RESUMEN
RESUMEN: Ocasionalmente la incisura escapular puede ser reemplazada por un foramen óseo producto de la osificación del ligamento transverso superior de la escápula. Esta formación ósea se considera un factor precipitante de la compresión del nervio supraescapular. Ciento noventa y cinco escápulas de individuos adultos pertenecientes a osteotecas de universidades de Colombia (114 escápulas) y de Chile (81 escápulas), fueron estudiadas macroscópicamente para determinar la presencia de un foramen escapular óseo. Ambas escápulas de un mismo individuo colombiano (1,75 % del total) presentaban el foramen escapular y una escápula izquierda (1,23 %) presentaba esta formación en un individuo chileno. La prevalencia de la osificación del ligamento transverso superior de la escápula es muy variable en los distintos estudios y tiende a situarse inferior al 10 %, sin embargo, puede constituirse en un factor de riesgo debido al atrapamiento o compresión del nervio supraescapular, hecho conocido como neuropatía supraescapular.
SUMMARY: Occasionally the scapular notch can be replaced by a bony foramen product of the ossification of the superior transverse scapular ligament. This bone formation is considered a precipitating factor for compression of the suprascapular nerve. One hundred and ninety-five adult scapulae from Colombian (114 scapulae) and Chilean (81 scapulae) university osteotheques were studied macroscopically to determine the presence of a bony scapular foramen. Both scapulae of the same Colombian individual (1.75% of the total) presented the scapular foramen and one left scapula (1.23%) presented this formation in a Chilean individual. The prevalence of ossification of the superior transverse scapular ligament is highly variable in the different studies and tends to be less than 10%; however, it can become a risk factor due to entrapment or compression of the suprascapular nerve, a fact known as suprascapular neuropathy.
Asunto(s)
Humanos , Adulto , Escápula/patología , Osificación Heterotópica , Ligamentos/patología , Escápula/anatomía & histología , Chile , Colombia , Ligamentos/anatomía & histología , Síndromes de Compresión NerviosaRESUMEN
Animal models commonly serve as a bridge between in vitro experiments and clinical applications; however, few physiological processes in adult animals are sufficient to serve as proof-of-concept models for cartilage regeneration. Intriguingly, some rodents, such as young adult mice, undergo physiological connective tissue modifications to birth canal elements such as the pubic symphysis during pregnancy; therefore, we investigated whether the differential expression of cartilage differentiation markers is associated with cartilaginous tissue morphological modifications during these changes. Our results showed that osteochondral progenitor cells expressing Runx2, Sox9, Col2a1 and Dcx at the non-pregnant pubic symphysis proliferated and differentiated throughout pregnancy, giving rise to a complex osteoligamentous junction that attached the interpubic ligament to the pubic bones until labour occurred. After delivery, the recovery of pubic symphysis cartilaginous tissues was improved by the time-dependent expression of these chondrocytic lineage markers at the osteoligamentous junction. This process potentially recapitulates embryologic chondrocytic differentiation to successfully recover hyaline cartilaginous pads at 10 days postpartum. Therefore, we propose that this physiological phenomenon represents a proof-of-concept model for investigating the mechanisms involved in cartilage restoration in adult animals.
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Preñez/fisiología , Sínfisis Pubiana/anatomía & histología , Sínfisis Pubiana/patología , Animales , Antígenos de Diferenciación , Cartílago/patología , Tejido Conectivo/patología , Proteína Doblecortina , Femenino , Regulación del Desarrollo de la Expresión Génica/fisiología , Ligamentos/patología , Ratones , Modelos Animales , Pelvis , Periodo Posparto/metabolismo , EmbarazoRESUMEN
Fractures of the C1 vertebrae (atlas) are commonly the result of falls and other trauma, which cause hyperextension, or axial compression of the cervical spine. Although historically thought as a benign injury with lower neurological risks, current data suggests that this may not hold true for geriatric patients (aged 65 y and older) who may be predisposed to these fractures even after lower-energy trauma such as ground-level falls. Advancements in orthopedic trauma care has increased our diagnostic abilities to identify and manage patients with C1 fractures and other upper cervical spine trauma. However, there are no universal treatment guidelines based on level I trials. Current treatment ranges from nonoperative to operative management depending on fracture-pattern and integrity of the surrounding ligaments. Furthermore, in the elderly patients these fractures present a unique dilemma due to preexisting comorbidities and contraindications to various treatment modalities. C1 fractures warrant greater recognition to provide optimal treatment to patients and minimize the risk for developing complications. The goal of this review is to highlight the most updated treatment guidelines and to discuss the complications of both operative and nonoperative management of C1 fractures especially among the elderly patient population.
