Estudo da anatomia do nervo tibial e seus ramos ao nível do terço distal da perna

OBJETIVO: Determinar, através de dissecção em cadáveres frescos, a anatomia topográfica do nervo tibial e seus ramos ao nível do tornozelo, em relação ao túnel do tarso. MÉTODOS: Foram realizadas dissecções bilaterais em 26 cadáveres frescos e as localizações da bifurcação do nervo tibial e seus ramos aferidas em milímetros, com relação ao eixo maleolar-calcaneal (EMC). Para os ramos calcâneos, a quantidade e seus respectivos nervos de origens também foram analisados. RESULTADOS: A bifurcação do nervo tibial ocorreu sob o túnel em 88% dos casos e proximalmente em 12%. Quanto aos ramos calcâneos, o medial apresentou-se com um (58%), dois (34%) e três (8%) ramos, com a origem mais comum do nervo tibial (90%) e o inferior com ramo único por perna, tendo o nervo plantar lateral como origem mais comum (70%). Nivel de Evidência V, Opinião de especialista.

Tratamento endovascular dos aneurismas da aorta abdominal com anatomia complexa: resultados preliminares com a segunda geração de endoprótese com arcabouço metálico circular

INTRODUÇÃO: O tratamento endovascular dos aneurismas da aorta abdominal tem revolucionado o tratamento dessa afecção, em decorrência das baixas taxas de morbidade e mortalidade. Apesar dos avanços tecnológicos ocorridos nas endopróteses, ainda existem limitações anatômicas para o emprego da técnica. Este estudo teve por objetivo avaliar os resultados imediatos do tratamento de pacientes portadores de aneurisma da aorta abdominal com anatomia complexa com uma endoprótese de segunda geração. MÉTODOS: Estudo observacional, prospectivo, não-randomizado, realizado em um único centro, em uma série de pacientes submetidos a tratamento endovascular de aneurismas da aorta abdominal infrarrenais complexos, com prótese com arcabouço metálico disposta em anéis (Anaconda - Vascutek, Terumo, Inchinnan, Escócia). Foram avaliados as características clínicas e angiográficas, o sucesso técnico, o sucesso terapêutico, a morbidade e a mortalidade, e a taxa de reintervenção perioperatória. RESULTADOS: Foram analisados, no período de fevereiro de 2010 a dezembro de 2011, 108 pacientes consecutivos portadores de aneurisma da aorta, dos quais 16 eram portadores de aneurisma da aorta abdominal com anatomia complexa tratados com a prótese Anaconda . A média de idade foi de 76 + 7 anos e 75% eram do sexo masculino. Houve sucesso técnico em 94% e êxito terapêutico em 75% dos casos. Ocorreu um óbito no pós-operatório. As complicações perioperatórias mais prevalentes foram sangramento da ferida operatória (2/16) e embolia periférica (2/16). Foram necessárias reintervenções em 12,5% dos pacientes durante o seguimento. CONCLUSÕES: Neste estudo, a segunda geração da endoprótese Anaconda foi efetiva e apresenta resultados imediatos satisfatórios no tratamento do aneurisma da aorta abdominal infrarrenal de anatomia complexa.

Anatomia de Okenia zoobotryon (Gastropoda: Nudibranchia) procedente de São Sebastião, SP, Brasil

CAPES

Atlas colorido de anatomia veterinária dos ruminantes. [Revisão Técnica]

Supervisão da revisão do livro.

The Behavior of Demineralized Bone Matrix (DBM) in Post-Extraction Sockets

Autogenous bone grafts are considered to be the gold standard in bone regeneration because of their osteogenic activity; however, due to limited availability of intraoral donor sites and the need to resolve the demands of patients requires an alternative to these. Two male patients were submitted to implant surgery in two stages with 6 months intervals between each of them: the first was exodontia and placement of DBM graft into the socket; the second stage was the drill with a 2 mm internal diameter trephine in center of the alveolar ridge previously grafted with DBM and subsequent implant placement. The samples were analyzed under histological techniques. A very mature bone was observed at 6 months after DBM graft placement in the sockets, showing it to be a good alternative as bone graft.

