight macroporous mesh, Mpathy® mesh, was used. There was a significantly greater densitometric proportion of mature (type I) collagen (58.38%) for Mpathy® mesh compared to Prolene® (34.05%, P = 0.01). Although Prolene® has 3.6 times the burst strength of Mpathy® mesh, the implanted tissue strength was marginally greater for Mpathy® mesh. We conclude that Mpathy® mesh gives a surgical repair that is at least as strong as that provided by Prolene®, along with a higher concentration of mature collagen and less fibrosis (P = 0.07), in this canine histology model.

PURPOSE:To observe the effect of pro-inflamatory citokin, Interleukin-6 (IL-6), administration on the healing of colonic anastomosis in rats. METHODS: Thirty Wistar rats were divided into 2 groups of 15 animals each: a control group and an experiment group. The animals of the experiment group were submitted to injection of 500µg/kg of IL-6 Recombinant (Sandoz Phamarceutical®) subcutaneously 24 and 12 hours preceding the surgery, and the control group, were submitted to the injection of saline solution, using the same volume of solution as well as the way of administration. The rats were submitted to an end to end colonic anastomosis, being sacrificed in the 7th post-operative day, the site of the anastomosis was evaluated regarding to the adhesions that was quantified and the presence of complications was observed. The colon containing the anastomosis was submitted to a tensiometric study and a sample were sent for histological studies with HE and Sirius Red dye. RESULTS: The macroscopic and the tensiometric study did not demonstrate any significant differences between the control and experiment group. Regarding the histological evaluation, there was a significant reduction of the chronic inflammatory process in the experiment group (p=0,0209) and a lesser granulation area (p=0,0099). The total amount of collagen was similar in both groups, however, the experimental group showed a predominant area of immature collagen (p=0.009). CONCLUSIONS: The longer persistence of the acute phase of wound healing in the experiment group, as well as a decreased of the mature collagen type I, demonstrating that the IL-6 was harmful to the colonic healing anastomosis in rats.

PURPOSE: Experimental evaluation of the abdominal wall healing in reoperations on the same surgical site, by means of macroscopic analysis, histological and breaking strength studies of the surgical scar. METHODS: Twenty-four rats were selected and divided in 3 groups (G1, G2 and G3). A medium longitudinal laparotomy was performed, followed by laparorrhaphy on two synthesis planes, using an interrupted suture technique. The reoperations were performed in the same way, on the same surgical site. On the first day of the study all the 24 rats were operated, on the 30th day the 16 animals belonging to G2 and G3 were reoperated, and finally, on the 60th day, the 8 rats from G3 were operated for the third and last time. After 30 days of the last laparotomy of each group, euthanasia was performed. Complications such as adhesions were evaluated during the resection of surgical site. The breaking strength study was performed next, followed by the microscopical collagen analysis, using for that histological cuts stained with picrosirius. RESULTS: The adhesions were prevalent in G2 and G3 (16% each) when compared to G1. No significant difference was found in the breaking strength study. Statistically significant difference was observed in collagen concentration analysis. It was found higher mature collagen (type I) as well as total collagen concentration in the groups operated more than once (G2 and G3). The highest concentration of mature collagen (p

PURPOSE: To evaluate the biocompatibility and effectiveness of porcine SIS (small intestinal submucosa), when used as a patch to repair a defect on the anterior duodenal wall. METHODS: The experimental study was performed in 8 dogs. A segment of the anterior duodenal wall was removed and the defect was repaired with a patch of porcine intestinal submucosa. On the 120th post operative day the animals were sacrified and the segment of duodenum containing the patch was removed to a macroscopic and microscopic evaluation. RESULTS: There was no infection, suture dehiscence or fistula. The microscopic evaluation showed complete re-epithelization in 75% of the cases, with moderate fibroblastic proliferation in 87, 5% of the cases. CONCLUSION: The porcine SIS used as a patch acts as a tissue substitute for repairing induced lesions in duodenal wall of dogs.

Two types of monofilament polypropylene meshes of markedly different construction, configuration and pore size were compared and used to repair full-thickness muscle defects in the abdominal wall of 22 mongrel dogs to assess their biocompatibility with host tissues. The defects were repaired with Prolene (Ethicon) woven mesh (pore size=164×96 µm) and with an experimental, extruded mesh called T mesh (pore size=3 mm×4 mm). On the 30th postoperative day, the animals were sacrificed, and the segments of the abdominal wall containing the implanted meshes were excised. Although the Prolene mesh had greater tensile strength before implantation, 30 days after implantation, the T mesh showed similar tensile strength to Prolene mesh. The collagen densitometry showed a significant increase of total and mature collagen type I deposition in the T mesh. This suggests that the increased mature collagen type I deposition significantly increases the tensile strength of the reinforced mesh tissue and that the larger pore in the T mesh contributed to this finding by allowing increasing fibber orientation within the pores as a result of in vivo tension.

