Treatment of keloids and hypertrophic scars. Position statement of the Brazilian expert group GREMCIQ.

Keloids (K) and hypertrophic scars (HS) are abnormal responses to wound healing that occur as the result of dermal inflammation. Despite the advances on their treatment, many patients still suffer from the negative effects of excessive scarring; its approach is impaired by the lack of objective data on different treatments and the large genetic variability among patients and the difficulties in producing multicentre studies. Their incidence among the Brazilian population is high, as the result of an admixture of Amerindians, Europeans and Africans ancestral roots. With the aim of producing multicentre studies on K and HS, a panel of senior Brazilian dermatologists focused on their treatment was invited to contribute with the K and HS Treatment Brazilian Guidelines. In the first part of this study, different treatment modalities for keloids and HS are fully reviewed by the panel. The second part of the study presents a consensus recommendation of treatment for different types of lesions. More than a literature review, this article aims to show the pitfalls and pearls of each therapeutic option, as well as a therapeutic approach by the Panel of Experts on keloids and Scars on a highly mixed population, providing simple guidelines.

Ventral hernia secondary to giant omphalocele in a child: combined approach of botulinum toxin and preoperative progressive pneumoperitoneum.

Omphalocele is a congenital abdominal wall defect that occurs approximately 1 in 4000-6000 live births. The abdominal-visceral disproportion, large diameter of the defect, volume of liver in the sac along with high incidence of associated anomalies make the surgical management a real challenge. Currently, there are two strategies for managing giant omphaloceles, staged surgical closure and nonoperative delayed closure. The combined treatment with PPP and BoNT/A injection has recently been described in adults. There is strong evidence on safety and efficacy of the use of BoNT/As in other areas of pediatrics and no recent reports of PPP use in children. Also, there are no data available about the combination of both techniques in pediatric population. The purpose of this manuscript is to report a case of a 7-year-old female child that was referred to our institution with a large ventral hernia secondary to omphalocele. We opted for a combined approach with BoNT/A injection and PPP before the definitive surgery. The surgical result was great with midline closure with no tension and no need for prosthetic substitution or component separation needed. To our knowledge, this is the first case report of BoNT/A injection and PPP for large ventral hernias in children. BoNT/A application was safe and the PPP technique was also proved to be applicable on children. We believe that the combination of BoNT/A and PPP presented to be a safe approach with an excellent result, particularly for not needing abdominal wall prosthetic substitution.

[Pathological hip fracture of pediatric age. Revision of the cystic angiomatosis of the bone]. / Fractura patológica de cadera en edad pediátrica. Revisión de la angiomatosis quística ósea.

INTRODUCTION: Bone cystic angiomatosis is a disease with only 200 cases described, based on angiomatous nonmalignant proliferation, in bone tissue and viscera. It focuses on pelvis, long bones and scapular waist. Clinical evolution ranges from self-limiting forms to massive aggressive osteolysis (Gorham-Stout).Its diagnosis is of exclusion, with nonspecific clinical, radiological (lytic images) and histopathological findings. CLINICAL CASE: Our study is based on the clinical case of a 14-year-old man diagnosed with bone cystic angiomatosis, with disseminated bone involvement, who came to our center for pain and functional impotence in the right hip, diagnosing a pertrochanteric fracture. It was operated by open reduction and osteosynthesis with four-hole VERSA sliding plate screw. An allogeneic graft of cancellous bone was used from femoral head. The evolution was satisfactory, with ambulation at full load per month without requiring analgesic medication and control X-ray at eight months that showed signs of complete integration of the graft. The analgesic pain scale (visual analogue scale) showed a score of 2/10 per month. DISCUSSION: There is controversy regarding the treatment of these fractures by osteosynthesis with bone graft. We are facing a case without serious clinical criteria, but with multiple foci of osteolysis. It was decided not to intervene prophylactically the contraleteral hip, since it is asymptomatic and there are different patterns of evolution described in the literature and risks in surgery.

