Este projeto, analisou a distribuição dos neurônios nos plexos mioentérico (PM) e submucoso (PS) imunorreativos aos receptores P2X2 (ir) e P2X7 (ir), calbindina (Calb-ir), calretinina (Calr-ir), colina acetil transferase (ChAT-ir) e ao óxido nítrico sintase (NOS-ir) do colo distal de ratos submetidos à desnutrição a renutrição protéica. Utilizaram-se colos distais de ratos nutridos (N42), desnutridos (D42) e renutridos (RN42). Os resultados do plexo PM, demonstraram que 100% dos neurônios Calb-ir, Calr-ir, ChAT-ir e NOS-ir, expressavam os receptores P2X2-ir e P2X7-ir nos três grupos. A densidade neuronal no PM, demonstrou um aumento de 20% a 97% dos neurônios receptores P2X2-7-ir, Calr-ir, ChAT-ir e NOS-ir e no PS foi de 29% a 75%, ambos D42 e recuperação no RN42. O perfil neuronal P2X7-ir, Calb-ir, Calr-ir e ChAT-ir do PM demonstrou diminuição de 28% a 40% e no PS os neurônios P2X2-7-ir, Calb-ir e ChAT-ir de 19% a 47% no D42. Concluí-se que, a desnutrição afeta os neurônios entéricos havendo recuperação na renutrição, podendo influenciar nas funções gastrintestinais. / The aim of the work was to analyze the distal colon myenteric (MN) and submucous (SN) neurons immunoreactive for P2X2-7 receptors, calbindin (Calb-ir), calretinin (Calr-ir), choline acetyltransferase (ChAT) and nitric oxide synthase (NOS) of the animals submitted to undernutrition and refeeding proteic. Distal colon was used from nourished (N42), undernourished (D42) and refeeding (RN42) rats. The results have shown 100% coexpression of the myenteric and submucous Calb-ir, Calr-ir, ChAt-ir e NOS-ir neurons with P2X2-7-ir receptors. The MN density have shown increase of the 20% and 97% of the P2X2-7-ir, Calr-ir, ChAT-ir e NOS-ir neurons of the D42 group, and the SN have been increased 29% a 75% in the D42 group. In the MN neuronal profile have shown decrease P2X7-ir, Calb-ir, Calr-ir and ChAT-ir neurons of the 28% to 40% and in the PS P2X2-7-ir, Calb-ir and ChAT-ir of the 19% a 47% neurons in the D42 group. I concluded that, the undernutrition affects the enteric neurons and there was recuperation in the refeeding, this can influence the gastrintestinal functions.

Les interfaces sang-cerveau comme la barrière hémato-encéphalique (BHE), les plexus choroïdes (PC) ou les organes circumventriculaires (OCV), constituent des barrières physiologiques nécessaires au fonctionnement du système nerveux central. Ces barrières sont à la fois « physiques », constituées de jonctions serrées, et « enzymatiques ». Longtemps considérées comme immatures chez le fœtus, ces barrières sont en réalité présentes précocement au cours du développement. Leurs caractéristiques et leurs propriétés restent peu connues chez l'homme. Nos travaux montrent que les PC expriment, précocement au cours du développement, des protéines de jonction serrée, les claudines (CLDN) 1, 2 et 3 chez le rat et chez l'homme. Cette expression est dynamique au cours du développement avec une apparition progressive de la CLDN2 pouvant avoir un lien avec la sécrétion du liquide céphalo-rachidien. Les CLDN 1 et 3 sont identifiées chez le fœtus humain au niveau de l'organe sous-commissural (OSC), un des OCV. La CLDN5 est exprimée précocement au niveau de la BHE chez le rat et chez l'homme et son expression est altérée dans un modèle d'excitotoxicité néonatale. Nos travaux montrent également que l'analyse du profil des CLDN est utile en pathologie tumorale notamment dans la compréhension et le diagnostic de tumeurs développées à partir des PC ou de l'OSC. Enfin, diverses enzymes antioxydantes et de détoxification dont l'époxyde hydrolase microsomale sont exprimées à 22 semaines d'aménorrhée principalement au niveau des PC du fœtus humain. Ces données suggèrent des capacités de détoxification des PC, d'installation précoce au cours du développement chez l'homme / Blood-brain interfaces including blood-brain barrier (BBB), choroid plexuses (CP) or circumventricular organs (CVO) are physiological barriers required for brain homeostasis. These barriers are “physical”, with tight junctions, and “enzymatic”. Though long considered immature in fetuses, these barriers are present from an early stage of development. Their characteristics and their properties are largely unknown in humans. Our work demonstrates that CP express tight junction-associated proteins claudins (CLDN) 1, 2, and 3 at early stages of development in rat and human. This expression is dynamic during development as shown by the progressive increase of CLDN2 immunopositivity that may follow increase in cerebrospinal fluid secretion. CLDN 1 and 3 are identified in human fetal subcommissural organ (SCO), one of the CVO. CLDN5 is early expressed in rat and human BBB and its expression is disrupted by excitotoxic injury. Our work also shows that CLDN immunohistochemical profile is useful in tumoral pathology, notably to better understand and diagnose tumors arising from CP or the SCO. Finally, various antioxidant and detoxifying enzymes such as the microsomal epoxide hydrolase are expressed at 22 weeks of gestation in the human fetus, mainly in CP. These results suggest a high detoxifying capacity for the CP during development in humans

