No reduction with ageing of the number of myenteric neurons in benzalkonium chloride treated rats.

The number of myenteric neurons may be reduced by topical serosal application of benzalkonium chloride (BAC). We studied the effects of ageing in the population of neurons that survive after the application of BAC. Ten treated and ten control animals were killed at intervals of 2, 6, 12 and 18 months after the surgery. We performed myenteric neurons counting in serially cut histological preparations of the descending colon. The control animals revealed a continuous loss of myenteric neurons number with increasing of age. Interestingly, contrary to control animals, the BAC-treated rats presented no neuron loss with ageing at any experimental time. The reasons for their survival with ageing could be related to a neuroplasticity phenomenon.

Time necessary for neovascularization of a tracheal segment by the sternohyoid muscle.

INTRODUCTION: The reimplantation of a complete tracheal segment (CTS) as an autograft or homograft often results in total or partial necrosis of the CTS. However, previous experiments suggested that when the CTS is first vascularized by the sternohyoid muscle (SM) 21 days before the reimplantation, the CTS can be reimplanted without ischemia or stenosis. However, it is not clear if the CTS requires 21 days to attain full revascularization. GOAL: This study aims to ascertain the minimum time necessary for revascularization of the 6 rings CTS by the SM allowing reimplantation free of ischemia. METHODS: Fifteen mongrel dogs, divided into 3 groups were submitted to 2 sequential surgical procedures. In the first procedure, a SM flap was used to envelop 6 rings CTS in all dogs. After periods of 21 days (group 1, n = 5), 14 days (group 2, n = 5) and 7 days (group 3, n = 5), the compound flaps (CTS and SM) were neovascularized. Each CTS was transected and mobilized from the trachea and then replaced again in its original site, as an autoflap. RESULTS: After a period of at least 60 days, none of dogs presented any respiratory alteration. Macroscopic and microscopic analyses demonstrated adequate viability and no stenosis. CONCLUSION: Our findings suggest that it is possible to neovascularize the CTS using a SM flap within a period as short as 1 week.

Paracoccidioidomycotic aortitis with embolization to the lower limbs. Report of a case and review of the literature.

The authors report a clinical case of a 60-year-old Caucasian man, with two episodes of arterial embolization in the lower limbs. A microscope investigation of the emboli revealed that they originated from fungal aortitis caused by Paracoccidioides brasiliensis. A review of aortic infections showed only one similar report of this rare clinical expression of blastomycosis. The authors suggest a routine postoperative search for emboli followed by culture and histopathology.

SRY-negative true hermaphrodites and an XX male in two generations of the same family.

Two 46,XX true hermaphrodites and one XX male without genital ambiguities are reported. They coexist in two generations of the same pedigree, with paternal transmission and in the absence of SRY (sex-determining region, Y chromosome). These familial cases provide evidence to support the hypothesis that these disorders are alternative manifestations of the same genetic defect, probably an autosomal dominant mutation (with incomplete penetrance) or an X-linked mutation (limited by the presence of the Y chromosome).

Neonatal lupus erythematosus.

The patient is a newborn girl, born at term by cesarian section, weighing 3,550 g, and measuring 50 cm in length. According to her mother, she had been presenting erythematous spots involving the scalp, face, and trunk since birth that had increased in size with time. The mother denied any other changes and reported normal growth and development. Physical examination at 2 months of age revealed an infant in good general condition, hydrated, with no fever and no abnormalities detected on careful physical examination. The dermatologic examination revealed numerous circumscribed erythematous-brownish flat maculae with sharp borders and irregular contours, with no follicular hyperkeratosis, but with telangiectasias and areas of atrophy. They were lenticular and nummular, especially on the face (peri-orbital heliotropic lesions), and appeared as plaques on the trunk, with a tendency to confluence. The lesions also involved the scalp, neck, and extremities (Fig. 1). Histopathologic examination revealed an atrophic epidermis with focal areas of hydropic degeneration of the basal layer. A discrete perivascular and periannexal lymphohistiocytic infiltrate was observed in the superficial dermis, with melaninophages, frequent extravasation of red blood cells, angiectasia, and edema (Fig. 2). Serologic tests were reactive for antinuclear factor (ANF) (titer 1:100) of the speckled pattern, the presence of anti-Ro antibodies, and absence of anti-RNA and anti-Sm antibodies (Table 1). Blood counts and electrocardiogram were normal (Table 1). HLA typing showed positivity for DR-3 (Table 2). At 5 months of age the patient already showed a marked improvement of the skin lesions with only some areas of discrete pigmentation, a few atrophic areas, and rare telangiectasis (Fig. 3). The serologic tests (ANF, anti-Ro) had become nonreactive and the anti-RNA and anti-Sm tests continued to be negative. Examination of the mother revealed an asymptomatic 25-year-old woman reporting no manifestations suggestive of lupus. General and special physical examination revealed no abnormalities. Dermatologic examination showed no active or residual lesions of discoid or systemic lupus erythematosus. The pregnancy had been uneventful. Histopathologic examination of the girl's skin revealed the epidermis without obvious changes, minimal edema in the dermis, and a discrete perivascular inflammatory mononuclear cell infiltrate. Direct immunofluorescence of normal skin not exposed to the sun was negative. Blood counts revealed mild anemia and a tendency to leukopenia and thrombocytopenia (Table 1). Serologic tests showed reactive ANF (titers 1:400 and 1:800, speckled pattern), the presence of anti-Ro antibodies, and the absense of anti-RNA and anti-Sm antibodies (Table 1). HLA-typing revealed positivity for DR-3 (Table 2).