INTRODUCCIÓN: La angiomatosis quística ósea es una enfermedad con solamente 200 casos descritos basados en la proliferación no maligna angiomatosa en tejido óseo y vísceras. Se observa más en la pelvis, los huesos largos y la cintura escapular. La evolución clínica varía de formas autolimitantes a osteólisis agresiva masiva (Gorham-Stout). Su diagnóstico es por exclusión, con datos clínico-radiológicos (imágenes líticas) y resultados histopatológicos no específicos. CASO CLÍNICO: Nuestro estudio se basa en el caso clínico de un paciente de 14 años diagnosticado con angiomatosis quística ósea, con afección ósea diseminada, que vino a nuestro centro por el dolor y la impotencia funcional en la cadera derecha, diagnosticando una fractura pertrocantérea. Se le hizo una osteosíntesis con tornillo deslizante de la placa VERSA de cuatro agujeros. Se utilizó un injerto alogénico de hueso esponjoso de la cabeza femoral. La evolución fue satisfactoria con ambulación a plena carga por mes sin requerir medicación analgésica y control de rayos X a los ocho meses, los cuales mostraron signos de completa integración del injerto. La escala analgésica del dolor (EVA) mostró una puntuación de 2/10 por mes. DISCUSIÓN: Hay controversia con respecto al tratamiento de estas fracturas por la osteosíntesis con el injerto del hueso. Nos enfrentamos a un caso sin criterios clínicos serios, pero con múltiples focos de osteólisis. Se decidió no intervenir profilácticamente la cadera contralateral, ya que es asintomática y hay diferentes patrones de evolución descritos en la literatura y los riesgos en la cirugía.

Fractura patológica de cadera en edad pediátrica. Revisión de la angiomatosis quística ósea / Pathological hip fracture of pediatric age. Revision of the cystic angiomatosis of the bone

Resumen: Introducción: La angiomatosis quística ósea es una enfermedad con solamente 200 casos descritos basados en la proliferación no maligna angiomatosa en tejido óseo y vísceras. Se observa más en la pelvis, los huesos largos y la cintura escapular. La evolución clínica varía de formas autolimitantes a osteólisis agresiva masiva (Gorham-Stout). Su diagnóstico es por exclusión, con datos clínico-radiológicos (imágenes líticas) y resultados histopatológicos no específicos. Caso clínico: Nuestro estudio se basa en el caso clínico de un paciente de 14 años diagnosticado con angiomatosis quística ósea, con afección ósea diseminada, que vino a nuestro centro por el dolor y la impotencia funcional en la cadera derecha, diagnosticando una fractura pertrocantérea. Se le hizo una osteosíntesis con tornillo deslizante de la placa VERSA de cuatro agujeros. Se utilizó un injerto alogénico de hueso esponjoso de la cabeza femoral. La evolución fue satisfactoria con ambulación a plena carga por mes sin requerir medicación analgésica y control de rayos X a los ocho meses, los cuales mostraron signos de completa integración del injerto. La escala analgésica del dolor (EVA) mostró una puntuación de 2/10 por mes. Discusión: Hay controversia con respecto al tratamiento de estas fracturas por la osteosíntesis con el injerto del hueso. Nos enfrentamos a un caso sin criterios clínicos serios, pero con múltiples focos de osteólisis. Se decidió no intervenir profilácticamente la cadera contralateral, ya que es asintomática y hay diferentes patrones de evolución descritos en la literatura y los riesgos en la cirugía

