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PURPOSE:To investigate the subcutaneous injection of carbon dioxide (CO 2 ) on neuropeptides Calcitonin Gene-Related Peptide (CGRP) and Substance P (SP) secretion in rat skin. METHODS:Fifty-six Wistar-EPM rats were distributed in two groups: one for CGRP analysis, the other for SP analysis. Each group was subdivided into four subgroups: control (Cont), control with needle (ContNd), CO 2 injection (CO 2 Inj) and atmospheric air injection (AirInj) -with seven animals each. Sample analyses of partial skin were conducted by Western Blotting (WB). RESULTS:In SP group, there was a decrease in the amount of neuropeptides in subgroups CO 2 Inj and AirInj. Similarly, in CGRP group, there was a decrease in the amount of pro-CGRP neuropeptides (15 kDa) in subgroups CO 2 Inj and AirInj; Nevertheless, there was no decrease in the amount of CGRP (5 kDa) in any subgroups.CONCLUSION: Subcutaneous injection of CO 2 and atmospheric air decreased the amount of Substance P and pro-Calcitonin GeneRelated Peptide (15 kDa) neuropeptides in rat skin.

Introdução: Para que um serviço de fisioterapia possa oferecer tratamento adequado aos pacientes pós-cirurgia plástica, é preciso compreender as necessidades, limitações e queixas desses sujeitos. Objetivo: Identificar o perfil dos pacientes atendidos em fisioterapia assistencial à cirurgia plástica. Métodos: Realizou-se um estudo retrospectivo por análise de prontuários do setor de Fisioterapia do Hospital Ipiranga, São Paulo (SP), de fevereiro de 2009 a julho de 2010. A análise estatística foi descrita em porcentagem, média e desvio-padrão, sendo utilizados os testes de igualdade de duas proporções e Mann-Whitney. Resultados: Foram incluídos 102 prontuários de pacientes, destes, 96,1% do gênero feminino, com faixa etária de 45±13 anos, submetidos à abdominoplastia (50,5%) e à blefaroplastia (19,2%), apresentando queixas de dor (34,3%) e edema (33,3%). Conclusão: O perfil clínico de pacientes atendidos em fisioterapia assistencial à cirurgia plástica caracterizou-se por mulheres, por volta de 45 anos, submetidas a abdominoplastias e blefaroplastias, com dor e edema.

PURPOSE:To investigate the neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) after subcutaneous injection of dexamethasone prior to skin incision in rats. METHODS:Twenty seven Wistar-EPM-1 rats were randomly divided into three groups. The sham group (SG) of rats was injected with 0.9 % saline. The second group (Dexa) was injected with 1.0 mg/kg dexamethasone, and the third group (Dexa+) was injected with 10.0 mg/kg dexamethasone. In all groups, the three subcutaneous injections were performed 30 minutes prior to the surgical skin incision and tissue collection. SP and CGRP (15 kDa pro-CGRP and 5 kDa CGRP) were quantified by Western Blotting. RESULTS:No statistically significant differences (p>0.05) were found in pro-CGRP, CGRP and SP values in all three groups. CONCLUSION:The anti-inflammatory effect of dexamethasone did not occur when the substance P and calcitonin gene-related peptide levels were altered during the neurogenic inflammation process of skin wound healing in rats.

Kiyan KM et al. Accuracy of frozen section biopsy in non-melanoma skin cancer Acurácia da biópsia de congelação no câncer de pele não-melanoma ABSTRACT Together, basal cell and squamous carcinomas account for more than 50% of all new cases of cancer. Frozen section biopsy is often used in areas such as the head and neck, in which a wide margin could cause disfiguring scars or difficulties with reconstruction, but the results of frozen biopsy do not always correspond to the results of paraffin sections. This paper aims to review existing literature on the correlation between the results of intraoperative frozen biopsy and final pathological examination of surgical specimens (examination of paraffin sections), because of the importance of frozen biopsy in curative resection and reconstruction of affected sites. A literature review was conducted, based on scientific articles published over the previous 10 years about the accuracy of intraoperative frozen sections. Frozen section biopsy is an efficient and reliable method that should be applied in areas where resection should be as economical as possible. However, in cases with small tumors and excess skin, the results of frozen biopsy are poor, dispensable, and not meaningful. Frozen biopsy is an efficient, affordable, and reproducible method when performed by experienced staff in well-selected cases.

Tratamento cirúrgico da hipertrofia clitorianaSurgical treatment of clitorian hypertrophy RESUMO Introdução: Segundo vários autores, a hipertrofia discreta do clitóris está presente em 25% das mulheres. Quando o volume passa a incomodar no ato sexual, acompanhado ou não de distúrbios psicológicos, as pacientes buscam inicialmente ajuda de ginecologistas ou endocrinologistas e não raramente são encaminhadas à cirurgia plástica para a resolução dos problemas. Método: Nossa experiência é baseada em 9 pacientes, durante 15 anos, portadoras de genitália ambígua, submetidas a tratamento cirúrgico. Foram selecionados 3 casos para ilustrar os resultados obtidos com a técnica. Duas pacientes com hipertrofia clitoriana do tipo II de Prader foram selecionadas; uma de origem adquirida na idade adulta, e outra de origem possivelmente congênita. A terceira paciente apresentava anomalias sexuais múltiplas, de origem congênita: agenesia de vagina, hipertrofia clitoriana, presença de ovários e testículos atrofiados, pseudo-hermafroditismo feminino, catalogada como tipo V de Prader. Todos os três pacientes foram submetidas a redução do clitóris pela dissecção da cobertura músculo-cutânea (desenluvamento) e sepultamento do corpo clitoriano por sutura. Resultados: Os procedimentos cirúrgicos realizados preservaram a estética e a sensibilidade, com redução das dimensões do clitóris. Conclusão: Os procedimentos apresentam relativa simplicidade, porém dentro de critérios cirúrgicos buscando a preservação das funções e da anatomia da genitália externa.Descritores: Clitoris/cirurgia. Vulva/cirurgia. Genitália feminina/cirurgia. ABSTRACT Introduction:Moderate clitoris hypertrophy has been described in 25% of the women. When its shape and volume disturb at the sexual activity, combined or not by psychological problems, initially patients search for help from gynecologists and or by endocrinologists and not rarely are send to plastic surgeons. Our experience is based on 9 patients with ambiguous external genitalia, submitted to these surgeries during the last 15 years. Three cases were selected to demonstrate the obtained results with the technique. Two female patients with Prader type II clitoris aspect were selected; one of them presents the problem at adult age and, in the other, the etiology was possible congenital. The third patients presented hypertrophic clitoris combined with pseudo-hermaphroditism with ovarium, atrophic testicles as described in Prader Type V. Methods: The all three patients were submitted to clitoris reduction by dissection of the mucous-cutaneous covering and its excess buried by suture. The third patient with pseudo-hermaphroditism had also neo-vagina reconstruction. Results: The surgical procedures preserved esthetic and sensibility, with clitoris dimensions reduction. Conclusion: The surgical procedures presented moderate simplicity, but within the surgical criteria to preserve the functions and the external genitalia anatomy.

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