Seqüência de moebius: Manifestações clínicas e avaliação auditiva

Introduction: Children with Moebius syndrome may present paralysis of cranial nerves III, IV, V, VI, VII, VIII, IX, X and XII, compromising motor and sensorial functions. Hands and feet defects (syndactyly, equinovarus and arthrogryposis) are frequently associated. These manifestations can be attributed to the use of misoprostol during pregnancy to induce abortion. Study design: Clinical prospective. Aim: To evaluate the main clinical manifestations, hearing acuity and possible etiologic factors in children with Moebius syndrome. Material and method: The children were submitted to clinical, otolaryngological and hearing acuity assessment. Hearing acuity was evaluated through behavioral tests, pure tone audiometry, tympanometry and auditory brainstem response (ABR). We investigated possible etiologic factors. Results: Three boys and two girls were evaluated. The main manifestations were: facial paralysis, paralysis of masseter muscle, defects in dental occlusion, retraction of tympanic membrane, equinovarus, oblique palpebral fissure and tongue atrophy. Conductive hearing loss was detected in three children and sensorineural hearing loss in one child. The use of misoprostol during pregnancy was reported by four mothers. Conclusions: The children with Moebius syndrome evaluated in the present study manifested palsies of various cranial nerves, especially V, VII and XII nerves, responsible for motor and sensorial alterations. Inadequate eustachian tube function associated to conductive hearing loss was frequent. The use of misoprostol during pregnancy was reported by the mothers and it was considered a possible etiologic factor.

Avaliação experimental dos efeitos do anestésico local ropivacaína em nervos ciáticos

This study was undertaken to investigate the effects of ropivacaine after intrafascicular injection into the sciatic nerves of albino rabbits. Twenty adult albine rabbits were used, following sedation with intramuscular ketamine (50 mg/kg) for nerve exposure by lateral incision. We considered three experimental groups: Group I:sciatic nerve control; Group II: intrafascicular injection with 0.2 mL of physiologic saline solution in the left nerves and intrafascicular injection with 0.2 mL of local anesthetic ropivacaine into the rigth nerves. The specimens were colected at 48 h after drugs administration; Group III. intrafascicular injection with 0.2 mL of physiologic saline solution in the left nerves and intrafascicular injection with 0.2 mL of local anesthetic ropivacaine in the rigth nerves. The specimens were colected at 7 days after drugs administration. The sciatic nerves were removed from these animals and fixed in Karnowisky solution for 24 hours. After partial dehydration up to 95% ethanol, they were embedded in historesin (Leica). The tissue was then sectioned at 1-2μm. Sections were stained with haematoxylin-eosin (HE); toluidine blue (TB) or picrosirius-haematoxylin (PSH). Comparing with control group the histological evidence of inflammatory reaction (migration of macrophagic cells and eosinophils-appeared soon after injection, with intense proliferation of perineurial cells. The results show that after 7 days of intrafascicular injection there was a severe fibrosis and an increase on perineurial vascularization. In group 2 the inflammatory reaction was noted near the local of the injection. Furthermore in this experiment we observed an increase on the number of epineurial lipoblasts and adipocytes. This study demonstrated that the toxic effects of ropivacaine are transient. In many cases there was an initial fascicular recover and axonal regeneration after 7 days of the injection.

Laryngeal electromyography: Contribution to vocal fold immobility diagnosis

Laryngeal Electromyography (LEMG) is a diagnostic test commonly used in patients with vocal fold movement disorder The aim of this study is to describe LEMG in patients with vocalfold immobility. A total of 55 dysphonic patients with vocal fold immobility diagnosed by laryngeal endoscopy were grouped according to probable clinical cause: 1) unknown; 2) traumatic; or 3) tumoral compression. They were submitted to LEMG by percutaneous insertion of concentric needle electrode. LEMG was conclusive in all patients and showed a majority with peripheral nerve injury. LEMG diagnosed peripheral nerve damage in 25 group 1, 12 group 2, and 11 group 3 patients. LEMG was normal in 4 patients, suggesting cricoarytenoid joint fixation. Central nervous system disorders was suggested in 2 and myopathic pattern in 1. As the major cause of vocal fold immobility is peripheral nerve damage, LEMG is an important test to confirm diagnosis.

