Extrusive, Intrusive Luxation and Avulsion in a 7-Year- Old Child: One year of Clinical, Radiographic and Tomographic Follow-Up

ABSTRACT: Dental trauma is a serious injury that occurs frequently in children and adolescents, requiring urgent dental care. The upper central incisors are the most vulnerable teeth to such traumatic injuries, which can lead to bite restrictions, difficulties in phonation and esthetical questions. The aim of this study was to report the success of a conserva tive approach carried out on a 7-year-old patient, victim of multiple dental trauma, involving permanent and deciduous teeth. The male patient fell from his own height, causing soft tissue lacerations and dento-alveolar traumatism in both deciduous and permanent teeth. Complementary examinations (periapical radiographs and computed tomography) were carried out. Based on the diagnoses the patient was referred to specialists for appropriate treatment. The present report highlights the importanc e of an early diagnosis, suitable treatment and follow-up of patients after an alveoli-dental trauma and shows the direct relationship of this approach with the prognosis of the patient and the tooth.

RESUMEN: El trauma dentario es una lesión grave que ocurre con frecuencia en niños y adolescentes y requiere atención dental urgente. Los incisivos centrales superiores son las piezas dentarias más vulnerables a dichos traumas, pudiendo generar restricciones en la mordida, la fonación y a nivel estético. El objetivo de este estudio fue reportar el éxito de un enfoque conservador llevado a cabo en un niño de 7 años de edad, víctima de un trauma dentario múltiple, que involucró tanto dientes temporales como permanentes. El paciente masculino, cayó desde su propia altura, causando laceraciones en los tejidos blandos y traumatismo dento- alveolar en piezas de ambas denticiones. Se llevaron a cabo exámenes complementarios (radiografías periapicales y tomografía computarizada). Basado en el diagnóstico, el paciente fue referido a especialistas para realizar el tratamiento apropiado. El presente reporte destaca la importancia de un diagnóstico precoz, un tratamiento adecuado y el seguimiento de los pacientes luego de un trauma dento-alveolar, y cómo este enfoque muestra relación directa con el pronóstico del paciente y del diente.

Molecular diagnosis and immunotherapy selection in a Portuguese population sensitized to grass and olive pollens / Diagnóstico molecular e seleção de imunoterapia numa população portuguesa sensibilizada ao pólen de gramíneas e de oliveira

Introduction: Phleum pratense (Phl p) and Olea europaea (Ole e) are common allergenic pollen. Objectives: To describe the sensitization patterns to Phl p and Ole e allergens in a subset of allergic rhinitis patients with positive skin prick tests (SPTs) to these pollens and compare the allergen immunotherapy (AIT) choice before and after determination of molecular components. Methods: Candidates to pollen immunotherapy with positive SPTs to both Phl p and Ole e were recruited. All of them underwent an SPT with a panel of aeroallergens and measurements of serum specific IgE (sIgE) to Phl p, Ole e, Phl p1, Phl p5, Phl p7, Phl p12, Ole e1, Ole e7, and Bet v2. Results: Forty adults were included. Of these, 83% and 65% were sIgE-positive to Phl p and Ole e, using the 0.35 kUA/L and 0.70 kUA/L cut-offs, respectively. Moreover, 42.5% of patients had positive sIgE to Phl p1 and/or Phl p5, 2.5% only to Ole e1, and 47.5% to both (0.35 kUA/L cutoff). By increasing the cut-off to 0.7 kUA/L, 55% of patients were sensitized to Phl p1 and/or Phl p5, and no patient was sensitized only to Ole e1. After component-resolved diagnosis, AIT choice was changed in 15 (37.5%) patients, with a decrease in the number of prescriptions of AIT with both grass and olive pollens and with olive alone, together with an increase in the prescriptions of AIT with grass pollen alone. Conclusion: Genuine sensitization to Olea europaea was reduced, and the sensitization patterns were heterogeneous. Knowledge of pattern of sensitization to molecular components changed immunotherapy prescription in more than one third of the patients.