Muitas substâncias têm sido utilizadas após hepatectomias parciais a fim de conhecer como elas atuam sobre o processo de regeneração hepática. Adequado fluxo sangüíneo parece ter muita importância neste processo. Autores descreveram, após hepatectomias em ratos, elevação dos níveis plasmáticos de histamina. Substâncias inibidoras da histidina-decarboxilase e da histaminase leva a elevação da histamina endógena com vasodilatação sinusoidal e aceleração da regeneração hepática. No presente estudo busca-se conhecer a influência da histamina exógena administrada à ratos parcialmente hepatectomizados. Utilizaram-se 32 ratos Wistar que sofreram hepatectomia de aproximadamente 67% da víscera. Os animais do grupo experimento receberam por via subcutânea 0,5 mg/Kg/dia de histamina e os do grupo controle igual volume de solução salina isotônica. As aferições foram realizadas com 36 horas e 7 dias. A avaliação do peso da víscera não mostrou diferença entre os grupos. O número de figuras de mitose em 10 campos foi maior no grupo experimento com 36 horas (p=0,010). No sétimo dia o número delas era semelhante nos dois grupos. Concluiu-se que a administração de histamina exógena, talvez pela sua vida média curta, aumenta o número de figuras de mitose no início do processo, não interferindo na regeneração ao final de 7 dias. Many substances have been used after partial hepatectomy in order to determine how they act on the process of hepatic regeneration. An adequate blood flow seems to be very important in this process. Increased plasma histamine levels after hepatectomy in rats have been reported by some investigators. Substances that inhibit histidine-decarboxylase and histaminase lead to an elevation in endogenous histamine with sinusoid vasodilation and acceleration of hepatic regeneration. The objective of the present study was to determine the effect of exogenous histamine administered to partially hepatectomized rats. Thirty two Wistar rats were submitted to approximately 67% hepatectomy. The animals in the experimental group received subcutaneously 0.5 mg/kg/day of histamine and the controls received an equal volume of isotonic saline. Determinations were made after 36 hours and after 7 days. Liver weight did not differ between groups. The number of mitotic figures in 10 fields was higher in the experimental group after 36 hours (p=0.010). On the seventh day, the number of mitotic figures was similar for both groups. We conclude that the administration of exogenous histamine, perhaps due to the short half-life of the substance, increases the number of mitotic figures at the beginning of the process but has no effect on regeneration after 7 days.

Os ácidos graxos de cadeia curta (AGCC) derivam da fermentação das fibras ingeridas na dieta e atuam como substrato das células da mucosa colônica. O presente estudo tem como objetivo avaliar a ação dos AGCC na cicatrização do cólon. Utilizaram-se 16 ratos fêmea divididos em 2 grupos de 8 animais. No grupo controle (HC) os animais foram submetidos à cirurgia de Hartmann e infusão pós-operatória de solução salina isotônica via retal por 7 dias. No grupo experimento (HA) a solução salina foi substituída por solução isosmolar contendo AGCC. Nos animais do grupo controle, a pressão média de ruptura do segmento distal do cólon foi de 128,37 mmHg, sendo este valor de 137,25 mmHg no grupo experimento (p=0,5693). A avaliação histológica em hematoxilina-eosina foi semelhante nos dois grupos estudados. A densitometria do colágeno demonstrou concentração significativamente maior de colágeno maduro (tipo I) no grupo experimento, quando comparado com o grupo controle (p=0,0094). O colágeno total também foi mais encontrado no grupo experimento, comparado-se com o grupo controle (p=0,0371). Conclui-se que os ratos submetidos à infusão intraluminal de AGCC têm maior concentração de colágeno maduro e total na linha de sutura do coto retal, quando comparados com o grupo controle. Short-chain fatty acids (SCFA) derive from the fermentation of fibbers ingested in the diet and act as a cell substrate of the colonic mucosa. The object aim of the present study was to evaluate the action of SCFA in colonic wound healing .Sixteen female rats were used, divided into 2 groups of 8 animals each. In the control group (HC) the animals underwent Hartmann procedure and post-operative infusion of isotonic saline solution per rectum for 7 days. In the experimental group (HA) saline solution was replaced by isomolar solution with SCFA. In the animals of the control group, the average bursting pressure of the rectal stump was 128.37 mm Hg, and 137.25 mm Hg in the experimental group (p=0.5693). Histologic evaluation with hematoxicilin and eosin was similar in both groups studied. The collagen densitometry analysis showed a significantly greater concentration of the mature collagen (type I) in the experimental group when compared with the control group (p=0.0094). Greater concentration of total collagen was found in the experimental group when compared to the control group (p=0.0371). It was concluded that rats who underwent intraluminal infusion of SCFA have greater concentration of mature and total collagen in the suture line of the rectal stump, when compared with to the control group.