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Atlas Cervical/patología , Fracturas Óseas/diagnóstico , Fracturas Óseas/terapia , Directrices para la Planificación en Salud , Anciano , Atlas Cervical/cirugía , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/epidemiología , Humanos , Ligamentos/patologíaRESUMEN
PURPOSE:: To compare two different experimental models of osteoarthritis in rabbits: intra-articular collagenase injection and anterior cruciate ligament transection. METHODS:: Ten adult rabbits were randomly divided in two groups: COLL (collagenase group) and ACLT (anterior cruciate ligament transection). The COLL group was treated with 0.5 ml collagenase solution (2mg collagenase/0.5 ml sterile PBS), and the ACTL group was subjected to anterior cruciate ligament. After six and twelve weeks, respectively, the animals in the COLL and ACTL groups were euthanized. The gross appearance and histological examinations conducted in the cartilage articular surface was blindly scored according to the criteria developed by Yoshimi et al. (1994) and Mankin et al. (1971), respectively. RESULTS:: The gross morphologic observation, macroscopic score and histological examinations have demonstrated that the ACTL group presented the highest scores, and lesions more severe than those in the COLL group. CONCLUSIONS:: Both methods, anterior cruciate ligament transection and collagenase, applied to the stifle joint of the rabbits have effectively induced degenerative changes in the cartilage tissue, through statistically significant analysis (p≤0.05). The ACTL method has presented more severe lesions.
Asunto(s)
Ligamento Cruzado Anterior , Cartílago Articular/patología , Colagenasas , Modelos Animales de Enfermedad , Osteoartritis/patología , Conejos , Animales , Ligamento Cruzado Anterior/patología , Ligamento Cruzado Anterior/cirugía , Cartílago Articular/efectos de los fármacos , Colagenasas/administración & dosificación , Inyecciones Intraarticulares , Articulación de la Rodilla/efectos de los fármacos , Articulación de la Rodilla/patología , Ligamentos/patología , Masculino , Osteoartritis/etiología , Distribución AleatoriaRESUMEN
ABSTRACT PURPOSE: To compare two different experimental models of osteoarthritis in rabbits: intra-articular collagenase injection and anterior cruciate ligament transection. METHODS: Ten adult rabbits were randomly divided in two groups: COLL (collagenase group) and ACLT (anterior cruciate ligament transection). The COLL group was treated with 0.5 ml collagenase solution (2mg collagenase/0.5 ml sterile PBS), and the ACTL group was subjected to anterior cruciate ligament. After six and twelve weeks, respectively, the animals in the COLL and ACTL groups were euthanized. The gross appearance and histological examinations conducted in the cartilage articular surface was blindly scored according to the criteria developed by Yoshimi et al. (1994) and Mankin et al. (1971), respectively. RESULTS: The gross morphologic observation, macroscopic score and histological examinations have demonstrated that the ACTL group presented the highest scores, and lesions more severe than those in the COLL group. CONCLUSIONS: Both methods, anterior cruciate ligament transection and collagenase, applied to the stifle joint of the rabbits have effectively induced degenerative changes in the cartilage tissue, through statistically significant analysis (p≤0.05). The ACTL method has presented more severe lesions.
