Blefarospasmo essencial e espasmo hemifacial: Características dos pacientes, tratamento com toxina botulínica A e revisão da literatura

Purpose: To evaluate the characteristics of the essential blepharospasm and hemifacial spasm patients and the feasible treatment with botulinum toxin. A. Methods: Thirty-four essential blepharospasm or hemifacial spasm patients were evaluated according to gender, ocular complaint, time of disease, treatment outcome and complications. Results: Age median was 63 years and the mean was 61 years, with no difference regarding sex; 66.66% of the patients had hemifacial spasm and 33.33%, essential blepharospasm. Many patients complained of dry eye associated with involuntary spasm. Botulinum toxin A showed a positive outcome in 91.30% of the treated patients and complications observed after treatment were eyelid ptosis (8.33%) and buccal angle deviation (8.33%). Conclusion: Essential blepharospasm and hemifacial spasm occurred in the elderly, of both sexes. Treatment with botulinum toxin A was useful, with very low complication rates.

Avaliação de diferentes híbridos suínos submetidos à insensibilização elétrica e gasosa (CO 2). Parte 3 - Mensurações visuais de qualidade

Three pig genetics lineages A, B and C marketed in Brazil, were stunning with the manual electric stunning (Karl Schermer 220-230/250 volts, 45-60 Hz and 1.4 - 1.5 A) and the collective gaseous system (COMBI-BUTINA 90% CO 2). The electric stunning provided higher blood splashed levels in the areas of the inside round (0.477 and 0.26, p ≤ 0.01), shoulder/cranial (0.154 and 0.039, p ≤ 0.005), shoulder/central (0.261 e 0.052, p ≤ 0.001), shoulder/caudal (0.180 and 0.030, p ≤ 0.01), loin/central (0.185 and 0.065, p ≤ 0.01), loin/caudal (0.06 and 0.207, p ≤ 0.01) and loin/lateral external (0.061 and 0.013, p ≤ 0.05), as well as more diffuse blood splashed in the areas of the inside round (0.461 and 0.279, p ≤ 0.05), shoulder/cranial (0.154 and 0.039, p ≤ 0.001), shoulder/central (0.231 and 0.039, p ≤ 0.001) and shoulder/caudal (0.185 and 0.026, p ≤ 0.001). The electric stunning also provided higher skin damage levels in the areas of the shoulder (1.098 and 0.795, p ≤ 0.001), body (1.04 and 0.948, p ≤ 0.05) and ham (0.84 and 0.68, p ≤ 0.001), as well as higher eyelid reflex levels (11.57%) comparatively to the gaseous system (2.86%) of a total of 426 pigs. Small indexes of bone fractures and muscle bruises were found in both systems.

Palpebral dimensions in Brazilian children: Assessment based on digital images

Purpose: To determine palpebral dimensions and development in Brazilian children using digital images. Methods: An observational study was performed measuring eyelid angles, palpebral fissure area and interpupillary distance in 220 children aged from 4 to 72 months. Digital images were obtained with a Sony Lithium movie camera (Sony DCR-TRV110, Brazil) in frontal view from awake children in primary ocular position; the object of observation was located at pupil height. The images were saved to tape, transferred to a Macintosh G4 (Apple Computer Inc., USA) computer and processed using NIH 1.58 software (NTIS, 5285 Port Royal Rd., Springfield, VA 22161, USA). Data were submitted to statistical analysis. Results: All parameters studied increased with age. The outer palpebral angle was greater than the inner, and palpebral fissure and angles showed greater changes between 4 and 5 months old and at around 24 to 36 months. Conclusion: There are significant variations in palpebral dimensions in children under 72 months old, especially around 24 to 36 months. Copyright © 2006 Informa Healthcare.