Abstract: Introduction: Bone cystic angiomatosis is a disease with only 200 cases described, based on angiomatous nonmalignant proliferation, in bone tissue and viscera. It focuses on pelvis, long bones and scapular waist. Clinical evolution ranges from self-limiting forms to massive aggressive osteolysis (Gorham-Stout).Its diagnosis is of exclusion, with nonspecific clinical, radiological (lytic images) and histopathological findings. Clinical case: Our study is based on the clinical case of a 14-year-old man diagnosed with bone cystic angiomatosis, with disseminated bone involvement, who came to our center for pain and functional impotence in the right hip, diagnosing a pertrochanteric fracture. It was operated by open reduction and osteosynthesis with four-hole VERSA sliding plate screw. An allogeneic graft of cancellous bone was used from femoral head. The evolution was satisfactory, with ambulation at full load per month without requiring analgesic medication and control X-ray at eight months that showed signs of complete integration of the graft. The analgesic pain scale (visual analogue scale) showed a score of 2/10 per month. Discussion: There is controversy regarding the treatment of these fractures by osteosynthesis with bone graft. We are facing a case without serious clinical criteria, but with multiple foci of osteolysis. It was decided not to intervene prophylactically the contraleteral hip, since it is asymptomatic and there are different patterns of evolution described in the literature and risks in surgery.

Three new sensitive and specific heat-shock protein 70 PCRs for global Leishmania species identification.

The heat-shock protein 70 gene (hsp70) has been exploited for Leishmania species identification in the New and Old World, using PCR followed by restriction fragment length polymorphism (RFLP) analysis. Current PCR presents limitations in terms of sensitivity, which hampers its use for analyzing clinical and biological samples, and specificity, which makes it inappropriate to discriminate between Leishmania and other trypanosomatids. The aim of the study was to improve the sensitivity and specificity of a previously reported hsp70 PCR using alternative PCR primers and RFLPs. Following in silico analysis of available sequences, three new PCR primer sets and restriction digest schemes were tested on a globally representative panel of 114 Leishmania strains, various other infectious agents, and clinical samples. The largest new PCR fragment retained the discriminatory power from RFLP, while two smaller fragments discriminated less species. The detection limit of the new PCRs was between 0.05 and 0.5 parasite genomes, they amplified clinical samples more efficiently, and were Leishmania specific. We succeeded in significantly improving the specificity and sensitivity of the PCRs for hsp70 Leishmania species typing. The improved PCR-RFLP assays can impact diagnosis, treatment, and epidemiological studies of leishmaniasis in any setting worldwide.

Heat-shock protein 70 PCR-RFLP: a universal simple tool for Leishmania species discrimination in the New and Old World.

INTRODUCTION: Species typing in leishmaniasis gains importance in diagnostics, epidemiology, and clinical studies. A restriction fragment length polymorphism (RFLP) assay of PCR amplicons from a partial heat-shock protein 70 gene (hsp70) had been described for the New World, allowing identification of some species. METHODS: Based on an initial in silico analysis of 51 hsp70 sequences, most of which we recently determined in the frame of a phylogenetic study, species-specific restriction sites were identified. These were tested by PCR-RFLP on 139 strains from 14 species, thereby documenting both inter- and intra-species variability. RESULTS: Our assay could identify Leishmania infantum, L. donovani, L. tropica, L. aethiopica, L. major, L. lainsoni, L. naiffi, L. braziliensis, L. peruviana, L. guyanensis, and L. panamensis by applying 2 subsequent digests. L. mexicana, L. amazonensis, and L. garnhami did not generate species-specific restriction fragment patterns. CONCLUSION: Currently no assay is available for global Leishmania species discrimination. We present a universal PCR-RFLP method allowing identification of most medically relevant Old and New World Leishmania species on the basis of a single PCR, obviating the need to perform separate PCRs. The technique is simple to perform and can be implemented in all settings where PCR is available.

Thyroid alar cartilage laryngotracheal reconstruction for severe pediatric subglottic stenosis.

