O gel de plasma rico em plaquetas propicia a regeneração da cartilagem articular do joelho de ovelhas / Platelet-rich plasma gel promotes regeneration of articular cartilage in knees of sheeps

Objetivo: Avaliar a regeneração da cartilagem articular em defeitos osteocondrais do joelho induzidos pelo plasma rico em plaquetas (PRP) autógeno. Métodos: Defeitos osteocondrais produzidos no sulco troclear de ambos os joelhos de dez ovelhas foram preenchidos com PRP autógeno à direita e deixados vazios à esquerda. Avaliação macroscópica e histológica foram efetuadas 12 semanas mais tarde. Os resultados foram avaliados por um escore geral de ambas as avaliações macroscópica e histológica comparativamente entre os lados por meio do teste pareado de Wilcoxon. Resultados: o aspecto macroscópico não foi uniforme entre os animais, nem diferiu entre os joelhos direitos e esquerdos (p=0,03125); em nenhum caso o tecido regenerado se nivelou com a cartilagem normal circundante. Ao exame histológico, cartilagem aparentemente normal não foi detectada em nenhum joelho, mas uma cartilagem pouco diferenciada estava presente em sete joelhos direitos e em três joelhos esquerdos. Tecido fibrocartilaginoso estava presente nos joelhos restantes, com diferença significante no escore geral entre os joelhos direitos e esquerdos (p=0,0313). Conclusão: o PRP como usado neste estudo tem propriedades reparativas da cartilagem articular no joelho de ovelhas, principalmente por estimular a formação de tecido fibrocartilaginoso. Trabalho Experimental.

Objective: To assess the regeneration of osteochondral defects in the joint cartilage of the knee induced by autologous platelet-rich plasma (PRP). methods: osteochondral defects produced in the trochlear groove of both knees of ten sheep; defects of the right knees were filled with autologous PRP and the left knees were left unfilled. macroscopic and microscopic evaluation was carried out 12 week later. the results were evaluated by the total score of both macroscopic and microscopic evaluations comparing the two sides through the wilcoxon paired test. Results: macroscopic appearance was not uniform among animals, nor was it different between the right and left knees (p=0.3125), and in no case the regenerated tissue was equal to the normal surrounding cartilage. At histological examination, apparently normal cartilage was not detected in any knee, but a poorly differentiated cartilage was present in 7 right knees, compared to 3 left knees. Fibrocartilaginous tissue was present in most of the remaining knees, with a significant difference in the overall score between right and left knees (p=0.0313). conclusion: the pRp as used in this study has reparative properties of the joint cartilage of sheep knees, mostly by stimulating the formation of a fibrocartilaginous tissue. Laboratory Investigation.

Grado de desviación en posición primaria de la mirada (PPM) en lesión del III y VI nervio / Degree of deviation in primary position in III and VI nerve injury

Objetivo: Evaluar las características en el grado de desviación en las lesiones del II y VI nervio, para establecer correlación entre cada una de las situaciones clínicas. Materiales y métodos: Se estudiaron expedientes de pacientes con lesión del III y VI nervio en el Hospital Nuestra Señora de La Luz, desde enero de 2000 hasta enero de 2005. En todos los pacientes se realizó examen oftalmológico completo, donde se evidenciara limitación de -4 ó mayor en III nervio, y limitación de la abducción de -4 ó mayor en VI nervio. Resultados: Se analizaron 71 expedientes, 31 con lesión del III nervio (11 con parálisis, 20 con paresia); 40 con lesión del VI nervio (16 con parálisis y 24 con paresia). En cuanto a la desviación media y la moda según el grado de limitación, se evidenció mayor desviación en la lesión del III nervio. Conclusiones: Las desviaciones horizontales encontradas cuando existe daño al III nervio son en general de mayor magnitud que las encontradas cuando existe daño al VI nervio.

Purpose: To evaluate characteristics in the amount of deviation in III and VI nerve palsies, to establish a correlation between each one of clinical situations. Methods: Retrospective study where the files of patients with the diagnosis of III or VI nerve injury in the Hospital Nuestra Señora de La Luz were reviewed from january of 2000 to january of 2005. All patients had a complete ophthalmologic evaluation, in whitch the deviation was noticed, and in those with an affection of the III nerve the limitation of the adduction went from -4 or more, and in those with de VI nerve affected, the limitation of the abduction went from -4 or more. Results: 71 patients were included, 31 with III nerve injury and 40 with VI nerve injury. Conclusions: Horizontal deviations found in III nerve palsies are larger than those found in VI nerve palsies.

Neurotization of oculomotor, trochlear and abducent nerves in skull base surgery / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To anatomically reconstruct the oculomotor nerve, trochlear nerve, and abducent nerve by skull base surgery.</p><p><b>METHODS</b>Seventeen cranial nerves (three oculomotor nerves, eight trochlear nerves and six abducent nerves) were injured and anatomically reconstructed in thirteen skull base operations during a period from 1994 to 2000. Repair techniques included end-to-end neurosuture or fibrin glue adhesion, graft neurosuture or fibrin glue adhesion. The relationships between repair techniques and functional recovery and the related factors were analyzed.</p><p><b>RESULTS</b>Functional recovery began from 3 to 8 months after surgery. During a follow-up period of 4 months to 6 years, complete recovery of function was observed in 6 trochlear nerves (75%) and 4 abducent nerves (67%), while partial functional recovery was observed in the other cranial nerves including 2 trochlear nerves, 2 abducent nerves, and 3 oculomotor nerves.</p><p><b>CONCLUSIONS</b>Complete or partial functional recovery could be expected after anatomical neurotization of an injured oculomotor, trochlear or abducent nerve. Our study demonstrated that, in terms of functional recovery, trochlear and abducent nerves are more responsive than oculomotor nerves, and that end-to-end reconstruction is more efficient than graft reconstruction. These results encourage us to perform reconstruction for a separated cranial nerve as often as possible during skull base surgery.</p>