Importância do raciocínio etiológico e topográfico de lesões: relato de neuropatia óptica traumática conduzida como acidente vascular cerebral / Importance of etiological and topographic injury reactions: report of a traumatic optic neuropathy conducted as a cerebrovascular accident

Introdução: O trauma ocular ou periocular pode afetar o nervo óptico e causar baixa acuidade visual ou alteração de campo visual. Essa lesão, denominada neuropatia óptica, quando de etiologia traumática, pode ser classificada como direta, através da compressão, perfuração ou laceração do nervo óptico por ação de corpos estranhos, fraturas do assoalho da órbita ou hemorragias, e indireta, quando a partir de um trauma externo ao globo ocular há lesão por transmissão da onda de choque ou desaceleração, levando à lesão do nervo óptico pelo estiramento de suas fibras ou edema comprometendo sua vascularização, comum nos acidentes automobilísticos e nas quedas. Descrição do Caso: O presente estudo objetiva relatar um caso de neuropatia óptica traumática conduzida erroneamente como acidente vascular cerebral em uma paciente do sexo feminino de 29 anos, com história de queda da própria altura. Discussão: A investigação feita pela história clínica, evolução do quadro e novos achados fundoscópicos permitiu o diagnóstico correto e melhor orientação da paciente. Conclusão: O conhecimento da neuropatia óptica traumática e da anatomia da via óptica têm extrema importância no raciocínio topográfico e etiológico das lesões traumáticas que cursam com comprometimento visual, poupando o paciente de possíveis intervenções invasivas e desnecessárias (AU)

Introduction: Eye or periocular trauma can affect the optic nerve and cause low visual acuity or visual field alteration. This lesion, called optic neuropathy, when of traumatic etiology, can be classified as direct, through compression, perforation or laceration of the optic nerve by action of foreign bodies, fractures of the orbit floor or hemorrhages, and indirect, when from an external trauma to the eyeball there is injury by transmission of the shock wave or deceleration, leading to optic nerve injury by stretching its fibers or edema compromising its vascularization, common in automobile accidents and falls. Case Report: The present study aims to describe a case of traumatic optic neuropathy mistakenly conducted as a stroke in a 29-yearold female patient with a history of falling from his own height. Discussion: The investigation was possible because of the clinical history, evolution of the condition and new fundoscopic findings that allowed the correct diagnosis and better orientation of the patient. Conclusion: Knowledge of traumatic optic neuropathy and anatomy of the optical pathway have extreme importance in the topographic and etiological reasoning of traumatic lesions that present with visual impairment, saving the patient from possible interventions invasive and unnecessary. (AU)

A concise survey on 3D modeling in the science of anatomy.

This report provides a concise overview of the rendering and utilization of three-dimensional models in the field of anatomy. Anatomical three-dimensional virtual models are widely used for educational purposes, preoperative planning, and surgical simulations because they simply allow for interactive three-dimensional navigation across the human organs or entire body. Virtual three-dimensional models have been recently fabricated as accurate replicas of the anatomical structures thanks to advances in rapid prototyping technology.

Marcello Malpighi (1628-1694): Pioneer of microscopic anatomy and exponent of the scientific revolution of the 17th Century

Marcello Malpighi (1628-1694) was an Italian anatomist and an eminent scientist who significantly contributed to the advancement of the anatomical sciences in the 17th century. Malpighi was one of the first to use the compound microscope (an instrument designed by Galileo in 1609) and made the most important discovery of his life in 1661 when he identified capillaries as connecting vessels between small arteries and veins in the lungs. Malpighi thus provided the missing link in William Harvey's theory of blood circulation. He made significant contributions in the field of embryology based on his observations on chick embryo, and his efforts provided deep insights into the development of the heart and the nervous system. His communications based on microscopic studies scripted valuable details on the structural organization of organs like the liver, kidney and spleen. He identified the hepatic lobule as the fundamental unit of the liver and noted that bile was being secreted by these lobules and not from the gall bladder (the popular belief then). In the kidney he discovered the glomerulus (Malpighian Corpuscle), and was the first to observe the convoluted tubules in the renal cortex. He was the first to describe the presence of lymphatic bodies (Malpighi's Corpuscle) in the spleen. Although he was exceedingly successful in his scientific activities, his life was fraught with unfortunate events and savage criticism from detractors arising out of professional jealousy and personal feuds. Nevertheless his exploits were instrumental in understanding the human microscopic anatomy (histology) and his accomplishments have etched his name in the pages of medical science forever