Purpose The objective of this thesis is to establish an evidence-based clinical practice guideline for the primary management of obstetrical brachial plexus injury (OBPI). Four gaps are identified for management of OBPI in Canada: 1) The historic poor use of evidence, 2) Timing of referral to multidisciplinary care, 3) Indications and timing of operative nerve repair, and 4) Distribution of expertise in Canada. Methods The guideline is intended for all providers delivering perinatal care, and all specialists delivering care to OBPI patients. The consensus group was composed of clinicians representing each of Canada’s ten multidisciplinary centres. An original systematic review comparing the effectiveness of primary operative versus nonoperative management, and a review of Canadian OBPI epidemiology were completed. Quality indicators for referral to a multidisciplinary centre were established. Recommendations were based on best evidence, and interpretation of this evidence by clinical experts. An electronic modified Delphi approach was used for consensus, with agreement criteria defined a priori following RAND procedures. Results Nerve repair reduces functional impairment in OBPI versus nonoperative management of similar patients, and modern microsurgery has low incidence of major adverse events. The quality of evidence was low. Residual impairment is underestimated and uncharacterized in nonoperative literature. OBPI incidence was at least 1.24 per 1000 births in Canada, and consistent over the study period. The strongest risk factors for OBPI were comorbid humerus fracture, shoulder dystocia and comorbid clavicle fracture. Most patients were not referred to a multidisciplinary centre. The guideline group approved seven recommendations. Discussion Recommendations address the identified gaps in care, and guide identification, referral, treatment and outcome assessment for OBPI. The process established a new network of opinion leaders and researchers for further guideline development, and multicentre research. The next step is to facilitate the implementation of the recommendations. / Thesis / Master of Science (MSc)

Traumatic injuries to the spinal cord and brachial plexus induce a significant inflammatory response in the nervous tissue with progressive degeneration of neurons and glial cells, and cause considerable physical and mental suffering in affected patients. This thesis investigates the effects of the antioxidants N-acetyl-cysteine (NAC) and acetyl-L- carnitine (ALC) on the survival of motoneurons in the brainstem and spinal cord, the expression of pro-apoptotic and pro-inflammatory cell markers, axonal sprouting and glial cell reactions after spinal hemisection in adult rats. In addition, a novel MRI protocol has been developed to analyse the extent of neuronal degeneration in the spinal cord. Rubrospinal neurons and tibial motoneurons were pre-labelled with the fluorescent tracer Fast Blue one week before cervical C3 or lumbar L5 spinal cord hemisection. The intrathecal treatment with the antioxidants NAC (2.4mg/day) or ALC (0.9 mg/day) was initiated immediately after injury using Alzet2002 osmotic mini pumps. Spinal cord injury increased the expression of apoptotic cell markers BAX and caspase 3, induced significant degeneration of rubrospinal neurons and spinal motoneurons with associated decrease in immunoreactivity for microtubule-associated protein-2 (MAP2) in dendritic branches, synaptophysin in presynaptic boutons and neurofilaments in nerve fibers. Immunostaining for the astroglial marker glial fibrillary acidic protein and microglial markers OX42 and ED1 was markedly increased. Treatment with NAC and ALC attenuated levels of BAX, caspase 3, OX42 and ED1 expression after 2 weeks postoperatively. After 4-8 weeks of continuous intratheca ltreatment, NAC and ALC rescued approximately half of the rubrospinal neurons and spinal motoneurons destined to die, promoted axonal sprouting, restored the density of MAP2 and synaptophysin immunoreactivity and reduced the microglial reaction. However, antioxidant therapy did not affect the reactive astrocytes in the trauma zone. The inflammation modulating properties of ALC were also studied using cultures of human microglial cells. ALC increased the microglial production of interleukin IL-6 and BDNF, thereby possibly mediating the anti-inflammatory and pro-regenerative effects shown in vivo. To study degeneration in the spinal cord following pre-ganglionic and post-ganglionic brachial plexus injuries, adult rat models of ventral root avulsion and peripheral nerve injury were used. A novel MRI protocol was employed and the images were compared to morphological changes found in histological preparations. Ventral root avulsion caused degeneration of dendritic branches and axonal terminals in the spinal cord, followed by significant shrinkage of the ventral horn. Extensive astroglial and microglial reactions were detected in the histological preparations. Peripheral nerve injury reduced the density of dendritic branches but did not cause shrinkage of the ventral horn. Quantitative analysis of MRI images demonstrated changes in the ventral horn following ventral root avulsion only, thus validating the developed MRI technique as a possible tool for the differentiation of pre-ganglionic and post-ganglionic nerve injuries.

