PURPOSE: To compare sciatic nerve regeneration in rats using three different techniques of repair.METHODS:Fifteen isogonics rats were divided into three groups according to the method used to repair a 5-mm long defect created in the sciatic nerve: autogenous graft (Group A), polyglycolic acid tube (PGAt) (Group B), and of the association of PGAt with the graft (Group C). Histological analysis, regenerated myelinated axon number count and functional analysis were used to compare after six weeks.RESULTS:There was no difference in fiber diameter and degree of myelinization presented by Groups A, B and C. Group B presented the lowest number of regenerated axons. The groups did not display any significant functional difference after walking track analysis (p<0.05).CONCLUSION: No differences between the three groups in terms of functional recovery, although there were histological differences among them.

Com a finalidade de conhecer os elementos úteis que o EEG poderia trazer para o diagnóstico da forma clínica da cisticercose encefálica, foram reunidos 118 casos desta afecção, com diagnóstico confirmado pela verificação cirúrgica, pelo exame do liqüido cefalorraqueano (presença de leucocitose, eosinofilia e reação de desvio de complemento positiva) ou pela verificação radiológica de cisticercos calcificados. Os resultados electrencefalográficos foram analisados particularmente visando os dados que pudessem informar sôbre existência de processo difuso envolvendo o parênquima nervoso dos hemisférios cerebrais, ou a existência de focos epileptógenos ativos, ou ainda, sinais de sofrimento do parênquima em conseqüência da hipertensão intracraniana. Êstes resultados foram estudados separadamente no grupo dos casos com síndrome clínica da convexidade cerebral, com a presença ou não de síndrome convulsiva e no grupo dos casos com síndrome clínica de base e fossa posterior. Além disso os resultados electrencefalográficos foram estudados comparativamente no grupo de pacientes com cisticercos não calcificados, assim como também foram estudados, comparativamente, em grupos de pacientes com síndrome inflamatória verificável pelo exame do líqüido cefalorraqueano e no de pacientes com o liqüido cefalorraqueano normal. Êstes resultados, projetados nos quadros 1 e 2, permitiram conclusões de algum interêsse clínico, significativas para a importância do exame electrencefalográfico na avaliação dos processos patológicos encefálicos decorrentes da neurocisticercose.

The present study has the purpose of showing the possible value of the EEG in the diagnosis of brain cysticercosis. The diagnosis of cysticercosis was based on (1) radiological calcification, (2) characteristic spinal fluid findings (increase of cells, increase of eosinophils and positive test for cysticercosis) and/or (3) neurosurgical findings. The total number of cases was 118 (14 verified by surgical approach, 35 diagnosed by X ray examination and 42 by the spinal fluid examination) : in 16 cases there were association of surgical and spinal fluid positive findings; in 4 cases there were surgical findings and X ray positive findings; in 7 cases there were spinal fluid and radiological positive findings. The surgical cases were mostly of cysticercus of the posterior fossa because of the spinal fluid blocking that asks such therapy. The patients were divided according to the localization of the cysticercus (1) on the cortical surface, (2) at the base of the brain and the posterior fossa, and (3) diffuse cysticercosis. The localization of the cysticercus was possible by the evaluation of the clinical signs, the radiological calcification or the neurosurgical finding of the cysticercus. The EEG records were analysed according to the changes possibly due to the lesion caused by the cysticercus (chronic and diffuse meningo-encephalitis of the brain surface, arachnoiditis of the base and of the posterior fossa, inflammatory reaction inside the fourth ventricle, with subsequent spinal fluid blocking and intracranial hypertension). The analysis showed: 1 - Focal paroxysmal changes have indicated the great incidence of epileptic seizures in these patients; 2 - δ waves were more frequent when the lesion was located in the posterior fossa. The meningo-encephalitis on the cerebral surface did not show EEG signs of acute brain involvement; 3 - θ waves were seen very seldom and were present only on those patients with signs of basal or posterior fossa involvement (due to intracranial hypertension probably) due to involvement of mesencephalic structure; 4 - The normal EEG was very rare in patients with cerebral cysticercosis and did not give any information regarding the localization of the cysticercus; 5 - Changes on background activity (disorganization or discrete slow waves) have been noticed in all groups of patients; 6 - In patients with diffuse cerebral cysticercosis the EEG changes (disorganization on background activity, slow waves or signs of focal activity) did not show striking difference from those patients with localized cerebral cysticercosis; 7 - The calcified cysticercus on the cerebral surface (chronic cysticercosis) was coincident more often with focal activity on the EEG, than on the group of not calcified cysticercus (recent, cysticercosis); 8 - The incidence of pathological EEG was the same on both groups (calcified and non calcified cysticercosis). The EEG on the last group showed very often δ waves.