Drogas vasoativas têm sido empregadas na tentativa de aumentar a viabilidade de retalhos cutâneos isquêmicos. O objetivo desse estudo foi avaliar os efeitos da droga vasoativa, buflomedil, na prevenção da isquemia de retalhos cutâneos em ratos. Utilizaram-se 20 ratos machos, que foram divididos em um grupo experimento (B) e um grupo controle (A). No grupo B foi administrado buflomedil na dose de 3mg/kg, via intraperitoneal a cada 12 horas por 2 dias antes da cirurgia e por 7 dias após a cirurgia. Utilizou-se um modelo de retalho cutâneo abdominal de 9 x 4cm com base cefálica. A avaliação consistiu na fluxometria a laser do retalho em pontos pré-determinados com leitura no pré e pós-operatório imediato e no 7.º dia de pós-operatório. Realizou-se análise planimétrica da área total do retalho, da área vascularizada e da área nécrotica no 7.º dia de pós-operatório. Observou-se presença de necrose inferior do retalho em todos os animais nos dois grupos. A análise estatística dos resultados obtidos não demonstrou na planimetria diferença significante entre os grupos controle e experimental. A fluxometria não apresentou diferença significante, em relação a média dos pontos, entre os dois grupos. Conclui-se que o buflomedil não é capaz de diminuir a necrose em retalhos cutâneos isquêmicos de ratos, da forma como utilizada neste experimento. Vasoactive drugs have been employed in an attempt to increase the viability of ischemic skin flaps. The aim of the present study was to evaluate the effects of the vasoactive drug, Buflomedil, in the prevention of ischemic skin flaps of rats. Twenty male rats were divided into na experimental group B and a control group A. In the animals of group B, 3mg/kg of Buflomedil was given intraperitoneally every 12 hours for 2 days before surgery and for 7 days after surgery. An abdominal skin flap was used as a model, with a cephalic base measuring 9 x 4cm. The viability of the flaps was evaluated with a laser fluxometer in predetermined points in the early pre and postoperative period and on the 7th post operative day Planimetric analysis of the total area of the flap, of the vascularized area, and of the necrotic area were done on the 7th day after the operation. Inferior necrosis of the flap was observed in all of the animals in both groups. The statistical analysis of the results obtained did not show a significant difference in the planimetry between the control and the experimental groups. Fluxometry did not show a significant difference in relation to the median points between the two groups. It was concluded that Buflomedil, in the manner in which it was used in this experiment, does not reduce necrosis in ischemic skin flaps of rats.

O tratamento das lesões do cólon têm se modificado com relação à escolha da técnica do reparo primário à colostomia e ao reparo secundário. Entre os fatores de risco para síntese primária está o tempo transcorrido. O objetivo deste estudo é avaliar as interferências do tempo transcorrido entre a feitura da lesão e a síntese, sobre o processo de cicatrização. Para isto utilizaram-se 80 ratos Wistar PUC-PR. Sob anestesia inalatória confeccionou-se uma lesão no cólon esquerdo compromentendo 50% da circunferência da intestinal. Após 12, 18 e 24 horas procedeu-se à síntese. Comparou-se estas colorrafias com as realizadas imediatamente após a lesão. Avaliaram-se as cicatrizes com 4 e 7 dias, verificando-se a existência de deiscências, a capacidade de suportar pressão e a síntese de colágeno. Registrou-se o óbito de 5 ratos. Encontrou-se peritonites nos 3 grupos de experimento que comparadas ao controle mostraram alta significância, para o grupo B (p=0,0018), para o C (p=0,0033) e para o D (p=0,000008)q Deiscências se fizeram presentes 19 vezes, tendo sido significante no grupo de 24 horas (p=0,000002). A quantidade de colágeno maturo (tipo I), no 4.º dia é semelhante ao controle no grupo de 12 e 18 horas e menor no grupo de 24 horas (p

Although ulcerative colitis has been known since 1875 and many extraintestinal manifesattions of this disease have been described, it was only that emphasis was placed on the involvement of the respiratory tract. Severe complications have been described in patients, such as inflammatory tracheal stenosis, bronchiolitis with pnemonia, interstitial pneumonitis, Wegener granulomatosis, chronic bronchitis with bronchiectasis, necrobiotic nodules, vasculitis, fibrosis and alveolitis. The objective of the present study was to determine the pulmonary changes occuring during the acute phase of the disease in rats submitted to induction of the disease with 10% acetic acid and to compared to normal controls. It was observed that 100% of the animals with colitis developed a pulmonary inflammatory reaction (p=0,0210) of moderate to severe intensity (p=0,0340). Vasculitis was observed in 58,33% of the lungs (p=0,0060) and focal hemorrhage, necrosis and abscesses were detected in 3 animals. These findings permit us to conclude about the presence of a strong correlation between inflammatory colon disease and changes in the respiratory apparatus during the acute phase of the disease in rats.