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Tips for studies with quantitative morphology (morphometry and stereology) / Consejos para los estudios de morfología cuantitativa (morfometría y estereología)

SUMMARY: The quantitative morphology contributes to making the studies less subjective and reproducible. Quantitative results are analyzed with statistics and should be based on a well-defined sample. Quantitative variables can be 'continuous' or 'discrete.' In this text, the term 'morphometry' is used to design a simpler procedure for measuring structures with a 'ruler.' The term 'stereology' is used in estimating quantities in the 3-dimensional space analyzing 2-D cut sections. Correction factors may be necessary for the retraction and compression of the tissues. In histological sections, the 'caps' of the objects that have been sectioned tangentially are lost when chemical agents remove the paraffin distorting the analysis. Moreover, the analyses based on digital images should consider the same format and the same size (pixels) to all pictures allowing a comparison between groups. Stereology can be 'model-based': points within a frame are counted to estimate the 'volume density' (Vv) of a structure, and intercepts are counted to assess the 'surface density' (Sv). Counting structures within a frame allow estimating the 'length density' (Lv). Newer and more complex 'design-based' procedures are considered unbiased. The key point is that design-based inference does not require assumptions about the material and uses the 'random sampling' approach. The estimation of the number of objects requires a 3-D (volume) probe and therefore the 'disector' technique. This review aimed to contribute to the execution of the project, the correct sampling and the data obtained with morphometry and stereology.

RESUMEN: La morfología cuantitativa contribuye a que los estudios sean menos subjetivos y reproducibles. Los resultados cuantitativos son analizados con estadística y deben basarse en una muestra bien definida. Las variables cuantitativas pueden ser "continuas" o "discretas". En este texto, el término 'morfometría' es usado para diseñar un procedimiento más simple para medir estructuras con una 'regla'. El término "estereología" se usa para estimar cantidades en espacio 3-D analizando secciones de corte en 2-D. Factores de corrección pueden ser necesarios por la retracción y compresión de los tejidos. En secciones histológicas, los "tapones" de las muestras que han sido seccionadas tangencialmente se pierden cuando los agentes químicos eliminan la parafina distorsionando así el análisis. Además, los análisis basados en imágenes digitales deben considerar el mismo formato y el mismo tamaño (píxeles) para todas las imágenes, lo que permite una comparación entre grupos. La estereología puede estar "basada en modelos": los puntos dentro de un marco se cuentan para estimar la "densidad de volumen" (Vv) de una estructura, y las interceptaciones o intersecciones son contadas para evaluar la "densidad de superficie" (Sv). Las estructuras contadas dentro de un marco permiten estimar la 'densidad de longitud' (Lv). Los procedimientos más nuevos y más complejos basados en el diseño se consideran imparciales y objetivos. El punto clave es que el diseño basado en la inferencia no requiere suposiciones acerca del material y utiliza el enfoque de "muestreo aleatorio". La estimación del número de objetos requiere una prueba 3-D (volumen) y, por lo tanto, la técnica "disector". Esta revisión tuvo como objetivo contribuir a la ejecución del proyecto, el muestreo correcto y los datos obtenidos con morfometría y estereología.