Als Therapieversuch bei Plexusläsionen wird die Replantation ausgerissener Vorderwurzelfasern durchgeführt. Voraussetzung für die erfolgreiche Regeneration von Motoneuronaxonen sind 1. Überleben einer ausreichenden Anzahl von Motoneuronen 2. erfolgreiche Wiederherstellung der Kontuität ausgerissener Axone mit dem Rückenmark und 3. funktionelle Hochwertigkeit regenerierter Axone. Neurotrophe Faktoren können Überleben und Regenerationsfähigkeit von Motoneuronen fördern. Gegenstand der vorliegenden Arbeit war die Analyse des Einflusses von CNTF und BDNF auf die Regeneration von Motoneuronaxonen nach Ausriss und Replantation im Segment C7 nach einer Überlebenszeit von 3 Wochen bzw. 6 Monaten. Vervollständigt wurden diese Untersuchungen durch detaillierte morphologische Analysen von Spinalganglien, durchtrennter Hinterwurzel und verletztem Hinterhorn. In verschiedenen Gruppen von adulten Kaninchen wurden CNTF, BDNF, oder beide Faktoren auf die ventrolaterale Replantationsstelle appliziert, Kontrollen wurden ohne Faktor belassen (n>5). Die Überlebenszeit der Versuchstiere lag bei 3 Wochen (n=3 Kontrollen) und 6 Monaten (n=27). Aus dem perfundiertem Gewebe wurden Semidünnschnitte durch Vorderwurzel/Spinalganglien und Kryostatserienschnitte durch das Segment C7 angefertigt. DiI-Fluoreszenztracing, Markscheidenfärbung, eine modifizierte Klüver-Barrera-Färbung der Kryostatschnitte sowie eine Touloidinblaufärbung der Semidünnschnitte ermöglichte die morphologische und morphometrische Analyse des Gewebes. Die Anzahl der überlebenden Motoneurone lag nach sechs Monaten bei allen Versuchsgruppen bei etwa 30%. Fluoreszenz-Tracing und Markscheidenfärbungen von Serienschnitten zeigten, dass Axone sowohl über die ursprünglichen ventralen Austrittstellen als auch über die ventrolaterale Replantationsstelle das Rückenmark verließen und im Bereich des Spinalganglions eine kompakte Vorderwurzel bildeten. Ventral austretende Axone zeigten signifikant größere Durchmesser als lateral austretende. Ausmaß und Art der Regeneration waren interindividuell unterschiedlich, die besten Ergebnisse zeigte die Replantation nah am ursprünglichen Austrittsort der Vorderwurzel. Unterschiede zwischen den Gruppen waren nicht deutlich. In Semidünnschnitten durch die regenerierte Vorderwurzel fanden sich nach drei Wochen kaum intakte, myelinisierte Axone, nach sechs Monaten war die Zahl der Axone auf etwa 45% der Zahl der gesunden Seite angestiegen. Regenerierte Axone waren dünn, typische Motoneuronaxone stellten nur einen kleinen Teil der regenerierten Axone. Gruppenunterschiede fanden sich im Axon-Myelinverhältnis, das bei Kontrollen der replantierten Seiten signifikant erniedrigt war. Diese Erniedrigung war noch vorhanden, jedoch nicht mehr signifikant bei Tieren, die mit CNTF- und BDNF-behandelt wurden. Die replantierten Vorderwurzeln der CNTF+BDNF-Gruppe zeigte überwiegend eine signifikant bessere Myelinisierung als die replantierten Kontrollen. An der früheren Hinterwurzeleintrittszone am Rückenmark wurden in Tieren mit geringem Verletzungsausmaß kleine ZNS-Gewebsprotrusionen beobachtet, in denen sich myelinisierte Axone befanden. Diese Axone zeigten eine Wachstumsrichtung in die Peripherie, was auf eine Sprossung der sensorischen Rückenmarksneurone schließen lässt. Innerhalb des Spinalganglions waren Neuron- und Axondichte auf den verletzten Seiten nicht wesentlich verändert. Eine leichte Abnahme des relativen Anteils großer Neurone und Axone wurde in den verletzten Seiten der Kontrollgruppe beobachtet. Für Axone war diese Abnahme statistisch signifikant. Im Gegensatz dazu war dies in Tieren, die mit neurotrophen Faktoren behandelt wurden, nicht zu beobachten. Bei allen Tieren zeigte sich ein beträchtliches Auswachsen von Hinterwurzelaxonen aus dem Spinalganglion. Diese Axone fanden keine spontane Verbindung mit dem proximalen Rest der Wurzel, sondern waren durch Bindegewebe eingehüllt. Bei etwa der Hälfte der Tiere zeigte sich, dass einer Untergruppe dieser Axone in Richtung des Narbengewebes der replantierten Vorderwurzel gewachsen war und über Defekte in der Bindegewebshülle teilweise sogar in die Vorderwurzel einwuchsen. Ein möglicher Einfluss der applizierten neurotrophen Faktoren auf das quantitative Regenerationsergebnis scheint also in diesem Modell gering zu sein. Auf eine qualitative Verbesserung deutet die Normalisierung des Axon-Myelinverhältnisses großer regenerierter Axone bei Kombinationsbehandlung hin. Die im vorliegenden Modell beträchtliche Regenerationskapazität der