BACKGROUND/PURPOSE: Laryngotracheoplasty has become an accepted treatment alternative for subglottic stenosis. However, the best autogenous material for laryngotracheoplasty remains controversial. Autogenous superior thyroid alar cartilage (TAC) has been used successfully in single stage laryngotracheal reconstruction in children with subglottic stenosis. METHODS: This is a retrospective study of 6 children (mean age, 16.6 months) undergoing TAC graft laryngotracheoplasty between September 1995, and June 1999. Two children had immediate tracheal intubation for congenital subglottic stenosis. Four others had previous tracheostomy: 3 for severe postintubation subglottic stenosis and 1 for congenital subglottic stenosis. After an anterior cricoid split, a piece of TAC was sutured between the cut ends of the cricoid, with the graft perichondrium facing intraluminally. Endotracheal intubation was maintained postoperatively. RESULTS: Four children underwent successfully extubation 9 to 21 days (mean, 15.5 days) postoperatively. Two required tracheostomy, which was maintained because of severe laryngomalacia and laryngotracheobronchomalacia. One child was treated with CO2 laser because of symptomatic recurrence of the subglottic stenosis 3 weeks after the surgery; another required fundoplication for gastroesophageal reflux 12 months after laryngotracheoplasty. There were no donor site complications in any of the 6 cases. Repeat laryngoscopy and bronchoscopy showed a patent subglottic airway. All of them are without symptoms after a mean follow-up of 26 months. CONCLUSIONS: (1) This preliminary experience indicates that the TAC graft technique is a viable option for laryngotracheal reconstruction; (2) the TAC graft has significant advantages, including a single operative incision and absence of donor-site morbidity.

[Experimental empyema in rats through intrapleural injection of bacteria] / Indução de empiema em ratos através da inoculação pleural de bactérias.

OBJECTIVE: To evaluate empyema formation in rats through the injection of two bacteria (Pasteurella multocida and Staphylococcus aureus), using a simple, easy-to-use surgical technique. METHODS: Twenty four anesthetized Wistar white rats, 250-300g in weight, submitted to right anterior thoracotomy, muscular retraction and injection of a 0.2ml solution into pleural space according the following scheme: Group I (n=12): injection of 10(10) Pasteurella multocida cultured in brain heart infusion broth. Group II (n=8): injection of 10(10) Staphylococcus aureus cultured in brain heart infusion broth. Group III (n=4): injection of bacterium-free brain heart infusion (control). The rats were sacrificed after seven days, and pleural reaction was assessed by macroscopy. Mortality, and intrathoracic liquid volume were evaluated, and bacteriological tests were also performed. RESULTS: Seven rats died within the first 48 hours in Group I (Pasteurella multocida); five completed the experiment, but none of them presented empyema. Only one animal died within the first 24 hours in Group II (Staphylococcus aureus); seven (88%) presented empyema at the time of sacrifice. All animals survived in Group III (control), without empyema or thoracic abnormalities. Pleural inoculation of Staphylococcus aureus (Group II) was significantly associated with empyema formation (P<0.001). In this group, the amount of pleural liquid ranged from 0.9 to 3.9ml. CONCLUSION: It is possible to induce empyema in rats through Staphylococcus aureus pleural injection by a simple surgical technique. Differently from other experiments, the pleural injection of Pasteurella multocida did not provoke empyema in rats.

[Endoscopic supraglottoplasty in children with severe laryngomalacia with and without neurological impairment] / Supraglotoplastia endoscópica em crianças com laringomalacia grave com e sem doença neurológica associada.

OBJECTIVE: To describe indications and results of supraglottoplasty for severe laryngomalacia in children with or without neurological impairment. METHODS: Eight children with severe laryngomalacia submitted to endoscopic supraglottoplasty were retrospectively studied. Four had neurological impairment (male, mean age 6 years), and 4 did not present neurological problems (3 female, mean age 11.5 months). Surgery indications were respiratory distress, feeding difficulties, failure to thrive, and low oxygen saturation. Polysomnographic evaluation was carried out on the last 2 children, showing abnormal oxygen saturation, obstructive apnea, and hypoventilation. All children received preoperative antibiotics and corticosteroids. RESULTS: All children without neurological impairment had significant relief of symptoms. Children with neurological impairment had different outcome: one needed tracheotomy immediately after surgery due to edema and supraglottic granulation tissue. The other three children presented initial relief of symptoms, but subsequent follow-up showed progressive airway obstruction: one needed another endoscopic surgery 6 months later; other needed tracheotomy 7 months later. The children who were not submitted to tracheostomy presented persistent severe airway obstruction. No endoscopic surgery complication was observed. CONCLUSIONS: 1) Endoscopic supraglottoplasty is well tolerated and does not present complications when used in children; 2) Endoscopic supraglottoplasty was efficient in the treatment of children with severe laryngomalacia and in without neurological impairment; however, supraglottoplasty did not resolve airway obstruction in children with neurological impairment.