Asunto(s)
Animales , Masculino , Conejos , Osteoartritis/patología , Cartílago Articular/patología , Ligamento Cruzado Anterior , Colagenasas , Modelos Animales de Enfermedad , Osteoartritis/etiología , Cartílago Articular/efectos de los fármacos , Distribución Aleatoria , Ligamento Cruzado Anterior/cirugía , Ligamento Cruzado Anterior/patología , Colagenasas/administración & dosificación , Inyecciones Intraarteriales , Articulación de la Rodilla/efectos de los fármacos , Articulación de la Rodilla/patología , Ligamentos/patologíaRESUMEN
AIM OF THE VIDEO / INTRODUCTION: Pelvic congestion syndrome is a well-known cause of cyclic pelvic pain (Ganeshan et al., Cardiovasc Intervent Radiol 30(6):1105-11, 2007). What is much less well known is that dilated or malformed branches of the internal or external iliac vessels can entrap the nerves of the sacral plexus against the pelvic sidewalls, producing symptoms that are not commonly seen in gynecological practice, such as sciatica, or refractory urinary and anorectal dysfunction (Possover et al., Fertil Steril 95(2):756-8. 2011). The objective of this video is to explain and describe the symptoms suggestive of vascular entrapment of the sacral plexus, as well as the technique for the laparoscopic decompression of these nerves. METHOD: Two anecdotal cases of intrapelvic vascular entrapment are used to review the anatomy of the lumbosacral plexus and demonstrate the laparoscopic surgical technique for decompression at two different sites, one on the sciatic nerve and one on the sacral nerve roots. RESULT: After surgery, the patient with the sciatic entrapment showed full recovery of the sciatica and partial recovery of the myofascial pain. The patient with sacral nerve root entrapment showed full recovery with resolution of symptoms. CONCLUSION: The symptoms suggestive of intrapelvic nerve entrapment are: perineal pain or pain irradiating to the lower limbs in the absence of a spinal disorder, and lower urinary tract symptoms in the absence of prolapse of a bladder lesion. In the presence of such symptoms, the radiologist should provide specific MRI sequences of the intrapelvic portion of the sacral plexus and a team and equipment to expose and decompress the sacral nerves should be prepared.
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Endometriosis/complicaciones , Síndromes de Compresión Nerviosa/etiología , Nervio Ciático , Enfermedades del Sigmoide/complicaciones , Malformaciones Vasculares/complicaciones , Adulto , Endometriosis/cirugía , Femenino , Humanos , Ligamentos/patología , Ligamentos/cirugía , Síntomas del Sistema Urinario Inferior/etiología , Síndromes de Compresión Nerviosa/cirugía , Ciática/etiología , Enfermedades del Sigmoide/cirugía , Malformaciones Vasculares/cirugía , Venas/anomalías , Venas/cirugíaRESUMEN
RESUMOObjetivos:verificar os itens componentes das contas hospitalares, conferidos por enfermeiros auditores, que mais recebem ajustes no momento da pré-análise; identificar o impacto dos ajustes no faturamento das contas analisadas por enfermeiros e médicos auditores e identificar as glosas relacionadas aos itens conferidos pela equipe de auditoria.Método:pesquisa quantitativa exploratória, descritiva, do tipo estudo de caso único.Resultados:após a análise de 2.613 contas constatou-se que o item mais incluído por enfermeiros foram gases (90,5%) e o mais excluído medicamentos de internação (41,2%). Materiais de hemodinâmica; gases e equipamentos foram os que mais impactaram nos ajustes positivos. Os ajustes negativos decorreram de lançamentos indevidos nas contas e não geraram prejuízos de faturamento. Do total de glosas 52,24% referiu-se à pré-análise dos enfermeiros e 47,76% a dos médicos.Conclusão:a presente investigação do processo de pré-análise fornece subsídios que contribuem para o avanço no conhecimento sobre a auditoria de contas hospitalares.
RESUMENObjetivos:comprobar los elementos que componen las cuentas del hospital, controladas por enfermeras auditores que reciben más ajustes en el momento de pre-análisis, identifi car el impacto de los ajustes a la facturación de las cuentas examinadas por las enfermeras y los médicos auditores; identifi car las glosas relacionadas con los puntos otorgados por equipo de auditoría.Método:estudio cuantitativo, exploratorio, descriptivo, tipo de investigación de caso único.Resultados:después de análisis de 2613 cuentas se encontró que el elemento más incluido por el enfermeros fue gas (90,5%) y lo más excluido fue hospitalización medicamentos (41,2%). Materiales de gases y equipos hemodinámicamente fueron los más afectados en los ajustes positivos. Los ajustes negativos fueron el resultado de errores en las cuentas y no generan pérdidas de ingresos. El rechazo total fue de 52,24% en relación a la pre-análisis de las enfermeras y de 47,76% de los médicos.Conclusión:esta investigación del proceso de preanálisis proporciona subsidios que contribuyen al avance de los conocimientos sobre la auditoría de las cuentas de los hospitales.