Hinterwurzel scheint bisher unterschätzt worden zu sein. Das unerwartete Einwachsen von Hinterwurzelaxonen in die Vorderwurzel könnte mit einer funktionellen Beeinträchtigung der regenerierten Vorderwurzel verbunden sein. / Treatment of brachial plexus lesions is attempted by surgical replantation of avulsed nerve roots. Prerequisites for successful regeneration of motoneuron axons are 1. survival of a large number of motoneurons, 2. restoration of connectivity between avulsed nerve roots and spinal cord and 3. high quality of regenerated axons. Regeneration and survival of motoneurons can be supported by neurotrophic factors. In the present study, the influence of CNTF and BDNF on regeneration of motoneurons after C7 ventral root avulsion and replantation after 3 weeks and 6 months was analysed. Additionally, detailed morphological analyses of dorsal root ganglia (DRG), severed dorsal roots and injured dorsal horns were performed. In adult rabbits C7 dorsal roots were severed, ventral roots were avulsed and replanted ventrolaterally. CNTF, BDNF, or both was applied to the replantation site, controls were replanted without application of neurotrophic factors (n>5). After 3 weeks (n= 3 controls) and 6 months (n= 27) after avulsion and replantation semi-thin sections of ventral roots and DRGs as well as cryostat serial sections from C7 spinal cord segment were prepared. DiI-fluorescence tracing, myelin-sheath staining, modified Klüver-Barrera staining of cryostat section and touloidinblue staining of semi-thin sections served for morphological and quantitative analyses. Six months after lesion, a survival of 30% of the C7 motoneurons was found without differences between the experimental groups. Retrograde fluorescent tracing and histological analysis documented that many axons had regrown through the original ventral exit zones or had exited the spinal cord at the lateral replantation site. However, many laterally exiting axons had not grown out directly from the ventral horn through the lateral white matter but had elongated vertically before leaving the spinal cord. The mean axonal diameter was significantly higher in regenerated axons that had exited through the original ventral exit zones in comparison with axons which had grown out laterally. Application of BDNF and/or CNTF did not show any effects on the pathways of regeneration into the replanted root. Three weeks after ventral root avulsion and replantation the number of axons was rare. After six months, the number of myelinated axons increased to 45% compared to unlesioned sides. Regenerated axons were mainly of small caliber with few axons showing typical properties of motoneuron axons. In controls myelination was significantly reduced compared to the unlesioned sides. This was not observed after CNTF, BDNF and CNTF+BDNF treatment. In CNTF+BDNF treated animals myelination was significantly increased compared to replanted controls in the majority of cases. At the dorsal root entry zone, small myelinated axons extended into central tissue protrusions, in cases with well-preserved morphology. This suggested sprouting of spinal neuron processes into the central dorsal root remnant. In lesioned DRGs, the density of neurons and myelinated axons was not significantly altered, but a slight decrease in the relative frequency of large neurons and an increase of small myelinated axons was noted (significant for axons). Unexpectedly, differences in the degree of these changes were found between control and neurotrophic factor-treated animals. Central axons of DRG neurons formed dorsal root stumps of considerable length which were attached to fibrous tissue surrounding the replanted ventral root. In cases where gaps were apparent in dorsal root sheaths, a subgroup of dorsal root axons entered this fibrous tissue. Continuity of sensory axons with the spinal cord was never observed. Some axons coursed ventrally in the direction of the spinal nerve. In summary, the number of surviving motoneurons and regenerating axons appeared not to be influenced by a single- dose application of neurotrophic factors in this model. However, improvement of myelination indicated that the quality of regeneration can be increased especially by CNTF+BDNF- treatment. Moreover, the considerable capacity of dorsal root regeneration we observed in this study has possibly been underestimated previously. The unexpected ingrowth of dorsal root axons into the regenerated ventral roots could be harmful for ventral root regeneration.