Introdução: Os polens de Phleum pratense (Phl p) e de Olea europaea (Ole e) são fontes alergênicas comuns. Objetivos: Descrever os padrões de sensibilização aos alergênios destes dois polens num subconjunto de pacientes com rinite alérgica polínica e comparar a escolha de imunoterapia, antes e depois da determinação de alergênios moleculares para Phl p e Ole e. Métodos: Foram recrutados candidatos para imunoterapia com polens, com testes cutâneos positivos para Phl p e Ole e. Todos realizaram um painel de testes em picada a aeroalergênios e determinação de IgE séricas específicas para Phl p, Ole e, rPhl p1, rPhl p5, rPhl p7, rPhl p 12, rOle e 1, nOle e 7, rBet v2. Resultados: Foram incluídos 40 adultos. Em relação à sIgE para Phl p e Ole e, 83% e 65% dos pacientes apresentaram positividade para ambos, usando o cut-off de 0,35 kUA/L e 0,70 kUA/L, respectivamente. A positividade para Phl p1 e/ou Phl p 5 foi encontrada em 42,5%, para Ole e 1 apenas em 2,5%, enquanto 47,5% apresentaram sIgE positivo para ambos (cut-off corte de 0,35 kUA/L). Aumentando o cut-off para 0,7 kUA/L, 55% foram sensibilizados para Phl p1 e/ou Phl p5, nenhum paciente foi sensibilizado apenas para Ole e 1. Após a determinação dos alergênios para os componentes moleculares, a escolha de imunoterapia foi alterada em 15 (37,5%) pacientes, com uma diminuição no número de vacinas para Phleum + Olea e apenas para Olea e um aumento na prescrição de vacinas para Phleum. Conclusão: A sensibilização genuína do Olea europaea foi reduzida e os padrões de sensibilização foram heterogêneos. O conhecimento da sensibilização aos componentes moleculares dos alergênios mudou a prescrição de imunoterapia em mais de um terço dos pacientes.

Kounis syndrome - Report of 4 cases / Síndrome de Kounis - Relato de 4 casos

Kounis syndrome is described as the occurrence of myocardial injury following a hypersensitivity reaction triggered by allergen exposure. The actual incidence is unknown, as most of the information comes from case reports and there are no international recommendations. Kounis syndrome does not seem to be rare but rather underdiagnosed. We report and discuss the clinical presentation and management of 4 cases of Kounis syndrome. All patients presented with anaphylaxis and chest pain. Patient age ranged from 44 to 83 years. Anaphylaxis triggers were nonsteroidal anti-inflammatory drugs and antibiotics. It is important to recognize Kounis syndrome in order to conduct an adequate investigation and prevent further events. A major difficulty is that the treatment of the 2 entities (hypersensitivity reaction and acute coronary syndrome) may worsen each other. Large prospective studies are needed to establish definitive treatment guidelines for these patients.

A síndrome de Kounis caracteriza-se pela ocorrência de uma síndrome coronária aguda no contexto de uma reação alérgica concomitante desencadeada por exposição a um alergênio. A sua incidência real é desconhecida e não há consenso relativamente à abordagem, uma vez que a maioria dos dados provem de relatos de casos. A síndrome de Kounis não parece ser uma entidade rara, mas é infrequentemente diagnosticada. Apresentamos quatro casos, a sua apresentação clínica e abordagem diagnóstica e terapêutica. Todos os doentes, com idades entre os 44 e os 83 anos, se apresentaram com anafilaxia e dor torácica. Os fatores desencadeantes foram fármacos: anti-inflamatórios não esteroides e antibióticos. Torna-se importante reconhecer a síndrome de Kounis, de modo a que possa ser feita investigação adequada e prevenidos novos eventos. A grande dificuldade reside no fato de que o tratamento das duas entidades (Reação de hipersensibilidade e Síndrome coronária aguda), pode agravar uma à outra. São necessários estudos prospetivos alargados de modo a estabelecer diretrizes definitivas para o tratamento destes doentes.