Restabelecimento funcional do tendão extensor digital longo submetido a ressecção parcial em equinos: Observação macroscópica, histopatológica e ultra-sonográfica

The objective of this work was to study the macroscopic, ultrasonographic and histopathologic aspects from the newly formed cicatricial tissue at the site of the partial resection of the long digital extensor tendon in 10 equines at the moment of functional restoration of the limb with the animal in walk locomotion. The macroscopic exam was performed every 48 hours, the planimetric mensuration every 10 days, the ultrasonographic exam every 15 days and the histopathologyc exam at the end of the study. The wounds showed granulation tissue in retraction, without total lesion epithelization, and the aspects ultrasonographics revealed wound healing with newly formed tissues with variable density and high neovascularization without tendon structural reorganization. The histopathology showed newly formed vascularized tissue, with leukocytic infiltrate and collagenous deposition without full epithelization. The cicatrization tissue formed in the resection region of the tendon, immature and without the structural organization of the normal tendon, showed to be able to functional restoration of the operated limb.

Ectrópio palpebral: Características e relação com alterações óculo-palpebrais

Objective: To evaluate the gender and the characteristics of the ectropion carriers in our region. Methods: A retrospective study was done evolving 112 ectropion carriers. The sex, race, eyelashes alterations (trichiasis and distichiasis), anterior and posterior blepharitis, conjunctival redness, íris color and pterygium presence were evaluated. Gender data were correlated to ectropion classification (involutional, cicatricial, mechanic or paralytic) and submitted to statiscal analysis. Results: The eyelid ectropion occurred more between 71 and 80 years old.The involutional ectropion was the most frequently observed (66,07%), followed by the cicatricial, mechanic, associated types and paralytic. The majority of the patients were male (70,53%), with White skin. Trichiasis (21,42%) and distichiasis (4,46%) were associated to the ectropion eyelid and mainly in the involutional ectropion carriers. Half of the sample had blepharitis and the majority of the patients had red eye (60%) and brown iris (63,39%). Perygium was absent in the majority of the patients. Conclusion: The involutional ectropium is the most frequently observed in our region, mainly in elderly, male, White skin, brown iris and associated to trichiasis, blepharitis and red eyes.

Ectrópio palpebral em portador da síndrome de Down e conjuntivite alérgica: Relato de caso

This is a case report of a patient with Down's syndrome with an important mechanical ectropion and elongation of the lower lid related to chronic allergic conjunctivitis, besides cataract and keratoconus. The tarsal strip technique and ressection of redundant and thick conjunctiva was the surgical approach chosen for this case. Functional and cosmetic outcomes were considered satisfactory.

Prolapso de glândula de terceira pálpebra em cäes: Avaliação cito e histopatológica

The present experiment was carried out in ten animals with third eyelid prolapsed gland. All of the prolapsed glands were surgically excised. The age of the dogs ranged from two month to ten years old, and the breeds were Beagle (20%), Teckel (10%), Pinscher (10%), Poodle (10%) and other mongrel dogs. Aspirative citology was made in all the removed glands, after that they were fixed in 10% formalin and stained with Hematoxiline and Eosine. It was observed a focal mononuclear inflamatory infiltrate in the conjunctive and periacinal tissues. Ductal dilatation and metaplasia were noted on cells of the ducts. Cyitologic examination showed similar inflamatory infiltrate to histopatologic findings. The glands showed a chronic adenitis. The absence of histo and cytologic significance changes justify the tissue function observed during surgical excision.

carcinoma basocelular com invasão orbitária

The purpose of this paper is to report a recidivate basal cell carcinoma of the eyelid with orbital invasion located in the inner canthus of the left eye. A 79 year old, male, Caucasian patient had a basal cell carcinoma removed from the left inner eyelid canthus 8 years ago and the edges of the resection were compromised by the lesion. The patient had recurrence of the lesion and orbital invasion. He was submitted to orbital exenteration and the ethmoid bone was removed too. The authors call attention to the necessity of correct diagnosis and followup to have success in the management of the patient.