Uso da glicerina para a substituição do formaldeído na conservação de peças anatômicas / Gliceryn can replace formaldehyde for anatomic conservation

A formalização é a principal forma de conservação de corpos e peças anatômicas, devido principalmente ao seu baixo custo. A técnica baseia-se na utilização do formaldeído (5-20%) como fixador e conservador. Entretanto existem vários fatores negativos à sua utilização, como odor desagradável, escurecimento, aumento de peso e rigidez das peças e sérios problemas ambientais quando descartada de forma incorreta, além de ser um produto classificado pela Agência Internacional de Pesquisas em Câncer como altamente cancerígeno. Existem várias opções para substituir o formaldeído, a glicerinação é uma delas, cujo será tratada neste trabalho. A glicerina atua como antifúngico e bactericida, além de ter muitas vantagens em relação ao formol, tratando-se de odor, textura e coloração, além de não ser prejudicial a saúde. Porém o seu custo ainda é elevado e isso explica sua pouca utilização em laboratórios de anatomia. Este trabalho tem como objetivo mostrar as vantagens do uso da glicerina em relação ao formol e propor uma possível substituição deste produto cancerígeno para preservar a saúde dos alunos, funcionários e professores dentro do laboratório, além de permitir um ambiente mais agradável para o aprendizado.(AU)

The formalization is the main form of body and anatomic conservation, mainly due to its low cost. The technique is based on the use of formaldehyde (5-20%) as fixative and preservative. However there are several negative factors on their use, unpleasant smell, browning, weight gain and stiffness of parts and serious environmental problems if disposed of incorrectly, and is a product classified by the International Agency for Research on Cancer as highly carcinogenic. There are several options to replace formaldehyde and glicerinação is one of them, whose which will be treated in this work. Glycerin dehydrates the cell and acts as antifungal and antibacterial, and has many advantages compared to formaldehyde. But its cost is still high and this explains their limited use in the anatomy lab. This work aims to show the advantages of using glycerin in relation to formaldehyde and propose a possible replacement of this carcinogen to preserve the health of students, staff and teachers within the laboratory, and allows a more pleasant environment for learning.(AU)

Modelando ciencia. La ceroplástica de Ignacio Lacaba en el Colegio de Cirugía de San Carlos de Madrid / Modelling science. The ceroplastics of Ignacio Lacaba in the Colegio de Cirugía de San Carlos, Madrid

El uso de la ceroplástica como medio de divulgación científica tuvo en la didáctica anatómica del siglo XVIII una enorme difusión. Llegó a trascender las fronteras de una ciencia que impregnaba de conocimiento científico la expresión artística de la belleza a través de la que se manifestaba. Bajo estas premisas se creó en el Real Colegio de Cirugía de San Carlos de Madrid la colección de modelos anatómicos, de la que es custodio el actual Museo de Anatomía Javier Puerta de la Facultad de Medicina de la Universidad Complutense de Madrid. La colección se inició en 1786 con Ignacio Lacaba, primer disector del colegio de cirugía madrileño, cuya sensibilidad artística y profundo conocimiento de la anatomía contribuyó y facilitó la armonización entre la labor de los ceroescultores y el lenguaje y expresión anatómica (AU)

Models made of wax had enormous diffusion in the anatomical teaching of the 18th century. It transcended the borders of a science that impregnated with scientific knowledge the artistic expression of beauty. Based on this premise, the San Carlos Royal College of Surgery created in Madrid a large collection of anatomical models, which is currently maintained by the Javier Puerta Anatomy Museum in the School of Medicine at Madrid Complutense University. The collection began in 1786 with Ignacio Lacaba, the first dissector of the Surgery College of Madrid, whose artistic sensibility and deep knowledge of anatomy contributed and facilitated harmonization between the work of the wax sculptors and language and anatomical expression (AU)

Design-based stereology: Planning, volumetry and sampling are crucial steps for a successful study.

Quantitative data obtained by means of design-based stereology can add valuable information to studies performed on a diversity of organs, in particular when correlated to functional/physiological and biochemical data. Design-based stereology is based on a sound statistical background and can be used to generate accurate data which are in line with principles of good laboratory practice. In addition, by adjusting the study design an appropriate precision can be achieved to find relevant differences between groups. For the success of the stereological assessment detailed planning is necessary. In this review we focus on common pitfalls encountered during stereological assessment. An exemplary workflow is included, and based on authentic examples, we illustrate a number of sampling principles which can be implemented to obtain properly sampled tissue blocks for various purposes.

