Axonal quantification of the white matter association fasciculi in cerebral hemispheres of cow (Bos taurus), pig (Sus scrofa domesticus) and rabbit (Oryctolagus cuniculus).

BACKGROUND: Cerebral white matter consists mainly of axons surrounded by myelin sheaths, which are grouped to form association, commissural, and projection fasciculi. The aim of our work was to quantify and compare under the microscope the axons of the white matter association fasciculi in the cerebral hemispheres of cow (Bos taurus), pig (Sus scrofa domesticus) and rabbit (Oryctolagus cuniculus) indirectly by identification of their myelin sheaths. MATERIALS AND METHODS: The samples were taken from 30 cerebral hemispheres: 10 cow, 10 pig and 10 rabbit (15 right and 15 left). They were obtained following a protocol based on the Talairach-Tournoux coordinate system for human and primate brains. The slides were stained with Luxol Fast Blue, observed by optical microscopy, and photographed at 600×. Samples were also prepared for observation in scanning transmission electron microscopy with osmium tetroxide. The myelin sheaths/axons were counted with the ImageJ software. RESULTS: Statistically significant differences in the number of myelin sheaths per 410 µm² were found in the inferior and superior longitudinal fasciculi between the left and right hemispheres of cows, with predominance of the right hemisphere; and in the inferior occipitofrontal fasciculus of the rabbit with predominance of the left hemisphere. CONCLUSIONS: The use of animal models for experiments in the cerebral fasciculi, especially pig, could give us a greater understanding of the behaviour of demyelinating and neurodegenerative diseases in humans.

Angiotomografía de la arteria cística en preoperatorio y comorbilidad en colecistectomía laparoscópica por colelitiasis / Angiotomography of the cystic artery in preoperative and comorbidity in laparoscopic cholecystectomy for cholelithiasis

La colecistectomía laparoscópica es el tratamiento de elección de la colelitiasis; sin embargo, se acompaña de comorbilidades y no está exenta de complicaciones mayores que pueden ser letales; la identificación del trígono cistohepático con disección y ligadura de la arteria cística son pasos obligatorios de la cirugía; la identificación de las variaciones de la arteria cística y los conductos biliares pueden minimizar las eventuales complicaciones. Al protocolo preoperatorio se implementó una angiotomografía con Tomógrafo Siemens Somatón Sensation ® de 64 cortes para identificar la arteria cística en pacientes con colelitiasis de la Unidad de Cirugía General del Hospital de Especialidades Teodoro Maldonado Carbo IESS de Guayaquil. Se escogieron 60 pacientes femeninos en forma aleatoria (edades 19-70 años, promedio 44,25 años) y la muestra se dividió en dos grupos de 30; al grupo estudio se aplicó angiotomografía hasta un mes antes de la cirugía y al grupo control se le aplicó el protocolo convencional. Se evaluó morbilidades relacionadas con: hemorragia operatoria por lesión de la arteria cística y en el posoperatorio: infección de herida operatoria, íleo y drenaje. La angiotomografía permitió identificar la arteria cística en el preoperatorio y contribuyó a disminuir comorbilidades que acompañan a la colecistectomía laparoscópica.

Laparoscopic cholecystectomy is the treatment of cholelithiasis of choice; however, it is accompanied by comorbidities and is not exempt from major complications that can be lethal; the identification of the cystohepatic trigone with dissection and ligation of the cystic artery are mandatory steps of surgery; the identification of the variations of the cystic artery and the bile ducts can minimize the possible complications. The preoperative protocol was implemented with an angiotomography with Siemens Somatón Sensation ® 64-slice Tomograph to identify the cystic artery in patients with cholelithiasis of the General Surgery Unit of the Teodoro Maldonado Carbo IESS Specialty Hospital of Guayaquil. 60 female patients were chosen at random (ages 19 -70 years, average 44.25 years) and the sample was divided into two groups of 30; Angiotomography was applied to the study group up to one month before surgery and the conventional protocol was applied to the control group. Morbidities related to: operative haemorrhage due to cystic artery and postoperative injury: operative wound infection, ileus and drainage were evaluated. Angiotomography allowed to identify the cystic artery in the preoperative period and contributed to decrease comorbidities that accompany laparoscopic cholecystectomy.

