OBJETIVO: Avaliar o diâmetro, o perímetro e a área das valvas atrioventriculares do coração fetal, bem como a espessura das paredes ventriculares e os diâmetros das cavidades ventriculares. MATERIAIS E MÉTODOS: Foram dissecados 20 corações de fetos com idade gestacional entre 28 e 36 semanas. Em seguida foram medidos os diâmetros ântero-posterior e transverso e aferidos as áreas e os perímetros das valvas mitral e tricúspide, bem como foram medidas as espessuras das paredes ventriculares e os diâmetros de suas cavidades, utilizando-se um paquímetro com acurácia de1/10 mm. RESULTADOS: Os diâmetros ântero-posterior e transverso da valva atrioventricular esquerda mediram, em média, 10,35 ± 1,62 mm e 9,90 ± 1,79 mm, respectivamente, e os diâmetros ântero-posterior e transverso da valva atrioventricular direita, 10,98 ± 1,90 mm e 9,51 ± 1,81 mm, respectivamente. A área e o perímetro da valva mitral foram de 84,06 ± 25,09 mm² e 29,87 ± 3,96 mm, respectivamente. A área e o perímetro da valva tricúspide mediram, respectivamente, 84,49 ± 26,79 mm² e 28,44 ± 3,85 mm. No ventrículo direito a espessura da parede anterior foi de 5,00 ± 1,70 mm e a da parede posterior foi de 3,83 ± 0,91 mm; no ventrículo esquerdo a espessura da parede anterior foi de 4,25 ± 0,87 mm e a da parede posterior foi de 4,14 ± 0,89 mm. O septo interventricular teve espessura de 4,10 ± 1,13 mm. O ventrículo direito teve como diâmetro ântero-posterior 9,25 ± 0,85 mm, e como diâmetro transverso 8,24 ± 0,42 mm. O ventrículo esquerdo mediu 9,95 ± 0,37 mm para o diâmetro ântero-posterior e 9,20 ± 0,40 mm para o diâmetro transverso. CONCLUSÃO: O conhecimento dos dados morfométricos do coração do feto é de grande importância para o diagnóstico ecocardiográfico de possíveis malformações cardíacas.

OBJECTIVE: To evaluate the diameter, perimeter and area of atrioventricular valves as well thickness of ventricular walls and diameter of ventricular cavity of fetal hearts. MATERIALS AND METHODS: Twenty fetal hearts at gestational age between 28 and 36 weeks were dissected. A paquimeter with 1/10 mm accuracy was utilized for the following morphological measurements: anteroposterior and transverse diameters, mitral and tricuspid valves areas and perimeters. RESULTS: Anteroposterior and transverse diameters of the left atrioventricular valve measured 10.35 ± 1.62 mm and 9.90 ± 1.79 mm, respectively; and anteroposterior and transverse diameters of the right atrioventricular valve measured 10.98 ± 1.90 mm and 9.51 ± 1.81 mm, respectively. Mitral valve area and perimeter were, respectively, 84.06 ± 25.09 mm² and 29.87 ± 3.96 mm. Tricuspid valve area and perimeter were, respectively, 84.49 ± 26.79 mm² and 28.44 ± 3.85 mm. The thicknesses of the anterior and posterior right ventricular walls were, respectively, 5.00 ± 1.70 mm and 3.83 ± 0.91 mm. The thicknesses of the anterior and posterior left ventricular walls were, respectively, 4.25 ±0.87 mm and 4.14 ± 0.89 mm. The thickness of the interventricular septum measured 4.10 ± 1.13 mm. The anteroposterior diameter of the right ventricle was 9.25 ± 0.85 mm, and the transverse diameter was 8.24 ± 0.42 mm. The anteroposterior diameter of the left ventricle measured 9.95 ± 0.37 mm, and transverse diameter measured 9.20 ± 0.40 mm. CONCLUSION: The role of morphometric data of fetal atrioventricular valves is highly significant in the echocardiographic diagnosis of possible congenital cardiac malformations.