As anastomoses colônicas estão associadas à alta incidência de deiscências e o choque é um dos fatores etiológicos relacionados.O objetivo do presente estudo foi correlacionar as alterações do fluxo sanguíneo intestinal decorrentes do choque hipovolêmico e a cicatrização das anastomoses colônicas. Dezesseis cães foram submetidos à anastomose cólon-colônica, sendo que em oito deles o choque hipovolêmico foi induzido. Excetuando o período de confecção da anastomose, o fluxo sanguíneo intestinal foi continuamente aferido. Registrou-se a freqüência cardíaca e pressão arterial média durante todo o experimento. Coletou-se três amostras de sangue para determinação do volume globular em três momentos diferentes da cirurgia. No 7º dia de pós-operatório os cães foram submetidos novamente à operação para avaliação clínica da anastomose (presença de abscessos, fistulas ou deiscências). Retirou-se uma porção de 15 cm do cólon contendo a anastomose para aferição da pressão de ruptura e estudo anátomo-patológico com as colorações: H-E e picrosírius (densitometria do colágeno). Os parâmetros clínicos avaliados determinaram um índice de complicações infecciosas duas vezes superior no grupo chocado que no grupo controle. Não houve diferença estatisticamente significante com relação à pressão de ruptura, todavia a concentração de colágeno total foi maior no grupo controle do que no grupo submetido ao choque. O estudo anátomo-patológico (H-E) demonstrou parâmetros de cicatrização mais favoráveis no grupo controle. Assim, concluiu-se que a diminuição do fluxo sanguíneo intestinal acarretou deterioração do processo cicatricial das anastomoses, pelo maior número de complicações, menor concentração de colágeno total e comprometimento nos parâmetros histológicos.

In 1981 Glotzer et al. described a kind of proctocolitis, limited to a segment of colon, excluded from the fecal stream, with pathological features similar to the ulcerative colitis. The purpose of the present study was to establish a experimental model in order to evaluate the pathologic alterations of the colonic mucosa, excluded from the intestinal transit. Thirty five PUCPR Wistar male rats, with a mean age of 120 days were allocated in 4 groups. Under ether anesthesia, the animals were submitted to a 0,5cm resection of the left colon. A proximal terminal colostomy was performed and the distal rectal stump was closed. The excluded segment of the bowel was evaluated macro and microscopically a week (A group), 2 weeks (D group), 4 weeks (B group) and 8 weeks (C group) after the operation. The inflammatory reaction, collagen concentration and changes in the goblets cells were analyzed .Mo was considered the features of the excluded colon seen at the beginning of the experiment and Mf was these features seen at the end of experiment. When we compared these two different phases of the experiment, we verified that a mild acute and cronic inflammatory reaction was present in all of the groups. Ulcers were seen in 11 colons (p=0,0010) and they were not related to the exclusion phase. A significant reduction in the thickness of the colonic wall was observed in all the specimens. In Mo, the mature collagen (type I) was the predominant one (p=0.008) whereas in Mf, the immature collagen ( type III) was the predominant one (p=0.008). Reduction of total collagen, loss of collagen type I and the increase of collagen type III were constant. There was no significant change in the percentage of area occupied by the goblets cells. It was concluded that in rats, the exclusion of the distal colon by colostomy of up to 8 weeks, determines: colon atrophy and the occurrence of superficial ulcerated lesions with low-level inflammatory reaction.

Ischemia following intestinal reperfusion is a common place event that favors bacterial translocation in remote organs, such as the lungs. Previous antibioticotherapy may be an efficient procedure to lessen the hazards of this process. The purpose of this study was to analyse the concentration of polimorphonuclears (PMN) in the lung alveolar septum of rats, after induced ischemia followed by intestinal reperfusion, with and without previous antibiotictoherapy. Forty-eight rats were used, randomly divided into 6 groups of 8 animals each (A, B, C, D, E, and F). Groups A, C and E did not receive antibiotic and groups B, D and F received 500mg/Kg of erythromycin orally. Groups A and B were the control groups. In the groups C and D intestinal ischemia was induced for 30 min; and in groups E and F reperfusion for 30 min followed the ischemia. A thoracothomy was performed and the lungs were removed and sent for histopathologic and histometric analysis. The number of PMN in the alveolar septum was observed. The control group (A) showed a mean number of 4.2 PMN per field in the septum; in the ichemia group (C) , the mean number of PMN was 13.6 and in the group where the reperfusion followed ischemia (E), the number of PMN was 17,5. The comparison between the mean number of PMN in groups A and C and A and E showed a statistically significant difference (p

Com o objetivo de conhecer o comportamento dos monócitos e mastócitos em peritônio livre na vigência de doença inflamatória do cólon, células que sabe-se participam ativamente do processo inflamatório, colite ulcerativa é induzida em ratos com ácido acético à 10%. Utilizaram-se 20 animais Wistar, 10 para controle e 10 para indução de colite. Os macrófagos são marcados com azul de Tripan e células são capturadas do peritônio livre após 5 dias de evolução. Observou-se que o número de monócitos/macrófagos era 3 vezes maior no líquido peritoneal obtido dos animais com doença inflamatória do que nos seus controles e o número dos mastócitos 2 vezes maior (p

For centuries, mankind has been incessantly researching with drugs that could accelerate the normal wound healing process. In the Hospital de Clinicas da Universidade Federal do Parana, it has been recommended that the cleansing of clean wounds with saline solution of 0.9% sodium chloride, followed by a cover of dry dressing. However, some services have empirically used Agarol and Trigliceril in the confection of dressings after cleansing. This study aimed to evaluate the evolution of cutaneous wounds treated with normal saline, Agarol and Trigliceril in rats. A group of twenty-four rats were submitted to three skin circular incisions of 1.2 cm in diameter on their backs which exposed the subcutaneous tissue. The wounds were cleaned daily with normal saline solution. This group was distributed at random within three groups: Group C, control, received a clean and dry dressing after cleansing; groups A and T received dressings with Agarol and Trigliceril respectively. The evaluation of the wounds was done on the 3rd, 7th and 14th postoperative days by histological and macroscopic studies. The results showed that on the 3rd and 14th days, no evident influence of the drugs on the healing wound was noticed. On 7th postoperative day, Agarol demonstrated to increase the amount of granulation tissue, while Trigliceril appears to decrease the neovasculature during the healing process.

