Resumo Justificativa e objetivos A cateterização da veia jugular interna guiada por ultrassom é um procedimento comum e geralmente seguro em sala cirúrgica. No entanto, a punção inadvertida de uma artéria não compressível, como a artéria subclávia, embora rara, pode estar associada a sequelas e risco para vida, incluindo hemomediastino, hemotórax e pseudoaneurisma. Relato de caso Descrevemos um caso bem-sucedido da correção endovascular de lesão da artéria subclávia direita em uma paciente de 75 anos. A artéria subclávia foi lesionada após cateterização guiada por ultrassom da veia jugular interna direita sob anestesia geral para cirurgia ortopédica. Conclusão Sob anestesia geral, vários fatores, como a hipotensão, podem mascarar os sinais de lesão da artéria subclávia. Este relato de caso indica que os médicos devem estar cientes das complicações da cateterização venosa central e tomar medidas imediatas.

Abstract Background and objectives Ultrasound-guided internal jugular vein catheterization is a common and generally safe procedure in the operating room. However, inadvertent puncture of a noncompressible artery such as the subclavian artery, though rare, may be associated with life-threatening sequelae, including hemomediastinum, hemothorax, and pseudoaneurysm. Case report We describe a case of the successful endovascular repair of right subclavian artery injury in a 75-year-old woman. Subclavian artery was injured secondary to ultrasound-guided right internal jugular vein catheterization under general anesthesia for orthopedic surgery. Conclusion Under general anesthesia several factors such as hypotension can mask the signs of subclavian artery injury. This case report indicates that clinicians should be aware of the complications of central venous catheterization and take prompt action.

ABSTRACT In complicated urinary tract infection with ureteral calculi, urinary diversion is inevitable. So, stenting or percutaneous drainage can be an option. In hemodynamically unstable patients, percutaneous drainage is superior to ureteral stenting (1). Once acute infection is controlled, definite treatment of the stone is necessary. According to a guideline, semirigid ureteroscopy is recommended for lower and mid - ureter stone and flexible ureteroscopy for upper ureter stone (2). Semi - rigid ureteroscopy can migrate stone to kidney, especially in upper ureter stone, lowering stone free rate (3). Not only flexible ureteroscopy creates additional costs but also is barely available in developing countries (4, 5). So, the authors would like to introduce anterograde irrigation - assisted ureteroscopic lithotripsy in patients with percutaneous nephrostomy. Retrograde irrigation was connected and flowed minimally enough to secure visual field. Once stone is noted, another saline irrigation, which is placed above 40 cm over the patient is connected to nephrostomy. Retrograde irrigation is disconnected from ureteroscope and the previous connected channel on ureteroscope is opened. Actual pressure detected by barometer from the opened channel of ureteroscope is usually about 30 cmH2 O while anterograde irrigation is administered in maximal flow, which means fully opened anterograde irrigation is not hazardous to kidney. There was no complication in 17 patients submitted to this method. Video shows advantages of our practice: clear visual field; reduced risk of stone migration into kidney; induced spontaneous passage of fragments without using instrumentation; and decreased operation time. In short, most of surgeons, even unexperienced, can perform an excellent procedure with less time consuming using our method.

"Espécimes" inodoros, secos e quase eternos, produzidos a partir de cadáveres humanos por uma técnica chamada plastinação, estão sendo amplamente usados como modelos de anatomia em exposições e faculdades de medicina. Milhões de leigos já viram corpos dissecados em uma das espetaculares exposições de anatomia pelo mundo e um novo mercado on-line de "espécimes" humanos plastinados está crescendo. Mais do que transformações físico-químicas, a plastinação, associada a outros procedimentos, também realiza uma transformação simbólica que reduz o corpo-pessoa a corpo-objeto para neutralizar a poluição e o tabu associados aos cadáveres humanos. Contudo, as circunstâncias obscuras sobre como esses corpos foram doados, comprados ou mesmo roubados traz o status de pessoa de volta aos corpos, assim como chama a nossa atenção para novas questões éticas e morais.

Odorless, dry and almost everlasting "specimens", produced from human corpses by a technique called plastination, are being used as anatomy models in exhibitions and medical schools. Millions of lay people have already seen dissected corpses in one of the spectacular human anatomy exhibitions around the world and a new on-line market for plastinated human "specimens" is growing. More than chemical and physical transformations, plastination, associated with other procedures, also makes a symbolic transformation that reduces the person-body into object-body in order to neutralize the pollution and the taboo associated with human corpses. But unclear circumstances about these bodies and questions as to whether they have been donated, sold, or even stolen bring status as "people" back to the corpses and draws our attention to new ethical and moral questions.

A teoria cibernética de Wiener, da década de 1940, originou pesquisas e influenciou vários campos científicos, incluindo a antropologia. Atualmente, a cibernética está praticamente esquecida como uma ciência, mas deixou importantes resíduos para a cultura. Esses resíduos, dentre outros provenientes do discurso técnico e cientifico, são meios criativos para as reavaliações do consenso social acerca dos significados das coisas. Resultados de um processo de reinvenção cultural, o ciborgue e o ciberespaço são referências emblemáticas de uma nova ordem do real que projeta o sistema antigo de interpretação da realidade sob novas formas, restringidas pelas dadas possibilidades históricas e culturais de significação.

The Wiener's cybernetics theory, from 1940's, has inspired researches and has influenced many scientific fields, including anthropology. Nowadays, the cybernetics is almost forgotten as a science but it has left important residues for the culture. These residues, amongst others from scientific and technical discourse, are creative means for the revaluations of social consensus about the meanings of things. As results of cultural process of reinvention, the cyborg and the cyberspace are emblematic references of a new order of real, which projects the old interpretational system of reality in new forms, constrained by its given historical and cultural possibilities of signification.