Potencial cognitivo P300 em indivíduos com diabetes mellitus

Diabetes Mellitus may lead to alterations in the eyes, kidneys, cranial nerves, peripheral nerves, ears etc. The cognitive function, also, seems to be compromised in subjects presented with Diabetes Mellitus, since the cortical and subcortical structures responsible for this function are hindered in some insulin-dependent patients. The cognitive potential P300 has been used as an objective procedure to assess cerebral cognitive functions. Objective: Analyze the sensitivity of P300 cognitive potential for the detection of alterations on the auditory cortex secondary to Diabetes Mellitus. Study design: transversal cohort. Material and Method: Sixteen diabetic subjects of both genders aged 7 to 71 years, and seventeen non-diabetic individuals at the same age range participated in this study, the evaluation procedures were pure tone audiometry (PTA) and P300 cognitive potential. Glycemia of the group presented with Diabetes was assessed prior to applying the P300. Results: No statistically significant difference was shown for the PTA results. A statically significant difference was observed between groups when analyzing the latency of the P300 component measured in Fz. there was a correlation between glycemia and the latency and amplitude of P300. Conclusion: The investigation of the cognitive potential of P300 is an important procedure for the prevention and early diagnosis of neurological changes in individuals presented with Diabetes Mellitus.

Mononeuropathy of the suprascapular nerve: Study of 3 South American cases

In this work 3 new cases of suprascapular nerve mononeuropathy are described. ENMG diagnosis criteria were: a) normal sensory conduction studies of the ipsolateral ulnar, median and radial nerves; b) bilateral suprascapular nerve latencies with bilateral compound muscle action potential, obtained from the infraspinatus muscle with symmetrical techniques; and c) abnormal neurogenic infraspinatus muscle electromyographic findings, coexisting with normal electromyographical data of the ipsolateral deltoideus and supraspinatus muscles. These 3 cases of suprascapular mononeurpathy were found in 6,080 ENMG exams from our University Hospital. For us this mononeuropathy is rare with a 0.05% occurrence.

Anatomia do nervo isquiático em mocós (Kerodon rupestris WIED, 1820) aplicada a clínica de animais silvestres

To know the origin of the ischiatic nerve in mocos (Kerodon rupestris Wied,1820) near by intervertebral forames and the muscling belonging to its routes were used 10 adult animals, from CEMAS-ESAM. After natural obit, they were fixed in formol (10%) and dissected to exposition and to singt of the ischiatic nerve. The results were indicated in percentage. Variations in the quantity of the lumber and sacral vertebras nere observed, five animals (50,00%) reveled seven lumbar vertebras and three sacral ones; two animals recrealed seven lumbar vertebras and four sacral ones, and two animals reveled six lumbar vertebras and three sacral ones. An animal (10,00%) revealed six lumbar vertebras and four ones. Therefore, the origin of the nerve was differentiated five animals (50,00%) had the participation of L 7,S 1,S 2; two animals (20,00%) with L 7,S 1; and a little part of S 2. Two animals (20,00%) with L 6,S 1,S 2, and an animal (10,00%) with L 6,S 1, and a little part of S 2. The last root of the ischiatic nerve in all its origins, contribute to the constitution of the first root of pudental nerve. It was verified that in all its route, the ischiatic nerves (100,00%) ceded branches to the muscles: medial gluteus, deep gluteus, superficial gluteus, emiting muscular branches to the femoral biceps or to thigh, and to the semimembranous and semi-tendinous muscles, that is continuous with a high calibre trunk, originating the fibular nerve(sideways), the tibial nerve(medial) and the lateral plantar sural cutaneous nerve (caudal).

Estudo comparativo experimental da injeção perineural do álcool benzílico 0,75% e do álcool etílico absoluto nos nervos palmares de eqüinos

The clinical and histopathological effects of two alcoholic neurolytics were studied in horses. Normal horses were shod with a designed shoe adaptted with 5 screws to produce solar pain. After gait and lameness score analysis, the palmar nerve of 5 horses was injected with 5 ml of 0,75% benzyl alcohol (Group A) and 5 horses were injected with 5 ml of absolute ethyl alcohol (Group B). The animals were submitted to regular lameness evaluation and solar sensibility tests during next six months. The solar sensitivity returned 5 months latter in the group injected with benzyl alcohol 0,75%, while in the group injected with absolute ethyl alcohol, the sole was still desensitized 6 months latter. The histopathological findings showed that the nerve injected with benzyl alcohol 0,75%, resulted in axonotmesis, characterized by axonal nerve degeneration, with possibilities for the nerve conduction recovery. The perineural injection of ethyl alcohol absolute, resulted in neurotmesis with difficult nerve regeneration. It was concluded that chemical neurolysis with alcohol is an option for temporary or permanent nerve blocks in horses.

