Anatomic variation of the thoracic duct and absence of accessory hemiazygos and hemiazygos veins : case report.

The thoracic duct is a lymph vessel extending from the abdomen to the base of the neck where it drains to one of the large veins in the region. Many cases are described in the scientific literature, regarding anatomical variations of the thoracic duct, from its origin, path, until its end, and the vast majority intended to relate variations in the last part of the duct. The reports related to variations of its path are very scarce. In a male cadaver dissection in the anatomy laboratory of the Faculdade de Ci?ncias M?dicas of Minas Gerais (FCMMG), an anatomical variation of the position of the thoracic duct was found. The thoracic duct was presented to the left of the aorta and spine, from its entry in the aortic hiatus of the diaphragm and chest throughout its length. There were also anatomical variations of interest in the venous circulatory system, such as the absence of the veins: hemiazygos and accessory hemiazygos, and the different location of the azygos vein, which was located to the left of the aorta. These variations have no relation to each other. The study of this variation is important because the knowledge of variations in the thoracic duct path allows lower rates of trauma and iatrogenic lesions in thoracic surgery, with possible serious complications, such as a chylothorax

Human T-cell lymphotropic virus types I and II infections in a cohort of patients with neurological disorders in Belém, Pará, Brazil Infecção pelos vírus linfotrópicos humanos de células T tipos I e II entre pacientes com doença neurológica em Belém, Pará, Brasil

Serum- and/or- cerebrospinal fluid (CSF) samples obtained from 190 patients suffering from chronic, progressive neurological disease were screened for the presence of human T-cell lymphotropic viruses type I (HTLV-I) and type II (HTLV-II) antibodies over a six-year period (1996 to 2001) in Belém, Pará, Brazil. Patients were of both sexes (male subjects, 52%) with ages ranging from 2 to 79 years (mean, 35.9). Overall, 15 (7.9%) subjects - of whom 12 (80%) were female adults - reacted HTLV-I/II-seropositive when screened by enzyme-linked immunosorbent assay (ELISA). Serum samples from 14 of these patients were also analyzed using a recombinant Western blot (WB) assay that yielded HTLV-I-, HTLV-II-, and HTLV-I/II- reactivities for 10 (71.4%), 3 (21.4%) and 1 (7.2%) of them, respectively. The yearly rates of HTLV-I/II antibodies ranged from 2.6% (2001) to 21.7% (2000), with progressively increasing seropositivities from 1998 to 2000. Altogether, walking difficulty (n = 5 subjects), spasticity (n = 4) and leg weakness (n = 3) accounted for 80% of symptoms recorded among the 15 patients whose sera had antibodies to HTLV-I/II as detected by ELISA. These findings provide evidence that both HTLV-I and HTLV-II play a role in the development of chronic myelopathy in Belém, Pará, Northern Brazil.<br>Amostras de soro e/ou líquido céfalo-raquidiano (LCR) foram obtidas de 190 pacientes com quadro de doença neurológica crônica e progressiva, com vistas à detecção de anticorpos para os vírus linfotrópicos humanos de células T dos tipos I (HTLV-I) e II (HTLV-II), durante um período de seis anos (1996 a 2001) em Belém, Pará, Brasil. O grupo compreendia ambos os sexos (homens, 52%), com idades variando de 2 a 79 anos (média, 35,9 anos). Tomando-se os resultados como um todo, 15 (7,9%) indivíduos, incluindo 12 (80%) mulheres adultas, apresentaram anticorpos para HTLV-I/II a partir da triagem pelo procedimento imunoenzimático (ELISA). Soros de 14 desses pacientes também foram testados utilizando-se procedimento de Western blot (WB), alcançando-se freqüências de anticorpos para HTLV-I, HTLV-II e dupla reação (HTLV-I e HTLV-II) em 10 (71,4%), 3 (21,4%) e 1 (7,2%) indivíduos, respectivamente. As freqüências anuais de positividade para HTLV-I/II variaram de 2,6% (2001) a 21,7% (2000), em escala crescente no período de 1998 a 2000. Em conjunto, dificuldade na deambulação (n = 5 pacientes), espasticidade (n = 4) e hipotonia crural compreenderam 80% das manifestações clínicas registradas entre os 15 pacientes cujas amostras de soro continham anticorpos para HTLV-I/II, com base em ELISA. Tais resultados oferecem indicadores quanto a uma possível associação do HTLV-I e do HTLV-II à gênese das mielopatias crônicas em Belém, norte do Brasil