Overview of nuclear bodies and their classification in the Terminologia Histologica.

BACKGROUND: Nuclear bodies (NB) are membrane-less subnuclear organelles that perform important functions in the cell, such as transcription, RNA splicing, processing and transport of ribosomal pre-RNA, epigenetic regulation, and others. The aim of the work was to analyse the classification of NB in the Terminologia Histologica (TH) and biological and bibliographical databases. MATERIALS AND METHODS: The semantic structure of the Nucleoplasm section in the TH was analysed and unsystematic bibliographical search was made in the PubMed, SciELO, EMBASE databases and European Bioinformatics Institute (EMBL-EBI) biology database to identify which structures are classified as NB. RESULTS: It was found that the terms Corpusculum convolutum, Macula interchromatinea and Corpusculum PML are not correctly classified in the TH, since they are subordinated under the term Chromatinum and not under Corpusculum nucleare. The bibliography consulted showed that 100%, 92.6% and 81.5% of articles mentioned Corpusculum convolutum, Macula interchromatinea and Corpusculum PML, respectively as nuclear bodies. CONCLUSIONS: It is suggested to relocate the terms Corpusculum convolutum, Macula interchromatinea and Corpusculum PML with the name of Corpusculum nucleare and the incorporation of two new entities to the Histological Terminology according to the information collected: paraspeckles and histone locus body.

Temporomandibular joint arthrocentesis in a rabbit model: technique and recommendations in the study of temporomandibular disorders.

INTRODUCTION: Arthrocentesis has been used in the temporomandibular joint (TMJ) to analyze components of the synovial fluid or as a therapeutic procedure associated or not with the administration of a drug. The rabbit is one of the most commonly used animal species as a model for pathologies that affect the TMJ. The aim of this study was to propose a specific technique to perform arthrocentesis on the rabbit TMJ, emphasizing descriptions of reference points and measurements for a successful puncture without complications. MATERIALS AND METHODS: Fourteen adult rabbits (Oryctolagus cuniculus) were used. The project was approved by the Scientific Ethics Committee of the Universidad de La Frontera (File Nº083/2016). RESULTS: The description of the technique was divided into three steps: 1) Location of the rabbit TMJ, 2) Positioning of the needles in the TMJ, and 3) Passage of fluid through the TMJ. CONCLUSIONS: This arthrocentesis technique could help to simplify the procedure and give the investigator a guide for joint washing and extraction of synovial fluid in the rabbit TMJ.

Histomorphometrics and quantitative unbiased stereology in canine uteri treated with medroxyprogesterone acetate.

This article describes the effects of MPA use on the canine uterus using stereological methods. Entire reproductive tracts were removed from normal healthy canine bitches (Canis lupus familiaris) and grouped as: nulliparous (n = 11), multiparous (n = 11) and MPA-treated (n = 11; nulliparous; two treatments; 5 mg/kg). 1 cm samples were cut from the corpus, horn and uterine tube and fixed in 10% formaldehyde. Sections of each were mounted on slides and stained with hematoxylin-eosin. We assessed the fraction area for components of endometrium and myometrium and VV (volume density) and SV (surface density) of the gland and stroma using the M36 test system provided by the STEPanizer Stereological Tool. No gross histological differences were observed between study groups in the uterine tube, uterine corpus and horn. The wall of the uterine corpus and horn in MPA-treated bitches was characterized as being thicker than in the other groups. A cross-section of the uterine corpus revealed no differences between components of uterine wall in the corpus and horn; however, differences were observed in the volume density [VV; %] in variables such as: VV[str.vasc/uterus] (nulliparous vs. multiparous; p = 0.0019) and VV[str.supravasc/uterus] (multiparous vs. nulliparous and MPA; p = 0.0035). In the endometrial gland, differences were detected in SV[gland/endom] (multiparous vs. MPA, p = 0.0442). In the uterine horn, differences were only observed in the variable VV[lumen.gland/endom] (multiparous vs. MPA; p = 0.0019). This study shows quantitative changes in the architecture of the endometrium and myometrium in all the uterine segments, mainly morphological endometrial gland changes of the uterine corpus, increasing the surface area per unit of volume; however, these changes usually do not differ quantitatively from those observed in the uterus of multiparous bitches.