Since the XIX century the greater omentum has been used for different purposes in the surgical practice. The aim of the present study is to determine the effects of the omental wrapping on the healing of colonic anastomoses in rats. Sixty four, Wistar male rats were used. The animals were divided in four groups (A,AN,B,C). A colonic anastomoses located 5 cm from the anal verge was performed in three different ways: for A and AN groups the anastomoses was done in one layer with 8 nylon interrupted propylene(prolene) slitches, for B group an ischemic anastomose was created and for group C a deficient anastomose was performed .Half of animals in each group had this anastomose protected by omental wrapping (AO, ANO, BO, CO). All the animals were sacrificed on the 7th P.O. In the AN and ANO groups just before the sacrifice a dye (China ink) was injected in order to evaluate the neovascularity of the anastomoses. We concluded that the omental wrapping increased the vascularity in the colonic anastomoses improving its healing and decreasing the adhesions on the anastomotic line.

PURPOSE: To investigate the influence of methylene blue, on the healing of intestinal anastomoses subjected to ischemia and reperfusion in rats. METHODS: Forty-five rats divided into the following three groups were used: control (G1); ischemia without methylene blue (G2); and ischemia with methylene blue (G3). A laparotomy was performed and the cranial mesenteric artery isolated. Whereas the cranial artery was temporarily occluded for 45 minutes in groups G2 and G3, prior to enterotomy and intestinal anastomosis, in group G1 the enterotomy and intestinal anastomosis were performed without prior lesion. Afterwards, 2mL of 0.5% methylene blue were instilled in the peritoneal cavities of the animals in group G3, and 2mL of isotonic saline solution in the peritoneal cavities of the animals in group G2. After the reperfusion, an enterectomy and intestinal anastomosis were performed. After the animals had been sacrificed on the seventh day after the operation, the abdominal cavity was examined by resection of a segment of the intestine containing the anastomosis in order to measure its strength and for histopathological examination. RESULTS: Free fluid or abscesses in the peritoneal cavity were rare. When inflammation was analyzed, the group subjected to ischemia without methylene blue had a higher score for mononuclear cells (p=0.021) and granulation tissue (p=0.044). No significant difference was observed in the density of type I or type III collagens. CONCLUSION: The methylene blue did not show beneficial effect on the healing of intestinal anastomoses subjected to ischemia and reperfusion in rats. OBJETIVO: Investigar a influência do azul de metileno, na cicatrização de anastomoses intestinais de ratos submetidas a isquemia e à reperfusão. MÉTODOS: Quarenta e cinco ratos foram divididos em três grupos: controle (G1); isquemia sem azul de metileno (G2) e isquemia com azul de metileno (G3). Foi feita uma laparotomia e a artéria mesentérica cranial isolada. Enquanto a artéria mesentérica cranial foi ocluída por 45 minutos nos grupos G2 e G3, antes da anastomose, no grupo G1 a anastomose foi realizada sem esta lesão prévia. Em seguida 2 mL de azul de metileno 0,5% foi instilado na cavidade peritoneal dos animais do grupo G3, 2 mL de solução salina isotônica na cavidade dos animais do grupo G2. Após a reperfusão uma enterectomia seguida de anastomose foi realizada. Os animais foram submetidos à eutanásia no 7.º dia após a operação, a cavidade abdominal foi examinada e um segmento intestinal que continha a anastomose foi ressecado. Este serviu para a medida de resistência e para exame anátomo-patológico. RESULTADOS: Líquido livre ou abscessos foram raros. A análise da inflamação mostrou que o grupo submetido à isquemia sem azul de metileno apresentou maior score para células mononucleares (p=0,021) e tecido de granulação (0,044). Não se observou diferença significante na análise do colágeno I e III. CONCLUSÃO: O azul de metileno não mostrou efeitos benéficos na cicatrização de anastomoses intestinais submetidas à isquemia e à reperfusão em ratos.