CONTEXTO: O desenvolvimento de terapia alternativa à convencional para a destruição de microvarizes e telangiectasias sem o uso de produtos químicos tem como objetivo reduzir os efeitos colaterais, faz uso de agulha para lise mecânica dos vasos e tem como modelo experimental galinhas da linhagem Lohmann Brown. OBJETIVO: Elaborar uma nova técnica, desenvolvendo um tratamento alternativo, sem uso de produtos químicos, objetivando a redução dos efeitos colaterais. MÉTODOS: Foram utilizadas 30 galinhas da linhagem Lohmann Brown, sendo que 15 foram submetidas ao método convencional de tratamento de microvarizes e telangiectasias (grupo-controle) e as outras 15 receberam o tratamento experimental proposto (grupo experimental). O grupo experimental foi tratado com agulha de lise vascular, percorrendo todo o trajeto dos vasos escolhidos em punções escalonadas até que todo o vaso ser atingido. O grupo-controle foi tratado com oleato de monoetanolamina e glicose a 50%, puncionando-se o vaso com agulha 13 x 3 mm e injetando-se, em média, 0,3 mL da solução em cada vaso. RESULTADOS: Dos 50 vasos tratados no grupo experimental, dois apresentaram recidiva total, cinco apresentaram recidiva parcial, e 43 apresentaram destruição (lise) satisfatória; enquanto que, no grupo-controle, dos 51 vasos tratados, quatro apresentaram recidiva total, 12, recidiva parcial, 22, destruição satisfatória, e em 13 ocorreu endurecimento de trajeto. CONCLUSÃO: O presente estudo demonstrou que o método experimental proposto, com uso de agulha de lise vascular, possui mais eficiência no tratamento de microvarizes se comparado com o método convencional, devido à redução das recidivas e à ausência de hipercromia de trajeto endurecido.

BACKGROUND: The development of an alternative to the conventional therapy for microvarices and telangiectasias without using chemical products aims at reducing side effects, using a needle for mechanical lysis of vessels. It uses Lohmann Brown hens as the experimental model. OBJECTIVE: To develop a new technique, creating an alternative treatment without using chemical products, aiming at the reduction of side effects. METHODS: Thirty Lohmann Brown hens were used, 15 submitted to the conventional method of treating microvarices and telangiectasias (control group) and 15 receiving the proposed experimental treatment (experimental group). The experimental group was treated using a needle for vascular lysis, passing through the whole extension of chosen vessels in staggered punctures until the whole vessel was reached. The control group was treated with ethanolamine oleate and 50% glucose, puncturing the vessel with a 13 x 3 mm needle and injecting on average 0.3 mL of the solution in each vessel. RESULTS: Of the 50 vessels treated in the experimental group, two presented total recurrence, five partial recurrence and 43 satisfactory destruction (lysis), whereas of the 51 vessels treated in the control group, four presented total recurrence, 12 partial recurrence, 22 satisfactory destruction and 13 presented conduit vessel stiffness. CONCLUSION: The present study demonstrated that the experimental method using a needle for vascular lysis is more efficient for the treatment of microvarices when compared with the conventional method, due to reduction in recurrence rates and absence of hyperchromatism of conduit vessel stiffness.

The lingual artery constitutes one of the branches of the external carotid artery, which is responsible for the vascularization of the tongue and neighbour regions. The hemorrhage caused by a lesion of the lingual artery can occur during a dental procedure (surgical accidents by the use of an instrument or rotating disc), by trauma, biopsy and dental implant. In some cases is difficult to stop the hemorrhage of injured vase, so is necessary to realize the extraoral ligature of this artery. Hence, this work studied the anatomic aspects of the lingual artery, by forty-eight dissections of twenty-four corpses settled in formol 10%, aiming to detail the origin, pathway and anatomic relations of the lingual artery in the region of anterior trigone of the neck, and also to measure the distances among the lingual artery and the arteries: facial, superior thyroid and with the bifurcation of the common carotid. The results concluded that the lingual artery is found in a position more inferior than classicaly described, based on the digastric muscle and the hypoglossal nerve; and that the hyoid bone can be used as a point of reference for the surgical access to the lingual artery in the region of the anterior trigone of the neck