Histomorphometric analysis of unilateral condylar hyperplasia in the temporomandibular joint: the value of the condylar layer and cartilage island.

This study aimed to describe the condylar layer and cartilage island in subjects with unilateral condylar hyperplasia (UCH). Five individuals (15-18 years old) with a diagnosis of UCH, treated in a university hospital in Temuco, Chile, were included. The analysis examined the presence, extension, and thickness of the layers on the condylar surface, the number, depth, and area of the cartilage islands, and the argyrophilic proteins of the nucleolar organizer region (AgNOR) score. Statistical significance was set at P<0.05. The fibrocartilaginous layer was thickest (0.13±0.05mm) and the joint layer was thinnest (0.07±0.01mm) (P<0.05). With respect to the number, depth, and area of the islands, case 1 presented the highest values, followed by case 2; the cartilage island was related to the fibrocartilaginous layer (P<0.05). All cases had AgNOR proteins in the proliferative and fibrocartilaginous layers, as well as the islands with the greatest presence of chondrocytes (P=0.245). A relationship was observed between the histopathological alterations in the different layers on the condylar surface and the thickness of the fibrocartilaginous layer, as well as the thickness of the latter and the number, depth, and area of the cartilage islands in the trabecular bone.

Histopathological analysis of unilateral condylar hyperplasia: difficulties in diagnosis and characterization of the disease.

The aim of this study was to perform a histological analysis of the conditions in patients undergoing surgery for unilateral condylar hyperplasia (UCH) using different histopathological analytical techniques and to describe the complications and existing controversy in order to better define the disease. A partial condylectomy was performed in five patients who had been diagnosed with UCH using clinical and imaging methods. The samples obtained were analyzed using routine histological techniques including haematoxylin-eosin, Van Gieson, picrosirius, alcian blue/haematoxylin-eosin, and AgNOR staining. The analyses were performed by an observer who was blinded to the clinical parameters of the disease. The cellularity, tissue layers, size of the anatomical structures, and the relationships between them were assessed. The analysis of these patients was complemented by a review of the scientific literature. Variability was observed in the analysis of the cases. The presence of connective tissue was detected at the bone level, with cartilage formation at different levels. Each island presented levels of involvement that could indicate various degrees of aggressiveness. Type I collagen was observed in most cases, although type III was also identified. The development of histological diagnostic methods to determine the aggressiveness or level of involvement in UCH is not currently possible. Further studies are needed to establish new histological classifications.

Uso del combitube en anestesia general: evaluación cardio-respiratoria / Use of combitube in general anestesia: cardiorespiratory evaluation

La intubación endotraqueal bajo laringoscopia directa continúa siendo la técnica de elección para el control de la vía aérea, sin embargo su realización exitosa no es siempre posible, por lo que nuevos dispositivos han surgido como alternativas en los últimos años. En el trabajo se evalua la eficacia del combitube en anestesia general.Se realizó un estudio comparativo entre el combitube y el tubo endotraqueal en anestesia general. Se seleccionaron 60 pacientes ASA I para cirugía electiva, divididos aleatoriamente en 2 grupos de 30 cada uno. Se Compararon con ambos dispositivos la respuesta cardiovascular inmediata y a los 5 minutos de colocado, además del comportamiento de los gases sanguíneos durante el transoperatorio. La respuesta cardiovascular inmediata con el combitube se asoció a cifras tensionales sistólicas, diastólicas y de frecuencia cardíaca (139,16 ± 17,52 mmHg; 91,33 ± 11,95 mmHg y 89,50 ± 13,50 lpm) significativamente menores respecto al tubo endotraqueal (151,00 ± 18,81 mmHg; 99,66 ± 11,59 mmHg y 103,30 ± 14,45 lpm). A los 5 minutos de colocados las cifras tensionales no mostraron diferencias entre los grupos, pero la frecuencia cardíaca continuó significativamente menor con el combitube (GII: 83,80 ± 11,63 lpm) (GI: 92,73 ± 13,55 lpm). Los valores hemogasométricos fueron normales en ambos grupos, aunque las cifras de PaCO2 con el combitube fueron significativamente superiores (GII: 38,51 ± 2,26 mmHg) (GI: 36,49 ± 1,81 mmHg). No hubo complicaciones en ningún grupo. Concluimos que el combitube es un dispositivo alternativo eficaz para el manejo de la vía aérea en anestesia general(AU)