Ramificação e distribuição dos nervos frênicos no músculo diafragma do gato doméstico

The ramification and the distribution of the phrenic nerves right and left had been studied in 30 muscles diaphragms of unknown breed adult domestic cats, 7 males and 23 females, and were fixed in 10% buffered formalin solution. After fixation and dissection, it was observed that the phrenic nerves ramified for the respective carnous parts of the muscle diaphragm, pars lumbalis, costalis and sternalis, and had finished in higher frequency in dorsolateral trunk and ventral branch (63.33%). We observed the following arrangements: dorsal, ventral and lateral branches (25.0%); dorsal branch and ventrolateral trunk (6.66%); dorsolateral and ventrolateral trunks (3.33%); dorsolateral trunk, lateral and ventral branches (1.66%). The phrenic nerves had distributed symmetrically in 11 samples (36.66%), only showing the termination in dorsolateral trunk and ventral branch. The dorsal branches supplied pars lumbalis (73.33% to right and 56.66% to the left) and pars costalis (13.33% to right and 10.0% to the left). The right dorsal branch supplied the crus mediale dexter of the right pillar (100.0%) and the left dorsal branch supplied the crus mediale sinister of the right pillar and the left pillar (100.0%). The lateral branches supply pars lumbalis (23.33% to right and 33.33% to the left), pars costalis (96.66% to right and 100.0% to the left) and pars sternalis (3.33% only to the right). The ventral branches supplied the ventral region of pars costalis (46.66 % to right and 43.33% to the left) and pars sternalis (96.66% to right and 100.0% to the left). Four female animals (13.33%) had shown fibers crossing proceeding from the left ventral branch for right antimere had been that in one of these samples (3.33%) occurred connection between the left ventral branch and the right.

Arranjos configurados pelos nervos do plexo braquial no urubu (Coragyps atratus foetens - Linnaeus, 1758)

The anatomical study of the origin and distribution of brachial plexus in vulture (Coragyps atratus foetens) was performed in 14 animals, adults, males and females, deriving of the region of Araçatuba (SP). After fixed in watery solution of formaldehyde 10,00%, became dissected bilateral of the origin of the brachial plexus, and yours distribution. The analysis allowed verify that brachial plexus of vulture, four root possess, which originate from the ventral branches of cervical spinal nerves eleven (C11), twelve (C12) and thirteen (C13) and of the ventral branches of thoracic spinal nerve one (T1) and (T2) in both sides (100%). The first root part of C11 in the right and left side, and of the edge skull of the dorsal lace the nerves subescapular, subcoracoescapular e supracoracóide in both antímeros (100%). As the root originates from C12 in both sides, giving origin to the dorsal lace, giving the axilar, radial and anconeal nerves (100%). The third root of plexus originates solely from C13 (100%) and the root of T1 in both sides (100%). The roots of C12, C13 and T1 was united the ventral lace originates, which breaks the nerves to medianoulnar that divided in medium and to ulnar and the pectoral nerves (100%). T2 emits filaments that join it root nervous of T1, being one filament (35,55%) and two filaments (64,29%) in side right, while that in the left one filament (42,85%), two filaments (50%) and three filaments (7,15%).

Caracterização morfológica do diásporo e da plântula de Archontophoenix cunninghamii (Arecaceae)

The palm Archontophoenix cunninghamii H.Wendl. & Drude, even widely used in landscaping, has been poorly studied. In general, there are few articles on morphology of seeds and seedlings of Arecaceae species. With the aim of filling this gap, the objective of the present work describes the diaspore (seed with adhering endocarp) and the seedling morphology. A. cunninghamii seeds present rounded shape and a ruminated endosperm of hard consistency. The embryo is lateral, peripheral and relatively undifferentiated, approximately 4 mm long, conical, with one of the extremities convex, and in its inside there is a small protuberance while the other extremity is rounded and narrower. The seedling is adjacent ligulated and hypogeal, with the development starting from a mass of undifferentiated cells in the micropillar depression, the differentiation of shoot and root primordium, being the first enveloped by a sheath closed. The root system is fasciculate, with different adventitious roots and several lateral roots with few absorbent hairs. The stem comprises three sheaths surrounding the first young leaf, which are opened in succession, permitting the emergence of the primary bifid leaf, with typical parallel nerves.