O ácido 2,4 diclorofenoxiacético (2,4-D) é um herbicida amplamente utilizado na agricultura sendo moderadamente tóxico para os seres humanos e demais animais. Apresenta neurotoxicidade, mas seu mecanismo de ação no sistema nervoso não está totalmente esclarecido. Há indícios de que este herbicida atue nos neurônios serotoninérgicos e dopaminérgicos de maneira seletiva, mas não há estudos suficientes para afirmarem sua exata ação sobre o sistema nervoso periférico. Entre os efeitos advindos da intoxicação com 2,4-D estão manifestações gastrointestinais. O presente trabalho teve como objetivo verificar os efeitos da administração do 2,4-D diluído em água nos neurônios mioentéricos do duodeno de ratos. Para tanto, 36 ratos (Rattus norvegicus) foram separados em três grupos (n = 12): controle (C); tratamento com 2,5 &#956;g/Kg de 2,4-D (B) e tratamento com 5 &#956;g/Kg de 2,4-D (A). Após 15 dias de experimento, os animais foram anestesiados, eutanasiados e seus duodenos foram retirados. Os neurônios mioentéricos foram evidenciados por meio de preparados de membrana corados pelo método de Giemsa e pela técnica de evidenciação neuronal pela ação da NADH-diaforase. Estes preparados de membrana foram analisados ao microscópio de luz para contagem dos neurônios e através de programa computadorizado de análise de imagens foi feita a mensuração do perfil do corpo celular (PCC) desses neurônios. A análise quantitativa demonstrou diminuição no número de neurônios do duodeno nos animais que receberam 2,4-D, em ambas as técnicas (p<0,05). Predominaram nos três grupos de animais neurônios de tamanho entre 101 e 300&#956;m2. A incidência de neurônios grandes (entre 301 e 600 µm2) foi significantemente maior (p<0,05) nos animais tratados com 2,4-D. Os resultados sugerem que o 2,4-D afeta o plexo mioentérico, sendo sua ação neurotóxica manifestada pela diminuição no número de neurônios e aumento no número de neurônios grandes. / The 2,4 dichlorophenoxyacetic acid (2,4-D) it is a herbicid thoroughly used in the agriculture and it is poisonous for the human beings and other animals. It presents neurotoxicity but its action mechanism in the nervous system is not totally known. There are evidences that herbicid actuate on selective mode in serotoninergics and dopaminergics neurons, but there isn?t significant studies to prove its discuss action on the peripheric nervous system. Among the effects succeeding of the intoxication with 2,4-D are gastrointestinal manifestations. The present work had as objective verifies the effects of the administration for 15 days of 5 &#956;g and 2,5 &#956;g/Kg of body weight of 2,4-D diluted in water in the duodenum myenteric neurons of the rats. In order to do so, 15 rats (Rattus norvegicus) were divided into three groups (n = 12): controls (C); treatment with 2,5&#956;g/Kg of 2,4-D (B); and treatment with 5&#956;g/Kg of 2,4-D (A). 15 days later, the animals were anesthetized, killed without pain and your duodenums were removed. The myenteric neurons were stained employing the Giemsa and the NADH-diaforase methods by means of whole mounts preparations. These whole mounts preparations were analyzed in light microscope to count the neurons and through image analysis software to measured the cellular body profile (CBP) of these neurons. The quantitative analysis evidenced reduction in the number of duodenum neurons in animals which received 2,4-D, in both techniques (p<0,05). Predominated in three groups neurons with size between 101 and 300 &#956;m2. Incidence of big neurons (between 301 e 600 &#956;m2) was significantly higher (p<0,05) in the treated with 2,4-D. The results suggest that the 2,4-D affect the myenteric plexus, and its action is expressed by reduction in neurons number and increase in incidence of big neurons.

