Procedimiento de Nishida asociado a toxina botulínica en parálisis completa del sexto par craneal bilateral de larga evolución

In severe cases of abducens or sixth cranial nerve palsy, transpositions of the superior rectus and inferior rectus into the paralytic lateral rectus have been demonstrated to be useful. Numerous techniques have been described over time to carry out these transpositions, such as the Hummelsheim, O’Connor, Jensen, Foster, or Nishida technique. The first 4 techniques mentioned above have an increased risk of anterior segment ischaemia.The case is presented of a long-standing bilateral sixth cranial nerve palsy secondary to a severe cranial injury. Given the risk of ischaemia of the anterior segment, the Nishida technique was chosen in order to reduce the risk of suffering from this complication. This is combined with botulinum toxin in both middle rectus to try to resolve the muscle contracture associated with the long evolution of the case, obtaining good results at 6, and 12 months after the surgical procedure.     

Relationship between European Mitochondrial Haplogroups and Chronic Renal Allograft Rejection in Patients with Kidney Transplant

Mitochondrial DNA variants may contribute to differences in mitochondrial function, leading to an altered immune system. The aim of this study was to analyze the relationship between mtDNA haplogroups and the development of chronic allograft dysfunction in patients with kidney transplant. A retrospective observational study was carried out on 261 patients who received kidney transplant (114 had stable transplant and 147 patients developed chronic allograft dysfunction). DNA samples were genotyped for 14 mtDNA polymorphisms by using Sequenom''s MassARRAY platform (San Diego, CA, USA). Only European white patients within the N macro-cluster were included. Patients with haplogroups V (odds ratio (OR)=0.32; p=0.037) and J (OR=0.36; p=0.038) showed lower odds for developing CRAD than patients with haplogroup H. After adjusting for the most significant variables, haplogroups V and J tended to statistical significance (p=0.091 and p=0.067 respectively). This is a preliminary study in which mtDNA haplogroups seem to be implicated in susceptibility or protection for developing chronic allograft dysfunction.     

Depressing effect of electroacupuncture on the spinal non-painful sensory input of the rat

The aim of this study was to explore the effect of electroacupuncture (EA) applied in the Zusanli (ST36) and Sanyinjiao (SP6) points on the N1 component of the cord dorsum potential (CDP) evoked by electrical stimulation of the sural nerve (SU) in the rat. The experiments were performed in 44 Wistar rats (250–300 g) anesthetized with ketamine (100 mg/kg) and xylazine (2 mg/kg). A bilateral laminectomy was performed to expose the L3 to S2 segments of the spinal cord. The SU nerve was exposed and placed on pairs of hook electrodes for electrical stimulation. The N1-CDPs were recorded with three silver-ball electrodes located on the dorsal surface of the L5 to S1 segments. Ipsilateral high and low EA stimulation (100, 2 Hz, 6 mA, 30 min) induced a considerable reduction in the amplitude (45 ± 5.6, 41 ± 6.2 %) of the N1-CDP recorded at the L6 segmental level. Recovery of the N1-CDP amplitude occurred approximately 1–3 s after EA. Sectioning of the saphenous and superficial peroneal nerves reduced the depressing effect provoked by the EA stimulation (18.7 ± 1.3, 27 ± 3.8 %). Similarly, sectioning of the posterior and anterior tibial, deep peroneal and gastrocnemius nerves partially reduced the effect provoked by EA (11 ± 1.5, 9.8 ± 1.1, 12.6 ± 1.9 %). Intravenous picrotoxin (1 mg/kg) also reduced the action of low and high EA (23 ± 4.8, 27 ± 5.2 %). It is suggested that EA stimulation depresses non-painful sensory pathways through the activation of specific inhibitory pathways that receive modulatory actions from other sensory and muscle afferent inputs in the rat spinal cord.