Bovine Bone Matrix Action Associated With Morphogenetic Protein in Bone Defects in Rats Submitted to Alcoholism

Extended excessive alcohol use causes changes in bone tissue, thus affecting osteogenesis. The objective of this study was to evaluate if demineralized bone matrix (Gen-ox (R)) associated with bone morphogenetic protein (Gen-pro (R)) changes bone neoformation in rats submitted to experimental alcoholism. Forty male rats (Rattus norvegicus) were separated into 2 groups of 20 animals each: Group E1, which received ethyl alcohol at 25% and had the surgical cavity filled in only with blood clot; and Group E2. which received ethyl alcohol at 25% and had the surgical cavity filled in with demineralized bovine cortical bone associated with bone morphogenetic protein. The animals were submitted to a three-week period of gradual adaptation to alcohol, and then continued receiving alcohol at 25% for 90 days, when the surgical cavity was made. After the surgery, the animals continued consuming alcohol until reaching the sacrifice periods of 10, 20, 40, and 60 days, when the tibias were removed for histological processing. Results showed that surgical cavity repair and bone marrow reorganization occurred faster in Group E1 than in Group E2. At the end of the experiment, it was observed that animals in Group E2 had thick bony trabeculae surrounding the implanted material particles and a small area of connective tissue in the surface region. In conclusion, the implanted material did not accelerate bone neoformation, rather it served as a structure for osteogenesis.

Extensor indicis brevis Muscle: an Unusual Muscular Variant

Knowledge of anatomical variations of the musculoskeletal system is important for interpreting unusual clinical presentations. We observed the presence of an abnormal extensor indicis muscle in the left hand of an adult male cadaver. In this case, the muscle comes from the ligament and over the scaphoideum and trapezoideum bones and continues after the short muscle belly; it is attached to the dorsal aponeurosis of the indicis. This muscular disposition was described in other studies which demonstrated approximately 1.0% of incidence. Clinically, this anatomical variation may be associated with pain and swelling at the back of the hand. In these cases symptoms tend to increase due to mechanical stress and can be confused with the presence of a dorsal synovial cyst. This report will help clinicians, surgeons, occupational and physical therapists formulate better clinical or surgical decisions when presented with a rare anatomical variation.

Kidney of Minke Whale (Baleanoptera acutorostrata): Architecture and structure

Sarmento C. A. P., Ferreira A. O., Rodrigues E. A. F., Lesnau G. G., Rici R. E. G., Abreu D. K., Biasi C. & Miglino M. A. 2012. [Kidney of Minke Whale (Baleanoptera acutorostrata): Architecture and structure.] Rins de Baleia Minke (Baleanoptera acutorostrata): arquitetura e estrutura. Pesquisa Veterinaria Brasileira 32(8): 807-811. Departamento de Cirurgia, Setor de Anatomia dos Animais Domesticos e Silvestres, Universidade de Sao Paulo, Av. Prof. Dr. Orlando Marques de Paiva 87, Sao Paulo, SP 05508-270, Brazil. E-mail: sarmento@usp.br Among marine mammals, whale is one of the most attention-arousing animals, especially concerning its urinary tract. This system follows the pattern of mammals with regard to its constitution, however, it differs in renal morphology and number of lobes, which, in turn, form complete reniculi, agglutinated in hundreds. This structure is supported by fibrous connective tissue, but highly capable of maintaining electrolyte balance. Six pairs of kidneys of Minke whale (Balaenoptera acutorostrata), collected in 1982, in Cabedelo, Paraiba, Brazil, in the last fishing allowed, were dissected. These kidneys were preserved in 10% formaldehyde and they presented a very large histologic layer of collagen surrounding the medullary wall. The urinary collecting duct form papillary glasses, that reach a single collecting center which discharges in the ureter. It was found that the kidney of Minke whale has a lobe characteristic, with, on average, 700 reniculi; each reniculus has anatomical and functional characteristics of a unipyramidal kidney, with an inner layer (medulla), and an outer layer (cortex), and independent irrigation, with formation of individually arcuate arteries, as observed in unipyramidal terrestrial mammals. However, the set gathering all these reniculi constitutes, in the end, a multilobular and polipyramidal kidney, contrary to the morphology of most terrestrial mammals. It was not possible to distinguish the renicular cortex structures of the Minke whale in the level of light microscopy. Through scanning electron microscopy, it was possible to visualize a cortical layer located between two fibrous capsules. This joint, in turn, consists of connective tissue, which, along with a layer of collagen and elastic fibers, separates the cortex from the medulla; the kidney glomeruli were visualized, completely taken by the glomerular vessels and arranged into several layers. One notices that the glomerular cavity is almost a virtual space into which the glomerular filtrate is drained, and it does not present a globular shape. Vascularization is increased in the medullary region. The difference between the kidneys of terrestrial and marine mammals consists in the arrangement of morphological components, favoring the organ's physiology.

