Divisão Alta do Nervo Isquiático: Duas Variantes Anatómicas Distintas

Introduction: Sciatic nerve variations are relatively common. These variations are often very significant in several fields of Medicine. The purpose of this paper is to present two such variants and discuss their clinical implications. Material and Methods: Three Caucasian cadavers with no prior history of lower limb trauma or surgery were dissected and found to present anatomical variants of the sciatic nerve. Results: In all cases the sciatic nerve divided above the popliteal fossa. In two cases (cadavers 1 and 2) it divided on both sides in the inferior portion of the gluteal region in its two terminal branches: the common fibular and the tibial nerves. In another case (cadaver 3) the sciatic nerve was found to divide inside the pelvis just before coursing the greater sciatic notch. The common fibular nerve exited the pelvis above the pyriformis muscle and then passed along its posterior aspect, while the tibial nerve coursed deep to the pyriformis muscle. Discussion: According to the literature, the anatomical variant described in cadaver 3 is considered relatively rare. This variant can predispose to nerve entrapment and thus to the pyriformis syndrome, sciatica and coccygodynia. The high division of the sciatic nerve, as presented in cadavers 1 and 2, can make popliteal nerve blocks partially ineffective. Conclusion: The anatomical variants associated with a high division of the sciatic nerve, must always be born in mind, as they are relatively prevalent, and have important clinical implications, namely in Anesthesiology, Neurology, Sports Medicine and Surgery

Morphometric Analysis of the Extensor Tendons of the Hallux and Potential Implications for Tendon Grafting

Although several tendon sources are available for reconstructive surgical procedures, all have one or more shortcomings. The aim of this work was to evaluate if the extensor tendons of the hallux showed anatomical characteristics that could make them an additional source for tendon grafting procedures.The authors performed a detailed morphometric analysis of the extensor tendons of the hallux in 26 lower limbs in order to evaluate the putative association of anatomical variants with hallux valgus, and to attempt to assess the feasibility of using part of the extensor apparatus of the hallux as a source of tendon for grafting procedures.An accessory extensor hallucis longus ten-don was found in 92.3% of cases. The extensor hallucis brevis tendon length was 10.5 ± 0.6 cm; its width was 0.5 ± 0.1 cm, and its thickness varied between 1-2 mm, making it a potentially good candidate as a source of ten-don grafts. Several anatomical variations were observed, namely the fusion of the tendons of the extensor hallucis brevis and the accessory extensor hallucis longus muscles in the distal part of the foot.This new therapeutic option, if implemented, would possibly increase the supply of autogenous donor tissue for reconstructive procedures, thereby enhancing the reconstructive surgeon’s armamentarium

Synthetic approaches to multifunctional indenes

The synthesis of multifunctional indenes with at least two different functional groups has not yet been extensively explored. Among the plausible synthetic routes to 3,5-disubstituted indenes bearing two different functional groups, such as the [3-(aminoethyl)inden-5-yl)]amines, a reasonable pathway involves the (5-nitro-3-indenyl)acetamides as key intermediates. Although several multistep synthetic approaches can be applied to obtain these advanced intermediates, we describe herein their preparation by an aldol-type reaction between 5-nitroindan-1-ones and the lithium salt of N,N-disubstituted acetamides, followed immediately by dehydration with acid. This classical condensation process, which is neither simple nor trivial despite its apparent directness, permits an efficient entry to a variety of indene-based molecular modules, which could be adapted to a range of functionalized indanones

Azolium-based systems: application of an anion exchange resin (A- form) method and 1H NMR analysis of the charged-assisted (C<br>H)+·anion hydrogen bonds

The counteranion exchange of quaternary 1,2,3-triazolium salts was examined using a simple method that permitted halide ions to be swap for a variety of anions using an anion exchange resin (A¯ form). The method was applied to 1,2,3-triazolium-based ionic liquids and the iodideto- anion exchange proceeded in excellent to quantitative yields, concomitantly removing halide impurities. Additionally, an anion exchange resin (N3¯ form) was used to obtain the benzyl azide from benzyl halide under mild reaction. Likewise, following a similar protocol, bis(azidomethyl)arenes were also synthesized in excellent yields. The results of a proton NMR spectroscopic study of simple azolium-based ion pairs are discussed, with attention focused on the significance of the charged-assisted (CH)+···anion hydrogen bonds of simple azolium systems such as 1-butyl-3-methylimidazolium and 1-benzyl-3-methyl-1,2,3-triazolium salts

1,2-Diaryl(3-pyridyl)ethanone Oximes. Intermolecular Hydrogen Bonding Networks Revealed by X-ray Diffraction

The synthesis of a set of 1-aryl-2-aryl(3-pyridyl)ethanones 1-5 and thecorresponding ketoximes 6-9 is reported. Structural studies of oximes 6, 7 and 9 wereperformed in solution using 1H-NMR and in the solid state by X-ray crystallography,providing evidence of H-bonding networks. The crystal packing was controlled byhomomeric intermolecular oxime···oxime H-bond interactions for 6 and cooperativeoxime···N(pyridyl) and CH/π interactions for 7 and 9. Keywords: Oximes; ethanones; hydrogen bonds; self-assembly; X-ray diffraction crystalograph

