Contribution of the study of the styloid prominence in the posterior tympanic cavity

70 human temporal bones were analyzed with the aid of an otologic microscope. The styloid prominence was found to be extremely variable in shape, location and occurrence. Depending on the degree of development, the prominence establishes important relationships with the sinus tympani, with the fossula of the cochlear fenestra, and with the suprapyramidal recess. Serial sections were used to study the relationship of the styloid process with the facial nerve inside the bony mass of the mastoid portion of the temporal bone.

Reaction of the human gingival tissue to different suture materials used in periodontal surgery.

The gingival reaction to 4 different suture materials used in periodontal surgery was studied in 36 patients. The gingiva was sutured prior to surgery and biopsies were taken at 3, 7 and 14 days to observe the tissue reaction. The histological examination showed that silk caused the most intense and longest inflammatory response. Polyester and perlon provoked shorter, less intense tissue reactions than silk, and nylon caused the least inflammatory response, with earlier tissue repair.

Psychological evaluation of patients scheduled for orthognathic surgery.

Using a questionnaire, 41 patients scheduled for orthognathic surgery were evaluated pre- and postoperatively to determine some of their psychological characteristics and treatment outcome from the patient's standpoint. Among other conclusions, the results showed that some patients may not fully understand the details of their deformity, despite a full explanation by the orthodontist and surgeon. Expectations regarding treatment outcome may be unrealistic even in patients with valid self-motivation for surgery. Social adjustment usually improves after treatment. Functional changes were noticed by over 80% of the patients and esthetic changes in over 90%.

ASPECTOS ETIOLOGICOS DA HIPERNASALIDADE CONSEQUENTE A PARALISIA DE PALATO MOLE - RELATO DE 6 CASOS

The authors studied the main aspects of etiology of the palate paralysis in six children suffering from soft palate paralysis. They emphasized the importance of multidisciplinary approach in the management of patients with this disease. In the author's cases the most likely etiologies were: neuropathy post-viral epidemic parotitis, tumors localized in the posterior cerebral fossa and idiopathic. They concluded that it is extremely important in these patients a detailed otorhinolaryngologic, neurologic and fonoaudiologic examinations.

New option for anterior traction of the face by using a cervical collar

This case required anteroposterior traction of the maxilla. Once none of the traditional methods could be used because of the lack of support in the chin and in the frontal region. Thus, we opted to use a cervical collar.

Experimental surgery of the facial nerve. Assessment of the intraperitoneal use of exogenous gangliosides

Compression and section of the facial nerve were performed in 48 rats in order to study the anatomopathological alterations occurring after daily intraperitoneal injections of 100 mg of exogenous gangliosides (Sinaxial®) for 45, 90, 180 days. In groups submitted to nerve compression, the histopathological changes were discrete and in the 180-day subgroups the nerve was practically normal. In animals submitted to section and neurorrhaphy there was formation of an amputation neuroma, a granuloma around the suture, axonal unstructuration and inter and perineural fibrosis. No significant differences were observed between the groups submitted or not to injection of exogenous gangliosides, indicating that the major factors involved in the quality of nerve regeneration were the technique and the formation of fibrosis and of an amputation neuroma.

Compression of the peripheral branches of the sciatic nerve by lipoma

The authors report two female patients with chronic sensitive and motor findings in lower limbs caused by compression of distal branches of sciatic nerve by lipoma. Similar eases were not described on literature. Nerve conduction studies allowed to localize the exact site of compression. At surgery, lipomas compressing the deep peroneal nerve (case 1) and the posterior tibial nerve (case 2) were observed. Histologic studies of tumors confirmed the diagnoses.

Preoperative combined with intraoperative skin-surface warming avoids hypothermia caused by general anesthesia and surgery

Study Objectives: To evaluate the effects of intraoperative skin-surface warming with and without 1 hour of preoperative warming, in preventing intraoperative hypothermia, and postoperative hypothermia, and shivering, and in offering good conditions to early tracheal extubation. Design: Prospective, randomized, blind study. Setting: Teaching hospital. Patients: 30 ASA physical status I and II female patients scheduled for elective abdominal surgery. Interventions: Patients received standard general anesthesia. In 10 patients, no special precautions were taken to avoid hypothermia. Ten patients were submitted to preoperative and intraoperative active warming. Ten patients were only warmed intraoperatively. Measurements and Main Results: Temperatures were recorded at 15-minute intervals. The patients who were warmed preoperatively and intraoperatively had core temperatures significantly more elevated than the other patients during the first two hours of anesthesia. All patients warmed intraoperatively were normothermic only at the end of the surgery. The majority of the patients warmed preoperatively and intraoperatively or intraoperatively only were extubated early, and none had shivering. In contrast, five unwarmed patients shivered. Conclusions: One hour of preoperative warning combined with intraoperative skin-surface warming, not simply intraoperative warming alone, avoided hypothermia caused by general anesthesia during the first two hours of surgery. Both methods prevented postoperative hypothermia and shivering and offered good conditions for early tracheal extubation. © 2003 by Elsevier B.V.