ABSTRACTObjectives:to determine which component items of hospital bills, examined by nurse auditors, were adjusted the most during pre-analysis; to identify the impact upon revenue caused by the adjustments to bills analyzed by physician and nurse auditors; and to identify disallowances related to items checked by the audit team.Method:quantitative, exploratory, descriptive, singlecase study.Results:after analysis of 2,613 bills, it was found that the item most included by nurses was gas (90.5%) and the most excluded was inpatient drugs (41.2%). Hemodynamics materials, gases and equipment had the greatest impact on upward adjustments. Downward adjustments were the result of improper entries on bills and did not generate revenue losses. Of total disallowances, 52.24% were related to the pre-analysis of nurses and 47.76% to that of physicians.Conclusion:this study of the pre-analysis process provides input that enhances knowledge about hospital bill audits.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Síndrome del Túnel Carpiano/diagnóstico , Imagen de Difusión Tensora , Imagen por Resonancia Magnética , Nervio Mediano/patología , Articulación de la Muñeca/patología , Área Bajo la Curva , Síndrome del Túnel Carpiano/patología , Ligamentos/patología , Curva ROC , Sensibilidad y EspecificidadRESUMEN
Background: Median arcuate ligament syndrome (SLAM) is caused by extrinsic compression of the celiac artery by fibrous bands of this ligament and periaortic lymph node tissue. Case report: We report a 59 years old man with a history of weight loss, epigastric pain and a postprandial murmur. The syndrome was diagnosed by CT angiography. The patient was operated, performing a midline laparotomy and releasing the extrinsic compression. An early and sustained remission of symptoms was achieved.
Introducción: El síndrome del ligamento arcuato medio (SLAM), es causado por la compresión extrínseca del tronco celíaco por bandas fibrosas de este ligamento y tejido ganglionar periaórtico. Caso clínico: Reportamos el caso de un hombre de 59 años con historia de baja de peso, dolor postprandial y soplo epigástrico, al cual se le diagnostica SLAM por medio de angioTC. Se realiza abordaje quirúrgico, con laparotomía media y liberación de la compresión extrínseca, logrando remisión de los síntomas de forma inmediata y sostenida. El SLAM es una causa infrecuente de dolor abdominal, requiere estudio por imágenes para su diagnóstico, la resolución quirúrgica constituye su tratamiento.
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Humanos , Masculino , Persona de Mediana Edad , Arteria Celíaca/cirugía , Arteria Celíaca/patología , Constricción Patológica/cirugía , Constricción Patológica/etiología , Ligamentos/cirugía , Ligamentos/patología , Angiografía , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Magnetic resonance (MR) techniques used to detect lesions of the ligament complex for articulation of the ankle lack the desired accuracy for the study of the calcaneofibular ligament (CFL). The lack of sensitivity of the conventional techniques is due to variations in the dimensions of the CFL. The best results are obtained when the image plane is oriented parallel to the ligament. This study aims to develop a model that addresses the width, length and angle parameters of the CFL and the orientation of the MR image plane, and thus determine a technique in the oblique transversal plane with the foot in anatomical flexion, that is adequate for the majority of patients. METHOD: To determine this orientation and adapt it to the majority of people, images of the articulation of the ankle in the 3D isotropic, volumetric, sagittal plane of 100 volunteers were taken using the MR technique. None of the volunteers had a clinical history of ligament lesions, serious pathologies, or surgeries. A measurement of the length, width, and angle of the CFL relative to the sole of the foot was performed using the MR tools. A virtual model was developed that simulated the visualization of the CFL in the oblique transversal image plane from 35° to 45° using the CFL dimensions of 100 volunteers. The comparison of the simulations with the reconstructed images validated the model and permitted the calculation of the agreement and sensitivity of each technique in the detection of the complete CFL. RESULTS: Using the simulator, it was possible to obtain the limit angle for complete CFL visualization as a function of its dimensions for any angle of the oblique transversal image plane of the MR. CONCLUSION: The results suggest that a single image acquisition technique in the oblique transversal plane at 38° with the foot in anatomical flexion would serve the majority of patients.