A Rare Variation of the Extensor Indicis Proprius Tendon With Important Clinical Implications

Introduction: Anatomical variations of the extensor tendons to the fingers are of great clinical interest, due to the relatively high frequency of tendon injury in clinical practice. Material and methods: During routine dissection of the right upper limb of a 67-year-old female preserved corpse, the extensor indicis proprius (EIP) muscle belly originated 3 independent tendons, each with a separate fascial sheath, forming a triple EIP tendon. There was a larger tendon, which occupied a central position, that represented the usual single EIP tendon. In addition, there were two thinner radial and ulnar accessory EIP tendons. The radial-EIP tendon crossed deep to the extensor digitorum communis (EDC) tendon to the index finger in the distal half of the dorsum of the hand to reach the radial side of the extensor expansion hood of the index finger. Discussion: According to the literature, the frequency of a triple EIP tendon ranges from 0%, to as high as 7%, although most authors do not acknowledge the presence of this variant in their series. This variant of the EIP tendon, in which the radial-EIP terminated laterally to the termination of the tendon of the EDC to the index finger, may be a source of confusion intraoperatively, as the EIP tendon has traditionally been identified on the basis of its ulnar location with respect to the EDC tendon. Conclusion: The possibility of a triple EIP tendon should certainly be born in mind by all surgeons when performing tendon repairs, tenoplasties or tendon transfers

Lessons from the decoupling limit of Horava gravity

We consider the so-called "healthy" extension of Horava gravity in the limit where the Stuckelberg field decouples from the graviton. We verify the alleged strong coupling problem in this limit, under the assumption that no large dimensionless parameters are put in by hand. This follows from the fact that the dispersion relation for the Stuckelberg field does not have the desired z = 3 anisotropic scaling in the UV. To get the desired scaling and avoid strong coupling one has to introduce a low scale of Lorentz violation and retain some coupling between the graviton and the Stuckelberg field. We also make use of the foliation preserving symmetry to show how the Stuckelberg field couples to some violation of energy conservation. We source the Stuckelberg field using a point particle with a slowly varying mass and show that two such particles feel a constant attractive force. In this particular example, we see no Vainshtein effect, and violations of the Equivalence Principle. The latter is probably generic to other types of source and could potentially be used to place lower bounds on the scale of Lorentz violation.Comment: 18 pages, 1 figure. Version to appear in JHEP. Conclusions with respect to strong coupling modified - our strong coupling analysis does not apply to a low scale of Lorentz violation. Expanded Equivalence Principle violation discussion, noting it presents a challenge to low scale Lorentz violation, exactly the scenario designed to cure strong coupling. Other minor corrections and references adde

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

Free tissue transfer has been increasingly used in clinical practice since the 1970s, allowing reconstruction of complex and otherwise untreatable defects resulting from tumor extirpation, trauma, infections, malformations or burns. Free flaps are particularly useful for reconstructing highly complex anatomical regions, like those of the head and neck, the hand, the foot and the perineum. Moreover, basic and translational research in the area of free tissue transfer is of great clinical potential. Notwithstanding, surgical trainees and researchers are frequently deterred from using microsurgical models of tissue transfer, due to lack of information regarding the technical aspects involved in the operative procedures. The aim of this paper is to present the steps required to transfer a fasciocutaneous epigastric free flap to the neck in the rat. This flap is based on the superficial epigastric artery and vein, which originates from and drain into the femoral artery and vein, respectively. On average the caliber of the superficial epigastric vein is 0.6 to 0.8 mm, contrasting with the 0.3 to 0.5 mm of the superficial epigastric artery. Histologically, the flap is a composite block of tissues, containing skin (epidermis and dermis), a layer of fat tissue (panniculus adiposus), a layer of striated muscle (panniculus carnosus), and a layer of loose areolar tissue. Succinctly, the epigastric flap is raised on its pedicle vessels that are then anastomosed to the external jugular vein and to the carotid artery on the ventral surface of the rat's neck. According to our experience, this model guarantees the complete survival of approximately 70 to 80% of epigastric flaps transferred to the neck region. The flap can be evaluated whenever needed by visual inspection. Hence, the authors believe this is a good experimental model for microsurgical research and training.info:eu-repo/semantics/publishedVersio

Lepton CP Asymmetries in B Decays

In the decay of Upsilon(4S, the decay time distribution of Upsilon(4S) -> f + X, where f is a final state that B^0 or B^0bar can decay to, is the sum of the decay time distributions of B^0 -> f and B^0bar -> f. Using this general rule, we estimate the sensitivity of single lepton CP violation measurements with respect to that of traditional di-lepton measurements. We find that the sensitivity of the single lepton method is comparable to or better than that of the di-lepton method. The two data samples are largely statistically independent, so that they can be combined to improve sensitivity. The advantage of the single lepton measurement increases for large mixings, which suggests that the single lepton method holds promise for B_s. We also discuss lepton asymmetry measurements on the Z^0 peak and in hadron colliders. The achievable sensitivity with the currently available data is already in the range relevant to standard model predictions. PACS numbers: 11.30.Er, 13.20.Gd, 13.20.He, 03.65.BxComment: 13 pages, no figures, Latex. References update