Diagnóstico prenatal ultrasonográfico de hemivértebra / Prenatal Ultrasonographic Diagnosis of Hemivertebrae

Introducción: La hemivértebra es un raro defecto congénito de la columna vertebral fetal en la que solo se desarrolla el cuerpo vertebral de un lado, lo cual provoca su deformidad. Objetivo: Presentar un caso con diagnóstico ecográfico tridimensional prenatal de hemivértebra, como único defecto. Método: Se realizó evaluación ecográfica prenatal y examen anátomo patológico y radiológico posmortem al feto con escoliosis congénita provocado por hemivértebra. Se revisó la literatura sobre este defecto congénito, su diagnóstico prenatal y otros aspectos genéticos que deben tenerse en cuenta para el asesoramiento a la familia. Presentación de caso: Gestante de 28 años remitida a la consulta provincial de Genética Médica en la ciudad de Camagüey, Cuba, el 25 de septiembre del 2018, por sospecha ultrasonográfica de hemivértebra fetal con 20 semanas de gestación. Se confirma diagnóstico a esta instancia, mediante ultrasonografía tridimensional. Con el consentimiento familiar informado se realiza interrupción de la gestación y se comprueba el diagnóstico prenatal realizado por estudios radiológicos y anátomo patológico de la región dorso lumbar. Conclusiones: Se concluye como un defecto congénito múltiple, aislado, de posible etiología multifactorial. Se destacó el valor de la ecografía tridimensional, vista sagital coronal, como método no invasivo más empleado para el diagnóstico prenatal(AU)

Introduction: The hemivertebrae is a rare congenital defect of the fetal spine in which only the vertebral body develops on one side, resulting in deformity. Objective: To present a case with three-dimensional prenatal ultrasound diagnosis of hemivertebrae, as the only defect. Method: Prenatal ultrasound evaluation, postmortem anatomopathological and radiological examination were performed in a fetus with congenital scoliosis caused by hemivertebrae. The literature on this congenital defect, the prenatal diagnosis and other genetic aspects that should be taken into account for family counseling was reviewed. Case report: A 28-year-old pregnant woman referred to the provincial office of Medical Genetics in Camagüey, Cuba, on September 25, 2018, due to ultrasonographic suspicion of fetal hemivertebrae. She was 20 weeks of gestation. Diagnosis is confirmed by three-dimensional ultrasonography. After the informed family consent, the pregnancy was interrupted. The prenatal diagnosis was verified by radiological and pathological studies of the lumbar back region. Conclusions: It is concluded as a multiple congenital defect, isolated, of possible multifactorial etiology. The value of three-dimensional ultrasound, coronal sagittal view, was highlighted as the most commonly used, non-invasive method for prenatal diagnosis(AU)

Rapid maxillary expansion effects: An alternative assessment method by means of cone-beam tomography

INTRODUCTION: This study aims to develop a method to assess the changes in palatal and lingual cross-sectional areas in patients submitted to rapid maxillary expansion (RME). METHODS: The sample comprised 31 Class I malocclusion individuals submitted to RME and divided into two groups treated with Haas (17 patients) and Hyrax (14 patients) expanders. Cone-beam computed tomography scans were acquired at T0 (before expansion ) and T1 (six months after screw stabilization). Maxillary and mandibular cross-sectional areas were assessed at first permanent molars and first premolars regions and compared at T0 and T1. Mandibular occlusal area was also analyzed. RESULTS: Maxillary cross-sectional areas increased in 56.18 mm2 and 44.32 mm2 for the posterior and anterior regions. These values were smaller for the mandible, representing augmentation of 40.32 mm2 and 39.91 mm2 for posterior and anterior sections. No differences were found when comparing both expanders. Mandibular occlusal area increased 43.99mm2 and mandibular incisors proclined. Increments of 1.74 mm and 1.7 mm occurred in mandibular intermolar and interpremolar distances. These same distances presented increments of 5.5 mm and 5.57 mm for the maxillary arch. CONCLUSION: Occlusal and cross-sectional areas increased significantly after RME. The method described seems to be reliable and precise to assess intraoral area changes. .