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Articulación del Tobillo/patología , Ligamentos Laterales del Tobillo/patología , Ligamentos/patología , Imagen por Resonancia Magnética/métodos , Adulto , Simulación por Computador , Reacciones Falso Positivas , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
AIM: To report on a patient with Eagle's syndrome with a complete and very large ossification of the stylohyoid complex on the right side that to our best knowledge has never been published previously. BACKGROUND: Eagle's syndrome is characterized by a set of symptoms that are caused by the irritation of the neurovascular and soft-tissues caused by an elongated styloid process or ossification of stylohyoid ligament. CASE DESCRIPTION: Because of the high discomfort and pain degree as well as limitations of mandibular and head mobility and also the thickness of the ossifed stylohyoid chain, the patient was treated surgically by removing the hypertrophic segment. CONCLUSION: These symptoms subsided completely after the surgical excision of the anomaly. The elongated styloid process on the left side was symptom free. CLINICAL SIGNIFICANCE: Eagle's syndrome symptoms are not specific and can mimic those of other disorders, the syndrome must be included in the differential diagnosis of patients with pain in the orofacial, pharyngeal and cervical area.
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Osificación Heterotópica/diagnóstico , Hueso Temporal/anomalías , Trastornos de Deglución/diagnóstico , Diagnóstico Diferencial , Dolor de Oído/diagnóstico , Dolor Facial/diagnóstico , Humanos , Imagenología Tridimensional/métodos , Ligamentos/patología , Masculino , Persona de Mediana Edad , Dolor de Cuello/diagnóstico , Síndrome de la Disfunción de Articulación Temporomandibular/diagnóstico , Tomografía Computarizada por Rayos X/métodosRESUMEN
La mayoría de los diagnósticos de procesos estiloides elongados y osificaciones de ligamentos estilohioideos corresponden a hallazgos en el análisis de radiografías panorámicas. En la presente investigación se evaluaron 3028 Radiografías Panorámicas digitales, tomadas entre Junio de 2009 y Junio de 2011. Se registraron las osificaciones de ligamento estilohiodeo de acuerdo a sexo, edad y bilateralidad. El análisis de datos se desarrolló con el Test estadistico Chi cuadrado, con un nivel de significancia estadística a< 0,05. En las imágenes evaluadas se encontró una prevalencia de osificaciones de un 8,42%, siendo más frecuentes en individuos de sexo femenino, osificaciones bilaterales y con patrón discontinuo. En cuanto a la edad se evaluó de acuerdo a grupos de edad menor o igual a 40 años y mayores de 40 años, encontrándose relación con la variable patrón de osificación. También se encontró relación entre las variables lateralidad y patrón de osificación. El presente estudio entrega información relevante para la odontología y la otorrinolaringología.
Most diagnoses of elongated styloid processes and ossification of stylohyoideus ligaments correspond to findings in the analysis of panoramic radiographs. In the present study we evaluated 3028 digital panoramic radiographs, taken between June 2009 and June 2011. Stylohyoideus ligament ossifications were recorded according to sex, age and bilaterality. Data analysis was carried out with the chi square test, with a statistical significance level a <0.05. In the images assessed we found a prevalence of 8.42% of ossifications, which was more frequent in female subjects, and bilateral ossification discontinuous pattern. In terms of age we evaluated according to age group less than or equal to 40 and older than 40 years, as related to the variable pattern of ossification. We also found relation between laterality variables and patterns of ossification. This study provides information relevant to dentistry and otolaryngology.