Structural and ultrastructural evidence for telocytes in prostate stroma

The prostate comprises a glandular epithelium embedded within a fibromuscular stroma. The stroma is a complex arrangement of cells and extracellular matrix (ECM) components in addition to growth factors, regulatory molecules, remodelling enzymes, blood vessels, nerves and immune cells. The principal sources of ECM components are fibroblasts and smooth muscle cells (SMC), which synthesize the structural and regulatory components of the ECM. Telocytes (TCs) were recently described as a novel stromal cell type that exhibited characteristic features. The aim of this study was to confirm the presence of TCs in prostate stromal tissue of gerbils, as the stromal compartment of this gland is a dynamic microenvironment. We used transmission electron microscopy (TEM), light microscopy and immunohistochemistry methods to provide morphological evidence for the presence of TCs. Cells that resembled TCs were observed in gerbil prostatic stroma. These cells had small cellular bodies with very thin and extremely long cellular processes. They were found primarily in the subepithelial area and also at the periphery of SMC layers. TCs also exhibited moniliform processes, caveolae and nuclei surrounded by small amounts of cytoplasm. Close contacts between TC podomers were evident, particularly in the adjacent epithelial compartment. This morphological evidence supported the presence of TCs in the gerbil prostatic stroma, which we report for the first time. © 2013 The Authors. Published by Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Trigeminal neuralgia: Literature review

The trigeminal nerve, fifth equal of cranial nerves, a mixed nerve is considered by possessing motor and sensitive components. The sensitive portion takes to the Nervous System Central somesthesics information from the skin and mucous membrane of great area of the face, being responsible also for a neural disease, known as the Trigeminal Neuralgia. The aim of this study was to review the literature on the main characteristics of Trigeminal Neuralgia, the relevant aspects for the diagnosis and treatment options for this pathology. This neuralgia is characterized by hard pains and sudden, similar to electric discharges, with duration between a few seconds to two minutes, in the trigeminal nerve sensorial distribution. The pain is unchained by light touches in specific points in the skin of the face or for movements of the facial muscles, it can be caused by traumatic sequels or physiologic processes degenerative associate the vascular compression. Prevails in the senior population, frequently in the woman. In a unilateral way it attacks more the maxillary and mandibular divisions, rarely happens in a simultaneous way in the three branches of trigeminal nerve three branches.

Visceral colouration of Eupemphix nattereri (Anura: Leiuperidae): effects of NDP-α-melanocyte stimulating hormone

Amphibians have melanin-containing cells in visceral organs that are similar to pigmentary cells from the epidermis. Both of them are derived from the ectodermal neural crest. Epidermal cells respond to α-melanocyte stimulating hormone (α-MSH), which is associated to the dispersion of melanin granules within melanocytes. Therefore, our aim was to test whether a non-degradable analogue of the α-MSH changes the superficial colouration of organs of Eupemphix nattereri. The hormone rapidly increases (within 12 hours) the colouration on the surface of the pericardium, heart, testes, nerves of the lumbar plexus, and lumbosacral parietal peritoneum. Colouration increased late (after 24 hours) in the kidneys and mesentery following hormone administration. However, this hormone did not change colouration of intestine, rectum and lungs. Our findings could be explained by the similarities between epidermal and visceral melanocytes, since both cells have a common embryonic origin. Furthermore, the increase in visceral colouration may be related to the dispersion of melanosomes within melanocytes, which causes the darkening of organs. Our results demonstrate for the first time that the visceral colouration is responsive, thereby altering the internal pattern of organs' colouration in anurans. © 2013 Copyright 2013 Unione Zoologica Italiana.

Intraoral schwannomas: Presentation of a series of 12 cases

Introduction: Schwannomas are benign and not very frequent tumors of the peripheral nerves, derived from the nerve supporting Schwann cells. Study Design: Data were collected on the clinical manifestations (sex, age), location, size and symptonts of the lesions as well as the evolution time and the initial (presumption) diagnosis. Results: Twelve patients were documented, with a mean age of 29,5 ± 12,1 years (range 16-50) and a balanced gender distribution. The mean duration of the lesions was 42,17± 45,3 months. The lesion located in the floor of the mouth was the largest tumor, measuring about 4 cm in maximum diameter, while the average size of the 12 schwannomas was 2.04± 1.1 cm. Conclusion: We present 12 oral schwannomas diagnosed and treated over a period of 10 years. © Medicina Oral S. L. C.I.F. B 96689336 - eISSN: 1989-5488.

Estudo comparativo com diferentes números de pontes na neurorrafia término-lateral em ratos

Pós-graduação em Bases Gerais da Cirurgia - FMB