Alterações dentoesqueléticas e do perfil facial em pacientes tratados ortodonticamente com extração de quatro primeiros pré-molares

Objective: the purpose of this prospective study was to cephalometrically analyze the dentoalveolar and soft tissue changes after the orthodontic treatment followed by the extraction of four premolars. Material and methods: the sample was comprised by 30 Class II division 1 patients with mean initial age of 12 years and 4 months. Two lateral cephalograms were obtained from each patient at the beginning and at the end of the treatment. The variables analyzed were the nasalabial changes and upper and lower incisors changes in relation to a vertical and horizontal x and y reference lines. Results: upper and lower incisors retraction was 3.4 and 1.8mm, respectively. The SNA angle was decresead by 1.7 degrees followed by a retraction of point A mainly due to the upper incisor retraction. There was a significant decrease of the Wits and ANB variables. There was an increase in the lower anterior facial height. Upper incisor retraction was followed by an increase in the nasolabial angle (ratio 1:2.8 degrees). However, a wide range of individual variability was found. Conclusions: the present study did not support the simple expectation that treatment with extractions of four premolars will result in a dished in face. It appeared that facial changes were more related to a normal facial growth, the amount of incisor retraction and the anchorage control during the upper and lower incisor.

Microscopic, morphometric and ultrastructural analysis of anastomotic healing in the intestine of normal and diabetic rats

The purpose of this study was to investigate if experimental alloxanic diabetes could cause qualitative changes in intestinal anastomoses of the terminal ileum and distal colon in rats, as compared to controls. 192 male Wistar rats, weighing ± 300g were split into four experimental groups of 48 animals each, after 3 months of follow-up: a control group with ileum anastomoses (G1), a control group with colon anastomoses (G2), a diabetic group with ileum anastomoses (G3) and a diabetic group with colon anastomoses (G4). Animals were evaluated and sacrificed on days 4, 14, 21 and 30 after surgery, and fragments of the small and large intestine where the anastomoses were performed were removed. Samples from 6 animals from each sacrifice moment were submitted to ultrastructural analysis of the collagen fibers using a scanning electron microscope and samples from another 6 animals were submitted to histopathology and optical microscopy studies using picrosirius red-staining. Histopathological analysis of picrosirius red-stained anastomosis slides using an optical microscope at 40x magnification showed that the distribution of collagen fibers was disarranged and also revealed a delay in scar tissue retraction. The morphometric study revealed differences in the collagen filled area for the ileum anastomoses 14 days post surgery whereas, in the case of colon anastomoses, differences were observed at days 4 and 30 post surgery, with higher values in the diabetic animals. Ultrastructure analysis of the ileum and colon anastomoses using a scanning electron microscope revealed fewer wide collagen fibers, the presence of narrower fibers and a disarranged distribution of the collagen fibers. We conclude that diabetes caused qualitative changes in scar tissue as well as in the structural arrangement of collagen fibers, what could explain the reduced wound strength in the anastomosis of diabetic animals. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart.

La technique de l’arc segmenté. Contrôle de l’ancrage et modification significative du profil facial : une étude de cas

This article evaluates space closure mechanics efficiency in an extraction case where maximum anchorage was a requirement. The Segmented Arch Technique (SAT) was utilized as an anchorage control strategy to obtain maximum anterior retraction and, in consequence, significant facial profile change. A 20-year-10-month old woman needed severe labial and profile changes. The patient had four premolars extracted and SAT with type A mechanics [1] (Marcotte [2] activation protocol) was applied. The results showed significant reduction in labial protrusion and incisal angulation with effective anchorage control. The results were compared to others available in the literature derived from different techniques, where anterior retraction was also accomplished with maximum anchorage [3-7]. In conclusion, the SAT with type A mechanics has been shown to be another treatment option when significant changes in the soft-tissue profile are needed in extraction cases. © 2008. CEO. Published by Elsevier Masson SAS. All rights reserved.