Macroscopic description of teeth of Azara's agouti (Dasyprocta azarae)

Oliveira F.S., Martins L.L., Canola J.C., Oliveira P.T., Pecora J.D. & Pauloni A.P. 2012. Macroscopic description of teeth of Azara's agouti (Dasyprocta azarae). Pesquisa Veterinaria Brasileira 32(1):93-95. Departamento de Medicina Veterinaria, Universidade Estadual de Maringa, Campus Umuarama, Cx. Postal 65, Umuarama, PR 87501-970, Brazil. E-mail: singaretti@ig.com.br The teeth of Azara's agouti (Dasyprocta azarae) were described macroscopically in order to provide biological data on one of the largest wild rodents of the Americas. Radiography was taken on six heads and the teeth were described. Enamel surrounds the coronal dentin, projects to the roots and is present as parallel inner laminae in buccolingual direction. The dentin is located among the enamel laminae and surrounds the pulp horns. The cementum is located internally to the enamel laminae. On the lingual surface, the cementum and dentin are the outer elements.

Protease Inhibitor and Metabolic Alteration

Protease inhibitors (PIs), part of HAART (Highly Active Antiretroviral Therap) are selective, competitive inhibitors of protease, a crucial enzyme to viral maturation, infection and replication. A lipodystrophic syndrome has been reported in individuals treated with HAART, and associated to hyperglycemia, hypercholesterolemia, hypertrigliceridemia, hyperlipidemia, hypertension and hypreinsulinemia. The HAART-associated metabolic abnormalities were first associated with protease inhibitors, Ritonavir mostly, but the mechamisns that underlie these metabolic alterations are to date, not completely understood. Since Pis are candidate to be the drug of choice for other diseases treatment, such as the Hepatitis C, malaria and some types of cancer, it seems to be important to clarify the metabolic alterations associated to PIs. Wistar rats were treated twice a week with 30mg/kg Ritonavir for 4 and 8 weeks. Total cholesterol, HDL, LDL, VLDL, triglycerides and glycemic levels were measured by the end of each period of time selected. To avoid confunding effects of food intake, the animals were fasted 16 hours before. Our results showed rapid increase in serum triglycerides, total cholesterol, LDL-C and glycemic levels. No significant differences were observed for HDL-C or VLDL serum levels. Our study addresses the importance to observe the possible family history of dyslipidemia or diabetes, and control any other cardiovascular and diabetes risk factors when using protease inhibitors

Analysis of the NMDA in Focal Cerebral Ischemia in Rats

NMDAR (N-methyl-D-aspartate receptor) is one subtype of ionotrophic glutamate receptor which is extensively distributed in the central nervous system (CNS). In the mammalian CNS, NMDAR serves prominent roles in the pathophysiologic process of cerebral ischemia. This study aimed to investigate the pattern of expression of protein and gene of the excitatory neurotransmitter NMDAR in experimental focal cerebral ischemia and the hole of neuroprotection with hypothermia and ketoprofen. 120 rats were randomly divided into 6 groups (20 animals each): control - no surgery; sham - simulation of surgery; ischemic - focal ischemia for 1 hour, without reperfusion; ischemic + intraischemic hypothermia; ischemic + previous intravenous ketoprofen, and ischemic + hypothermia and ketoprofen. Ten animals from each experimental group were used to establish the volume of infarct. Transient focal cerebral ischemia was obtained in rats by occlusion of the middle cerebral artery with an intraluminal suture. The infarct volume was measured using morphometric analysis of infarct areas defined by triphenyl tetrazolium chloride and the patterns of expression of the protein and gene NMDA were evaluated by immunohistochemistry and quantitative real-time PCR, respectively. Increases in the protein and gene NMDA receptor in the ischemics areas were observed and these increases were reduced by hypothermia and ketoprofen. The increase in the NMDA receptor protein and gene expression observed in the ischemic animals was reduced by neuroprotection (hypothermia and ketoprofen). The NMDA receptor increases in the ischemic area suggests that the NMDA mediated neuroexcitotoxicity plays an important role in cell death and that the neuroprotective effect of both, hypothermia and ketoprofen is directly involved with the NMDA.

Immunohistochemical Analysis of Human Homologue of Drosophila Patched (PTCH) in Dental Follicles of Impacted Third Molars

This study investigated the immunodetection of PTCH in epithelial components of dental follicles associated with impacted third molars without radiographic signs of pathosis. One hundred and five specimens of dental follicles associated with impacted third molars with incomplete rhizogenesis (between Nolla's stage 6 and 9) were surgically removed from 56 patients. Epithelial cell proliferation was determined by using immunohistochemical labeling. Statistical analysis was performed using Fisher exact test and a level of significance of 5%. Of the 105 dental follicles collected, 3 were PTCH-positive. The specimens with squamous metaplasia and epithelial hyperplasia had higher rates of positivity for PTCH, as well as those with active remnants of odontogenic epithelium. This study suggests that the odontogenic cells of the dental follicle might be proliferating during the rhizogenesis, while the squamous metaplasia and hyperplasia of the epithelial lining and proliferative odontogenic epithelial rests show the differentiation potential of dental follicles.

