Estudo anatômico da parede anterior do abdome em cadáver e hérnia de Spiegel

OBJETIVO: Tentar correlacionar a hérnia de Spiegel com eventuais alterações anatômicas da parede anterolateral do abdome. Abordar as particularidades do estudo anatômico em cadáver, com destaque aos músculos oblíquo interno, transverso abdominal, aponeurose de Spiegel, linha semilunar e ao aparecimento de hérnias de Spiegel. MÉTODO: A parede anterolateral do abdome foi dissecada em 31 cadáveres frescos do Departamento de Patologia da Santa Casa de Misericórdia de São Paulo, sendo realizada nos dois primeiros cadáveres a dissecção unilateral e nos 29 restantes o estudo bilateral da parede abdominal, completando 60 dissecções. Considerando que operamos no Hospital São Luiz Gonzaga, da Irmandade da Santa Casa de Misericórdia de São Paulo, 13 doentes com 14 hérnias de Spiegel, pudemos correlacionar os elementos clínicos aos estudos anatômicos em cadáver. RESULTADOS: Defeitos encontrados nos músculos e aponeuroses: Oblíquo externo: 4/60 (6,6%) - Oblíquo interno: 6/60 (10%) - Transverso abdominal: 14/60 (23,3%). Disposição dos músculos em forma de feixes de fibras: Oblíquo interno: 10/60 (16,6%) - Transverso abdominal: 12/60 (20%). CONCLUSÕES: As variações anatômicas e os defeitos encontrados, durante as dissecções do oblíquo interno e transverso abdominal, não se acompanharam de hérnias de Spiegel no cadáver, já a gordura pré-peritoneal, dissecando as fibras da aponeurose de Spiegel e oblíquo interno, foi encontrada nas operações e nas dissecções, podendo representar uma relação entre os defeitos musculoaponeuróticos da parede anterolateral do abdome e a hérnia de Spiegel

A Modified SCS-CN Method Incorporating Storm Duration and Antecedent Soil Moisture Estimation for Runoff Prediction

In one of the widely used methods to estimate surface runoff - Soil Conservation Service Curve Number (SCS-CN), the antecedent moisture condition (AMC) is categorized into three AMC levels causing irrational abrupt jumps in estimated runoff. A few improved SCS-CN methods have been developed to overcome several in-built inconsistencies in the soil moisture accounting (SMA) procedure that lies behind the SCS-CN method. However, these methods still inherit the structural inconsistency in the SMA procedure. In this study, a modified SCS-CN method was proposed based on the revised SMA procedure incorporating storm duration and a physical formulation for estimating antecedent soil moisture (V 0 ). The proposed formulation for V 0 estimation has shown a high degree of applicability in simulating the temporal pattern of soil moisture in the experimental plot. The modified method was calibrated and validated using a dataset of 189 storm-runoff events from two experimental watersheds in the Chinese Loess Plateau. The results indicated that the proposed method, which boosted the model efficiencies to 88% in both calibration and validation cases, performed better than the original SCS-CN and the Singh et al. (2015) method, a modified SCS-CN method based on SMA. The proposed method was then applied to a third watershed using the tabulated CN value and the parameters of the minimum infiltration rate (f c ) and coefficient (β) derived for the first two watersheds. The root mean square error between the measured and predicted runoff values was improved from 6 mm to 1 mm. Moreover, the parameter sensitivity analysis indicated that the potential maximum retention (S) parameter is the most sensitive, followed by f c . It can be concluded that the modified SCS-CN method, may predict surface runoff more accurately in the Chinese Loess Plateau