Congenital bilateral perisylvian syndrome: familial occurrence, clinical and psycholinguistic aspects correlated with MRI.

OBJECTIVE: Congenital bilateral perisylvian syndrome (CBPS) is frequently caused by polymicrogyria (PMG). The aim of this study was to correlate the clinical and psycholinguistic aspects with neuroradiological data of patients with CBPS. METHODS: Thirty-one patients were studied. We performed a clinical investigation of the patients and their families, including MRI scanning, neuropsychological tests and language evaluation. RESULTS: The statistical analysis showed that: a) prenatal events are associated with the non-familial type of PMG; b) diffuse PMG is associated with pseudobulbar signs, as opposed to BPPP; c) motor deficit is associated with diffuse PMG; d) epilepsy is equally present in patients with both familial or non-familial PMG, but is more frequently seen in patients with diffuse PMG; e) dyslexia and SLI can be a feature of both the diffuse or BPPP, and either familial or sporadic cases of PMG. CONCLUSIONS: The severity of clinical manifestations in CBPS is correlated with the extent of cortical involvement. Most patients with CBPS have a history of speech delay or language difficulties and no epilepsy. Dyslexia can be found in patients with PMG.

Magnetic resonance imaging of the gallbladder: spectrum of abnormalities.

Various pathologies involving the gallbladder can manifest clinically, producing nonspecific clinical symptoms and making diagnosis difficult and challenging. Real-time sonography is the most widely used diagnostic study for the gallbladder and the primary screening examination of choice. With increasing use of magnetic resonance imaging (MRI) and MR cholangiopancreatography (MRCP), gallbladder pathology is frequently seen. Understanding the basic patterns of various disease manifestations and appearance on MRI is the key to making an accurate diagnosis. Given its inherent tissue contrast and contrast sensitivity, MRI in conjunction with MRCP can be a very valuable test in evaluating gallbladder pathology. Gallbladder pathology can be classified into congenital (such as absence), inflammatory (acute, hemorrhagic, and chronic cholecystitis), traumatic, benign (polyps) and malignant tumors (gallbladder carcinoma and lymphoma), and other disease processes can be seen in cholelithiasis, cholesterosis, thickened gallbladder wall, and Mirrizzi syndrome.

Deformation and fracture of RaCe and K3 endodontic instruments according to the number of uses.

AIM: To evaluate, by scanning electron microscopy, the deformation and fracture of NiTi RaCe and K3 size 25, 0.04 taper instruments. METHODOLOGY: Ten sets of instruments from RaCe and K3 NiTi rotary systems were used to prepare 100 simulated canals in epoxy resin blocks with 20 or 40 degree curvatures beginning 8 or 12 mm from the orifice. Each instrument set was used to prepare five simulated canals using a crowndown technique. The size 25, 0.04 taper instruments were analysed by SEM when new and again after each use. Three observers scored images of the instruments after each use for distortion of the spirals (no distortion, distortion of one spiral or distortion of more than one spiral), wear (no wear, small, moderate or severe wear) and fracture (yes or no). Two-way anova was used to analyse differences between instruments for distortion and wear; Fisher's exact test looked for differences related to fracture of instruments. RESULTS: No fractures occurred with K3 instruments, whereas six RaCe instruments fractured (P = 0.005). A statistically significant difference occurred between RaCe and K3 instruments in terms of distortion of spirals and surface wear (P < 0.001). Distortion of spirals and wear increased with progressive use of RaCe instruments, whereas K3 instruments remained relatively undamaged after their fifth use. The simulated canals with smaller radii of curvature were positively associated with fracture of RaCe instruments. CONCLUSIONS: A significant difference was found between RaCe and K3 in terms of deformation and fracture of size 25, 0.04 taper instruments; K3 instruments had more favourable results.

Utility of 3D magnetic resonance imaging in preoperative evaluation of hepatobiliary diseases.