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Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Hueso Temporal/diagnóstico por imagen , Osificación Heterotópica/epidemiología , Osificación Heterotópica/diagnóstico por imagen , Ligamentos/diagnóstico por imagen , Hueso Temporal/patología , Calcinosis , Radiografía Panorámica , Distribución de Chi-Cuadrado , Epidemiología Descriptiva , Prevalencia , Osificación Heterotópica/patología , Distribución por Edad y Sexo , Ligamentos/patologíaRESUMEN
This purpose of this article was to report the clinical case of a patient with Eagle's syndrome. She was referred to the orthodontic clinic by her general clinician, with the complaint of temporomandibular dysfunction. The orthodontic records showed a styloid process elongation accompanied by calcification and fracture on the right side. Eagle's syndrome was diagnosed, and the patient was referred to a buccomaxillofacial surgeon for surgical correction.
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Osificación Heterotópica/complicaciones , Osificación Heterotópica/cirugía , Sobremordida/complicaciones , Adulto , Calcinosis/complicaciones , Calcinosis/cirugía , Femenino , Humanos , Ligamentos/lesiones , Ligamentos/patología , Hueso Temporal/anomalías , Hueso Temporal/cirugía , Trastornos de la Articulación Temporomandibular/complicacionesRESUMEN
The petrotympanic fissure, a narrow slit in the temporal bone, allows the temporomandibular joint (TMJ) and the middle ear to communicate. Both the chorda tympani and the ligament cross the fissure between the posterior region of the joint disk and the malleolar ossicle. The parasympathetic fibers of the chorda tympani spread into the major salivary glands and are responsible for the taste sensibility on the anterior two-thirds of the tongue. After chronological identification of 30 human skulls, petrotympanic fissures were macroscopically and stereomicroscopically analyzed for the presence and disposition of ossification areas. Digitalized images were analyzed using computer program UTHSCSA ImageTool 3.0 (developed by the Department of Dental Diagnostic Science at The University of Texas Health Science Center, San Antonio, Texas). The total extension of the fissures and ossification areas was measured. The macroscopic analysis did not constitute an appropriated method for this evaluation and the ossification of the fissures increased with aging, suggesting its influence on the causes of otalgia in cases of TMJ dysfunction.
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Ligamentos/patología , Osificación Heterotópica/patología , Hueso Temporal/patología , Articulación Temporomandibular/patología , Adulto , Factores de Edad , Calcinosis/patología , Nervio de la Cuerda del Tímpano/anatomía & histología , Oído Medio/anatomía & histología , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Cápsula Articular/anatomía & histología , Ligamentos/anatomía & histología , Martillo/anatomía & histología , Persona de Mediana Edad , Hueso Petroso/anatomía & histología , Fotograbar/métodos , Hueso Temporal/anatomía & histología , Articulación Temporomandibular/anatomía & histología , Disco de la Articulación Temporomandibular/anatomía & histologíaRESUMEN
A lombalgia é uma das mais importantes causas de problemas no desempenho do equino atleta. A dificuldade de acesso às estruturas envolvidas e a ausência de um sinal clínico específico, tornam o diagnóstico difícil e requer a utilização de métodos de diagnóstico por imagem. Portanto, um histórico detalhado, associado a um exame físico completo e exames complementares, como termografia e ultrassonografia são essenciais. Dentre as patologias toracolombares estão incluídas as desmites do ligamento supraespinhoso, as miosites, as lesões dos discos interverebrais, as osteoartrítes e as fusões dos processos espinhais. Os tratamentos baseiam-se no uso de crioterapia, calor, antiinflamatório não esteroidal, infiltrações locais com corticóides, acupuntura, relaxantes musculares, fisioterapia e modificação nos programas de exercícios.
Back pain is one of the most important causes that lead to performance issues in the equine athlete. The difficulty of access to the structures involved and the lack of specific clinical signs, making diagnosis difficult and requires the use of diagnostic imaging methods. Therefore, a detailed history, associated with a complete physical examination and complementary examinations such as thermography and ultrasound are essential. Among the thoracolumbar pathologies are included desmitis supraspinous ligament, the myositis, lesions interverebrais discs, osteoarthritis, and the process spinal fusions. The treatments are based on the use of cryotherapy, heat, nonsteroidal anti-inflammatory drugs, local corticosteroid injections, acupuncture, muscle relaxants, physical therapy and change in exercise programs.