Innervation of the abductor digiti minimi muscle of the human foot: anatomical basis of the entrapment of the abductor digiti minimi nerve.

The origin, relationships and innervation of the abductor digiti minimi muscle were determined in 145 human feet, from formaldehyde-fixed cadavers. The muscle arises from both processes of the calcaneal tuberosity, from the plantar aponeurosis and from the septum which separates it from the flexor digitorum brevis muscle. The nerve to the abductor digiti minimi muscle arises next to the origin of the lateral plantar nerve, close to the abductor hallucis muscle, and descends becoming closely related to the medial face of the calcaneus and the deep face of the abductor hallucis muscle. Then, it passes inferiorly through the origin of the quadratus plantae muscle and later divides into two branches for the two heads of the muscle.

Biometric study of the relationships between palmar neurovascular structures, the flexor retinaculum and the distal wrist crease.

During surgical exposure of the carpal tunnel it is possible to injure the neurovascular structures closely related to the flexor retinaculum, such as the superficial palmar arch and the communicating branch between the ulnar and median nerves. Because of the importance of these structures and with the purpose of increasing knowledge of anatomical details concerning to their location, a biometric study was performed on the retinaculum and the communicating branch, and between the communicating branch and the distal wrist crease, as well as between the retinaculum and the superficial palmar arch. We dissected 56 hands from 28 Brazilian formalin-preserved cadavers of both sexes (24 male) at the Federal University of São Paulo-Escola Paulista de Medicina, Brazil. The communicating branch was observed in 96.4% of cases and the superficial palmar arch in 78.6%. The communicating branch was found between the common palmar digital nerve of the 4th interosseous space (from the ulnar nerve) to the homonymous nerve of the 3rd interosseous space (from the median nerve). In males, the distance between the distal wrist crease and the site where the communicating branch originates from the ulnar component had an average of 33.9 +/- 5.5 mm on the right side and 30.2 +/- 8.2 mm on the left. The distance between the distal wrist crease and the junction of the communicating branch with the common palmar digital nerve of the 3rd interosseous space was 43.6 +/- 6.9 mm on the right and 40.2 +/- 6.2 mm on the left side. Conversely, in 14.8% of cases (1 female), the communicating branch was observed to emerge from the common palmar digital nerve of the 3rd interosseous space. The distance between the retinaculum and the superficial palmar arch in the axial line of the 4th metacarpal bone was on average 7.3 +/- 4.3 mm on the right and 8.3 +/- 3.5 mm on the left side. At the same level, the distance between the retinaculum and the communicating branch was 6.2 +/- 3.7 mm on the right side and 5.1 +/- 2.8 mm on the left. These results can be used as a reference during surgical procedures in the palmar region.

Anatomical relationships between the deep palmar arch and the deep branch of the ulnar nerve.

The relationship between the deep palmar arch (DPA) and the deep branch of the ulnar nerve (dbUN) was analysed in 60 hands from 30 formaldehyde treated cadavers of adult individuals, of both sexes, with age ranging from 21 to 70 years, in the Division of Descriptive and Topographic Anatomy of the Federal University of São Paulo (UNIFESP). The arteries were injected with neoprene latex and dissections were performed under a magnifying glass. DPA was ventral to dbUN in 50% of the cases (type I) and dorsal in 45% (type). In type I dbUN crossed the arterial arch at the following levels: in the 4th interosseous space in 17.9% of the cases, in the 3rd interosseous space in 21.4% and in the 3rd metacarpal bone in 39.3%. In type II dbUN crossed the arterial arch in the 4th metacarpal bone in 25.9% and in the 3rd intersseous space in 37%. The relationship between the nerve and the palmar metacarpal arteries was also studied. The data obtained may be of practical use in the surgery of the palmar region.