Three-dimensional (3D) imaging is playing an increasingly important role in modern diagnostic radiology. The recent improvements in magnetic resonance (MR) hardware, scanning protocols and 3D volumetric reconstruction software have facilitated great expansion of the role of 3D imaging for use in hepatobiliary surgery. In this review, we address the various 3D reconstruction techniques used in MRI and demonstrate the value of 3D imaging in preoperative evaluation of hepatobiliary diseases.

Antihypertensive, vasodilator and antioxidant effects of a vinifera grape skin extract.

Cumulative evidence suggests that moderate wine consumption exerts a cardioprotective effect. We investigated the occurrence of an antihypertensive effect of an alcohol-free hydroalcoholic grape skin extract (GSE) obtained from skins of a vinifera grape (Vitis labrusca) in experimental rodent hypertension models. The vasodilator effect of GSE (polyphenols concentration 55.5 mg g(-1)) was also assessed in the isolated mesenteric vascular bed of Wistar rats and the antioxidant effect was studied on lipid peroxidation of hepatic microsomes. Oral administration of GSE significantly reduced systolic, mean and diastolic arterial pressure in Wistar rats with desoxycorticosterone acetate-salt and N(G)-nitro-L-arginine methyl ester (L-NAME) induced experimental hypertension. In the rat isolated mesenteric vascular bed pre-contracted with norepinephrine, bolus injections of GSE induced endothelium-dependent vasodilatation that was substantially inhibited by L-NAME, but not by indometacin, tetraethylammonium or glibenclamide. Lipid peroxidation of hepatic microsomes estimated as malondialdehyde production was concentration-dependently inhibited by GSE. In conclusion, the antihypertensive effect of GSE might be owing to a combination of vasodilator and antioxidant actions of GSE. These findings also suggest that the beneficial effect of moderate red wine consumption could be owing to an antihypertensive action induced by compounds occurring in the skin of vinifera grapes.

Perfil do câncer gástrico no Hospital das Clínicas da Universidade Federal de Pernambuco / Profile of gastric cancer at the University Hospital of the Federal University of Pernambuco

A partir de um estudo retrospectivo realizado no Serviço de Endoscopia do Hospital das Clínicas-UFPE, em 10.230 exames de endoscopia digestiva alta efetuados nos anos de 91, 92 e 93 foram diagnosticados 60 casos de adenocarcinoma gástrico, resultando em incidência de 0,58 por cento da amostra. Os 60 casos estudados mostram dados rigorosamente semelhantes aos publicados na literatura mundial quanto aos aspectos epidemiológicos (idade e sexo), clínicos (dor em abdome superior, perda de peso, etc.) e localizaçao da lesao (antro e corpo). Por outro lado, encontramos baixíssimo índice de diagnóstico de câncer precoce (1,6 por cento) e elevada incidência do tipo histológico difuso (46 por cento), indiferenciado. Noventa por cento das lesoes eram Bormann III e IV. Esses três fatos podem estar relacionados com baixa suspeiçao em relaçao às lesoes precoces e/ou precursoras ou ainda a comportamento biológico mais agressivo do adenocarcinoma em nossa regiao, incluindo aí fatores ambientais diferenciados quando comparados com outras áreas de elevada incidência.

Toxicity of amphotericin B to analbuminemic rats.

Nagase analbuminemic rats (NAR), a strain derived from Sprague Dawley rats (SDR), are suitable to determine the in vivo effect of hyperlipidemia and analbuminemia on the toxicity of the antifungal agent amphotericin B (AB). Cholesterol content was increased in all plasma lipoprotein fractions when SDR serum was compared with NAR serum. Incubation of AB with plasma from animals of both strains and further isolation of plasma lipoprotein by ultracentrifugation, showed that, while in SDR approximately 40% of the injected AB was in the lipoprotein fraction, in NAR almost all (approximately 80%) AB was associated with lipoproteins, especially in the low density lipoprotein fraction. AB spectrophotometry showed differences in the extent of AB aggregation between SDR and NAR plasma fractions. The lack of albumin results in aggregation of the AB present in the infranatant fraction. In vivo, a strong reduction in lethality was observed for NAR when compared to SDR (LD 50% of 6.4 and 1.9 mg/kg respectively). The preferential distribution of AB in the plasma lipoprotein fraction seems to affect pharmacological parameters, with a consequent reduction of toxicity.