Polycystic hydatid disease (Echinococcus vogeli). Clinical, laboratory and morphological findings in nine Brazilian patients.

Polycystic hydatid disease occurs in neotropical zones and is caused by Echinococcus vogeli. The paca, a wild rodent, is the intermediate host and the final host is the dog. Seven cases of polycystic hydatid disease autochthonous to the Brazilian Amazon region are described. The disease was polycystic in all cases and diagnosis was based on anatomopathological findings. E. vogeli was identified by the shape and dimensions of the rostellar hooks. The liver was the organ most often involved (6/7), followed by the lungs (2/7) and mesentery (2/7), spleen (1/7) and pancreas (1/7). The main clinical manifestations were abdominal pain, hepatomegaly, jaundice, weight loss, anemia, fever, hemoptysis, palpable abdominal masses and signs of portal hypertension. Hepatic calcifications were detected in four cases. Two cases from the hinterland of the State of São Paulo are also reported. Both had calcified round structures in the liver, highly suggestive of calcified polycystic hydatids. The aim of the present report was to report on this relatively unknown hydatid disorder of Tropical America and to disseminate its clinical, ultrasound and radiological features.

[Nonfunctioning parathyroid cyst simulating thyroid nodule]. / Cisto não funcionate de paratiróide simulando nódulo tiróideo.

A parathyroid cyst is a rare disease. A 48 year old man with a nonfunctioning parathyroid cyst is described. The cyst was initially misdiagnosed and taken for a thyroid cyst based on physical examination, thyroid scan, sonography and needle biopsy. Cervical exploration was performed due to the recurrence of the lesion. The cyst was resected and histology showed it to be a parathyroid cyst. Pre and post operative clinical aspects are discussed.

Megacolon in rats.

Four months of sigmoid colon intrinsic denervation of young male Wistar rats resulted in typical megacolon. Average 46.0% denervation of the Auerbach plexus was obtained by serosal application of benzalkonium chloride (0.2% v/v). Denervation was assessed by ganglion cell counts in a 480-nm extension of the treated segment. Increased thickness of the megacolon wall was due to muscle hypertrophy (+117.4%) and mucosal hyperplasia (+53.9%) as shown by morphometry. The potential usefulness of this experimental model is emphasized.

Polycystic hydatid disease (Echinococcus vogeli): clinical and radiological manifestations and treatment with albendazole of a patient from the Brazilian Amazon region.

We present a case of polycystic hydatid disease produced by Echinococcus vogeli in a tapper of rubber trees from the State of Acre, Brazil. The most relevant clinical data were pain, increased abdominal volume caused by palpable painful masses, fever and poor clinical condition. Laboratory tests showed anemia, eosinophilia, hypoalbuminemia, hypergammaglobulinemia and increased plasma levels of alkaline phosphatase. Computerized tomography revealed diffuse cysts throughout the peritoneal cavity up to the pelvis, and inside the liver, pancreas and spleen. Anatomopathological examinations of cysts obtained by laparotomy confirmed the etiological diagnosis. Treatment with 10 mg/kg Albendazole for 6 months caused complete regression of the disease.