Naso-orbicular tissue necrosis by Streptococcus parasanguis in a patient with Fanconi anemia: Clinical and laboratory aspects

Fanconi anemia (FA) is a rare autosomal recessive disorder, characterized by pancytopenia and progressive hypoplasia of the bone marrow. A 23-year-old woman with FA showed severe pancytopenia and developed an abscess on the infraorbicular region on the right side of the face that progressed to phlegmon and caused tissue necrosis of the nostrils, nasal septum, nasal fossa, and posterior orbital region. Laboratory examination showed Streptococcus parasanguis as the etiologic agent of the phlegmon. Supportive treatment was recommended due to donor incompatibility for bone marrow transplant. The intraoral examination showed spontaneous gingival bleeding, edema of the interdental papillae, hematomas on the superior and inferior lips, bacterial and fungal infections, and adequate oral hygiene. The patient was treated with the administration of an antibiotic (imipenem), an antifungal (amphotericin B), and mouth washing with antiseptic solutions. Periodontal prophylaxis and orientation to and control of oral hygiene and diet were also used during the remission period. For functional and esthetic rehabilitation of the alar regions and nasal dorsum, an acrylic resin nasal prosthesis was made, supported by a spectacle frame.

Sildenafil for pulmonary hypertension treatment after cardiac surgery

Objective: To report on the use of sildenafil for pulmonary hypertension treatment of a newborn patient after cardiac surgery. Description: A female, full term newborn infant with diagnosis of double outlet right ventricle, pulmonary hypoplasia and subaortic ventricular septal defect, was submitted to Blalock surgery in the first week of life. In postoperative the newborn had pulmonary hypertension and persistent hypoxia, without response to nitric oxide, but with improved oxygenation after continuous intravenous infusion of prostaglandin E1. After several failed attempts to discontinue prostaglandin E1, oral sildenafil was used. There was a decrease in pulmonary vascular resistance with consequent oxygenation improvement and 48 hours later it was possible to discontinue prostaglandin E1 infusion. Comments: Sildenafil can be an alternative therapy for pulmonary hypertension, especially when there is no response to conventional therapy. Copyright © 2005 by Sociedade Brasileira de Pediatria.

Restorative treatment on class I and II restorations in primary molars: A survey of Brazilian dental schools

A survey was sent to 70 Brazilian dental schools evaluating techniques and restorative materials being taught for Class I and II preparation in posterior primary teeth by Pediatric Dentistry courses. After a 54% response rate, marked teaching diversity was found among Brazilian dental schools. Amalgam continues to be taught, but a tendency of preference towards more esthetic-like materials was observed.

Comparison of hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of anesthesia with isoflurane and halothane in horses undergoing arthroscopic surgery

Objective - To compare hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of halothane and isoflurane in horses undergoing arthroscopic surgery. Animals - 8 healthy adult horses. Procedure - Anesthesia was maintained with isoflurane or halothane (crossover study). At 6 intervals during anesthesia and surgery, cardiopulmonary variables and related derived values were recorded. Recovery from anesthesia was assessed; gastrointestinal tract motility was subjectively monitored for 72 hours after anesthesia. Horses were administered chromium, and fecal chromium concentration was used to assess intestinal transit time. Venous blood samples were collected for clinicopathologic analyses before and 2, 24, and 48 hours after anesthesia. Results - Compared with halothane-anesthetized horses, cardiac index, oxygen delivery, and heart rate were higher and systemic vascular resistance was lower in isoflurane-anesthetized horses. Mean arterial blood pressure and the dobutamine dose required to maintain blood pressure were similar for both treatments. Duration and quality of recovery from anesthesia did not differ between treatments, although the recovery periods were somewhat shorter with isoflurane. After isoflurane anesthesia, gastrointestinal motility normalized earlier and intestinal transit time of chromium was shorter than that detected after halothane anesthesia. Compared with isoflurane, halothane was associated with increases in serum aspartate transaminase and glutamate dehydrogenase activities, but there were no other important differences in clinicopathologic variables between treatments. Conclusions and clinical relevance - Compared with halothane, isoflurane appears to be associated with better hemodynamic stability during anesthesia, less hepatic and muscle damage, and more rapid return of normal intestinal motility after anesthesia in horses undergoing arthroscopic procedures.