PURPOSE: To study the role of methylene blue as an inhibitor of superoxide production by xanthine oxidase. METHODS: Thirty-two Wistar rats were divided into 2 groups of 16 animals: the control group and the experimental group. All were submitted to a laparotomy for the occlusion of the cranial mesenteric artery during 60 minutes. The reperfusion was confirmed by the pulsation of the artery after the release of the temporary ligature and color change of the intestines. In the animals of the control group, 2 ml of saline were injected in the peritoneal cavity and in the animals of the experimental group, 2 ml of methylene blue were injected in the peritoneal cavity. After reperfusion for 4 hours, the animals were then sacrificed. The lungs were excised from all 32 rats. Simultaneously, the small intestine and kidneys were ressected in 20 animals (10 from the control group and 10 from the experimental group). Samples of the organs were taken to evaluate the action of xanthine-oxidase, for histopathology studies and for characterization of the edema. RESULTS: In the animals of the experimental group, the inflammatory lesion as well as the edema in the lung was greater than in the control group. The intestinal and renal lesions were similar in both groups, but the lung damage was superior to that observed in the intestines and kidneys. . CONCLUSION: Despite similar action of the xanthine oxidase in the control and the experimental group, after intestinal ischemia and reperfusion, the protective effect of methylene blue was observed only in the lungs of the experimental group. OBJETIVO: Estudar a ação do azul de metileno como supressor da produção de radicais livres de oxigênio, atuando como receptor alternativo de elétrons na enzima xantina-oxidase. MATERIAIS E MÉTODOS: Foram utilizados 32 ratos Wistar (Rattus norvegicus albinus, Rodentia mammalia) divididos em 2 grupos de 16 animais, os quais foram denominados grupos: experimento e controle. Todos os animais foram submetidos a laparotomia mediana e oclusão da artéria mesentérica cranial por 60 minutos. A reperfusão foi confirmada por meio da verificação do reaparecimento da pulsação da arcada mesentérica. Foi então administrado no grupo experimento 2 ml de azul de metileno 1% intra-peritonealmente, enquanto que no grupo controle o mesmo volume de solução salina isotônica foi administrado pela mesma via. Após 4 horas de reperfusão, os animais foram sacrificados. Os pulmões foram ressecados nos 32 animais do estudo, ao passo que o intestino delgado e os rins em 20 animais (10 ratos do grupo controle e 10 ratos do grupo experimento). Amostras dos órgãos retirados foram obtidas para medição da xantina-oxidase, análise histopatológica e avaliação do edema. RESULTADOS: O dano pulmonar encontrado no grupo controle foi superior ao encontrado no grupo experimento. Observou-se uma maior formação de edema e uma maior atividade inflamatória nos pulmões do grupo controle. O dano intestinal e renal encontrado foi semelhante em ambos os grupos, mas não tão intenso quanto o dano pulmonar. A atividade da xantina-oxidase foi semelhante em ambos os grupos. CONCLUSÃO: A atividade protetora do azul de metileno foi evidenciada nos pulmões, todavia o mesmo efeito não foi demonstrado nos rins nem no intestino delgado.

Purpose: The aim of the present study was to evaluate the biocompatibility of small intestinesubmucosa (SIS) in the reconstruction of the ureter in swine.Materials and Methods: An experimental study was performed in 10 half-breed pigs weighingbetween 20 and 30 K, in which a previously prepared segment of SIS measuring approximately 2.0cm was implanted in the upper third part of the right ureter.Results: Of the 10 operated animals, one died 14 days after the surgery due to a dehiscenceon the suture line of the implanted graft. The remaining 9 animals were submitted to ultrasoundexamination of the urinary tract and were sacrificed on the 40th postoperative day. The macroscopicevaluation showed no calculus, incrustation, fistula, abscesses or adhesions in the ureters with thegraft. Microscopic evaluation with hematoxylin-eosin and Sirius red showed in the experimental area(graft) the presence of urothelium in 100% of the cases, collagen in 100% of the cases, and smoothmuscle layer in 87.5% of the animals. In the area adjacent to the graft (proximal and distal), weobserved 92.86% of urothelium, 42.86% of collagen and 71.43% of smooth muscle. In the contralateralureter, it was found 100% of urothelium and smooth muscle and just 11.11% of collagen. Themicroscopic analysis of the kidneys whose ureters received the graft of SIS evidenced congestion in55.55%, pelvic edema in 66.66% and interstitial nephritis in 77.78%. Hydronephrosis was present in33.33% and chronic pyelonephritis in 44%. Only 1 animal presented total absence of glomerulus inthe renal parenchyma.Conclusion: The SIS graft behaved as a biological tissue support, allowing the regenerationof the urothelium and smooth muscle grow, despite of chronic inflammatory process.Key words : small intestine; submucosa; ureter; graft; swineInt Braz J Urol. 2004; 30: 327-35