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Animales , Dorso/diagnóstico por imagen , Dolor de la Región Lumbar/terapia , Caballos , Ligamentos/patología , Termografía/veterinaria , Ultrasonografía/veterinaria , Modalidades de Fisioterapia/veterinariaRESUMEN
O prolapso uterino tem sua incidência aumentada na pós-menopausa. O objetivo deste estudo é identificar as alterações na matriz extracelular do ligamento cardinal associadas à menopausa e ao prolapso uterino. Ligamento cardinal de três diferentes grupos de mulheres, pré-menopausa, prolapso uterino e pós-menopausa, foram identificados e biopsiados durante 57 histerectomias abdominais ou vaginais. As amostras foram processadas por métodos bioquímicos para caracterização e quantificação de glicosaminoglicanos sulfatados e colágeno. As concentrações relativas de glicosaminoglicanos foram obtidas por eletroforese. Procedimentos histológicos foram feitos para identificar fibras elásticas (Weigert), distribuição de colágeno (Picro Sirius) e decorin (imunohistoquímica). Nossos resultados mostraram aumento na concentração de GAG de 72,2%, redução na concentração de colágeno de 37% e diminuição de 22% de fibras elásticas no grupo de prolapso uterino quando comparado ao grupo da pós-menopausa (p<0,05, p<0,04 e p<0,05 respectivamente). As concentrações relativas de glicosaminoglicanos sulfatados para condroitin sulfato, heparan sulfato e dermatan sulfato não mostraram diferenças entre os três grupos. A organização do colágeno foi similar entre os três grupos e a marcação do decorin pareceu estar diminuída no grupo de prolapso uterino. Nossos resultados indicam alterações no metabolismo do tecido conjuntivo. O ligamento cardinal da mulher na pós-menopausa possui uma matriz extracelular mais densa. Esta alteração não ocorre na mulher com prolapso uterino.
Uterine prolapse has increase of incidence after menopause. The aim of this study was to identify the changes in extracellular matrix of cardinal ligaments associated to menopause and uterine prolapse. Cardinal ligament of 3 different groups (pre-menopause, menopause and uterine prolapse) are identified and biopsied during 57 women's abdominal or vaginal hysterectomy. Biopsy specimens were assessed by biochemical methods to characterize and quantify sulfated glycosaminoglycans and collagen. Relative concentrations of GAG were obtained by electrophoresis. Histological procedures are made to identify elastic fibers (Weigert) collagen distribution (Picro sirius) and decorin (immunohistochemistry). Our results showed increase in GAG concentration 72.2% in uterine prolapse group compared to menopause group (p<0.05). Collagen concentration was 37% lower in uterine prolapse group compared to menopause group (p<0.04). Relative concentration of GAG: heparan sulfate, chondroitin sulfate and dermatan sulfate showed no differences among three groups. Elastic fibers showed a significant reduction of aproximately 22% uterine prolapse group compared to menopause group (p<0.05). Collagen organization was similar in three groups and the staining pattern of decorin seemed to be decreased in uterine prolapse group. Our results indicate changes in connective tissue metabolism. Cardinal ligament in postmenopausal women has a denser extracellular matrix. This change is not observed in women with uterine prolapse.
Asunto(s)
Humanos , Femenino , Colágeno/análisis , Electroforesis , Glicosaminoglicanos/análisis , Inmunohistoquímica , Ligamentos/metabolismo , Ligamentos/patología , Matriz Extracelular/metabolismo , Posmenopausia/metabolismo , Prolapso Uterino/metabolismo , Tejido Elástico/metabolismo , Tejido Conectivo/metabolismoRESUMEN
Eagle syndrome is symptomatic elongation of the styloid process, or calcification of the stylomandibular ligament. Difficulty with deglutition, phonation, cervical movement, and the sensation of a foreign body in the oropharynx are all symptoms of this syndrome. Its treatment consists of partial removal of the styloid process, leaving it within the range of normality. We describe the technique, report a case, and point out some of the advantages, such as the simplicity of the procedure, reduced operating time, and lack risks of operative complications.