Autologous orbicularis muscle for filling facial foldsan experimental and clinical study

Purpose: To present a technique for filling facial folds by using autologous orbicularis oculi muscle, based on an experimental model. Methods: two studies are presented: (1) an experimental study using 15 albino guinea-pigs from which a strip of the sural triceps muscle was removed and implanted in the subcutaneous tissue of the dorsal area. The animals were sacrificed 7, 30 and 60 days after the implantation, and the material was histologically evaluated. And (2%) an interventional prospective clinical trial carried out on 20 patients referred to blepharoplasty surgery. They received autologous preseptal orbicularis muscle for filling facial folds. The results where evaluated by patients satisfaction and clinical exam. Results: the sural tricep muscle, when implanted in the subcutaneous tissue, resulted in fibrosis. The patients whom received autologous orbicularis muscle implanted for filling facial folds showed that the procedure can be successfully carried out. Conclusions: autologous preseptal orbicularis muscle is a good material for filling facial folds. Cicatricial tissue will be formed on its implantation site, filling the tissue gap that forms the folds on the skin.

Cryptococcus gattii and Cryptococcus albidus in captive domestic Pigeon (Columba livia)

Cryptococcosis in animals is an important fungal disease caused by the encapsulated yeast Cryptococcus neoformans. This report describes the occurrence of Cryptococcus gattii and Cryptococcus albidus in domestic pigeon (Columba livia), living together with other birds in a breeding center. The animal presented a pinkish, vascularized mass with gelatinous aspect localized subcutaneously under the right lower eyelid, with approximately 2cm in diameter. At microbiological exam it was isolated Cryptococcus gatti from the eyelid mass, lungs and liver, C. albidus from the trachea and both Cryptococcus species from muscle and kidney.

Prolapso da glândula da terceira pálpebra em cão -relato de caso

The updating of the of the prolapse of the third eyelid gland treatment in the literature is pertinent, due to the different surgical techniques for his resolution, with advantages and disadvantages. The work aimed to report the Moore technique in surgical treatment of the bilateral prolapse of the third eyelid gland in a female dog with bilateral entropion, six months, Shar-Pei breed, attended in the Veterinary Hospital School, Mozambique. The Moore technique showed good results and if the bilateral entropion was not a spastic type, was able to do the both surgeries in same day. The surgery using the Moore technique continues easy to learn, more simple to do and does not affect the third eyelid mobility.

Aspectos clínicos do enxerto conjuntival 360° e do implante da membrana amniótica criopreservada no tratamento de úlceras de córnea em cães

To evaluate the clinical application of implant of the canine cryopreserved amniotic membrane (DMEM plus DMSO 1:1) and 360° conjunctival flap in the treatment of progressive corneal ulceration. 10 dogs of the different breeds, males and females, aging four months to four years old with deep corneal ulceration and different clinical progression were divided in two groups: G1=360° conjunctival graft (n=5) and G2=implant of amniotic membrane, sutured at the edge of the ulcer with epithelial side facing up, associated with the third eyelid flap (n=5). The comparative analysis between groups was: complications, blepharospasm, ocular secretion, corneal vascularization, epithelial defect and corneal opacification in six moments (first emergency care, surgery and 3, 7, 15 and 30 days of postoperative). Without epithelial defect was evaluated quality of the scar. It was used score scale for subjective to qualify of the ocular signs. In G1, it was observed the non-adherence of the conjunctival graft to the ulcer (n=2), dehiscence of the suture (n=2), anterior synechia (n=2) and intense chemosis (n=1). In G2, it was not observed these complications. It was not significant difference between the groups to others ocular parameters, but it was different among the start and end moments of the same groups (ocular secretion, corneal vascularization, epithelial defect). The corneal opacity was more intense in G1. According to the clinical results, the cryopreserved amniotic membrane implant proved to be as effective in the corneal ulceration in comparison to the 360° conjunctival flap, because probably, the membrane promoted a trophic support for epithelialization, anti-inflamatory effect associated with important to the end result phenotype.