Com o objetivo de verificar a relação entre a concentração de colágeno e a capacidade de suportar pressão em anastomoses de cólon quando existe peritonite, utilizaram-se 40 ratos machos, Wistar-TECPAR, com idade média de 120 dias e peso médio de 302 g, os quais foram divididos em 2 lotes de 20 animais que compuseram os grupos controle e peritonite. Sob anestesia inalatória e submetidos à laparotomia os ratos do grupo peritonite tiveram infecção induzida pelo método de Wichterman e col. e os do grupo controle laparotomia com manipulação dos segmentos intestinais envolvidos no experimento. Após 24 horas eram relaparotomizados, sofriam colotomia transversa total esquerda à 2,0 cm da reflexão peritoneal e anastomose em plano único, extra-mucoso. As aferições foram realizadas nop tereciro e sétimo dias de pós-operatório. Ressecava-se 4,0 cm do cólon esquerdo contendo a anastomose e media-se a pressão de ruptura. Realizou-se estudo histopatológico, empregando-se a coloração do Sirius-red e análise da concentração de colágeno através de método computadorizado. Verificou-se que a capacidade de suportar pressão aumentou com o tempo de evolução de forma semelhante nos dois grupos. A concentração de colágeno foi menor no grupo com peritonite no terceiro dia (p = 0,000168) e no sétimo dia (p = 0,0020). Os percentuais de colágeno I e III foram semelhantes no terceiro dia. Já no sétimo dia, no grupo peritonite predominou o colágeno tipo III ( p = 0,000079). Os resultados analisados demonstram que existe diminuição da concentração e da maturação do colágeno nas anastomoses colo-cólicas realizadas quando existe peritonite porém esta alteração não interfere na capacidade da anastomose suportar pressão. The purpose of the present study was to evaluate the burst strength and the collagen concentration in a left colonic anastomosis when peritonitis was present. Forty Wistar male rats were used, with a mean age of 120 days and a mean weight of 302 g. The animals were allocated in two groups of 20 animals each: a control group and an experimental group. Under ether anesthesia, the rats of the experimental group were submitted to a laparotomy and the abdominal sepsis was induced according to the Wichterman method, while those in the control group were submitted to laparotomy and manipulation of the intestinal segments involved in the experiment. Twenty four hours later, the animals underwent to a new laparotomy and a left colonic anastomosis, with a single layer of polypropilene interrupted suture, 2,0 cm above the peritoneal reflection. On the 3rd and 7th post-operative day, the colonic segment with the anastomosis was resected in order to evaluate the bursting strength . The Red Sirius dye was used to evaluate collagen concentration in the histopathological study. Results showed in both groups an increase in the bursting strength , relating to post-operative day. Collagen concentration was poorer in the peritonitis group on the 3rd and 7th post-operative days (p = 0.000168) (p = 0.0020) respectively. The percentages of collagen I and III were similar on the 3rd post-operative day. On the 7th day, however, collagen type III (p =0.000079) predominated in the peritonitis group. The results above showed that the concentration and maturation of collagen are reduced in a colonic anastomosis performed when peritonitis is present. These alterations does not interfere in the bursting strength.

Muito se tem questionado sobre os efeitos da isquemia intestinal seguida de reperfusão (I/R), chamando a atenção para o papel dos leucócitos na patobiologia da I/R. A fisiopatogenia das lesões está intimamente ligada à geração de radicais de oxigênio durante o período em que se processa a reperfusão. A ruptura da barreira intestinal permitindo a translocação bacteriana agravaria ainda mais estas lesões. Este estudo tem por objetivo avaliar as lesões intestinais na vigência de isquemia e na reperfusão com e sem antibioticoterapia. Submeteram-se 42 ratos Wistar à anestesia e laparotomia mediana. Obteve-se isquemia intestinal por clampeamento das artérias mesentéricas cranial e caudal por 30 minutos. Após reperfundiu-se por igual tempo. Metade destes animais receberam 50 mg/kg de eritromicina por via oral nas 24 horas que antecederam o procedimento. Cada um destes grupos foi subdividido em outros 3, constituíndo os subgrupos de controle, isquemia e isquemia/reperfusão. Ao final, ressecaram-se segmentos do intestins delgado para processamento histológico. Avaliaram-se os resultados pela escala de CHIU e col. e submeteram-se os resultados à tratamento estatístico. Observou-se que a mucosa intestinal apresentava-se com padrão normal nos grupos de controle, tanto com antibioticoprofilaxia como sem. Os intestinos submetidos à isquemia com ou se antibioticoprofilaxia mostraram, lesões com descolamento e perda de vilosidades até infartamento transmucoso. Os intestinos reperfundidos apresentavam lesões semelhantes. Verificou-se que os intestinos reperfundidos que receberam antibioticoprofilaxia apresentavam lesões mais graves do que os que sofreram isquemia sem antibioticoprofilaxia (p=0,0303). Concluiu-se que o uso de antibióticos pré-isquemia não diminui a gravidade das lesões histopatológicas da mucosa intestinal, não protegendo das lesões após a reperfusão. The role of the white blood cells in the ischemia and reperfusion have been studied. Free radicals appear to be envolved in the phisiopathology of the ischemia and reperfusions lesions. The intestinal barrier disruption would allow bacterial translocation and increase in the severity of such lesions. The aim of the present study was to evaluate intestinal injury after ischemia and reperfusion with and without antibiotic coverage. Under ether anesthesia forty-two Wistar male rats were submitted to an abdominal midline incision. The mesenteric arteries were clamped for 30 minutes. After this period of ischemia, reperfusion was induced for equal period of time. Twenty-one rats received eritromicin, 50mg/kg orally, 24 hours before the operation. The remain animals were operated without antibiotics coverage. Each of the two groups animals were divided into 3 others groups: control, ischemia and ischemia-reperfusion groups. After the reperfusion period, a intestinal segment was excised for histopathological studies. Results were evaluated according to the criteria of CHIU and col. and were submitted to statical analysis. In the control group any difference was found in the intestines of the animals with and without antibiotic coverage. The ischemia group, with or without antibiotic, showed lesions that ranged from vilos loss to mucosal infarction. The lesions were similar in the ischemia-reperfusion group. We verified that intestines submitted to reperfusion under antibiotic coverage showed more severe lesions than ischemic intestines without antibiotics coverage (p= 0,0303). We can conclude that the administrations of antibiotics before the induction of ischemia or ischemia-reperfusion does not improve the severity of histological lesions.