Myxopapillary ependymoma of the posterior mediastinum

A left paravertebral mass discovered incidentally on routine examination in a 39-year-old woman is described. Computerized tomography studies revealed a 7 × 6 cm, well circumscribed, noncalcified soft tissue mass with lobular borders abutting the left inferior pulmonary vein and descending aorta. It was not possible to determine the exact anatomic location of the mass based on the imaging studies as both peripheral lung tumors and posterior mediastinal lesions may exhibit the imaging findings described here. At thoracotomy, the mass was seen to be well circumscribed, focally attached to the pleura but without involvement of lung parenchyma, and situated in the left posterior mediastinum. On histological examination, the lesion showed the classical features of myxopapillary ependymoma. Immunohistochemical studies confirmed this impression by demonstrating strong positivity of the tumor cells for S-100 protein, glial fibrillary acidic protein, and CD99 and negative staining with other differentiation markers. A review of the literature with a discussion of the histologic and radiologic differential diagnosis of these lesions is presented. © 2006 Elsevier Inc. All rights reserved.

Molecular typing of bacterial strains isolated from the Clinics of Surgery and Face Traumatology at Ribeirão Preto University

The number of infectious illnesses and cross infection is spreading drastically among the professionals of the dentistry area. Controlling infections in dental offices is one of the greatest challenges for dentists and researchers of this area. In practice, contacts between professionals and infected patients are relatively common. The transmission of infectious illnesses from the health professionals to their patients is also possible, either by direct contact or due to lack of cares in relation to biosafety, increasing the cycle of cross infection. Molecular typing is necessary since these methods are an important tool to investigate the epidemiology of bacterial infections. Moreover, they are important for supplying information and precedents through the analysis of the infectious agents eletrophoretic profile. The aim of the present work was to analyze by molecular typing the genomic profile of aerobic bacteria isolated from the Clinics of Surgery and Face Traumatology, Ribeirão Preto University, through the technique of Random Amplified Polymorphic DNA (RAPD) and grouped based on similarity coefficients. Of two carried out collections, 55 strains were isolates belonging to the following groups: 12 Staphylococcus aureus; 13 Klebsiella oxytoca; 7 Klebsiella pneumoniae; 8 Pseudomonas aeruginosa; 5 Hafnia alvei; 5 Proteus vulgaris; 4 Escherichia coli; and 1 Proteus mirabilis. The adopted molecular typing strategy allowed the determination of the persistence of definitive strains at the collection environment, besides the identification of strains proceeding from the hands and gloves of the surgeon dentists, which could have been found in distant places as sinks and reflectors.

Variaciones del índice de cono en suelo movilizado posterior al tráfico de un tractor equipado con dos tipos de neumáticos y a cuatro velocidades de desplazamiento

The tractor is one of the machines that more traffics over the soil during the processes involving agricultural production. The interaction tractor/soil is made by the tires which, in most of the cases, are pneumatic. The tire type and the tractor travel speed, interfere directly on the pressure over the soil. One of the techniques employed to evaluate the alterations that tractor traffic causes in the soil is to measure its Cone Index. The aim of this research was to evaluate the same Cone Index alterations caused by an agricultural tractor equipped with both radial tires and bias ply tires, trafficking mobilized soil in four different travel speeds. The experiment was performed in a LATOSSOLO VERMELHO, located 22°51' S, 48°25'W and 770 m of altitude, in Botucatu-SP, Brazil. The soil mobilization was performed with a chisel plow and a disc arrow. The traction was accomplished with a John Deere tractor, model 6600, with 88 kW of power and 6,723 kg. Equipment requiring a force of 25kN was traced by the tractor draw bar. The experimental design was in randomized blocks with 4 × 2 factorial arrangements, with two distinct treatments corresponding to the types of tires (bias and radial) and the four travel speeds, with six replications. There were selected the following speeds: 3.5, 3.9, 5.1 and 5.9 km h-1. To determine the soil resistance, there was utilized MSSU - Mobile Soil Sampling Unit, with which the Cone Index was obtained in layers from 0-100, 100-200, 200-300, 300-400, 400-500 and over 500 mm deep. The Cone Index where evaluated in areas with non contact between tire and soil (ICn) and in the tire footprint track (ICp). There were calculated the Cone Index increments caused by the tractor tire (AIC) and the results showed that as the tractor travel speed increased, there were observed decrements in the medium values of cone index. The radial tire provided smaller values of the Cone Index in the superficial layer of the soil (0 to 100 mm) in relation to the bias ply tire, when the speed was approximately 6 km h-1. The increment in the Cone Index, promoted by the tractor, was more intense in the first 200 mm depth, but it also reached the layer from 200 to 300 mm.