El músculo pectoral mayor como opción para la valoración electromiográfica del plexo braquial / The major pectoral muscle as an option for the electromyographic value of the brachial plexus

El registro electromiográfico es una forma de evaluación de los impulsos eléctricos aferentes y eferentes del sistema muscular al sistema nervioso, su valoración permite explorar lesiones nerviosas o patologías neuromusculares en unidades motoras o nerviosas específicas, en este caso, valoramos el plexo braquial y se desea comparar la actividad de este plexo entre los músculos del brazo con el pectoral mayor, ya que, este último puede servir como una opción de valoración del plexo braquial y además de fácil acceso. Este estudio se realizó comparando 4 pacientes de la unidad de neurofisiología de la Caja Nacional de Salud de la ciudad de La Paz, donde se comparó la actividad eléctrica de los músculos del brazo y el pectoral mayor. Los resultados obtenidos mostraron que el músculo pectoral mayor sería suficiente para valorar la actividad eléctrica en las lesiones del plexo braquial, hemos observado que, sirve para valorar lesiones, tanto del tronco superior e inferior del plexo braquial como una lesión total de este plexo, además, permite mejor acceso que los músculos del brazo en caso de accidentes con lesión de los miembros superiores.

Docosanoids are multifunctional regulators of neural cell integrity and fate: significance in aging and disease.

The identification of neuroprotectin D1 (NPD1), a biosynthetic product of docosahexaenoic acid (DHA), in brain and retina as well as the characterization of its bioactivity, is generating a renewed interest in the functional role and pathophysiological significance of omega-3 fatty acids in the central nervous system. Neurotrophins, particularly pigment epithelium-derived factor (PEDF), induce NPD1 synthesis and its polarized apical secretion, implying paracrine and autocrine bioactivity of this lipid mediator. Also, DHA and PEDF synergistically activate NPD1 synthesis and antiapoptotic protein expression and decreased proapoptotic Bcl-2 protein expression and caspase 3 activation during oxidative stress. In experimental stroke, endogenous NPD1 synthesis was found to be upregulated, and the infusion of the lipid mediator into the brain under these conditions revealed neuroprotective bioactivity of NPD1. The hippocampal CA1 region from Alzheimer's disease (AD) patients (rapidly sampled) shows a major reduction in NPD1. The interplay of DHA-derived neuroprotective signaling aims to counteract proinflammatory, cell-damaging events triggered by multiple, converging cytokine and amyloid peptide factors, as in the case of AD. Generation of NPD1 from DHA thereby appears to redirect cellular fate toward successful preservation of retinal pigment epithelial (RPE)-photoreceptor cell integrity and brain cell aging. The Bcl-2 pro- and antiapoptotic proteins, neurotrophins, and NPD1, lie along a cell fate-regulatory pathway whose component members are highly interactive, and have potential to function cooperatively in cell survival. Agents that stimulate NPD1 biosynthesis, NPD1 analogs, or dietary regimens may be useful as new preventive/therapeutic strategies for neurodegenerative diseases.

Microsurgical anatomy of the short central artery.

We studied the origin, length, external diameter, disposition, branching patterns and the perforators of short central artery in the circle of Willis in eighty fresh, unfixed cerebral hemispheres (40 brains). We also examined the relationship of the short central artery, the recurrent artery of Heubner, and M1 perforators to the anterior perforated substance, caudate and putamen. The short central artery arises at 5.2 +/- 3.36 mm from the origin of the anterior cerebral artery, hidden and overlapped by the internal carotid artery bifurcation. The recurrent artery of Heubner arises distally to the origin of the short central artery. Four main anatomical variations were found: 1. Presence of short central artery and recurrent artery of Heubner (37.5%). 2. Isolated presence of the short central artery (27.5%). 3. Isolated presence of the recurrent artery of Heubner (21.25%). 4. Absence of short central artery and recurrent artery of Heubner (13.75%). Two different branching patterns were observed: 1. 2-4 straight perforators from the short central artery, perforators from the recurrent artery of Heubner and lenticulostriate from the most medial portion of the M1, in 42 of 80 hemispheres (52.5%). 2. 8-10 perforators from only short central artery in 10 of 80 hemispheres (12.5%) with absent or hypoplastic recurrent artery of Heubner and lenticulostriates from M1 and M2.

[Cystic adenoid carcinoma. Apropos of 2 cases originating in the salivary glands]. / Carcinoma adenoide quístico. A propósito de dos casos originados en glándulas salivales.

The CAQ is a tumor of the major and minor salivary glands, of superior airway glands, uterine cervix glands, and the Bartholin glands of the vulva. However, recently, primary cases of CAQ of the skin, originating in eccrine sweat glands were described. We report 2 CAQ cases, one, case 1, of minor salivary glands of the palate, that by extension, reached the skin of the face, finishing with kidney metastasis; and its histological type corresponded to the cribiform variety in both the primary tumor and the kidney metastasis. Case 2 presented in the parotid gland and its histological type is the solid variety of the CAQ.

[Robles' disease (onchocerciasis). Presentation of the first confirmed case in Ecuador]. / Enfermedad de Robles (oncocercosis). Presentación del primer caso comprobado en Ecuador.

For the first time a case of "onchocercosis " was found in Ecuador. The patient is a coloured person which was examined in the Dermatology Department of the "Luis Vernaza" Hospital. The diagnosis was established on the bases of a biopsy of a thoracic nodule. The principal lesions which were established are the following: intense and generalized pigmentation of violet tones; a very accentuated ictiosiform statey specially on the trunk; hardened accematous plaques in the fore-arms; eruptions on the buttocks nodules in the region of the iliac bone and zones of vitiligo on the anterior part of the legs; linfatic nodules were also observed. Elefantiasis of the penis and scrotum. With this case we have established an endemic focus of onchocercosis in Esmeraldas, Ecuador.