Complicações relacionadas com a anastomose são descritas com freqüência nas cirurgias para o tratamento da doença inflamatória do cólon. Para conhecer a interferência da inflamação na cicatrização de anastomoses 40 ratos Wistar são utilizados e divididos em 2 grupos. Um deles serviu de controle e no outro induziu-se doença inflamatória com ácido acético 10% por sondagem retal. No sétimo dia procedeu-se à laparotomia em ambos os grupos, colotomia e anastomose término-terminal com pontos separados em plano único. Avaliadas no terceiro e sétimo dias, pode-se verificar que o número de complicações no grupo de animais com doença inflamatória foi maior assim como a mortalidade. As deiscências com peritonite foi a situação mais comum (p=0,0222). A capacidade de suportar pressão, nas anastomoses que evoluíram sem complicações foi menor nestes cólons, porém a diferença quando comparada ao controle não foi significante (p=0,0836). Verificou-se que as anastomoses construídas em cólons com doença inflamatória apresentavam maior concentração de colágeno total, com predomínio de colágeno imaturo (tipo III) (p=0,0000) enquanto que nas feitas em cólons normais predominava colágeno maduro (tipo I) (p=0,0102). Observou-se ainda que a organização do colágeno era menor, no terceiro dia, nas anastomoses com doença inflamatória. Entretando a análise da reação inflamatória ao nível da anastomose foi semelhante nos dois grupos. Estes resultados permitem sugerir que a doença inflamatória leva a aumento do número de deiscências provavelmente pelo atraso da maturação e ordenação do colágeno. Complications related to anastomosis failure are frequently described in the surgery of inflammatory bowel disease. The aim of the present study was to evaluated colonic wound healing in an inflamed bowel. Forty Wistar rats were divided in 2 groups: the control and experimental groups. In the experimental group, colitis was induced by the infusion of 10% acetic acid per rectum to understand how inflammation interferes with the healing process of intestinal. On the7th post-operative day an end to end colonic anastomosis was performed with interrupted suture. On the 3rd and 7th post-operative days, the anastomosis were evaluated. We observed that mortality and the number of complications were greater in the group of animals with inflammatory bowel disease. Dehiscence with peritonitis was the most common complication(p=0.0222). The bursting strength in the colons without leakage was lesser than those in the control group, however this difference was not statistically significant (p=0,0836). It was verified that the anastomosis performed in colons with inflammatory bowel disease showed greater total collagen concentration, with a predominance of immature collagen (type III) (p=0.0000). The mature collagen (type I) was the predominant collagen in the wounds of normal colon. (p=0.0102). On the 3th post-operative day It was also observed that the organization of collagen was poorer on the third day in the colonic wounds with inflammatory bowel disease. Nevertheless, the analysis of the inflammatory reaction at the level of the anastomosis was similar in both groups. These results suggest that inflammatory bowel disease increases the risks of anastomosis dehiscence, probably because of the delay in the maturation and the organisation of collagen.

Verificou-se o grau de isquemia produzido pela tração dos afastadores, bem como determinou-se o índice de infecção nas feridas limpas e contaminadas quando submetidas a trações conhecidas e progressivas. Foram utilizados 104 ratos machos da cepa Wistar com peso entre 180 e 190 gr, sendo que 40 animais foram utilizados para a determinação da isquemia provocada por afastadores e 64 para estudo da correlação do emprego de afastadores com infecção. Para a análise da isquemia produzida por afastadores sobre a ferida cirúrgica, os 40 ratos foram divididos em 4 grupos: T0, T1, T2, T3. Para o estudo do risco de infecção produzido por afastadores sobre a ferida cirúrgica, 64 ratos foram divididos em oito grupos: C0, C1, C2, C3, L0, L1, L2 e L3. Todos animais foram submetidos a laparotomia paramediana, conservando-se íntegro o peritônio. A ferida foi então submetida a tração por afastadores. A tração empregada foi de 0Kgf nos grupos T0, L0, C0; 0,062Kgf nos grupos T1, L1 e C1; 0,125Kgf nos grupos T2, L2 e C2 e 0,25Kgf nos grupos T3, L3 e C3. Nos grupos T0, Tl, T2 e T3 injetou-se o corante azul de Evans e após 1 hora foram retirados fragmentos da ferida, com posterior extração do corante e análise espectrofotocolorimétrica, que serviu para avaliar indiretamente o grau de isquemia da ferida. Nos grupos CO, Cl, C2 eC3 foi inoculado na ferida uma solução contendo 10(5) Stafilococcus aureus l ml. As feridas nos grupos C0, C1, C2, C3, L0, L1, L2 e L3 foram suturadas e os animais sacrificados após sete dias para análise bacteriológica das amostras. Verificou-se que nos grupos T1, T2, T3 o grau de isquemia aumentou a medida que se usava maior tração, fato este comprovado pela diminuição progressiva da concentração tissular do corante azul de Evans (p