Evaluation of dentinogenesis inducer biomaterials: an in vivo study

Abstract When exposure of the pulp to external environment occurs, reparative dentinogenesis can be induced by direct pulp capping to maintain pulp tissue vitality and function. These clinical situations require the use of materials that induce dentin repair and, subsequently, formation of a mineralized tissue. Objective: This work aims to assess the effect of tricalcium silicate cements and mineral trioxide aggregate cements, including repairing dentin formation and inflammatory reactions over time after pulp exposure in Wistar rats. Methodology: These two biomaterials were compared with positive control groups (open cavity with pulp tissue exposure) and negative control groups (no intervention). The evaluations were performed in three stages; three, seven and twenty-one days, and consisted of an imaging (nuclear medicine) and histological evaluation (H&E staining, immunohistochemistry and Alizarin Red S). Results: The therapeutic effect of these biomaterials was confirmed. Nuclear medicine evaluation demonstrated that the uptake of 99mTc-Hydroxymethylene diphosphonate (HMDP) showed no significant differences between the different experimental groups and the control, revealing the non-occurrence of differences in the phosphocalcium metabolism. The histological study demonstrated that in mineral trioxide aggregate therapies, the presence of moderate inflammatory infiltration was found after three days, decreasing during follow-ups. The formation of mineralized tissue was only verified at 21 days of follow-up. The tricalcium silicate therapies demonstrated the presence of a slight inflammatory infiltration on the third day, increasing throughout the follow-up. The formation of mineralized tissue was observed in the seventh follow-up day, increasing over time. Conclusions: The mineral trioxide aggregate (WhiteProRoot®MTA) and tricalcium silicate (Biodentine™) present slight and reversible inflammatory signs in the pulp tissue, with the formation of mineralized tissue. However, the exacerbated induction of mineralized tissue formation with the tricalcium silicate biomaterial may lead to the formation of pulp calcifications

Dental caries and bacterial load in saliva and dental biofilm of type 1 diabetics on continuous subcutaneous insulin infusion

Abstract Objectives Since most of the studies evaluates diabetics on multiple daily injections therapy and continuous subcutaneous insulin infusion may help gain better metabolic control and prevent complications, the objective of this study was to evaluate the prevalence of dental caries, the unstimulated salivary flow rate and the total bacteria load, Streptococcus spp. levels and Lactobacillus spp. levels in saliva and supragingival dental biofilm of type 1 diabetics on insulin pump. Material and Methods Sixty patients with type 1 diabetes on insulin pump and 60 nondiabetic individuals were included. The dental caries evaluation was performed using ICDAS and the oral hygiene was assessed according to Greene and Vermillion Simplified Oral Hygiene Index. Unstimulated saliva and supragingival dental biofilm were collected. Total bacteria, Streptococcus spp. and Lactobacillus spp. was quantified by qPCR. Results Patients with type 1 diabetes had a higher prevalence of dental caries and filled and missing teeth when compared with the control group. These patients were associated with more risk factors for the development of dental caries, namely a lower unstimulated salivary flow rate and a higher bacterial load in saliva and dental biofilm. Conclusion Some risk factors related to dental caries were associated with type 1 diabetics. An early diagnosis combined with the evaluation of the risk profile of the diabetic patient is imperative, allowing the dental caries to be analyzed through a perspective of prevention and the patient to be integrated into an individualized oral health program.

Effects on gastric mucosa induced by dental bleaching – an experimental study with 6% hydrogen peroxide in rats

The value of aesthetic dentistry has precipitated several developments in the investigation of dental materials related to this field. The free marketing of these products is a problem and it is subject to various interpretations regarding its legality. There are several techniques for tooth whitening, the most used one being the external bleaching. It is the later version of such technique that poses the greatest danger of ingesting the product. The present study analysed the systemic effect of these products when they are swallowed.Objective This experimental study aimed to observe the effects of a tooth whitening product, whose active agent is 6% hydrogen peroxide, on the gastric mucosa of healthy and non-tumour gastric pathology animals.Material and Methods Fifty Wistar-Han rats were used and then distributed into 5 groups, one for control and four test groups in which the bleaching product was administered in animals with and without non-tumour gastric pathology (induced by the administration of 1 sample of 50% ethanol and 5% of drinking water during 6 days) at different times of study by gavage. There was a decrease in body weight in animals of groups handled during the study period, which was most pronounced in IV and VA groups. Changes in spleen weight relative to body weight revealed no statistically significant changes. An analysis of the frequency was performed on the results of macroscopic observation of the gastric mucosa.Results The gastric mucosa revealed lesions in all manipulated groups, being more frequent in groups III and IV. It appears that there is a synergism when using hydrogen peroxide and 50% ethanol in the same group.Conclusion Therefore, it seems that there are some signs of toxicity 3 to 4 days after administration of 6% hydrogen peroxide. The prescription of these therapies must be controlled by the clinician and the risks must be minimized.