La arteria lingual es un ramo de la arteria carótida externa, responsable de la vascularización de la lengua y regiones vecinas. La hemorragia proveniente de una lesión de la arteria lingual puede ocurrir durante el procedimento dental (accidentes operatorios por un instrumento quirúrgico o disco rotatorio), por trauma, biopsia y por colocación de implante dentario. Como en algunos casos, se vuelve difícil contener la hemorragia donde el vaso fue lesionado, se hace necesario realizar la ligadura extra-oral de esta arteria. Por lo anterior, en este trabajo fueron estudiados los aspectos anatómicos de la arteria lingual, en 48 disecciones de cadáveres humanos fijados en formol 10%, con el objetivo de detallar el origen, trayecto y relaciones anatómicas de esta arteria en la región del trígono anterior del cuello, como también medir las distancias entre la arteria lingual y las arterias: facial, tireoidea superior y con la bifurcación de la arteria carótida común. Los resultados permitieron concluir que la arteria lingual se encuentra, generalmente, más inferior de lo clásicamente descrito, tomándose como base el músculo digástrico y el nervio hipogloso; y que el hueso hioide puede ser usado como punto de referencia para el acceso quirúrgico a la arteria lingual, en la región del trígono anterior del cuello

OBJECTIVE: To investigate the morphometric and topographic aspects of coronary ostia, correlating them with the aortic leaflets. METHODS: Fifty-one hearts with the great vessels attached were analyzed in this study. The ascending aorta was transversally sectioned 1 cm above the commissures of the aortic leaflets. The right and left coronary ostia were analyzed, as were the distances from these ostia to the bottom of the aortic sinuses and to the commissures of the aortic leaflets. RESULTS: The left coronary ostium was located below the intercommissural line in 42% of cases, above that line in 40% of cases, and at the level of that line in 18% of cases. The mean distance from the left coronary ostium to the bottom of the corresponding sinus was 12.6±2.61 mm. The right coronary ostium was located below the intercommissural line in 60% of cases, above that line in 28% of cases, and at the level of that line in 12% of cases. The mean distance from the right coronary ostium to the bottom of the corresponding aortic sinus was 13.2±2.64 mm. The mean diameters of the left and right coronary ostia were 4.75±0.93 mm and 3.46±0.94 mm, respectively. The mean diameters of the juxtamural portion of the left and right coronary arteries were 3.75±0.79 mm and 2.9±0.73 mm, respectively. In one case, both ostia were located in the left coronary sinus. CONCLUSION: The left coronary ostium may be located either above or below the intercommissural line. The right coronary ostium is predominantly located below the intercommissural line. The coronary ostia have reduced diameters as compared with the juxtamural diameters of their respective coronary arteries.

OBJECTIVE: To analyze the relationship between myocardial bridges and the anterior interventricular branch (anterior descending) of the left coronary artery. METHODS: The study was carried out with postmortem material, and methods of dissection and observation were used. We assessed the perimeter of the anterior interventricular branch of the left coronary artery using a pachymeter, calculated its proximal and distal diameters in relation to the myocardial bridge, and also its diameter under the myocardial bridge in 30 hearts. We also observed the position of the myocardial bridge in relation to the origin of the anterior interventricular branch. RESULTS: The diameters of the anterior interventricular branch were as follows: the mean proximal diameter was 2.76±0.76 mm; the mean diameter under the myocardial bridge was 2.08±0.54 mm; and the mean distal diameter was 1.98±0.59 mm. In 33.33% (10/30) of the cases, the diameter of the anterior interventricular branch under the myocardial bridge was lower than the diameter of the anterior interventricular branch distal to the myocardial bridge. In 3.33% (1/30) of the cases, an atherosclerotic plaque was found in the segment under the myocardial bridge. The myocardial bridge was located in the middle third of the anterior interventricular branch in 86.66% (26/30) of the cases. CONCLUSION: Myocardial bridges are more frequently found in the middle third of the anterior interventricular branch of the left coronary artery. The diameter of the anterior interventricular branch of the left coronary artery under the myocardial bridge may be smaller than after the bridge. Myocardial bridges may not provide protection against the formation of atherosclerotic plaque inside the anterior interventricular branch of the left coronary artery.

