[Use of botulin toxin in the treatment of diffuse esophageal spasm. A case report]. / Emprego da toxina botulínica no tratamento do espasmo difuso esofagiano. Relato de caso.

The diffuse esophageal spasm distinguishes from others esophageal disturbs by the symptoms severity and bad results to conservative treatment. This situation requires formal indication to surgical treatment or dilation. In high risk patients this situation becomes a big problem, due to the lack of another therapeutic option. In a patient with this problem we use an endoscopic injection of botulin toxin in cardia with good results in three months follow-up. Despite this short period of observation we believe that the infiltration with botulin toxin in cardia constitutes a valid therapeutic option in treatment of diffuse esophageal spasm.

[Experimental surgery of the facial nerve. Evaluation of the intraperitoneal use of exogenous gangliosides]. / Chirurgie expérimentale du nerf facial. Evaluation de l'utilisation intrapéritonéale des gangliosides.

Compression and section of the facial nerve were performed in 48 rats in order to study the anatomopathological alterations occurring after daily intraperitoneal injections of 100 mg of exogenous gangliosides (Sinaxial) for 45, 90, 180 days. In groups submitted to nerve compression, the histopathological changes were discrete and in the 180-day subgroups the nerve was practically normal. In animals submitted to section and neurorrhaphy there was formation of an amputation neuroma, a granuloma around the suture, axonal unstructuration and inter and perineural fibrosis. No significant differences were observed between the groups submitted or not to injection of exogenous gangliosides, indicating that the major factors involved in the quality of nerve regeneration were the technique and the formation of fibrosis and of an amputation neuroma.

Tirotoxicose endogena no decurso de terapeutica de bocio difuso atoxico com hormonio tiroidiano. Relato de caso e revisao da literatura. / Endogenous thyrotoxicosis on the course of nontoxic diffuse goiter treatment with thyroid hormone. A case report and review of the literature

Os autores descrevem paciente de 49 anos, branca, com bocio atoxico de longa duracao, que na vigencia de terapeutica com hormonio tiroidiano desenvolveu hipertiroidismo, com aumento do bocio. O hormonio tiroidiano foi tratada com 10mCi de 131 I. Como a melhora clinica foi discreta, foi introduzido propiltiouracil, com o que a paciente alcancou eutiroidismo. Apos 10 meses o PTU foi interrompido e a paciente permaneceu eutiroidea. A biopsia percutanea da tiroide mostrou bocio difuso atoxico, sem evidencias de tiroidite de Hashimoto. Os autores, apos discutirem varias hipoteses, concluem que, no presente caso, o bocio difuso atoxico provavelmente foi manifestacao inicial da doenca de Graves