The effect of Emdogain gel on periodontal regeneration in autogenous transplanted dog's teeth.

Aim: The aim of this study was to assess the enamel matrix derivative (EMD) as biomaterial used in autogenous tooth transplantation. Material and Methods: The study consisted of 3 beagle dogs, 5 months old, in which six incisors and six premolars were transplanted to mechanically prepared recipient alveolar sockets. One group of teeth was transplanted to a recipient bed, with EMD in the root surface. The second groups of teeth were transplanted using saline solution in the root surface. Every week, clinical examinations were done. Nine weeks later, the animals were killed and the specimens decalcified and prepared for histological and imunohistochemical analysis. Periodontal healing was evaluated by undertaking histomorphometric investigation and analyzed using the Mann- Whitney test (P = 0.05). Results: In both groups, all the transplanted teeth survived. Between the experimental groups, there was statistically significant difference in the complete healing (P = 0.004). There was statistically significant difference between the treatment group in the occurrence of inflammatory root resorption (P = 0.015) and the occurrence of replacement root resorption (P = 0.041). Conclusions: Emdogain gel used on the surface of transplanted teeth improves the occurrence of complete healing and reduces root resorption.

Effect of calcium hydroxide as intracanal medication on the apical sealing ability of mineral trioxide aggregate (MTA): an in vitro apexification model / Efeito da medicação intracanal de hidróxido de cálcio na capacidade seladora do mineral trióxido agregado (MTA): um modelo de apicificação in vitro

Objective - To evaluate the effect of calcium hydroxide premedication on the apical seal of White MTA, placed as an apical barrier in permanent teeth with simulated immature apices. Furthermore, we intended to compare potential changes, under the influence of calcium hydroxide, in the apical seal of MTA over time. Methods - Thirty-four single-rooted extracted teeth were prepared in order to simulate a divergent open apex. Two experimental groups of 10 teeth were created: group 1 (G1) and group 2 (G2) with and without calcium hydroxide intracanal medication previous to the placement of MTA apical plug. Two control groups, positive and negative, each with 7 teeth were created. On the 7th and on the 28th day after placement of the MTA apical plug, the apices of the teeth were submersed in a solution of sodium pertechnetate (99mTcO4Na) for 3 hours. The radioactivity was measured using a gamma camera. Results - Results revealed statistically significant differences between the 2 control groups and the 2 experimental groups with respect to the microleakage. Within the experimental groups no statistically significant differences were found; nor between the two observed periods. Conclusion - Based on the results obtained in this study, it was concluded that intracanal medication with calcium hydroxide did not affect the sealing ability of WMTA, placed as an apical plug, neither on the 7th, nor on the 28th day.

Objetivo - Avaliar o efeito do hidróxido de cálcio como medicação intracanal, no selamento apical do MTA branco, colocado como uma barreira apical em dentes permanentes com ápices imaturos simulados. Métodos - Trinta e quatro dentes unirradiculares extraídos foram preparados para simular um ápice aberto divergente. Foram separados em dois grupos experimentais (n=10): G1 e G2 com e sem medicação intracanal de hidróxido de cálcio antes da colocação do tampão apical com o MTA e dois grupos controle, positivos e negativos (n=7 em cada). Em 7 e 28 dias após a colocação do tampão apical de MTA, os ápices dos espécimes foram submersos em uma solução de pertecnetato de sódio (99mTcO4Na) por 3 horas. A radioatividade foi medida usando uma câmara gama. Resultados - Os resultados revelaram diferenças estatisticamente significativas entre os grupos controle e os grupos experimentais com relação a microinfiltração. Não houve diferença entre os grupos experimentais nos dois períodos. Conclusão - Com base nos resultados obtidos neste estudo, concluiu-se que a medicação intracanal com hidróxido de cálcio não influenciou na capacidade seladora do MTA.