O desenvolvimento de um método eficiente de avaliação prognóstica precoce seria de grande utilidade na seleção de lactentes com plexopatia braquial obstétrica para cirurgias de reconstrução do plexo braquial. Realizamos estudos de condução motora em 54 pacientes entre 10 e 60 dias de vida. Foram comparadas lado a lado as amplitudes dos potenciais de ação musculares compostos dos nervos axilar (músculo deltóde), musculocutâneo (músculo bíceps), radial proximal (músculo tríceps), radial distal (músculo extensor comum dos dedos), mediano (eminência tenar) e ulnar (eminência hipotenar). A relação entre a amplitude do potencial motor do lado lesado sobre o lado são foi chamada de Índice de Viabilidade Axonial (IVA), sendo este calculado tanto a partir da amplitude negativa como da amplitude pico-a-pico. Os pacientes foram seguidos clinicamente e classificados em três grupos: Grupo A, com recuperação total até os seis meses de vida; Grupo B, recuperação satisfatória até os doze meses de vida, e Grupo C, recuperação insatisfatória até os doze meses de vida. Analisamos a curva ROC (Receive Operator Characteristic Curve) de cada IVA para definir o melhor ponto de corte para detecção dos pacientes do Grupo C (mau prognóstico). Para o nervo axilar, o ponto de corte ideal foi IVA menor que 10%, com sensibilidade de 88,2% e especificidade de 89,2% ou 91,9%. Para o nervo musculocutâneo, o ponto de corte foi a ausência de potencial de ação motor, com sensibilidade de 88,2% e especificidade de 73,0%. Para o nervo radial proximal, o ponto de corte foi IVA menor que 20%, com sensibilidade de 82,4% ou 94,1% e especificidade de 97,3% ou 100%. Para o nervo radial distal, o ponto de corte foi IVA menor que 50%, com sensibilidade de 76,5% ou 82,4% e especificidade de 97,3%. Para o nervo ulnar, o ponto de corte foi IVA menor que 50%, com sensibilidade de 58,8% e especificidade de 97,3% ou 100%. O IVA do nervo mediano teve um desempenho ruim e seu uso não pode ser recomendado. Os IVAs dos nervos radial proximal, radial distal e ulnar apresentaram maior especificidade do que o critério clínico mais utilizado para a avaliação prognóstica, ou seja, ausência de função bicipital aos três meses de vida. A sensibilidade dos IVAs dos nervos axilar, musculocutâneo, radial proximal e radial distal foram equivalentes à do critério clínico. A utilização do estudo de condução motora entre 10 e 60 dias de vida forneceu uma avaliação prognóstica mais precoce e mais específica do que o critério clínico, podendo ser utilizada para indicação cirúrgica destes pacientes. / Early prognostic assessment of obstetric brachial plexopathies would be a major step for rational selection of infants for brachial plexus surgery. We performed nerve conduction studies in 54 patients from 10 to 60 days of life. We compared sideto-side the compound muscle action potentials amplitudes from the axillary (deltoid muscle), musculocutaneous (biceps), proximal radial (triceps), distal radial (extensor digitorum communis), median (thenar eminence) and ulnar nerves (hypothenar eminence). The ratio between the amplitude of the affected limb and that of the healthy side was called Viability Axonal Index (VAI), which was calculated using both the negative and the peak-to-peak amplitudes. The patients were followed-up and classified in three groups: Group A, with full recovery at six months of age; Group B, with satisfactory recovery at twelve months of age, and Group C, with poor recovery at twelve months of age. We analyzed the ROC (Receive Operator Characteristic) curve of each VAI to define the best cut-off point for detection of Group C patients (bad prognosis). The best cut-off point for the axillary nerve was a VAI of less than 10%, whith sensibility of 88.2% and specificity of 89.2% or 91.9%. For the musculocutaneous nerve, the cut-off point was an absent motor action potential, with sensibility of 88.2% and specificity of 73.0%. For the proximal radial nerve, the cut-off point was a VAI of less than 20%, with sensibility of 82.4% or 94.1% and specificity of 97.3% or 100%. For the distal radial nerve, the cut-off point was a VAI of less than 50%, with sensibility of 76.5% or 82.4% and specificity of 97.3%. For the ulnar nerve, the cut-off point was a VAI of less than 50%, which sensibility of 58.8% and specificity of 97.3% or 100%. The VAI from the median nerve had a poor performance and its use could not be recommended. The VAIs from proximal radial, distal radial and ulnar nerves had better specificities compared to the most used clinical criterion: absence of biceps function at three months of age. The VAIs sensitivities from axillary, musculocutaneous, proximal radial and distal radial nerves were equivalent to the clinical criterion. The use of motor conduction studies between 10 and 60 days of age yielded an earlier and more specific prognostic estimation than the clinical criterion, and could be used for indication of surgery in these patients.

