Cinedacryocystography in the diagnosis of lacrimal obstruction in children

Purpose: To analyze the cinedacryocystography in children with congenital nasolacrimal obstruction suspicion. Methods: The cinedacryocystographic examination was done in 143 children (58% of girls and 42% of boys) younger than 5 years old, suspected of congenital nasolacrimal obstruction. The exams were done under general anesthesia and the children were probed immediately when obstruction was detected. Results: Epiphora, discharge or both were the most common complaints. Nevertheless 11% children had undergone unsuccessfully probing once, no one had any radiologic evaluation previously. The cinedacryocystographic exam showed nasolacrimal duct obstruction in 65,73%. Permeable lacrimal vies were presented in 34,3% of the children with epiphora. The obstruction was mainly at the Arlt's sinus. Using the cinedacryocystography, it was possible to observe the lacrimal sac enlargement and alterations in the contiguous structures such as hypertrophic turbinates (91,1%), sinusitis (44,6%) and septum deviation (24,1%). Conclusion: Cinedacryocystographic evaluation provides important information about lacrimal system obstruction in children, therefore, it is useful in all children with suspected congenital lacrimal obstruction.

Masseter muscle hypertrophy - case report

Masseter muscle hypertrophy is characterized by unilateral or bilateral enlargement of the masseter muscles affecting both males and females after puberty. Its etiology remains unknown. Limitations on mouth opening and also tension in the region of the hypertrophied muscle are symptoms reported. This paper reports a case of masseter muscle hypertrophy diagnosed using imaging modalities such as conventional radiography, computed tomography and magnetic resonance imaging scans. The familiarity with this condition is important to settle the differential diagnosis with other pathologies such as parotid gland tumors and dental infection.

Efeito da mitomicina c no epitélio ciliar estudo experimental em coelhos com microscopia eletrônica de varredura e de transmissão

Purpose: To evaluate and correlate in the rabbit the possible changes caused by mitomycin C under the scleral flap in the ciliary epithelium with transmission electron microscopy (TEM) and scanning electron microscopy (SEM). Methods: The eyes of 32 albino rabbits were studied and divided in 4 experimental groups. The right eye (RE) was intended for the experimental groups and the left eye (LE) for the controls. Group I (G1) was formed by 8 eyes that received 0,5 mg/ml of mitomycin C under the scleral flap and were examined after 15 days. Group II (G2) differed from G1 only in the time of the exam, after 30 days. Group III (G3) was formed by 8 eyes that received 0,2 mg/ml of mitomycin C under the scleral flap and were examined after 15 days. Group IV (G4) differed from group 3 just in the time of the exam, after 30 days. In each eye the internal ciliary epithelium were examined with TEM. Results: The following changes in the internal ciliary epithelium were observed in groups G2, G3, and G4 with TEM: discontinuous and irregular basement membrane, more irregular and electron-dense nucleous, enlargement among interdigitation, edematous mitochondria and myelin figures. These alterations were not found in all the animals of the groups. Group G 1 did not present alterations. Roughness in groups G 1, G2, G3 and G4 were observed with SEM. In groups G 1 and G2 continuity solutions were also observed. Conclusion: Mitomycin C in 0,2 mg/ml and 0,5 mg/ml concentrations caused changes in the internal ciliary epithelium 15 and 30 days after, with TEM and SEM. There was no correlation between dosage, time and with TEM and SEM.

Hysteroscopic myomectomy in a submucous fibroid 3 mm from the serosa: A case report - Case report from the endoscopy service of Ginendo-RJ

This is a case report of a 39-year-old black woman, nulliparous, married who presented a heavy menstrual flow with clots and dysmenorrhea. Gynaecological examination of the uterus revealed RVF, mobility, no pain, slight enlargement, and right displacement. Magnetic resonance imaging (MRI) of the pelvis showed a 40 mm submucous fibroid with intramural component less than 50%, type 1, with a 3 mm distance from serosa. In an office hysteroscopy, it was noted a 40 mm submucous fibroid with an intramural component with less than 50%, type 1, classified in STEP-W submucous fibroids classification as a Score 6, Group II. The patient was submitted to partial hysteroscopic myomectomy, removing 60% of the fibroid volume in a 48.75-minute surgery. GnRH analogue was indicated for 3 months before another intervention. In the second evaluation MRI revealed a 22 mm-fibroid with intramural component more than 50%, type 2, with a 7 mm distance from serosa. Hysteroscopy found a 20 mm submucous fibroid, with intramural component more than 50%, type 2, Score 4, Group I on STEP-W classification. The patient was submitted to a second hysteroscopic myomectomy with complete removal and 10.5 minutes operating time, without complications. © 2006 Springer-Verlag.