Limas endodônticas: esterilizar ou descartar

Objetivo: o objetivo desse trabalho foi comparar, qualitativa e quantitativamente, a presença de matéria orgânica em limas endodônticas depois de utilizadas, descontaminadas e esterilizadas. Métodos: foram usadas 30 limas tipo K #30, das quais 5 serviram como grupo controle positivo e 5 como negativo. Instrumentaram-se 10 molares suínos pela técnica Crown-Down, inserindo uma lima por canal num total de 25 limas. As limas do grupo 1 (n=10) foram esterilizadas em autoclave. As limas do grupo 2 (n=10) foram colocadas em banho de ultrassom com solução enzimática e posteriormente esterilizadas em autoclave. As do grupo 3 (n=5) foram utilizadas, mas não foram esterilizadas; e as do grupo 4(n=5) não foram utilizadas nem esterilizadas. As limas experimentais e de controle foram posteriormente coradas com solução de Van Gieson, observadas ao microscópio óptico e atribuído um valor representativo da quantidade de matéria orgânica ainda existente na lima, de acordo com uma escala previamente estabelecida. Essa quantificação foi realizada nos terços apical, médio e cervical da parte ativa de cada lima, e foram elaboradas tabelas comparativas entre os diferentes grupos. Resultados:os resultados demonstraram que ambos os grupos experimentais apresentaram resultados significativamente inferiores aos das limas do grupo controle positivo.Conclusão: comparando-se os grupos experimentais,as limas imersas em banho de ultrassom com solução enzimática apresentaram valores inferiores aos daquelas que não foram submetidas a esse procedimento.

Remote sensing of vegetation: evolution and state of the art - DOI: 10.4025/actascibiolsci.v30i4.5868 / Sensoriamento remoto da vegetação: evolução e estado-da-arte - DOI: 10.4025/actascibiolsci.v30i4.5868

Systematic surveys of the vegetative cover in Brazil include the semi-detailed mappings conducted within the scope of the Radam and Radambrasil projects, between 1971 and 1977, based on side-looking airborne radar images, and more recently, the assessments, based on Landsat 7 ETM+ imagery, of the remnant vegetation cover of the Brazilian biomes (MMA/PROBIO), finished in 2006. In a little more than 30 years, many changes have occurred, both in vegetation cover as well as in orbital remote sensing. In this review article, we discuss, from a conceptual and technological perspective, the evolution and the state of the art of imager sensors, as well as some of the enhancement techniques utilized for decoding (e.g., in biophysical parameters, etc.) and classifying the spectral response of vegetation. Likewise, we present the main current (pioneering) initiatives for land cover monitoring of the Brazilian biomes.

Levantamentos sistemáticos da cobertura vegetal no Brasil, à escala de semidetalhe, incluem aqueles realizados no âmbito dos projetos Radam e Radambrasil, no período de 1971 a 1977, tendo por base imagens de radar aerotransportadas e, mais recentemente, os mapeamentos, com base em imagens Landsat 7 ETM+, dos remanescentes da cobertura vegetal nos biomas brasileiros (projeto MMA/PROBIO), concluídos em 2006. Nestes pouco mais de 30 anos, muitas mudanças ocorreram, tanto na cobertura vegetal do país quanto no sensoriamento remoto orbital. Neste artigo de revisão, apresentamos, do ponto de vista conceitual e tecnológico, a evolução e o estado-da-arte dos sistemas sensores e discutimos algumas das técnicas mais utilizadas para decodificar (ex. em parâmetros biofísicos etc.) e classificar a resposta espectral da vegetação. Da mesma forma, apresentamos as principais iniciativas, históricas ou em curso, voltadas ao monitoramento da cobertura vegetal dos biomas brasileiros.

Infecciones profundas de cabeza y cuello en el nuevo milenio / Deep head and throat infections in the new millenium

Las infecciones profundas de cabeza y cuello constituyen actualmente un tema de importancia en la consulta diaria de ORL dado el incremento en frecuencia y potencial mortal. Se realizó un estudio retrospectivo de 278 pacientes de enero de 1994 a diciembre de 2001 en el Servicio de Otorrinolaringología del Hospital Universitario de Caracas. Promedio de edad: 29,01 años. Distribución: 155 masculino, 123 femenino. Se hace un estudio de etiología, clínica, evaluación y tratamiento. 168 pacientes drenaron espontáneamente o necesitaron drenaje quirúrgico. La clindamicina fue el antibiótico más usado, seguido por la penicilina a dosis antianaerobias y en tercer lugar la oxacilina.