Biomodelo para la docencia de grado y postgrado en pediatría / Biomodel for teaching undergraduate and graduate in pediatrics

Introducción: La incorporación de la Clínica y la Imagenología permiten una mejor comprensión de la Anatomía. El objetivo de este trabajo es desarrollar un prototipo rápido en material sintético que replique detalles anatómicos para ser utilizado en la docencia de grado y postgrado en Pediatría. Material y Método: Caso 1: Niña de 1 año de edad con síndrome de dificultad respiratoria a causa de una malformación vascular. Caso 2: recién nacido con malformación torácica. Con la finalidad de analizar una conducta adecuada, se solicitó la confección de un prototipo rápido a escala 1:1 que simulara una condición idéntica a la topografía torácica del paciente, utilizando imágenes virtuales 3D almacenadas en formato DICOM.Técnica de generación de prototipo rápido: Se obtuvouna malla digital tridimensional y se generó el código “g”que se utilizó para controlar el hardware de producción. Se efectuó simulación digital y producción en material plástico (ABS) con técnica de deposición y fusión (MDF).Se validó el prototipo comparándo lo con las mediciones testigos del modelo virtual en 3 D.Resultados y Discusión: El modelo replicó exactamente los defectos hallados en la tomografía y endoscopía, confirmando la presencia de la malformación vascular y su repercusión sobre el aparato respiratorio. El prototipo rápido muestra las estructuras internas y externas del cuerpo humano con máxima precisión permitiendo una visión topográfica de situaciones “normales o patológicas” que facilitaría la docencia y el entrenamiento del equipo quirúrgico para proponer un plan de tratamiento adecuado. Hay numerosas áreas de la medicina que sebeneficiarían con este modelo que podría ser construído con diversos tipos de materiales de diferente flexibilidad y consistencia. Conclusiones: El prototipo rápido le da estado físico a las imágenes virtuales 3D, permitiendo la docencia y entrenamiento del equipo quirúrgico.

Introduction: The incorporation of the clinic and the imaging allow a better understanding of anatomy. Theaim of this work is to develop a rapid prototype in synthetic material that replicates anatomical details to be used inteaching and surgical training in Pediatrics. Material and method: Case 1: one year old female with respiratory distress syndrome because of vascular malformation. Case 2: newborn patient with thoracic malformation. In order to discuss appropriate conduct, the making of rapid prototyping in scale 1:1 was requested to simulate an identical condition of the thoracic topography of the patients, using virtual 3D images stored in the DICOM format. Rapid prototype technique: code "g" was generated, which was used to control the hardware of production and a three-dimensional digital grid was obtained. Digital simulation and production in plastic (ABS) with deposition and fusion technique (MDF) was performed. The prototype was validated by comparing measurements with witnesses of the virtual model in 3 D. Results and discussion: the model replied exactly the defects found in the scan and endoscopy, confirming the presence of vascular malformation and its impact on the respiratory system. Rapid prototype shows the internal and external structures of the human body with maximum precision allowing a topographic view of "normal or pathological" situations that would facilitate the teaching and training of the surgical team to propose an appropriate treatment plan. There are many areas of medicine that would benefit from this model that couldbe built with different types of materials with different flexibility and consistency. Conclusions: Rapid prototype gives form to virtual 3D images, allowing teaching and training of the surgical team.

Smart laser scanning sampling head design for image acquisition applications.

A smart laser scanning sampling head design is presented using an electronically controlled variable focal length lens to achieve the smallest sampling laser spot possible at target plane distances reaching 8 m. A proof-of-concept experiment is conducted using a 10 mW red 633 nm laser coupled with beam conditioning optics that includes an electromagnetically actuated deformable membrane liquid lens to demonstrate sampling laser spot radii under 1 mm over a target range of 20-800 cm. Applications for the proposed sampling head are diverse and include laser machining and component inspection.