INTRODUÇÃO: o presente estudo teve como objetivo desenvolver um método para avaliar as mudanças nas áreas transversais palatinas e linguais em pacientes submetidos à expansão rápida da maxila (ERM). MÉTODOS: a amostra foi composta por 31 indivíduos com má oclusão Classe I de Angle, submetidos a ERM e divididos em dois grupos, tratados com expansores tipo Haas (17 pacientes) e de Hyrax (14 pacientes). Tomografias computadorizadas de feixe cônico foram adquiridas em T0 e T1 (antes da expansão e seis meses após a estabilização do parafuso). Áreas transversais da maxila e mandíbula foram avaliadas nas regiões de primeiros molares permanentes e pré-molares e comparadas entre T0 e T1. A área oclusal mandibular também foi analisada. RESULTADOS: as áreas transversais maxilares aumentaram 56,18mm2 e 44,32mm2 para regiões posterior e anterior, respectivamente. Esses valores foram menores para mandíbula, representando aumentos de 40,32mm2 e de 39,91mm2 para as seções anterior e posterior. Não foram encontradas diferenças quando se comparam os dois expansores. A área oclusal mandibular aumentou 43,99mm2 e incisivos inferiores vestibularizaram. Incrementos de 1,74mm e 1,7mm ocorreram entre as distâncias intermolares e interpré-molares inferiores. Essas mesmas distâncias apresentaram incrementos de 5,5mm e de 5,57mm para maxila. CONCLUSÃO: as áreas transversais avaliadas e oclusal de mandíbula aumentaram significativamente após a ERM. O processo descrito parece ser um método confiável e preciso para avaliar as mudanças das área intrabucais propostas. .

Anatomía microquirúrgica en 3D de la superficie cerebral / Microsurgical anatomy in 3D of the brain cortex

Introducción: El estudio de la superficie externa del cerebro es analizado desde diferentes puntos espaciales, es decir unasuperficie lateral, medial y basal. La superficie lateral del cerebro se distingue por la presencia de dos puntos de referencia quedividen a cada hemisferio cerebral en lóbulos. Estos dos puntos son la fisura de Silvio (fisura lateral) y el surco de Rolando (surcocentral). Estos dos surcos dividen a cada hemisferio en lóbulo frontal (superior a la fisura de Silvio y anterior al surco de Rolando),el lóbulo temporal (inferior a la fisura de Silvio) y lóbulo parietal (superior a la fisura de Silvio y posterior al surco de Rolando). Ellóbulo occipital se ubica por detrás del surco parietooccipital, y el lóbulo de la ínsula que se sitúa en la profundidad de la fisurade Silvio. Objetivo: Describir la anatomía Microquirúrgica de la superficie cerebral en imágenes estereoscópicas anaglíficas tridimensionales.Material y Métodos: La superficie cerebral fue examinada en 30 cerebros humanos con la ayuda de microscopioquirúrgico D.F. Vasconcellos M900 con una magnificación de 16x y 40x, el equipo fotográfico marca Nikon modelo D60, lenteAF-S VR Micro-Nikkor 105 mm f/2.8G IF-ED de Nikon, instrumental de microcirugía y sistema de vernier calibrado en décimasde milímetros. Resultados: La superficie cerebral de cada hemisferio esta dividida por medio de la fisura de Silvio y el surco deRolando en; Lóbulo frontal que se localiza superior a la fisura de Silvio y anterior al surco de Rolando, el lóbulo temporal que sesitúa inferior a la fisura de Silvio, lóbulo parietal de localización superior a la fisura de Silvio y posterior al surco de Rolando, el lóbulooccipital se ubica por detrás del surco parietooccipital. En la profundidad de la fisura de Silvio se encuentra el lóbulo de la ínsula...