Colocación de stent endovascular en arteria aorta distal en el tratamiento de arteriosclerosis obliterante: presentación de un caso / Arteriosclerosis oblirante placement of stetn palmaz presentation of a case

La arteriosclerosis, es un término genérico que alude al engrosamiento y endurecimiento de la pared arterial, y es responsable de la mayoría de las muertes en Estados Unidos, y en la mayoría de las sociedades occidentalizadas. Un tipo de arteriosclerosis es la aterosclerosis, es un término que describe lesiones engrosadas y endurecidas de las arterias musculares y elásticas de mediano y gran calibre. La arteriosclerosis obliterante es la más frecuente causa de arteriopatías obstructivas de las extremidades y suele manifestarse en clínica entre 50 y 70 años. Se presenta el caso de una paciente femenina de 72 años de edad, con síntomas de dolor que aparece en uno o varios músculos de los miembros inferiores, por insuficiencia del riesgo sanguíneo que es más notable al realizar ejercicios y desaparece a unos minutos después de suspender el mismo. Presentamos este caso de arteriosclerosis obliterante diagnosticado por clínica aortografía, se hace mención de la técnica empleada para la resolución del caso, con seguimiento y evolución satisfactoria de 5 meses de evolución

Colocación de Stent endovascular en arteria aorta distal en el tratamiento de arteriosclerosis obliterante: presentación de un caso, Servicio de Radiología, Clínica Santa Sofía / Implants of the stents endovascular in aorta artery in the treatment of arteriosclerosis obliterans: presentation of the a case, Service of the Radiology, Clínica Santa Sofía

La Arteriosclerosis, es un término genérico que alude al engrosamiento y endurecimiento de la pared arterial y es responsable de la mayoría de las muertes en Estados Unidos, y las sociedades occidentalizadas (1). Un tipo de Arteriosclerosis es la Aterosclerosis, un término que describe lesiones engrosadas de las Arterias musculares y elásticas de mediano y gran calibre (2). La Arteriosclerosis Obliterante es la más frecuente causa de arteriopatías obstructivas de las extremidades y suele manifestarse en clínica entre 50 y 70 años (2). Se presenta el caso de una paciente femenina de 72 años de edad, con síntomas de dolor que aparece en uno o varios músculos de los miembros inferiores, por insuficiencia del riesgo sanguíneo que es más notable al realizar ejercicios y desaparece a unos minutos después de suspender el mismo. Presentamos este caso de Arteriosclerosis Obliterante diagnosticado por clínica y Aortografía, se hace mención de la técnica empleada para la resolución del caso, con seguimiento y evolución de 5 meses de evolución

Estenosis de la arteria subclavia resuelta tras la colocación de Stent endovascular: Servicio de Diagnóstico por Imágenes, Hospital Vargas-Caracas / Stenosis of subclavian artery resolute in the intravascular of the Stents: Service by imaging, Hospital Vargas-Caracas

En nuestro trabajo se describe el caso de una paciente con Estenosis proximal en la Arteria Subclavia izquierda presentado en cuadro clínico de Izquemia progresiva crónica. En la Arteriografía pre-stent y en el estudio hemodinámico inicial se observó una disminución del flujo vascular en un 90 por ciento, presentando la paciente un cuadro clínico de claudicación intermitente, se le establecieron a la paciente alteraciones quirúrgicas y la colocación endoluminal del stent en dicha región, decidiéndose por esta última, lo que dio como resultado la restauración del flujo sanguíneo en un 100 por ciento, así como la desaparición de la sintomatología

Estenosis de la arteria subclavia resuelta tras la colocación de stent endovascular: presentación de un caso / Stenosis of the subclavia artery result after the place of endovascular stent: presentation a case

En nuestro trabajo se describe el caso de una paciente que presenta Estenosis proximal en la Arteria Subclavia izquierda presentando un cuadro clínico de Isquemia progresiva crónica. En la Arteriografía pre-stent y en el estudio hemodinámico inicial se observó una disminución del flujo vascular en un 90 por ciento, presentando la paciente un cuadro clínico de claudicación intermitente, se le establecieron a la paciente alternativas quirúrgicas y la colocación endoluminal del stent en dicha región, decidiéndose por esta última, obteniéndose como resultado la restauración del flujo sanguineo en un 100 por ciento así como la desaparición inmediata de la sintomatología