The genome sequence of the plant pathogen Xylella fastidiosa. The Xylella fastidiosa Consortium of the Organization for Nucleotide Sequencing and Analysis.

Xylella fastidiosa is a fastidious, xylem-limited bacterium that causes a range of economically important plant diseases. Here we report the complete genome sequence of X. fastidiosa clone 9a5c, which causes citrus variegated chlorosis--a serious disease of orange trees. The genome comprises a 52.7% GC-rich 2,679,305-base-pair (bp) circular chromosome and two plasmids of 51,158 bp and 1,285 bp. We can assign putative functions to 47% of the 2,904 predicted coding regions. Efficient metabolic functions are predicted, with sugars as the principal energy and carbon source, supporting existence in the nutrient-poor xylem sap. The mechanisms associated with pathogenicity and virulence involve toxins, antibiotics and ion sequestration systems, as well as bacterium-bacterium and bacterium-host interactions mediated by a range of proteins. Orthologues of some of these proteins have only been identified in animal and human pathogens; their presence in X. fastidiosa indicates that the molecular basis for bacterial pathogenicity is both conserved and independent of host. At least 83 genes are bacteriophage-derived and include virulence-associated genes from other bacteria, providing direct evidence of phage-mediated horizontal gene transfer.

Estudio experimental de técnicas de fijación testicular / Experimental study on orchipexy

La fijación testicular se realiza para prevenir la torsión del órgano y en la corrección de la criptorquidia.Se han utilizado para ello diversas técnicas,persistiendo discordancia respecto a cúal es la mejor,con menor daño testicular.Este estudio se realizó para comparar la fijación y el grado de lesión testicular con distintas técnicas quirúrgicas,utilizando dos tipos de sutura.Cuarenta ratas adultas de la raza Wistar,anestesiadas con eter etílico se sometieron a la incisión del escroto y exposición de ambos testículos.Se definieron en forma aleatoria cuatro grupos:grupo 1(n=10)fijación con un punto único,grupo 2(n=10)al que se fijó el testículo con dos puntos,grupo 3(n=10)en el que el testículo se fijó con tres puntos.En la mitad de los animales fue utilizado Vicryl 5-0,y en le resto se utilizó Mersilene 5-0,en el grupo 4 (n=10)el testículo se colocó en la bolsa sabdártica sin puntos de sutura.El testículo contralateral no tratado fue utilizado como control.Todos los animales se sacrificaron a los 30 días,evaluándose el grado de fijación macroscópica,eltamaño del testículo,y las alteraciones microscópicas del mismo.Todos los animales completaron el período previsto de observación.Se observó una diferencia significativa de la fijación entre los grupos(p<0,0038):los animales del grupo 1 presentaron una fijación menor respecto a los otrso grupos.Entre los grupos 2,3 y 4 no se observó una diferencia significativa en la fijación,tampoco hubo diferencia entre los animales del mismo grupo suturados con vicryl o mersilene.No se observaron alteraciones inflamatorias testiculares estadísticamente significativas entre los grupos ni entre los animales del mismo grupo fijados con las dos suturas.La fijación testicular con 2 o 3 puntos en la bolsa subdártica es superios a la realizada con un punto único.Esta última provoca alteraciones semejantes a las encontradas con las otras técnicas,que produce significativamente menor fijación

Estudio experimental de técnicas de fijación testicular / Experimental study on orchipexy

