SUMMARY Basal frequency of sphincter of Oddi phasic contractility has been repeatedly measured during endoscopic manometry and reported to range, in control subjects, from (M±SE) 3-0±0-6 to 7*5±0*7 c/min. Recently, high frequency (>8 c/min) phasic contractions or absence of phasic activity were recorded in patients with postcholecystectomy or pancreatic complaints, possibly suggesting a sphincter of Oddi dysfunction. In the present study, sphincter of Oddi (biliary tract) phasic contractility was measured by perendoscopic manometry in 13 subjects without specific clinical symptoms of biliopancreatic disease and with a normal common bile and pancreatic duct at ERCP. Four T-tube patients with no evidence of common bile duct stones or papillary stenosis were studied for comparison (transductal sphincter of Oddi manometry). Basal frequency was found to range from 0 to 7 c/min (M±SE: 2-99±0.46) in perendoscopic manometry (85 min of recording time) and from 0 to 12 c/min (2.0±0.3) in transductal manometry (2546 min of recording time). Long lasting transductal recordings also showed that frequency of activity derived from the sphincter area varied cyclically in close relation with the duodenal migrating motor complex. It is concluded that the sphincter of Oddi in man is likely to participate in the interdigestive gastrointestinal motor activity and that short perendoscopic recordings may not be representative of the overall sphincter of Oddi activity.The sphincter of Oddi is a specialised and, to a large extent, embryologically independent' muscular structure surrounding the terminal end of common bile and pancreatic duct. It determines a resistance to flow toward and from the duodenum and displays rapid closing and opening movements. As shown by cinefluorography opening is accompanied by an apparently free flux of ductal contrast medium into the duodenum. Closing movement begins with a ring like contraction at about half way of the sphincter, then the ducts obliterate and ampulla empties distally. Both movements appear to be relatively' independent from duodenal motor activity.A quantitative evaluation of sphincter of Oddi motility is possible by intra-Oddian manometry, and the endoscopic cannulation of the papilla allows measurements to be made in intact subjects and in both the biliary and pancreatic tract of the sphincter.Address for corrcspondence: Aldo Torsoli MD,

Objective To describe the epidemiology and mortality of thoracolumbosacral arthrodesis surgery in Brazil in the last 10 years. Methods Study conducted using data from the SIH of the Unified Health System (SUS) covering the time period from 2008 to 2018 for all regions of Brazil. The data obtained were analyzed using the BioStat 5.3 program, using Chi-square statistical tests, observing a p-value <0.05 and a 95% confidence interval. Results A total of 66,631 anterior or posterior approach TLS surgeries were registered. The overall mortality rate was 9.37 deaths per thousand procedures. There are regions with mortality much higher than the national average. The mortality rate increases proportionally with the number of levels involved in posterior arthrodesis. Conclusions The study of the epidemiological profile of thoracolumbosacral arthrodesis is important, especially in a country whose population is heterogeneous but has different mortality rates among regions. Therefore, it is necessary to create measures that identify and prevent the factors that lead to the death of patients undergoing such a procedure. Level of evidence II; Retrospective, analytical, quantitative and descriptive study.

A solitary giant lipoma of the omentum and gastrocolic ligament in an 8-year-old boy is reported. The patient had a large abdominal mass and signs of partial intestinal obstruction. Radiographs showed the characteristic radiolucency of a fatty mass, excluding a mesenteric cyst.

Purpose: To describe the anatomical aspects of the cervical rootlets and to quantify the number of rootlets that compose C1 to T1. Methods: Twenty male rats were used in this study. The dorsal rootlets from C1 to T1 were analyzed. To study the ventral rootlets, the posterior root avulsion was performed using a microhook, allowing exposure of the ventral roots through manipulation of the denticulate ligament and arachnoid mater. The parameters analyzed were the number of ventral and dorsal rootlets by side and level. Results: The formation of the respective spinal nerve was observed in the spinal roots the union of the ventral and dorsal roots. In four animals the C1 spinal root had no dorsal and/or ventral contribution. There is no normal pattern of numerical normality of the dorsal and ventral rootlets. The average number of fascicles per root was 4.08, with a slight superiority on the left side. There was a slight superiority of the dorsal rootlets compared to the ventral rootlets. Conclusions: This investigation was the first to study cervical rootlets in rats. In 20% of the sample studied, the dorsal root of C1 was absent mainly on the left side. There is a nonlinear numerical increase from C1 to T1 in the rootlets. There is a numerical predominance of cervical fascicles on the left side, confronting several studies related to the functional predominance of right laterality, requiring new studies that correlate these variables.

OBJETIVO: Avaliar o posicionamento de parafusos pediculares aplicados em vértebras da coluna torácica e lombar em pacientes portadores de escolioses, introduzidos pela técnica "free hand". MÉTODOS: Avaliação de quinze tomografias computadorizadas de 284 parafusos pediculares em 15 pacientes (sete homens e oito mulheres), com idade entre 12 e 39 anos (média de 16,7 anos) com escoliose. Os parafusos foram inseridos de T2 a S1 para as seguintes afecções: duas escolioses congênitas e 13 escolioses neuromusculares, visando avaliar o posicionamento dos parafusos com relação às paredes dos pedículos. RESULTADOS: Em relação às corticais do pedículo, 244 parafusos (86%) foram posicionados entre as corticais ou apenas as tocaram. Houve lesão da cortical lateral em 16 parafusos e lesão da cortical medial em 13 parafusos, sendo maior o número de violações nas vértebras torácicas. CONCLUSÃO: O uso de parafusos pediculares na instrumentação de vértebras torácicas e lombares nas escolioses mostrou -se segura e efetiva quando aplicado em diferentes níveis com a técnica "free hand''. Nas vértebras torácicas as violações da cortical pedicular foram mais frequentes, mas não prejudicaram a estabilidade da fixação e não lesaram estruturas neurais, vasculares e viscerais.