Immunohistochemistry Analysis of Proteins Related with Apoptosis as Prognostic Factor in Epidermoid Carcinoma of Penis

The aim was to analyze the protein expression of apoptotic genes caspase-3, caspase-8 and bcl-2 with the immunohistochemistry technique, correlating with tumor grade (I, II and III) and with the patient survival in order to understand the basic mechanism of tumoral transformation. The immunohistochemistry reactions on 50 samples of squamous cell carcinoma were carried out with the avidin-biotin immunoperoxidase method and antigen recovery. The analyses were made using the graduation method "in crosses" (0 to 4 crosses - no stain to more than 75% of positives cells) and in categories (low, intermediate, high) of the cytoplasm immunoreactivity of the epidermoid penile carcinoma cells. It was observed a statistically significant difference when the expression of caspase-3 were compared with the grades land II of the tumor (p=0.0010) and when comparing the patient survival with the grades I and II of the tumor (p=0.0212). The protein bcl-2 was more expressed than caspase-3 and caspase-8 proteins, suggesting that the apoptotic rate in this carcinoma is low. The higher expression of the anti-apoptotic protein bcl-2 suggests a higher preservation of the tumoral cells.

Morphological and Biometric Study of the Infraorbital Foramen (E2-Sibai Point) in Adult Skulls

The objective of this work was to study the morphology and biometry of the infraorbital foramen (FIO), variations in its shape, size and number as well as to obtain measurements of its location. 60 dry skulls were analyzed. The test of Qui-quadrant and the T Test were used in measurements with a 5% significance. On the right side, the FIO was measured at a distance of 6.49(+/- 1.68) mm from the lower, 39.65(+/- 3) mm from the upper, 17.7(+/- 2.97) mm from the medial and 20.46(+/- 2.9) mm from the lateral margin of the orbit; its pear-shaped opening distance was 13.67(+/- 2.17) mm. On the left side, the distance of the FIO to the lower margin of the orbit was 6.52(+/- 1.82) mm; to the upper margin was 39.9(+/- 2.62) mm and to the lateral and medial margin were 17.93(+/- 2.58) mm and 21.12(+/- 3) mm, respectively; its distance to the pear-shaped opening was 14.26(+/- 1.83) mm. It was found predominately in an oval shape, in 39 (65%) of the skulls, on both sides. Accessory foramens were present in 11 samples on the right and in 15 samples on the left side. The FIO was most frequently found on the side of, or laterally to the sagittal plane that passes through the middle of the supraorbital foramen/incisures, in 38 skulls (63.3%) on the right side and in 45 skulls (75%) on the left and middle to the zigomatic-maxillary suture, in 41 skulls (68.3%) on right and in 42 skulls (70%) on the left side, besides being most frequently found in a region between the first and second premolars, in 22 skulls (36.7%) on the right side and in 17 skulls (28.3%) on the left.

Repression of Ppargc1a Gene in Liver of Hyperglycemic Rats Induced with High Fat Diet Combined with Streptozotocin

Type 2 diabetes mellitus implies deregulation of multiple metabolic processes, being the maintenance of glycemia one of the most important. Many genes are involved in the deregulation of this particular process. Therefore, the aim of this study was to evaluate gene expression of genes related to type 2 diabetes mellitus, in the liver and pancreas of rats with hyperglycemia induced by high fat diet along with a low single dose of streptozotocin. Ahsg and Ppargc1a genes were studied in liver, whereas Kcnj11 and Slc2a2 genes were analyzed in pancreas. For this purpose, 210-240 g female rats were fed a high fat diet or a control diet for three weeks. At day 14, animals fed with high fat diet were injected with a single low dose of streptozotocin (35 mg/kg) and the control group rats were injected only with the vehicle. Plasmatic glucose, triglycerides and total cholesterol levels were measured at the beginning, day 14 and end of treatment. Body weight was also measured. Once the treatment was complete, rats were appropriately euthanized and then, pancreas and liver were surgically removed and frozen in liquid nitrogen. Total RNA was isolated using TRIzol reagent, treated with DNase land reversely transcribed to cDNA. Gene expression analysis was performed using SYBR Green - Real time PCR and comparative Cq method, using three reference genes. Rats fed with high fat diet and treated with streptozotocin showed higher values of plasmatic glucose (17.09 +/- 0.43 vs. 5.91 +/- 0.29 mmol/L, p < 0.01) and a minor expression of Ppargc1a versus the control group (2-fold less expressed, p < 0.05) in liver. We conclude that repression of Ppargc1a gene may be an important process in the establishment of chronic hyperglycemia, probably through deregulation of hepatic gluconeogenesis. However, further studies need to be performed in order to clarify the role of Ppargc1a deregulation in liver glucose homeostasis.