The large vestibular aqueduct syndrome: A cause of neurosensory dysacusia

Background: The large vestibular aqueduct syndrome (LVAS) is characterized by the enlargement of the vestibular aqueduct associated with sensorioneural hearing loss. The level of hearing loss varies and may be fluctuant, progressive or sudden. Vestibular symptoms may be present. The diagnosis is reached by imaging methods. Aim: To report an LVAS case. Method: A female infant was submitted to a computerized tomography of the ears and to audiologic tests. Results: Enlargement of the vestibular aqueduct of more than 1.5mm and sensorioneural hearing loss in the right ear were observed. Conclusion: With an early hearing evaluation it is possible to diagnose hearing loss, even in children were this loss is unilateral. Although the literature indicates that the diagnosis of LVAS occurs at a later age, in this case time etiologic diagnosis was enabled by computerized tomography.

Evolução da margem atlântica equatorial do Brasil: Três fases distensivas

The extension of the Pangaea started in the Upper Triassic and evolved to uplifts, magmatism and development a triple junction during the Mesozoic, and opening the Central Atlantic Ocean. The Brazilian Equatorial Atlantic margin was formed in three Mesozoic extensional events. The first event is recorded by the Calçoene Graben of the Foz do Amazonas Basin. The second event started in the Valangian and is recognized by the enlargement of the Foz do Amazonas Basin, formation of the Marajó and Grajaú basins, and the Gurupi Graben System. The third event commenced in the Albian related to northwestward progression of the rift system, which enlarged the Foz do Amazonas and formed the Potiguar, Ceará, Barreirinhas and Pará-Maranhão basins. At the end of the Lower Cretaceous the movements attenuated in the Marajó Basin and Gurupi Graben System; the extension concentrated in the Foz do Amazonas, Pará-Maranhão and Barreirinhas basins, and evolved to continental rupture of northern South America and western Africa opening of the Equatorial Atlantic Ocean.

Análise da evolução da paisagem no entorno da represa dos rios jaguari e jacareí, estado de são paulo, com base em sensoriamento remoto e SIG

The primary objective of this study is to evaluate by means of remote sensing and GIS, the landscape evolution around the Jaguari and Jacareí River Dam, located in the eastern section of the State of São Paulo, Brazil. For this purpose we used LANDSAT 5/YM and CBERS-2/CCD images from 1984/1985 and 2006, respectively, considering the following classes of land use: forest, cultivated forest, agriculture, urban areas and water bodies. The two selected dates reflect important changes in the region such as the installation of the dam and subsequent urbanization of parts of its margins and the enlargement of the Fernão Dias Federal Highway, which contributed to an increase of areas of anthropic activities in the studied region. The results also indicate an increase in areas covered by native and planted forests, thus confirming a similar trend in other areas of the State of São Paulo.

Hysteroscopic myomectomy in a submucous fibroid near from tubal ostia and 5 mm from the serosa: A case report from the Endoscopy Service of Ginendo-RJ

This is a case report of a 27-year-old white woman, nuliparous, single, who presented a heavy menstrual flow with clots, dysmenorrhoea and anaemia. Gynaecological examination of the uterus revealed anteverted position, mobility, no pain, slight enlargement and right displacement. Magnetic resonance imaging of the pelvis showed a 29-mm submucous fibroid with intramural component more than 50%, type 2, in the posterior wall, with a 5-mm distance from serosa. In office hysteroscopy, a 30-mm submucous fibroid with an intramural component with more than 50%, type 2, near around 5 mm from left tubal ostia, classified in STEP-W submucous fibroids classification as score 6, group II, was noted. GnRH analogue was indicated for 3 months before intervention to treat anaemia. The patient was submitted to hysteroscopic myomectomy with direct mobilisation technique, with the fibroid completely removed without complications in a surgery which lasted for 52 min and 20 s. © 2008 Springer-Verlag.

Cherubism: Clinical case and genetic standpoints

Cherubism is a rare non-neoplastic hereditary disease, characterized by bilateral bone enlargement of the jaws and is accompanied by inflammation and fibrosis in childhood. An increase in jaw size is noted, with maximum enlargement occurring within 2 years of onset in most cases. By age 7, the lesions become static or progress relatively slowly until puberty. During the late teens, the disease may undergo spontaneous involution. The present case show a patient with history of bilateral enlargement of the jaw with the triad of clinical, histological and radiological findings that helps in the final diagnosis of cherubism.

Transnational innovation systems

Includes Bibliography

Maritime sector and ports in the Caribbean: the case of CARICOM countries

Includes bibliography

Could albumin level explain the higher mortality in hemodialysis patients with pulmonary hypertension?