Introduction: Brain cortex is studied from different views: lateral, medial and basal surfaces. The brain lateral surface is distinguished by the presence of referential points and sulci. Those specific surgical points consist of the Sylvian fissure (lateral fissure) and the Rolandic sulcus (central sulcus). Those sulci divide each hemisphere in frontal lobe (superior to the Sylvian fissure and anterior to the Rolandic sulcus), temporal lobe (inferior to the Sylvian fissure), and parietal lobe (superior to the Sylvian fissure and posterior to the Rolandic sulcus). The occipital lobe is located posteriorly to the parietooccipital sulci, and the insular lobe is located deep into the Sylvian fissure. Objetive: To describe the microsurgical anatomy of the brain cortex in tridimensional surface imaging reconstruction. Material and Methods: Human cadaveric speciments of 30 human brains were studied through the surgical microscopy D.F. Vasconcellos M900, 16x and 40x magnification, Nikon D60 camera, AF-S VR Micro-Nikkor 105 mm f/2.8G IF-ED lens, and microsurgical instruments. Results: Brain surface is divided in each hemisphere basically through the Sylvian fissure and the Rolandic sulcus in frontal lobe, superiorly to the to the Sylvian fissure and anteriorly to the Rolandic sulcus, temporal lobe, inferiorly to the Sylvian fissure, parietal lobe, superiorly to the Sylvian fissure and posteriorly to the Rolandic sulci, and occipital lobe behind the parietooccipital sulci. Deep into the Sylvian fissure is located the insular lobe...

Comparação de diferentes métodos para medida do tamanho do infarto experimental crônico em Ratos / Comparison of different methods to measure experimental chronic infarction size in the rat model

OBJETIVO: Avaliar as diferenças entre três métodos para medida do infarto experimental em ratos, em relação ao método tradicional. MÉTODOS: A área infartada por histologia (AREA), o perímetro interno da cavidade infartada por histologia (PER) e o perímetro interno por ecocardiograma (ECO) foram comparados ao método tradicional (análise histológica das circunferências epicárdicas e endocárdicas da região infartada - CIR). Utilizaram-se ANOVA de medidas repetidas, complementada com o teste de comparações múltiplas de Dunn, o método de concordância de Bland & Altman e o teste de correlação de Spearman. A significância foi p < 0,05. RESULTADOS: Foram analisados dados de 122 animais, após 3 a 6 meses do infarto. Houve diferença na avaliação do tamanho do infarto entre CIR e os outros três métodos (p < 0,001): CIR = 42,4 por cento (35,9-48,8), PER = 50,3 por cento (39,1-57,0), AREA = 27,3 por cento (20,2-34,3), ECO = 46,1 por cento (39,9-52,6). Assim, a medida por área resultou em subestimação de 15 por cento do tamanho do infarto, enquanto as medidas por ecocardiograma e pelo perímetro interno por meio de histologia resultaram em superestimação do tamanho do infarto de 4 por cento e 5 por cento, respectivamente. Em relação ao ECO e PER, apesar de a diferença entre os métodos ser de apenas 1,27 por cento, o intervalo de concordância variou de 24,1 por cento a -26,7 por cento, sugerindo baixa concordância entre os métodos. Em relação às associações, houve correlações estatisticamente significativas entre: CIR e PER (r = 0,88 e p < 0,0001); CIR e AREA (r = 0,87 e p < 0,0001) e CIR e ECO (r = 0,42 e p < 0,0001). CONCLUSÃO: Na determinação do tamanho do infarto, apesar da alta correlação, houve baixa concordância entre os métodos.