Os autores apresentam os resultados obtidos com a lobotomia transorbitária em 54 pacientes de um hospital psiquiátrico privado. Fazem, inicialmente, uma revisão da experiência que já obtiveram com as diversas técnicas de lobotomia, salientando as principais indicações do método terapêutico. Apontam, como fatôres de importância para a seleção dos casos, a sintomatologia clínica (conduta anti-social agressiva, intensidade da tensão emocional e produtividade intelectual patológica), a necessidade da cooperação familiar e a escolha da técnica operatória. Descrevem a técnica da lobotomia transorbitária, modificada por Freeman e analisam o material clínico constante de 54 casos que puderam ser observados durante mais de 6 meses, dos 70 casos já submetidos ao mesmo método, no período de 1953-1955. Os resultados que obtiveram compreendem 16 casos de remissões totais, 10 de remissões parciais, 13 de boas melhoras, 14 inalterados e 1 falecido em conseqüência da operação. Avaliados os resultados de acôrdo com as possibilidades de readaptação familiar, social e de trabalho, os autores relatam que 21 pacientes obtiveram alta e retomaram suas atividades anteriores, 18 permanecem no lar sem atividade útil, 14 continuam internados. O método proporcionou 72,1% de resultados favoráveis, dos quais 38% com reintegração social. As neuroses obsessivas, as depressões ansiosas e as esquizofrenias paranóides constituíram os quadros clínicos melhor influenciados.

Freeman's transorbital lobotomy has been used in 70 patients from a private psychiatric hospital. The results obtained in 54 of these patients are presented. The authors present the results obtained with several techniques and analyse the indications for lobotomy. In the selection of patients which should be treated by psychosurgery, the authors consider several factors : the emotional tension, the aggressive antisocial behavior and the presence of rich morbid mental defects. The cooperation of patient's family is emphasized as one of the important factors contributing to the operation success. Freeman's technique is described. The follow-up in the 54 patients was at least of 6 months: 16 cases showed total remission of the symptoms, 10 cases showed partial remission, 13 cases have improved, 14 cases did not show any improvement and one patient died as result of the operation; 72.1 per cent of patients presented good results and in 38 per cent there was very good social recovery. From the psychiatric clinical aspects the best results were obtained in cases of obsessional neurosis, anxiety and paranoid schizophrenia.

Depois de rápidas considerações sobre as dificuldades do diagnóstico topográfico dos tumores da região do terceiro ventrículo e sobre as aquisições recentes da eletrencefalografia nesse sentido, os AA. apresentam a observação de uma paciente de 36 anos de idade, com história de 4 meses, portadora de uma síndrome de hipertensão intracraniana grave, acompanhada de hemiparesia esquerda muito discreta e alterações psíquicas. O exame do liqüido cefalorraquidiano revelou hipertensão e a eletrencefalografia evidenciou alterações difusas e bilaterais, ao lado de surtos persistentes e repetidos de ritmo teta, simétrica e sincronicamente reproduzidos, em áreas centrais e parietais de ambos os hemisférios, bem como ondas de ritmo delta focal, no lobo frontal direito, com típicas figuras de reversão. Os primeiros foram atribuídos ao edema cerebral e à hipertensão intracraniana, enquanto que estas (as ondas de ritmo teta acompanhadas de ritmo delta focal frontal direito) foram interpretadas como dependentes de tumor cerebral profundamente situado, mediano, da região do terceiro ventrículo, comprometendo secundariamente o lobo frontal direito. A ventriculografia, em parte, e a intervenção cirúrgica subseqüente, confirmaram o diagnóstico, revelando a existência de um tumor cístico pediculado, que, da sela turca invadia o terceiro ventrículo e a parte profunda do lobo frontal direito (craniofaringioma).

The authors stress the difficulties of a precise topographical diagnosis of tumors in the region of the third ventricle and point out the recent advànces in this field. A case of a 36 year old man with a four months history characterized by severe signs of increased intracranial pressure, mild left hemiparesis and psychic disturbances is reported. The cerebrospinal fluid test revealed increased pressure, The electroencephalographic findings were: 1 - diffuse and bilateral abnormalities; 2 - repetitive bursts of bisynchronous theta waves from the central-parietal regions; 3 - focal delta waves with phase reversals from the right frontal region. Increased intracranial pressure and cerebral oedema were considered to be responsible for the first type of abnormality. The focal delta and theta waves were interpreted as being the manifestations of a deep seated midline tumor in the region of the third ventricle with secondary involvement of the right frontal lobe. The localization was confirmed by ventriculography. At operation it was found a cystic pediculated tumor coming from the sella turcica and invading the third ventricle and right frontal lobe.

Lembrando os benéficos efeitos dos medicamentos à base de quinacrina (Metoquina, Atebrina) cuja descoberta veio reforçar de maneira eficiente o combate à malária, os autores salientam a possibilidade do aparecimento de complicações mentais em pequena percentagem de doentes tratados com esses medicamentos. É necessário reconhecer a possibilidade de certas pessoas serem provàvelmente sensíveis ao medicamento e que, mesmo com doses normais ou inferiores às usadas no tratamento convencional, apresentam reações mentais anômalas. A presente comunicação tem por fim apenas chamar a atenção para esta eventualidade, exemplificando-a com o relato de dois casos observados em um hospital psiquiátrico.

With the employment of drugs on a Quinacrine basis (Metoquin y Atabrine) the anti-malaria treatment was reinforced but not without side-effects. A small percentage of patients treated with this drug showed mental disturbances even though the dosage was the one used in the conventional treatment, or smaller than that. There is probably in these cases a hipersensitivity to the drug. The authors present two cases observed in a psychiatric institution, calling attention to the possibility of such effects.