Background: The pathogenesis of pulmonary hypertension (PH) in hemodialysis is still unclear. The aim of thisstudy was to identify the risk factors associated with the presence of PH in chronic hemodialysis patients and toverify whether these factors might explain the highest mortality among them.Methods: We conducted a retrospective study of hemodialysis patients who started treatment from August 2001to October 2007 and were followed up until April 2011 in a Brazilian referral medical school. According to theresults of echocardiography examination, patients were allocated in two groups: those with PH and those withoutPH. Clinical parameters, site and type of vascular access, bioimpedance, and laboratorial findings were comparedbetween the groups and a logistic regression model was elaborated. Actuarial survival curves were constructed andhazard risk to death was evaluated by Cox regression analysis.Results: PH > 35 mmHg was found in 23 (30.6%) of the 75 patients studied. The groups differed in extracellularwater, ventricular thickness, left atrium diameter, and ventricular filling. In a univariate analysis, extracellular waterwas associated with PH (relative risk = 1.194; 95% CI of 1.006 1.416; p = 0.042); nevertheless, in a multiple model,only left atrium enlargement was independently associated with PH (relative risk =1.172; 95% CI of 1.010 1.359;p = 0.036). PH (hazard risk = 3.008; 95% CI of 1.285 7.043; p = 0.011) and age (hazard risk of 1.034 per year of age;95% CI of 1.000 7.068; p = 0.047) were significantly associated with mortality in a multiple Cox regression analysis.However, when albumin was taken in account the only statistically significant association was between albuminlevel and mortality (hazard risk = 0.342 per g/dL; 95% CI of 0.119 0.984; p = 0.047) while the presence of PH lost itsstatistical significance (p = 0.184). Mortality was higher in patients with PH (47.8% vs 25%) who also had astatistically worse survival after the sixth year of follow up.Conclusions: PH in hemodialysis patients is associated with parameters of volume overload that sheds light on itspathophysiology. Mortality is higher in hemodialysis patients with PH and the low albumin level can explain thisassociation.© 2012 Greenfield et al.; licensee BioMed Central Ltd.

Cardiac remodeling induced by smoking: Concepts, relevance, and potential mechanisms

Cardiac or ventricular remodeling is characterized by molecular, cellular, and interstitial alterations that lead to changes in heart size, mass, geometry and function in response to a given insult. Currently, tobacco smoke exposure is recognized as one of these insults. Indeed, tobacco smoke exposure induces the enlargement of the left-sided cardiac chambers, myocardial hypertrophy, and ventricular dysfunction. Potential mechanisms for these alterations include hemodynamic and neurohormonal changes, oxidative stress, inflammation, nitric oxide bioavailability, matrix metalloproteinases and mitogen-activated protein kinase activation. This review will focus on the concepts, relevance, and potential mechanisms of cardiac remodeling induced by tobacco smoke. © 2012 Bentham Science Publishers.

Effects of neem oil (Azadirachta indica A. Juss) on midgut cells of predatory larvae Ceraeochrysa claveri (Navás, 1911) (Neuroptera: Chrysopidae)

The effects of ingested neem oil, a botanical insecticide obtained from the seeds of the neem tree, Azadirachta indica, on the midgut cells of predatory larvae Ceraeochrysa claveri were analyzed. C. claveri were fed on eggs of Diatraea saccharalis treated with neem oil at a concentration of 0.5%, 1% and 2% during throughout the larval period. Light and electron microscopy showed severe damages in columnar cells, which had many cytoplasmic protrusions, clustering and ruptured of the microvilli, swollen cells, ruptured cells, dilatation and vesiculation of rough endoplasmic reticulum, development of smooth endoplasmic reticulum, enlargement of extracellular spaces of the basal labyrinth, intercellular spaces and necrosis. The indirect ingestion of neem oil with prey can result in severe alterations showing direct cytotoxic effects of neem oil on midgut cells of C. claveri larvae. Therefore, the safety of neem oil to non-target species as larvae of C. claveri was refuted, thus the notion that plants derived are safer to non-target species must be questioned in future ecotoxicological studies. © 2012 Elsevier Ltd.

Ovarian Fibrothecoma in Mare - Case Report

A 5-year-old Mangalarga mare was referred to the Veterinary Teaching Hospital of the Veterinary Medical School in Botucatu with a complaint of a persistent 2-month ovarian follicle which had grown progressively to 20 cm in diameter. Ultrasonography showed a circular, cystic structure in the right ovary, whose wall was thickened and interior was filled with anechoic content. Ovarian neoplasia was suspected, and a unilateral ovariectomy was performed through the paralumbar fossa, using general anesthesia through inhalation. Histopathological evaluation concluded that the ovarian enlargement was caused by a fibrothecoma. The present report describes features of fibrothecoma, which is extremely rare in the equine species. © 2013 Elsevier Inc. All rights reserved.