Abnormal course of the superficial palmar branch of the radial artery.

The structures in the carpal tunnel are the flexor muscle tendons and their sheaths and the median n. Due to the inflexibility of its walls, any swelling of its contents that produces decrease of its volume, may compress the median n. There are many possible causes of nerve compression, such as the presence of arteries in this tunnel [3, 13]. The carpal tunnels of 70 hands of 35 adult cadavers of both sexes, whose age ranged from 23 to 77 years, were studied by dissection. An abnormal course of the superficial palmar branch of the radial a. was found in 2 hands (2.85%). This vascular branch passed through the carpal tunnel. This unusual course of the superficial palmar branch of the radial a. is described with details correlating its presence in the carpal tunnel with the median n.

[Cefminox versus cefotaxime in the treatment of complicated urinary tract infection]. / Cefminox versus cefotaxima en el tratamiento de la infección urinaria complicada.

A comparative study of Cefminox, a new cefamicin, and Cefotaxime was conducted to evaluate the efficacy and safety of the former in the treatment of complicated urinary infection, and to correlate in both cases the bacteriological response with isolates MICs. To this end a phase III, randomized, blind and controlled clinical trial was conducted in 22 patients who met the study's preestablished criteria, 19 of which were evaluable. Both treatments achieved 100% clinical efficacy, while microbiological eradication was accomplished in 90.9% patients treated with Cefminox and 75% patients who received the comparator. Cefminox shows greater in vivo activity than that expected for the MICs, excellent efficacy and safety.

Distribution patterns of the muscular branch of the median nerve in the thenar region.

Studies on the distribution patterns of the muscular branch of the median nerve to the thenar muscles are scarce. Available accounts give only general descriptions. To establish the distribution pattern more precisely, we dissected 60 palmar regions from 30 cadavers of adult individuals, ranging in age from 23 to 77 y. The distribution pattern of the muscular branch was classified into 3 types. In 50% of subjects there were branches to the superficial head of flexor pollicis brevis (FPB), abductor pollicis brevis (APB) and opponens pollicis (OP) (type I). In 40% there were branches only to APB and OP (type II). In the remainder (type III) the muscular branch provided independent branches to APB, OP and FPB, to APB and OP, or to APB and FPB, after dividing precociously. Types I and II were further subdivided according to the site, direction and number of the individual branches.

[The accessory soleus muscle: 2 cases]. / El musculo soleo accessorio: 2 casos.

The accessory soleus muscle is infrequently found; no reports of it are available in South American literature. It is found between the tibia and the soleus muscle in the distal leg. It may be misdiagnosed as a hemangioma, lipoma or sarcoma. It may be the cause of functional disorder such as varus or equino-varus. Among 254 dissections performed in young adults of both sexes and different ethnic origin we found only 2 accessory soleus muscles, both in males. One originated from the soleus muscle and was inserted in the superior aspect of the "calcaneo", in front of the "tendon calcaneo". The other originated from the anterior fascia of the soleus muscle and was inserted on the medial aspect of the "calcaneo". The clinical significance of the accessory soleus muscle is related to the presence of pain or functional disorders.

[Metopism in Brazilians]. / Metopismo no indivíduo brasileiro.

The authors studied 400 dry skulls of adult Brazilian individual (135 females and 265 males) beloging to the collections of the laboratories of Descriptive and Topographic Anatomy of the São Paulo School of Medicine and the Medical School of the University of São Paulo. Metopism was observed in 11 skulls (2.75%, 4 females and 7 males). Incomplete metopic suture was present in 115 skulls (28.75%, 27 females and 88 males). The form of metopic suture was mainly linear (64.35%). The presence of metopism must be remembered, for instance, in skull fractures.