Effect of a proteinase inhibitor from the plasma of Bothrops jararaca on coagulant and myotoxic activities of Bothrops venoms.

A proteinase inhibitor purified from the plasma of Bothrops jararaca was tested for the neutralization of total blood clotting activity, prothrombin activating factor and thrombin-like activity of B. jararaca venom and also myotoxic activity of B. jararacussu venom. This inhibitor was also tested for neutralization of the lethality induced by the venom of B. jararaca and B. jararacussu. The inhibitor markedly reduced the total blood clotting activity (95%) and the prothrombin activating factor (98%), and partially decreased the thrombin-like activity of B. jararaca venom. The proteinase inhibitor failed to neutralize the myotoxic activity of B. jararacussu. Lethality induced by the venom of B. jararaca in mice was inhibited by the proteinase inhibitor, whereas the protection on B. jararacussu venom was only partial. These results show that the proteinase inhibitor purified from the plasma of B. jararaca inhibits different proteinases but not myotoxins of Bothrops venoms, and consequently neutralizes the toxic effect due to these proteins.

Immunoenzymatic assay of anti-diphtheric toxin antibodies in human serum.

An enzyme-linked immunosorbent assay was developed for measuring immunoglobulin G anti-diphtheric toxin antibodies in human serum. The assay was done in plastic plates coated with purified diphtheric toxoid. Since a straight-line relationship was found between logs of extinction values and of antibody concentrations, with a very constant slope, serum titers could be expressed as log10 of the serum dilution corresponding to a definite optical density, such as 0.5. The assay furnished highly reproducible titers on a continuous range, with coefficients of variation less than 10%. Only one or two serum dilutions were usually sufficient for serum titration. To establish correspondence of the enzyme-linked immunosorbent assay titers with biologically determined antitoxin international units, a regression equation was fitted between the respective values for 112 serum samples titrated in both tests. The enzyme-linked immunosorbent assay titer of 2.38 corresponded to an antitoxin titer of 0.01 U, which is considered as the minimal protective level. Simple to perform, economical, and precise, the immunoenzymatic assay seems to be a very practical procedure for seroepidemiological purposes.

Quantificacao de anticorpos diftericos em cobaias. I. Persistencia do titulo de anticorpos sericos em animais inoculados com uma dose de toxoide difterico. / Qualification of diphtheria antibodies in guinea pigs. I. Persistence of serum antibodies level in animals inoculated with a dose of diphtheria toxoid

Foi estudado o comportamento da cinetica de anticorpogenese em cobaias inoculadas com uma dose de toxoide difterico precipitado pelo alumen. Paralelamente, foi estudada a dinamica da imunidade passiva naturalmente transmitida aos filhotes. Em cobaias vacinadas com uma dose de antigeno, foi verificado que a sintese de antitoxina difterica persiste, em titulos detectaveis, ate 36 meses apos. Os anticorpos transferidos, passivamente, da mae vacinada para os filhotes atingiram nestes,concentracoes plasmaticas superiores, sendo que a imunidade perdurou em titulos detectaveis ate cerca de tres meses de idade dos mesmos

Meduloepitelioma clinicamente manifesto em adulto como tumor epibulbar. / Medulloepithelioma clinically presented in adult as epibulbar tumor

E relatado um caso de meduloepitelioma ocorrendo em individuo adulto, clinicamente manifesto como um tumor epibulbar. Os autores tecem comentarios acerca da conceituacao da neoplasia, nomenclatura, aspectos clinicos e histopatologicos e chamam a atencao para a raridade de tal manifestacao clinica deste tumor