La fijación testicular se realiza para prevenir la torsión del órgano y en la corrección de la criptorquidia.Se han utilizado para ello diversas técnicas,persistiendo discordancia respecto a cúal es la mejor,con menor daño testicular.Este estudio se realizó para comparar la fijación y el grado de lesión testicular con distintas técnicas quirúrgicas,utilizando dos tipos de sutura.Cuarenta ratas adultas de la raza Wistar,anestesiadas con eter etílico se sometieron a la incisión del escroto y exposición de ambos testículos.Se definieron en forma aleatoria cuatro grupos:grupo 1(n=10)fijación con un punto único,grupo 2(n=10)al que se fijó el testículo con dos puntos,grupo 3(n=10)en el que el testículo se fijó con tres puntos.En la mitad de los animales fue utilizado Vicryl 5-0,y en le resto se utilizó Mersilene 5-0,en el grupo 4 (n=10)el testículo se colocó en la bolsa sabdártica sin puntos de sutura.El testículo contralateral no tratado fue utilizado como control.Todos los animales se sacrificaron a los 30 días,evaluándose el grado de fijación macroscópica,eltamaño del testículo,y las alteraciones microscópicas del mismo.Todos los animales completaron el período previsto de observación.Se observó una diferencia significativa de la fijación entre los grupos(p<0,0038):los animales del grupo 1 presentaron una fijación menor respecto a los otrso grupos.Entre los grupos 2,3 y 4 no se observó una diferencia significativa en la fijación,tampoco hubo diferencia entre los animales del mismo grupo suturados con vicryl o mersilene.No se observaron alteraciones inflamatorias testiculares estadísticamente significativas entre los grupos ni entre los animales del mismo grupo fijados con las dos suturas.La fijación testicular con 2 o 3 puntos en la bolsa subdártica es superios a la realizada con un punto único.Esta última provoca alteraciones semejantes a las encontradas con las otras técnicas,que produce significativamente menor fijación

[Thoracoscopy with mediastinoscope in pediatric complicated parapneumonic effusion] / Pleuroscopia com mediastinoscópio em crianças com derrame parapneumônico complicado.

OBJECTIVE: To evaluate our experience with thoracoscopy with small mediastinoscope in complicated parapneumonic effusion in children.METHODS: From July 1995 to June 1997, seven children with complicated parapneumonic pleural effusion underwent thoracoscopy with mediastinoscope at Hospital de Clínicas de Porto Alegre. The procedure was carried out with a small mediastinoscope built in our hospital.RESULTS: There were six girls and one boy. The procedure was preformed under general anesthesia, without selective intubation. Six patients had previous intercostal tube drainage; one underwent thoracoscopy as a primary procedure. No complication was observed after the procedure. During follow-up, two children underwent pleurotomy due to residual pleural effusion with persistent fever; two others presented asymptomatic small pleural effusion.CONCLUSION: Thoracoscopy with small mediastinoscope is safe, efficient and without severe complications. It is very useful to remove loculated complicated parapneumonic effusion at fibrinopurulent stage and to enable lung expansion.

Urethral lengthening with anterior bladder wall flap for urinary incontinence: a new approach.

Urethral irregularity (impeding catheterization) and failure to achieve continence are common complications in surgery for urinary incontinence. We describe a surgical technique using an anterior bladder wall flap that is sutured to the posterior wall in an onlay fashion creating a flap valve mechanism. Experimental work in dogs demonstrated a significant increase in the leak point pressure in the surgical group when compared to controls (p = 0.019). Voiding cystourethrography and bladder inspection demonstrated an anterior flap valve with no fistula formation in all animals. Histological examination showed a viable anterior bladder wall flap in all cases. This technique was then applied to 6 patients with neurogenic bladder and low urethral resistance that failed to resolve with medical treatment. Urinary continence was achieved in 4 patients. In 1 patient a vesicourethral fistula developed 3 months postoperatively, since the mother failed to catheterize for 12 hours. This technique is a useful alternative in the treatment of urinary incontinence.

[Rigid respiratory endoscopy in children]. / Endoscopia respiratória rígida em criança.

