RESUMO
An attempt to make a canaliculoplasty for 53 cases with canalicular stenosis gave a functional favorable result for 40 cases; Microsurgery is essential. By pass procedures were performed only in case of failure in several cases. Our rules for canaliculoplasty were: a large DCR osteotomy systematically associated, direct exposure of the stenosis (modified DCR cutaneous incision), interrupted sutures with extramucosal not, restitution of a mucosal continuity between the punctum and the nose without stretch, long term (one year) or permanent bicanalicular silicone tubing, the different procedures are discussed: reimplantation of the common canaliculus in the lacrimal sac (9 cases); resection + direct suture for minimal stenosis (13 cases), Turning inside out of the lacrimal sac + large nasal mucosal flap (22 cases)... We emphasize the third procedure which provides in our hands much satisfactory results (18 successes and 4 failures) for 4 or 6 millimeters (sometimes 8 or more) canalicular stenosis when the natural punctum is still present: the lacrimal mucosa of the sac is turned inside out and provides the posterior flap of the new pathway. The anterior flap is provided by a very large nasal mucosal flap. Both flaps are sutured to the safe canalicular extremity.
Assuntos
Doenças do Aparelho Lacrimal/cirurgia , Humanos , Microcirurgia/métodosRESUMO
Ischemia of the anterior segment of the eye is rare but may be in relation with some strabismic procedures. The physiopathology is unclear. This experimental data on human cadaver studied the arterial vascularization of the major circle of iris with injection and opacification of an aqueous suspension of barium. The respective participation of anterior ciliary arteries and long posterior ciliary arteries, respectively were analysed. Some recti muscles were cut with various combinations and before injection. The breaks of the major arterial circle which resulted were noticed. They were large when both vertical recti were cut and minimal or absent when both horizontal recti were cut. The anterior ciliary arteries coming from interior and superior rectus are very important. The long posterior ciliary arteries seem to be more important than the anterior ciliary arteries coming from both horizontal recti muscles and especially the medial long posterior ciliary artery. Our study provides an explanation of classical iatrogenic iridociliary ischemia following Hummelsheim or O'Connors strabismus procedure.
Assuntos
Segmento Anterior do Olho/irrigação sanguínea , Artérias/anatomia & histologia , Isquemia , Adulto , Idoso , Segmento Anterior do Olho/diagnóstico por imagem , Artérias/patologia , Atrofia , Feminino , Humanos , Iris/irrigação sanguínea , Iris/patologia , Isquemia/diagnóstico por imagem , Pessoa de Meia-Idade , RadiografiaRESUMO
A 58 year old man underwent a facial trauma and developed, after several months, an acute dacryocystitis. A DCR procedure was performed but a pericystitis pursued its course for 6 years though a good patency of the lacrimal flow. The patient was reviewed with deep, large, solid and painless mass. A pathological examination showed a squamous cells carcinoma scattered around the lacrimal sac and through the previous DCR. An enlarged exenteration was performed.
Assuntos
Carcinoma de Células Escamosas/etiologia , Dacriocistite/complicações , Traumatismos Faciais/complicações , Doenças do Aparelho Lacrimal/etiologia , Doença Aguda , Carcinoma de Células Escamosas/patologia , Humanos , Doenças do Aparelho Lacrimal/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
We studied the arterial vascularization of the anterior segment of 25 cadaver eyes. Arteries had been opacified by an injection of an aqueous suspension of barium. Our study has focused on the anterior ciliary arteries (ACA), emerging from the four rectus muscles. Among the numerous individual variations, we have noticed the following predominant aspects: for the external rectus muscle, the ACA is usually unique and thin, located in the superior or inferior third of the muscle. For the others rectus muscles, the ACA are rather big and frequently observed in pairs. They tend to be found on each lateral side of the muscle. By and large, the vertical ACA look bigger and more numerous than the horizontal ACA. The number, the size and the position of the long posterior ciliary arteries are quite uniform. The major arterial circle of the iris seems to be discontinuous, and is more and less made of arterial anastomoses. This study enabled us to reconsider the usual anatomical description of arterial supply of the anterior segment. The vascularization by the ACA, especially at the level of the inferior and superior rectus muscle, has to be known in order to avoid an anterior segment ischemia following strabismus surgery.
Assuntos
Segmento Anterior do Olho/irrigação sanguínea , Adulto , Idoso , Segmento Anterior do Olho/anatomia & histologia , Segmento Anterior do Olho/diagnóstico por imagem , Artérias/anatomia & histologia , Sulfato de Bário , Corpo Ciliar/irrigação sanguínea , Dissecação , Humanos , Iris/irrigação sanguínea , Isquemia/etiologia , Pessoa de Meia-Idade , Músculos Oculomotores/irrigação sanguínea , Músculos Oculomotores/cirurgia , Artéria Oftálmica/diagnóstico por imagem , Complicações Pós-Operatórias/prevenção & controle , RadiografiaRESUMO
XTH-2 cells, a cell line derived from tadpole heart endothelial cells, were blocked at the end of the G1 phase of the cell cycle using desoxyguanosine (dG). Stress fibers are the dominant actin fibril structure in blocked cells. They disappear starting with the release of the dG block until the G2 phase of the cell cycle. In addition, after the release peripheral lamellae and microspikes appear, indicating increased surface motility of the cells. Concomitantly with these changes, net lactic acid production is increased while oxygen consumption remains constant. Increase in the content of F-actin per cell takes place only in subconfluent cultures. Similar morphological changes (organization of F-actin) have been induced by phorbol myristate acetate treatment. These are also accompanied by an increase in lactic acid production and unaltered oxygen consumption. Therefore, the changes in energy metabolism are supposed to result from the rearrangement of the F-actin network: The emanating loose fibrillar pattern provides an increased surface for the association with glycolytic enzymes, which enhances enzyme activity and represents a more motile state. The increased energy demand of the more motile structures is supplied predominantly by ATP derived from glycolysis.
Assuntos
Actinas/análise , Anuros/fisiologia , Lactatos/biossíntese , Animais , Anuros/embriologia , Ciclo Celular/fisiologia , Embrião não Mamífero/fisiologia , Metabolismo Energético/efeitos dos fármacos , Glicólise , Ácido Láctico , Ésteres de Forbol/farmacologiaRESUMO
In a preliminary report, the tracheal NaCl-myosin prepared from an old and a young subject was discussed. In the present paper, the total bound phosphate (P) content and its distribution is described in two parallel preparations of human muscle myosin. It was shown that a considerable amount of covalently bound P was present not only in NaCl, but in the fresh preparations of tracheal KCl-myosin. Analysing this phosphate fraction in the alkaline hydrolysate of RNA- and lipid-free preparations of myosin it was confirmed that phosphate was linked to the basic amino acid residues and their hydrolytic derivatives. As the phosphoryl binding sites are partly saturated, the phosphate concentration can be enhanced nearly three-fold compared to the fresh preparation. Phosphate incorporation is an autophosphorylation process depending on the ATP and Mg2+ concentration. Studying the actomyosin fraction in the presence of ATP it was found that its phosphate content can also be increased to a certain degree. It is supposed that the changes in phosphate content of myosin are associated with the formation of crossbridges between the actin and myosin filaments in the processes of muscle contraction and relaxation. The process can be influenced directly and indirectly by some natural factors and drugs resulting in the concentration or relaxation of bronchial muscles.