Quiste epidural dorsal en la enfermedad de Scheurmann: reporte de un caso / Dorsal epidural cyst in Scheurmann's disease: report of a case

La asociación de Enfermedad de Scheurmann con quistes epidurales es algo inusual. Presentamos paciente masculino de 15 años de edad, operado de Cordoma de la región lumbosacra en 1992, tres años después se ingresa por manifestaciones neurológicas en miembros inferiores, encontrándose entonces en una segunda intervención quirúrgica un quiste epidural. Se ingresa por tercera vez al siguiente año por signos radiológicos de acuñamiento vertebral dorsal y quiste epidural recidivante diagnosticandose entonces una Enfermedad de Scheurmann. No encontramos reporte en la literatura de asociación entre cordoma y Enf. de Scheurmann

Rol del endotelio en el efecto vasodilatador de la acetilcolina cuando el vaso aislado se somete a la acción contráctil de norepinefrina o de potasio / Role of endothelium in the vasodilator effect of the acetylcholine when the vaso isolated with endothelium contratedeith no repinephrine of potassium chloride

La acetilcolina depende de la conservación del endotelio vascular, para producir su efecto vasodilatador que es ocasionado por la liberación de un factor relajador derivado del endotelio y que corresponde al óxido nítrico. Se estudiaron las acciones de la acetilcolina, en manguitos aislados de aorta de rata con endotelio, contraídos por norepinefrina o cloruro de potasio. Se ensayaron dosis únicas de norepinefrina, 10-6 M y también dosis crecientes y acumulativas desde 10-8 hasta 10-4 antes y después de la incubación con acetilcolina. Además, se sometió la preparación con endotelio a los efectos de una solución despolarizante de potasio y luego se le agregó acetilcolina 10-3. También se observaron los efectos de la acetilcolina añadida previamente a la solución despolarizante. A modo de control, en otra serie experimental, se utilizó solución Krebs-Henseleir. La acetilcolina adicionada previamente a la solución de potasio antagoniza la contracción producida por esta solución despolarizante. En cambio, cuando la preparación es contraída previamente con dicha solución la acetilcolina no produce vasodilatación. La incubación en acetilcolina disminuye la acción contráctil de dosis creciente y acumulativas de norepinefrina, probablemente por liberación de factor de relajación derivado del endotelio

Regula la acetilcolina la sensibilidad del vaso aislado a la norepinefrina? / Regulation acetylcholine sensibility of vassel a the norepinephrine?

Furchgott demostró que la acetilcolina depende del endotelio vascular para ejercer su efecto dilatador cuando el vaso se encuentra por norepinefrina (NE). Nosotros hemos comprobado esto y además verificado que el neurotransmisor ejerce una acción constrictora en el vaso aislado que ha sido desprovisto de su endotelio. Esto nos hizo pensar que quizás la incubación del vaso aislado sin endotelio en acetilcolina, podría potenciar la acción constrictora de la NE. Para este estudio utilizamos manguitos aislados de aorta de rata, desprovistos mecánicamente de endotelio, inmersos en solución Krebs-Henseleirt (K-H) en pequeño baño de órgano aislado que permitía registrar el tono de las preparaciones mediante transductores de fuerzas y registrarlo en un fisiógrafo Grass. Se ensayaron dosis únicas de NE,10-6 M y también crecientes y acumulativas desde 10-7 hasta 10-4 M, antes y después de incubar la preparación en acetilcolina; agregando 1 ml de una solución 10-3 M al baño. A modo de control, en otra serie experimental, se usó solución K-H para incubar el vaso aislado sin endotelio. Al iniciar y al finalizar los experimentos, se cambió momentáneamente la solución K-H por una despolarización (K 70) como prueba funcional, porque la preparación responde con una contracción máxima a este estímulo. Contradictoriamente, la preparación sin endotelio que ha sido incubada previamente en acetilcolina, responde con menor intensidad a la acción vasoconstrictora de la NE. En esta situación experimental, con vasos desprovistos de íntima, no podemos invocar a la liberación del factor relajador derivado del endotelio. Presumiblemente hemos encontrado un procedimiento para desensibilizar los receptores adrenérgicos del vaso aislado