OBJETIVO: Estudar a morfologia do sistema biliar extra-hepático e do trígono cistohepático (triângulo de Calot) analisando a sua disposição, variações ou malformações MÉTODOS: foram investigados 50 cadáveres adultos. RESULTADOS: em 47 casos (94%) a junção hepato-cística se dava próxima ao hilo hepático. Em 3 casos (6%), a junção entre esses ductos se dava distalmente, ao nível da ampola hepato-pancreática (ampola de Vater). O ângulo formado pela junção hepato-cística foi menor que 30º em 72,3% dos casos; em 23,4% , ficou entre 30 e 45º; em 2,1% variou entre 45 e 60º e em 2,1% foi maior do que 60º. A junção hepato-cística se fez, na maior parte dos casos, pela direita (59,6%), seguida pela anterior (17%), posterior (12,8%) e esquerda (10,6%). Em relação aos componentes do trígono cistohepático, a artéria cística esteve presente em 56% dos casos; a veia porta em 36%; a artéria hepática direita em 34%; a artéria hepática esquerda em 2% e a artéria hepática própria em 2% dos casos. O comprimento e o diâmetro do ducto cístico foi 2,53± 1,19cm e 0,29± 0,12cm, respectivamente. A prega espiral do ducto cístico ( válvula de Heister) foi observada em 80% dos casos. O infundíbulo da vesícula biliar (bolsa de Hartmann) esteve presente em 74% dos casos. Esses conhecimentos são importantes, principalmente para os cirurgiões que atuam nesta região, através de videolaparoscopia. CONCLUSÃO: No trígono cistohepático a artéria cística foi encontrada com mais freqüência.

OBJECTIVE: study the morphology of the extrahepatic biliary system and cystichepatic triangle (Calot’s triangle) analysing the disposition, variations and malformations. METHODS: 50 adult cadavers were studied. RESULTS: in 47 cases (94%), the cysticohepatic junction ocurred near the hepatic hilum. In 3 cases (6%), the junction between cystic duct and common hepatic duct ocurred at the level of the hepatopancreatic ampulla (Vater's ampulla). The angle formed by the junction of the cystic duct with the common hepatic duct was less than 30º in 72,4% of the cases. In 23,0%, this angle was between 30 and 45º. In 21,3% was between 45 and 60º. In 2,3% of the cases it was greater than 60º. The common hepatic duct recieved the cystic duct on its right side in the majority of the cases (59,6%); anteriorly in 17% of the cases; posteriorly in 12,8% and on the left side in 10,6% of the cases. In relation to the cystichepatic triangle components the cystic artery was present in 56% of the cases; the portal vein in 36%; the right hepatic artery in 34%; the left hepatic artery in 2% and the proper hepatic artery in 2% of the cases. The dimensions of the cystic duct were 2,53±1,19cm of length and 0,29±0,12cm of diameter. The spiral fold (Heister's valve) was observed in 80% of the cases. The infundibulum of the gallbladder (Hartmann's pouch) was present in 74% of the cases. This knowledge contribute to the practice of video-assisted laparoscopy in this region. CONCLUSION: in cystichepatic triangle the cystic artery was found most frequently.