OBJECTIVE: To evaluate the differences between three methods for the measurement of experimental infarction in rats in comparison to the traditional method. METHODS: Histological analysis of the infarction area (AREA), histological analysis of the internal cavity perimeter (PER) and echocardiogram analysis of the internal perimeter (ECHO) were compared to the traditional method (histological analysis of the epicardial and endocardial circumferences of the infarction region - CIR). Repeated ANOVA measurements were used in conjunction with the Dunn multiple comparison test, the Bland and Altman concordance method and the Spearman correlation test. Significance was established as p < 0.05. RESULTS: The data of 122 animals were analyzed, 3 to 6 months after the infarction. Infarction size assessments revealed differences between CIR and the other three methods (p < 0.001): CIR = 42.4 percent (35.9-48.8), PER = 50.3 percent (39.1-57.0), AREA = 27.3 percent (20.2-34.3), ECHO = 46.1 percent (39.9-52.6). Therefore, measurement by area underestimated the infarct size by 15 percent, whereas the echocardiogram and histological internal perimeter measurements overestimated the infarct size by 4 percent and 5 percent, respectively. In relation to ECHO and PER, even though the difference between the methods was only 1.27 percent, the concordance interval ranged from 24.1 percent to -26.7 percent, suggesting a low level of concordance between the methods. In relation to associations, statistically significant correlations were found between: CIR and PER (r = 0.88 and p < 0.0001); CIR and AREA (r = 0.87 and p < 0.0001) and CIR and ECHO (r = 0.42 and p < 0.0001). CONCLUSION: Despite the high level of correlation, there was a low level of concordance between the methods to define infarct size.

Multiprobe laser reflectometry in imaging and characterization of biological tissues.

Laser backscattered radiation from human forearm and foot were measured by multi-probe reflectometer, which consisted of one input probe and three output probes placed at distances of 2, 4 and 6 mm from the input probe. The normalized backscattered intensity (NBI) signals from the tissue surface, measured by the output probes, after digitization, were used to reconstruct the reflectance images of tissues in various layers below the skin surface. From NBI profiles measured at various locations of the tissues on the forearm the corresponding optical parameters, the scattering (mu(s)) and absorption (mu(a)) coefficients and the anisotropy parameter g, by matching these with profiles as simulated by Monte Carlo procedure were determined. From these data the optical parametric images of forearm were reconstructed which show the variation of these parameters at various locations. Similarly, the NBI data were collected from the foot sole region of healthy and diabetes subjects and their images reconstructed. These images showed the variation in the NBI in the diabetic foot sole compared to that of healthy subject, indicating the tissue structural changes. These procedures could be useful for diagnostic and therapeutic applications of lasers.

Thin-Section CT Findings of Nontuberculous Mycobacterial Pulmonary Diseases: Comparison Between Mycobacterium avium-intracellulare Complex and Mycobacterium abscessus Infection

We aimed to compare the CT findings of nontuberculous mycobacterial pulmonary diseases caused by Mycobacterium avium-intracellulare complex (MAC) and Mycobacterium abscessus. Two chest radiologists analyzed retrospectively the thin-section CT findings of 51 patients with MAC and 36 with M. abscessus infection in terms of patterns and forms of lung lesions. No significant difference was found between MAC and M. abscessus infection in the presence of small nodules, tree-in-bud pattern, and bronchiectasis. However, lobar volume decrease (p=0.001), nodule (p=0.018), airspace consolidation (p=0.047) and thin-walled cavity (p=0.009) were more frequently observed in MAC infection. The upper lobe cavitary form was more frequent in the MAC (19 of 51 patients, 37%) group than M. abscessus (5 of 36, 14%) (p=0.029), whereas the nodular bronchiectatic form was more frequent in the M. abscessus group ([29 of 36, 81%] vs. [27 of 51, 53%] in MAC) (p=0.012). In conclusion, there is considerable overlap in common CT findings of MAC and M. abscessus pulmonary infection; however, lobar volume loss, nodule, airspace consolidation, and thin-walled cavity are more frequently seen in MAC than M. abscessus infection.