O sistema vascular de monocotiledôneas, incluindo Commelinaceae, tem sido estudado desde o sec. 17, sendo uma das maiores dificuldades em estudar esse sistema a grande quantidade de feixes vasculares e a complexidade de suas conexões, especialmente nas espécies que possuem plexo vascular nodal. As variações no sistema vascular não se restringem à relação caule/folha, uma vez que as raízes também podem apresentar certo grau de complexidade. Neste trabalho buscamos entender e apresentar uma arquitetura vascular em Commelinaceae baseado na reconstrução direta de análises tridimensionais dos sistemas caulinar e radicular. Para isto, foram analisadas amostras de caule (20 espécies) e raiz tuberosa (7 espécies) da família Commelinaceae, a partir de representantes das duas tribos de Commelinoideae (Commelineae e Tradescantieae). O rastreamento do sistema vascular no ápice caulinar mostrou que os feixes vasculares caulinares (em fase procambial) começam a ser distinguidos no 4º fitômero, a partir do ápice caulinar. A atividade meristemática do periciclo e o incremento foliar foram os principais fatores de espessamento primário do caule. A partir de análises tridimensionais complementares, como microscopia confocal, microtomografia computadorizada,vetorização gráfica e diafanização whole mount foram construídos modelos tridimensionais da arquitetura vascular em Commelinaceae. Nestes modelos foi possível verificar uma categoria de feixes ainda não relatada para Commelinaceae e que os feixes periféricos não são interrompidos ou terminam cegamente na periferia da medula. Três padrões de plexo vascular nodal são propostos, nos quais todos os feixes vasculares se conectam por meio de traqueídes. Para raiz tuberosa, dados morfométricos foram obtidos com auxílio do software ImageJ e vetorização gráfica foi utilizada para rastreamento do sistema vascular. Os resultados mostram quatro variações anatômicas do cilindro vascular e a quantificação morfométrica das características responsáveis por estas variações / The vascular system of monocotyledons, including Commelinaceae, has been studied since 17 th century, and one of the greatest difficulties in studying these systems is the great number of vascular bundles and the complexity of their connections, especially the species that have vascular nodal plexus. The variations in the vascular system are not restricted to the stem-leaf relation, since the roots can also present some degree of complexity. In this work we seek to understand and present a vascular architecture for Commelinaceae based on the direct reconstruction of 3D analyzes of shoot and root systems. Samples of stem (20 species) and tuberous root (7 species) of the Commelinaceae were analyzed including two tribes of Commelinoideae (Commelineae e Tradescantieae). The tracing of the vascular system in the shoot apex showed that the vascular bundles (in the procambial phase) begin to be distinguished in the 4th phytomer, from the apex. The meristematic activity of the pericycle (in the procambial phase) and the leaf increment were the main factors of primary stem thickening. From complementary 3D analyzes, such as confocal microscopy, computer microtomography, graphic vectorization and whole mount diaphanization, three-dimensional models of the vascular architecture were constructed from Commelinaceae. In these models it was possible to verify a category of bundles not yet reported for Commelinaceae and that the peripheral bundles are not interrupted or end blindly in the periphery of the vascular cylinder. Three patterns of nodal vascular plexus are proposed, in which all vascular bundles are connected by means of tracheids. For tuberous root, morphometric data were obtained by the aid of ImageJ software and graphic vectorization was used to trace the vascular system. The results show four anatomical variations of the vascular cylinder and the morphometric quantification of the characteristics responsible for these variations