OBJECTIVE: To study the arrangement of the myocardial fiber bundles at the pulmonary venous left atrial junction in patients with pulmonary hypertension, and to discuss the pathophysiological importance of this element in the etiology of acute pulmonary edema. METHODS: We obtained 12 hearts and their pulmonary vein extremities from postmortem examinations of patients with the anatomicopathological diagnosis of acute pulmonary edema. The specimens, which had no grossly visible morphological cardiac alterations, were fixed in 10% formalin, and the muscular arrangement of the pulmonary venous left atrial junctions was analyzed. This material was then isolated, embedded in paraffin, underwent serial cutting (50 µm of thickness), and was stained with Azam's trichrome. RESULTS: We observed in our specimens that: a) the myocardial fiber bundles that originate in the atrial wall and involve the openings of the pulmonary veins were fewer than those observed in healthy material; b) the myocardial fiber bundles that extend into the pulmonary veins were shorter than those found in material originating from individuals with no pulmonary hypertension. CONCLUSION: Anatomical changes that result in a reduction in the amount of myocardial fiber bundles in the pulmonary venous left atrial junction, isolated or associated with other factors, may be the cause of disorders in pulmonary circulation, leading to an increase in pulmonary venous pressure, and, consequently, to acute pulmonary edema.

OBJETIVO: Estudar o arranjo espacial dos elementos fibrosos que constituem os folhetos da valva mitral e do seu anel fibroso. MÉTODOS: Foram utilizados 20 corações adultos, de ambos os sexos, fixados em formol a 10%. Isolaram-se a valva mitral, juntamente com o anel fibroso, e uma pequena quantidade de tecido muscular ao seu redor. Parte desse material foi incluído em parafina, submetido a cortes seriados de 40µm de espessura e corados pelo tricrômio de Azan e pela resorcina-fucsina, e o restante das peças dissecadas sob lupa estereoscópica, com ajuda de delicadas pinças e agulhas, para se observar a disposição dos feixes miocárdicos ao nível do anel mitral. RESULTADOS: Observou-se que o anel fibroso mitral era constituído por feixes colágenos de trajetória semicircular, envolvendo de forma incompleta o óstio atrioventricular, uma vez que era ausente na região ântero-medial do óstio. Verificou-se que os feixes miocárdicos ventriculares inseriam-se de forma oblíqua, na borda externa do anel, sendo que na região ântero-medial assumiam uma trajetória semicircular. Os folhetos da valva mitral eram constituídos de feixes colágenos dispostos, paralelamente, no sentido do maior eixo da válvula, recobertos pelo endocárdio atrial e ventricular. Os feixes colágenos, presentes na base dos folhetos valvares, praticamente se continuavam com os do anel fibroso. Observou-se, em alguns casos, a existência de delgados feixes miocárdios atriais no folheto valvar anterior, que praticamente eram restritos à região central das válvulas. CONCLUSÃO: Os folhetos da valva mitral e seu anel fibroso possuem uma continuidade estrutural, que demonstra que estes elementos funcionam de forma integrada no fechamento do óstio atrioventricular esquerdo durante a sístole ventricular, no que seria auxiliado pela redução do diâmetro do anel fibroso, através da contração dos feixes miocárdicos semicirculares que nele se inserem.

PURPOSE: To study the spatial arrangement of the fibrous elements that form the leaflets of the mitral valve and its fibrous ring. METHODS: The study of 20 human adult hearts, of both sexes, fixed in 10% formaldehyde solution was made. The mitral valves with their fibrous rings and small parts of the adjacent atrial and ventricular muscles were removed. Part of this material was embedded in paraffin and cut serially at a thickness of 40µm and stained by Azan's trichrome and by resorcin-fuccin and another was dissected under stereoscope in order to verify the arrangement of the myocardial bundles at the level of the fibrous ring. RESULTS: It was observed that the fibrous ring is consisted of collagenous fibers which involved in an incomplete form the atrioventricular ostium, as they were absent in the anteromedial region of the ostium. The leaflets were made of collagenous fibers disposed parallel to the long axis of the valve. This collagenous fibers were covered by atrial and ventricular endocardium. The collagenous fibers of the leaflets were continuous, by their base, into the fibrous ring. It was observed, in a few cases, the presence of atrial muscle fibers into the anterior leaflet of the mitral, mainly in its central area. CONCLUSION: The leaflets of the mitral valve and its fibrous ring have a structural continuity suggesting that elements would act synchronously in the closure of the atrioventricular ostium during ventricular systole. The contraction of the myocardial bundles fixed in the fibrous ring contributes to decrease the diameter of the mitral ring.