From march 1989 to march 1992, three hundred and fifty six respiratory endoscopies were performed at "Hospital da Criança Santo Antônio", Porto Alegre, Brazil. The endoscopies were performed with a rigid pediatric bronchoscope and under general anaesthesia. The most common indications for endoscopy were stridor (52%), suspected foreign body (16%), atelectasis (16%) and difficult tracheal extubation (8%). The most frequent diagnosis were laryngomalacia (36%) and subglottic stenosis (6%) in the glottic and subglottic areas, and foreign body (9%) and tracheomalacia (7%) in the tracheobronchial area. Normal endoscopy was observed in 54 (21%) of the children. Only three slight complications of the endoscopy were observed. Two patients presented bradycardia during the exam, and the third needed tracheal intubation due to post-endoscopic subglottic edema. This confirms that the rigid endoscopy in children is efficient and has no serious complications.

Congenital rupture of scrotum: an unusual complication of meconium peritonitis.

Congenital rupture of the scrotum caused by meconium peritonitis occurred in a newborn with clinical findings of the Beckwith-Wiedemann syndrome. Ruptured omphalocele and jejunal atresia were present. Surgical repair 3 hours after birth was successful.

Theta waves and behavioral manifestations of alertness and dreaming activity in the rat.

Electro-oscillographic recordings show that when rats wake up, behavioral manifestations such as head dorsal extension and snout and eye movements (which occur in this sequence), occasionally followed by brief ear and limb twitches, are preceded by and are simultaneous with theta waves (around 6.5 Hz in frequency) in neocortical areas 3 and 17 and in the hippocampus. Heart rate increases when the animal passes from synchronized sleep to relaxed wakefulness to exploratory behavior. During desynchronized sleep theta waves, similar to those found during alertness, usually precede and are simultaneous with rostrum and eye movements and brief ear and limb twitches. Heart rate also increases during dreaming activity. A high degree of coherence (near 1.0) was found among theta bursts in different hippocampal areas in both highly attentive alertness and dreaming. It is suggested that theta waves are related to attention as part of some kinds of behavior and of the process of dream shaping and expression, both characterized by consciousness.

Theta waves and behavioral manifestations of alertness and dre4aming activity in the rat

Electro-oscillographic recordings show that when up, behavioral manifestations such as head dorsal extension and snout and eye movements (which occur in this sequence) occasionally followed by brief ear areas 3 and 17 and in the hippocampus. Heart rate increases when the animal passes from synchronized sleep to relaxed wakefulness to exploratory behavior. During desynchronized sleep theta waves, similar to those found during alertness, usually precede and are simultaneous with rostrum and eye movements and brief ear and limb twitches. Heart rate also increases during dreaming activity. A high degree of coherence (near 1.0) was found among theta bursts in different hippocampal areas in both highly attentive alertness and dreaming. It is suggested that theta waves are related to attention as part of some kinds of behavior and of the process of dream shaping and expression, both characterized by consciousness

Seromuscular enterocystoplasty in dogs.

An experimental canine model was developed to evaluate the possibility of using seromuscular segments of intestine for bladder augmentation. Of the 10 dogs 5 had bladder augmentations with seromuscular segments of sigmoid and 5 with seromuscular segments of ileum. After 8 weeks we observed that the seromuscular segment was viable and covered with urothelium but intense shrinkage had occurred. Because of the many theoretical advantages of performing bladder augmentation with intestinal segments free of mucosa, we believe that further investigation to elucidate the possible cause of retraction of the seromuscular segment is needed.

Electrical activity of the posterior thalamic nucleus and the hippocampus during wakefulness and desynchronized sleep in the rat: a spectral analysis.

The electrical activity of the posterior thalamic nuclear complex was studied in rats and related to the simultaneous hippocampal electro-oscillogram. Electrocorticographic tracings and spectral analysis showed that during attentive wakefulness the electro-oscillogram peaked at 8 Hz and in desynchronized sleep it oscillated at regular frequencies between 8 and 9 Hz. In quiet wakefulness, frequency was lower (around 6 Hz) and during synchronized sleep rhythmicity disappeared. The electrophysiological patterns during wakefulness and desynchronized sleep are proposed to be linked to the retrieval and combination of information for the generation of attention and dream content.