Sodium-, chloride-, and mibefradil-sensitive calcium channels in intestinal pacing in wild-type and W/WV mice.

Pacing of intestinal smooth muscle is driven by a network of cells found in the myenteric plexus called the interstitial cells of Cajal (ICC-MP), which produce a rhythmic pacemaker current. Using intact segments of circular (CM) and longitudinal (LM) muscle from wild-type and W/WV mice, we found that sodium-, chloride-, and mibefradil-sensitive ion channel currents are required for normal pacing to occur. Application of 30 micromol/L and 300 micromol/L lidocaine, 1 mmol/L 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS), 50 nmol/L and 500 nmol/L mibefradil, or low sodium Krebs significantly reduced pacing frequency in LM and CM. However, simultaneously applying DIDS and lidocaine or low sodium Krebs solution did not completely block pacing nor did it have an additive effect. Lidocaine and low sodium Krebs solution also abolished the gradient of pacing frequencies (higher proximally) found throughout the intestine, resulting in a uniform contraction frequency of 30-40/min. In W/WV mice, which lack ICC-MP, application of DIDS and lidocaine had no effect on the robust pacing in LM segments. In conclusion we found that sodium-, chloride-, and mibefradil-sensitive channel activities were required for normal pacing and to maintain the pacing gradient found throughout the intestines in wild-type but not W/WV mice.

Avaliação do alinhamento postural e do desempenho em atividades funcionais de crianças hemofílicas em idade inferior a sete anos, com e sem sinovite crônica: correlação com a incidência de hemartroses / Evaluation of postural alignment and performance in functional activities among hemophilic children under 7 years old with and without chronic synovitis: correlation with hemarthrosis incidence

INTRODUÇÃO: A sinovite na hemofilia pode induzir às alterações nos receptores sensitivos e proprioceptivos articulares. Tal efeito favorece a redução de estabilidade e um desalinhamento corporal, podendo comprometer a funcionalidade das crianças acometidas. OBJETIVO: Avaliar o alinhamento postural dos membros inferiores e o desempenho funcional de crianças hemofílicas, relacionando-os com a incidência de hemartroses. MÉTODO: Foi avaliado um grupo experimental (GE) de 28 crianças hemofílicas e um grupo controle (GC) de 20 crianças sem hemofilia. O GE foi dividido de acordo com o grau de comprometimento articular: 16 crianças no grupo sem sinovite crônica (GSS) e 12 no grupo com sinovite crônica (GCS). Cada grupo foi subdividido por faixa etária: 3-4 anos, 5-6 anos, 7 anos. A avaliação consistiu da análise do alinhamento dos ângulos do joelho e do tornozelo através do programa Geometer Sketchpad. O desempenho das atividades funcionais foi avaliado através de testes modificados a partir do Exame Neurológico Evolutivo de Lefévre. RESULTADOS: Foi constatado que a média dos sangramentos dos hemofílicos aumenta com a idade (p< 0,001) e parece ser relacionada com o grau de comprometimento articular (GCS>GSS), (p< 0,059); o ângulo do joelho do GCS tende a um menor valor (semiflexão) quando comparado aos outros grupos; e há diferença significativa no percentual de desempenho nos testes entre grupos na faixa etária de 7 anos (GSS>GC e GSS>GCS), (p< 0,087). DISCUSSÃO E CONCLUSÃO: Crianças hemofílicas de 7 anos apresentaram menor desempenho funcional quando comparadas aos outros grupos. Este resultado ressalta a importância da fisioterapia precoce associada à terapêutica médica para evitar comprometimentos articulares severos.

The effect of twist on microvascular anastomotic patency and angiographic luminal dimensions.

BACKGROUND: Microvascular anastomoses must be constructed perfectly in order to be successful. One of the subtle technical errors that can occur during construction is twisting of the anastomosis. In the present study, we examined the effect of twist on the immediate, 2-h postoperative angiographic dimensions and patency of microvascular anastomoses. MATERIALS AND METHODS: Sixty-four Sprague-Dawley rats were assigned randomly to four groups. The femoral arteries were dissected for a distance sufficient to permit the application of an 8.5-mm-long microanastomotic approximator clamp. Microarteriorrhaphies were performed with twists of 0 degrees, 90 degrees, 180 degrees, or 270 degrees. Patency was assessed 2 h after surgery using transabdominal aortic arteriography with run-off. Measurements were recorded for each anastomosis, as well as for the narrowest and widest diameters of the vessels within 10 mm of the anastomosis. RESULTS: Fifty-nine of the 64 rats had technically satisfactory angiograms which permitted measurement of vascular dimensions. The cross-sectional areas of the narrowest areas and the anastomoses were inversely related to the degree of twist, and were significantly reduced at 270 degrees (P < 0.05). Two-hour patency rates were 86% with 0 degrees twist, 82% with 90 degrees twist, 71% with 180 degrees twist, and 33% with 270 degrees twist. The reduction in patency with 270 degrees twist was statistically significant (P < 0.05). CONCLUSIONS: Twists of 0 degrees, 90 degrees, and 180 degrees did not impair patency at a statistically significant level, but twists of 270 degrees did significantly reduce patency of microvascular anastomoses (P < 0.05).

Angle of the articular eminence in patients with temporomandibular joint dysfunction and asymptomatic volunteers.

OBJECTIVE: The purpose of this study was to compare structural variations of the temporomandibular joint anatomy between symptomatic patients with temporomandibular joint dysfunction and asymptomatic controls. STUDY DESIGN: There were 74 symptomatic patients with temporomandibular joint dysfunction, 29 asymptomatic volunteers with normal joints, and 6 asymptomatic volunteers with disk displacement with reduction included in this study. All subjects had bilateral high resolution magnetic resonance imaging scans performed in the sagittal (closed and opened) and coronal (closed) positions. All subjects had right and left full profile laminagraphs, one in the centric occlusal position, and one with the incisors edge to edge. RESULTS: Student-Newman-Keuls tests demonstrated no significant angular or linear differences for depth of the articular fossa, angle of the articular eminence, horizontal and vertical overlap of the incisor teeth, and linear condylar translation. CONCLUSION: This study concludes that there are no significant differences in angular and linear measurements in the articular fossa of asymptomatic volunteers and symptomatic subjects with temporomandibular joint dysfunction.

The Tessier number 5 cleft: a report of two cases and a review of the literature.

Two cases of facial clefts that fit the anatomic description of the rare Tessier number 5 cleft are presented and bring the total number of reported cases to 19. These cases and a review of the literature help define the soft-tissue course of the cleft from just medial to the oral commissure to the junction of the middle and lateral thirds of the lower eyelid. They also emphasize the role of axial CT scanning to define the bony cleft as one passing from just distal to the canine tooth to the orbital rim lateral to the infraorbital foramen. The widespread use of CT scanning and a thorough dental examination of these patients should provide more accurate diagnosis and classification of these clefts.

Algodystrophy: pathophysiological considerations.

Algodystrophy can follow a wide variety of painful disorders and the Sympathetically Maintained Pain (SMP) syndromes form a chapter of medicine which is far more important than generally considered. The abnormal central sensitization of internucial pools of spinal neurones must be considered as the crucial element of these painful states. Treatment must be carried out in the first phase in order to minimize the state of spinal hypersensitivity.