Asunto(s)
Ligamentos/cirugía , Procedimientos Quirúrgicos Orales/métodos , Hueso Temporal/patología , Calcinosis/diagnóstico por imagen , Calcinosis/patología , Femenino , Humanos , Ligamentos/patología , Persona de Mediana Edad , Síndrome , Hueso Temporal/diagnóstico por imagen , Hueso Temporal/cirugía , Tomografía Computarizada por Rayos XRESUMEN
The objective of this study was to review some celiac trunk compression syndrome aspects such as: symptom-posture relationship; absence of symptoms; syndrome-age relationship; angiographic study on anatomy of the celiac trunk stenosis; congenital or acquired origin; invasive diagnostic tests; surgical and postoperative results.
El objetivo de este estudio fue hacer una revisión del síndrome de compresión del tronco celíaco, en cuanto a aspectos tales como: relación síntoma-postura; ausencia de síntomas; relación síndrome-edad; estudio angiográfico sobre la anatomía de la estenosis del tronco celíaco; origen congénito o adquirido; tests diagnósticos no invasivos; resultados quirúrgicos y post-quirúrgicos.
Asunto(s)
Humanos , Masculino , Femenino , Arteria Celíaca/cirugía , Arteria Celíaca/patología , Arteriopatías Oclusivas/cirugía , Arteriopatías Oclusivas/patología , Angiografía , Arteria Celíaca , Arteriopatías Oclusivas/etiología , Constricción Patológica , Diafragma/cirugía , Diafragma/patología , Ligamentos/cirugía , Ligamentos/patología , Postura , Síndrome , Signos y SíntomasRESUMEN
El síndrome de Eagle se caracteriza por la elongación del proceso estiloides y/o la calcificación de los ligamentos presentes en él, los que provienen embriológicamente del cartílago del segundo arco faríngeo (Reichert). Esto produce dolor intenso en la región craneocervical y limitación de los movimientos cervicales. Generalmente es confundido con otras patologías, tales como disfunciones en la articulación témporomandibular. El diagnóstico de esta entidad es realizado a través de los correctos exámenes clínico y radiográfico. En este trabajo se reporto un caso y se hace una breve revisión de la literatura, mostrando la importancia del correcto diagnóstico de esta entidad y su sintomatología.
The Eagle's syndrome is characterized by the elongation of the styloid process and/or their ligaments calcification, which come embryologically from Reichert's cartilage or second branchial arch. This produces pain in thecraniocervical region and limitation of cervical movements. Generally is confused with other dysfunctions, such as temporomandibular joint dysfunction. The diagnosis of this entity is by the correct clinical and radiographic exam. In this work is done reporting a case and makes a brief review of the literature, showing the importance of this entity correct diagnosis and their symptoms.
Asunto(s)
Humanos , Adulto , Femenino , Dolor Facial/etiología , Dolor de Cuello/etiología , Enfermedades Óseas/diagnóstico , Enfermedades Óseas/patología , Calcinosis , Hueso Temporal/patología , Ligamentos/patología , Osificación Heterotópica/diagnóstico , Osificación Heterotópica/patología , SíndromeRESUMEN
A Síndrome de Ernest, componente da dor orofacial, é caracterizada pela inflamação do ligamento estilomandibular. O exame radiogrßfico não é de grande ajuda no diagnóstico desta síndrome, porém alguns autores sugerem uma possível calcificação desse ligamento. Uma história adequada, a palpação da inserção do ligamento estilomandibular e um bloqueio anestésico local da inserção ligamentosa afetada são de grande utilidade na confirmação diagnóstica. O objetivo do presente estudo é realizar uma revisão de literatura sobre essa síndrome, com intuito de ampliar os conhecimentos a despeito de sua etiologia, sintomas, diagnóstico diferencial e tratamento. Pôde-se concluir que a Síndrome de Ernest apesar das semelhanças com outras condições ßlgicas orofaciais existem sintomas que podem diferenciß-las. Com relação ao uso do laser e de sua eficßcia terapêutica, sugere-se que este pode ser utilizado isoladamente ou como coadjuvante em tratamentos convencionais, principalmente pelas suas ações analgésicas, antiinflamatórias e como reparador tecidual.