Para evitar a presença de microorganismos nas rações fornecidas para animais de laboratório, são utilizados processos de esterilização como a autoclavagem, porém esta ocasiona perda de nutrientes, como as proteínas, devido à alta temperatura usada. A deficiência protéica pode afetar a atividade celular, provocando diferentes alterações nos tecidos. Por estes fatos, objetivou-se avaliar a ação da ração autoclavada sobre os neurônios do plexo mioentérico do jejuno de ratos em período de crescimento. Para tanto, foram utilizados ratos em período dedesmame (21 dias) provindos de mães que receberam ração autoclavada ou não autoclavadadurante a gestação e lactação e ratos em período de pós-desmame (21 a 70 dias) alimentados com o mesmo tipo de dieta que as mães recebiam. Para a mensuração do perfil do corpo celular e contagem do número de neurônios por área, estes foram evidenciados pelo método de nadh-diaforase. O peso corpóreo dos animais não apresentou diferença significativa em relação ao tipo de alimentação (p > 0,05). Houve uma diminuição do comprimento jejuno-íleo em ratos alimentados com ração autoclavada (p > 0,05). O número de neurônios por área aumentou aproximadamente 10% para ratos que receberam ração autoclavada (p > 0,05). Já a área do perfil dos corpos dos neurônios apresentou um aumento para ratos alimentados com ração autoclavada, sendo este significativo para animais em período de desmame. Todos os fatores observados apresentaram diferença significativa em relação às idades / Autoclaving is the most common sterilization process to avoid the presence of pathogens in the diet of laboratory animals. However, it may cause the loss of nutrients such as proteins due to the high temperature used. The protein deficiency can affect cellular activity, leading todifferent changes in the tissues. Due to these facts, this research aimed to verify the effect of autoclaved diet in the jejunum neurons of the myenteric plexus in rats during their growing phase. The experiment groups were constituted by rats in weaning period (21 days) from mothers that received autoclaved or not diets during the gestation and lactation, and rats in post weaning period (21 to 70 days) fed the same diet the mothers received. In order to measure the neurons body profile and to quantify the number of neurons by area, they were stained by the nadh-diaphorase method. No significant changes were observed to the weight body in animals with autoclaved diet (p > 0.05). There was a decrease in the length of jejunum-ileum in rats treated with autoclaved diet (p > 0.05). The number of neurons by area increased approximately 10% in the rats supplied with autoclaved diet (p > 0.05). The neuron body profile area increased in the rats that received autoclaved diet and it was significant in the animals in weaning period. Nevertheless, all factors observed showed significant differences when related to animal age

A desnutrição é responsável pela metade das 11 milhões de crianças abaixo de 5 anos de idade que falecem todo ano. A desnutrição é fator determinante para instalação de doenças do sistema respiratório e nervoso. Avaliaram-se os efeitos da desnutrição e renutrição no plexo traqueal de ratos. Foram utilizados filhotes dos grupos: nutridos (N) (20% de caseína), desnutridos (D) (5% de caseína) e renutridos (R) (alimentados com 5% de caseína até 21 dias e com 20% até os 42 dias). Os espécimes foram avaliados pela NADH-d; NADPH-d; AChE; SP; VIP e MEV. Observou-se fraca reatividade à AChE dos neurônios do grupo D. Não houve diferença do número de neurônios e gânglios (NADH-d e NADPH-d). A área neuronal foi maior no grupo N (NADH-d e NADPH-d.) Os gânglios do grupo N eram maiores (NADH-d) e sem diferença entre gânglios reativos à NADPH-d. Na metade torácica da traquéia havia cerca de 80% dos neurônios e gânglios (NADH-d e NADPH-d). A desnutrição protéica alterou componentes do plexo traqueal e a renutrição foi responsável pela recuperação parcial deste desenvolvimento. / Malnutrition is responsible for half of the 11 million children under age 5 who die every year. Malnutrition is a determining factor for plant diseases of the respiratory system and nervous. We assessed the effects of malnutrition and renutrition tracheal plexus of rats. We used offspring of the groups: nourished (N) (20% casein), undernourished (UN) (5% casein) and renourish (R) (fed 5% casein up to 21 days and 20% up to 42 days ). The specimens were evaluated by NADH-d, NADPH-d, AChE, SP, VIP and SEM. There was a weak reactivity to AChE neurons of group UN. There was no difference in the number of neurons and ganglia (NADH-d and NADPH-d). The neuronal area was higher in group N (NADH-d and NADPH-d). Ganglia were higher in group N (NADH-d) and no difference between the ganglia reactive to NADPH-d. In half of the thoracic trachea was about 80% of neurons and ganglia (NADH-d and NADPH-d). Protein malnutrition altered components of the tracheal plexus and renutrition was responsible for the partial recovery of this development.