New approach to the study of intraosseous vasculature.

BACKGROUND: The study of intraosseous vasculature has always been challenging due to the hard, calcified structure of bone. Techniques used to study intraosseous vasculature usually involve diaphanization with a Spalteholz technique, followed by X-ray imaging to display the radio contrast-injected blood vessels. These techniques produce results with fine detail when successfully executed. However, high failure rates and the extensive length of time required to perform these techniques are drawbacks. This paper describes a faster, alternative method for the study of intraosseous vasculature. METHOD: Five embalmed and two fresh shoulder girdles were harvested from six cadavers. Cannulas were inserted into the origins of the anterior (ACHA) and posterior (PCHA) circumflex humeral arteries and injected with ink diluted in water or 6% hydrogen peroxide. The arteries and their branches were dissected until they entered their respective bony foraminae. A hammer, chisel, bone nibbler and mounted needles were used to follow the intraosseous course of these arteries and their branches. RESULTS: The intraosseous vasculature was seen in all specimens. The branches of the main nutrient artery to the proximal humerus were followed until they reached articular cartilage or crossed cortical bone again to enter the rotator cuff tendons. DISCUSSION: An innovative, new approach to the study of intraosseous vasculature with direct visualization of the intraosseous arteries of the proximal humerus is described.

Progressive data transmission for anatomical landmark detection in a cloud.

BACKGROUND: In the concept of cloud-computing-based systems, various authorized users have secure access to patient records from a number of care delivery organizations from any location. This creates a growing need for remote visualization, advanced image processing, state-of-the-art image analysis, and computer aided diagnosis. OBJECTIVES: This paper proposes a system of algorithms for automatic detection of anatomical landmarks in 3D volumes in the cloud computing environment. The system addresses the inherent problem of limited bandwidth between a (thin) client, data center, and data analysis server. METHODS: The problem of limited bandwidth is solved by a hierarchical sequential detection algorithm that obtains data by progressively transmitting only image regions required for processing. The client sends a request to detect a set of landmarks for region visualization or further analysis. The algorithm running on the data analysis server obtains a coarse level image from the data center and generates landmark location candidates. The candidates are then used to obtain image neighborhood regions at a finer resolution level for further detection. This way, the landmark locations are hierarchically and sequentially detected and refined. RESULTS: Only image regions surrounding landmark location candidates need to be trans- mitted during detection. Furthermore, the image regions are lossy compressed with JPEG 2000. Together, these properties amount to at least 30 times bandwidth reduction while achieving similar accuracy when compared to an algorithm using the original data. CONCLUSIONS: The hierarchical sequential algorithm with progressive data transmission considerably reduces bandwidth requirements in cloud-based detection systems.

Reliability of a set of protractors for direct anatomical measurements around the glenoid and humeral head rims.

Functional biomechanics studies of the glenohumeral (GH) soft tissues require an understanding of their sites of bony attachment. Anatomical positions of GH capsular structures have often been quantified relative to the rims of the glenoid and humeral head (HH). The aim of this study was twofold: (1) to quantify the reliability of a set of protractors that directly fit on to the glenoid and HH rims and (2) to use this to determine direct angular position referencing of landmarks and soft tissue attachment points. Three assessors independently used the protractors to assess nine prescribed landmarks on 30 dry bone specimens (15 glenoids and 15 HHs) recording the angular positions of the structures relative to the glenoid and HH. The collected data showed high levels of validity as indicated by the protractor's intra- and inter-assessor reliabilities: 98.2 and 98.7% for the glenoid component, and 96.2 and 96.5% for the humeral component, respectively. The device could be useful in anatomical studies, description of defects and pathologies on glenohumeral articulation, and planning of scapular reconstructive surgery.

Anatomia dos órgãos vegetativos de Hymenaea martiana Hayne (Caesalpinioideae-Fabaceae): espécie de uso medicinal em Caetité-BA / Anatomy of vegetative organs of Hymenaea martiana Hayne (Fabaceae-Caesalpinioideae): a species of medicinal use in Caetité-Bahia State, Brazil

Hymenaea martiana Hayne (Fabaceae-Caesalpinioideae) apresenta grande valor na medicina popular em Caetité. A casca, entrecasca do caule e a resina, são utilizadas no tratamento de diversos males. Neste estudo são apresentadas a caracterização anatômica e histoquímica dos órgãos vegetativos. Amostras foram coletadas e processadas segundo técnicas usuais em anatomia vegetal e histoquímica. Todos os órgãos apresentam, em visão transversal, epiderme unisseriada e cavidades secretoras. Cutícula espessa ocorre em todos os órgãos aéreos. A raiz é tetrarca. Colênquima lacunar foi encontrado no caule. Bainha de fibras esclerenquimáticas envolve os feixes vasculares dos órgãos aéreos. Células pétreas ocorrem no pecíolo. Tricomas tectores ocorrem em ambas as faces da folha. A folha é hipoestomática com estômatos paracíticos e o mesofilo é dorsiventral. Cristais de oxalato de cálcio ocorrem no caule, pecíolo e lâmina foliar. Compostos fenólicos ocorrem na raiz, pecíolo e nervura central da folha. Grãos de amido ocorrem na raiz, caule e pecíolo. Lipídios ocorrem em todos os órgãos. Acredita-se que compostos fenólicos e cavidades secretoras de resina podem justificar a utilidade medicinal da espécie pela população de Caetité.

Hymenaea martiana Hayne (Fabaceae-Caesalpinioideae) shows a great value in folk medicine in Caetité. Its bark, stem-bark and resin are used to treat various ailments. In this study, the anatomical and histochemical characterization of vegetative organs is reported. Samples were collected and processed according to usual techniques of plant anatomy and histochemistry. All organs have, by cross-sectional view, uniseriate epidermis and secretory cavities. Thick cuticle occurs in all aerial organs. The root is tetrarch. Lacunar collenchyma was found in the stem. Sclerenchymatic sheath of fibers surrounds the vascular bundles of the aerial organs. Stone cells occur in the petiole. Trichomes occur on both sides of the leaves. The leaf is hypostomatic with paracytic stomata and the mesophyll is dorsiventral. Calcium oxalate crystals occur in the stem, petiole and leaf blade. Phenolic compounds occur in the root, petiole and midrib of the leaf. Starch grains occur in the root, stem and petiole. Lipids occur in all organs. It is believed that phenolic compounds and resin secretory cavities may justify the use of medicinal species by the population of Caetité.

Guidelines for standard photography in gross and clinical anatomy.

Photography has a widespread usage in medicine and anatomy. In this review, authors focused on the usage of photography in gross and clinical anatomy. Photography in gross and clinical anatomy is not only essential for accurate documentation of morphological findings but also important in sharing knowledge and experience. Photographs of cadavers are supposed to demonstrate the required information clearly. Thus, photographs should be taken with certain techniques in order to obtain high quality and standardization. Camera, lens, lighting, background, and certain photographic techniques are among the factors to achieve precise images. A set of suggested guidelines for accomplishing these standards are given for anatomists.

Revision of the genus Macropsobrycon Eigenmann, 1915 (Characidae: Cheirodontinae: Compsurini)

The cheirodontine genus Macropsobrycon is redefined and considered monotypic. The type species, M. uruguayanae, is redescribed based on samples from the entire known geographical distribution of the species. Sexually dimorphic characters of M. uruguayanae are further described and the relationships of the species with the remaining Compsurini are discussed.

O gênero Macropsobrycon de Cheirodontinae é redefinido e considerado monotípico. A espécie-tipo, M. uruguayanae, é redescrita com base em amostras de toda a distribuição geográfica conhecida da espécie. Caracteres de dimorfismo sexual secundário de M. uruguayanae são descritos e as relações da espécie com outros Compsurini são discutidas.

Troncalidad en anatomía patológica / No disponible

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